The theory and practice of using in-house control in screening and verification studies for the diagnosis of HIV infection

Three batches of two diagnostic test kits for the in-house control (IHC) HIV infection were made up of the 8 pools of sera, containing antibodies to all antigens of HIV-1 (4) and HIV-negative sera (4) obtained from healthy donors. All sera used for this purpose did not contain antibodies to viruses of hepatitis A, B, C. In the process of the preparation of the batches of diagnostic test kits for IHC 500 individual donor sera and more than 100 of individual sera of HIV-infected persons were studied. The sera under study were also tested for the presence (absence) of specific antibodies to HIV-1,2 and viruses of hepatitis A, B, C. The evaluation of IHC in 300,000 tests under the conditions of a screening laboratory and 550 verification tests was done. The study revealed that the use of IHC makes it possible to improve the conditions of work with commercial diagnostic test kits, to introduce the semiquantitative determination of the level of specific antibodies on verification tests and, on the whole, to standardize the tests.     

Toxoplasmosis III. Studies Using the Complement-Fixation Test and Fluorescence-Inhibition Test with Sera of Experimentally Exposed Birds

The direct, modified direct and indirect complement-fixation tests and the fluorescence-inhibition test were investigated using sera from pigeons, chickens and turkeys which had been exposed to Toxoplasma gondii. The direct CF test was suitable for use with pigeon sera. The indirect CF method effectively demonstrated antibodies in chicken and turkey sera. FI tests were less sensitive than the CF methods.     

Use of microcapsular leptospiral antigens for detecting specific antibodies

The sensitivity of microcapsular leptospiral antigens, produced by Japan Lyophilization Laboratory and intended for use in tests for the detection of antibodies to leptospires in the sera of experimentally immunized laboratory animals, were studied. The comparative study of the microcapsular agglutination (MCA) test and other serological tests, such as the microagglutination (MA) test and the indirect enzyme immunoassay (EIA), was made. The leptospiral antigens under study were found to actively react with serospecific and group-specific antibodies. In infected guinea pigs and rabbits specific antibodies could be detected from days 3-4 in the MCA test and only from days 5-7 in the MA test. The average antibody level determined by titration in the MCA test was 3.3 times higher and in indirect EIA, 4.3 times higher than that determined by titration in the MA test. These data make it possible to recommend the use of microcapsular leptospiral antigens for the early diagnosis of leptospirosis.     

Comparative studies on surface antigenicity of Trypanosoma cruzi trypomastigotes from infected mouse blood and infected L-cell cultures

Differences in the antigenicities of surface components of blood-form trypomastigotes and trypomastigotes derived from L-cell cultures were studied by agglutination and indirect immunofluorescent tests on living parasites using various antisera from rabbits and mice. Antisera from rabbits immunized with L-cell-derived trypomastigotes and antisera obtained from rabbits infected with L-cell-derived trypomastigotes showed similar titers in both the agglutination and immunofluorescent test. Moreover, both antisera exhibited higher titers against trypomastigotes derived from L-cell cultures than against blood-form trypomastigotes. No detectable agglutination titer against either blood-form or L-cell-derived trypomastigotes was observed with sera from (a) mice infected with blood-form trypomastigotes after previous immunization with blood-form trypomastigotes, (b) mice infected with blood-form trypomastigotes and then treated with Lampit, or (c) mice infected with slightly less virulent trypomastigotes from L-cells. However, detectable and almost equal titers were observed with sera from (a), (b) and (c) in indirect immunofluorescent tests. Mouse sera also exhibited higher titers against trypomastigotes derived from L-cells than against the blood-form type. However, mouse sera showed more pronounced differences than rabbit sera. These results suggest that there may be two types of trypomastigotes in infected animals and that the surface components of blood-form trypomastigotes have lower antigenicity.     

