严重急性呼吸综合征冠状病毒2型 IgM / IgG、病毒核酸和白细胞介素6的联合检测在2019冠状病毒病诊断和治疗中的价值

探讨严重急性呼吸综合征冠状病毒2型(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)免疫球蛋白M(Immunoglobulin M,IgM)/免疫球蛋白G(Immunoglobulin G,IgG)、病毒核酸和白细胞介素6(interleukin 6, IL-6)的联合检测在2019冠状病毒病(coronavirus disease 2019, COVID-19)诊断和治疗中的临床价值。本研究按照《新型冠状病毒肺炎诊疗方案(试行第七版)》的标准收集了93例确诊病例(51例危重型、18例重型,15例轻型和9例普通型)和20例疑似病例(核酸检测阴性但临床症状和CT检测结果均符合标准)。选取110例儿科、妇科、肿瘤、血液和消化等疾病患者并排除COVID-19作为对照组。采用全自动化学发光免疫分析技术和电化学发光技术检测所有研究对象血清中SARS-CoV-2 IgM/IgG和IL-6。用实时荧光定量反转录聚合酶链反应对病例组和对照组的咽拭子进行SARS-CoV-2核酸检测。结果发现,血清IgM、IgG和IL-6在疑似病例中的阳性率分别为85%、75%和0%,在确诊病例中的阳性率分别为98.9%、95.7%和75.2%(其中危重型分别为100%、100%和100%,重型分别为94.4%、100%和97.9%,轻型分别为100%、93.3%和5%、普通型分别为100%、66.7%和0%)。IL-6和 SARS-CoV-2 IgM/IgG表达水平的改变与患者疾病的严重程度存在一定的关联性,差异有统计学意义(χ²＝273.51,χ²＝149.37;P＜0.05)。血清IL-6和SARS-CoV-2 IgM/IgG的联合检测可作为诊断和治疗COVID-19的监测指标,也可作为SARS-CoV-2核酸检测假阴性的有效互补。     

尿素解离法降低新型冠状病毒IgM和IgG检测结果假阳性的效果评价

探讨引起新型冠状病毒(SARS-CoV-2)免疫球蛋白M(IgM)和免疫球蛋白G(IgG)抗体检测结果假阳性的干扰因素,改良检测方法,完善实验室检测方案。本研究收集2020年1月2日至2020年3月5日就诊于川北医学院附属医院及南充市中心医院的门诊及住院患者血清样本共74份,其中19例为SARS-CoV-2核酸检测确诊阳性,10例为其他呼吸道病毒IgM抗体阳性,10例肝炎病毒抗体IgM阳性,20例类风湿因子IgM阳性,15例抗核抗体阳性。采用胶体金免疫层析法(试剂A、试剂B)分别对研究对象血清进行SARS-CoV-2 IgM和IgG抗体检测,并对结果为SARS-CoV-2 IgM或SARS-CoV-2 IgG阳性的病例进行分析,发现造成检测结果假阳性的可能因素。再采用合适浓度的尿素对检测为阳性结果的血清及3例SARS-CoV-2 IgM阳性的COVID-19早期患者血清进行解离,解离后分别重新测定SARS-CoV-2 IgM、IgG抗体。采用SPSS19.0统计软件对数据进行统计学分析。结果显示,19例COVID-19确诊患者血清中,试剂A检出SARS-CoV-2 IgM、IgG抗体阳...     

