小儿包虫病免疫球蛋白及IgG亚类抗体检测的诊断价值探讨

目的　研究小儿包虫病的免疫诊断方法 ,探索其抗体应答阴性反应原因。方法　采用间接ELISA和单克隆双抗体夹心ELISA方法 ,对 1998年 5月至 2 0 0 2年 5月新疆自治区人民医院普外科 5 5例小儿包虫病患儿血清的IgG及亚类IgG1、IgG2 、IgG3 、IgG4和IgA、IgM、IgE类抗体及抗原和循环免疫复合物 (CIC)进行检测。 结果　 8种抗体检查方法中IgG1亚型抗体检测的敏感性和特异性最好 ;15例IgG抗体阴性患儿中 ,有 12例分别检测出IgG亚类和 (或 )IgM、IgA、IgE ,有 3例患儿血清各种抗体均呈阴性反应 ;患儿IgM抗体阳性率高于成人 ;IgG1分别与其它种抗体联合检测 ,以IgG1 IgA IgM检出率最高 ;IgG阴性小儿患者血清的循环抗原和CIC阳性率分别为 4 0 %及 2 6 6 7%。结论　IgG1 IgA IgM抗体联合检测方法可提高小儿包虫病免疫诊断的敏感性。抗包虫总IgG抗体表达水平低下、抗体表达种类不同及CIC的形成 ,是造成包虫病患儿IgG抗体反应阴性的主要原因

Studies on the detection of specific antibodies of IgG subclasses to Cystic Echinococcosis granulosus in children

Objective To explore immunodiagnosis methods of Echinococcus granulosus(Eg) in children and the factors of false negative antibody response in patients with Eg.Methods Indirect ELISA and sandwich ELISA were used to detect the specific antibody of IgG subclass (IgG 1 ,IgG 2 ,IgG 3 ,IgG 4 ) and IgA,IgM,IgE,as well as circular antigen (CAg) and immunocomplex (CIC) in sera of Eg patients in children.Results Sensitivity and specificity of IgG1 subclass is superior to that of the other seven antibodies.Among 15 sera with the total IgG negative seroresponse of Eg in children,there were 12 revealed IgG subclass and(or) IgA,IgM and IgE antibody ,and 3 sera with negative in all 7 kinds of antibody response.The positive rate of IgM antibody was higher in children than in adults.In the detection of IgG 1 with one or two of the other six Ig antibodies,the highest positive rate was seen in IgG 1 IgA IgM antibody system.The positive rate of CAg and CIC in IgG negative patients were 40% and 26.7%,respectively.Conclusion Combined detection with IgG 1 IgA IgM can improve the sensitivity for diagnosing the Eg in children.The factors involved in sero negative response of total IgG in Eg patients in children were complex which may be low specific IgG,variant Ig antibodies expression or formation of CIC.