Counterimmunoelectrophoresis as a routine mycoserological procedure

Counterimmunoelectrophoresis (CIE) has been compared in a diagnostic laboratory with agar gel double diffusion (DD) as a routine procedure for detection of antibodies to pathogenic and allergenic fungi and actinomycetes. It was shown to be of particular value in detecting antibodies to Aspergillus fumigatus. Thus 72 of 106 sera in which precipitins were detected were positive by CIE alone. Some sera were positive only by CIE to antigens prepared from Histoplasma capsulatum, Allescheria boydii, Candida albicans and C. parapsilosis.     

Rapid enzyme-linked immunosorbent assay (ELISA) for detection of IgG antibodies to Candida albicans

A rapid enzyme-linked immunosorbent assay (ELISA) where the performance time was shortened to 4h was compared with counter-immunoelectrophoresis (CIE) and a standard ELISA procedure for the detection of IgG antibodies to Candida albicans in 61 patients with suspected invasive candidosis. Using a C. albicans cytoplasmic antigen the rapid ELISA compared well with CIE and the standard ELISA. Seventeen sera that reacted with two concentrations of C. albicans antigen in CIE were also positive in both forms of ELISA. Four sera that were CIE-negative were positive in the standard ELISA and three were also positive in the rapid ELISA. The rapid ELISA provides a sensitive and reproducible test for routine serological investigation of different forms of candidosis.     

Effect of antigen used in the detection of anti -Candida albicans antibodies

Antigens of different origins were used in the investigation of anti-Candida albicans antibodies. This can influence the results obtained.We have assayed three different antigenic preparations weekly for 8 weeks in the study of anti-C. albicans antibodies induced by cutaneous, digestive, and systemic inoculations with C. Albicans ATCC 26555 in rabbits free of specific antibodies, and using indirect immunofluorescence (IIF), direct agglutination (DA) and counterimmunoelectrophoresis (CIE) as serological methods.In IIF and DA, two antigens were used (C. albicans ATCC 26555 and C. albicans NCPF 3153). In CIE we also used a third commercial antigen. All three somatic antigens were used at three different concentrations.Using IIF and DA the titres obtained with both antigens were similar in different inoculations. The IIF was somewhat earlier in the detection of antibodies, and the titre reached was higher when the antigen used was obtained from the inoculated strain.The detection of precipitins by CIE was in most cases only positive with the antigen obtained from the homologous strain, the highest level being reached in the systemic inoculation.     

Preliminary investigation of the use of the enzyme linked immunosorbent assay (ELISA) in the serodiagnosis of mycetoma.

Antibody levels in a small group of Sudanese patients with clinically diagnosed mycetoma, and control groups were measured by countercurrent immunoelectrophoresis (CIE) and enzyme linked immunosorbent assay (ELISA). Antigens were prepared from the following organisms: Streptomyces somaliensis, Actinomadura madurae, A. pelletieri, Nocardia brasiliensis and Madurella mycetomi. Positive reactions were obtained in clinical cases against the homologous antigens in both CIE and ELISA; all heterologous and control sera negative in CIE but produced some reaction particularly against N. brasiliensis and M. mycetomi antigens in ELISA.     

Evaluation of skin test for chromoblastomycosis using antigens prepared from culture filtrates ofFonsecaea pedrosoi,Phialophora verrucosa,Wangiella dermatitidis andExophiala jeanselmei

Antigenic substances were prepared from culture filtrates ofFonsecaea pedrosoi, Phialophora verrucosa, Wangiella dermatitidis andExophiala jeanselmei. These antigenic substances were evaluated for detecting cutaneous delayed hypersensitivity in rats experimentally-infected withF. pedrosoi, P. verrucosa, W. dermatitidis, E. jeanselmei, Cladosporium carrionii andFonsecaea compactum and in patients with chromoblastomycosis caused byF. pedrosoi. TheF. pedrosoi antigen elicited positive reactions in all of the animals infected withF. pedrosoi and in 5 of 6 patients. TheP. verrucosa, W. dermatitidis andE. jeanselmei antigens elicited positive reactions in all of the animals infected with the homologous species. These antigens displayed cross-reactivity in some of the animals and patients, whereas more than half of them exhibited positive reactions only to the antigens prepared from the homologous species. These results suggest that a delayed-type skin test using the antigens prepared by the authors may be useful not only for the diagnosis of chromoblastomycosis but also for the identification of species of the causative agent.     

