A simple diagnostic test for Fanconi anemia by flow cytometry

A simple diagnostic test for Fanconi anemia (FA) by flow cytometry is proposed. It is based on the cell cycle disturbances of FA cells and their sensitisation by alkylating agents. Following PHA-stimulation of whole blood cell cultures in the presence or absence of nitrogen mustard, the accumulation of cells in G2/M phase was measured. A sharp increase of cells in G2/M was observed in cultures from FA patients when nitrogen mustard was added. This increase allows one to distinguish FA patients from patients with anemias of other origin, healthy controls, and FA heterozygotes, as effectively as chromosome breakage studies. The rapidity of the test and its reliability as demonstrated on the ten FA patients studied, will make the diagnosis of FA easier in centers without cytogenetic laboratory facilities.     

Analysis of the antigenic and immunogenic properties of protein M of the influenza virus by an immunoenzyme method

A test system permitting the detection of influenza virus protein M at a concentration of 0.1-0.5 ng/ml in ELISA has been developed. The use of this system made it possible to detect influenza viruses A and B directly in crude virus-containing material and clinical samples obtained from influenza patients. During the outbreak of influenza in the spring of 1983 ELISA was successfully used for the rapid diagnosis of influenza, and some of its advantages in comparison with the conventional immunofluorescence test were thus demonstrated. To overcome difficulties arising from the low immunogenic potency of protein M, in the process of obtaining diagnostic sera and ascitic fluids the animals were immunized with the conjugate of protein M and polyelectrolite, which ensured considerable activation of humoral immune response.     

Use of the indirect hemagglutination reaction in studying ornithosis infection. III. The diagnostic value of the IHR with an ornithosis erythocytic diagnosticum]

In both experimental and clinical conditions the passive hemagglutination test (PHAT with the use of an ornithosis erythrocytic diagnostic preparation was found to be sufficiently sensitive and specific as compared with the complement fixation test (CFT), a routine testing method. The study of the dynamics of immune response in infected animals and ornithosis patients allowed to regard the PHAT as a comparatively early method of serological analysis. Hemagglutinins were also found to circulate in the patients' blood sera only for a short time (on the average for 1 1/2--2 months). The CFT and the PHAT with erythrocytic diagnostic preparation, used in combination, will make it possible not only to diagnose ornithosis in patient more effectively, but also to differentiate between the cases of infection and anamnestic reaction.20     

The opsonizing activity of the sera of hamadryas baboons immunized with a preparation of the outer membranes of Francisella tularensis (based on data from the luminol-dependent luminescence method)]

The opsonizing properties of sera obtained from hamadryas baboons immunized with the preparation of F. tularensis outer membranes (OM) were studied with the use of luminol-dependent chemiluminescence (CL) of whole blood. The immunization of monkeys with the OM preparation was shown to lead to the formation of functionally active antibodies possessing opsonizing properties with respect to virulent F. tularensis. Immune sera obtained from the animals immunized with live vaccine and from those immunized with OM preparation had no essential differences in their opsonizing properties. The level of IgG antibodies in immune sera correlated with the CL parameters of whole blood in the presence of F. tularensis opsonized with these sera. Increased CL of phagocytes observed after addition of bacteria and immune sera under test to whole blood taken from a nonimmune donor made it possible to evaluate the functional activity of antibodies, thus permitting its use as a test for the evaluation of the effectiveness of new vaccine preparations.     

Differentiation of Fanconi anemia and aplastic anemia using mitomycin C test in Tunisia

Fanconi anemia (FA) is a recessive chromosomal instability syndrome that is clinically characterized by multiple symptoms. Chromosome breakage hypersensitivity to alkylating agents is the gold standard test for FA diagnosis. In this study, we provide a detailed laboratory protocol for accurate assessment of FA diagnosis based on mitomycin C (MMC) test. Induced chromosomal breakage study was successful in 171 out of 205 aplastic anemia (AA) patients. According to the sensitivity of MMC at 50 ng/ml, 38 patients (22.22%) were diagnosed as affected and 132 patients (77.17%) as unaffected. Somatic mosaicism was suspected in an 11-year-old patient with a FA phenotype. Twenty-six siblings of FA patients were also evaluated and five of them (19.23%) were diagnosed as FA. From this study, a standard protocol for diagnosis of FA was developed. It is routinely used as a diagnostic test of FA in Tunisia.     

