上海市松江区新型冠状病毒肺炎疫情前后呼吸道病原体抗体IgM检测分析

目的　了解新型冠状病毒肺炎疫情前后松江区呼吸道感染患者的呼吸道病原体抗体免疫球蛋白（Ig）M检测情况。方法　收集2019年3月至2021年2月上海市松江区中心医院所有因呼吸道感染就诊的患者5 769例（其中男性3 335例,女性2 434例,年龄3 d～86岁）的血清样本,采用间接免疫荧光法同时检测呼吸道合胞病毒（respiratory syncytial virus,RSV）、腺病毒（adenovirus,ADV）、流感病毒A型（influenza A virus,INFA）、流感病毒B型（influenza B virus,INFB）、副流感病毒（parainfluenza virus,PIV）、肺炎支原体（mycoplasma pneumoniae,MP）、肺炎衣原体（chlamydia pneumoniae,CP）及嗜肺军团菌（legionella pneumophila,LP）,对所得结果进行卡方检验分析。结果　2019年3月至2020年2月的3 579例呼吸道感染患者中呼吸道病原体谱抗体IgM检测结果为阳性者279例,阳性率为7.8%（279/3 579）;其中阳性率相对较高的病原体是INFB和INFA,阳性率分别为3.16%（113/3 579）和1.06%（38/3 579）。2020年3月至2021年2月2 190例呼吸道感染患者中呼吸道病原体谱抗体IgM检测结果为阳性者284例,阳性率为12.97%（284/2 190）;其中阳性率相对较高的病原体是INFB和INFA,阳性率分别为7.21%（158/2 190）和3.88%（85/2 190）。结论　新型冠状病毒肺炎疫情前后松江区呼吸道病原体抗体IgM检测阳性率的分布有差异。     

肺炎衣原体感染与急性脑梗死的研究

目的:我们对40例急性脑梗死患者进行了血清肺炎衣原体(chlamydia pneumonia,CP)特异性IgG、IgM抗体的测定分析,以了解慢性CP感染在急性脑梗死(cerebral infarction,CI)发病中的作用,探讨肺炎衣原体感染与其它危险因子之间的关系。方法:随机选取40例急性脑梗死病人作为观察组。38例门诊体检健康成人作为对照组。患者血清标本采用微量免疫荧光法(microimmunofluorescence,MIF)在2周内统一测试CP特异性抗体IgG、IgM滴度测定。血清学诊断标准为:①IgG抗体阳性:1:16《IgG抗体滴度<1:512表示既往感染;②IgM抗体阳性:IgM抗体滴度≥1:16或IgG》1:512表示急性感染。把所有观察对象按CPIgG阳性、阴性分组,以是否发生脑梗死发病为因变量,以年龄大于50岁、吸烟、男性、高甘油三脂、高血压、糖尿病为自变量,采用Logistic回归分析,评估慢性CP感染与其它传统危险因子之间的关系。结果:急性脑梗死组血清肺炎衣原体(CP)特异性IgG既往感染阳性率(86.36%)高于正常对照组(57.89%)(P<0.05)。IgM检测均为阴性。二组急性感染阳性率无明显差异(P>0.05)。结论:肺炎衣原体感染是脑梗死的危险因素;肺炎衣原体感染可以增加传统危险因素患脑梗死的危险性。     

SARS-CoV-2变异株的遗传学特征和致病特点

新型冠状病毒（SARS-CoV-2）可通过基因突变迅速进化,目前SARS-CoV-2变异株被分类为值得关切的变异株（B.1.1.7、B.1.351、P.1、B.1.617.2和B.1.1.529）、待留意的变异株（B.1.427/B.1.429、P.2、B.1.525、P.3、B.1.526、B.1.617.1、C.37和B.1.621）和受监控的变异株。这些变异株对病毒传播性和人群的发病率、再感染及死亡率产生了重大影响。与其他变异株相比,新变异株奥密克戎（Omicron）具有强传染性、免疫逃逸等特征,造成感染激增的高风险。该文概述了SARS-CoV-2变异株的遗传学特征,当前SARS-CoV-2新变异株Omicron流行病学特征、基因突变及临床特征,SARS-CoV-2样本采集方法及检测手段,疫苗接种以及COVID-19治疗等,以利于SARS-CoV-2的防治提供指导。     

