Use of a Novel Enzyme Immunoassay Based on Detection of Circulating Antigen in Serum for Diagnosis of Helicobacter pylori Infection

Recently, noninvasive diagnostic tests for Helicobacter pylori infection have gained in significance. We have developed a sensitive and specific noninvasive immunoassay based on the detection of an H. pylori circulating antigen (HpCA) in sera from H. pylori-infected individuals. Monospecific antibody and Western blot analyses were used to demonstrate the presence of the target antigen in H. pylori cell lysate and serum samples. A novel enzyme-linked immunosorbent assay (ELISA) was developed for the detection of HpCA in serum. Endoscopic biopsy specimens from the gastric antra of 221 individuals (143 males and 78 females) with dyspeptic symptoms were evaluated for H. pylori infection, with culture used as a “gold standard” for diagnosis. The target H. pylori antigen was identified at 58 kDa. HpCA has been detected by ELISA with high degrees of sensitivity, specificity, and efficiency (>90%), and ELISA results show no significant difference (P > 0.05) from results of H. pylori culture of gastric biopsy specimens. The test's positive and negative predictive values were also high (95 and 86%, respectively). In conclusion, a sensitive and specific immunoassay was developed for the detection of HpCA in human serum. This test can be applied for noninvasive laboratory and field diagnoses of H. pylori infection.     

Evaluation of Clonorchis sinensis Recombinant 7-Kilodalton Antigen for Serodiagnosis of Clonorchiasis

The diagnostic applicability of the Clonorchis sinensis recombinant 7-kDa protein was evaluated. In enzyme-linked immunosorbent assays and immunoblots, the protein showed high sensitivities (81.3 and 71.9%, respectively) and specificities (92.6 and 89.7%, respectively) for sera obtained from various helminthic infections. Some paragonimiasis sera showed cross-reactions. The antigen might be valuable in the serodiagnosis of human clonorchiasis.     

Characterization of a 34-Kilodalton Protein of Mycobacterium leprae That Is Isologous to the Immunodominant 34-Kilodalton Antigen of Mycobacterium paratuberculosis

During DNA sequence analysis of cosmid L373 from the Mycobacterium leprae genome, an open reading frame of 1.4 kb encoding a protein with some homology to the immunodominant 34-kDa protein of Mycobacterium paratuberculosis, but lacking significant serological activity, was detected. The DNA sequence predicted a signal peptide with a modified lipoprotein consensus sequence, but the protein proved to be devoid of lipid attachment.     

A Valuable Antigen Detection Method for Diagnosis of Acute Hepatitis E

Hepatitis E virus (HEV) is a serious public health problem. The commonly used tests that are specific for current HEV infection diagnosis include the detection of anti-HEV IgM and HEV RNA. Here, we report an improved enzyme-linked immunosorbent assay (ELISA) method for HEV antigen detection with a linear range equivalent to 6.3 × 10³ to 9.2 × 10⁵ RNA copies per ml. The monoclonal antibody (MAb) 12F12, a high-ability MAb that binds HEV virus, was selected as the capture antibody from a panel of 95 MAbs. The positive period of HEV antigenemia in infected monkeys using this test was, on average, 3 weeks longer than previously reported and covered the majority of the acute phase. The positive detection rates of IgM, RNA, and new antigen from the first serum samples collected from 16 confirmed acute hepatitis E patients were 81% (13/16), 81% (13/16), and 100% (16/16), respectively. In three patients, the initial serum specimens that tested negative for IgM, despite the presence of symptoms of acute hepatitis and elevated alanine aminotransferase (ALT) levels, were positive for HEV antigen and HEV RNA. In contrast, the serum samples of the three RNA-negative patients were antigen positive (and IgM positive), possibly due to the degradation of HEV nucleic acids. Our results suggest that this new antigen detection method has acceptable concordance with RNA detection and could serve as an important tool for diagnosing acute hepatitis E.     

