Immunoglobulin and antibody content in the blood serum, coprofiltrate and saliva of patients with Sonne dysentery]

The authors studied the immunoglobulin and specific antibodies content of various classes in the serum, coprofiltrates and the saliva of 68 patients suffering from Sonne dysentery and in 48 healthy adult persons. Mancini's test demonstrated a significant elevation of IgG and IgM content in the blood of dysentery patients in comparison with that in healthy persons, and the absence of any changes in the IgA content. The titres of specific IgG-, IgA- and IgM-antibodies in determination in the modified Coombs' test increased consideerably during dysentery infection and were found in high titres during the first week of the disease; they reached the maximum during the second week and persisted at this level for 3 weeks. The greatest antibody elevation was in the IgA-class. Antibodies revealed in the coprofiltrates and the saliva of dysentery patients belonged to IgA- and IgG-class. There proved to be a correlation of the antibody changes in these two secretions.     

Study of the immunological effectiveness of the enteral vaccination of volunteers with detergent Sonne dysentery monovaccine]

The authors evaluated the immunological results of enteral and subcutaneous injection of detergent Sonne dysentery vaccine to volunteers (changes in homo- and heterologous antibodies in the blood and saliva recorded by means of common indirect hemagglutination test and that modified according to Coombs' test, and IgG, IgM, and IgA concentration recording. Both immunization methods induced specific antibody formation: enteral vaccination caused chiefly the accumulation of secretory antibodies of IgA class, and subcutaneous -- of serum antibodies belonging to IgG class. The supposed mechanisms determining the capacity of enteral administration of the antigen to provoke an immune response different from that caused by its subcutaneous injection are discussed.     

Content of A-, G- and M-class immunoglobulins in adults perorally immunized with a liver Sonne dysentery vaccine]

The authors studied the immunological shifts in the blood and saliva of 357 adults immunized with live enteral dysentery Sonne vaccine from a spontaneous mutant according to different schemes (1, 2, 3, 4 injections at 2--3-day intervals. The general level of IgA, IgG, and IgM increased during the immunization; there was also an elevation of the specific antibodies level of these classes in the blood of the persons vaccinated. Accretion was the greatest of IgA both in the blood and in saliva of the immunized persons; this pointed to a marked, chiefly local, immunological activity of the vaccine. As shown, during the immunization the rise and the changes in the antibody level of various immunoglobulin classes differed from such in dysentery infection; in the latter case, along with the IgA-antibodies there was a marked elevation of the IgG- and IgM-antibodies level. It is supposed that there was a possibility of a changed of a 4-time immunization scheme to-3-time one, with increase of intervals between the vaccine administration.     

Immunoglobulins and antibodies of various classes in children immunized with live oral Shigella sonnei vaccine from the spontaneous mutant]

The authors determined the immunoglobulin and specific antibodies level in the blood serum of 17 children aged from 7 to 10 years during the immunization with live dysentery Some vaccine. Mancini's test demonstrated the absence of any differences in the amount of IgA and IgG in children of the given age group and in adults before the immunization; in comparison with adults, IgM was increased in children. 14 to 20 days after the immunization in children there was a significant elevation of the IgG only, whereas in adults the immunoglobulin level of all the 3 classes increased significantly. The titres of specific antibodies of the IgA-, IgG-classes and of hemagglutinins before the immunization detected by Coombs' test failed to differ in children from the titres of antibodies of these classes in adults; the level of IgM antibodies was much greater in children than in adults. The changes and accumulation of antibodies of various classes in children and adults during the enteral immunization with live dysentery vaccine differed significantly: in children the vaccine stimulated the IgA- and the IgM-antibody synthesis, whereas adults responded to the immunization by increased production of all the 3 antibody classes. On the basis of the noted immunological shifts a conclusions was drawn on a marked local immunization activity of the live enteral Sonne dysentery vaccine from the spontaneous mutant in children.     

