Antibody avidity indices of the saliva and serum antibodies in salmonellosis patients

The avidity characteristics of salivary and serum antibodies have been determined in 179 salmonellosis patients by means of the indirect hemagglutination inhibition test. These investigation have shown that, in contrast to serum antibodies, no changes occur in the avidity of salivary antibodies in the course of the disease. This is due to the fact that secretory antibodies belong to IgA which have no tendency to ripening. The regularities thus established reflect the role of secretory and serum antibodies in the pathogenesis of Salmonella infections.     

Avidity criteria in assessing the functional activity of antigens, antibodies and non-specific serum inhibitors on a model of the kinetic reaction of hemagglutination suppression with arboviruses]

The functional activity of some arboviruses of groups A and B, of the antibodies and serum inhibitors was studied on a model of the kinetic hemagglutination inhibition test (HAI) by different avidity criteria (velocity, completeness and stability of formation of a neutral complex). The avidity indices of the antigens, antibodies and the inhibitors proved to depend on the group, species and strain peculiarities of the arboviruses, the method of preparation of the antigen, the biological species of the donor of the immune and normal blood sera, the method of treatment of the sera and a number of other factors. There proved to be no constan-correlation between the avidity of the strain and the avidity of the serum immune to it. Inhibitors of the normal rabbit and human sera were not less effective in comparison with the specific antibodies to a number of viral strains of tick-borne encephalitis and Japanese encephaliti or even exceeded them by the avidity indices to the antigens in the HAI test. The most active (functionally) strains can be recommended for obtaining high-quality viral (antigenic and serum) preparations.     

Neutralization of bacterial viruses by antibodies of young animals

The development of the avidity of 19S and 7S neutralizing antibodies was studied after the immunization of young rabbits with ΦX 174 bacteriophage. Both 19S and 7S antibodies formed during the entire course of the immunization process were able to neutralize bacteriophage ΦX 174 without the participation of thermolabile serum components: neither heat inactivation at 56°C nor addition of piglet complement into the neutralizing system influenced the titer in the neutralization test. In both immunoglobulin classes (IgM and IgG) the first antibodies formed possessed a low avidity that increased in the course of the immunization process so that in the secondary response antibodies of both 19S and 7S type were formed possessing a high binding activity towards the specific antigen. Following the immunization with a high dose of the phage antigen (10¹⁰ PFU of ΦX 174 phage) 19S antibodies were formed at a relatively fast rate, the avidity of which did not further increase during immunization. When a low antigen dose was used for immunization the avidity of antibodies significantly increased in the course of immunization.     

Performance of the immunoglobulin G avidity and enzyme immunoassay IgG/IgM screening tests for differentiation of the clinical spectrum of toxoplasmosis

Toxoplasmosis has been well known as an important human infection to consider especially in pregnant women. Although many serologic methods are available, the diagnosis of toxoplasmosis can be extremely difficult. The presence of increased levels of Toxoplasma-specific IgG antibodies indicates an infection, but it does not differentiate between a recent and past infection. The purpose of our study was to compare the performance of the ELISA T. gondii IgG/IgM test, a widely used enzyme-linked immunosorbent assay, to the ELISA IgG avidity method. One hundred and four serum samples (from 38 males and 66 females) were tested and evaluated from symptomatic patients (chorioretinitis, lymphadenopathy), and from women in their first trimester of pregnancy who were suspected of having toxoplasmosis. The high IgG avidity and ELISA IgG antibody levels were in agreement for 51 of the specimens (49.0%). Thirty-eight discrepant (borderline) results from the IgG avidity method were positive for IgM (3 specimens) and IgG (37 specimens). Interestingly, out of the eight serum samples that were positive for both IgG and IgM antibodies, two samples were low IgG avidity, and three samples were borderline. There was no statistically significant relation observed between the results of the IgG avidity method and the ELISA IgG test, and the IgG avidity method and ELISA IgM test (chi2 = 1.987; p = 0.370 and chi2 = 2.152; p = 0.341, respectively). The IgG avidity method was considered easy to perform and an acceptable approach for the differentiation of discrepant results (recent/chronic) and for the current detection of T. gondii antibodies. We concluded that the determination of IgG avidity is a helpful tool for the diagnosis of the ocular form of toxoplasmosis and it is a safe method for screening this disease in the first trimester of pregnancy.     

Complement-mediated solubilization of immune precipitates prepared with antibodies of different avidity.