Cloning and Characterization of the Acidic Ribosomal Protein P2 of Cryptosporidium parvum,a New 17-Kilodalton Antigen

Cryptosporidium infection is commonly observed among children and immunocompromised individuals in developing countries, but large-scale outbreaks of disease among adults have not been reported. In contrast, outbreaks of cryptosporidiosis in the United States and Canada are increasingly common among patients of all ages. Thus, it seems likely that residents of regions where Cryptosporidium is highly endemic acquire some level of immunity, while residents of the developed world do not. A new immunodominant Cryptosporidium parvum antigen in the 15- to 17-kDa size range was identified as the Cryptosporidium parvum 60S acidic ribosomal protein P2 (CpP2). We developed a recombinant protein-based enzyme-linked immunosorbent assay for serologic population surveillance for antibodies that was 89% sensitive and 92% specific relative to the results of the large-format Western blot assay. The human IgG response is directed almost exclusively toward the highly conserved, carboxy-terminal 15 amino acids of the protein. Although IgG antibody cross-reactivity was documented with sera from patients with acute babesiosis, the development of an anti-CpP2 antibody response in our Peru study population correlated better with Cryptosporidium infection than with infection by any other parasitic protozoan. In Haiti, the prevalence of antibodies to CpP2 plateaus at 11 to 20 years of age. Because anti-CpP2 IgG antibodies were found only among residents of countries in the developing world where Cryptosporidium infection occurs early and often, we propose that this response may be a proxy for the intensity of infection and for acquired immunity.Cryptosporidium parvum and C. hominis are enteric protozoan parasites that commonly cause outbreaks of diarrheal disease in the developed world (for reviews, see references 24 and 26). All age groups are affected, and the disease is usually self-limiting in immunocompetent individuals (5, 13). Outbreaks have been linked to public water system treatment failures, recreational exposure to contaminated water, contamination of unpasteurized fresh-squeezed juices, and contamination of food products by infected food handlers (14, 28, 35, 37, 39, 58). In the developing world, where potential sources of food and water contamination are widespread, acute cryptosporidiosis is usually limited to young children and to immunocompromised populations (4, 5, 48, 50, 59). In a longitudinal serologic study of enteric parasites in Peru, we reported that repeated infection was common among young children and that Cryptosporidium-specific IgG antibody levels increased with age and with experience of infection (54). Large-scale outbreaks of overt illness among immunocompetent adults in these regions where cryptosporidiosis is highly endemic have not been reported. These observations suggest that some level of immunity to disease (although not necessarily to infection) may eventually develop upon repeated exposure to the parasite (20).In previous work (68), we noted that sera from individuals who live in Haiti often contain IgG antibodies to several C. parvum antigens, in addition to the immunodominant 27- and 17-kDa antigens. In the current work, we demonstrate that one of these novel antigens, located in the 17-kDa-molecular-mass range but distinct from the C. parvum 17-kDa antigen family (56), is the C. parvum acidic ribosomal protein P2 (CpP2). Several acidic ribosomal proteins (P0, P1, P2, or variants) have been described as prominent antigens in leishmaniasis (69, 70), Chagas'' disease (32, 65, 67), malaria (10), Brucella abortus infection (6), Babesia bovis infection (12), and systemic lupus erythematosus (SLE) (16, 17, 62). In particular, ribosomal proteins P0 and P2 from Leishmania spp., Plasmodium falciparum, and Trypanosoma cruzi have been reported to be immunostimulatory, as sera from infected animals and humans recognize these antigens (10, 65, 66, 67,69, 70). Although the acidic ribosomal proteins are classically associated with the cytoplasmic ribosomes, they have also been localized to the cell surface of some parasites. Chatterjee et al. (9) used antibody fluorescence to demonstrate the presence of the P0 protein on the surface of P. falciparum merozoites, and Sehgal et al. (63) used transiently transfected Toxoplasma gondii cells to demonstrate the translocation of tagged P0 to the parasite surface.Because of their surface localization and immunogenicity, it has been suggested that P proteins may be possible vaccine candidates. In recent reports, immunization with the P-domain peptide of ribosomal protein P0 provided protection against P. falciparum challenge (60), immunization with Babesia gibsoni P0 protein was cross-protective for infection with Babesia microti (73), and antibodies against Neospora caninum P0 inhibited infection with T. gondii in vitro (79). Furthermore, a Leishmania infantum ribosomal protein DNA vaccine conferred protective immunity against Leishmania major infection in mice (22). The strong anti-CpP2 antibody responses observed for most of the Haitians who were also antibody positive for the 27-kDa antigen suggest that the CpP2 antigen may play a role in the generation of immune responses against C. parvum in areas where it is highly endemic and, therefore, might be a potential vaccine target.     

