Use of murine monoclonal antibodies for laboratory diagnosis of varicella-zoster virus infection.

The laboratory diagnosis of varicella-zoster virus (VZV) infection was reevaluated by direct immunofluorescent-antibody staining (DFA) and centrifugation culture with newly available murine monoclonal antibodies. Specimen smears were examined by DFA using monoclonal antibodies to VZV and to herpes simplex virus types 1 and 2. Specimens were also inoculated into shell vials for centrifugation culture and into standard tube cell culture. Of 68 specimens tested from 60 patients, 39 (57%) were positive for VZV by at least one method. DFA was positive in 36 of 39 (92%); centrifugation culture was positive at 24 h in 23 of 39 (59%) and at 48 h in 31 of 39 (79%); and standard culture was positive in 25 of 39 (64%). Twenty-three of the 39 positive specimens (59%) were positive by all three techniques. Forty-three of the 60 patients were considered to have VZV by clinical criteria, and 35 of these 43 (81%) had laboratory confirmation of the diagnosis. These data confirm that DFA is the method of choice for the rapid laboratory confirmation of VZV infection. The centrifugation culture assay can provide an alternative method to DFA for the laboratory diagnosis of VZV infection.     

Rapid detection of varicella-zoster virus in clinical specimens using monoclonal antibodies on shell vials and smears

Monoclonal antibodies were used for detecting varicella-zoster virus (VZV) by immunofluorescence (IF) in clinical specimens inoculated on shell vial cultures. Vesicles of 74 patients with varicella or herpes zoster-like eruptions were tested by this method and by conventional cell culture. Further diagnostic tests were direct IF on smears (42 patients), the cytological Tzanck test (28 patients), and serology (30 patients). Both IF assays were performed with the commercial VZV-specific monoclonal antibody 3B3 (Ortho). Using the shell vial technique, we found VZV in 37 (50%) of the patients, on average after 3 days. The conventional culture method yielded 26 positives (35%), on average after 7.5 days. Twenty-nine of the shell vial IF-positive patients were also positive by direct IF on smears (30 tested), while 15 gave positive Tzanck smears (18 tested). The sensitivities of the shell vial IF test, the direct IF test, the conventional culture method, and the Tzanck test were about 95%, 97%, 70%, and 79%, respectively. For the specificities, we found at least 97% for the shell vial IF test, at least 91% for the direct IF test, and about 78% for the Tzanck test. We conclude that both VZV IF tests are much more reliable than the conventional cell culture method and the Tzanck test for the laboratory diagnosis of VZV infections.     

Comparison of immunofluorescence with commercial monoclonal antibodies to biochemical and biological techniques for typing clinical herpes simplex virus isolates.

Immunofluorescence with monoclonal antibody reagents from two commercial sources for differentiating herpes simplex viruses types 1 and 2 demonstrated 100% agreement with cell culture selectivity (chicken embryo and guinea pig embryo cells) and (E)-5-(2-bromovinyl)-2'-deoxyuridine sensitivity for typing a total of 94 clinical herpes simplex virus isolates.     

Monoclonal antibodies against three major glycoproteins of varicella-zoster virus.

Varicella-zoster virus (VZV) codes for three prominent glycoproteins--gp62, gp98, and gp118--in infected cell cultures. To characterize individually these known immunogens, we first inoculated BALB/c mice with crude VZV extracts, produced hybridoma cultures by Köhler-Milstein cell-fusion technology, and screened culture supernatants by indirect immunofluorescence for reactivity directed against unfixed VZV-infected cells (FAMA assay). Supernatants from five independently derived and subcloned hybridomas with a high VZV-FAMA titer but no reactivity against either uninfected or herpes simplex virus-infected cells were further analyzed by immunoprecipitation of [3H]fucose-labeled and detergent-solubilized VZV antigen preparations. Fractionation of the precipitates by sodium dodecyl sulfate-polyacrylamide gel electrophoresis demonstrated that four monoclonal antibodies reacted with both gp62 and gp98, and one precipitated only gp118. The profiles were unchanged whether performed under reducing or nonreducing conditions. When assayed for neutralizing activity, the secretory product of the single anti-gp118 hybridoma, but not the supernatants from the four anti-gp62/gp98 clones, inhibited VZV plaque formation by greater than 80%. Thus, at least one of the glycosylated antigens detected by the FAMA assay is a determinant which elicits neutralizing activity.     