Assessment of the diagnostic effectiveness of antigenic preparations from Sonne shigellae]

The authors studied the diagnostic possibilities of 4 diagnistic agents from Sh. sonnei. A total of 1500 from 1122 persons were investigated. Specificity and sensitivity of the diagnostic agents from Sh. sonnei were determined. Methodical priciples of the objective assessment of the diagnostic efficacy of the antigenic preparations in the controlled epidemiological trial were elaborated. A possibility of establishment of the etiological diagnosis of Sonne dysentery in the passive hemagglutination or blast agglutination tests by the results of testing with the diagnostic agents of the serum obtained from the patient once or by determining the dynamics of the antibody titre rise in coupled serum portions was not great.     

Determination of the O antigen of Shigella sonnei by a competitive immunoenzyme method

A technique for immunoenzymatic diagnosis of dysentery by Shigella sonnei O-antigen was developed. For induction of antibodies to O-antigen rabbits were immunized by intravenous administration of a commercial antidysentery vaccine. Specific antibodies to O-antigen belonging to class G immunoglobulins and not binding to O-antigens of Sh. flexneri and Salmonella typhimurium were obtained. beta-Lactamase of Bacillus licheniformis 749/c was used as a marker enzyme in the immunoenzymatic assay. To increase the sensitivity, beta-lactamase molecules were preliminarily linked with glutaric aldehyde into oligomers. Conjugates of Sh. sonnei O-antigen with the oligomers of B. licheniformis 749/c beta-lactamase were prepared with the periodate method by oxidizing O-antigen. The conjugate was used in competing solid phase immunoenzymatic assay for determination of Sh. sonnei O-antigen in blood serum of patients with dysentery. The sensitivity of the assay is 0.5-1 ng per 1 ml of O-antigen.     

Comparative information value of humoral immunity characteristics in some bacterial and viral infections

Serological examination of 144 patients with different bacterial and viral infections was carried out. Antibodies to Brucella were detected in blood serum in 42 patients (85.7%) with the average titer of 1:996 and in saliva in 41 patients (83.7%) with the average titer of 1:567 by passive hemagglutination test with brucella erythrocyte diagnosticum. Out of 26 dysentery patients, antibodies in blood serum were detected in the diagnostic titer in 17 patients (65.4%) with the average titer of 1:282 and in saliva in 21 patients (80.8%) in the titer of 1:100 and higher. Anti-HAV and anti-HBc IgM were detected in specimens of saliva from patients with serologically confirmed viral hepatitis A and B in 100% of cases. The presence of HBsAg in saliva from hepatitis B patients was established in 95.4% of cases. In blood serum and in specimens of saliva anti-HCV IgM were detected in 100% and 85.7% of cases respectively. Out of 25 women with aggravated obstetric history, IgG antibodies to CMV were detected in blood serum in 23 women (88.5%) and in saliva in 22 women (84.6%). The results of these investigations revealed that the detection rate of antibodies in blood serum and saliva in cases of infections, both bacterial (brucellosis, shigellosis) and viral (hepatitis A, B, C and CMV infection), was not essentially different. The simplicity of obtaining material for analysis make it possible to recommend the use of saliva for diagnosing bacterial and viral infections, especially in mass epidemiological surveys.     

Use of immunoenzyme analysis in the rapid diagnosis and study of the characteristics of circulating O-antigen in biological fluids of patients with acute dysentery Sonne

The data on the clinical approval of the original enzyme immunoassay system for the determination of somatic O-antigen in the blood serum and urine of patients with acute Sonne dysentery are presented. The level of the antigen determined in the biological fluids of patients has been shown to depend on the severity of the disease. Different types of dynamic curves, reflecting the level of O-antigen in the biological fluids of patients with acute Sonne dysentery and characteristic of different clinical forms of the disease, have been established.     