Is there a role for antibody testing in the diagnosis of invasive candidiasis?

During the last decades, the use of antibody tests for the diagnosis of invasive mycoses has declined as a consequence of the general belief that they are insensitive and non-specific. However, there is a clear evidence that antibodies can be detected in highly immunodeficient patients (such as bone marrow transplant recipients), and that those antibodies are useful for the diagnosis. Antibody tests are currently in use as diagnostic tools for some primary mycoses, such as the endemic mycoses, aspergilloma, allergic bronchopulmonary aspergilosis and sporothrichosis. For invasive candidiasis, diagnostic methods must differentiate Candida colonization of mucous membranes or superficial infection from tissue invasion by this microorganism. Substantial progress has been made in diagnosis of invasive candidiasis with the development of a variety of methods for the detection of antibodies and antigens. However, no single test has found widespread clinical use and there is a consensus that diagnosis based on a single specimen lacks sensitivity. It is necessary to test sequential samples taken while the patient is at greatest risk for developing invasive candidiasis to optimize the diagnosis. Results obtained from a panel of diagnostic tests in association with clinical aspects will likely be the most useful strategy for early diagnosis and therapy.     

The role of the World Health Organization in the study of influenza

The World Health Organization (W.H.O.), since its inception in 1947, has given close attention to influenza. In its early years W.H.O. laid the foundations of its present network of over 100 national influenza centres and collaborating laboratories which today constitute the backbone of its influenza activities. The activities of the network include the isolation and characterization of influenza strains and the early notification of any changes in surface antigens, the preparation of reference reagents, standardization of diagnostic procedures, formulation of requirements for vaccines, training, and collaboration in research. The efficacy of the network has been proved in the 1957, 1968 and 1977 epidemics. Collaborative research organized by W.H.O. has made important contributions to our understanding of the epidemiology of influenza, including the possible role of lower animals as the origin of some pandemic strains. The latter subject is briefly discussed.     

Preparation of diagnostic antitoxic serum to Clostridium difficile

The results of the studies on the preparation of diagnostic antitoxic sera to C. difficile, intended for use in biological assays with the aim of the laboratory diagnosis of clostridial enteric infections, are presented. The conditions for the detoxification of C. difficile native toxin have been established, the optimum schedules for the immunization of rabbits have been selected and specific antitoxic sera to C. difficile have been obtained. The neutralizing activity of these sera has been evaluated in the lethality test and in the cytotoxic test on human embryo dermo-muscular fibroblast cells M-19.     

Diagnostic Utility of DNA from Aspergillus in Whole Blood Specimens

For several years, PCR-based detection of Aspergillus DNA has been considered a promising tool for the diagnosis of invasive aspergillosis, but its broader implementation has been hampered by a lack of standardization and the uncertain diagnostic accuracy of the wide variety of published protocols. Recently, new attempts have been made to address this problem and define a quality standard for diagnostic Aspergillus PCR. This review summarizes technical aspects of up-to-date protocols, focusing on the recently proposed guidelines of the European Aspergillus PCR Initiative (EAPCRI) for whole blood PCR testing.     

SPan-1 and exocrine pancreatic carcinoma. The clinical role of a new tumor marker

AIMS OF THE STUDY: Considerable progress has been made in imaging techniques over the past few years, yet this has not resulted in the ability to reach an earlier diagnosis of exocrine pancreatic cancer. The search for a noninvasive diagnostic tool capable of early diagnosis has led to the development of a series of serum tumor markers. This article discusses the clinical evaluation of SPan-1 and its comparison with established markers such as CA 19.9, CEA, TPA and CA 242. METHODS: The markers were measured in preoperative serum samples collected from 46 patients who had undergone surgery for ductal carcinoma of the pancreas, 20 patients with chronic pancreatitis, and 23 patients with other digestive neoplasms. RESULTS: The sensitivity, specificity and diagnostic accuracy for pancreatic cancer were as follows: [table: see text] CONCLUSIONS: The antigenic determinant SPan-1, recognized by monoclonal antibodies, is elevated in sera of patients with exocrine pancreatic cancer. SPan-1 may be considered as an additional useful and reliable serum marker for the detection of this neoplasm, but it does not significantly improve the diagnostic accuracy obtained with CA 19.9.     