Encephalocytozoon intestinalis-specific monoclonal antibodies for laboratory diagnosis of microsporidiosis.

Two monoclonal antibodies which can be used for the unambiguous identification by fluorescence microscopy of Encephalitozoon intestinalis spores in clinical specimens are described. Monoclonal antibody Si91 is specific for the extruded polar filament, and Si13 recognizes the surfaces of E. intestinalis spores. No cross-reaction with spores of Encephalitozoon hellem was observed. Immunogold electron microscopy confirmed the specific reactivities of both antibodies. Combined in an indirect immunofluorescence assay, these antibodies are used to identify spores in feces. Although there was some cross-reaction with fecal bacteria and fungi, the typical morphology of the extruded polar filaments enabled proper identification of the E. intestinalis spores. Parasites could also be demonstrated to be present in urine, nasal swabs, lung brush biopsy specimens, and bronchoalveolar lavage fluid from a patient with disseminated infection with E. intestinalis. The use of these monoclonal antibodies facilitates the detection and species determination of E. intestinalis in clinical specimens.     

Serological reactivity of some monoclonal antibodies to varicella-zoster virus

Summary Monoclonal antibodies to varicella-zoster virus, free from host cell reactivity, were produced by cell fusion technics. Antibodies from four different clones showed diverse activities in neutralization, immunofluorescence and complement fixation assays. The antibodies provide useful reagents for viral diagnosis and viral antigenic characterization.With 1 Figure     

Comparison of three commercial ELISA kits for the detection of turkey rhinotracheitis virus antibodies.

Three commercial ELISAs (Pathasure, Svanovir and Flockscreen) were compared in their ability to detect turkey rhinotracheitis virus (TRTV) vaccine-induced antibodies. Sequential sera taken from specified pathogen-free chickens, vaccinated with two combinations of live and inactivated TRTV vaccines were used. The vaccines were based on TRTV strains from the United Kingdom (Intervet) and from France (Rhone Merieux). One ELISA failed to detect antibodies after live vaccination with both French and UK vaccines, but detected antibodies induced by both inactivated vaccines by 8 days after vaccination. The two other ELISAs responded to both live vaccinations equally well and both detected a rise in antibody level 8 days after the inactivated vaccination. The specificity of the three ELISAs was 100%. When tested on field samples, all three ELISAs indicated a high prevalence of TRTV antibodies in turkey flocks in the Netherlands.     

Comparison of polyclonal antiserum versus monoclonal antibodies for the rapid diagnosis of influenza A virus infections by immunofluorescence in clinical specimens.

A pool of monoclonal antibodies was compared with polyclonal antiserum for the rapid detection of influenza A virus in 28 clinical specimens by immunofluorescence. Monoclonal antibodies showed higher sensitivity (69 versus 46%) and accuracy (86 versus 75%) and easier slide interpretation than did polyclonal antiserum. The procedure proved useful for rapid detection of a community outbreak of influenza A virus infection.     

Direct and indirect fluorescent-antibody staining techniques using commercial monoclonal antibodies for detection of respiratory syncytial virus

A comparison was made between direct and indirect fluorescent-antibody staining techniques using commercial monoclonal antibodies for detection of respiratory syncytial virus in respiratory secretions. Overall agreement between the two tests was 94 %. Using virus isolation as the reference method, the indirect test had a higher sensitivity but a similar specificity when compared with the direct test. The slight delay in reporting using the indirect technique is not clinically significant and is offset by the possibility of convenient combination of the technique with indirect fluorescent-antibodies for detection of other respiratory viruses in respiratory secretions.     

Comparison of three commercially available assays for detection of varicella-zoster virus antibody.