Reactogenicity and immunologic activity of live enteric Sonne dysentery vaccine from a spontaneous mutant]

Live dysentery Sonne vaccine from a spontaneous mutant proved to be practically areactogenic and specifically harmless in oral immunization of children aged from 7 to 13 years, in doses of from 3 to 25 milliard live microbial cells and in single and triple immunization schemes. Weak reactions of the gastro-intestinal tract were noted with the same frequency (1.7%) in children immunized with the vaccine and in children given placebo (2.2%). There proved to be a significant increase in the serum of the immunized persons of the level of specific hemagglutinins, and also of the IgA-and IgM-titers in 82% of the persons vaccinated; they persisted at a high level for 2 months. The appearance of IgA-antibodies in high titres in the persons vaccinated orally pointed to a marked local and general immunological activity of the live dysentery Sonne vaccine from the spontaneous mutant processing the capacity to survive in the intestine of children for a long time.     

Serological method of detecting the antigens of the causative agent of Sonne dysentery in lysates of the fecal inoculates from patients]

Serological method of detection of Sh. sonnei antigens in the lysates of the patients, fecal cultures is suggested and approved. In the majority of cases of the results of bacteriological and serological methods of study of the feces coincided. Data confirming the specificity of the antibody neutralization test (ANT) in Sonne dysentery are presented. In connection with detection of the screening action of the Vi-antigen of typhoid bacilli there were elaborated additional methods for verifying the specificity of the ANT results. It is recommended to keep agar plates after selection of suspicious colonies during the bacteriological test; the lysate of the microbial crop should be additionally subjected to the ANT, this considerably increasing the percentage of laboratory confirmations of dysentery caused by Sh. sonnei.     

A method for determining specific circulating immune complexes in patients with acute Sonne dysentery]

The antigen-specific method for the determination of specific immune complexes in the blood serum of patients with acute Sonne dysentery has been developed on the basis of the enzyme-linked immunosorbent assay with the use of reagents manufactured in the USSR. The possibility of the early prognostication of prolonged carrier state by using the proposed method for the determination of the level of specific circulating immune complexes has been shown.     

Immunologic properties of soluble shigella antigens]

Of the live Sh. Flexner 2a and Sonne soluble antigens containing glucide-lipoid-protein complex, characterized by low toxicity, a high yield of dry substances, and the capacity to induce immunity production in mice after subcutaneous and oral immunization, were obtained by salt extraction and physical disintegration. Local antigen application into eye mucosa of guinea pigs produced local resistance against homologous causative agents and also stimulated production of the highest level of specific antibodies at the site of administration in oral and conjunctival vaccination. A marked antigenic-immunological activity of soluble shigella antigens in local administration permits to refer them to the group of protective ones and to recommend their further study in the capacity of preparations for enteral vaccination against dysentery.     

Test of the safety, reactogeneity and immunogeneity of live Flexner 2a and Sonne dysentery vaccine from spontaneous mutants, prepared in dragee form, in a controlled experiment on adults]

Controlled experiment was conducted on 428 adult persons. A study was made of the reaktogenic properties and the immunological activity of live enteral dysentery vaccine Flexner 2a and Sonne from the spontaneous mutants developed at the N.F. Gamaleya Institute of Epidemiology and Microbiology. The vaccine is prepared in the form of sugar-coated pills covered with an acid-fast substance protecting from the gastric juice action. A single administration of the vaccine in a dose of up to 4 pills (6 to 8 X 10(9) live microbial cells) induced no general or local reactions. At the same time enteral administration of such low vaccine doses of the vaccine caused a significant accretion of specific hemagglutinins, including IgA, IgG, IgM antibodies in the serum, this pointing to the marked general and local immunological activity of the vaccine. Vaccine strains Flexner 2a and Sonne were isolated from 16 to 40% of the persons vaccinated, for the maximum period of 5 to 8 days. The isolated strains were avirulent when checked by the keratoconjuctival test.     

