Profile of total IgG, IgG1, IgG2, IgG3 and IgG4 levels in sera of patients with paracoccidioidomycosis: treatment follow-up using Mexo and rPb27 as antigens in an ELISA

Lílian Da Silva Santos,Viviane Cristina Fernandes,Samuel Gonçalves Da Cruz,Ênio Roberto Pietra Pedroso,Alfredo Miranda Goes,Weverton César Siqueira

doi:10.1590/s0074-02762012000100001

Lílian Da Silva Santos, Viviane Cristina Fernandes + Show 4 more

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https://doi.org/10.1590/s0074-02762012000100001

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Abstract

The levels of total of IgG, IgG1, IgG2, IgG3 and IgG4 were evaluated in 54 patients with chronic paracoccidioidomycosis (PCM) before, during and after treatment using an enzyme-linked immunosorbent assay with Mexo and recombinant Pb27 (rPb27) as the antigens. Mexo was effective in distinguishing PCM patients from individuals in the negative control group (NC) based on total IgG and rPb27 performed worse than Mexo when these two groups were compared. IgG1, IgG2, IgG3 and IgG4 could not be used to clearly distinguish PCM patients from those in the NC group using either antigen. There was no clear relationship between antibody levels and the period of treatment. The majority of patients presented with decreased antibody levels during treatment, with no statistically significant differences among the different periods of treatment. Only IgG4 presented a negative correlation between its levels and clinical improvement during treatment. In total, 65% of untreated PCM patients showed reactivity against IgG4 when the Mexo antigen was used and this reactivity decreased over the course of treatment. There was a tendency towards decreasing antibody levels during treatment, but these antibody levels did not necessarily clear after the treatment was stopped. Mexo was useful for PCM diagnosis using total IgG; however, more studies are necessary before this antigen can be used in measuring the levels of total IgG and its subclasses for monitoring patients during treatment.

Highlights

Paracoccidioidomycosis (PCM) is a systemic disease caused by the thermodimorphic fungus Paracoccidioides brasiliensis (Marques 1998)
When the recombinant Pb27 (rPb27) antigen was used, statistically significant differences were found between the PCM patients and the negative control group (NC) group with respect to total IgG, IgG1, IgG2 and IgG4
Using rPb27, total IgG showed higher antibody reactivity, which was similar to the results observed for the Mexo antigen

Summary

Introduction

Paracoccidioidomycosis (PCM) is a systemic disease caused by the thermodimorphic fungus Paracoccidioides brasiliensis (Marques 1998). This deep mycosis is endemic in many Latin American countries, with the majority of cases occurring in Brazil, followed by Venezuela, Colombia, Ecuador and Argentina (ShikanaiYasuda 2006, Ameen et al 2010). Different serological techniques are used to measure the levels of IgG, such as double immunodiffusion (DI), counterimmuno-electrophoresis (CIE), immunofluorescence (IFI), enzyme-linked immunosorbent assay (ELISA) and immunoblotting. These techniques may use various antigenic preparations to assess antibodies against P. brasiliensis. There is no consensus on the best techniques for the diagnosis and follow-up care of PCM patients (Campos et al 1990, Alves 1996, Martins et al 1997, Del Negro et al 2000, Camargo 2008)

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