Antigens of Cryptosporidium sporozoites recognized by immune sera of infected animals and humans

The humoral response of humans, calves, and horses to Cryptosporidium sporozoite antigens was evaluated using a western blot technique. Sera from calves, humans, and horses were obtained at various times following the detection of infection. Sera were reacted with detergent-solubilized, sodium dodecyl sulfate polyacrylamide gel-electrophoresed (SDS-PAGE) sporozoite antigens. The number of antigens recognized by immune sera from humans and animals increased with time postinfection. A 20-kDa antigen appears to be a major sporozoite surface determinant labeled via membrane protein biotinylation and recognized by mouse monoclonal antibodies using indirect immunofluorescence and western blotting. Detectable recognition of the 20-kDa band occurred in 3-wk postinfection (PI) sera from all species tested. Reactivity to the 20-kDa band diminished significantly in sera 5 mo PI or longer from infected humans with no known recurrence of cryptosporidial diarrhea. In contrast, 12-mo PI sera from an individual constantly exposed to oocysts under working conditions was as strongly reactive as the 3-wk convalescent sera. Serum reactivity to the 20-kDa antigen appears to be a good indicator of exposure to Cryptosporidium.     

False-Positive Anti-Toxoplasma Fluorescent-Antibody Tests in Patients with Antinuclear Antibodies

The indirect fluorescent-antibody (IFA) method for diagnosis of toxoplasmosis is widely used and is considered to be as specific as the Sabin-Feldman dye test. After observing a patient with systemic lupus erythematosus (SLE) who had a positive toxoplasma IFA test but a negative dye test, we studied sera with high titers of antinuclear antibodies from 16 SLE patients and from 2 with rheumatoid arthritis for Toxoplasma antibodies in the immunoglobulin G and M (IgG and IgM) IFA tests and the dye test. Results of these tests were compared with titers of antinuclear antibodies, precipitating antibodies to single-strand deoxyribonucleic acid (DNA), and binding antibodies by use of DNA labeled with (3)H-actinomycin D. Of 18 patients, 11 had IgG and 4 had IgM IFA Toxoplasma antibodies; only 2 had antibodies detectable in the dye test. The immunofluorescence patterns in the Toxoplasma IFA test were indistinguishable from those obtained in patients with toxoplasmosis without antinuclear antibodies. Absorption of SLE sera with DNA did not result in a decrease in Toxoplasma IFA titers. When SLE sera were absorbed with live T. gondii, a marked drop in IgG IFA titer was observed as well as a decrease in titers of antinuclear antibodies and (3)H-DNA binding. Treatment of Toxoplasma cells with deoxyribonuclease and ribonuclease did not decrease their fluorescence. These results suggest that T. gondii nuclear antigens can absorb antinuclear antibodies but do not have exposed substrates for deoxyribonuclease. Tests in which organisms containing "nuclear" antigens for IFA detection of antibodies to these organisms are used may result in "false-positives" with sera containing antinuclear antibodies.     

Comparative sensitivity of different serological tests for seromonitoring and surveillance of Edwardsiella tarda infection of Indian major carps

Different serological tests viz. indirect ELISA, indirect blocking ELISA, competitive ELISA and serum agglutination tests were evaluated to detect antibodies against Edwardsiella tarda in naturally infected fish sera for seromonitoring and epizootiological studies. Approximately 66.6, 62.5, 57.6 and 16.6% of the field sera samples were found to be positive by indirect ELISA, competitive ELISA, indirect blocking ELISA and serum agglutination test, respectively. The percentage of serum samples positive for E. tarda antibodies in serum agglutination, competitive ELISA and indirect blocking ELISA, when compared with indirect ELISA, were 33.3, 83.6 and 66.6%, respectively, but its use was restricted due to the requirement of several conjugates against different fish species and the difficulty in assaying large numbers of serum samples from different fish species in a limited time to enable seromonitoring of the disease prevalence. No significant difference (P<0.05) in the mean optical density value was found in indirect and competitive ELISA. Although the competitive ELISA was slightly less sensitive than the indirect ELISA, it could accommodate a large number of serum samples with one anti-rabbit conjugate, and the need for different fish conjugates as required in indirect ELISA was eliminated. As in medical and veterinary practices, these tests can now be used in aquaculture practices for seromonitoring and study of pre-exposure of Indian major carps to pathogens in enzootic areas.     