Data to substantiate the early immunological diagnosis of dysentery]

The interaction of the whole blood from patients with dysentery and gastrointestinal diseases of non-dysenteric etiology, with the causative agents of dysentery, Sh. sonnei and Sh. flexneri, and saprophytic, staphylococci labeled with radioactive isotopes was studied in vitro. In dysentery an increase in the capacity of the blood for Shigella fixation was observed from the beginning of the disease. During the 1st week of the disease this reaction was strictly specific and accompanied by a decrease in the fixation of staphylococci, but later the reaction became relatively specific. An increase in Shigella fixation occurred considerably earlier than immune antibody formation, as revealed by the indirect hemagglutination test. This research substantiates the possibility of an earlier immunological diagnosis of dysentery as compared with the serological methods.     

The determination in saliva of IgA antibodies to Shigella ribosomes for the diagnosis of dysentery

The levels of antiribosomal antibodies to Shigella ribosomes in serum and saliva samples from 38 dysentery patients (15 S. sonnei cases and 23 S. flexneri cases), 14 patients with salmonellosis and 136 healthy adults were determined in ELISA with ribosomes from S. sonnei R-mutant used as solid-phase antigen. High levels of "normal" antiribosomal IgA, IgG and IgM antibodies were revealed in the sera of healthy persons while the level of salivary IgA antibodies was very low. In dysentery infection no increase in the levels of serum IgG and IgM antibodies and only a slight increase in the level of IgA antibodies were revealed. Local immune response was manifested by the early (on days 2-4 from the onset of infection) and significant augmentation (12- to 16-fold) of salivary antiribosomal IgA antibodies. An increase in the level of these antibodies was registered in 95-100% of dysentery patients but not in patients with salmonellosis, which made it possible to recommend the method for diagnosing shigellosis. Immune response to Shigella ribosomal antigens, in contrast to the response induced by Shigella O-antigen, is almost exclusively local.     

Detection of lymphokines in patients' blood serum]

A factor suppressing the migration of donor leukocytes and macrophages of guinea pigs in vitro was revealed in the blood serum of patients suffering from chronic inflammatory diseases (pneumonia, rheumatism, tuberculosis) and carcinoma. A factor stimulating the leukocyte migration was sometimes revealed in the blood sera of the patients. In chromatography of the blood sera on sephadex G-100 the activity of both factors proved to localize in fractions with the mol wt of 15000--45000 dalton. Depression of stimulation of leukocyte migration could be also caused by immunoglobulin fractions (mol wt--150000 dalton) of the blood sera of patients suffering from acute pneumonia, apparently on account of the presence in them of the antigen-antibody complex; however, these sera contained no migration suppression factor. The blood serum fractions with the mol wt of 15000--45000 dalton, including those containing the migration suppression factor inhibited the inhibited the spontaneous and induced by phytohemagglutinin blast transformation lymphocytes, and the immunoglobulin ones--the latter only. Apparently the migration suppression factor of the blood serum served as the product of activated lymphocytes.     

Value of determining the spectrum of blood serum fatty acids in evaluating increasing the effectiveness of antibiotic therapy of dysentery in children with prodigiozan and ephedrine

One hundred and ninety one children with acute Sonne and Flexner dysentery were observed with respect to the disease process, immunity indices and blood serum fatty acid spectrum. 104 children were treated with monomycin alone and 87 children were treated with the antibiotic in combination with prodigiozan and ephedrine as immunostimulators. It was shown that the recovery terms in the patients treated with the use of the immunostimulators decreased as compared to the patients treated with the antibiotic alone. The fatty acid spectrum in the children treated with the use of the immunostimulators differed from that in the children treated without them by low levels of fatty acids of the C12:0 to C18:1 composition.     

