EB病毒BRLF1基因及EB病毒Rta/IgG抗体在鼻咽癌中表达的临床意义

目的探讨EB病毒BRLF1基因(EBV-BRLF1)表达量及血清EB病毒Rta/IgG(EBV-Rta/IgG)抗体浓度在鼻咽癌(NPC)早期诊断、临床分期中的意义。方法运用实时荧光定量聚合酶链反应法测量89例NPC组织的EBV-BRLF1基因表达量,采用EBV-Rta/IgG定量抗体试剂盒检测228例血清的Rta/IgG抗体浓度,分析它们与NPC早期诊断、临床分期的相关性。228例血清包括NPC组89例、鼻咽部慢性黏膜炎病例(高危组)19例和同期健康人群120例。结果 89例NPC组血清的EBV-Rta/IgG抗体浓度为(111.81±76.77)U/mL,灵敏度为75.3%(67/89),特异度为94.2%(131/139),诊断符合率为86.8%(198/228);19例高危组血清的EBV-Rta/IgG抗体浓度为(15.14±33.04)U/mL,120例健康体检组血清的EBV-Rta/IgG抗体浓度为(6.63±11.26)U/mL;各组间比较浓度差异具有统计学意义(P<0.05)。EBV-BRLF1基因在NPC肿瘤组织中的表达率为63.51%(47/74),中位表达量为8.53。NPC组中EBV-BRLF1基因表达量与N分期、M分期及临床分期无关(P>0.05),与T分期差异有关(P=0.061),接近临界范围。血清EBV-Rta/IgG抗体浓度与N分期、M分期及临床分期无关(P>0.05)。在T分期组间比较中发现,T3期呈一定上升趋势,T2与T3组间差异具有统计学意义(P=0.048)。结论 EBV-BRLF1基因在NPC组织中高度表达;EBV-Rta/IgG定量抗体试剂盒检测可以作为早期筛查NPC的临床指标之一;EBV-BRLF1基因表达量及血清EBV-Rta/IgG抗体浓度与NPC的N分期、M分期及临床分期无关,与T分期局部组织浸润呈一定相关性。     

眼弓蛔虫病患者眼内液与血清犬弓蛔虫特异性IgG抗体检测

目的 评价眼内液犬弓蛔虫特异性IgG抗体检测在眼弓蛔虫病诊断中的作用.方法 临床确诊为眼弓蛔虫病的50例患者(眼弓蛔虫病组)、就诊于耳鼻喉科的152例患者(血清对照组)及就诊于眼科的70例其他病患者(眼内液对照组)纳入研究.眼弓蛔虫病组收集房水样本28份,玻璃体液样本22份,血清样本50份;血清对照组收集血清样本152份;眼内液对照组收集房水样本46份,玻璃体液样本24份.采用酶联免疫吸附试验检测所有受检者眼内液及血清中犬弓蛔虫特异性IgG抗体的阳性率.同时对眼弓蛔虫病组患者的血清及眼内液样本进行配对检测,对比分析两者之间的犬弓蛔虫特异性IgG水平的差异.结果 眼弓蛔虫病组血清犬弓蛔虫特异性IgG阳性率为68.00％,U值为20.42±17.01;眼内液犬弓蛔虫特异性IgG阳性率为88.00％,U值为25.72±23.04.血清对照组血清犬弓蛔虫特异性IgG阳性率为2.63％,U值为2.37±2.71;眼弓蛔虫病组患者血清特异性IgG水平较血清对照组明显偏高,差异有统计学意义(Z=8.962,P=0.000).眼内液对照组未见眼内液犬弓蛔虫特异性IgG阳性者,U值为0.69±0.34;眼弓蛔虫病组患者眼内液特异性IgG水平较眼内液对照组明显偏高,差异有统计学意义(Z=8.120,P=0.000).眼弓蛔虫病组50例患者中,血清及眼内液犬弓蛔虫特异性IgG均为阳性者28例,占56.00％;血清犬弓蛔虫特异性IgG阳性,而眼内液犬弓蛔虫特异性IgG阴性者6例,占12.00％;血清犬弓蛔虫特异性IgG阴性,而眼内液犬弓蛔虫特异性IgG阳性者16例,占32.00％.血清与眼内液犬弓蛔虫特异性IgG阳性率比较,差异有统计学意义(x2=4.720,P=0.028).眼弓蛔虫病组患者的血清及眼内液样本配对检测结果显示,32例患者的眼内液犬弓蛔虫特异性IgG水平高于血清样本,占64.00％.结论 眼内液犬弓蛔虫特异性IgG抗体检测相对于血清具有更高的检出率.眼内液与血清犬弓蛔虫特异性IgG抗体的共同检测可能具有更好的诊断价值.     