41例新型冠状病毒肺炎患者血清抗体检测分析

目的比较新型冠状病毒肺炎(corona virus disease 2019, COVID-19)不同临床分型患者血清中新冠病毒(SARS-CoV-2)特异性IgM和IgG抗体的差异和不同时期的浓度变化,并以抗体水平变化判断核酸复阳是否为二次感染。方法选取2020年2—3月南华大学附属南华医院收治的41例COVID-19患者,共收集其患病15-65天血清标本126份;作为对照,同时选取91例发热门诊核酸检测阴性患者采集血清各1份。采用化学发光免疫分析法(chemiluminescence immunoassay, CLIA)检测血清中新冠病毒IgM和IgG抗体水平,经组间t检验和Mann-Whitney U检验对抗体浓度变化进行统计学分析。结果无症状感染者IgM和IgG抗体平均浓度高于阴性对照组,低于普通型和重型患者,差异均具有统计学意义(P0.05);普通型患者IgM和IgG抗体浓度均低于重型患者,IgM抗体差异有统计学意义(P0.05),但IgG抗体差异没有统计学意义(P=0.06);COVID-19患者急性期的IgM和IgG抗体浓度均高于康复期,差异均有统计学意义(P0.05)。复阳后,患者体内IgM和IgG抗体浓度没有增加,持续下降。结论 COVID-19患者的SARS-CoV-2 IgM和IgG抗体浓度,依无症状感染、普通型、重症型患者临床类型逐次升高,康复期逐渐降低,但大部分体内仍存在较高水平的IgG抗体。核酸复阳之后的SARS-CoV-2 IgM和IgG抗体浓度并未增高,说明未发生二次感染。     

胶体金免疫层析法检测新型冠状病毒IgM/IgG抗体的临床评价与应用

新型冠状病毒(SARS-CoV-2)感染暴发流行已成为全球公共卫生事件,急需快速有效的现场诊断试剂。为探讨SARS-CoV-2病毒IgM/IgG抗体胶体金免疫层析法检测效果及临床应用价值,本研究选取304例新冠肺炎临床诊断病例、114例SARS-CoV-2核酸检测阴性的正常人(138)及其他发热伴呼吸道症状病例(64),采用胶体金法对采自上述病例的血浆或血清标本进行IgM和IgG抗体检测,并选取部分病例进行了全血和血浆或血清标本的检测同源性比较,进一步对304例临床诊断病例的病毒核酸、IgM/IgG抗体的时间分布进行了分析。结果显示,304临床诊断病例中,SARS-CoV-2核酸检测阳性病例为105例,胶体金法检测SARS-CoV-2 IgM和IgG抗体的敏感性分别为76.2%(80/105)和86.6%(91/105),IgM/IgG抗体阳性总体符合率为96.1%(101/105);核酸、抗体均为阴性者为73例;其余126例临床诊断病例中,IgM阳性率为69.2%(87/126),IgG阳性率为98.3%(125/126),IgM/IgG总体符合率为100%(126/126)。健康人...     

基于三种试剂盒分析新型冠状病毒特异性抗体的动态变化

为了解新型冠状病毒肺炎(COVID-19)发病后血清中新型冠状病毒(SARS-CoV-2)特异性抗体的动态变化,本研究使用三种不同检测原理的SARS-CoV-2抗体检测试剂盒,对来自甘肃省33例核酸检测阳性的COVID-19确诊病例的58份血清标本,分别进行了病毒特异性抗体(IgM、IgG和总抗体)的检测。结果显示,COVID-19发病后IgM、IgG和总抗体阳性率随发病时间的推移而逐渐上升:发病早期3d以内,三种试剂盒检测病毒特异性抗体阳性率在13.6%～31.8%之间;发病4～7d时,阳性率在36.4%～45.5%之间;发病8～14d时,阳性率在55.6%～77.8%之间;而发病15d以上时,阳性率达到100%。此外,本研究使用三种试剂盒检测了健康人血清标本,检测特异性在99%～100%之间。统计学分析结果显示,三种检测试剂盒的检测结果差异无显著性(P>0.05)。综上所述,三种SARS-CoV-2抗体检测试剂盒均具有较好的敏感性和特异性,可用于COVID-19疑似病例在核酸检测阴性时的辅助诊断;本研究初步获得的SARS-CoV-2特异性抗体动态变化特征可为COVID-19血...     

