应用合成肽检测病毒性心肌炎患者血清中柯萨奇B组病毒抗体

目的研究应用合成肽代替完整病毒检测柯萨奇Ｂ组病毒（ＣＶＢ）抗体及其在病毒性心肌炎（ＶＭＣ）病因诊断中的作用。方法从ＣＶＢ衣壳蛋白ＶＰ１及ＶＰ３的保守区及ＣＶＢ３衣壳蛋白ＶＰ２的非保守区各选出一段多肽（分别称为ＶＰ１－１肽、ＶＰ３－１肽、ＶＰ２－１肽）进行化学合成，应用酶联免疫吸附法（ＥＬＩＳＡ）检测这几条多肽与型特异性ＣＶＢ１～６抗体的结合反应。以ＶＰ１－１肽、ＶＰ３－１肽作包被抗原，用间接ＥＬＩＳＡ检测患者血清中ＣＶＢＩｇＧ及ＶＣＢＩｇＭ抗体。结果ＶＰ１－１肽和ＶＰ３－１肽与型特异性ＣＶＢ１～６抗体均有良好的结合反应。８５例健康人、６７例急性ＶＭＣ、３９例慢性ＶＭＣ患者血清ＣＶＢＩｇＧ阳性率分别为２３．５％、５３．７％、３８．５％，ＣＶＢＩｇＭ阳性率分别为７．１％、４９．３％、２８．２％。ＣＶＢＩｇＭ抗体与中和抗体检测结果之间有良好的相关性（Ｐ＜０．００１），阳性率无明显差别（Ｐ＞０．０５）。结论应用合成肽抗原检测ＣＶＢＩｇＭ抗体有较好的敏感性和特异性。

Detection of Antibodies to Coxsackie B Viruses in Sera of Patients with Viral Myocarditis by Using Synthetic Peptides

Purpose To study the detection of antibodies to coxsackie B viruses(CVB) by using synthetic peptides and their use in the etiologic diagnosis of viral myocarditis. Methods Two peptides(VP11 and VP31)derived from the conserved regions of CVB4 coat protein VP1 and VP3 and one peptide(VP21)derived from the non conserved regions of CVB3 coat protein VP2 were synthesized chemically.Typespecific sera against CVB1 6 were tested with ELISA for binding to the synthetic peptides.Indirect ELISA techniques for detecting antibodies to CVB using VP11 peptide or VP31 peptide as the coating antigen were carried out. Results All the six anti CVB sera excellently bound to VP11 peptide and VP31 peptide,and antisera raised against CVB2,B3, B4,and B5 bound to VP21 peptide.Eightyfive healthy controls,67 patients with acute viral myocarditis,and 39 patients with chronic viral myocarditis were tested with ELISA for CVBIgG and CVBIgM antibodies.The CVBIgG positive rate was 23.5%,53.7%,and 38.5%,respectively.The CVBIgM positive rate was 7.1%, 49.3%,and 28.2%,respectively. A significant correlation between the results from the indirect ELISA using the peptides as the coating antigen for the CBVIgM antibodies and the results from neutralization test for the neutralization antibodies was found( P <0.001).The positive rate of CVBIgM was similar to that of neutralization antibody( P >0.05). Conclusions Indirect ELISA with the synthetic peptides as the coating antigens is sensitive and specific for detecting IgM antibodies to CVB.