传染性单核细胞增多症合并钱币状(nummular)角膜炎

传染性单核细胞增多症为一常见病,其临床表现多变,从无症状到可以影响包括眼在内的多个不同器官的严重疾病。病因为DNA疱疹型Epstein-Barr(EB)病毒。实验室确诊根据下述二项血清学检查:(1)嗜异性抗体试验;(2)间接荧光抗体滴定以测定EB病毒的细胞或病毒抗原。本文报告一例严重的单核细胞增多症并发双眼对称性实质性钱币状角膜炎。患者16岁男孩,     

急性视网膜坏死患者眼内液中的单疱病毒Ⅰ型抗体

本文从3例急性视网膜坏死患者的眼内液(房水,玻璃体和视网膜下液)及血清中检出单疱病毒Ⅰ型抗体。并选择120例经常规内眼手术而无单疱病毒感染者作为对照。例1为55岁女性。于左眼施行继发性视网膜脱离手术时取得视网膜下液,经检查发现单疱病毒Ⅰ型抗体IgG效价为1:128,其血清中抗体效价亦为1:128。例2为56岁女性,亦于继发性视网膜脱离施术时取得右眼玻璃体和视网膜下液,血清中单疱病毒Ⅰ型抗体IgG阴性,而视网膜下液和玻璃体中存在单疱病毒Ⅰ型抗体IgG,效价均为1:16。例3为     

