Diagnosis of Epstein-Barr virus (EBV) infection is based on clinical symptoms and serological markers, including the following: immunoglobulin G (IgG)and IgM antibodies to the viral capsid antigen (VCA), heterophile antibodies, and IgG antibodies to the EBV early antigen-diffuse (EA-D) and nuclear antigen (EBNA-1). The use of all five markers results in 32 possible serological patterns. As a result, interpretation of EBV serologies remains a challenge. The purpose of this study was to use a large population of patients to develop evidence-based tools for interpreting EBV results. This study utilized 1,846 serum specimens sent to the laboratory for physician-ordered EBV testing. Chart review was performed for more than 800 patients, and diagnoses were assigned based on physician-ordered testing, clinical presentation, and patient history. Testing for all five EBV antibodies was performed separately on all serum samples using the Bio-Rad BioPlex 2200 system. Presumed EBV diagnosis (based on previous publications) was compared to EBV diagnosis based on a medical record review for each serological pattern. Interestingly, of the 32 possible serological patterns, only 12 occurred in >10 patients. The remaining 20 patterns were uninterpretable because they occurred with such infrequency. Two easy-to-use tables were created to interpret EBV serological patterns based on whether three (EBV VCA IgG, IgM, and heterophile) or five markers are utilized. The use of these two tables allows for interpretation of >95% of BioPlex serological results. This is the first evidence-based study of its kind for EBV serology.
A rapid, reproducible method is described for extracting and comparing levels of the ether-soluble fish androgen 11-ketotestosterone (11-KT) in blood serum, muscle tissue and surface mucus. Because widely different volumes of extract were recovered after centrifugation from the three sources, it was important to express androgen levels as pg 11-KT/mg of total soluble protein (TSP). For six male and four female sexually-staged freshwater Koi (Cyprinus carpio), the method yielded similar pg 11-KT/mg TSP ratios in blood serum and extracts of muscle tissue and surface mucus, with the strongest correlation between blood serum and surface mucus. While male Koi were distinguishable from females based on the magnitude of 11-KT levels, reproductive stage and gonadosomatic index levels were not correlated with the 11-KT levels of either sex. Similar pg 11-KT/mg TSP ratios were also found for autologous muscle tissue and surface mucus extracts of 37 captured and sexed wild marine fishes representing seven genera. However, high 11-KT levels were not restricted to mature males. Collectively, results suggest that surface mucus collection (followed by 11-KT assay) is a useful alternative to more invasive methods of determining systemic hormone levels in fish. Without knowledge of seasonal variation in levels of this and other sex hormones, however, reliance on 11-KT levels alone may lead to spurious identification of gender, let alone reproductive stage.
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