基于频数直方图检测QRS波的新方法

简要评述了从心电图检测QRS波的现行方法(特别是利用小波变换的方法)，指出了其中的不足，还提出了一种简便有效的、基于频数直方图的检测QRS波新方法，介绍了频数直方图的原理，以及用于检测QRS波所依据的匹配原则，并利用MIT／BIH心电数据库的数据及北京工业大学校医院提供的数据对此新方法进行了验证。     

Conservation of the 17-Kilodalton Antigen Gene within the Genus Bartonella

The 17-kDa antigen of Bartonella henselae has previously been shown to elicit a strong humoral immune response in patients with cat scratch disease (CSD) and to be useful in screening human serum samples for CSD. In this study, PCR amplification of genes homologous to the 17-kDa antigen gene of B. henselae was performed using genomic DNAs from several species of Bartonella, including the currently recognized human pathogens. Amplicons of similar size were demonstrated using the following chromosomal DNA templates: B. henselae (two strains), B. quintana (two strains), B. elizabethae, B. clarridgeiae, B. vinsonii subsp. vinsonii, and B. vinsonii subsp. berkhoffii. No evidence of a B. bacilliformis homolog of the 17-kDa antigen gene was obtained using multiple primer pairs. DNA sequencing revealed open reading frames capable of coding for proteins with sizes similar to that of the 17-kDa antigen of B. henselae in all of the amplicons; however, extensive sequence divergence across the genus was noted. Cloning of the amplified products into pUC19 resulted in recombinants that directed synthesis of homologs of the 17-kDa protein. Immunoblot analysis using human sera from CSD cases demonstrated very little cross-reactivity among different species for this protein. In contrast, immunoblots using rabbit serum raised to the recombinant B. henselae antigen showed extensive cross-reactivity with the proteins of other Bartonella species. The data suggest that the use of the 17-kDa antigen as a serologic reagent may allow the development of more specific diagnostic assays. Furthermore, the nucleotide sequences from the various versions of the 17-kDa antigen gene should be useful for rapid identification of Bartonella at the species level.     

Identification of the Gene Encoding a 38-Kilodalton Immunogenic and Protective Antigen of Streptococcus suis

In our continued effort to search for a Streptococcus suis protein(s) that can serve as a vaccine candidate or a diagnostic reagent, we constructed and screened a gene library with a polyclonal antibody raised against the whole-cell protein of S. suis type 2. A clone that reacted with the antibody was identified and characterized. Analysis revealed that the gene encoding the protein is localized within a 2.0-kbp EcoRI DNA fragment. The nucleotide sequence contained an open reading frame that encoded a polypeptide of 445 amino acid residues with a calculated molecular mass of 46.4 kDa. By in vitro protein synthesis and Western blot experiments, the protein exhibited an electrophoretic mobility of approximately 38 kDa. At the amino acid level the deduced primary sequence shared homology with sequences of unknown function from Streptococcus pneumoniae (89%), Streptococcus mutans (86%), Lactococcus lactis (80%), Listeria monocytogenes (74%), and Clostridium perfringens (64%). Except for strains of serotypes 20, 26, 32, and 33, Southern hybridization analysis revealed the presence of the gene in strains of other S. suis serotypes and demonstrated restriction fragment length differences caused by a point mutation in the EcoRI recognition sequence. We confirmed expression of the 38-kDa protein in the hybridization-positive isolates using specific antiserum against the purified protein. The recombinant protein was reactive with serum from pigs experimentally infected with virulent strains of S. suis type 2, suggesting that the protein is immunogenic and may serve as an antigen of diagnostic importance for the detection of most S. suis infections. Pigs immunized with the recombinant 38-kDa protein mounted antibody responses to the protein and were completely protected against challenge with a strain of a homologous serotype, the wild-type virulent strain of S. suis type 2, suggesting that it may be a good candidate for the development of a vaccine that can be used as protection against S. suis infection. Analysis of the cellular fractions of the bacterium by Western blotting revealed that the protein was present in the surface and cell wall extracts. The functional role of the protein with respect to pathogenesis and whether antibodies against the antigen confer protective immunity against diseases caused by strains of other pathogenic S. suis capsular types remains to be determined.     