Complement-mediated solubilization of immune precipitates prepared with HSA and rat IgG anti-HSA has been quantitatively analyzed. Early and late IgG anti-HSA antibodies were obtained 27 and 49 days after immunization, respectively. Immune precipitates prepared with early IgG anti-HSA were solubilized by rat serum to a larger extent than complexes prepared with late IgG anti-HSA. The affinities for HSA of the early and late antibodies were not significantly different. The quantitative differences in solubilization were neither due to differences in the Ab/Ag ratios of the immune precipitates, nor appeared to be brought about by changes in the distribution of the antibodies over the IgG sub-classes. The avidity of the late IgG anti-HSA antibodies was higher than the avidity of the early IgG antibodies. Presumably, the avidity of the antibodies greatly affected the complement-mediated solubilization of the immune precipitates. In addition, the solubilization was found to be dependent on the conditions employed to prepare the immune precipitates.     

Anti-nef antibodies and other predictors of disease progression in HIV-1 seropositive injecting drug users.

A cross-sectional and retrospective longitudinal study has been conducted in three Italian infectious disease centres to evaluate the role of anti-nef antibodies and other markers (HIV-1 p24 antigen, p24 Ag; Beta 2-microglobulin, B2-M; and number of CD4+ lymphocytes) as predictors of disease progression in HIV seropositive injecting drug users (IDUs). The selected patients were: 1) HIV-seropositive IDUs in different stages of HIV infection; 2) HIV-seropositive IDUs who had developed AIDS, from whom serial serum samples were available during the asymptomatic stage, and 3) HIV seropositive IDUs who remained asymptomatic through a follow-up period of the same duration as the patients who developed AIDS. Absence of anti-nef antibodies was associated with symptomatic HIV infection. A significant association between the absence of anti-nef antibodies, the presence of p24 Ag, high levels of B2-M, a number of CD4+ lymphocytes less than 500/ml at first visit and disease progression was found. Subjects who were persistently positive for antibody to nef were less likely to develop AIDS than those who were transiently or persistently negative. This difference was statistically significant (p = 0.03). The results of this study show that absence or disappearance of anti-nef antibodies may be used as predictor of disease evolution in HIV seropositive IDUs. This study also confirms the usefulness of other markers, such as p24 Ag, B2-M and number of CD4+ lymphocytes previously shown to be predictive of rapid disease progression for predicting the course of HIV seropositive IDUs.     

Differential responsiveness to immunoablative therapy in refractory rheumatoid arthritis is associated with level and avidity of anti-cyclic citrullinated protein autoantibodies: a case study

In order to identify pathogenic correlates of refractory rheumatoid arthritis (RA), antibodies against anti-cyclic citrullinated protein (ACPAs) were investigated in RA patients in whom the dysregulated immune system had been ablated by high-dose chemotherapy (HDC) and autologous haematopoietic stem cell transplantation (HSCT). Six patients with refractory RA were extensively characterized in terms of levels of total immunoglobulins, RA-specific autoantibodies (ACPAs and rheumatoid factor) and antibodies against rubella, tetanus toxoid (TT) and phosphorylcholine before and after HDC plus HSCT. Additionally, the avidity of ACPAs was measured before and after treatment and compared with the avidity of TT antibodies following repeated immunizations. Synovial biopsies were obtained by arthroscopy before HDC plus HSCT, and analyzed by immunohistochemistry. In the three patients with clinically long-lasting responses to HDC plus HSCT (median 423 days), significant reductions in ACPA-IgG levels after therapy were observed (median level dropped from 215 to 34 arbitrary units/ml; P = 0.05). In contrast, stable ACPA-IgG levels were observed in three patients who relapsed shortly after HDC plus HSCT (median of 67 days). Clinical responders had ACPA-IgG of lower avidity (r = 0.75; P = 0.08) and higher degree of inflammation histologically (r = 0.73; P = 0.09). Relapse (after 38 to 530 days) in all patients was preceded by rising levels of low avidity ACPA-IgG (after 30 to 388 days), in contrast to the stable titres of high avidity TT antibodies. In conclusion, humoral autoimmune responses were differentially modulated by immunoablative therapy in patients with synovial inflammation and low avidity ACPA-IgG autoantibodies as compared with patients with high levels of high avidity ACPA-IgG. The distinct clinical disease course after immunoablative therapy based on levels and avidity of ACPA-IgG indicates that refractory RA is not a single disease entity.     

