IgM Antibodies Research Articles

Real-world experience of thrombopoietin receptor agonists in pediatric immune thrombocytopenia: a report from a Chinese tertiary children's hospital.

Primary immune thrombocytopenia (ITP) is the most common bleeding disorder in children. There are approximately 20% pediatric ITP patients respond poor to corticosteroids as first-line treatment. Recently thrombopoietin receptor agonists (TPO-RAs) have been used to treat refractory ITP and have achieved certain therapeutic effects. To investigate the efficacy and safety of TPO-RAs in the treatment of pediatric ITP, we conducted this real-world study. Fifty-three pediatric patients with ITP who did not respond well to corticosteroids were treated with TPO-RAs. Clinical data, including therapeutic response rate, changes in platelet (PLT) count, and adverse events (AEs) were collected. Of the 51 evaluable patients, 37 (72.5%) responded to TPO-RAs. Patients aged >4 years had a higher response rate than those aged ≤4 years (81.1% vs. 50.0%, P=0.04). There was no effect of sex, duration of disease, prior therapy, Mycoplasma pneumoniae (MP) immunoglobulin M (IgM) positivity, antinuclear antibody (ANA) positivity, CD4/CD8 ratio or baseline PLT count on the response rate (P>0.05). Other than 10 patients with PLT counts that exceeded the upper limit of normal, AEs were sporadic, including increased aminotransferase levels, cough, headache, and vomiting. TPO-RAs exhibited good clinical efficacy in pediatric ITP patients who failed to respond to first-line treatment, especially patients aged >4 years, and the side effects were minor.

Toxoplasmosis in thalassemic iraqi patients: serological and hematological study

Background. Toxoplasmosis is a zoonotic parasitic disease with high prevalence, it causes by an obligate intracellular parasite Toxoplasma gondii. Thalassemia is a blood disturbance has undergone through families in which the body makes an atypical form or sufficient amount of hemoglobin. The condition results in great numbers of red blood cells being damaged which cause to anemia. The purpose of this study was to identification the prevalence of T. gondii antibodies and hematological changes among thalassemic patients. Methods. Samples were collected during March to June 2022 from Al-Karama Teaching Hospital in Baghdad, Iraq. After doctors diagnosis, necessary blood tests to detect thalassemia in a group of 165 thalassemic patients and 80 healthy controls. Serum specimens were investigated for Toxo IgM and IgG antibodies using immunochromatography test and chemiluminescent (CIMA) test, their age from 2-45 years. Results. For immunochromatography test showed 44/165(26.67%) in thalassemic patients who have positive response for anti-Toxo IgG antibodies comparative with non-thalassemic control groups 33/80(41.25%) samples of have positive response for this test. The percentage infection with toxoplasmosis from thalassemia patients,60/165(36.36%) patients who have positive response for anti-Toxoplasma IgG antibodies as well as 25/80(31.25%) of non-thalassemic control group have positive response in chemiluminescent micro particle immunoassay(CMIA). However, result of CBC test showed that low significant levels in the group of thalassemic patients with toxoplasmosis with mean of Hb(8.286±0.128g/dl), MCV(62.027±2.146Fl), MCH(23.111±0.327pg) and MCHC (26.888±0.385 g/dl) respectively in comparison with control group.

Prevalence of toxoplasmosis in Iraqi patients with diabetic type 2

Background. The obligate intracellular protozoan parasite Toxoplasma gondii is a member of the phylum Apicomplexa. In people with impaired immune systems, it can result in opportunistic infections. Diabetes mellitus is regarded as a metabolic disease that raises the host's vulnerability to and risk from several infections, including T. gondii infection. The main object of this study is to ascertain the toxoplasmosis seroprevalence and correlation among Iraqi patients with type 2 diabetes. Methods. The level of Toxoplasma antibodies IgG, IgM, and IgA was measured in 109 samples of Iraqi diabetes type 2 patients using immunochromatography rapid test, CMIA, and ELISA. Eighty samples, considered to be a healthy control group, were collected from a private laboratory in Baghdad, Iraq, between March 2022 and June 2022, with an age range of 15 to 85 years. Results. Comparing the diabetes patient group to the non-diabetic control group, the results showed that the diabetic patient group had the highest mean glucose levels in their fasting test (174.55 ± 3.96 mg/dL), random test (216.89 ± 4.96 mg/dL), and HbA1C (7.1 ± 0.178), respectively. Furthermore, the study demonstrated that, in an immunochromatography fast test, the group of diabetic patients had the largest distribution of IgG anti-Toxoplasma when compared to the non-diabetic control group. Additionally, all samples were seronegative for anti-Toxoplasma IgM and IgA, with significant differences in CMIA and ELISA. However, 51/109 (46.79%) and 30/80 (37.5%) of the diabetes group and the non-diabetic group, respectively, showed seropositive for anti-Toxoplasma IgG. Conclusion. This study found that no acute toxoplasmosis detected in the studied cases while chronic toxoplasmosis detected among diabetic type 2 patients.