Diagnosis of California (La Crosse) Encephalitis by Precipitin Techniques: a Prospective Study

Counterelectrophoresis (CEP) and immunodiffusion (ID) were evaluated prospectively as methods for the early and rapid laboratory diagnosis of California encephalitis (CE). CEP and ID studies were done on paired sera from 127 patients with acute central nervous system infections. After the precipitin tests were completed, conventional hemagglutination-inhibition, neutralizing, and complement fixing antibody titers were measured. The CEP system detected antibodies in 7 (41%) of 17 CE patients during their acute illness and in all 17 patients during convalescence. The ID method was less sensitive; 3 of 17 acute sera and 16 of 17 convalescent sera were ID positive. Comparative precipitin studies indicated that La Crosse virus was the infecting California group subtype in all 17 CE patients. Because CEP can be performed in 1.5 h, is at least as sensitive as hemagglutination-inhibition, neutralizing, and complement fixing tests, and can detect prospectively 41% of CE patients during their acute illness, it is recommended as a rapid diagnostic test for CE.     

PCR结合反向斑点杂交法检测侵袭性曲霉感染的初步实验研究

目的评价PCR结合反向斑点杂交法检测动物模型和临床免疫抑制患者的侵袭性曲霉感染的可行性。方法建立侵袭性曲霉感染动物模型,收集动物血清和健康人群、免疫抑制患者的血清,进行PCR-种特异性探针检测。以1对真菌特有的28S rRNA保守序列结构作为真菌通用引物,以临床常见的4个曲霉菌种,即烟曲霉、黄曲霉、黑曲霉、土曲霉的种特异性序列为种特异性探针,与扩增产物进行反向斑点杂交。结果PCR-探针杂交检测动物接种后24h时阳性血清为16/24,48h为18/24,72h为19/24,96h为24/24。阳性率为80%,特异性为95.8%。同时取血行真菌培养,烟曲霉阳性率仅为5%。临床标本显示两例确诊IA患者血清均为阳性,且能鉴定菌种。健康对照人群标本检测显,阴性38例,假阳性2例。结论PCR-探针杂交法较传统血培养法能更快速、灵敏地检测动物模型的侵袭性曲霉感染,并可用于对IA高危患者的监测。     

Evaluation of concentration and storage effects of mitomycin C in the diagnosis of Fanconi anemia among idiopatic aplastic anemia patients

BACKGROUND:

Fanconi anemia (FA) is a rare autosomal recessive genetic disorder that shows an increased sensitivity to the intercalating agents such as mytomycin C (MMC), measured as chromosomal aberrations. This study was conducted to differentiate between FA and “idiopathic” aplastic anemia on the basis of induced chromosomal breakage study with MMC.

MATERIALS AND METHODS:

MMC stress tests in different final concentrations of 20 and 50 ng/ml of MMC were conducted on peripheral blood lymphocytes from 32 patients with aplastic anemia and 13 healthy controls. Fifty nanograms per milliliter of MMC from old, fresh and frozen stocks was used to check the sensitivity of diagnosis on FA-diagnosed patients. Statistical analysis was used for the assessment of aberrations, including chromatid and chromosome breaks and exchanges.

RESULTS:

Eight patients (25%) with a very high percentage of chromosomal breakage were diagnosed as FA on the basis of the chromosomal breakage study. Six of these patients exhibited congenital anomalies at presentation, while another two lacked such anomalies or had minor physical problems. Freshly made MMC has shown more sensitivity to detect FA patients compared with frozen or 1-week-old MMC stock.