Combined rapid (TUBEX) test for typhoid-paratyphoid A fever based on strong anti-O12 response: design and critical assessment of sensitivity

Rapid diagnostics can be accurate but, often, those based on antibody detection for infectious diseases are unwittingly underrated for various reasons. Herein, we described the development of a combined rapid test for two clinically-indistinguishable bacterial diseases, typhoid and paratyphoid A fever, the latter fast emerging as a global threat. By using monoclonal antibodies (mAbs) to bacterial antigens of known chemical structures as probes, we were able to dissect the antibody response in patients at the level of monosaccharides. Thus, a mAb specific for a common lipopolysaccharide antigen (O12) found in both the causative organisms was employed to semi-quantify the amounts of anti-O12 antibodies present in both types of patients in an epitope-inhibition particle-based (TUBEX) immunoassay. This colorimetric assay detected not only anti-O12 antibodies that were abundantly produced, but also, by steric hindrance, antibodies to an adjoining epitope (O9 or O2 in the typhoid or paratyphoid bacillus, respectively). Sensitivity and, particularly, reaction intensities, were significantly better than those obtained using an anti-O9 or anti-O2 mAb-probe in the examination of paired sera from 22 culture-confirmed typhoid patients (sensitivity, 81.8% vs 75.0%) or single sera from 36 culture-confirmed paratyphoid patients (52.8% vs 28.6), respectively. Importantly, sensitivity was better (97.1% for typhoid, 75.0% for paratyphoid) if allowance was made for the absence of relevant antibodies in certain specimens as determined by an independent, objective assay (ELISA)--such specimens might have been storage-denatured (especially the older paratyphoid samples) or procured from non-responders. Benchmarking against ELISA, which revealed high concordance between the two tests, was useful and more appropriate than comparing with culture methods as traditionally done, since antibody tests and culture target slightly different stages of these diseases. Paired sera analysis was insightful, revealing 64% of typhoid patients who had no change in antibody titer over 4-16 days, and 14% with no IgM-IgG class-switching.     

Diagnosis of toxoplasmosis in pregnancy: importance of immunoglobulin G avidity test

The immunoglobulin G (IgG) avidity test has proved to be a highly useful test in the diagnosis of toxoplasmosis during pregnancy, especially in combination with conventional serological assays. Acute infections at the time of gestation predispose the offspring to the risk of congenital toxoplasmosis. The IgG avidity test was developed to differentiate between recent and more distant infection; this method is valuable in the situation in which a single serum sample is obtained in the first trimester of pregnancy. This paper describes the utility of IgG avidity test during pregnancy, and its role in ruling out, by a high avidity, a recently acquired infection. Testing for specific IgG avidity has been reported to be useful for confirmatory testing in patients who have positive IgG and IgM antibodies.     

Enhanced B-Cell Receptor Recognition of the Autoantigen Transglutaminase 2 by Efficient Catalytic Self-Multimerization

A hallmark of the gluten-driven enteropathy celiac disease is autoantibody production towards the enzyme transglutaminase 2 (TG2) that catalyzes the formation of covalent protein-protein cross-links. Activation of TG2-specific B cells likely involves gluten-specific CD4 T cells as production of the antibodies is dependent on disease-associated HLA-DQ allotypes and dietary intake of gluten. IgA plasma cells producing TG2 antibodies with few mutations are abundant in the celiac gut lesion. These plasma cells and serum antibodies to TG2 drop rapidly after initiation of a gluten-free diet, suggestive of extrafollicular responses or germinal center reactions of short duration. High antigen avidity is known to promote such responses, and is also important for breakage of self-tolerance. We here inquired whether TG2 avidity could be a feature relevant to celiac disease. Using recombinant enzyme we show by dynamic light scattering and gel electrophoresis that TG2 efficiently utilizes itself as a substrate due to conformation-dependent homotypic association, which involves the C-terminal domains of the enzyme. This leads to the formation of covalently linked TG2 multimers. The presence of exogenous substrate such as gluten peptide does not inhibit TG2 self-cross-linking, but rather results in formation of TG2-TG2-gluten complexes. The celiac disease autoantibody epitopes, clustered in the N-terminal part of TG2, are conserved in the TG2-multimers as determined by mass spectrometry and immunoprecipitation analysis. TG2 multimers are superior to TG2 monomer in activating A20 B cells transduced with TG2-specific B-cell receptor, and uptake of TG2-TG2-gluten multimers leads to efficient activation of gluten-specific T cells. Efficient catalytic self-multimerization of TG2 and generation of multivalent TG2 antigen decorated with gluten peptides suggest a mechanism by which self-reactive B cells are activated to give abundant numbers of plasma cells in celiac disease. Importantly, high avidity of the antigen could explain why TG2-specific plasma cells show signs of an extrafollicular generation pathway.     