Seroprevalence and Risk Factors of Toxoplasmosis in Female Students from Northwest Iran

Background: Toxoplasmosis is a significant zoonotic disease caused by the protozoan parasite Toxoplasma gondii. This infection can have dire consequences if it occurs during pregnancy, as it may result in spontaneous abortion or congenital disorders. Using serological methods, we investigated the seroprevalence of Toxoplasma infection in female students of childbearing age and also determined the association between Toxoplasma infection and pregnancy. Methods: In this cross-sectional study, blood samples were collected from female students of childbearing age from three provinces in northwest Iran who studied at Maragheh University of Medical Sciences. Anti-Toxoplasma IgG and IgM antibodies were identified by ELISA and ELFA methods, and the relationship between Toxoplasma infection, demographic characteristics, and risk factors was evaluated. Results: The ELISA and ELFA serology test results for measuring IgG and IgM, were similar. One hundred cases (28.73%) were positive for Toxo IgG, and 6 cases (1.72%) were positive for Toxo IgM. The results showed that some risk factors, such as contact with cats and activities, such as agriculture or contact with soil, were significantly (P<0.05) related to T. gondii seropositivity. Conclusion: More than 70% of the childbearing-age female students studied in this investigation were susceptible to infection during pregnancy, and the performance of regular serological testing during pregnancy and health education about toxoplasmosis before and after gestation is essential to prevent congenital toxoplasmosis.

Evaluation of a Rapid Diagnostic Test (TUBEX-TF) for Diagnosis of Enteric Fever

Abstract Background and Aim: Enteric fever is a systemic febrile disease caused by Salmonella enterica serovars Typhi and Paratyphi. Culture provides a conclusive diagnosis of enteric fever. The main difficulties are a longer turnaround time and practicality in a developing nation with a huge population. The two RDTs that are now most often used are TUBEX-TF and Enterocheck-WB, where TUBEX-TF can identify IgM antibodies against S. Typhi and S. Paratyphi which are anti-O9 and anti-O2. The aim of this study was to evaluate the performance of the TUBEX-TF test in a typhoid fever endemic area of North India. Materials and Methods: In this cross-sectional study, we have performed TUBEX-TF, Enterocheck-WB /Immuno-chromatographic card test, Enzyme linked immunosorbent assay (ELISA), and Widal tests on the sera of 94 clinically suspected cases of enteric fever It was a cross-sectional comparative study that was carried out at a tertiary care institute in North India. In the present study, the ELISA test was taken as a comparative reference test. Results: ELISA, TUBEX-TF, Widal, and Immunochromatographic card test were performed on serum samples collected from 94 clinically suspected enteric fever cases, in which 50(53.19%) were positive by ELISA, 45 (47.87%) were positive by TUBEX- TF, 40 (42.5%) were positive by Typhidot and 19 (20.2%) were positive by Widal. For evaluation of TUBEX-TF, sensitivity specificity, diagnostic accuracy, positive predictive and negative predictive values, a comparison with IgM Anti-LPS ELISA test results was performed & it was found 75%,79.55%,80%,74.47%, and 77.17% respectively. Conclusion: We conclude that the TUBEX-TF test has a greater sensitivity and specificity than other rapid tests currently on the market. It is a simple, rapid test to diagnose enteric fever. The necessity for large-scale research to evaluate TUBEX-TF is necessary due to interviewer variances so that it can become a novel RDT test for the diagnosis of enteric fever.

No detection of tick-borne encephalitis virus RNA in blood, urine or saliva of hospitalised immunocompetent tick-borne encephalitis patients.