戊型肝炎病毒IgG抗体滴度差异对急性戊型肝炎的诊断价值

目的比较急性戊型肝炎患者与既往感染患者之间抗HEV—IgG,滴度之间的差异,判断抗HEV-IgG与急性戊型肝炎诊断之间的关系。方法采用蛋白免疫印迹（western—blot）方法确认所检测110份血清抗HEV—IgG的特异性,其中10份IgM阳性与100份IgM阴性;然后将抗HEV—IgG特异血清十倍系列稀释,采用酶联接免疫吸附试验法（ELISA）检测血清中抗HEV—IgG滴度。结果既往感染患者血清中抗HEV—IgG血清滴度与急性戊型肝炎患者血清中抗HEV-IgG血清滴度（10^3与10^5）差异有统计学意义（P〈0．05）。结论患者血清中抗HEV—igG的高滴度对判断急性戊型肝炎有重要参考价值。     

细小病毒B19感染与SLE发病关系探讨

目的：探讨细小病毒B19感染与SLE发病关系,方法：应用间接免疫荧光法对24例SLE、20例RA患者对照、20例正常对照血清标本进行血细小病毒B19IgG及IgM检测。结果24例SLE中,血细小病毒B19IgG阳性8例,IgM阳性2例,20例RA患者对照中,血小板病毒B19IgG阳性2例,IgM均阳性,20例正常对照中,血细小病毒B19IgG阳性4例,IgM均阴性,结论,细小病毒B19抗体在SLE中检出率为41．67％（10／24）,明显高于RA患者对照组的10％（2／10）及正常对照组的20％（14／20）（P＜0．01）,提示细小病毒B19感染与SLE发病有一定关系。     

人类细小病毒B19通过凝血因子浓制剂传播

感染人类细小病毒B19后通常引起轻微发热,儿童可出现皮疹,成人出现关节病。有人报告此病毒可通过凝血因子浓制剂传播。作者调查了86例先天性出血性疾病患儿。按治疗类型分为4组,对每例患儿随意选择3名年龄相当的儿童作为正常对照。对照组未接受过输血或血液制品,无出血性疾病。用放射免疫法(RIA)检测患儿的B19抗原及抗-B19 IgM和IgG,对照组仅测抗-B19IgM和IgG,以<1.0RIA单位为抗体阴性。     

口服伤寒、霍乱活菌苗的免疫效果

本文介绍一种口服的伤寒和霍乱活菌苗,对10例健康成人志愿受试者口服活菌苗进行致免疫性的研究。结果表明,在10例受试者血清中抗伤寒杆菌脂多糖的IgA、IgG和IgM抗体增加≥4倍者,分别为7、4和3例。血清中抗霍乱弧菌脂多糖的IgA、IgG及IgM抗体增加≥4倍的志愿者分别为4、3及1例。对伤寒杆菌和霍乱弧菌的杀菌性抗体滴度增加≥4倍的志愿者分别为8和4例,可见活菌苗口服的耐受性良好。作者指出,受试者口服杂种伤寒和霍乱     

细小病毒B19和儿童急性白血病关系的探讨

目的：对急性白血病儿童细小病毒B19的感染及其影响进行探讨。方法回顾性分析某院2011年1月－2015年1月住院的110例急性白血病儿童的临床资料,把110例儿童分为两组：第1组：60名已接受化疗的急性白血病儿童;第2组：50例新发现的、未接受化疗急性白血病儿童;第3组：选取100例性别、年龄均匹配的儿童为健康对照组。采用聚合酶链反应（ PCR）技术检测细小病毒B19 DNA,ELISA法检测以上3组儿童的血清细小病毒B19 IgM抗体。结果①在110例患儿中,细小病毒B19 DNA和（或） IgM阳性的为61例,阳性率为55．5％;对照组均为阴性。②第1组细小病毒B19 DNA和IgM阳性率分别为28．3％和33．3％;第2组细小病毒B19 DNA和IgM阳性率分别为42．0％和52．0％。③细小病毒B19感染的急性白血病儿童贫血发生率为73．8％,无感染儿童贫血发生率为42．9％（ P＜0．05）;细小病毒B19感染的急性白血病儿童血小板减少发生率为68．9％,无感染儿童血小板减少发生率为36．7％（ P＜0．05）。结论50％左右的急性白血病儿童存在细小病毒B19感染;新发现、未接受化疗的急性白血病儿童更容易存在细小病毒B19感染;细小病毒B19感染是急性白血病儿童红细胞系和血小板减少的重要原因。     