Mathematical model of the infection process in diphtheria for determining the therapeutic dose of antitoxic anti-diphtheria serum

It is known that administration of horse serum against diphtheria toxin can cause autoimmune and allergic complications. Therefore it is important for improvement of serotherapy to develop methods of prediction of disease course and quantity of diphtheria toxin and antitoxic antibodies in a serum. We have developed the mathematical model of diphtheria infection, which consists of six differential equations describing dynamics of diphtheria toxin and antitoxic antibodies in a serum, quantity of infection agent and macrophages in a site of inflammation. This mathematical model allows to predict the course of infectious process, the level of diphtheria toxin and antitoxic antibodies in the sera of people with diphtheria and to calculate the individual therapeutic dose of antitoxic serum for each patient.     

Avidity of immunoglobulin G to rubella virus in post-vaccination and post-infection immunity

Comparative evaluation of avidity of IgG to rubella virus in vaccinated persons, in patients with rubella or other exanthematous illness, and in healthy persons revealed similar patterns in post-vaccination and post-infection immunity. Virus specific low avidity IgG (index of avidity < or =30%) were detected in patients with rubella during 7 weeks after symptoms appeared as well as in vaccinated persons which were tested 6 weeks after vaccination. Low avidity antibodies in sera were detected in 96% of patients with rubella and in 75% of vaccinated persons which were not immune before immunization. Live attenuated vaccines Ervevax, Priorix, and MMR-II had similar ability to induce low avidity IgG to rubella virus. Increase of low avidity antibodies concentration was noted after immunization of children with low levels of antibodies before vaccination. After immunization of persons with high avidity antibodies in serum, index of avidity remained above threshold. Anamnestic high avidity IgG (index of avidity 51-100%) were detected in majority of immune healthy persons (96.4%) as well as in patients with exanthematous illnesses not related to rubella infection (93.6%). ELISA test-systems for detection of low avidity IgG to rubella virus allow to obtain reliable information about seroconversion rate and characteristics of immune response in vaccines. Detection of low avidity IgG in serum obtained 5-6 weeks after immunization points to primary immune response, whereas identification of high avidity antibodies reveals already immune persons.     

Persistent or Slow Viral Infections and Related Diseases

The discovery of persistent transmissible agents by veterinarians has led to striking advances in the infectious cause of neuropathies of human beings. There is evidence for persisting infection in congenital rubella and the herpes group of viruses including cytomegalovirus infections. Hepatitis types A and B are candidates for inclusion in the category of persisting viral infections.The rubeola or measles virus is established as a persistent virus which causes elevated antibodies in the serum and cerebrospinal fluid of many patients with severe demyelinating disease such as subacute sclerosing panencephalitis and multiple sclerosis. Elevated antibodies against vaccinia virus have been found in the cerebrospinal fluid of some patients with multiple sclerosis and neuromyelitis optica, a rare form of multiple sclerosis.     

A role for nonprotective complement-fixing antibodies with low avidity for measles virus in atypical measles

In the 1960s, a formalin-inactivated measles vaccine (FIMV) predisposed recipients to atypical measles, an immune complex-mediated disease. To identify characteristics of the immune priming that leads to atypical measles, responses of monkeys to FIMV were compared with responses to live attenuated virus (LAV) and hemagglutinin (H-DNA) vaccines that do not prime for atypical measles. Antibodies induced by FIMV were transient and avidity did not mature. Antibodies induced by LAV and H-DNA vaccines were sustained and avidity matured over time. After challenge with measles virus, FIMV and H-DNA recipients developed high titers of complement-fixing antibodies. In FIMV recipients, the antibodies were of low avidity, whereas in H-DNA vaccine recipients, the antibodies were of high avidity. Neutralizing capacity in B958 cells correlated with avidity. Only FIMV recipients had immune complex deposition. Failure of FIMV to induce affinity maturation results in anamnestic production of nonprotective, complement-fixing antibodies, immune complex deposition and atypical measles.     

The role of IgM in paratyphoid immunity

The authors analyze the results of studies on the effect produced by the immunization of calves with paratyphoid vaccine on the production of agglutinins, changes in the blood serum immunoglobulin levels, and the specificity of IgM to Salmonella dublin and Salmonella typhimurium antigens. The highest level of agglutinins to paratyphoid antigens in the blood sera of the immunized calves was registered on days 14-21 after immunization, changes in the levels of different immunoglobulin classes being insignificant. The agglutination test and the enzyme immunoassay have revealed that antibodies to S. dublin anb S. typhimurium antigens belong to IgM.     