Antibodies to iron-regulated proteins of meningococci in blood sera of healthy persons of different age groups

One hundred and twenty individual sera obtained from healthy persons of different age groups were studied for the presence of antibodies to meningococcal iron-regulated proteins (IRP). The study revealed that occurrence of such antibodies in sera under study was IRP nature- and age-dependent. Antibodies to two IRP were found to occur most frequently: 85 kD (TbpB) and 72 kD (FrpB). Antibodies to the former IRP were detected in more than 50% and antibodies to the latter IRP, in more than 90% of sera. This was probably due to the presence of epitopes common with those in protein antigens of some other microorganisms, such as Moraxella catarrhalis and Haemophilus influenzae. The occurrence of antibodies to periplasmatic IRP with 34 kD (FbpA) in blood sera varied within the range of 5 to 30%. At the same time the occurrence of antibodies to this protein in the sera under study was age-depended: children until five years exhibited the minimal occurrence (about 5%), while in adults it reached 30%.     

Evaluation of ELISA for the Detection of Toxoplasma Antibodies in Swine Sera

Enzyme-linked immunosorbent assay (ELISA) is compared with the indirect fluorescent antibody test (IFAT), the indirect haemagglutination test (IHAT) and the latex agglutination (LA) test for the detection of toxoplasma antibodies in swine sera. The 100 swine sera examined represent ELISA values from > 0 to 154 EIU. The agreement was highest (0.67) between ELISA and IFAT with an ELISA cut-off value of 30 EIU, and between ELISA and the LA test with an ELISA cut-off value of 50 EIU (0.74). All sera giving < 10 EIU were negative in the other tests, and all those with > 70 EIU were positive in 1, 2 or all of the reference tests. In order to avoid false positive results with ELISA, all sera giving 10–70 EIU should be confirmed with a test which has a good specificity, e.g. IFAT. ELISA is a sensitive test and is highly suitable for the screening of large amounts of samples, but it may be too complicated for screening toxoplasma antibodies in the laboratories of abattoirs.     

Evaluation of the sensitivity of selected serological tests and activity of Coxiella burnetii antigens in the diagnosis of Q fever]

Sensitivity of three serological tests: indirect immunofluorescence assay (If), complement fixation test (CF), and microagglutination test (MA) was evaluated. Sera (118 samples) of humans suspected of C. burnetii infection were tested. Phase II antibodies were detected in 68.6% of sera and phase I antibodies--in 38.2% of sera. Among seropositive to phase II antigen--93.8% of sera reacted in IF, 62.9% in MA, and 32.1% in CF; among seropositive to phase I antigens--100% of samples reacted in IF, 2.6% in MA and 2.6% in CF. Calculated sensitivity of above tests was as followed: IF-93.8%, MA-67.1%, CF-34.2%. Some human sera (6.1%) reacted with hen egg antigens in CF. Reactivity of diagnostic antigens prepared from reference Henzerling strain and four others isolated in Poland with rabbit immune sera and sera of individuals suspected of C. burnetii infection in IF was compared. Generally, the immune sera reacted in highest titres with homologous antigens derived from homologous strains. Human sera showed differentiated activity to particular antigens. The titres of phase I antibodies fluctuated from 0 to 16 depending on the antigen applied. Because of that fact diagnostic antigens should be prepared from the mixture of reference strains and isolates from a region under study.     

Serological activity of incomplete antibodies]

Blood sera containing incomplete antibodies were studied in various serological tests, by the results of Coombs' and the inhibition of complement fixation tests. It was shown that division of antibodies into complete and incomplete by their serological activity was conditioned. Antibodies detected in Coombs' test could fix the complement. The blocking antibodies depressing the complement fixation test could fix the homologous complement. Proceeding from the latter the author suggests the test of the conglutinating complex fixation which proved to be effective in detection of antibodies inactive in the agglutination and complement fixation tests.     

