Comparative evaluation of different meningococcal group-specific erythrocyte diagnostic kits in passive hemagglutination test

The comparative evaluation of the sensitivity and specificity of serogroup A, C, Y meningococcal antigenic preparations obtained by different methods was carried out by means of the passive hemagglutination test. In case of group 0 (I) human red blood cells sensitized with serogroup A and C vaccinal preparations obtained by Gotschlich's method (designated as A-1 and C-1) were used. In the other case formalin-treated sheep red blood cells sensitized with group-specific polysaccharides obtained by alcohol precipitation from the cultural fluid of group A, C and Y meningococci with subsequent heating (designated as A-2, C-2, Y) were used. Titrations with commercial immune rabbit sera showed that both variants of the antigenic preparations were similar in their specificity and sensitivity. In patients with the symptoms of meningitis the diagnostic titer was 1:40 for preparations A-1, C-1 and 1:80 for preparations A-2, C-2 and Y. The results of the examination of 164 patients (220 serum specimens) demonstrated that these preparations were of equal diagnostic value.     

Erythrocyte reagents in the study of Erysipelothrix antigens

The activity of species-specific and type-specific antigens in various preparations isolated from the bacterial mass of standard strains of Erysipelothrix, and also in bacterial cells was studied by means of prepared erysipeloid erythrocyte antigen (species-specific and with general type- and species-specificity) and antibody (species-specific, with general type- and species-specificity as also with type-specificity only) diagnosticums. It has been demonstrated that the activity of these antigens differs in preparations from different strains, depending on the method of extraction. An efficient method of serotyping of Erysipelothrix, based on agglutination of erythrocyte antibody diagnosticums, was proposed.     

Microanalytical methods: latex agglutination and immunoenzyme analysis in the diagnosis of meningococcal infection

Modified polystyrene latexes with high adsorption capacity, comparable to that of latexes produced by Difco Laboratories (USA), have been developed in the USSR. Diagnostic latex preparations for the detection of meningococci of serogroups A, C, Y and Haemophilus influenza, type b, prepared on the basis of these new latexes, have shown high specificity and sensitivity in experimental and clinical tests.The latex preparations for the detection of serogroup B meningococci requires further improvement. The use of latex preparations, together with other laboratory methods, in the diagnosis of meningococcal infection has promoted the etiological confirmation of the disease in 84% of cases; this method has proved to be 1.5 times more effective than the bacteriological one and not less sensitive than the enzyme immunoassay, while being more specific.     

Specific latex preparations in the etiological diagnosis of suppurative bacterial meningitis

The results of the evaluation of the diagnostic latex preparations Bactigen, manufactured by Wampole Laboratories (USA) and intended for the detection of meningococcal antigens, serogropus A, B, C, Y, pneumococcal polyantigens and type b Haemophilus influenzae antigens in the spinal fluid and blood of patients with meningococcal infection and purulent bacterial meningitides, are presented. The pathological material was studied by traditional methods and by the latex agglutination (LAG) test. 522 LAG tests were made, including 414 tests for meningococcal infection, 60 tests for pneumococcal infection and 48 tests for type b H. influenzae. The results of this study revealed that the latex preparations were highly specific with respect to type b H. influenzae antigens and meningococcal antigens (false positive reactions constituted 0.96%). The simplicity of the test and the rapid techniques making it possible to obtain results within 30-40 minutes indicate good prospects of using the LAG test in laboratory practice.     

Shelf Life of Fluorescent Treponemal Antibody-Absorption Test Reagents

Properly prepared, standarized, and stored fluorescent treponemal antibody-absorption (FTA-ABS) reagents have been shown to have stabilities equal to other biological reagents. A liquid antigen over 10 years old has been shown to give a satisfactory reaction. Newer preparations have now been shown to be stable for over 5 years, and the tests on each are being continued. The very new liquid antigens which were originally standardized by the FTA-ABS method have shown no decrease in potency over a 20-month period. Stability studies on antigens dried on slides are now in their eighth month, with no apparent loss in potency. The stability of the conjugate is constant when stored frozen at -20 C or lyophilized. When stored as a liquid at 4 C, the stability is governed by the pH and the molarity of the buffer. The standardized and lyophilized sorbent has been shown to be stable for over 1 year.     