房水检测在青光眼睫状体炎综合征诊断中应用的临床研究

目的观察青光眼睫状体炎综合征(PSS)的临床表现特点,评估应用房水检测在PSS早期诊断中的效果。 方法回顾性分析2019年5月至2021年7月于北京首都医科大学附属北京朝阳医院眼科确诊PSS患者41例(41只眼)和老年性白内障患者30例(30只眼)的病例资料。其中,男性38例(38只眼),女性33例(33只眼);年龄15~86岁,平均年龄(54.4±10.3)岁。患有PSS者定义为PSS组;老年性白内障患者定义为对照组。使用非接触式眼压计检查患者的眼压;使用光学相干断层扫描仪检查患者的视盘杯盘比;使用裂隙灯显微镜观察房水的性状,包括羊脂状角膜后沉着物(KP)、Tyndall征及前房浮游细胞。采集所有患者的房水,检测其病毒载量、病毒抗体及细胞因子浓度。病毒包括巨细胞病毒(CMV)、单纯疱疹病毒(HSV)、带状疱疹病毒(VZV)及EB病毒(EBV);细胞因子包括白细胞介素(IL)-6、IL-8、IL-10、血管内皮生长因子(VEGF)、血管细胞黏附分子(VCAM)及碱性成纤维细胞生长因子(bFGF)。对患者的年龄和以房水为标本检测的HSV、VZV、CMV、EBV、IL-6、IL-8、IL-10、VEGF、VCAM及bFGF等指标的检测结果行正态性分布检验,符合正态分布的计量资料以±s表示,组间比较采用独立样本t检验;偏态分布的计量资料以中位数和上下四分位数表示,组间比较采用Mann-Whitney秩和检验。房水病原体阳性率以例数和百分比表示,组间比较采用Mcnemar配对卡方检验。 结果PSS组患者行房水生物显微镜观察羊脂状KP、Tyndall征及前房浮游细胞者分别为33例、32例及29例;行眼压测量者33例;行光学相干断层扫描检查杯盘比者32例。其中,羊脂状KP(+)者24例,占72.7%;Tyndall征(+)者12例,占37.5%;前房浮游细胞(+)者5例,占17.2%;眼压增高(>21 mmHg)(1 mmHg＝0.133 kPa)者15例,占45.5%;杯盘比≥0.6者7例,占21.9%。PSS组患者行HSV、VZV、CMV及EBV核酸检测者分别为22例、22例、38例及25例。其中,CMV(+)者9例,占23.7%,其余均为阴性。PSS组患者行HSV、VZV、CMV及EBV的免疫球蛋白(Ig)G抗体检测者分别为23例、21例、31例及20例。其中,HSV-IgG(+)、VZV-IgG(+)及CMV-IgG(+)抗体者分别为2例、1例及16例,分别占8.7%、4.8%及51.6%。其余均为阴性。对照组30例HSV、VZV、CMV及EBV核酸和IgG抗体检测阳性者均为0。PSS组患者中同一病例同时检测CMV核酸与CMV-IgG抗体者29例。PSS患眼房水CMV的核酸检测阳性检出率为24.1%,CMV-IgG抗体的阳性检出率为48.3%,高于前者。经Mcnemar配对卡方检验,组间比较的差异无统计学意义(P>0.05)。PSS患眼房水IL-6、IL-8、IL-10、VEGF、VCAM及bFGF的含量分别为22.5(5.1,212.7)pg/ml、18.1(8.4,54.1)pg/ml、3.6(0.5,9.0)pg/ml、20.2(14.7,28.0)pg/ml、1212.4(369.9,3617.9)pg/ml及5.9(0.0,7.3)pg/ml。对照组患眼分别为9.9(3.7,34.9)pg/ml、9.6(2.0,24.2)pg/ml、1.6(1.0,5.2)pg/ml、20.5(11.2,24.5)pg/ml、116.4(83.8,178.5)pg/ml及7.1(1.0,15.6)pg/ml。经Mann-Whitney秩和检验,两组患者IL-8、VCAM及bFGF比较的差异有统计学意义(Z＝-2.57,-4.77,-2.07;P<0.05);两组患者IL-6、IL-10及VEGF比较的差异无统计学意义(Z＝-1.56,-1.18,-0.25;P>0.05)。 结论PSS的主要临床表现为羊脂状KP(+)、眼压升高。房水中CMV核酸阳性、IgG抗体阳性、细胞因子IL-8升高及VCAM升高在诊断PSS时灵敏度高,对PPS的辅助诊断有临床价值。     

水痘-带状疱疹病毒特异性迟发性超敏反应与水痘-带状疱疹病毒感染引起的前葡萄膜炎之间的关系

临床上患者出现急性视网膜坏死时 ,机体缺乏对水痘 -带状疱疹病毒 (VZV)抗原的迟发性超敏反应 (DH) ,提示机体对VZV抗原的DH可减缓急性视网膜坏死。该研究目的是确定VZV感染与前葡萄膜炎患者是否也同样存在相关关系。方法 :用VZV和纯蛋白衍生物(PPD)抗原评价DH ,用皮试检测VZV引起的急性前葡萄膜炎患者 1 2例 ,VZV引起的前葡萄膜炎而无皮炎患者 3例 ,以年龄与之匹配的眼部带状疱疹病毒感染而无葡萄膜炎的患者 7例为对照组。采用PCR方法和血清抗体滴度测定诊断VZV感染引起的前葡萄膜炎。采集血样检测和分析抗VZV抗体滴度。前…     