Immunohistochemical study of cardiolipin and phosphatidylinositol in mouse liver]

Localization of two phospholipid haptens--cardiolipin and phosphatidylinositol--in mouse liver sections was studied by the indirect method of fluorescent antibodies. Two types of liver sections--paraffin and cryostat, and two type of fixation--in acetone, and in the acetone, buffer, and formalin mixture--were used. Antiphospholipid sera stain specifically the plasma membrane of hepatocytes and predominantly the membrane region overlooking the blood capillary. A possibility of detecting the specific phospholipid haptens depends on the method of obtaining the sections and their fixation. Two types of immunization give two types of antiphospholipid sera which differ by the stability, by the possibility of monospecific antibodies isolation from them on lipid immunosorbents, and by the types of liver section staining.     

A serological survey for human immunodeficiency virus types 1 and 2 of individuals who visited health centers in Tokyo

The serum antibodies to human immunodeficiency virus types 1 (HIV-1) and 2 (HIV-2) were examined for among individuals who visited health centers in Tokyo. Of 8,198 sera screened, one was true-positive and 37 false-positive for HIV-1 antibodies. These 37 false-positives and 305 sera from the population groups at risk for HIV-2 (42 sojourners in Africa, 251 homo- and bisexuals, and 19 prostitutes) were further examined for HIV-2 antibodies by indirect immunofluorescence and Western blotting. No antibodies reactive with HIV-2 were detected in the sera examined. Serological cross-reactivity between HIV-1 and HIV-2 was examined by use of rabbit antisera.     

Detection of poliovirus antigens and antibodies: microindirect haemagglutination and haemagglutination inhibition tests for poliovirus types I, II, and III.

Microtitre indirect haemagglutination (IHA) and IHA-inhibition (IHAI) procedures were adapted to determine the reactivities of type I, II, and III poliovirus antibodies and antigens. Glutaraldehyde-fixed sheep erythrocytes were sensitized for these tests with concentrated, partially purified preparations of type I, II, and III poliovirus. Antibody titres by IHA were generally 10 to 100 times greater than serum microneutralization (SN) titres. The SN and IHA reactivities of three kinds of sera were compared. Of these sera, virus type specific antibodies, in monospecific guinea pig sera one week after immunization and in sera from hyperimmunized horses, could be readily differentiated and measured; antibodies in human diagnostic specimens, however, showed some intertypic cross reactivity. Monovalent one-week immune guinea pig sera reacted specifically in the IHAI test to differentiate viruses, and could be used for virus typing and differentiating strains of poliovirus type III.     

Pneumocystis carinii: immunoblotting and immunofluorescent analyses of serum antibodies during experimental rat infection and recovery

Serum antibodies to Pneumocystis carinii were measured in rats by the indirect fluorescent antibody and immunoblotting techniques. Serum IgG and IgM antibodies developed with environmental exposure to P. carinii, were low or absent during immunosuppression to induce P. carinii pneumonia, and rose when immunosuppression was withdrawn. The IgG and IgM antibodies formed at the same time, but the titers of each antibody varied in individual rats. Serum IgG antibodies by immunoblotting recognized bands of 45, 50, and 116 kDa as the major reactive moieties of P. carinii. The bands were detected with sera from all rat groups in a temporal pattern which closely paralleled antibody formation by indirect immunofluorescence. The pattern of immunoblotting reactivity varied among individual rats, particularly with immunosuppression. Additional bands were detected with prolonged exposure to P. carinii. Thus, the rat makes both IgG and IgM antibodies to P. carinii, and specific P. carinii antigens identified in this immune response might be targeted for future serologic studies.     

Qualitative evaluation of selective tests for detection of Neospora hughesi antibodies in serum and cerebrospinal fluid of experimentally infected horses

Neospora hughesi is a newly recognized protozoan pathogen in horses that causes a myeloencephalitis similar to Sarcocystis neurona. There are no validated serologic tests using the gold standard sera that are currently available to detect specific N. hughesi antibodies and, thus, no tests available to detect antemortem exposure or estimate seroprevalence in the horse. The objectives of the present study were to establish a bank of gold standard equine sera through experimental infections with N. hughesi and to assess several serologic tests for the detection of related protozoan antibodies. Seven horses were inoculated with N. hughesi tachyzoites, and 7 horses received uninfected cell culture material. The horses were monitored, and blood and cerebrospinal fluid were collected repeatedly over a 4-mo period. With the sera, 4 different serologic techniques were evaluated. including a whole-parasite lysate enzyme-linked immunosorbent assay (ELISA), a recombinant protein ELISA, a modified direct agglutination test, and an indirect fluorescent antibody test. Qualitative and quantitative evaluation of the results showed that the N. hughesi indirect fluorescent antibody test (IFAT) consistently discriminated between experimentally infected and noninfected horses, using a cutoff of 1:640. Sera from 3 naturally infected horses had titers >1:640. Cerebrospinal fluid in all but I infected horse had very low N. hughesi IFAT titers (<1:160), starting at postinoculation day 30.     

