Dissecting the IgM antibody response during the acute and latent phase of toxoplasmosis

Meek, Bob; Gool, Tom van; Gilis, Henk; Peek, Ron

doi:10.1016/s0732-8893(01)00291-7

Cited by 22 publications

(16 citation statements)

References 35 publications

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“…Repeat testing of IgM is not sufficient to confirm acute infection because IgM antibodies may persist for months or even years after acute infection (1,4,15). In an evaluation of IgM-positive sera from pregnant women, submitted by clinical laboratories using FDA-cleared tests, 60% of the sera were determined to be consistent with chronic (nonacute) infection when tested by the U.S. reference laboratory for T. gondii IgM antibodies at the Research Institute, Palo Alto Medical Foundation (PAMF), Palo Alto, Calif. (13).…”

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confidence: 99%

“…This reference laboratory uses a toxoplasma serum profile that includes a double sandwich IgM ELISA (17), a differential agglutination test (AC/HS test) (2), and the Sabin-Feldman dye test (22) in combination with IgG avidity results (8,11,12,16) to distinguish between recently acquired and distant infections. A positive IgM and IgG test with a high IgG avidity test during the first trimester rules out acute infection in women, but the presence of low-avidity IgG antibody does not rule out a nonacute infection (15). In this situation, the results from the additional methods are carefully considered.…”

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confidence: 99%

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Detection of Immunoglobulin M Antibodies Specific for Toxoplasma gondii with Increased Selectivity for Recently Acquired Infections

2004

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Toxoplasma gondii infections can cause serious complications in pregnant women, leading to miscarriage, stillbirth, and birth defects. Definitive diagnosis of T. gondii acute infection is therefore critical for the clinical management of a mother and her fetus. Positive immunoglobulin M (IgM) results are not sufficient as evidence of recent infection, as these antibodies are often present for many months. Further, IgG avidity and differential agglutination tests, two tests used by reference laboratories to distinguish between recent and past infections, are not always in agreement, and both methods yield a significant number of indeterminate results. We report the development of a new toxoplasma IgM immunoassay that is performed by using a bead-based immunoassay on an automated analyzer (BioPlex 2200). Initial validation included 204 samples from pregnant women and 198 samples from asymptomatic healthy adults. An overall specificity of 99% was observed. Further, 100% sensitivity for acute infections was observed for 10 well-characterized seroconversion panels. We then examined 50 samples from pregnant women, all of which were IgM positive by ELISA, which had been fully evaluated in a reference laboratory. Of the 50 samples, 34 (68%) tested positive in the BioPlex 2200 toxoplasma IgM assay, of which 32 of 34 (94%) exhibited an acute or equivocal pattern by differential agglutination. Of the 16 negative samples, 15 (94%) showed high-IgG-avidity antibodies. Collectively, these results suggest that this new toxoplasma assay shows a preferential response to IgM antibodies produced by recent infections, reducing the number of positive results for pregnant women that will require extensive additional clinical evaluation.

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confidence: 99%

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confidence: 99%

Detection of Immunoglobulin M Antibodies Specific for Toxoplasma gondii with Increased Selectivity for Recently Acquired Infections

2004

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“…For a definite diagnosis, the patients were further investigated by subsequent serum sample analysis (by the Sabin-Feldman dye test and IgM ISAGA) and/or IgG avidity. The IgM ISAGA has been reported to be more sensitive than a double sandwich enzyme-linked immunosorbent assay (5,10). The IgM ISAGA is suitable for the diagnosis and screening of acute Toxoplasma infection in pregnant women, as well as for the detection of IgM in the blood samples of children to identify connatal infection (2,12).…”

Section: Methodsmentioning

confidence: 99%

Evaluation of the Vitros ECiQ Immunodiagnostic System for Detection of Anti- Toxoplasma Immunoglobulin G and Immunoglobulin M Antibodies for Confirmatory Testing for Acute Toxoplasma gondii Infection in Pregnant Women

