棘球蚴病患者IgG抗体阴性反应血清再检测的研究

目的　探索棘球蚴病患者抗体应答假阴性反应原因 ,以改进棘球蚴病的免疫诊断方法。　方法　采用间接ELISA和双抗体夹心ELISA方法 ,检测 42例IgG抗体阴性反应棘球蚴病患者血清的IgG亚类 (IgG1、IgG2、IgG3和IgG4 )、IgA、IgM、IgE抗体及抗原和循环免疫复合物。　 结果　 42例阴性血清中 ,32例IgG亚类或IgA、IgM、IgE抗体阳性 ,1 0例血清抗体全部阴性。其中IgG1、IgG4及IgA、IgM、IgE的检出率明显高于正常人 ,分别为 42 .9%、1 1 .9%、2 8.6 %、2 6 .2 %和 2 1 .4 %。小儿的IgM高于成人。肝棘球蚴病患者的IgG亚类高于肺棘球蚴病患者。IgG1与其它抗体联合检测 ,以IgG1 +IgA +IgM检出率最高 ,为 64 .3 %。IgG阴性患者血清的CAg和CIC阳性率分别为 2 8.57%及30 .95 %。　结论　抗棘球蚴总IgG抗体表达水平低下 ,抗体表达种类不同及循环免疫复合物的形成 ,是造成棘球蚴病患者IgG抗体反应阴性的主要原因。IgG1 +IgA +IgM检测可提高棘球蚴病患者的诊断率

Reexamination of Specific Antibodies in Sera of Cystic Echinococccosis Patients with IgG Negative Seroresponse

Objective To explore the factors of false negative antibody response in patients with echinococcosis granulosus (Eg) for improving immunodiagnosis. Methods Indirect ELISA and sandwich ELISA were used to detect the specific antibody of IgG subclass (IgG1, IgG2, IgG3, IgG4) and IgA, IgM, IgE, as well as circulating antigen (CAg) and immunocomplex (CIC) in sera of Eg patients with negative response of total IgG. Results Among 42 sera with IgG negative seroresponse, 32 were positive with IgG subclass, IgA, IgM or IgE antibody, 10 were negative in all 7 kinds of antibody response. The detection rate of specific IgG1, IgG4, IgA, IgM and IgE was 42.9%, 11.9%, 28.6%,26.2%and 21.4% respectively, being significantly higher than in sera of the control. IgM level in children was higher than that in adults. IgG subclass in patients with liver Eg was higher than that of pulmonary hydatidosis, when testing with IgG1 combined one or two of the other six Ig antibodies. The highest positive rate (64.3%) was seen in IgG1+IgA+IgM antibody system. The positive rate of CAg and CIC in IgG negative patients was 28.57% and 30.95%, respectively. Conclusion The factors involved with seronegative response of total IgG in Eg patients might be low specific IgG, variant Ig antibody expression and formation of CIC. Combined detection of IgG1+IgA+IgM could enhance the sensitivity of serological tests in Eg patients.