单纯疱疹病毒眼感染的实验室诊断（二）

(二)抗体检测在HSV感染诊断中的应用由于成人90％以上都感染过HSV,因此血液HSV抗体检测对HSV感染诊断意义不大,而测定泪液中的HSV特异性抗体IgG,由于其它炎症的泪液中的阳性率也占14.2％,故其不能鉴别此类抗体在泪液中是否是局部产生或炎症损伤血管而产生的渗出性血清抗体。Pedersen(1982)用RIA从泪液中测出具有特异性抗HSV分泌型IgA(SIgA)其仅出现在HSK病人患眼泪中,作者在复发性HSK病人泪液中测得抗HSV特异性SIgA在初次症状发生后3—5天达到最高峰,较之正常对照组高20倍,因而认为泪液中HSV特异性SIgA测定对HSK的诊断有一定价     

急性咽喉感染患者肺炎衣原体的检测

目的探索肺炎衣原体(Chlamydia pneumoniae,Cpn)与急性咽喉感染之间的关系.方法用直接免疫荧光(direct immunofluorescence,DIF)法检测外周血单核细胞中的Cpn特异性抗原,间接微量免疫荧光(microimmunofluorescence,MIF)法检测血浆中Cpn抗体.结果在94例急性咽喉感染患者和87例正常人血浆中,Cpn IgG的阳性检出率分别为54.3%(51/94)和32.2%(28/87),P＜0.05;Cpn IgM的阳性检出率分别为59.6%(56/94)和12.6%(11/87),P＜0.05;外周血单核细胞中的Cpn特异性抗原阳性检出率分别为62.78%(59/94)和31.0%(27/87),P＜0.05.结论急性咽喉感染与肺炎衣原体有密切关系.检测外周血单核细胞中Cpn特异性抗原可为诊治急性咽喉感染提供实验依据.     

疱疹病毒性角膜炎患者泪液病毒学检测及临床特征

目的探讨疱疹病毒性角膜炎的病毒病原学检测结果、临床特征及治疗。设计回顾性病例系列。研究对象2012年12月至2014年9月在北京同仁医院眼科门诊临床诊断为疱疹病毒性角膜炎并且溃疡累及角膜上皮层或基质层的80例患者。按年龄将患者分为儿童组(0~16岁)4例(5%)、成年组(17~59岁)56例(70%)和老年组(≥60岁)20例(25%)。其中男性43例(53.75%),女性37例(46.25%)。方法对患者的泪液进行病毒抗体检测。对泪液和溃疡区角膜上皮细胞进行RT-PCR检测。分析患者的一般情况、眼部症状、体征及并发症。上皮型溃疡患者给予抗病毒及促角膜修复治疗;基质浅层溃疡患者给予抗病毒、抗炎及散瞳治疗;基质深层溃疡患者给予抗病毒、免疫抑制剂及散瞳治疗。随访,分析其疗效。平均随访时间8.5个月。主要指标病毒检测结果、发病季节、年龄、性别、眼部表现及治疗。结果 80例患者中,75例(93.75%)为单眼发病。发病季节:冬季44例(55.00%),春季20例(25.00%),秋季9例(11.25%),夏季7例(8.75%)。单纯疱疹病毒-1(HSV-1)抗体检测阳性20例,HSV-2抗体检测阳性11例。PCR检测HSV-1阳性23例,EB病毒(EBV)阳性2例,HSV-2、水痘-带状疱疹病毒(VZV)和巨细胞病毒(CMV)检测均为阴性。病毒性角膜炎患者中,上皮型32例(40%),基质型48例(60%)。此两种类型在各年龄组分别为:儿童组1例、3例,成年组25例、31例,老年组6例、14例。不同年龄段患者在上皮型和基质型角膜炎中所占比例差异无统计学意义(χ2=1.975,P=0.43)。不同性别的患者在上皮型和基质型角膜炎中所占比例差异无统计学意义(χ2=2.20,P=0.14)。治疗1个疗程(2周)后,58例(72.5%)患者均有好转(角膜溃疡较前缩小,结膜充血及前房反应减轻)。HSV-1阳性患者复发0~3次,平均1.48次;2例EB阳性患者分别复发5次和3次,两者比较差异有统计学意义(F=18.2065,P=0.000)。结论疱疹病毒性角膜炎除HSV-1外,也可由EB病毒感染引起。且EB病毒感染者更易复发。病毒性角膜炎好发于冬季。发病与性别、年龄无关。     