Effect of gamma radiation on the immunobiological and immunochemical properties of cholera exotoxin. I. Change in the biological activity of nonpurified cholera exotoxin as affected by ionizing radiation

Crude cholera exotoxin (filtrate toxin) was irradiated with increasing doses of gamma radiation. A significant drop in enterotoxicity, in the activity of the permeation factor and a decrease in toxicity were shown to occur as radiation doses increased. Radiation doses of 50-70 kGy were found to completely inactivate enterotoxicity in liquid toxic preparations. A higher radioresistance of dried preparations in comparison with liquid ones was registered: inactivation occurred at 150-200 kGy. Different batches of the initial filtrate toxin had varying radiosensitivity. The sterilizing effect of gamma radiation was achieved at doses of 20 kGy for liquid preparations and 30 kGy for dried preparations. During the prolonged storage of the irradiated preparations of crude toxin (the term of observation being 1.5 years) at different temperatures no reversion of toxicity was found to occur, while their immunogenic properties remained unchanged.     

Perspectives for development of polyvalent meningococcal vaccine

Experimental whole-culture oral polyvalent meningococcal vaccines against serogroups A, B and C consisting of three monovalent components in different proportions have been developed and evaluated. Kinetics of IgG response to meningococcal antigens (outer membrane proteins, polysaccharide, lypooligosaccharide of these serogroups) in sera of rabbits immunized orally with these preparations was measured. Sharp rise of IgG levels (on 2 - 3 orders) compared to baseline has been detected as well as persistence of high titers during the observation period (322 days).     

Development and evaluation of a rapid multianalyte particle-based flow cytometric assay for the quantification of meningococcal serogroup B-specific IgM antibodies in sera for nonculture case confirmation

Serogroup-specific antibody has been shown to be present in the sera of patients recovering from meningococcal disease, and thus the detection of such antibodies may aid in the confirmation of disease. There are currently no standard methods for measuring meningococcal serogroup B-specific antibody in sera. Here, we report the development of a microsphere-based immunoassay which utilizes colominic acid from Escherichia coli 07:K1 (L):NM to detect immunoglobulin M directed against serogroup B polysaccharide. The serogroup B assay was incorporated into a multiplex assay which also detects serogroup-specific immunoglobulin M for meningococcal serogroups A, C, Y and W-135. Using the method of cross-standardization, serogroup B-specific immunoglobulin M concentrations were assigned to the standard serum CDC 1992. The assay is able to detect increases in specific immunoglobulin M concentrations from acute to convalescent phase serum from serogroup B cases, and can be utilized in conjunction with the previously developed tetraplex immunoglobulin G detection assay for serogroups A, C, Y and W-135.     

Meningococcal group W-135 and Y capsular polysaccharides paradoxically enhance activation of the alternative pathway of complement

Although capsular polysaccharide (CPS) is critical for meningococcal virulence, the molecular basis of alternative complement pathway (AP) regulation by meningococcal CPSs remains unclear. Using serum with only the AP active, the ability of strains to generate C3a (a measure of C3 activation) and subsequently deposit C3 fragments on bacteria was studied in encapsulated group A, B, C, W-135, and Y strains and their isogenic unencapsulated mutants. To eliminate confounding AP regulation by membrane-bound factor H (fH; AP inhibitor) and lipooligosaccharide sialic acid, the meningococcal fH ligands (fHbp and NspA) and lipooligosaccharide sialylation were deleted in all strains. Group A CPS expression did not affect C3a generation or C3 deposition. C3a generated by encapsulated and unencapsulated group B and C strains was similar, but CPS expression was associated with reduced C3 deposition, suggesting that these CPSs blocked C3 deposition on membrane targets. Paradoxically, encapsulated W-135 and Y strains (including the wild-type parent strains) enhanced C3 activation and showed marked C3 deposition as early as 10 min; at this time point C3 was barely activated by the unencapsulated mutants. W-135 and Y CPSs themselves served as a site for C3 deposition; this observation was confirmed using immobilized purified CPSs. Purified CPSs bound to unencapsulated meningococci, simulated findings with naturally encapsulated strains. These data highlight the heterogeneity of AP activation on the various meningococcal serogroups that may contribute to differences in their pathogenic mechanisms.     