Detection of circulating antigen of Aspergillus fumigatus in sera of mice and rabbits by enzyme-linked immunosorbent assay

Circulating antigen of Aspergillus fumigatus was demonstrated in the sera of experimentally infected, cortisone-treated mice and rabbits by enzyme-linked immunosorbent assay (micro-ELISA), confirming earlier results where fungal antigen had been detected by counter-immunoelectrophoresis (CIE). Peaks of detection of circulating antigen by CIE and micro-ELISA in mice were not simultaneous suggesting that the nature of the predominant antigens may have altered during the course of infection. CIE failed to detect fungal antigen in infected rabbits whereas micro-ELISA monitored antigenemia until death. Both CIE and micro-ELISA demonstrated the rapid clearance of intravenously inoculated Aspergillus-antigen from the rabbit circulation.     

Preparation and study of an exoantigen of Histoplasma capsulatum for serological reactions.

The aim of this study was to determine the usefulness of a yeast-phase exo-antigen of Histoplasma capsulatum in standard serologic reactions. Three native strains of H.capsulatum which belong to Mycology Center collection were employed. They were maintained in their yeast-phase by weekly subcultures in 2% dextrose broth agar at 37 degrees C. After one week incubation yeast cells were suspended in distilled water containing thimerosal and phenylmethyl sulfonyl fluoride at a concentration of 1:5000. This suspension was left at room temperature for 72 h, then the supernatant was separated by centrifugation and it was lyophilized. Proteins and polysaccharides concentrations were determined. Immunodiffusion (ID) tests were carried out with an antigenic dilution containing 1.4 mg/ml of proteins. This exo-antigen was submitted to SDS-PAGE. Seven protein fractions were detected but only two of them showed antigenic activity against a pool of positive human sera; the molecular weights of these two proteins were 97 kDa and 66 kDa respectively. A metabolic antigen from the mycelial phase of H. capsulatum was used as control. A rabbit gammaglobulin anti-H. capsulatum was prepared and employed as positive control in serologic reactions. The antigenic capacity of ten batches of this exo-antigen was studied by ID and counterimmunoelectrophoresis (CIE) tests using serum samples of 20 hamsters experimentally infected by intracardiac inoculation of the yeast-phase of H. capsulatum. All tests presented positive results after three weeks of the infection. Fifty sera from patients suffering progressive histopasmosis were analyzed: ID, CIE and complement fixation (CF) tests were performed in all cases. HIV negative patients presented 7/7 (100%) positive reactions with the yeast-phase exoantigen and 5/7 (71.4%) with histoplasmin. In HIV positive patients CIE and CF were the most sensitive serologic tests, they gave positive results in 15/43 cases (34.8%) with the yeast-phase exo-antigen and in 7/43 cases (13.9%) with histoplasmin. Sera from 10 patients with paracoccidioidomycosis, aspergillosis and candidiasis respectively were studied by ID with the aim of detecting serologic cross reactions. No cross reaction was detected in these serum samples. This yeast-phase exo-antigen of H. capsulatum is more sensitive than and equally as specific as control histoplasmin.     

Studies on circulating gonococcal antibodies and antigens.

One hundred human sera obtained from acute gonococcal disease and 100 sera from nongonococcal diseases or healthy persons were concentrated four times and examined for the presence of circulating gonococcal antigens and antibodies by means of a counterimmunoelectrophoresis (CIE) and delayed hypersensitivity assay. Antibodies reacting with cytoplasmic gonococcal antigens were detected by CIE in 92% of sera received from patients suffering from acute gonococcal disease. Gonococcal antigens were found in the concentrated sera of 82.3% of patients on the basis of dermal reactions observed upon injections of these sera into the skin of rabbits sensitized with disrupted gonococci; 51.8% of the patients' sera gave delayed hypersensitivity reactions in rabbits sensitized with cytoplasmic antigens of N. gonorrhoeae. Control sera from healthy people and those with non-gonococcal diseases did not react with any of the preparations tested.     

Counterimmunoelectrophoresis compared with complement fixation and passive haemagglutination tests in the evaluation of the immune response in Campylobacter infections

The immune response was studied in 238 human patients with Campylobacter jejuni/coli (CJC)-infections in Rotterdam by the counterimmunoelectrophoresis (CIE) test, a commercial complement fixation test (CFT) and the passive haemagglutination test (HA). Antibodies became detectable in the three tests around 4 days after the onset of complaints. Between the 7th and the 20th days after onset of illness 79%, 80% and 53% of the patients demonstrated antibodies by the CIE, the CFT and the HA, respectively. The HA took 30 days to reach 60% positive serum samples and this percentage declined to 35 by the 50th day. Antibody titres demonstrated in the CIE and the CFT declined more slowly. CIE and CFT performed with antigens from a limited number of heat-stable serotypes can be used in the evaluation of the humoral immune response in CJC-infections.     