先天性青光眼患儿房水及血清疱疹病毒抗体检测分析

目的研究原发性先天性青光眼(PCG)患儿房水及血清中的疱疹病毒感染情况,并比较分析病毒抗体阳性和阴性PCG患儿临床特点的差异。方法抽取13例PCG患儿首次手术眼13眼的房水及血清,采用酶联免疫吸附试验(ELISA)检测房水单纯疱疹病毒(HSV)、水痘-带状疱疹病毒(VZV)、巨细胞病毒(CMV)Ig G抗体,血清中HSV、VZV、CMV Ig G和Ig M抗体,并采用聚合酶链反应(PCR)验证房水中病毒情况。抽取13例老年性白内障患者的房水作为房水对照组;抽取50例同年龄健康儿童外周血作为血清对照组。对PCG疱疹病毒抗体阳性组和阴性组间年龄、性别、眼别、最高眼压、杯盘比、角膜直径、房角结构、Haab纹等临床特点进行比较分析。结果 13例PCG患儿中9例(69.2%)血清疱疹病毒抗体检测阳性,对照组50例儿童无血清疱疹病毒抗体检测阳性病例;在所有13例PCG患儿中,房水病毒抗体阳性1例(CMV-Ig G),另1例CMV PCR阳性,此2例患者血清疱疹病毒Ig G抗体检测均为阳性,其余房水样本及对照组房水病毒检测均为阴性。PCG患儿中,起病最高眼压、角膜直径、杯盘比和Haab纹所占比例在病毒阳性组和阴性组间差异均无统计学意义。结论超过一半(69.2%)的PCG患者存在血清疱疹病毒抗体阳性。病毒阳性组与阴性组的起病最高眼压、角膜直径、杯盘比及Haab纹占比基本相似。     

荧光定量反转录-聚合酶链反应检测鼻咽癌患者外周血肿瘤细胞微转移的研究

目的 探讨荧光定量反转录聚合酶链反应(FQ-RT-PCR)检测外周血CK14 mRNA、表皮生长因子受体(EGFR)mRNA的表达在鼻咽癌患者外周血肿瘤细胞微转移诊断中的价值.方法 采用FQ-RT-PCR方法检测87例入组鼻咽癌患者外周血CK14 mRNA、EGFR mRNA的表达,并分析其与肿瘤TNM分期、临床分期、组织分化程度的关系.结果 87例鼻咽癌患者外周血中,CK14 mRNA、EGFR mRNA阳性表达率分别为64.4%( 56/87)、58.6% (51/87),两者联合检测的阳性表达率为71.3% (62/87);CK14 mRNA、EGFR mRNA的表达水平与T分期、N分期、临床分期、组织分化程度有关(P＜0.05),分期越晚,外周血中CK14 mRNA、EGFR mRNA 的表达水平越高,低分化鳞癌患者外周血中CK14 mRNA、EGFR mRNA的表达水平高于高中分化鳞癌患者.结论 FQ-RT-PCR方法检测鼻咽癌患者外周血CK14 mRNA、EGFR mRNA的表达,能够较准确反映外周血肿瘤细胞微转移的情况,在诊断鼻咽癌患者外周血肿瘤细胞微转移方面有一定的可行性;鼻咽癌患者外周血肿瘤细胞微转移与肿瘤的恶性程度和病情进展有关.(中国眼耳鼻喉科杂志,2011,11:219-223)     

Tear IgA and serum IgG antibodies against Acanthamoeba in patients with Acanthamoeba keratitis