SLE患者血清免疫球蛋白及补体水平与自身抗体相关性研究

目的探讨SLE患者血清免疫球蛋白及补体与自身抗体的相关性。方法采用速率散射免疫比浊法检测109例SLE患者和30例体检健康对照者的血清Ig及C3、C4水平并与自身抗体结果进行比较。结果SLE患者血清IgG、IgA水平高于对照纽（P〈0．05）;血清IgM水平与对照组比较差异无统计学意义（P〉0．05）;补体C3、C4水平低于对照组（P〈0．05）。ANA高滴度组与低滴度组相比较,IgG明显升高,补体C3明显降低（P〈0．01）;而IgA、IgM及c4差异无统计学意义（P〉0．05）。抗Sm及抗ds-DNA抗体阳性组分别与其对应的阴性组血清Ig及c3、C4水平相比较,Ig水平差异无统计学意义（P〉0．05）,而C3水平明显降低（P〈0．叭）。结论SLE患者存在血清IgG水平升高,血清补体C3、C4降低的现象;随自身抗体滴度升高差异更为显著,且IgG与疾病活动呈正相关,C3、C4与疾病活动呈负相关;C3可作为反映SLE疾病活动的参考指标。     

一种候选口服伤寒/霍乱杂交活菌苗对人体的免疫原性

本文报道,将稻叶型霍乱弧菌569B株O抗原基因插入到伤寒杆菌减毒菌苗株Ty21a中,制备成口服杂交菌苗.口服免疫10名志愿者,用ELISA测定周围血淋巴细胞(PBL)和血清对菌苗的特异性免疫应答.测定PBL结果表明,10名接种者对伤寒杆菌脂多糖(LPS)产生IgA抗体应答,并观察到IgG(7名)和IgM(10名)应答.血清IgA、IgG和IgM抗伤寒杆菌LPS抗体增加4倍以上者分别为7人、4人和3人.10人中有8人杀菌抗体滴度明显增加     

The presence of both antivirus and antiself antibodies in sera from patients with adenovirus and influenza B

Using the ELISA method we examined serum samples from 62 male patients aged 19-23 infected with adenovirus (serotype 7), 22 children aged 7-14 infected with influenza B (B/Norway 1/84) and 113 normal subjects aged 5-30. The infections were diagnosed serologically by complement fixation, by inhibition of hemagglutination, by ELISA and by viral culture. Moreover using enzyme-linked short-time culture assay, the production of specific antivirus antibodies and autoantibodies in vitro by spleen cells (1 x 10(6) cells/well) from normal mice and from mice immunized with adenovirus and influenza B was studied. At the same time their sera antibody titers were determined. All the serum samples were tested against the following antigens: adenovirus, influenza B, ds-DNA, actin, myosin, myoglobin, thyroglobulin, H. transferrin, H. interferon a and BSA. FV. For the further characterization of positive sera, an evaluation of specificity by competitive ELISA-test and by preparations of F(ab')2 fragments from patients' sera was also carried out. It was found that the percentage of positivity for the specific virus and other antigens was higher in the patients' samples than in the samples from the normal subjects. The specific antivirus antibody was of IgG class and their titers ranged from 1/4, 800 up to 1/19,200. Autoantibodies belonged to IgM, IgA, IgG classes and their titers ranged from 1/400 to 1/1,600. In comparison, titers of normal subjects' sera ranged from 1/150 to 1/600 and 1/150 to 1/300, respectively and both were IgG classes. Both specific virus antibodies and autoantibodies appeared at the same time. The competitive ELISA-test showed a marked inhibition (95-98%) of antivirus antibodies with the specific antigen, whereas autoantibodies were less inhibited (40-50%) by homologous antigens. The antigen-antibody reaction occurred at the Fab portion of the immunoglobulin molecule, since these fragments inhibited antibody reactivity. The same results were observed with spleen cells from immunized mice and the above-mentioned antigens when cultured in vitro.     