Three commercially available diagnostic assays for the detection of antibodies to varicella-zoster virus were evaluated to determine which would be the most suitable for our clinical laboratory. Three different methods were examined: an enzyme-linked immunosorbent assay (ELISA), latex agglutination (LA), and an indirect fluorescent-antibody technique. For the 141 serum specimens tested, the ELISA had an agreement of 90.1% and LA had an agreement of 92.2% with the indirect immunofluorescent-antibody technique. The ELISA had a lower sensitivity (85.6%) than LA (100.0%), but suffered from a low specificity (78.4%) compared with the ELISA (98.0%).     

Comparison of three monoclonal antibody-based enzyme immunoassays for detection of herpes simplex virus in clinical specimens

Three commercial monoclonal antibody-based enzyme immunoassays (Herpchek, IDEIA HSV and SureCell HSV) for detection of herpes simplex virus antigen were compared with isolation of virus in cell cultures. A total of 51 culture positive and 49 culture negative consecutively collected specimens that had been stored at -70°C for a period of up to ten months were used in the study. Herpchek, IDEIA HSV and Sure-Cell HSV assays gave a sensitivity of 88.2 %, 82.4 % and 47.1 % respectively, and a specificity of 95.9 %, 93.9 % and 83.7 % respectively compared to cell culture. A blocking antibody test showed that two culture negative specimens contained herpes simplex virus-specific antigens. If these two specimens were considered to be true positive, Herpchek, IDEIA HSV and SureCell HSV assays had a sensitivity of 88.7 %, 83.0 % and 47.2 %, and a specificity of 100 %, 97.9 % and 85.1 % respectively. The positive predictive value (using the resolved sample results) for Herpchek, IDEIA HSV and SureCell HSV was 100 %, 97.8 % and 78.1 % respectively, and the negative predictive value 88.7 %, 83.6 % and 58.8 % respectively. These results demonstrated that Herpchek and IDEIA HSV are sensitive and highly specific assays. Results could be obtained in less than five hours after receipt of specimens. SureCell HSV gave results in 15 minutes, but both the sensitivity and specificity were too low for this test to be considered as a substitute for culture.     

Comparison of three rapid diagnostic techniques for detection of respiratory syncytial virus from nasal wash specimens.

We report results of three rapid tests for respiratory syncytial virus antigen detection. An immunofluorescence assay using commercial antibody and two commercial enzyme immunoassays (Ortho Diagnostics, Inc., Raritan, N.J., and Abbott Laboratories, North Chicago, Ill.) were applied to 199 nasal wash specimens. The Abbott enzyme immunoassay was the most sensitive technique, with a sensitivity of 93.8%. The specificities of the three techniques were comparable and greater than 95%. The availability of reliable rapid diagnostic techniques will allow for better care of infants with severe respiratory syncytial virus infection.     

Enzyme immunofiltration staining assay for immediate diagnosis of herpes simplex virus and varicella-zoster virus directly from clinical specimens.

A simple, sensitive, 30-min assay for the detection of herpes simplex virus (HSV) and varicella-zoster virus (VZV) antigens in clinical specimens is described. The assay utilizes a filter manifold, biotinylated monoclonal antibodies, streptavidin-horseradish peroxidase conjugate, and the substrate aminoethylcarbazole. The method stains infected cells and cell debris a bright red and is easily interpreted with a dissecting microscope. Reconstruction experiments indicated that as few as two virus-infected cells per swab could be detected. This was equivalent to an infectivity titer of 29 to 160 50% tissue culture infective doses per infected cell and 250 times more sensitive than an enzyme immunofiltration assay which detects a soluble reaction product. Clinical swab specimens collected from ocular, oral, skin, and genital lesions were cultured for virus, and the remaining cell debris was immobilized on glass fiber filters and stained for the presence of virus antigens. Of 71 HSV culture-positive specimens, 66 (93%) were positive for HSV antigens. All of nine VZV culture-positive specimens were positive for VZV antigens. Of 98 culture-negative specimens, 7 were positive for either HSV (n = 3) or VZV (n = 4) antigens.     

Sensitive and specific monoclonal immunoassay for detecting yellow fever virus in laboratory and clinical specimens.