Tick-borne encephalitis (TBE) is usually diagnosed based on the presence of TBE virus (TBEV)-specific IgM and IgG antibodies in serum. However, antibodies induced by vaccination or cross-reactivity to previous flavivirus infections may result in false positive TBEV serology. Detection of TBEV RNA may be an alternative diagnostic approach to detect viral presence and circumvent the diagnostic difficulties present when using serology. Viral RNA in blood is commonly detectable only in the first viremic phase usually lasting up to two weeks, and not in the second neurologic phase, when the patients contact the health care system and undergo diagnostic work-up. TBEV RNA has previously been detected in urine in a few retrospective TBE cases in the neurologic phase, and furthermore RNA of other flaviviruses has been detected in patient saliva. In this study, blood, saliva and urine were collected from 31 hospitalised immunocompetent patients with pleocytosis and symptoms of aseptic meningitis and/or encephalitis, suspected to have TBE. We wanted to pursue if molecular testing of TBEV RNA in these patient materials may be useful in the diagnostics. Eleven of the 31 study patients were diagnosed with TBE based on ELISA detection of TBEV specific IgG and IgM antibodies. None of the study patients had TBEV RNA detectable in any of the collected patient material.

Clinical characteristics, viral dynamics, and antibody response of monkeypox virus infections among men with and without HIV infection in Guangzhou, China.

Monkeypox virus (MPXV) is spreading globally and nearly half of the infected people were human immunodeficiency virus (HIV) positive. Therefore, an in-depth understanding of the effects of HIV infection on the outcomes of MPXV infection is urgently needed. This study aimed to explore the clinical features, viral dynamics, and antibody response to MPXV infections in men who had sex with men (MSM) with and without HIV co-infection. MPXV-infected patients diagnosed by PCR were recruited in this study and were divided into MPXV and MPXV + HIV groups based on whether they were co-infected with HIV. Clinical data and samples were collected during of the hospital stay and follow up interviews. The symptoms and signs, laboratory examinations, viral shedding in various body fluids or swabs, antibody dynamics were tracked and compared between the two groups. A total of 41 MPXV patients were recruited through June 2023 to September 2023 in Guangzhou. The MPXV group and MPXV + HIV group comprised 20 and 21 MSM, respectively. Patients in the two groups exhibited similar clinical characteristics except for pruritus and eschar, both were significantly fewer in MPXV + HIV group than in MPXV only group. Among the 355 clinical samples collected, MPXV DNA was detected in 100% of scabs, 97.4% of skin swabs, and 92.3% of exudate swabs from lesions, while the positive rate was 87.5% from oropharyngeal swabs, 59% from saliva, 51.3% from anal swabs, 50% from feces, 30.6% from urine samples, 37.5% of semen, and 28.2% from sera. Dynamics analysis revealed that viral DNA was undetectable in most patients 20 days after symptom onset. IgM and IgG antibodies to MPXV were detected in all patients with 3-5 days earlier in the MPXV group than in the MPXV + HIV group. This cohort analysis based on a large outbreak among MSM in Guangzhou indicated no obvious differences in clinical symptoms, viral DNA data, but antibody responses were 3-5 days later in mpox patients with HIV infection.

A case of infectious mononucleosis caused by Epstein-Barr virus complicated by autoimmune hemolytic anemia

We represent a rare clinical case of infectious mononucleosis with hepatitis, caused by Epstein-Barr virus, complicated by rare secondary autoimmune hemolytic anemia associated with warm agglutinins in a 16-year-old patient. The disease was long-lasting, with a two-wave course of febrile fever. Signs of hepatitis with the development of anemia of moderate severity appeared during the second wave of febrile fever. The etiology of the disease was confirmed by the detection of Epstein-Barr virus DNA in blood and the detection of anti-VCA IgM antibodies to Epstein-Barr virus in the absence of anti-EBNA IgG antibodies. Hemolytic anemia was verified using markers of hemolysis (increased lactate dehydrogenase activity, decreased haptoglobin concentration), and positive results of a direct Coombs test. After successful initiation of prednisone therapy and clinical improvement, the patient was discharged from the hospital on the 24th day of disease to continue treatment on an outpatient basis (prednisone was replaced by methylprednisolone).This case demonstrates the development of a rare autoimmune complication in infectious mononucleosis caused by the Epstein-Barr virus.

