Development of a New Cytomegalovirus (CMV) Immunoglobulin M (IgM) Immunoblot for Detection of CMV-Specific IgM

Lazzarotto, Tiziana; Ripalti, Alessandro; Bergamini, Giovanna; Battista, M. C.; Spezzacatena, P.; Campanini, Fabio; Pradelli, P.; Varani, Stefania; Gabrielli, Liliana; Maine, Gregory T.; Landini, Maria Paola

doi:10.1128/jcm.36.11.3337-3341.1998

Cited by 52 publications

(25 citation statements)

References 34 publications

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“…Moreover, serum IgM from women who transmit CMV infection reacts with a higher number of antigen bands than serum IgM from women who do not transmit the infection, probably because transmitting women have a higher viral load. (p <0.0001) [23].…”

Section: Serological Findingsmentioning

confidence: 87%

Update on the prevention, diagnosis and management of cytomegalovirus infection during pregnancy

Lazzarotto¹,

Guerra

Gabrielli³

et al. 2011

Clinical Microbiology and Infection

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150

103

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Human cytomegalovirus (CMV) is the leading cause of congenital infection, with morbidity and mortality at birth and sequelae. Each year approximately 1-7% (Rev Med Virol 2010; 20: 311) of pregnant women acquire a primary CMV infection. Of these, about 30-40% transmit infection to their fetuses. The risk of serious fetal injury is greatest when maternal infection develops in the first trimester or early in the second trimester. Between 10 and 15% of congenitally infected infants are acutely symptomatic at birth and most of the survivors have serious long-term complications. Until a few years ago, laboratory testing was not possible to precisely define the maternal immune status, the recent development of advanced serological tests (IgG avidity test, IgM immunoblot and neutralizing antibody testing) allow us to identify, among pregnant women with suspected CMV, those with primary infection who are therefore at high risk of transmitting CMV to the fetus. This is done with the use of a screening test. As most maternal infections are asymptomatic, the only way to disclose primary infection is to implement specific serological testing as early in pregnancy as possible (before week 12-16 of gestation). Given the high risk of mother-fetus transmission and fetal damage, prenatal diagnosis is recommended to women with primary CMV infection contracted in the first half of pregnancy and in case of fetal abnormalities suggestive of infection. The correct interpretation of serological and virological tests followed by appropriate counselling by an expert physician is an effective tool to reduce the number of unnecessary pregnancy terminations by over 70%.

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Section: Serological Findingsmentioning

confidence: 87%

Update on the prevention, diagnosis and management of cytomegalovirus infection during pregnancy

Lazzarotto¹,

Guerra

Gabrielli³

et al. 2011

Clinical Microbiology and Infection

Self Cite

150

103

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show abstract

“…(ii) Selected positive specimens. Specimens from pregnant women and heart transplant recipients (n ϭ 73) positive for CMV IgM antibody as determined with the Enzygnost anti-HCMV/IgM kit (Behring AG, Marburg, Germany) or by the CMV IgM immunoblot assay (16,17) were used to evaluate assay sensitivity. Due to the low natural prevalence of CMV IgM antibody in the general population, it was necessary to run selected positive specimens.…”

Section: Methodsmentioning

confidence: 99%

Development and Clinical Evaluation of a Recombinant-Antigen-Based Cytomegalovirus Immunoglobulin M Automated Immunoassay Using the Abbott AxSYM Analyzer