A solid-phase radioimmunoassay (RIA) was developed for the detection of yellow fever (YF) virus in infected cell culture supernatant fluid and clinical samples. The test employed a flavivirus group-reactive monoclonal antibody attached to a polystyrene bead support and a radiolabeled type-specific antibody probe in a simultaneous sandwich RIA format. Optimal assay conditions specified a 16-h incubation at high temperature (45 degrees C). Monoclonal antibody to tetanus toxoid was added to the radiolabeled probe to inhibit nonspecific binding. The sensitivity of the assay for cell culture-propagated virus was 2.0 log10 50% mosquito infectious doses per 100 microliters or 100 pg of gradient-purified virion protein per 100 microliters. Specificity, assessed with human sera from 512 patients with liver diseases other than YF, including acute viral hepatitis, showed a false-positive rate of 0.0 to 0.6%. Sera from experimentally infected rhesus macaques containing greater than 3.0 log10 units/100 microliter of YF virus were positive by RIA. Sera and liver tissue from human patients were found to be positive.     

Evaluation of three techniques for differential diagnosis of prostatic needle biopsy specimens.

AIMS: To determine whether acidic mucin staining, lectin histochemistry using Wisteria floribunda agglutinin, and immunohistochemistry using the monoclonal antibody EAB 903 are of benefit in distinguishing between hyperplastic and carcinomatous prostatic glandular tissue in needle biopsy specimens. METHODS: Formalin fixed, paraffin wax embedded prostatic needle biopsy specimens of benign and malignant tissue were examined. Alcian blue-periodic acid Schiff staining was performed on 33 benign and 34 malignant cases. Wisteria floribunda agglutinin (WFA) binding sites were demonstrated by the avidin-biotin peroxidase (ABC) technique with and without neuraminidase pretreatment on 34 benign cases and 32 malignant cases. EAB903 anticytokeratin antibody binding sites were demonstrated using both an indirect immunoperoxidase (IIP) technique and an avidin-biotin peroxidase complex method on seven benign and 31 malignant cases. RESULTS: Acidic mucin staining was found in 17 of 34 malignant glands and was weakly positive in five of 33 benign glands. WFA positivity before neuraminidase pretreatment was present in 29 of 32 malignant glands and in 19 of 34 benign glands. After neuraminidase all benign and malignant cases showed positivity. EAB 903 positivity was seen in 11 of 31 malignant glands using the IIP technique and in two of 31 malignant glands using the ABC technique. In seven benign cases there was positivity in all glands using the IIP method with predominant basal cell staining in three and superficial cell staining in four. In benign cases using the ABC method two cases were negative. CONCLUSIONS: None of the three methods studied showed sufficient sensitivity and specificity to allow their recommendation for routine diagnostic use.     

Evaluation of three commercial screening tests for AIDS virus antibodies

Three commercial enzyme-linked immunosorbent assays (ELISA) for acquired immune deficiency syndrome (AIDS) virus antibodies were evaluated using serum that had been characterized by an ELISA and western blot procedure developed at the University of California at Davis (UCD). Each of the commercial tests was more specific than the UCD ELISA, but the UCD ELISA was more sensitive in the detection of sera that lacked reactivity by western blot to the envelope glycoprotein (gp-41). The HTLV-III Bio-EnzaBead (Litton Bionetics, Charleston, SC) was less sensitive and specific than the Abbott HTLV-III EIA (Abbott Laboratories, North Chicago, IL) or the Virgo HTLV-III ELISA (Electro-Nucleonics Inc., Columbia, MD). Overall, 22.9% (57 of 250) and 51.0% of sera that were repeatedly (X2) positive by commercial screening kits tested at blood donor centers and clinical laboratories, respectively, were confirmed by western blot. These results indicate that the screening assays for AIDS virus antibodies are not equal in performance and that positive screening test results must be confirmed by a more specific test like western blot before results are released.     

Legionella micdadei and Legionella dumoffii monoclonal antibodies for laboratory diagnosis of Legionella infections.

