Kinetics of specific immunoglobulins M, E, A, and G in congenital, primary, and secondary cytomegalovirus infection studied by antibody-capture enzyme-linked immunosorbent assay

Abstract

Antibody-capture enzyme-linked immunosorbent assay (ELISA) using enzyme-labeled cytomegalovirus (CMV) nuclear antigen is a reliable and easily performed test suitable for routine use. As the serologic response to CMV infection may, however, vary considerably among patients, we have studied the kinetics of CMV-specific immunoglobulin M (IgM), IgE, IgA, and IgG antibodies in 352 sera from 61 patients by using antibody-capture ELISA and complement fixation (CF) tests. In a CMV mononucleosis group (n = 17), most patients had antibodies of all four immunoglobulin classes, but antibody levels decreased rapidly, with half the patients having a borderline-positive or a negative reaction for all classes, except IgG, 2 months after the appearance of symptoms. Twelve patients with a primary CMV infection after renal or bone marrow transplantation also developed all immunoglobulin-class antibodies. In only two patients did CMV IgM and IgE antibodies precede seroconversion of CF antibodies, and in one patient, these antibodies lagged months behind. Most patients had all classes of CMV antibodies, except IgA, for a year or more. Among 10 transplant patients with a secondary CMV infection, 50% had long-lasting IgM antibodies, and very few had IgE or IgA antibodies, but all had IgG antibodies to CMV. In 13 infected infants, the CMV-specific serologic response was also characterized by long-lasting IgM, IgE, and IgG antibodies. Two patients did not develop detectable IgM antibodies, and one of these did not show IgE antibodies either. The IgA response in infants as a whole was * Corresponding author.

A novel Western blot test containing both viral and recombinant proteins for anticytomegalovirus immunoglobulin M detection

“…For this reason we decided to assign a positive result exclusively to a serum sample with reactivity to at least one band in the recombinant section of the blot and at least one band in the viral section of the blot. By using this algorithm, 1% of sera from blood donors appear to have HCMVspecific IgM, as detected by the newWB, which is consistent with the normal rate of infection in healthy adults (18,19). Furthermore, 100% of the IgM-positive sera were shown to be positive by newWB, indicating a very high sensitivity of the novel test.…”

“…Human cytomegalovirus (HCMV)-specific immunoglobulin M (IgM) is a sensitive and specific indicator of primary HCMV infection in immunocompetent subjects and is often produced during active viral reactivation in immunocompromised patients (1,4,17,19,24). Serum IgM to HCMV can be detected by a variety of different procedures, but its detection has been hampered by several technical problems causing interassay variability.…”

Immunoglobulin A-specific serodiagnosis of acute human cytomegalovirus infection by using recombinant viral antigens

“…These reports emphasize the general importance of IgA serodiagnosis for the identification of acute primary and secondary HCMV infection. One of the preceding studies has reported a poor sensitivity of IgA-specific serodiagnosis in neonates with congenital or acquired HCMV infection (7). These findings are confirmed Immunocompetent individuals with HCMV infections c (10) 9 9 9 2 6 2 5 5 6 6…”

“…Several preceding studies have investigated the IgA-specific immune response against cell culture-derived antigens in different stages of HCMV infection (1,3,(7)(8)(9). These reports emphasize the general importance of IgA serodiagnosis for the identification of acute primary and secondary HCMV infection.…”

“…Although the new diagnostic procedures PCR and pp65-specific antigenemia assay have proven to be useful diagnostic methods for monitoring HCMV infection in transplant recipients, serological methods like enzymelinked immunosorbent assay (ELISA) are widely used for the diagnosis of acute and past HCMV infections especially in immunocompetent individuals (5). Previous investigations have demonstrated that the detection of specific immunoglobulin A (IgA) antibodies might be a useful diagnostic tool for the identification of acute HCMV infection (3,7,9). The majority of these studies were performed with poorly defined antigen preparations derived from HCMV-infected fibroblast cultures.…”