Seroprevalence of hepatitis A virus among people born before and after implementation of universal vaccination in Argentina

Background Until 2005, when a single dose of vaccine was implemented in one-year-old children, the Hepatitis A virus (HAV) was responsible for approximately 90% of acute hepatitis cases in the paediatric population in Argentina. However, despite vaccination success, sporadic outbreaks of HAV still occur among adults. This study aimed to assess the seroepidemiology of HAV in Argentina, analysing IgG and IgM antibodies against HAV in a large population, both vaccinated and unvaccinated. Methods The study included 16,982 patients attending a hospital from 2001 to 2023. The cohort was divided into two groups: 16,638 individuals who were not reached by the vaccination program implemented in 2005 and 344 children who were covered by the universal vaccination. Results Anti-HAV IgG was detected in 56.7% of cases. The rate was significantly higher in individuals born after 2005 (77.7%) compared to those born before (56.3%), p < 0.001. The age groups 19–40 and 41–60 years showed the anti-HAV IgG lowest rates. On the other hand, 100/3956 cases (2.5%) with suspected acute hepatitis were positive for Anti-HAVIgM. Notably, none of these were born after the mandatory vaccine rollout. Conclusions The study of this large cohort contributes to the understanding of the seroepidemiology of HAV. Although the implementation of the vaccine achieved its main goal, the age segment between 19 and 60 years does not reach the estimated threshold to achieve herd immunity. These findings reveal the importance of targeting vaccination campaigns, provide essential insights for public health planning, and guide future immunisation strategies against HAV in Argentina.

The Prevalence of Toxoplasma Gondii Infection in Duhok, Kurdistan Region, Iraq

Toxoplasmosis is a parasitic infection, with widespread gestational and congenital transmission rates globally, consequently, it is regarded as a public health concern and an overlooked medical condition. Human infection occurs through various routes, including the ingestion of oocysts found in cat feces, consumption of raw or undercooked meat containing the parasite, and vertical transmission from an infected pregnant mother to her fetus. Objective. The aim of this study is to determine the prevalence of Toxoplasma gondii infection among individuals in various age groups and genders in Duhok City. Methods. In this research, 2251 individuals of various ages and genders visited the central laboratory in Duhok Сity, Kurdistan Region, Iraq, and peripheral blood samples were taken from individuals to identify specific anti-Toxoplasma gondii IgM and IgG antibodies using serological test (ELISA test). Results. Based on the findings of this study, it was observed that the prevalence of toxoplasmosis among females with infections detected in both IgM and IgG was 0.3 % and 20.6 %, respectively, and in males, the rate of infection with IgG was found to be 0.3 %, while no infections were detected with IgM. Also, among female individuals, the study recorded a 0.3 % infection rate for toxoplasmosis, which encompassed both IgM and IgG cases. Conclusions. Based on this study, it can be concluded that Toxoplasma infection is more common in females than in males, chronic toxoplasmosis appears to be more prevalent than acute infection with the highest rate of acute infections was found in the age group of 21–40 years.

COMPARISON SEROPREVALENCE OF TOXOPLASMA GONDII, RUBELLA, AND CYTOMEGALOVIRUS IN MUŞ PROVINCE BEFORE AND DURING THE COVID-19 PANDEMİC

The aim of this study is to determine the seroprevalence of Toxoplasma gondii (T. gondii), rubella and cytomegalovirus (CMV) and the primary infection rates of these agents with avidity test in pregnant women in Muş province. Additionally, the effect of prevention and protection measures implemented during the Covid-19 pandemic on the prevalence of T. gondii, rubella and CMV in pregnant women was also investigated. Between 2018 and 2021, IgG and IgM antibodies in the serum samples of pregnant women who applied to the Department of Gynecology and Obstetrics polyclinic of Muş State Hospital were examined by enzyme-linked immunosorbent assay (ELISA) and chemiluminescence immunoassay (CLIA). High and low avidity assays were examined by enzyme linked fluorescence assay (ELFA). Low seroprevalence of T. gondii IgG antibody (28%) and the detection of low avidity detection in 38 of 102 pregnant women indicate that this parasite may be a risk for intrauterine life. Rubella IgG (89%) and CMV IgG (99%) antibodies were found to carry a low risk due to their high seroprevalence and avidity. It was determined that Covid-19 prevention and protection measures caused a significant decrease in the prevalence of rubella and CMV, but had no effect on the prevalence of T.gondii.