Two different monoclonal antibodies directed against Legionella micdadei and L. dumoffii (Genetic Systems Corp., Seattle, Wash.) were evaluated for their specificity and ability to detect L. micdadei and L. dumoffii in human and animal clinical samples and bacterial isolates in an indirect immunofluorescence assay. All three frozen sputum samples and all three Formalin-fixed sputum and liver samples from patients with culture-documented L. micdadei pneumonia were positive when tested with the L. micdadei monoclonal antibody. A Formalin-preserved lung sample from a patient with culture-documented L. dumoffii pneumonia was positive with its homologous monoclonal antibody. No cross-staining reactions were found with either monoclonal antibody on any of 25 human sputum samples tested from patients without Legionella infections. A total of 66 Legionella strains and 56 non-Legionella strains including 22 Pseudomonas strains and 34 other bacterial strains were studied. No cross-staining reactions were found except in Staphylococcus aureus Cowan 1 ATCC 12598. The lower limit of detection in seeded sputum samples was about 7 X 10(4) cells per ml for both monoclonal antibodies. Lung and tracheal lavage specimens from L. micdadei- or L. dumoffii-infected guinea pigs showed specific staining only with their respective monoclonal antibodies. The monoclonal antibodies stained homologous bacteria slightly less intensely than did the polyclonal antisera, but the signal-to-noise ratio was considerably higher for the monoclonal antibodies. No differences in sensitivity of staining of clinical specimens or bacterial isolates were noted between the monoclonal antibodies and the polyclonal reagents for L. micdadei and L. dumoffii (Centers for Disease Control, Atlanta, Ga., and BioDx, Denville, N.J. These monoclonal antibodies ae sensitive and specific, making them good candidates for laboratory diagnostic purposes.     

Comparison of two methods for detecting varicella-zoster virus antibody with varicella-zoster virus cell-mediated immunity.

We evaluated an enzyme-linked immunoassay (EIA; BioWhittaker) and a latex agglutination (LA; Becton Dickinson) for varicella-zoster virus (VZV) antibody determination, using cell-mediated immunity (CMI) as a "gold standard." VZV EIA had a sensitivity, specificity, positive predictive value, and negative predictive value of 87, 91, 87, and 91%, respectively, compared with CMI. Correlation was excellent except when the varicella index was 0.9 to 1.2. We defined sera with varicella indices of 0.9 to 1.2 as indeterminate. LA had a sensitivity, specificity, positive predictive value, and negative predictive value of 96, 91, 97, and 90%, respectively, compared with EIA. LA reactivity only at a 1:2 dilution did not correlate with CMI, but sera reactive at dilutions of > or = 1:8 indirectly did. We defined indeterminate sera as those reactive at 1:2 and nonreactive at 1:8. EIA and LA were equivalent for determining VZV immune status, and both methods required modified criteria of interpretation to increase their specificity.     

Characterization of neutralizing domains on varicella-zoster virus glycoprotein E defined by monoclonal antibodies

Summary. The genome of varicella-zoster virus (VZV), encodes at least six glycoproteins and they elicit the formation of complement-independent, complement-dependent, and non-neutralizing antibody responses. We have used our library of MAbs to VZV glycoprotein E (gE) to determine the neutralizing epitopes of gE, and shown that gE has 3 distinct neutralizing domains. In this report we have used the baculovirus expression system to identify the antigenic domains of gE. We have generated 3 recombinant baculoviruses, expressing the full-length gE and two overlapping truncated forms (the amino-terminal and the carboxy-terminal) of gE. By immuno-fluorescence and immunoblotting we have explored the physical interactions of Mabs to gE on these constructs. Our panel of MAbs revealed 3 district antigenic domains on gE. All MAbs reacted with the full-length gE; MAbs with high titered complement-dependent neutralizing activities reacted with the N-terminal truncated gE; MAbs with low titered or non-neutralizing activities reacted with the C-terminal truncated gE; MAbs with complement-enhanced neutralizing activities reacted with both truncated constructs. However, although the antibody binding in immunofluorescence and immunoblotting was carried out under denatured conditions, whereas the neutralization is under non-denatured conditions, still the antigenic mapping was similar in both conditions. Received April 24, 1996 Accepted July 29, 1996