Improvement of serological diagnosis of human cytomegalovirus infection in renal transplant recipients by testing for specific immunoglobulin E by ELISA

Abstract

The kinetics of human cytomegalovirus (HCMV)-specific immunoglobulin E (IgE), M (IgM), A (IgA) and G (IgG) were studied in 421 sera obtained from 19 renal allograft recipients by enzyme-linked immunosorbent assay (ELISA). Cytomegalic inclusion disease (CID) occurred in 11 (57.9%) patients. HCMV infection was diagnosed in all (100%) of these patients by testing for specific IgE. In contrast, increased levels of IgM and IgA class antibody against HCMV were detected in only 45.5% and 18.2% patients suffering from primary or recurrent HCMV infection, respectively. Concerning the time interval between the onset of clinical symptoms and the first positive test, no significant differences in the kinetics of HCMV-specific immunoglobulins E, M, A and G were observed. Elevated specific IgE levels persisted for longer time intervals than the other immunoglobulin classes. As shown by the present study, specific IgE proved to be a more reliable serologic marker than IgM and IgA for the serologic detection of HCMV infection in renal allograft recipients.

Diagnosis of Human Immunodeficiency Virus Infection Using an Immunoglobulin E-Based Assay

“…Nonreactivity against the control conjugate and depleted IgG samples during our study suggest nonspecific reactions with the IgE assay and non-cross-reactivity with IgG antibodies. This is consistent with studies based on IgE antibodies for the diagnosis of cytomegalovirus infection (15,22,26). The plates used in this assay contained both HIV-1 and HIV-2 peptides.…”

“…The IgE response is rapid and reaches a peak earlier than the IgG antibodies, suggesting that an IgE-based assay may detect seroconversion earlier than the conventional method. The high sensitivity of the IgE assay is in accord with other reports showing that immunoassays based on IgE antibodies directed to infectious agents are at least as specific and sensitive as those based on other immunoglobulin antibody responses (1,14,15,16,18,22,26). Of particular advantage to laboratories in developing countries, the IgE test can be rapidly performed without complex laboratory equipment and can be run at room temperature, and the same technology may be used for both children and adults (14).…”

“…The reactivity of specific IgE antibodies, expressed as absorbance in our study, was greater than the specific IgG response in approximately 70% of the positive sera from HIV-1-infected individuals. The higher specific reactivity in the IgE assay may be due to background differences in the assays, as well as a larger increase in total IgE (3-fold) than in total IgG (1.4-fold) antibodies (13,22,26), probably reflecting higher amounts of specific antibodies. Nonreactivity against the control conjugate and depleted IgG samples during our study suggest nonspecific reactions with the IgE assay and non-cross-reactivity with IgG antibodies.…”

“…The potential advantage of an IgE antibody test in HIV disease is supported by previous findings demonstrating specific IgE directed to infectious agents. Certain viral infections are known to produce specific IgE antibodies, to the extent that significant changes in the level of total serum IgE may occur (1,14,15,16,18,20,21,22,26). Of importance, during the early stages of HIV-1 disease a significant elevation of total IgE has been reported in children (7,24,25).…”

Serologische Diagnose der Cytomegalievirus-Infektion: Evaluierung von drei Enzymimmunoassays zum Nachweis von HCMV-spezifischen IgM-Antikörpern in Serumproben von immunkompetenten und immunsupprimierten Patienten

“…Über den zusätzlichen Nachweis von HCMV-spezifischem IgA konnte in früheren Studien die serologische Diagnostik der Cytomegalie bestimmter Risikoprobanden (speziell AIDS-Patienten) verbessert werden [19,22]. Zur Zeit werden neuere Test verfahren entwickelt, welche auf der cc-capture-Technik beruhen.…”