Antígenos del paracoccidioides brasiliensis para las Reacciones serológicas

Summary The sera from normal subjects gave negative results with the following antigens used in the complement-fixation tests: 1) polysaccharide prepared according toFava Netto's technic; 2) a filtrate of shaked cultures followingAjello et al.'s technic; 3) an aqueous extract of mechanically disrupted yeast cells ofP. brasiliensis.The sera from patients of S.A. blastomycosis gave positive c.f. tests with the three antigens with titer ranging from 1/20 to 1/5, 160. Antigen No 2 gave in 11/18 cases higher titers than the other antigens.Immunodiffusion tests gave positive results with the antigen no 2. The sera from 10 cases of histoplasmosis gave cross reactions with the antigen No 3, in 5/10 cases with the antigen No 2 and in not any case with the antigen No 1.     

Delayed-type Hypersensitivity Response to Crude and Fractionated Antigens from Fonsecaea pedrosoi CMMI 1 Grown in Different Culture Media

Chromoblastomycosis is a subcutaneous fungal disease caused by dematiaceous fungi, especially by Fonsecaea pedrosoi, regarded as its major causative agent in Brazil. In recent years there has been a decline in the use of skin testing for delayed-type hypersensitivity (DTH) in epidemiological surveys of fungal infections, mainly because of the unpredictability of positive reactions and lack of specificity of the antigens used. The aim of the present study was to assess delayed-type skin tests in guinea pigs experimentally infected with F. pedrosoi using exoantigens prepared from two culture filtrates. Sixteen adult male guinea pigs were inoculated intratesticularly with fungal cells and submitted to sensitivity assays 4 weeks after inoculation. They received an intradermal injection with crude and fractionated antigens from Alviano’s and Smith’s cultures, and were assessed 24 and 48 h thereafter. Except for one animal, all of them had positive indurations after 48 h. There were no statistical differences between the measurements at 24 and 48 h for each exoantigen used, neither among the induration measurements at 48 h when different preparations were compared. Our results suggest that a delayed-type skin test using antigens produced in synthetic media may be useful for the assessment of primary exposure to chromoblastomycosis.     

Detection of Candida albicans mannan by immunodiffusion,counterimmunoelectrophoresis, and enzyme-linked immunoassay

Anti-mannan was produced in rabbits after peptidoglucomannan in adjuvant was injected. The antiserum was used to detect mannan by immunodiffusion and counterimmunoelectrophoresis (CIE) in gel and by sandwich enzyme-linked immunosorbent assay (ELISA). The antiserum detected lower concentrations of mannan of serotype A than of serotype B. Except in CIE, the reactions were more pronounced at 4°C than at higher temperatures. CIE detected 0.8 g/ml mannan A or 12.5 /ml mannan B. Sandwich ELISA detected 3 ng/ml mannan A or 10⁵ ng/ml mannan B. Mannan was not detected in the serum of patients or rabbits with candidiasis.Use of trade names is for identification only and does not constitute endorsement by the Public Health Service or by the U.S. Department of Health, Education and Welfare.     

Immunity to Epstein-Barr virus in Hodgkin's disease preceded by infectious mononucleosis

A patient who developed Hodgkin''s disease four years after infectious mononucleosis had elevated serum antibody titres to Epstein-Barr virus and delayed hypersensitivity reactions to membrane antigens prepared from fresh autologous spleen, from spleen cells of another Hodgkin''s patient, and from cell lines known to carry the Epstein-Barr virus genome. Additional studies in more lymphoma patients will be needed to determine the significance of the reactivity against tumour and virus-associated antigens which has been documented in this patient.     

Crossed immunoelectrophoretic analysis of proteins from Antarctic krill (Euphausia superba) with special reference to serine proteinases

Summary Immunochemical characterization of proteins from Antarctic krill (E. superba) and particularly serine proteinases was performed by crossed immunoelectrophoresis (CIE). A reference pattern with 34 arbitrarly numbered immunoprecipitates was established for a crude krill extract using IgG rabbit antiserum. A zymographic technique for detection of proteolytic activity was applied and revealed 4 casein-positive antigens. Introduction of different affinity media as intermediate gels in CIE demonstrated several proteins which strongly interacted with Sepharose-bound arginine and Con A. These results suggest the presence of trypsin-like enzymes and other serine proteases and a high content of glycoproteins with alfa-D-mannopyranoside and alfa-D-glycopyranoside residues. The CIE method thus offers a reliable and reproducible tool for identification and characterization of different krill enzymes as well as application in process control, when purifying individual proteins/enzymes. Moreover this technology may serve as a fingerprinting method suitable for biological studies such as classification of geographical subpopulations, genotyping a specific species as well as comparisons between different species.     