Kasper

Prusa²,

Hayde³

et al. 2009

J Clin Microbiol

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Infection with Toxoplasma gondii is often asymptomatic and, when acquired during pregnancy, may lead to connatal toxoplasmosis in the offspring. The newly introduced Vitros anti-Toxoplasma immunoglobulin G (IgG) and IgM assays, designed for the Vitros ECiQ immunodiagnostic system, a fully automated system based on chemiluminescence, were evaluated as a screening method for the serological detection of acute and chronic Toxoplasma infections in the sera of 719 pregnant women. Infection with the protozoan Toxoplasma gondii is mostly asymptomatic for immunocompetent individuals (11). The incidence of gestational Toxoplasma infection in European countries ranges from 0.2 to 1.0% (7). Maternal infection during pregnancy may cause placental and fetal infections. Connatal toxoplasmosis is associated with a wide spectrum of clinical symptoms, such as retinochoroiditis, intracerebral calcifications, and hydrocephalus. These symptoms may be present at birth or may develop later in life, leading finally to blindness, psychomotor retardation, and hearing difficulties (13, 21).Austria and France are the only countries that have implemented nationwide obligatory serological screening programs for the detection of gestational Toxoplasma infections. These systems provide systematic serological assessment early in pregnancy and periodic follow-up of pregnant women at risk (7). Serological diagnosis of infection with T. gondii is performed indirectly by enzyme immunoassays, an indirect immunofluorescence test, and, more precisely, by the Sabin-Feldman dye test (18). The dye test is considered the reference test for the detection of Toxoplasma infection (16).Any serological test system has to meet several criteria of adequacy, such as high sensitivity and specificity, easy handling, and reproducible results under routine laboratory conditions. The present study investigated the newly introduced Vitros ECiQ Toxoplasma immunoglobulin G (IgG) and IgM assays (Ortho-Clinical Diagnostics, NJ) as a screening method for the diagnosis of acute and chronic Toxoplasma infections in the sera of pregnant women. The Vitros test results were compared with those of the Sabin-Feldman dye test and the immunosorbent agglutination assay (ISAGA) for the determination of anti-T. gondii-specific IgM (10). Diagnosis of maternal infection status was provided via routine serology by the toxoplasmosis reference laboratory at the Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria. In addition, the technical precision of both the Vitros Toxoplasma IgG and IgM assays was evaluated by serial specimen measurements. MATERIALS AND METHODSSamples and patients. Serum samples were collected from 719 healthy pregnant women according to the recommendations of the Austrian toxoplasmosis screening program and were submitted to the laboratory for routine analysis. The Sabin-Feldman dye test and the IgM ISAGA were performed within 24 to 48 h from the time when the samples were received. Sera were stored at Ϫ20°C. For the evaluat...

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“…However, because of its complex life cycle, a number of proteins produced at different stages of the parasite life cycle can play different roles in stimulating host immune responses during the infectious process. Furthermore, a precise distinction between acute and latent invasion may be difficult since IgM antibodies, a specific marker for early infection, could be present in sera for many years (Meek et al, 2001). Therefore, certain antigens that are specific to the acute or chronic stages of the infection that produce specific IgG antibodies could serve as a mean to distinguish the recent from a chronic infection.…”

Section: Recombinant Proteins In Serodiagnosis Of Toxoplasmosismentioning

confidence: 99%

Toxoplasmosis: IgG Avidity and Its Implication in Serodiagnosis

Nissapatorn¹,

Sawangjareon²

2012

Trends in Immunolabelled and Related Techniques

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Dissecting the IgM antibody response during the acute and latent phase of toxoplasmosis

Cited by 22 publications

References 35 publications

Detection of Immunoglobulin M Antibodies Specific for Toxoplasma gondii with Increased Selectivity for Recently Acquired Infections

Detection of Immunoglobulin M Antibodies Specific for Toxoplasma gondii with Increased Selectivity for Recently Acquired Infections

Evaluation of the Vitros ECiQ Immunodiagnostic System for Detection of Anti- Toxoplasma Immunoglobulin G and Immunoglobulin M Antibodies for Confirmatory Testing for Acute Toxoplasma gondii Infection in Pregnant Women

Toxoplasmosis: IgG Avidity and Its Implication in Serodiagnosis

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