IgM serum antibodies to Epstein-Barr virus are uniquely present in a subset of patients with the chronic fatigue syndrome

BACKGROUND: A unique subset of patients with chronic fatigue syndrome (CFS) and IgM serum antibodies to cytomegalovirus (HCMV) non-structural gene products p52 and CM2 (UL 44 and UL 57) has been described. PATIENTS AND METHODS: Fifty-eight CFS patients and 68 non-CFS matched controls were studied. Serum antibodies to EBV viral capsid antigen (VCA) IgM and EBV Early Antigen, diffuse (EA, D) as well HVCMV(V), IgM and IgG; VP (sucrose, density purified V); p52 and CM2 IgM serum antibodies were assayed. RESULTS: Mean age of CFS patients was 44 years (75% women). Control patients were 9 years older (73% women). Serum EBV VCA IgM positive antibody titers were identified in 33 CFS patients (Group A subset EBV VCA IgM 62.3+/-8.3, neg. <20), but were not present in other CFS patients, (Group B subset EBV VCA IgM 6.8+/-0.7) controls (p<0.0001). EBV VCA IgM titers remained positive in CFS patients from Group A for 24-42 months. CONCLUSION: Serum antibody to EBV VCA IgM may be a specific diagnostic test for a second subset of CFS patients.     

Enzyme-linked immunosorbent assay, immunofluorescent assay, and recombinant immunoblotting in the serodiagnosis of early Lyme borreliosis

Serum samples from Bulgarian patients with physician-diagnosed erythema migrans (EM) (n=105) were examined using Borrelia burgdorferi ELISA (Boehring, Germany) after previous absorption with Treponema phagedenis. For IgM antibody detection sera were additionally pretreated with anti-IgG serum (RF absorbent). Serum samples of 93% of persons from healthy control group were IgM negative and all were IgG negative. Out of 105 patients with EM, 49% were IgM positive and 14 % were borderline. IgG ELISA showed positive results for 17% and borderline for 6% of the patients. Positive and borderline serum samples were examined further by immunofluorescent assay (IFA) and immunoblot test with recombinant B. burgdorferi proteins from strain PKo (B. afzelii) - p100, flagellin, OspA and OspC, and internal flagellin fragments from strains PKo and PBi (B. garinii) [B.Wilske, V.Fingerle, P. Herzer et al. 1993. Med. Microbiol. Immunol. 182:255]. IFA detected IgM antibodies against B. burgdorferi in 47 % of the positive and in none of the borderline by IgM ELISA serum samples as well as IgG antibodies in 83% of the positive and in 50% of the borderline by IgG ELISA samples. Presence of specific antibodies was confirmed by immunoblot in 71 % of the IgM ELISA postive and in 67 % of the IgG ELISA positive sera. In addition, anti-B. burgdorferi antibodies were detected in 60 % of the borderline by IgM ELISA serum samples. IgM serum reactivity was directed mainly against OspC antigen and flagellin and IgG antibodies were directed mainly against flagellin and p100. These findings clearly showed advantages of the ELISA test based on previous pretreatment of sera and capable to detect specific antibodies in more than half of patients with early Lyme borreliosis despite the well-known delayed immune response. IFA was less sensitive than ELISA in detection of anti-B. burgdorferi antibodies. An additional examination of ELISA borderline sera by immunoblot revealed more positive results. Serum reactivity to a single OspC antigen seems to be a sufficient criterion for positive IgM immunoblot.     

Murine cytomegalovirus infection model in Balb/c mice. 3. Immunoglobulin production during infection.