内蒙地区发热患者血清中冠状病毒抗体的检测

目的分析内蒙地区发热患者中冠状病毒的感染情况。方法以SARS冠状病毒感染Vero细胞涂片为冠状病毒抗原片,用间接免疫荧光法分别检测55例发热患者和68例正常人血清中冠状病毒的IgG、IgM抗体。结果发热患者血清中冠状病毒IgG抗体和IgM抗体阳性率分别为29.1%(16/55)和10.9%(6/55),而正常人血清中只检测到2.9%(2/68)的IgG抗体,且未检测到IgM抗体,2组患者的IgG和IgM抗体阳性率比较差异均有显著性;随机选取7例患者的IgG阳性血清进行SRAS冠状病毒的特异性抗体封闭实验,结果有6例血清仍为阳性,有1例血清转为阴性,说明冠状病毒IgG抗体阳性血清中85.7%为普通冠状病毒特异性,14.3%为SARS冠状病毒特异性。结论普通冠状病毒是内蒙地区发热患者的主要病原体之一,部分患者还存在SARS冠状病毒的既往感染。     

念珠菌特异性IgM和IgG抗体在肺念珠菌病中的诊断价值

目的:评价念珠菌特异性IgM和IgG抗体在肺念珠菌病中的诊断价值。方法:入选2017-09-01～2018-03-31住院患者76例,其中临床诊断肺念珠菌病患者8例、拟诊诊断肺念珠菌病患者13例、非念珠菌病患者55例(曲霉菌病患者12例、非真菌病患者28例、未确定病原菌患者15例);用胶体金法念珠菌特异性IgM和IgG抗体检测患者血液标本,与血清G实验和肺泡灌洗液(BALF)G实验比较,分析IgM和IgG抗体检测在诊断肺念珠菌病中的价值。结果:76例患者全部行IgM和IgG抗体检测,IgM抗体检测阳性33例,IgG抗体检测阳性22例;38例患者行血清G实验检测,阳性1例;35例患者行BALF G实验检测,阳性15例。检测灵敏度、特异度和Youden指数,IgM抗体检测分别为100.0%、64.2%和0.642,IgG抗体检测分别为87.5%、77.9%和0.654,血清G实验分别为0%、97.1%和-0.029,BALF G实验分别为83.3%、65.4%和0.487。结论:IgM抗体检测诊断肺念珠菌病的灵敏度高,可作为高危患者的筛查指标;IgG抗体检测灵敏度和特异度均较高,可作为诊断肺念珠菌病的指标。     

侵袭性真菌深部感染的早期实验室诊断

目的探讨假丝酵母菌甘露聚糖抗原和假丝酵母菌IgG/IgM抗体、曲霉半乳甘露聚糖抗原和烟曲霉IgG抗体在侵袭性真菌病早期临床诊断中的应用价值。方法收集已确诊侵袭性假丝酵母菌病患者18例,侵袭性烟曲霉病患者6例,单纯细菌感染患者20例,浅部真菌感染患者20例,健康体检者(正常对照组)20例,通过酶联免疫吸附法(ELISA)检测患者血清甘露聚糖和假丝酵母菌IgG/IgM抗体以及曲霉半乳甘露聚糖抗原和烟曲霉IgG抗体浓度,计算各指标的灵敏度、特异度、阳性预测值、阴性预测值和受试者工作特征(ROC)曲线下面积。结果甘露聚糖抗原和假丝酵母菌IgG/IgM抗体联合测定的敏感度为66.7%,特异度为83.3%,阴性预测值为100.0%,阳性预测值为85.7%,ROC曲线下面积为0.992(95%CI:0.974~1.000);半乳甘露聚糖抗原和烟曲霉IgG抗体联合测定的敏感度为66.7%,特异度为95.0%,阴性预测值为98.2%,阳性预测值为100.0%,ROC曲线下面积为0.978(95%CI:0.934~1.000)。结论甘露聚糖抗原和假丝酵母菌IgG/IgM抗体、半乳甘露聚糖抗原和烟曲霉IgG抗体联合检测对深部真菌感染的早期诊断具有重要意义。     

