Heterophilic infectious mononucleosis antigen used in the latex diagnostic test. II. Preliminary evaluation of the usefulness of latex reagents for detection of serum heterophile antibodies in patients with infectious mononucleosis

The aim of this study was to evaluate the usefulness of laboratory made reagent of polystyrene latex coated with three preparations of mononucleosis antigen (reagent MZ-I, MZ-II, and MZ-III) for detection of heterophile antibodies in patients sera with clinical symptoms of infectious mononucleosis. These studies were carried out on 153 serum samples taken from persons suspected of being infected with EB virus and on 100 healthy controls--blood donors. The results of latex tests were compared to the results of Paul-Bunnell-Davidsohn (PBD) and hemolytic tests. Out of three latex reagents evaluated only one (reagent MZ-I) showed sensitivity equal to PBD and haemolytic tests. The sensitivity reached 91.1%. Agglutination reaction when appeared in latex test at serum dilution 1:5, is considered positive and diagnostically significant result.     

Use of heterophilic mononucleosis antigen in the latex diagnostic test. III. Diagnostic field studies

The aim of this study was to evaluate usefulness of latex coated with a preparation of heterophilic mononucleosis antigen for the detection of antibodies present during a course of infectious mononucleosis. Studies were performed in district serological laboratories. Sanitary-Epidemiological Stations in conditions of routine diagnostics. Studies were performed on 656 blood serum samples collected from individuals with a clinical suspicion of infectious mononucleosis. Latex and Paul-Bunnell-Davidsohn (PBD) tests were run in parallel. Out of 154 blood serum samples which contained antibodies detected by PBD test in diagnostically significant titer of 1:56 or higher, 151 were reactive in latex test in the dilution 1:5 or higher, while in the remaining three cases agglutination appeared with undiluted serum only. Out of 268 serum samples tested in latex test 167 reacted in 1:5 titer - diagnostically accepted as a significant or in higher titers. The sensitivity of latex test amounted to 98.1% and specificity was 96.9% as compared to reference Paul-Bunnell-Davidsohn test. The results of our study suggest the possibility of replacing Paul-Bunnell-Davidsohn test by latex test performed as a method providing the possibility of determination of the presence of heterohilic antibodies in blood serum samples and the follow up of their dynamics.     

Isolation and partial characterization of the heterophile antigen of infectious mononucleosis from bovine erythrocytes

The heterophile antigen (Paul-Bunnell antigen, PBA) of infectious mononucleosis was isolated by extraction of an aqueous suspension of bovine erythrocyte stromata with chloroform-methanol (2:1). The upper aqueous layer contained gangliosides, PBA, and a high-molecular-weight glycoprotein. PBA and gangliosides were separated from the high-molecular-weight glycoprotein by extraction of lyophilized upper layer with chloroform-methanol solvents. Separation of PBA from gangliosides was carried out by chromatography on DEAE-cellulose with chloroform-methanol solvents. PBA appeared to be a minor glycoprotein component of the erythrocyte membrane and had both hydrophobic and hydrophilic properties. It was soluble in either organic or aqueous solvents. On SDS-polyacrylamide gel electrophoresis, it migrated as a single component that stained for protein with Coomassie blue, for carbohydrate with periodic acid-Schiff reagent, and for lipid with oil red 0; it had an apparent molecular weight of 26,000. It was composed of 62% protein with major amino acids: glutamic acid, proline, glycine, isoleucine, leucine, and threonine (158, 116, 98, 90, 85, and 82 residues per 1,000 residues, respectively). Carbohydrate content was 9.2% with major sugar constituents: sialic acid, galactosamine, and galactose. Serologic activity of PBA was destroyed by pronase but not by trypsin.     

Paul-Bunnell antigen and a possible mechanism of formation of heterophile antibodies in patients with infectious mononucleosis

Sera of patients with infectious mononucleosis contain heterophile anti-Paul- Bunnell (PB) antibodies to erythrocytes of numerous mammalian species. Evidence is presented that the corresponding antigen of bovine erythrocytes is not, as previously described, a single molecule, but a series of glycoproteins with glycans terminated with N-glycolylneuraminic acid (Neu5Gc). The latter compound should be an important part of the PB epitope because, in agreement with the results of others, we found that desialylation of the PB antigen abolishes almost completely its activity. We examined three different preparations of GM3 ganglioside for their capacity to bind anti-PB and found that only GM3 from horse erythrocytes containing Neu5Gc exhibited a low although ELISA measurable PB activity. The other two GM3 preparations, from bovine milk and dog erythrocytes, containing N-acetylneuraminic acid (Neu5Ac) bound little if any anti-PB antibodies. This finding confirms a previous report that human erythrocyte Neu5Ac containing sialoglycoprotein with similar O-linked glycans as the PB-antigen of bovine erythrocytes exhibits only very low PB activity (Patarca & Fletcher, 1995, Crit Rev Oncogen., 6: 305). In conclusion, we present a hypothesis that anti-PB antibodies in patients with infectious mononucleosis are formed against infection-induced cell membrane glycoconjugates containing highly immunogenic Neu5Gc.     

Accuracy of diagnostic content of hospital activity analysis in infectious diseases.

Hospital activity analysis (HAA) was used to identify 2151 patients in whom the diagnostic code fell within the infectious disease categories of the International Classification of Disease. The clinical notes of these patients were examined by a doctor and in 414 (19.2%) the diagnostic coding was incorrect. Diarrhoea and viral infections were miscoded most often. The possibility of inaccuracy must be considered when HAA aggregated data are used for planning purposes. Accuracy could be improved if clinicians routinely completed the diagnostic sections of the HAA form.     

A statistical method for the comparison of a discrete diagnostic test with several continuous diagnostic tests.

In this paper we study a statistic that is suitable for comparing a discrete diagnostic marker to one or more continuous diagnostic markers. Test procedures and confidence intervals are based on asymptotic normality. The statistic is applicable for correlated data in which all the markers are obtained for each subject. The statistic was studied for use in comparing two markers for rectal bleeding. Examples for this application and two more general applications are presented.     

Use of the indirect hemagglutination test in the study of ornithosis. I. Hemosensitizing activity of ornithosis phosphlipid antigen and a method of performing tests with it]

A possibility was shown of using the phospholipid group-specific antigen of the ornitosis causative agent in the capacity of a hemosensitin for conducting the indirect hemagglutination test (IHAT). There was revealed a direct proportional relationship between the sensitizing activity and the complement fixing properties of the antigens obtained. A method of sorption of this antigen on the tannin-treated erythrocytes and the optimal parameters of conducting the test with it were elaborated. A sufficiently high sensitivity and specificity of the IHAT was revealed as a result of parallel titration of hetero-and homologous sera in the complement fixation test and in the IHAT. The suggested test can be successfully used for the diagnosis of ornithosis.     

Brucella abortus in coyotes. I. A serologic and bacteriologic survey in eastern Texas.

Prevalence of Brucella abortus serum antibodies in coyotes from east central Texas was determined by the buffered Brucella antigen (card test), rivanol, standard agglutination tube, and cold complement fixation tube tests. Eighteen percent (9 of 51) of the coyotes were positive serologically. B. abortus biotype 1 was isolated from various tissues from 7 of 43 coyotes by bacteriologic culture. Congenital transmission was found.