Evaluate the Concordance Between Two Diagnostic Methods, RT-PCR And ELISA Techniques for the Detection of CCHFV in Karbala City

Crimean-Congo haemorrhagic fever virus (CCHFV) is a widespread pathogen virus transmitted by ticks that causes a severe disease known as Crimean-Congo haemorrhagic fever in animals and humans. This study aims to investigate the occurrence of CCHFV in ticks and bovines in different regions of Karbala City/Iraq. Tick and blood samples were collected from four cattle farms, and molecular RT-PCR and serological analyses were conducted. The serum sodium concentration was calculated to compare infected and non-infected cattle with CCHFV. The study identified five tick genera, with Rhipicephalus (Boophilus) microplus and Amblyomma variegatum being the most prevalent species. However, no ticks tested positive for CCHFV. Serological analysis of the blood samples showed that none was positive for IgM antibody, but 19.00% tested positive for IgG antibodies and 29.3% for both IgG and IgM. The seroprevalence was higher in cattle from Ayn al-time (36.70%) and Hindiya (16.70 %) compared to other regions, the study found fair concordance between the two serological and molecular assays used for diagnosis of CCHFV virus; as well as the study concluded that sodium levels are an important prognostic factor for CCHFV infection, cattle with CCHFV.

A Paper-Based Multiplexed Serological Test to Monitor Immunity against SARS-COV-2 Using Machine Learning.

The rapid spread of SARS-CoV-2 caused the COVID-19 pandemic and accelerated vaccine development to prevent the spread of the virus and control the disease. Given the sustained high infectivity and evolution of SARS-CoV-2, there is an ongoing interest in developing COVID-19 serology tests to monitor population-level immunity. To address this critical need, we designed a paper-based multiplexed vertical flow assay (xVFA) using five structural proteins of SARS-CoV-2, detecting IgG and IgM antibodies to monitor changes in COVID-19 immunity levels. Our platform not only tracked longitudinal immunity levels but also categorized COVID-19 immunity into three groups: protected, unprotected, and infected, based on the levels of IgG and IgM antibodies. We operated two xVFAs in parallel to detect IgG and IgM antibodies using a total of 40 μL of human serum sample in <20 min per test. After the assay, images of the paper-based sensor panel were captured using a mobile phone-based custom-designed optical reader and then processed by a neural network-based serodiagnostic algorithm. The serodiagnostic algorithm was trained with 120 measurements/tests and 30 serum samples from 7 randomly selected individuals and was blindly tested with 31 serum samples from 8 different individuals, collected before vaccination as well as after vaccination or infection, achieving an accuracy of 89.5%. The competitive performance of the xVFA, along with its portability, cost-effectiveness, and rapid operation, makes it a promising computational point-of-care (POC) serology test for monitoring COVID-19 immunity, aiding in timely decisions on the administration of booster vaccines and general public health policies to protect vulnerable populations.

Divergent humoral responses between males and females against 24 kDa excretory-secretory protein of Haemonchus contortus and influence of ovine β-globin polymorphism

Lambs harboring the Hb-AA β-globin haplotype present improved cell-mediated responses and increased resistance against Haemonchus contortus infection. The aim of the present study was to compare the effect of sex and β-globin haplotypes on specific humoral responses and phenotypes of resistance during H. contortus infection in Morada Nova sheep. As expected, females displayed stronger resistance during the first and second experimental challenges. Differential systemic humoral immune responses were observed comparing sex groups, in which higher levels of specific antibodies targeting 24 kDa excretory-secretory (ES24) protein of H. contortus of IgG and IgM antibodies were respectively observed as predominant isotypes in males and females. The IgM levels were significantly correlated with phenotypes of resistance, evaluated by packed cell volume and fecal egg counts. To our knowledge this is the first study reporting divergent humoral responses profiles to H. contortus infection between male and female sheep. The impact of β-globin haplotypes was less pronounced in females compared to males. Notably, only males showed significant weight differences across haplotypes, with Hb-AA lambs being the heaviest. Additionally, Hb-AA males had significantly higher PCV (indicating better red blood cell health) and lower FEC (indicating lower parasite burden). These findings suggest a more pronounced effect of β-globin polymorphisms on H. contortus infection in males, potentially due to their generally weaker resistance compared to females. This study highlights the importance of sex and β-globin haplotypes in shaping immune responses to H. contortus infection. Specifically, IgM antibodies targeting the ES24 protein appear to play a crucial role in host-parasite interactions and may hold promise for therapeutic development.