A Novel Antigen Detection Immunoassay for Field Diagnosis of Hepatitis C Virus Infection

Abstract

The limitations of dominant methods-based on the detection of anti-HCV antibodies or HCV viremia currently used for the diagnosis of HCV infection enhance efforts to have a rapid, simple, sensitive, and specific alternative diagnostic approach to detect viral antigens. A highly reactive IgG antibody was raised to HCV-NS4 recombinant antigen. The produced antibody showed no cross-reactivity with the other HCV structural and nonstructural recombinant antigens (C1 + 2, C3 + 4, E2/NS1, NS3, NS5). The well established ELISA technique was adapted to detect the new target HCV-NS4 antigen in serum samples. Extremely high agreement was found between the results of ELISA and qualitative detection of HCV-RNA, using a RT-PCR test as a gold standard for the diagnosis of HCV infection. Based on these encouraging results, a novel enzyme immunoassay; dot-ELISA was developed for rapid (?5 min) and simple qualitative detection of the target HCV antigen in serum. The developed method detected the HCV target antigen in 95% of serum samples from HCV infected individuals, with a specificity of 97% using sera of noninfected individuals in comparison with PCR test. The antigen detection method showed high predictive values of positive (99%) and negative (90%). Moreover, the dot-ELISA could detect the HCV target antigen in sera negative for anti-HCV Abs, but positive for HCV-RNA, and in sera of HCV infected individuals with low viremia, as well as those with high viremia, using quantitative RT-PCR. Accordingly, the developed highly sensitive and specific HCV antigen detection method could be applied for mass screening of HCV infection.     

Cloning of a Novel Babesia equi Gene Encoding a 158-Kilodalton Protein Useful for Serological Diagnosis

In this study, we characterized a Babesia equi Be158 gene obtained by immunoscreening a B. equi cDNA expression phage library with B. equi-infected horse serum. The Be158 gene consists of an open reading frame of 3,510 nucleotides. The recombinant Be158 gene product was produced in Escherichia coli and used for the immunization of mice. In Western blot analysis, mouse immune serum against the Be158 gene product recognized 75- and 158-kDa proteins from the lysate of B. equi-infected erythrocytes. In an indirect fluorescent-antibody test with the mouse immune serum, the Be158 antigen appeared in the cytoplasm of Maltese cross-forming parasites (which consist of four merozoites) and was located mainly in the extraerythrocytic merozoite body. When the recombinant Be158 gene product was used in an enzyme-linked immunosorbent assay as a serological antigen, it was found to react to B. equi-infected horse sera, indicating that the Be158 gene product is useful as a serologically diagnostic antigen for B. equi infection.     

Detection of Low-Avidity Immunoglobulin G in Oral Fluid Samples: New Approach for Rubella Diagnosis and Surveillance

Low-avidity rubella immunoglobulin G (IgG) was detected in oral fluid samples from 30 of 32 rubella IgM-positive patients (sensitivity, 94%) and from 4 of 34 IgM-negative patients (specificity, 88%). Measuring IgG avidity in oral fluid samples could improve the reliability of rubella surveillance when the incidence of the disease and the positive predictive value of IgM tests are low.     

Comparison between PCR and Detection of Antigen in Sera for Diagnosis of Pulmonary Aspergillosis

We evaluated the usefulness of PCR and antigen detection for the diagnosis of pulmonary aspergillosis. Forty-four serum samples from patients with pulmonary aspergillosis (33 with pulmonary aspergilloma, 4 with allergic bronchopulmonary aspergillosis, 4 with invasive pulmonary aspergillosis, and 3 with aspergillus pyothorax) were used in this study. PCR detection of Aspergillus DNA in serum samples was successful in 39 patients. Galactomannan antigen was detected by sandwich enzyme-linked immunosorbent assay in 25 patients and by latex agglutination test in 13 patients. Detection of Aspergillus DNA in serum samples by nested PCR had the highest sensitivity of the three methods tested for the diagnosis of pulmonary aspergillosis.     