A群C群脑膜炎球菌结合疫苗稳定性

目的评价A群C群脑膜炎球菌结合疫苗原液和成品的稳定性。方法分别将A群、C群脑膜炎球菌结合疫苗原液及A群C群脑膜炎球菌结合疫苗各选取连续3批,分别放置于37℃、20~25℃和2~8℃3种温度下,在一定的时间取样进行主要项目测定,在关键时间点进行全面检测。结果 A群结合疫苗原液于2~8℃保存9个月,20~25℃保存4周,37℃保存4 d;C群结合疫苗原液于2~8℃保存9个月,20~25℃保存6个月,37℃保存4周;A群C群脑膜炎球菌结合疫苗于2~8℃保存2年3个月,20~25℃保存6个月,37℃可以保存9周;各项检测指标均符合质量标准的要求。结论在2~8℃条件下,A群、C群脑膜炎球菌结合疫苗原液存放6个月,A群C群脑膜炎球菌结合疫苗存放2年,其质量稳定。     

ACYW135群脑膜炎球菌多糖疫苗的免疫原性评价

目的评价ACYW135群脑膜炎球菌多糖疫苗在昆明健康人群接种的免疫原性,为流脑防治策略提供依据。方法 2010年对昆明市2岁!3、岁!、4岁!、5岁!、6岁!、10岁!、≥15岁共7个年龄组分层随机抽取筛选出654名健康人,分别采集免前和免后1个月血清。用微量杀菌力试验(TTC法)分别检测血清中抗A、C、Y和W135群脑膜炎球菌杀菌抗体的水平。结果免后1个月抗A、C、Y和W135群脑膜炎球菌的杀菌抗体阳转率分别为96.99%、96.37%、88.43%和87.07%,抗A、C、Y和W135群膜炎球菌血清的杀菌抗体几何平均滴度(GMT)分别为1∶297.991、∶195.80、1∶72.74和1∶45.95。结论 ACYW135群脑膜炎球菌多糖疫苗在≥2岁以上的健康人群中有较好的免疫原性。     

Nucleotide sequence analysis of the sialyltransferase genes of meningococcal serogroups B,C, Y and W135

A rapid method for serogrouping meningococci is essential for the characterization of phenotypically non-groupable meningococcal isolates and clinical samples, particularly for public health management purposes. The Scottish Meningococcus and Pneumococcus Reference Laboratory (SMPRL) provides serogrouping results of meningococcal isolates and clinical samples using a PCR assay which detects restriction fragment length polymorphisms in meningococcal serogroups B, C, Y and W135. Although this PCR system was invaluable when first introduced, it has several drawbacks and lacks the required sensitivity for detecting DNA in clinical samples. Due to the recent introduction of the meningococcal group C conjugate vaccine and an impending group B vaccine, a more robust and informative method for serogroup determination is required. A protocol was devised allowing PCR amplification of the siaD gene of serogroup B, C, Y and W135 meningococci. This system was multiplexed and allowed serogroup differentiation between serogroups B and C and also between B/C and Y/W135 by product size analysis. A nested stage was incorporated into the system for enhanced detection of meningococci in clinical samples, and finally a sequencing protocol was designed allowing detection of any nucleotide changes within the siaD gene. This system allows rapid serogrouping results for use within an agarose gel system as well as more informative results when used for sequencing within the siaD gene.     

Detection of individuals within a group of risk for meningococcal infection morbidity in organized collectives

The survey of 2,500 persons in different educational organized groups has been carried out by the method based on the study of changes occurring in the standard population of group A meningococci due to its interaction with the surviving culture of human leukocytes. The heterogeneity of humans with regard to the individual antimeningococcal activity of their blood irrespective of their levels of humoral immunity and complement activity has been revealed. The survey has shown the possibility of detecting the groups of risk among the members of organized groups having, according to our data, a significantly higher level of morbidity in generalized meningococcal infection and meningococcal carriership (including epidemiologically important groups A, B and C).     

Coagglutination test and its application to the rapid diagnosis of meningococcal meningitis

Modified technique of slide coagglutination test for detecting meningococcal group-specific antigens in the spinal fluid of patients with meningococcal meningitis has been developed. Precipitating meningococcal sera, groups A, C, X, Y, Z, were conjugated with formalin-treated staphylococcal cells, strain Cowan-I. To prevent nonspecific reactions, 5-minute boiling of the spinal fluid specimens is suggested. 111 specimens of spinal fluid were taken from 75 patients at different periods of the disease. All patients were administered antibiotics, and therefore the etiology of the disease was bacteriologically confirmed only in 31% of patients. Coagglutination test was positive in 56.7% of patients, the frequency of positive results reaching 71% during the first 4 days of the disease. The specimens of spinal fluid taken from the control group of patients yielded not more than 2% of the positive results. Coagglutination test is recommended as a rapid test for diagnosing meningococcal meningitis.     