Effect of thimerosal on the whole yeast phase antigen of Histoplasma capsulatum

Summary Thimerosal (merthiolate) and formalin treated whole-cell yeast phase antigens ofHistoplasma capsulatum were prepared and their reactivities with sera from cases of histoplasmosis, blastomycosis and coccidioidomycosis were compared. Thimerosal treated antigens often gave complement fixation titers with heterologous sera 2 to 8 fold lower than the titers obtained with formalin treated antigens. However, with certain anti-histoplasmosis sera, thimerosal killed antigens had less reactivity with homologous antisera also. In virtually all cases an equal or higher specificity ratio was obtained with thimerosal killed antigens. The effects of thimerosal and formalin were independent, indicating different sites of reactivity of these reagents. Uptake of thimerosal at several concentrations suggested two types of reactions with live yeast phase cells. Analyses of the cellular fractions for thimerosal showed it was present only in the soluble fractions from which it was readily removed by dialysis. Cellular fractions killed with thimerosal retained several of the same physical and antigenic characteristics of those fractions isolated from frozen and thawed cells.     

Immune response to different fractions of Taenia solium cyst fluid antigens in patients with neurocysticercosis

The immunopathogenesis of neurocysticercosis (NCC) largely remains unknown. We analyzed the immune response to different fractions of Taenia solium cyst fluid antigens in patients with NCC. Lymphocytes were separated from 48 patients with NCC-related active epilepsy and 30 healthy controls. T. solium (isolated from pig muscles) antigens (crude lysate, CL; cyst wall, CW and cyst fluid, CF) at 20 μg/well concentrations were used to stimulate the cells in a lymphocyte transformation test (LTT). Only CF antigen stimulated cell proliferation significantly greater than control (p < 0.001), hence cyst fluid antigens were further studied. The CF antigens were electro-blotted on nitrocellulose membrane (NC), cut at 0.5 cm distance and particulate antigens were prepared. A total of 12 fractions, designated F1 to F12 according to molecular weight were tested in-vitro for LTT. After 72 h of stimulation by the different fractions, Th1 (IL-1β, TNF-α, IL-2) and Th2 (IL-4, IL-10) cytokine responses were determined in culture supernatants by ELISA. Low molecular weight fractions F1 through F4 (Mol. wt. < 25 kDa) were found to be potent inducers of cytokines. Fractions F1, F3 and F4 induced the production of Th1 (IL-1β, TNF-α, IL-2), whereas F2 induced the production of Th2 (IL-4 and IL-10) cytokine. The study shows that the low molecular weight fractions of CF antigens are immuno-dominant. Most of these fractions (F1, F3, F4) induce strong Th1 immune response except F2 which induces Th2 response. Further studies are needed to identify the different antigens present in these fractions to determine the molecules responsible for the immune response.     

Production and standardization of Paracoccidioides brasiliensis, Histoplasma capsulatum and Aspergillus fumigatus antigens to be used in immunodiagnosis. Comparison between immunodiffusion and immunoelectrophoresis

Soluble antigens (Ag) from Paracoccidioides brasiliensis, Histoplasma capsulatum and Aspergillus fumigatus were prepared and standardized by double immunodiffusion (DID) and immunoelectroosmophoresis (IEOP). No difference in sensitivity was observed between the two techniques; 100% of standard patient sera were positive with P. brasiliensis and A. fumigatus Ag and 83.3% were positive with H. capsulatum Ag. The specificity of the tests was verified testing 96 sera from patients with paracoccidioidomycosis, histoplasmosis, systemic candidiasis, sporotrichosis, tuberculosis, lung cancer, visceral or cutaneous leishmaniasis and 18 sera from healthy individuals. All the three antigens were 100% specific with the DID (using the identification pattern indicated by the confluence of test serum with standard serum precipitin lines as a positive criterium). However in the IEOP, the specificity varied with each Ag. Positive reactions with P. brasiliensis Ag were observed in 16.7% of histoplasmosis sera and in 10% of cutaneous leishmaniasis sera. On the other hand 31.8% of paracoccidioidomycosis and 10% of cutaneous leishmaniasis sera reacted with H. capsulatum Ag. The high sensitivity and specificity of the DID test, its easy reproducibility and low cost, led us to consider it highly appropriate as a routine procedure for the screening of patients with respiratory infections.     