Molecular Cloning of the Gene for a Conserved Major Immunoreactive 28-Kilodalton Protein of Ehrlichia canis: a Potential Serodiagnostic Antigen

A gene encoding a 28-kDa protein of Ehrlichia canis was cloned, sequenced, and expressed, and a comparative molecular analysis with homologous genes of E. canis, Cowdria ruminantium, and Ehrlichia chaffeensis was performed. The complete gene has an 834-bp open reading frame encoding a protein of 278 amino acids with a predicted molecular mass of 30.5 kDa. An N-terminal signal sequence was identified, suggesting that the protein undergoes posttranslational modification to a mature 27.7-kDa protein (P28). The E. canis p28 gene has significant nucleic acid and amino acid sequence homologies with the E. chaffeensis outer membrane protein-1 (omp-1) gene family, with the Cowdria ruminantium map-1 gene, and with other E. canis 28-kDa-protein genes. Southern blotting revealed the presence of at least two additional homologous p28 gene copies in the E. canis genome, confirming that p28 is a member of a polymorphic multiple-gene family. Amino acid sequence analysis revealed that E. canis P28 has four variable regions, and it shares similar surface-exposed regions, antigenicity, and T-cell motifs with E. chaffeensis P28. The p28 genes from seven different E. canis isolates were identical, indicating that the gene for this major immunoreactive protein is highly conserved. In addition, reactivity of sera from clinical cases of canine ehrlichiosis with the recombinant P28 demonstrated that the recombinant protein may be a reliable serodiagnostic antigen.     

Detection of the 70-Kilodalton Histoplasma capsulatum Antigen in Serum of Histoplasmosis Patients: Correlation between Antigenemia and Therapy during Follow-Up

Histoplasmosis is an important systemic fungal infection, particularly among immunocompromised individuals, who may develop a progressive disseminated form which is often fatal if it is untreated. In such patients, the detection of antibody responses for both diagnosis and follow-up may be of limited use, whereas the detection of Histoplasma capsulatum var. capsulatum antigens may provide a more practical approach. We have recently described an inhibition enzyme-linked immunosorbent assay (ELISA) for the detection in patients’ sera of a 69- to 70-kDa H. capsulatum var. capsulatum-specific antigen which appears to be useful in diagnosis. To investigate its potential for the follow-up of histoplasmosis patients during treatment, antigen titers in the sera of 16 patients presenting with different clinical forms of histoplasmosis were monitored at regular intervals for up to 80 weeks. Sera from four of five patients with the acute form of the disease showed rapid falls in antigenemia, becoming antigen negative by week 14 (range, weeks 10 to 16). Sera from four patients with disseminated histoplasmosis showed falls in antigen levels; three of them became antigen negative by week 32; the fourth patient became negative by week 48. In contrast, antigen titers in four of six AIDS patients with the disseminated form of the disease remained positive throughout follow-up. Sera from only one patient who presented with the chronic form of the disease were analyzed, and this individual’s serum became antigen negative by week 9. The inhibition ELISA is shown to be of particular use in the monitoring of non-AIDS patients with the acute and disseminated forms of the disease and may complement existing means of follow-up.     

胃癌组织匀浆中一组新肿瘤相关抗原MG-Ags的测定及其价值

作者应用5种抗胃癌单克隆抗体(MG5,MG7 MG9 MGb2和MGd1)的等量混合物,以间接ELISA测定了14例胃癌组织及癌旁组织匀浆中胃癌相关抗原MG-Ags、发现14例癌组织中MG-Ags的平均含量是癌分组织的5.2倍,其中有12例(85.7％)癌组织中MG-Ags高于癌旁组织,说明MG-Ags与胃癌组织具有明显关系。     

A Novel Approach for Detecting an Immunodominant Antigen of Porphyromonas gingivalis in Diagnosis of Adult Periodontitis