Importance of secretory antibodies in nonsusceptibility to influenza B disease and the prevention of the spread of this virus

Under the conditions of the natural outbreak of influenza B a rise in the level of antibodies in the blood serum and respiratory tract secretions has been found to occur in nonimmunized persons during this disease. Secretory antibodies, along with serum antibodies and in interaction with them, prevent the development of clinically manifest influenza. The asymptomatic form of influenza infection has been revealed: during this form of the disease the response of the body is limited to the local immunity system.     

Determination of specific immunoglobin G avidity in serodiagnosis of toxoplasmosis

A total of 37 serum samples from pregnant women were examined for the avidity of toxoplasma IgG antibodies using commercially available enzyme immunoassay (Vidas Toxo IgG Avidity, bio Merieux). Low values of the avidity index were found for 4 samples and borderline ones were found in further 3 cases. Out of 19 serum samples showing the presence of IgG and IgM toxoplasma antibodies, 13 had high avidity index, including 9 samples from women in the first trimester of pregnancy. The results of examinations in these 9 cases allowed to exclude the possibility that toxoplasma infection was acquired during gestation. It is to be concluded that determinations of antitoxoplasma IgG avidity should become routine in every pregnant woman positive in the test for specific IgM antibody.     

Reactogenicity and immunological effectiveness study of a complex paratyphoid B antigen]

Reactogenic property and immunological efficacy of the paratyphoid preparation containing a complex of O-, K- and H-antigens obtained by single-stage antigens extraction were studied in a limited group of volunteers (22 persons). The antigen gave no untoward reactions and proved to be safe when given orally in doses of 25 to 150 mg. Paratyphoid B antigen was characterized by a marked immunization activity and stimulated formation of specific paratyphoid O-, K- and H-agglutinins and antibodies of the IgA,- IgG,- and IgM-classes.     

Correlation between Dengue-Specific Neutralizing Antibodies and Serum Avidity in Primary and Secondary Dengue Virus 3 Natural Infections in Humans

Although heterotypic secondary infection with dengue virus (DENV) is associated with severe disease, the majority of secondary infections are mild or asymptomatic. The mechanisms of antibody-mediated protection are poorly understood. In 2010, 108 DENV3-positive cases were enrolled in a pediatric hospital-based study in Managua, Nicaragua, with 61 primary and 47 secondary infections. We analyzed DENV-specific neutralization titers (NT₅₀), IgM and IgG avidity, and antibody titer in serum samples collected during acute and convalescent phases and 3, 6, and 18 months post-infection. NT₅₀ titers peaked at convalescence and decreased thereafter. IgG avidity to DENV3 significantly increased between convalescent and 3-month time-points in primary DENV infections and between the acute and convalescent phase in secondary DENV infections. While avidity to DENV2, a likely previous infecting serotype, was initially higher than avidity to DENV3 in secondary DENV infections, the opposite relation was observed 3–18 months post-infection. We found significant correlations between IgM avidity and NT₅₀ in acute primary cases and between IgG avidity and NT₅₀ in secondary DENV infections. In summary, our findings indicate that IgM antibodies likely play a role in early control of DENV infections. IgG serum avidity to DENV, analyzed for the first time in longitudinal samples, switches from targeting mainly cross-reactive serotype(s) to the current infecting serotype over time. Finally, serum avidity correlates with neutralization capacity.     

2009年全国其他感染性腹泻报告病例分析

目的了解我国2009年其他感染性腹泻的流行特点和病原学信息,提出改善建议,为更好的控制其他感染性腹泻病的流行提供数据支持。方法收集中国疾病控制信息系统"疾病监测信息报告管理系统"中2009年其他感染性腹泻的病例报告,对其流行病学及病原学信息进行描述性统计分析。结果 2009年全国共报告655 965例其他感染性腹泻病例,其中≤5岁儿童分别占报告总病例的50.38%和死亡病例的70.0%。实验室确诊病例占报告病例数的5.04%,其中病毒性感染占92.79%,细菌性感染占6.92%。结论≤5岁的散居儿童应为其他感染性腹泻的重点监测人群。其他感染性腹泻报告病例中约有95%为临床诊断病例。我国其他感染性腹泻的病原学诊断率及病原学诊断结果的报告率亟待提高。