DIPG-92. IMMUNE ACTIVATION STUDIES WITH THE NEOANTIGEN-BASED PEPTIDE VACCINE RHSC-DIPGVAX DEMONSTRATE ANTIBODY-MEDIATED RESPONSES AND EPITOPE SPREADING IN PEDIATRIC PATIENTS WITH DIFFUSE INTRINSIC PONTINE GLIOMAS (DIPG)

Abstract BACKGROUND Approximately 80% of DIPGs carry gain-of-function lysine-to-methionine (K27M) mutations in histone H3 proteins that frequently co-occur with other protein aberrations, including p53, ACVR1, and PDGFRA. Because the DIPG microenvironment has few infiltrating immune cells, resolution of negative regulatory mechanisms through checkpoint blockade may be necessary to promote vaccine-induced anti-tumor responses. Accordingly, rHSC-DIPGVax is a neoantigen-based peptide vaccine combined with checkpoint inhibitors currently under investigation in clinical trial, NCT04943848. The vaccine contains 16 neoantigen peptides, QS-21 adjuvant, and recombinant heat shock protein, Hsc70. In this study, we investigate vaccine-induced antibody-mediated immunity and the phenomenon of epitope spreading, an extension of the immune response to secondary epitopes not directly targeted by the therapy, thus promoting distinct, individualized responses. METHODS rHSC-DIPGVax is administered every two weeks to patients with DIPG and blood is collected pre-treatment and prior to each dose. To investigate vaccine-induced immunoreactivity to neoantigens targeted by rHSC-DIPGVax, DIPG lysates resolved by two-dimensional gel electrophoresis are immunoblotted with pre- and post-vaccine patient plasma containing antibodies against vaccine antigens. Proteins are immunoprecipitated (IP) from DIPG lysates, followed by mass spectrometry (MS) identification and validation. RESULTS In eight subjects to date, vaccination with rHSC-DIPGVax consistently induces IgM and IgG antibodies against proteins directly targeted by the vaccine, including strong immunoreactivity to ACVR1. Furthermore, antibodies against several secondary proteins are also detected in post-vaccination plasma. Immunoblotting and IP-MS analysis identified several distinct candidates of epitope spreading, including the tumor antigens CEP290, DNAH3, HRNR, KDM6B, LAMA5, and TRPA1. CONCLUSIONS rHSC-DIPGVax induces antibody-mediated tumor-specific responses to DIPG neoantigens, including direct vaccine targets and secondary targets via intra- and inter-molecular epitope spreading. We also present an experimental protocol to investigate vaccine-induced immune activation. Our ongoing studies aim to validate epitope spreading candidates and determine the important biological correlates between antibody responses and clinical outcomes.

Application of Interferon-γ Release Assay in the Assessment of T-Cell Immunity to SARS-CoV-2 Antigens in the Cohort of Pediatric Patients with Juvenile Idiopathic Arthritis.

Background: an accurate assessment of the immunity against SARS-CoV-2 can facilitate a better understanding and management of not only the recent coronavirus but similar pathogens as well. Objective: the aim of this study was to evaluate T-cell immunity with reference to antibody titers in a group of pediatric patients with autoimmune arthritides utilizing the widely known Interferon-γ Release Assay (IGRA). Materials and Methods: This study was conducted in the cohort of 55 children suffering from Juvenile Idiopathic Arthritis (JIA). This research analyzed the SARS-CoV-2 T-cell response measured by a specific quantitative IGRA, followed by a serological ELISA test measuring the presence and quantity of IgG, IgM, and IgA antibodies in serum. Results: The cellular response to SARS-CoV-2 measured by the IGRA test significantly correlated with the antibody titers, IgA (p < 0.00003, R = 0.537), IgG (p < 0.0001, R = 0.668), and IgG nucleocapsid protein (NCP) (p < 0.003, R = 0.0399), with no correlation with IgM levels. The antibody levels in patients receiving biological agents were significantly lower compared to the rest of the cohort (p = 0.0369), while traditional disease-modifying antirheumatic drugs had no such effect. Limitations: the main limitation of the research is the small sample size, mostly due to the specific cohort of patients and the lack of a healthy control. Conclusions: IGRA appears to be a viable tool in the accurate evaluation of T-cell responses to SARS-CoV-2, and serodiagnostics alone is not always sufficient in the assessment of immune responses.

Antiphospholipid antibodies in patients with antiphospholipid syndrome.