PURPOSE: Exposure to Acanthamoebaspecies appears to be ubiquitous, as 50% to 100% of healthy human subjects display anti-Acanthamoebaantibodies. However, the presence of specific anti-Acanthamoebaantibodies in the serum and tears of patients has not been investigated. The prevalence of serum immunoglobulin G (IgG) and tear IgA against three species of Acanthamoebawas assessed in healthy subjects and patients with Acanthamoebakeratitis. METHODS: The level of specific serum IgG and tear IgA against A. castellanii, A. astronyxis, and A. culbertsoniin the sera of 23 patients and 25 healthy subjects was tested by enzyme-linked immunosorbent assays. Total serum IgM, IgG, and IgA concentrations were measured by nephelometry. Acanthamoebakeratitis was diagnosed clinically and confirmed by in vivo confocal microscopy. In some patients, corneal biopsies were also performed and trophozoites were cultured on lawns of Escherichia colion non-nutrient agar. RESULTS: All healthy subjects and patients with Acanthamoebakeratitis had detectable serum IgG antibodies against all Acanthamoebaantigens. However, patients with Acanthamoebakeratitis had significantly higher anti-AcanthamoebaIgG antibody titers than healthy subjects. In contrast, Acanthamoeba-specific tear IgA was significantly lower in patients with Acanthamoebakeratitis in comparison with healthy subjects. Total serum immunoglobulins did not differ significantly between healthy subjects and patients with Acanthamoebakeratitis. CONCLUSIONS: The results suggest that a low level of anti-AcanthamoebaIgA antibody in the tears appears to be associated with Acanthamoebakeratitis.     

鼻咽癌放疗性角膜损伤的跟踪研究

目的:探讨鼻咽癌(NPC)放射治疗眼部并发症。方法:对 213 例 NPC 初程放疗患者进行跟踪观察。放疗前、放疗中及放疗后作视功能(包括远视力、裂隙灯活体显微镜、眼底、自动电脑视野及视诱发电位)检查和角膜荧光素染色。结果:发生角膜损伤 19 例,占 8.9 %(19/213)。I～Ⅱ期6 例,Ⅲ期 8 例,Ⅳ期 5 例。全部发病患者均无角膜刺激症状,放疗后 10mo 内,角膜病变消退,但知觉仍较对侧眼明显减退;20mo 后尚未恢复正常。未发现晶状体混浊的患者。结论:NPC 放疗性角膜损伤与鼻咽癌临床分期及照射剂量无密切关系(P>0.05),可能主要与角膜感觉神经损伤导致眼表疾病密切相关;不排除患者不同个体对辐射的敏感差异性。     

Chlamydia pneumoniae in central retinal artery occlusion

PURPOSE: There is increasing evidence that the common respiratory human pathogen Chlamydia pneumoniae has a causative role in atherosclerosis. We investigated the association of this pathogen with acute central retinal artery occlusion (CRAO). PATIENTS AND METHODS: Sera of 14 consecutive patients with CRAO and of 14 age- and sex-matched control subjects were examined. Antibodies against chlamydial lipopolysaccharide (LPS) and outer membrane proteins of C. pneumoniae were determined by an enzyme-linked immunosorbent assay (ELISA). RESULTS: In the CRAO group, seven patients (50%) were found to be IgA positive, 12 (86%) were IgG positive and one (7%) was IgM positive for chlamydial LPS antibodies. In the control group 36%, 79% and 14% were IgA, IgG and IgM positive, respectively. The results showed no significant difference between the groups. In the CRAO group, IgA, IgG and IgM antibodies to C. pneumoniae were found in 43%, 79% and 0% of subjects, respectively. These findings did not differ significantly from those pertaining to matched controls. CONCLUSIONS: These data do not support an association between acute CRAO and current C. pneumoniae infection.     