In mice infected with a lethal dose of murine cytomegalovirus (MCMV) the serum immunoglobulin (Ig) levels and the Ig-bearing cells in the spleen dropped to barely detectable levels 2 days after infection. In mice with acute but non-lethal MCMV infection, the serum IgM was twice and the IgG 32 times that of the uninfected controls by Day 8 of infection; the numbers of spleen cells bearing IgM and the IgG subclasses (IgG1, IgG2a, IgG2b, IgG3) were also greatly increased. In the asymptomatically infected group, serum IgM remained unchanged but the IgG increased to 16 times that of uninfected controls by Day 11 of infection; the numbers of spleen cells bearing IgM and IgG subclasses were also increased, although to a lesser extent than in the acute, non-lethally infected mice. In the latter two groups, serum IgA and IgA-bearing cells in the spleen did not alter significantly. Complement-requiring neutralizing antibodies to MCMV were detected 8 days post infection.     

Toxocarosis as zoonosis. A review of literature and the prevalence of Toxocara canis antibodies in 511 serum samples

A total of 511 serum samples from children aged between 6 months to 15 years old, with different clinical signs-living in the region of Northern Greece - were tested by ELISA (enzyme links immunosorbent assay) technique, for the detection of specific IgG and IgM antibodies against T. canis antigen. The reason IgM was detected was because IgM levels are elevated in the acute phase of toxocara infection, in spite of their notorious non-specificity. In this seroepidemiologic survey of children, a remarkably high percentage (12.5%) reacted positively to this method. Sixteen (3.1%) out of 511 sera showed IgG antibodies, 43 (8.4%) showed IgM, while 5 (1%) showed both IgG and IgM antibodies against T. canis E/S (excretory - secretory) antigen. Females were significantly more infected than males. Seropositivity rate was highest in children over the age of 10.     

反复呼吸道感染患儿血清免疫球蛋白、IgG亚类及细胞免疫水平分析

目的 探讨小儿反复呼吸道感染(RRTI)的发病机制.方法 选择我科被诊断为反复呼吸道感染的患儿35例,另选正常35例儿童为对照组,检测血清IgG、IgA、IgM及IgG亚类水平;检测CD分子的表达.结果 RRTI组患儿的血清IgG、IgA水平与对照组比较差异无统计学意义,IgM水平低于对照组,RRTI组患儿的血清IgG2和IgG4水平均低于对照组,IgG1、IgG3水平差异无显著性.35例RRTI患儿中IgG亚类缺陷共17例,检出率为48.6％( 17/35).RRTI组患儿的CD3、CD4分子表达水平较对照组明显降低,CD8、CD4/CD8、CD19、CD16+56等表达两组比较无差异.结论 IgG亚类能够比较敏感地反映反复呼吸道感染患儿的体液免疫功能,IgG亚类缺陷的患儿多伴有不同程度的T细胞功能障碍,因此在临床工作中应注意监测患儿血清IgG亚类及各项细胞免疫功能.     

Immunogenicity of a West Nile Virus DIII-Cholera Toxin A2/B Chimera after Intranasal Delivery

West Nile virus (WNV) causes potentially fatal neuroinvasive disease and persists at endemic levels in many parts of the world. Despite advances in our understanding of WNV pathogenesis, there remains a significant need for a human vaccine. The domain III (DIII) region of the WNV envelope protein contains epitopes that are the target of neutralizing antibodies. We have constructed a chimeric fusion of the non-toxic cholera toxin (CT) CTA₂/B domains to DIII for investigation as a novel mucosally-delivered WNV vaccine. Purification and assembly of the chimera, as well as receptor-binding and antigen delivery, were verified by western blot, GM1 ELISA and confocal microscopy. Groups of BALB/c mice were immunized intranasally with DIII-CTA₂/B, DIII, DIII mixed with CTA₂/B, or CTA₂/B control, and boosted at 10 days. Analysis of serum IgG after 14 and 45 days revealed that mucosal immunization with DIII-CTA₂/B induced significant DIII-specific humoral immunity and drove isotype switching to IgG2a. The DIII-CTA₂/B chimera also induced antigen-specific IgM and IgA responses. Bactericidal assays indicate that the DIII-CTA₂/B immunized mice produced DIII-specific antibodies that can trigger complement-mediated killing. A dose escalation resulted in increased DIII-specific serum IgG titers on day 45. DIII antigen alone, in the absence of adjuvant, also induced significant systemic responses after intranasal delivery. Our results indicate that the DIII-CTA₂/B chimera is immunogenic after intranasal delivery and merits further investigation as a novel WNV vaccine candidate.     