CONCLUSIONS:

The study indicates that freshly made MMC stress test provides an unequivocal means of differentiation between FA and “idiopathic” aplastic anemia. Further, the study, the first of its kind from Iran, stresses on the need for conducting this test in all aplastic anemia cases, even those without congenital anomalies, for accurate and timely diagnosis of FA to implement appropriate therapy.     

Use of Trypsin-Modified Human Erythrocytes in Rubella Hemagglutination-Inhibition Testing

A method of treating human erythrocytes with trypsin has been modified and found to be an efficient and practical indicator system for the rubella hemagglutination-inhibition test. Both the trypsin-treated human cells and the widely used, newborn chicken erythrocytes were used in comparative testing of 464 selected diagnostic rubella serums. Results with each cell system were essentially the same. The trypsin treatment procedure has been found to be relatively simple, and with our limited testing has not presented any problems with reproducibility. Other advantages include the ready availability of human cells, greater intralaboratory standardization of the test by using the same donors over a long period of time, and elimination of adsorption of test sera with red blood cells.     

Synthetic Peptides Mimic gp75 from Paracoccidioides brasiliensis in the Diagnosis of Paracoccidioidomycosis

Paracoccidioidomycosis (PCM) is a systemic granulomatous disease, endemic in Latin America, caused by the thermal dimorphic fungus Paracoccidioides brasiliensis. Although some fungal antigens have already been characterized and used for serological diagnosis, cross-reactions have been frequently observed. Thus, the examination of fungal forms in clinical specimens or isolation of P. brasiliensis by culture is still the most frequent method for the diagnosis of this mycosis. In this study, a random peptide phage display library was used to select mimotopes of P. brasiliensis, which were employed as antigens in an indirect enzyme-linked immunosorbent assay. The protective monoclonal antibody against experimental PCM (anti-gp75) was used as molecular target to screen a phage display library. That approach led to a synthetic peptide named P2, which was synthesized and tested against PCM patients' sera to check whether it was recognized. There was significant recognition of P2 by sera of untreated PCM patients when compared with normal human sera. Sera from treated PCM group, patients with other mycosis or co-infected with HIV had much lower recognition of P2 than untreated patient group. The test showed a sensitivity of 100 and 94.59% of specificity in relation to human sera control. These data indicate a potential use of P2 as diagnostic tool in PCM. Its application for serological diagnosis of PCM may contribute to the development and standardization of simpler, faster and highly reproducible immunodiagnostic tests at low cost.     

Use of the specific rosette formation test in tick-borne encephalitis for the purpose of laboratory diagnosis

In the study of blood samples collected from patients with tick-borne encephalitis, the modified antigen-specific rosette formation test with erythrocytes, loaded with tick-borne encephalitis virus antigen via the specific immunoglobulin, has been used. The number of rosette-forming cells has been the highest during the acute period of the disease. The use of this test has confirmed the clinical diagnosis of the disease, together with hemagglutination inhibition serving as the main diagnostic test, in 35% of cases. The results of this study make it possible to recommend the antigen-specific rosette formation test for the early diagnosis of tick-borne encephalitis.     

Evaluation of serological assays based on a novel excreted antigen preparation for the diagnosis of Cutaneous Leishmaniasis in Panama

The objective of the present study was to determine the efficacy of prototype diagnostic serological assays for American Cutaneous Leishmaniasis (ACL) in Panama. As such, we prospectively sampled 100 cutaneous leishmaniasis case-patients and tested their sera in two serological assays based upon novel soluble antigen preparations made from propagating the parasites in a protein-free, serum free media. Using serum and a Leishmania mexicana antigen preparation to sensitize plates, the assay correctly identified 89% of the case-patients. While using serum with an antigen preparation from Leishmania braziliensis, the assay correctly identified 71% of the patients. Concerning both test formats, performance was near equal in true positive and presumptive positive subsets demonstrating the improved sensitivity of these assays over reference methods of choice. Since the incidence of leishmaniasis in Panama has increased dramatically in the past 10 years, these assays may be useful in clinical and epidemiological studies and control programs.     

