Use of enzyme immunoassays and the latex agglutination test to measure the temporal appearance of immunoglobulin G and M antibodies after natural infection or immunization with rubella virus

Abstract

The time course of appearance of antibodies after infection with rubella virus was determined with an immunoglobulin G (IgG) detection enzyme-linked immunosorbent assay, a latex agglutination test, and an IgM detection enzyme-linked immunosorbent assay. In six naturally infected rubella patients and 26 vaccinees, antibodies measured by either the IgG enzyme-linked immunosorbent assay or the latex agglutination test generally appeared in parallel with those detected by the hemagglutination inhibition test. By 28 days after inoculation of live virus vaccine and by 2 days postonset of clinical rubella symptoms caused by natural infection, antibodies were found by the two tests for all individuals. A commercially available enzyme-linked immunosorbent assay kit was used to detect rubella-specific IgM. After natural infection, IgM appeared earlier than IgG, and although IgM titers decreased rapidly postinfection, in four of five patients antibodies were still detectable 40 to 43 days after the onset of clinical symptoms. After vaccine-induced infection, rubella-specific IgM was lower in titer than after natural infection and was detected in only three of seven vaccinees 70 days post-immunization.

Maturation of immunoglobulin G avidity after rubella vaccination studied by an enzyme linked immunosorbent assay (Avidity‐ELISA) and by haemolysis typing

“…Once matured, IgG avidity remained high. By comparison, titers of IgG after subcutaneous administration of Cendehill or RA 2713 virus vaccines have been shown to peak a t 1-2 months IFogel et al, 1970;Al-Nakib et al, 1975;Balfour et al, 1981;Meegan et al, 1983;O'Shea et al, 19851 or between 2 and 7 months IFogel et al, 1970;O'Shea et al, 19851. Kinetically, the present avidity-ELISA result was very similar to our previous results on natural rubella: although 92% of the 2month postvaccination sera in the present Cendehill group and 97% of corresponding sera in the RA 2713 group gave low (<30%) avidity indices, patient sera collected during the first month after the symptomatic onset of natural rubella demonstrated low IgG avidity in = 99%, of the cases IHedman and Seppala, 1988; Rousseau and Hedman, 19881. These results resemble the kinetics of maturation of IgG affinity after vaccination by inactivated hepatitis B virus, as studied using synthetic peptides in a globulin precipitation assay IBrown e t al., 19841.…”

“…Careful typing ofthe haemolytic zones is therefore a useful adjunct in a diagnostic laboratory, which is highlighted by the fact that one third of all rubella serodiagnoses (>400 patients) obtained during 1985-1987 a t the Department of Virology, University of Helsinki, were obtained by IgM examinations performed because of a soft RH zone [Hedman et al, 1986;our unpublished data]. In many studies, rubella-IgM has occurred less regularly after (primary) vaccination than after natural rubella [Al-Nakib et al, 1975;Diment and Chantler, 1981;Meegan et al, 1983;Mortimer et al, 1984;Suni et al, 19841. Similarly, IgM was observed in only 69% of our previously seronegative recipients of the Cendehill vaccine 2 months after injection. This result contrasts with the high frequency (> 10%) of prolonged (1.5 years) IgM responses, a phenomenon that was also previously observed [Al-Nakib et al, 1975;Meegan et al, 1983;Mortimer et al, 1984;Storch and Myers, 1984;OShea et al, 19851.…”

“…In many studies, rubella-IgM has occurred less regularly after (primary) vaccination than after natural rubella [Al-Nakib et al, 1975;Diment and Chantler, 1981;Meegan et al, 1983;Mortimer et al, 1984;Suni et al, 19841. Similarly, IgM was observed in only 69% of our previously seronegative recipients of the Cendehill vaccine 2 months after injection. This result contrasts with the high frequency (> 10%) of prolonged (1.5 years) IgM responses, a phenomenon that was also previously observed [Al-Nakib et al, 1975;Meegan et al, 1983;Mortimer et al, 1984;Storch and Myers, 1984;OShea et al, 19851. On the other hand, all the "vaccination reinfections" remained IgM-negative, as in a study employing a sensitive M-antibody capture radioimmunoassay [Mortimer et al, 19841. The antibody response to the attenuated rubella virus vaccines is weaker and more slowly evolving than the response to natural infection [Ogra et al, 1971;Serdula et al, 1974;Grillner, 1975;Perkins, 19851. Considering the similarity of the rate of occurrence of low-avidity IgG in the avidity-ELISA technique after vaccination and after natural rubella, it was interesting to observe that the soft haemolysis seemed to occur less regularly here, especially in the Cendehill group, than after natural rubella [Hedman et al, 19861.…”

Multicenter evaluation of five commercial rubella virus immunoglobulin G kits which report in international units per milliliter

“…This quantitative method was relatively well standardized worldwide (19,20). Several new techniques to detect rubella virus-specific immunoglobulin G (IgG) then became available; these techniques include single radial diffusion, indirect immunofluorescence, latex agglutination (13,18), and enzyme immunoassays (EIAs) (4,9,19,20,23,25). In many countries the EIA has become the most popular method of testing for rubella immunity because of technical ease, automation, sensitivity, and specificity and the low cost of reagents.…”

“…However, most commercial kits reported results in absorbances or indices that did not relate to results reported by other kits. This produced problems in (i) the interpretation of results by clinicians who use more than one pathology laboratory, (ii) the comparison of results from different commercial kits (13), and (iii) the introduction of standardized reporting of results.…”