Nasal immunoglobulin responses in acute rubella determined by the immunofluorescent technique

Abstract

SUMMARYThe indirect immunofluorescent technique has been used to study the specific immunoglobulin responses in nasal secretions from ten adults with acute rubella. Titres of IgA antibody in nasal washings usually exceeded those of IgG, but both types of antibody were detected in all patients. They appeared a few days after the rash, reached maximum titres during the second week and then declined. IgA antibody was no longer detectable after 47 days and was not detected at all in nasal washings from adults who had experienced rubella in the past. Low titres of IgG antibody persisted in some patients for longer than IgA and traces of IgG were found in nasal washings from a minority of adults with a past history of rubella. Nasal antibodies in acute rubella are therefore transient and unlikely to take part in resistance to reinfection.In sucrose-density gradients nasal IgA antibody sedimented more rapidly than IgG and there was little overlap between these two types of antibody. IgA antibody in serum was more heterogeneous; it was found in nearly all the fractions which contained IgG antibody and in many of those which contained IgM.

A simplified method for the detection of rubella-specific IgM employing sucrose density fractionation and 2-mercaptoethanol

“…Six patients with rheumatoid factor, which is an IgM antiglobulin, and so can give false positive results by other techniques (Fraser, Shirodaria & Stanford, 1971;Cradock-Watson et al 1972), showed no specific IgM by the present technique, although all had rubella antibodies. Desmyter (1972) likewise showed no false positive results with rheumatoid sera on sucrose gradients.…”

“…Since IgA is also found early after an infection, some workers have suggested that the detection of rubella-specific IgA would also help in these patients (Biurgin-Wolff et al 1971;Cradock-Watson et al 1972). By the present technique, IgA could not be separated from IgG.…”

“…It was found that in the concentration used in the present experiments, 2ME did not break down IgG and therefore give false positive results, for in all the IgG fractions in the calibration experiments, 2ME did not reduce the HAI titre, and in previous experiments with large numbers of whole sera from normal adults, treatment with 2ME did not affect the HAI titre. Cradock-Watson, Ridehalgh, Bourne & Vandervelde (1973) sometimes found IgA in the IgM fractions and suggested that early IgA might be partly in the polymeric form. This might give a false positive result, but would still indicate a recent infection.…”

“…Conventional laboratory tests may not help to decide whether the patient has had rubella during her pregnancy. The presence of rubella-specific IgM immunoglobulin seems to indicate recent infection (Vesikari & Vaheri, 1968;Best, Banatvala & Watson, 1969;Desmyter, South & Rawls, 1971;Ogra et al 1971; Cradock-Watson, Bourne & Vandervelde, 1972;Haire & Hadden, 1972;Field & Murphy, 1972;Forghani, Schmidt & Lennette, 1973). This has been detected by 2-mercaptoethanol (2ME) treatment of whole serum (Banatvala et al 1967), immunofluorescence (Baublis & Brown, 1968; Cohen, Ducharme, Carpenter & Deibel, 1968), separation of immunoglobulins in sucrose density gradients followed by rubella haemagglutination inhibition (HAI) (Vesikari & Vaheri, 1968) or radioimmunodiffusion (Ogra et al 1971), separation in a Sephadex column (Gupta, Peterson, Stout & Murphy, 1971) or agarose (Burgin-Wolff, Hernandez & Just, 1971) followed by HAI.…”

Rubella in the developing world

“…In the UK clinical epidemics are confirmed by an increase in laboratory reports of infection, although these represent only a fraction of the total cases. On the other hand, a serological study in the UK in 1973 [4] confirmed rubella infection in only about half the clinically diagnosed cases. Thus serological confirmation is essential to establish both past and present rubella infection.…”