In the course of long-term infection with Porphyromonas gingivalis in adult periodontitis, a specific antibody response to this organism is generated. We describe a potential novel approach for identifying an immunodominant antigen in human periodontitis patients. First, various monoclonal antibodies (MAbs) were established from mice immunized with crude antigen preparations of P. gingivalis FDC 381. The antigen specificities of these MAbs were compared with those of serum antibodies of 10 periodontitis patients in a competitive enzyme-linked immunosorbent assay. The binding of one MAb (termed PF18) was readily inhibited by sera from all patients but not by sera from healthy volunteers. The antigen recognized by PF18 existed on the cell surface, presumably in the capsule layer, shown by immunoelectron microscopic analysis. Purification of the antigenic substance, termed PF18-Ag, was performed by immunoaffinity chromatography with the MAb. Characterization of PF18-Ag suggested that the epitope was composed of carbohydrates but not peptides and that the substance was different from lipopolysaccharide. Measurement of levels of serum antibody to PF18-Ag better discriminated periodontitis patients from healthy individuals than measurement of antibodies to crude antigen preparations of P. gingivalis. Immunoglobulin G2 was the predominant isotype among the antibodies to PF18-Ag in the patients’ sera. These results suggest that PF18-Ag, which is possibly a novel substance, is an important antigenic substance and is potentially useful for the clinical diagnosis of adult periodontitis. The approach that was used would also be relevant to detecting immunodominant antigens of other infectious microorganisms.     

Evaluation of a Simple Blood Culture Amplification and Antigen Detection Method for Diagnosis of Salmonella enterica Serovar Typhi Bacteremia

In most areas where typhoid is endemic, laboratory diagnosis is not possible due to the lack of appropriate facilities. We investigated whether the combination of blood culture amplification of Salmonella enterica serovar Typhi with an S. Typhi antigen rapid diagnostic test (RDT) could be an accurate and inexpensive tool for the accelerated diagnosis of patients with acute typhoid in Laos. For a panel of 23 Gram-negative reference pathogens, the Standard Diagnostics (catalog no. 15FK20; Kyonggi-do, South Korea) RDT gave positive results for S. Typhi NCTC 8385, S. Typhi NCTC 786 (Vi negative), Salmonella enterica serovar Enteritidis (ATCC 13076), and Salmonella enterica serovar Ndolo NCTC 8700 (all group D). In a prospective study of 6,456 blood culture bottles from 3,028 patients over 15 months, 392 blood culture bottles (6.1%) from 221 (7.3%) patients had Gram-negative rods (GNRs) seen in the blood culture fluid. The sensitivity, negative predictive value, specificity, and positive predictive value were 96.7%, 99.5%, 97.9%, and 87.9%, respectively, for patients with proven S. Typhi bacteremia and 91.2%, 98.4%, 98.9%, and 93.9% for patients with group D Salmonella. The median (range) number of days between diagnosis by RDT and reference assays was 1 (−1 to +2) day for those with confirmed S. Typhi. The use of antigen-based pathogen detection in blood culture fluid may be a useful, relatively rapid, inexpensive, and accurate technique for the identification of important causes of bacteremia in the tropics.     

癌胚抗原检测方法学评价及其在胃癌诊断中的意义

为比较临床常用CEA检测方法的特异性和敏感性,探讨CEA在胃癌诊断中的意义,用ELISA、时间分辨荧光免疫法(TRFIA)、RIA、化学发光免疫法(CLIA)检测36例病理确诊胃癌患者血清CEA水平,同时检测20名健康体检者血清CEA水平.结果显示,四种方法的特异性均为100%,ELISA敏感性最低,为19.4%,CLIA的敏感性最高,为44.4%.结论是ELISA检测CEA的敏感性有待提高,CEA检测不能作为胃癌诊断的指标,可以作为部分胃癌患者疗效观察的指标.     

一种基于多尺度分析的CT图像边缘检测方法

为了准确提取CT图像中解剖组织几何形态特征,提出了一种基于多尺度分析的CT图像边缘检测方法。本文应用多尺度分析中含有尺度因子的平滑函数的负导数作为小波,对CT图像实施小波变换,并检测小波变换的模局部极大值,完成基于模局部极大值的解剖组织轮廓特征表达。本文还讨论了一种模局部极大值点的简单筛选方法,针对CT图像噪声较大的特点,以模局部极大值的均方根乘以一个与尺度有关的因子作为模局部极大值的阈值,在不同尺度上获得了清晰的边缘信息。阈值处理后的模局部极大值图表明,不同尺度下的边缘检测能给出大小不同的物体的边缘信息。本方法能在有效抑制噪声的基础上,准确提取感兴趣解剖组织的几何轮廓特征。