Nature of the epidemic process in Sonne and Flexner dysenteries and the causes of its induction

A comparative study of the epidemic process in Sh. sonnei and Sh. flexneri dysentery in different regions of the USSR revealed that the morbidity level of Sh. sonnei dysentery changed simultaneously in the regions under study at intervals of 2-3 years. Sh. flexneri dysentery showed morbidity rises occurring at intervals 6-8 years, and their occurrence did not coincide with the periods of elevated morbidity in Sh. sonnei dysentery. The data obtained in the cohort analysis and in the study of recurrent morbidity suggest that Sh. flexneri dysentery produces more pronounced postinfection immunity than Sh. sonnei dysentery, and the immunological factor probably affects the dynamics of the epidemic of these Shigella infections.     

Diagnostic value of dengue virus-specific IgA and IgM serum antibody detection

The diagnostic value of dengue virus (DV)-specific immunoglobulin A (IgA) serum antibody detection, by an indirect immunofluorescence assay (IFA) was evaluated. For this study, the kinetics of DV-specific IgA serum antibodies was analysed in two experimentally immunised macaques, paired samples from 35 patients suspected of a primary or secondary DV infection, paired sera from patients with high levels of IgA specific antibodies against influenza virus (n = 15), sera from patients with other viral infections (n = 40) and healthy blood donors (n = 10), which served as controls. The presence of DV-specific IgA serum antibodies in humans and in monkeys was compared with that of DV-specific IgM demonstrated in a capture enzyme-linked immunosorbent assay (ELISA). The development of DV-specific IgA and IgM antibodies in macaques proved to be similar to that observed in humans with a DV infection. In sera obtained from suspected primary DV patients during the acute phase and convalescent phase, DV-specific IgA was detected in 1/6 (17%) and 6/6 (100%), whereas IgM was detected in 4/6 (67%) and 5/6 (83%), respectively. In sera from suspected secondary DV patients during the acute phase and convalescent phase, DV-specific IgA was detected in 18/29 (62%) and 28/29 (97%), whereas IgM was detected in 20/29 (69%) and 28/29 (97%), respectively. The control group consisted of five paired serum samples from yellow fever vaccinated individuals and a patient with acute tick-borne encephalitis, 15 paired serum samples from patients with high levels of IgA antibodies specific for influenza virus and 40 serum samples from patients with specific IgM antibodies against other viruses. Ten serum samples from healthy blood donors were included. Among the control serum samples, in one patient, both DV-specific IgA and IgM antibodies were present, and in three sera DV-specific IgM antibodies could be demonstrated. These data suggest that detection of DV-specific IgA serum antibodies by IFA may have additional value for the diagnosis of DV infection.     

Immunodiagnosis of Dengue Virus Infection Using Saliva

Keeping in view the complications and the case fatality associated with dengue virus, several serologic tests have been developed. However, the major drawback of these serologic tests is the need for a venous blood sample obtained by invasive venipuncture. As a noninvasive alternative, saliva provides a body fluid that contains antibodies of diagnostic importance. Hence, the detection of DEN-specific IgM and IgG antibodies in serum and saliva from 80 patients was compared. Salivary IgM antibodies were detected in 100% of the serum IgM-positive samples and in 30% of the serum samples that were negative for IgM antibodies. Salivary IgG antibodies were detected in 93.3% of the serum samples that were positive for anti-dengue IgG antibodies and in none of the serum IgG-negative cases. None of the specimens from the healthy controls showed the presence of IgM or IgG antibodies. The detection of both IgG and IgM antibodies in saliva correlated well with the serum IgG and IgM detection by the ELISA test (r = 0.6322 and r = 0.4227). Detection of salivary IgM antibodies by ELISA showed 100% sensitivity, 70% specificity, 90.9% positive predictive value, and 100% negative predictive value. The detection of IgG in saliva proved to be a promising tool as the sensitivity, specificity, positive predictive value, and negative predictive value were found out to be 93.3%, 100%, 100%, and 83.3%, respectively. Thus, from this study we conclude that the detection of DEN-specific salivary IgG and IgM antibodies are useful markers for dengue infection.