Maine¹,

Stricker²,

Schüler³

et al. 2000

J Clin Microbiol

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A new microparticle enzyme immunoassay (MEIA), the Cytomegalovirus (CMV) Immunoglobulin M (IgM) test, was developed on the Abbott AxSYM analyzer. This test uses recombinant CMV antigens derived from portions of four structural and nonstructural proteins of CMV: pUL32 (pp150), pUL44 (pp52), pUL83 (pp65), and pUL80a (pp38). A total of 1,608 specimens from random volunteer blood donors (n = 300), pregnant women (n = 1,118), transplant recipients (n = 6), and patients with various clinical conditions and disease states (n = 184) were tested during development and evaluation of this new assay. In a preliminary clinical evaluation we tested specimens collected prospectively from pregnant women (n = 799) and selected CMV IgM-positive archived specimens from pregnant women (n = 39). The results from the new CMV IgM immunoassay were compared to the results of a consensus interpretation of the results obtained with three commercial CMV IgM immunoassays. The results for specimens with discordant results were resolved by a CMV IgM immunoblot assay. The relative sensitivity, specificity, and agreement for the AxSYM CMV IgM assay were 94.29, 96.28, and 96.19%, respectively, and the resolved sensitivity, specificity, and agreement were 95.83, 97.47, and 97.37%, respectively. We also tested serial specimens from women who experienced seroconversion or a recent CMV infection during gestation (n = 17) and potentially cross-reactive specimens negative for CMV IgM antibody by the consensus tests (n = 184). The AxSYM CMV IgM assay was very sensitive for the detection of CMV IgM during primary CMV infection, as shown by the detection of CMV IgM at the same time as or just prior to the detection of CMV IgG. Specimens from individuals with lupus (n = 16) or parvovirus B19 infection (n = 6) or specimens containing hyper IgM (n = 9), hyper IgG (n = 8), or rheumatoid factor (n = 55) did not cross-react with the AxSYM assay. One specimen each from individuals infected with Epstein-Barr virus (n = 26), measles virus (n = 10), herpes simplex virus (n = 12), or varicella-zoster virus (n = 13) infection, one specimen from an influenza vaccinee (n = 14), and one specimen containing antinuclear antibody cross-reacted with the assay. The overall rate of cross-reactivity of the specimens with the assay was 3.3% (6 of 184). The AxSYM CMV IgM assay is a sensitive and specific assay for the detection of CMV-specific IgM.

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“…Anti-CMV IgM was detected using an immunoblot described in detail elsewhere [Lazzarotto et al, 1998], that contains 4 native viral proteins (vp150, vp82, vp65, and vp28) in the upper section and four recombinant proteins (rp150, rp52, rp130, and rp38) in the lower section. Serum samples were diluted 1:100 in TBS and incubated with the strips.…”

Section: Serological Assaysmentioning

confidence: 99%

Laboratory signs of acute or recent cytomegalovirus infection are common in cirrhosis of the liver

et al. 2000

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Human cytomegalovirus (CMV) is an ubiquitous pathogen that can cause severe and often fatal infections in immunocompromised patients. Patients with cirrhosis often show various degrees of impaired cellular immunity that could lead to acute CMV reactivation. The aim of the present study was to determine whether laboratory findings of active CMV infections are common in patients with cirrhosis. Fifty-five patients with cirrhosis were studied for acute CMV infection by virological (antigenemia and quantitative polymerase chain reaction in polymorphonuclear leukocytes) and serological (detection of anti-CMV IgM by immunoblot) methods. The same tests were carried out on 50 blood donors and on 20 chronic hepatitis patients, considered as control populations. Acute or recent CMV infection had occurred in 31 (56%) of 55 patients with cirrhosis, whereas only 1 out of 20 (5%) patients with chronic non-cirrhotic liver disease and none of the 50 blood donors had laboratory signs of active CMV infection. The difference between patients with cirrhosis and the control groups was significant (P < 0.001, chi(2) test). CMV in patients with cirrhosis was not related to age, gender, hepatitis C virus infection or hepatocellular carcinoma. There was no significant correlation between impairment of liver function and the presence of active CMV infection. Patients with cirrhosis should be considered at risk for CMV infection, that seems to be mild and asymptomatic.

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Development of a New Cytomegalovirus (CMV) Immunoglobulin M (IgM) Immunoblot for Detection of CMV-Specific IgM

Cited by 52 publications

References 34 publications

Update on the prevention, diagnosis and management of cytomegalovirus infection during pregnancy

Update on the prevention, diagnosis and management of cytomegalovirus infection during pregnancy

Development and Clinical Evaluation of a Recombinant-Antigen-Based Cytomegalovirus Immunoglobulin M Automated Immunoassay Using the Abbott AxSYM Analyzer

Laboratory signs of acute or recent cytomegalovirus infection are common in cirrhosis of the liver

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