IgM serum antibodies to human cytomegalovirus nonstructural gene products p52 and CM2(UL44 and UL57) are uniquely present in a subset of patients with chronic fatigue syndrome

Human cytomegalovirus (HCMV) IgM serum antibodies to two nonstructural gene products UL44 and UL57 (p52 and CM2) were assayed in patients with the diagnosis of the chronic fatigue syndrome (CFS) according to criteria established by the US Centers for Disease Control and Prevention. A subset of 16 CFS patients demonstrated HCMV IgG, but no HCMV IgM serum antibodies to conformational structural HCMV antigens (designated, V). By convention, these findings are interpreted to indicate only a remote HCMV infection. However, HCMV IgM p52 and CM2 antibodies were uniquely present in these 16 CFS patients. Other CFS patients with similar HCMV (V) IgG antibodies (18 patients), non-fatigued HCMV (V) IgG-positive control patients (18 patients), random HCMV (V) IgG-positive control patients from a clinical laboratory (26 patients), and non-fatigued HCMV (V) IgG-negative control patients (15 patients) did not have HCMV, IgM p52 or CM2 serum antibodies (p < 0.05). Control HCMV (V) IgG-positive patients had no serum IgM HCMV (V) antibodies to conventional structural HCMV (V) antigen. Thus, 77 various control patients did not contain IgM p52 or CM2 serum antibodies. The presence of IgM p52 and/or CM2 HCMV serum antibodies in this subset of CSF-specific patients may detect incomplete HCMV multiplication in which a part of the HCMV protein-coding content of the HCMV genome is processed, but remains unassembled. These findings suggest that the presence of HCMV IgM p52 and CM2 serum antibodies may be a specific diagnostic test for the diagnosis of a subset of CFS patients. Further, these data suggest an etiologic relationship for HCMV infection in this group of CFS patients.     

SARS患者恢复期抗体动态变化及临床意义

目的：动态监测SARS患者恢复期抗SARS病毒IgG和IgM抗体变化，探讨其临床意义。方法：采用酶联免疫吸附测定法（ELISA），检测SARS患者发病后5，10，14个月末血清IgG、IgM抗体水平，并与临床诊断进行比较。同时观察感染SARS后抗体的持续维持水平及效能。结果：IgG诊断与临床诊断符合程度不一致。随访中3个时期患者恢复期IgG抗体整体水平下降，部分患者IgG抗体阴转，随访后期少数患者IgM抗体水平仍为阳性。结论：SARS患者的血清学IgG抗体检测诊断与临床诊断不一致，SARS病毒抗体变化规律与一般传染病抗体产生规律不同。     

反复呼吸道感染儿童血清1-25羟维生素D水平及免疫相关因素的研究

目的 检测反复呼吸道感染儿童血清1-25羟维生素D水平及免疫相关因素IgA、IgG、IgM水平,探讨反复呼吸道感染患儿血清1-25羟维生素D水平与体液免疫的关系.方法 选取2014年6月至2015年6月本院儿科门诊及住院部患儿中诊断为反复呼吸道感染的儿童60例为实验组,儿保科体检的健康儿童60例为对照组,对两组儿童血清1-25羟维生素D及免疫球蛋白IgA、IgG、IgM水平进行比较.结果 实验组血清1-25羟维生素D及血清免疫球蛋白IgA、IgG水平低于对照组,差异有统计学意义(P＜0.05),而两组IgM水平比较差异无统计学意义(P＞0.05).结论 反复呼吸道感染儿童血清1-25羟维生素D及血清免疫球蛋白IgA、IgG水平低于正常儿童,因此预防性补充维生素D可以提高机体免疫功能,防治反复呼吸道感染的发生.