鼻咽癌患者放化疗前后外周血浆EB病毒DNA含量变化

目的比较鼻咽癌（nasopharyngeal carcinoma,NPC）患者放化疗前后血浆EB病毒DNA（EpsteinBarrVirusDNA,EBV-DNA）水平的变化,评价EBV—DNA水平与NPC肿瘤负荷及短期疗效的关系。方法采用实时荧光定量聚合酶链反应测定60例鼻咽癌患者放化疗前后及40例健康对照者外周血浆中的EBV—DNA水平。结果NPC治疗前EBV-DNA阳性率为83．3％,中位拷贝数为8869copy／mL;治疗后阳性率为21．7％,中位拷贝数为0copy／mL;健康对照组阳性率为5．0％,中位拷贝数为0copy／mL。NPC残留组阳性率为81．8％,中位拷贝数为7263copy／mL;消退组阳性率为8．2％,中位拷贝数为0copy／mL。NPC患者治疗前及治疗后组血浆游离EBV—DNA水平及阳性率均高于健康对照组（P〈0．05）,治疗前高于治疗后（P〈0．01）。放化疗后,NPC残留组高于消退组（P〈0．01）。结论NPC患者血浆EBV—DNA水平是反映肿瘤负荷的灵敏指标,可作为短期疗效评估的参考。     

Circulating anti-galectin-1 antibodies are associated with the severity of ocular disease in autoimmune and infectious uveitis

PURPOSE: Galectin (Gal)-1, an endogenous lectin found at sites of immune privilege, plays a critical role in the regulation of the immune response. Therapeutic administration of Gal-1 or its genetic delivery suppresses chronic inflammation in experimental models of autoimmunity. The purpose of this work was to investigate the occurrence of circulating anti-Gal-1 antibodies in patients with autoimmune and infectious uveitis as potential determinant factors of disease progression. METHODS: IgG, IgE, and IgA anti-Gal-1 antibodies were assessed by ELISA and Western blot in sera from patients with autoimmune (n = 47) and infectious (n = 15) uveitis compared with healthy control subjects (n = 30). The frequency of anti-Gal-1 antibodies was examined in patients experiencing poor clinical outcome (n = 21) or good evolution (n = 9). Anti-Gal-1 antibodies were eluted by incubating patient sera with nitrocellulose filters adsorbed with rGal-1. The ability of these antibodies to recognize retinal tissue was assessed by ELISA, Western blot, and immunohistochemistry. RESULTS: IgE, IgG, and IgA anti-Gal-1 antibodies were increased in sera from patients with autoimmune uveitis (P < 0.001 vs. controls) and toxoplasmic retinochoroiditis (P < 0.001). The level of anti-Gal-1 IgE and IgG antibodies was associated with progressive disease and poor outcome in autoimmune and infectious uveitis. Furthermore, these antibodies strongly immunoreacted with retinal lysates and recognized retinal structures mainly photoreceptors in retinal sections. CONCLUSIONS: Anti-retinal Gal-1 antibodies are present in sera from patients with uveitis and can be associated with the progression of ocular disease, suggesting their potential use in follow-up observations of these patients.     

Circulating antibodies to human and bovine cornea in human keratoplasty

PURPOSE: To compare anti-human cornea and anti-bovine cornea serum reactivity in corneal transplantation and pathology. METHODS: We investigated the presence of IgG and IgM antibodies to bovine corneal extract (BCE) and human corneal extract (HCE) by ELISA in 48 healthy adults and in 30 corneal allograft recipients before and after grafting. Baseline levels of antibodies in healthy controls served to establish a positivity threshold. Anti-HLA antibodies were investigated in all patients. RESULTS: Preoperatively, five and one patient were positive respectively for IgG and IgM anti-BCE; one and ten patients were positive for IgG and IgM anti-HCE. The presence or absence of antibodies was not modified after grafting, and was not associated with rejection. Anti-HCE of the IgM class were more frequent in patients with keratoconus. Two patients had anti-HLA antibodies. CONCLUSIONS: Antibodies to non-HLA corneal antigens are detectable in corneal allograft recipients. Reactions against bovine and human substrates differ in frequency and class. This reactivity is not modified after grafting or rejection, but is increased in corneal disorders, including keratoconus.     