Serological diagnosis of autoimmune bullous skin diseases: Prospective comparison of the BIOCHIP mosaic-based indirect immunofluorescence technique with the conventional multi-step single test strategy

ABSTRACT: BACKGROUND: Various antigen-specific immunoassays are available for the serological diagnosis of autoimmune bullous diseases. However, a spectrum of different tissue-based and monovalent antigen-specific assays is required to establish the diagnosis. BIOCHIP mosaics consisting of different antigen substrates allow polyvalent immunofluorescence (IF) tests and provide antibody profiles in a single incubation. METHODS: Slides for indirect IF were prepared, containing BIOCHIPS with the following test substrates in each reaction field: monkey esophagus, primate salt-split skin, antigen dots of tetrameric BP180-NC16A as well as desmoglein 1-, desmoglein 3-, and BP230gC-expressing human HEK293 cells. This BIOCHIP mosaic was probed using a large panel of sera from patients with pemphigus vulgaris (PV, n equals 65), pemphigus foliaceus (PF, n equals 50), bullous pemphigoid (BP, n equals 42), and non-inflammatory skin diseases (n equals 97) as well as from healthy blood donors (n equals 100). Furthermore, to evaluate the usability in routine diagnostics, 454 consecutive sera from patients with suspected immunobullous disorders were prospectively analyzed in parallel using a) the IF BIOCHIP mosaic and b) a panel of single antibody assays as commonly used by specialized centers. RESULTS: Using the BIOCHIP mosaic, sensitivities of the desmoglein 1-, desmoglein 3-, and NC16A-specific substrates were 90 percent, 98.5 percent and 100 percent, respectively. BP230 was recognized by 54 percent of the BP sera. Specificities ranged from 98.2 percent to 100 percent for all substrates. In the prospective study, a high agreement was found between the results obtained by the BIOCHIP mosaic and the single test panel for the diagnosis of BP, PV, PF, and sera without serum autoantibodies (Cohen's kappa between 0.88 and 0.97). CONCLUSIONS: The BIOCHIP mosaic contains sensitive and specific substrates for the indirect IF diagnosis of BP, PF, and PV. Its diagnostic accuracy is comparable with the conventional multi-step approach. The highly standardized and practical BIOCHIP mosaic will facilitate the serological diagnosis of autoimmune blistering diseases.     

Serologic diagnosis of intestinal yersiniosis. The design of a stable erythrocyte preparation for the indirect hemagglutination reaction

Nine types of erythrocyte diagnostica of serovars O3 and O9, differing in the methods of obtaining sensitins and the physical state of erythrocytes, were put on trial. The preparations were used for the titration of hyperimmune sera and blood sera obtained from about 500 healthy persons, 300 patients with Yersinia enteric infection and 300 patients with other diseases. Freeze-dried diagnostica, when compared with liquid ones, were found to be less sensitive, but more stable and specific. Sensitins isolated by the methods of Westphal ad Boivin showed the highest degree of specificity. The authors believe freeze-dried sheep red blood with activated Boivin's antigen adsorbed onto them to be the optimal preparation for use in the passive hemagglutination (PHA) test. The preparation was found to retain its serological activity for as long as 2-3 years. The titer 1:160 (1:200) in the PHA test is recommended as the minimal diagnostic indicator. Erythrocyte diagnosticum is more sensitive, specific and stable than bacterial one. Since 1984 dried Yersinia erythrocyte diagnostica (serovars O3 and O9) have gone into quantity production at the Leningrad Research Institute for Vaccines and Sera.     

The rapid diagnosis of salmonellosis by a determination of the antigen in the biosubstrates of patients using the coagglutination reaction]

The diagnostic potential of the coagglutination test was checked with the aim of improving the laboratory diagnosis of Salmonella infections by the detection of Salmonella specific antigen in different biological materials (feces, urine, saliva and immune complexes in blood sera). The study of all specimens resulted in the confirmation of the diagnosis in 78% of patients, often during the first days of the disease. The proportion of nonspecific reactions, as shown in the control groups of healthy donors and patients with dysentery and other acute enteric infections, did not exceed 5%.