Toxoplasma gondii-positive human sera recognise intracellular tachyzoites and bradyzoites with diverse patterns of immunoreactivity

Antibody detection assays have long been the first line test to confirm infection with the zoonotic parasite Toxoplasma gondii. However, challenges exist with serological diagnosis, especially distinguishing between acute, latent and reactivation disease states. The sensitivity and specificity of serological tests might be improved by testing for antibodies against parasite antigens other than those typically found on the parasite surface during the acute stage. To this end, we analysed the reactivity profile of human sera, identified as positive for anti-Toxoplasma gondii IgG in traditional assays, by indirect immunofluorescence reactivity to acute stage intracellular tachyzoites and in vitro-induced latent stage bradyzoites. The majority of anti-Toxoplasma gondii IgG positive sera recognised both intracellularly replicating tachyzoites and in vitro-induced bradyzoites with varying patterns of immune-reactivity. Furthermore, anti-bradyzoite antibodies were not detected in sera that were IgM-positive/IgG-negative. These results demonstrate that anti-Toxoplasma gondii-positive sera may contain antibodies to a variety of antigens in addition to those traditionally used in serological tests, and suggest the need for further investigations into the utility of anti-bradyzoite-specific antibodies to aid in diagnosis of Toxoplasma gondii infection.     

Serology of Rubella—Comparison of Fluorescent Antibody,Complement Fixation and Neutralization Tests for Diagnosis of Current Infections and Determination of Sero-immunity

Neutralization, complement fixation (CF) and indirect fluorescent antibody (FA) assays for rubella virus were compared for sensitivity in the serologic diagnosis of infection, for demonstrating antibody in the sera of infants with suspected rubella syndrome, and in the detection of antibody elicited by past infection (determination of immunity status). The combination of CF and FA tests was shown to be the most useful for serologic diagnosis of infection, largely eliminating the need for the slower and more cumbersome interference neutralization test.Neutralizing antibodies were found to appear rapidly in the course of infection, antibodies demonstrable by immunofluorescent staining appeared slightly later, and CF antibodies were rarely demonstrable in sera collected earlier than 14 days after onset of illness. Antibodies detected by all three techniques showed good correlation in infants with clinical evidence of rubella syndrome and corresponding maternal sera. The indirect FA technique compared favorably with the neutralization test for the detection of antibody elicited by past infection (determination of immunity status) and offered distinct advantages in ease of technical performance and more rapid results. In both current and past infections, FA titers tended to be higher than neutralizing antibody titers.     

Determination of human IgI allotypes by using a set of stable erythrocyte antigenic diagnostica of varying specificity]

Technology of preparing a set of stable antigenic diagnostic agents of commercial type for determination of genetic determinants of human IgG and antibodies to them in the human blood sera and in the animal hyperimmune sera was worked out. Antisera against some human IgG allotypes were prepared. The frequency of detection of individual IgG allotypes and antibodies to them in human sera was studied.     

Visual detection of granulocyte surface antigens using the avidin-biotin complex

A visual test for detection of granulocyte surface markers using the avidin-biotin complex (ABC) has been developed. That this assay is highly specific, reproducible, and sensitive was determined by studying the expression of HLA antigens on granulocytes with monoclonal antibodies. Further, using granulocyte specific alloantisera, the results of the ABC test compared well to data from leukoagglutination assays and indirect immunofluorescence tests. The assay is particularly advantageous in that granulocytes can be stored, only small amounts of cells and sera are needed, and heterogeneous cell populations can easily be studied.