Immunoepidemiological characteristics of the duration of a meningococcal carrier state

The duration of meningococcal carriership in children and adults in the foci of infection and outside such foci and the immunological characteristics relating to group-specific meningococcal antigens A, C, X, Y and Z at different periods after the detection of the infective agent in the nasopharynx have been studied. Carrier state has been shown to last, on the average, 11 days. The duration of the release of meningococci from the nasopharynx has proved to be influenced by the epidemic situation in a given group. Differences in the time course of the immunological reorganization of the body in response to antigenic challenge in prolonged and short-term carrier state have been detected. These data suggest that rapid immune response to meningococcal antigens in the process of short-term carrier state is probably one of the factors preventing the prolonged colonization of the nasopharynx by the infective agent.     

Simple and rapid technique for monitoring the quality of meningococcal polysaccharides by high performance size-exclusion chromatography

The molecular size of meningococcal polysaccharides is an important physico-chemical parameter which correlates with immunogenicity. This paper describes the experimental conditions for high-performance size-exclusion chromatography on a PL Aquagel-OH 60 column to follow changes in the size distribution and therefore in the distribution coefficient (K(D)) of the meningococcal polysaccharides of groups A, C, Y and W-135 used to formulate anti-Neisseria meningitidis vaccines. The experimental conditions were also found to be suitable for a rapid monitoring of the quality (no group A polysaccharide depolymerization) of the tetravalent meningococcal polysaccharide vaccine.     

Vaccination against meningococcal disease in Europe: review and recommendations for the use of conjugate vaccines

At the end of 2005, six European countries had implemented public immunization campaigns with serogroup C conjugate vaccines, and all had experienced substantial declines in the incidence of serogroup C disease. A quadrivalent ACWY meningococcal vaccine is in use in the USA, but serogroup A is extremely rare in Europe and serogroups Y and W135 are infrequent causes of disease. This paper outlines recommendations on the use of conjugate vaccines in Europe based on the experience with meningococcal C conjugate (MCC) vaccines so far.     

Evaluation of the level of antibodies to purified meningococcal antigens

Group B meningococcal antigens, such as polysaccharide, lipopolysaccharide, protein preparation, as well as sonicates obtained from meningococcal cells, groups A, B and C, have been isolated. On the basis of these preparations the parameters of an enzyme immunoassay system for the detection of antibodies to individual meningococcal antigens have been established, and the specificity of the system and the possibility of using it for the evaluation of the level of antibodies to meningococci in human sera have been studied.     

Antibody studies in mice of outer membrane antigens for use in an improved meningococcal B and C vaccine

Abstract Since 1988, N. meningitidis , B:4:P1.15, ET-5 complex, has been responsible for an epidemic of meningococcal disease in Greater São Paulo, Brazil. Despite current trials to develop an effective vaccine against group B meningococci, children less than 2 years old have not been protected. It has been suggested that iron-regulated proteins (IRPs) should be considered as potential antigens for meningococcal vaccines. The vaccines under study consisted of outer-membrane vesicles depleted of lipooligosaccharide from three serogroup B strains and one serogroup C strain, IRPs, meningococcal group C polysaccharide and aluminum hydroxide. Four different protein and C polysaccharide concentrations were studied. The ELISA and bactericidal results showed a higher antibody response when 2 injections of 2.0 μg doses were administered. Despite higher IgG reactivity against antigen preparations containing IRPs seen in ELISA, the bactericidal activity was not increased if the target strain was grown in iron-restricted medium. The influence of addition of alkaline-detoxified lipooligosaccharide (dLOS) on immunogenicity of the vaccine was also investigated, and the dLOS provided for a more functionally specific antibody response.     

Increased specificity of immunoenzyme analysis for diagnosing meningococcal infection

The ELISA test system for the detection of polysaccharide antigens of meningococci, groups A and C, on the basis of the neutralization of specific antibodies has been developed. The specificity of this reaction is determined by the chemically pure preparations of group A and C meningococcal polysaccharides. The sensitivity of this test system based on the neutralization of antibodies is not inferior to that of ELISA with the use of double antiserum.