Performance of a Western Blot Assay to Compare Mother and Newborn Anti- Toxoplasma Antibodies for the Early Neonatal Diagnosis of Congenital Toxoplasmosis

Robert‐Gangneux, Florence; Commere, V.; Tourte-Schaefer, C; Dupouy‐Camet, Jean

doi:10.1007/s100960050366

Cited by 47 publications

(26 citation statements)

References 21 publications

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“…Western blotting (WB) (268) and an enzyme-linked immunofiltration assay (ELIFA) (258) both allow a qualitative analysis of specific IgG or IgM by a comparison of band patterns or precipitin patterns, respectively, from paired mother-newborn sera with an equal sensitivity (259). Several studies analyzed the diagnostic performance of WB and reported sensitivities of 48 to 50% and 78 to 82% for IgG detection at birth and within the first 3 months of life, respectively (274,320). The combination of WB detection of IgM and IgG allowed a gain in sensitivity, reaching 65 to 79% and 83 to 94% at birth and at 3 months of life, respectively (271,274,320).…”

Section: Diagnosis Of Congenital Toxoplasmosismentioning

confidence: 99%

“…Several studies analyzed the diagnostic performance of WB and reported sensitivities of 48 to 50% and 78 to 82% for IgG detection at birth and within the first 3 months of life, respectively (274,320). The combination of WB detection of IgM and IgG allowed a gain in sensitivity, reaching 65 to 79% and 83 to 94% at birth and at 3 months of life, respectively (271,274,320). The combination of ISAGA and WB yielded even better results in those studies.…”

Section: Diagnosis Of Congenital Toxoplasmosismentioning

confidence: 99%

“…Such variations in estimations between readers could account for specificities below 100% in some series (271,320). Aside from this restriction, WB was the earlier test allowing the diagnosis of congenital infection in 3/23 and 1/17 asymptomatic newborns in studies by Tissot-Dupont et al (320) and Robert-Gangneux et al (274), respectively. In these cases, where the detection of IgM, IgA, and parasites was negative at birth, it would have taken several months to observe the absence of a decrease of the IgG titer after repeated testing if WB had not been available.…”

Section: Diagnosis Of Congenital Toxoplasmosismentioning

confidence: 99%

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Epidemiology of and Diagnostic Strategies for Toxoplasmosis

2012

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SUMMARY The apicomplexan parasite Toxoplasma gondii was discovered a little over 100 years ago, but knowledge of its biological life cycle and its medical importance has grown in the last 40 years. This obligate intracellular parasite was identified early as a pathogen responsible for congenital infection, but its clinical expression and the importance of reactivations of infections in immunocompromised patients were recognized later, in the era of organ transplantation and HIV infection. Recent knowledge of host cell-parasite interactions and of parasite virulence has brought new insights into the comprehension of the pathophysiology of infection. In this review, we focus on epidemiological and diagnostic aspects, putting them in perspective with current knowledge of parasite genotypes. In particular, we provide critical information on diagnostic methods according to the patient's background and discuss the implementation of screening tools for congenital toxoplasmosis according to health policies.

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Section: Diagnosis Of Congenital Toxoplasmosismentioning

confidence: 99%

Section: Diagnosis Of Congenital Toxoplasmosismentioning

confidence: 99%

Section: Diagnosis Of Congenital Toxoplasmosismentioning

confidence: 99%

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Epidemiology of and Diagnostic Strategies for Toxoplasmosis

2012

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“…Detection of T. gondiispecific IgM antibodies eluted from the filter paper is followed by a request of a blood sample from both the mother and infant for confirmatory testing. Approximately 15 to 20% of these sera have been found to be negative for Toxoplasmaspecific IgM (3,8).Previous studies have shown that transferred maternal and neonate-synthesized T. gondii-specific IgG antibodies can be differentiated by immunoblotting or immunocomplexing (1,4,12,14). Immunoblotting identifies newborns with congenital toxoplasmosis with a sensitivity of ca.…”

mentioning

confidence: 99%

“…Previous studies have shown that transferred maternal and neonate-synthesized T. gondii-specific IgG antibodies can be differentiated by immunoblotting or immunocomplexing (1,4,12,14). Immunoblotting identifies newborns with congenital toxoplasmosis with a sensitivity of ca.…”

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confidence: 99%

Diagnosis of Congenital Toxoplasmosis by Two-Dimensional Immunoblot Differentiation of Mother and Child Immunoglobulin G Profiles

2005

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Differentiation between the specific immunoglobulin G (IgG) response to Toxoplasma gondii by a mother and her newborn child is helpful in the diagnosis of congenital infection with T. gondii in newborns without T. gondii-specific IgM and/or IgA antibodies at birth. Previous methods include immunoblotting and complexing T. gondii antigen with the sera from the mother and child and comparing the bands after electrophoresis. We developed a two-dimensional immunoblotting (2DIB) method with T. gondii RH strain tachyzoite antigen and validated the method with sera from 11 children identified through the neonatal screening program for congenital toxoplasmosis in Denmark. The children were identified by using Toxoplasma-specific IgM antibodies at the screening test, but the presence of T. gondii-specific IgM and/or IgA antibodies could not be confirmed at the subsequent serum sample tested. The children were monitored for at least 12 months, and in seven of eight patients monitored for 12 months the results of the 2DIB-predicted congenital infection were confirmed by the presence of persistent Toxoplasma-specific IgG antibodies. 2DIB is a sensitive technique that allows early differentiation between passively transferred maternal T. gondii-specific IgG antibodies and antibodies synthesized by the newborn child.Primary infection with Toxoplasma gondii during pregnancy may result in congenital infection of the fetus. The majority of congenitally infected newborns do not show clinical signs at birth but may later develop retinochoroiditis and reduced vision that can be prevented by early treatment (7). Diagnosis of congenital infection with T. gondii is difficult at birth if T. gondii-specific immunoglobulin M (IgM) and/or IgA antibodies are not present because present diagnostics methods can distinguish between maternal and fetal IgG only with difficulty.Congenital toxoplasmosis is treated for up to 12 months continuously with sulfadiazine and pyrimethamine, which may cause side effects, and it is therefore important that the diagnosis of congenital toxoplasmosis is firmly established before treatment is started.The detection of T. gondii-specific nucleic acid by PCR is possible in amniotic fluid if a primary T. gondii infection is diagnosed during pregnancy, but in countries without prenatal screening programs or with neonatal screening programs PCRbased diagnosis is not appropriate.Neonatal screening for congenital toxoplasmosis is performed in New England, Denmark, and parts of Brazil by analyzing the blood samples obtained on filter paper (Guthrie cards) on day 5 postpartum (5, 6, 9). Detection of T. gondiispecific IgM antibodies eluted from the filter paper is followed by a request of a blood sample from both the mother and infant for confirmatory testing. Approximately 15 to 20% of these sera have been found to be negative for Toxoplasmaspecific IgM (3,8).Previous studies have shown that transferred maternal and neonate-synthesized T. gondii-specific IgG antibodies can be differentiated by immunoblotting or immunoco...

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