改良抗体捕获ELISA方法检测流行性出血热特异性IgE,IgA,IgG抗体的初步研究

初步报道建立了一种检测流行性出血热(EHF)特异性IgE、IgA、IgG抗体的改良抗体捕获ELISA方法(EacELISA,AacELISA,GacELISA)。该法以抗人IgE、IgA或IgG单克隆抗体作包被抗体;酶标记物系两株组特异性较强的EHF·McAb(A_(35),A_(25-1)株);在实验中采用EHF病毒抗原与酶标记物混合后一次加入,而不是分别依次加入的方式,使操作步骤简化,实验时间缩短,又适当提高了试验敏感性。该法具有简便,特异性高,灵敏度较高(检测EHF·IgE,EHF·IgA>1:100;EHF·IgG>1:2560),重复性较好(CV:EHF·IgE 2.51％,EHF·IgA 11.80％,EHF·IgG 10.85％)等优点。检测39份EHF病人血清,急性期病人(3～7病日)血清三种抗体的检出率分别为84.21％(16/19,EHF·IgG),89.47％(17/19,EHF·IgA)和100％(19/19,EHF·IgG);而发病3～6月后患者血清三种抗体检出率分别为10.00％(2/20),45.00％(9/20)和100.00％。在急性期与恢复期病人之间,EHF·IgE和EHF·IgA两种抗体的检出率差异较显著(P<0.01)。70价其他人群血清三种抗体检出率均为阴性。     

微量免疫酶染色检测斑疹伤寒IgM、IgG抗体

本文介绍了微量免疫酶染色(Micro-IP)检测斑疹伤寒IgM、IgG抗体的方法,Micro-IP与临床诊断的符合率为78.9%。IgM抗体早于第四病日阳性,第一周阳性率达76.2%,适于早期诊断。检测IgG抗体适于流行病学调查。Micro-IP检测免疫兔及患者血清抗体为群特异性(对普氏及莫氏立克次体均反应)。     

Serum immunoglobulin levels in human hydatidosis

Serum IgG, IgM, IgA and IgD levels of 83 patients with hepatic or pulmonary hydatidosis and 15 postoperative individuals with no cysts were compared with the mean values of 80 healthy Lebanese controls. A significant increase of IgG was present in all patients. An increase in the mean IgM and IgA levels was significant only in pulmonary cases. There was no significant correlation between the titres of antibodies as detected by haemagglutination and complement-fixation tests and the respective serum IgG and IgM immunoglobin levels. Mean IgD levels were not different between patients and controls. Elevated IgE levels were detected in 77% of 21 hydatid patients. A persistent hyperglobulinemia was observed in postoperative follow-ups.     

Affinity purification of immunoglobulins from chicken egg yolk using a new synthetic ligand

Due to the peculiar composition of the egg yolk and the lack of specific affinity ligands, Y immunoglobulins are normally purified using complex and time consuming procedures involving a combination of precipitation and chromatographic steps first to extract and capture and then to polish IgY. In this study, we have examined the applicability for IgY affinity purification of TG19318, a synthetic ligand for immunoglobulin, obtained from the screening of combinatorial libraries, and already characterized for its capability to purify immunoglobulins of class G, M, E and A. Soluble proteins were separated from the lipidic fraction of egg yolk by the water dilution method and loaded on to TG19318 affinity columns prepared by immobilizing the ligand on the commercially available support Emphaze™. In a single chromatographic step TG19318 affinity columns led to an efficient capture of IgY directly from crude samples, and with a purity degree higher than 90%, as determined by densitometric scanning of SDS–PAGE analysis of bound fractions, and with full recovery of antibody activity, as determined by ELISA assay. Higher recovery and purity of IgY was obtained by using loading buffers at pH close to 6.5. Column capacity, determined by applying 4× excess IgY to 1 ml bed volume column, and eluting the retained immunoglobulins, was close to 65 mg of IgY per ml of resin. Chemical and chromatographic stability of TG19318/Emphaze was tested before and after various treatments. The derivatized matrix was found to be very stable, in terms of ligand leakage and maintenance of IgY binding capacity, under conditions of normal column usage, cleaning and storage.     