Comparative Assessment of ELISAs Using Recombinant Saposin-Like Protein 2 and recombinant Cathepsin L-1 from Fasciola hepatica for the Serodiagnosis of Human Fasciolosis

Two recombinant Fasciola hepatica antigens, saposin-like protein-2 (recSAP2) and cathepsin L-1 (recCL1), were assessed individually and in combination in enzyme-linked immunosorbent assays (ELISA) for the specific serodiagnosis of human fasciolosis in areas of low endemicity as encountered in Central Europe. Antibody detection was conducted using ProteinA/ProteinG (PAG) conjugated to alkaline phosphatase. Test characteristics as well as agreement with results from an ELISA using excretory–secretory products (FhES) from adult stage liver flukes was assessed by receiver operator characteristic (ROC) analysis, specificity, sensitivity, Youdens J and overall accuracy. Cross-reactivity was assessed using three different groups of serum samples from healthy individuals (n = 20), patients with other parasitic infections (n = 87) and patients with malignancies (n = 121). The best combined diagnostic results for recombinant antigens were obtained using the recSAP2-ELISA (87% sensitivity, 99% specificity and 97% overall accuracy) employing the threshold (cut-off) to discriminate between positive and negative reactions that maximized Youdens J. The findings showed that recSAP2-ELISA can be used for the routine serodiagnosis of chronic fasciolosis in clinical laboratories; the use of the PAG-conjugate offers the opportunity to employ, for example, rabbit hyperimmune serum for the standardization of positive controls.     

Pattern of serum immunoreactivity against breast cancer cell lysates may predict severity of disease in breast cancer patients

Humoral tumor-specific immunity has been investigated as a potential tool to identify tumor-associated antigens and evaluate cancer diagnosis and prognosis. Using SDS-PAGE and western blotting techniques we investigated the humoral immune response against tumor cell antigens in 36 breast cancer patients, 17 node-positive (NP) and 19 node-negative (NN). As a source of antigens, we prepared protein lysates from four breast cancer cell lines (AU565, BT474, MCF-7 and MDA-MB-231) which in vitro exhibit different features of invasion, estrogen receptor/progesterone receptor status and HER2/neu expression thereby potentially representing mild to aggressive forms of clinical disease. A higher number of immunocomplexes Ag–Ab were formed when serum from NN patients was immunoreacted against lysates from AU565 and MCF-7 in comparison to serum from NP patients (P < 0.01). BT474 cells were not a good antigenic source. MDA-MB-231 cells could not significantly discriminate between NN and NP patients since both groups showed higher amounts of reactivity against the lysate. However, comparative analysis of protein preparations purified from MCF-7 and MDA-MB-231 cells and immunodetected concomitantly with the same serum samples showed that serum from patients with cancers with worse prognosis (stage, nodality, HER2/neu and hormonal status) reacted more intensely to proteins purified from the relatively more invasive cell line MDA-MB-231 compared to MCF-7. These findings suggest that the study of serum antibody reactivity to antigens purified from breast cancer cell lines with different invasive properties should be further investigated for its potential in providing beneficial prognostic information in breast cancer. Supported by the United States Military Cancer Institute and the Department of Clinical Investigation at Walter Reed Army Medical Center. The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or reflecting the views of the Department of the Army or the Department of Defense.     

Immunology of histoplasmosis: Humoral and cellular activity from a polysacchari-de-protein complex and its deproteinized fraction in experimentally immunized mice

In a previous publication it was reported that a polysaccharide-protein complex (PPC), sensitive to -glucosidase, was isolated from Histoplasma capsulatum. This complex was strongly reactive in an agar gel diffusion assay with sera from patients with histoplasmosis, but was unreactive with sera from patients with coccidioidomycosis. Here, the studies with human sera have been expanded and attempts were made to determine the response of mice immunized with nonviable H. capsulatum or Cocccidioides immitis to PPC or its deproteinized fraction (D-PPC) using more sensitive tests for antibody and including also test for cell-mediated immunity. Histoplasmin and coccidioidin were compared with PPC or its deproteinized fraction (D-PPC) in all assays. In a counterimmunoelectrophoresis (CIE) assay, PPC and D-PPC reacted only with sera from patients with histoplasmosis, whereas cross reactions were noted with histoplasmin and coccidioidin using heterologous sera. Cross-reaction were observed with all four antigen preparations and both types of antisera using a micro complement fixation assay. The assay for macrophage migration inhibitory factor (MIF) was also relatively nonspecific, in that inhibition occurred with cells from animals sensitized with Histoplasma or Coccidioides using both homologous and heterologous antigens. In the footpad assay, histoplasmin and coccidioidin were highly cross-reactive in animals sensitized with the heterologous fungus, but the PPC and D-PPC from H. capsulatum elicited significant reactions only in animals sensitized with Histoplasma.