Secretory IgA specific for herpes simplex virus in lacrimal fluid from patients with herpes keratitis--a possible diagnostic parameter.

In the present study a solid-phase radioimmune assay was used for the demonstration of herpes simplex virus-specific IgG and secretory IgA antibodies in the lacrimal fluid from patients with active recurrent herpes keratitis. The method was quantitative and made it possible to test specifically for the production of secretory IgA antibodies produced during an active herpes simplex virus infection. The production of secretory IgA was followed in 2 patients with fresh recurrent lesions. The HSV-specific secretory IgA could be demonstrated during the first 10 days of infection, where the maximal concentration was reached 3-5 days after the first symptoms occurred. The secretory antibodies were locally produced, and it is shown for the first time that herpes virus-specific secretory antibodies were of diagnostic value.     

Chlamydial antibodies in patients with previous acute anterior uveitis.

PURPOSE. To determine the prevalence of antibodies to Chlamydia pneumoniae, C. trachomatis, and C. pneumoniae heat shock protein (Cpn Hsp60) in patients with acute anterior uveitis (AAU) and in sex- and age-matched healthy control subjects. METHODS. Altogether 64 patients with previous AAU were examined at the Helsinki University Eye Hospital from September through December 1999. Serum specimens from the patients and sex- and age-matched healthy control subjects were tested for antibodies to C. pneumoniae and C. trachomatis by a specific microimmunofluorescence test and for antibodies to Cpn Hsp60 by enzyme immunoassay (EIA). RESULTS. The prevalence of antibodies to C. pneumoniae (69% vs. 72%) and C. trachomatis (11% vs. 6%) did not differ significantly between the patients and control subjects, nor did the level of IgG antibodies to Cpn Hsp60 (median EIA unit, 65 vs. 48). The levels of IgA antibodies to Cpn Hsp60 were significantly higher in the patients with AAU than in the control subjects (median EIA unit, 18 vs. 10; two-tailed Wilcoxon signed rank test, P = 0.0001). CONCLUSIONS. The high frequency of IgA antibodies to Cpn Hsp60 in patients with past AAU indicates that such patients may have persisting or recurrent infections due to C. pneumoniae. This finding suggests that C. pneumoniae may play a role in the pathogenesis of AAU.     

Proteins in tears from healthy and diseased eyes

The levels of total protein in tears from healthy donors, conjunctivitis vernalis patients, and conjunctivitis follicularis patients, were 625, 1370 and 1160 mg% respectively. Serum albumin accounted for 3.3%, 43% and 67% of the total protein of tears from these groups, and the level of proteins probably synthesized by the lacrimal gland, was in tears from conjunctivitis follicularis patients only half the level in normal tears. By crossed immunoelectrophoresis with intermediate gel, 10 antigenic species could be recognized in normal tears, and of these the following were identified: Lysozyme, IgA, lactoferrin and serum abumin. In tears from patients with conjuntivitis vernalis three more immunoprecipitates were observed, of which one was due to IgG. No lysozyme could be demonstrated in tears from a case of conjunctivitis sicca by immunoelectrophoresis.In tears from healthy donors the mean level of IgA was 20 mg%, of IgG 3 mg%, and IgM could not be demonstrated. Rabbit anti-tear immunoglobulin did not precipitate a standard of human IgM in double immunodiffusion. In cases of conjunctivitis vernalis and follicularis the mean levels were increased to 80 and 114 mg% IgG, and 11 and 14 mg% IgM, but IgA was increased only to 32 and 41 mg%. It is assumed that the level of IgA in normal tears is almost entirely due to local synthesis, while serum albumin and other immunoglobulins may have escaped from the circulation by molecular sieving. The increased levels of immunoglobulins in inflammatory diseases is probably due to transudation. However, in blepharoconjunctivitis patients several tear samples with a high IgM and a low or zero level of IgG could be demonstrated. Possible explanations for this phenomenon are discussed.