Immunological identification and characterization of individual food allergens

Food allergies of type-I-allergy are immunoglobulin E (IgE) mediated and caused by certain proteins or glycoproteins, which are called food allergens. An analytical marker of allergens is the IgE-reactivity to these substances. Normally food allergens are minor components in allergenic source material, which consist of a huge number of chemical different substances. Thus allergen extraction, separation and immunological detection methods are described which identify and characterize individual food allergens by a minimum of manipulation. Favoured separation methods of allergenic extracts are electrophoretic ones allowing the combination of highly resolved protein separations with immunological detection methods subsumed by the term immunoblotting. These techniques are a useful basis to characterize allergens by chemical methods. Once the primary protein structure of a food allergen is established, the way is cleared for the identification of epitopes. Epitopes are immunological detectable parts of a protein or glycoprotein generating the interface between chemical structure and immune-system. The nature of epitopes may differ, for instance, can be conformational, continuous, or built up by glycoconjugates, which determine the stability of food allergens, especially in the case of food processing. Progress in identification and characterization of food allergens will improve diagnostics and therapy of food allergy.     

The role of oxygen radicals in immune complex injury

In this review we will summarize our current understanding of the mediation of immune complex induced tissue injury. Comparisons will be made between the mediation of IgG versus IgA immune complex injury with emphasis on the role that reactive oxygen products derived from leukocytic phagocytic cells play in the initiation of the tissue injury.     

Immunoglobulin heavy chain constant and heavy chain variable region genes in phylogenetically diverse species of bony fish

Summary Genomic DNA from 18 phylogenetically diverse species of bony fish was hybridized with probes specific for the channel catfish immunoglobulin heavy chain constant (CH) gene, as well as with immunoglobulin heavy chain variable (VH) probes specific for five channel catfish VH gene families. The results showed that CH probes strongly hybridized only to genomic fragments from other catfish species. In contrast, restricted DNA from most other species hybridized with at least two channel catfish VH probes. In those species whose DNA hybridized with multiple VH probes, the restriction pattern of hybridizing fragments was probe-dependent. These studies suggest that (1) the CH gene defined in channel catfish appears to share similarity only with CH genes in other catfish species, (2) families of VH genes appear to have diverged in early phylogenetic lineages of teleosts, and (3) VH genes similar to those defined in catfish appear to be widely represented in phylogenetically diverse species of teleosts.     

Relationship between immunoglobulin levels and extremes of solar activity

The possible relationship between epidemics and extremes of solar activity has been discussed previously. The purpose of the present study was to verify whether differences in the levels of immunoglobulins (IgA, IgG, IgM) could be noted at the highest (July 1989) and lowest (September 1986) points of the last (21st) and present (22nd) 11-year solar cycle. The work was divided into a 1-month study (covering the month of minimal or maximal solar activity), a 3-month study (1 month before and after the month of minimal or maximal solar activity) and a 5-month study (2 months before and after the month of minimal or maximal solar activity). A trend of a drop-off for all three immunoglobulins was seen on the far side of the maximal point of the solar cycle. Statistical significance was achieved in the 5-month study for IgM (P=0.04), and a strong trend was shown for IgG (P=0.07). Differences between the sexes were also noted.     

Progress on Ig Fusion Proteins Application

Ig融合蛋白是指在基因水平将目的基因同Ig部分片段基因相连 ,克隆并表达的重组蛋白。该蛋白具有目的蛋白的功能 ,又获取Ig的新特性。本文综述了Fab融合蛋白及Fc融合蛋白在临床及科学研究应用方面的进展。     

Anti-tumor antibody produced by human tumor-infiltrating and peripheral blood B lymphocytes

Cell suspensions from 69 human tumor biopsies and malignant effusions depleted of infiltrating T cells were incubated for 10–14 days with mitomycin-C-treated cells of the transformed T cell line MOT as feeder cells. B lymphocytes proliferated and differentiated as indicated by immunoglobulin (Ig) seerction in the culture supernatants (B cell expansion). Ig was present in culture supernatants of tumor cell suspensions incubated without MOT feeder cells (non-expanded cells), but the addition of MOT feeder cells to these cultures invariably resulted in a significant increase in Ig concentration. While IgG, IgA. and IgM isotypes were all detected in supernatants of both expanded- and nonexpanded tumor cell suspensions, the increase in total Ig induced by MOT feeder cells was mainly due to an increase in IgG. Peripheral blood B lymphocytes (PBBL) from 15 cancer patients and 4 healthy individuals were also successfully expanded by the same method. In these it was shown that IgA was the predominant Ig isotype. Using a modified enzyme-linked immunosorbent assay, IgG of 25/36 expansions from tumor cell suspensions showed reactivity with autologous tumor targets, and that from 10/13 expansions reacted with allogeneic tumor targets of the same histological diagnosis. No reactivity was found against tumor targets of different histology. IgG of 4/10 expansions of PBBL from cancer patients showed reactivity with allogeneic tumor targets of the same histology, while no reactivity was demonstrated against tumor targets of different histology. IgG of expanded PBBL from healthy individuals showed no reactivity against tumor targets. This method allows detailed study of the specific humoral antitumor immune response of intratumoral and peripheral blood B lymphocytes in cancer.Work supported by grants from the Share and Concern Foundations and grant CA MOPP from the National Institutes of Health, C.J.A.P. is a visiting scientist from the University of Nijmegen, Department of Medical Oncology, Nijmegen, The Netherlands, and is supported by a Fulbright Senior Research Grant and grants from the Dutch Cancer Society and the Regional Cancer Center of the East Netherlands (IKO). J.A.M.B. is a visiting scientist from the University of Sao Paolo, Department of Immunology, Brazil, and is supported by grant 90/1844-4 from the FAPESP     

Preparation and use of therapeutic antibodies primarily of human origin

Therapeutic antibodies include polyclonal immunoglobulins isolated from regular or high-titered human plasma, sera from immunized animals, and monoclonal antibodies. This array of therapeutic antibodies is used for the prevention and treatment of many infectious diseases, antibody immunodeficiencies, autoimmune and inflammatory diseases, neurological disorders, and cancers. Polyclonal human immunoglobulins are available for intramuscular injection (IGIM), intravenous infusion (IGIV) and subcutaneous infusion (SCIG). We review these products and detail the therapeutic use of polyclonal human antibodies in the treatment of antibody immunodeficiencies, including their occasional local side effects (tenderness, sterile abscesses), minor systemic side effects (chills, muscle aches, malaise, headaches) and major side effects (aseptic meningitis, nephropathy, thrombosis).     

免疫球蛋白缓释微囊的制备、结构表征与性能研究

微囊化是实现生物药物制剂缓控释放的最重要方法之一。以乙基纤维素(EC)为囊材,采用物理化学方法制备了免疫球蛋白乙基纤维素微囊。用扫描电镜(SEM)考察了微囊的孔结构和形貌特征,并通过体外溶出实验考察了微囊的缓释效果。结果表明,在给定制备条件下制得的微囊圆整度好,孔径分布范围较窄,在模拟条件下具有良好的缓释性能。微囊最佳制备工艺条件如下:囊心囊材比2.5∶1,30℃下反应6h,搅拌速率250r/min,吐温80用量8ml。