Antiphospholipid syndrome (APS) is a rare systemic autoimmune disease characterized by recurrent pregnancy morbidity or thrombosis in combination with the persistent presence of antiphospholipid antibodies (aPLs) in plasma/serum. Antiphospholipid antibodies are a heterogeneous, overlapping group of autoantibodies, of which anti-β2-glycoprotein I (aβ2GPI), anticardiolipin (aCL) antibodies and antibodies that prolong plasma clotting time in tests in vitro known as lupus anticoagulant (LAC) are included in the laboratory criteria for the diagnosis of APS. The presence of LAC antibodies in plasma is indirectly determined by measuring the length of coagulation in two tests - activated partial thromboplastin time (aPTT) and diluted Russell's viper venom time (dRVVT). The concentration of aβ2GPI and aCL (immunglobulin G (IgG) and immunoglobulin M (IgM) isotypes) in serum is directly determined by solid-phase immunoassays, either by enzyme-linked immunosorbent assay (ELISA), fluoroimmunoassay (FIA), immunochemiluminescence (CLIA) or multiplex flow immunoassay (MFIA). For patient safety, it is extremely important to control all three phases of laboratory testing, i.e. preanalytical, analytical and postanalytical phase. Specialists in laboratory medicine must be aware of interferences in all three phases of laboratory testing, in order to minimize these interferences. The aim of this review was to show the current pathophysiological aspects of APS, the importance of determining aPLs-a in plasma/serum, with an emphasis on possible interferences that should be taken into account when interpreting laboratory findings.

Diagnosis of Coccidioidomycosis with the Second-Generation Miravista IgG and IgM Enzyme Immunoassay and the Role of Adding Miravista Coccidioides Antigen Detection to Immunodiagnostic Assays.

In the present study, we validate and compare the second-generation Miravista Coccidioides IgG and IgM enzyme immunoassays (EIA) (MiraVista Diagnostics [MVD] Ab EIA) to Meridian Diagnostics Coccidioides IgG and IgM EIA (Meridian Ab EIA), immunodiffusion (ID) and complement fixation (CF). We also evaluated whether the addition of Coccidioides antigen testing to anti-Coccidioides antibody testing increased the sensitivity for the diagnosis of currently active coccidioidomycosis. We retrospectively studied 555 patients evaluated at Valleywise Health Medical Center between January 2013 and May 2017 for whom coccidioidomycosis was suspected and samples were submitted to MVD for testing. Specimens were tested for antigen in the MVD antigen enzyme immunoassay (MVD Ag EIA) and for IgG and IgM antibodies with MVD and Meridian Diagnostics EIAs. ID and CF were obtained from medical records. Sensitivity and specificity were 83.0% and 91.1% or MVD Ab EIA, 69.3% and 99.7% for Meridian Ab EIA, 85.4% and 100% for ID and 65.5% and 100% for CF. Combined MVD antigen and antibody detection by EIA and ID resulted in increased sensitivity in disseminated and pulmonary disease (MVD Ag/MVD Ab: 100%, 88.3%; MVD Ag/Meridian Ab: 98.2%, 78.6%; and MVD Ag/ID: 100%, 91.7%). The detection of antibodies by MVD EIA was more sensitive than Meridian EIA or CF but similar to ID. This study supports the use of antigen testing in immunocompromised patients and those with suspected disseminated disease. Furthermore, the addition of antigen detection by EIA to antibody detection resulted in higher sensitivity of all serological tests.

Estimating dengue burden among family contacts through cluster investigation around probable cases in 2022 and 2023 in the Central Region, Burkina Faso

BackgroundIn 2023, Burkina Faso experienced the largest dengue epidemic ever in Africa. This study aimed to estimate the prevalence of symptomatic, subclinical, and asymptomatic dengue and determine the associated factors among adult contacts of dengue in the Central Region, Burkina Faso.MethodsThis cross-sectional study included contacts of dengue probable cases through cluster sampling in 2022–2023. These suspected cases that tested positive were identified from the five health facilities (Pissy CMA, Saaba CM, Kossodo CMA, Samandin CM, and Marcoussis CSPS) that reported the highest number of cases in 2021 per district. All participants underwent dengue and malaria rapid diagnostic tests (RDT). Samples positive for non-structural 1 protein antigen (AgNS1) and/or immunoglobulin M (IgM) were tested for serotype detection by reverse transcription polymerase chain reaction (RT-PCR). Binary logistic regression was done to identify the determinants of asymptomatic, subclinical, and symptomatic dengue among contacts of probable dengue cases.ResultsA total of 484 contacts were included, mostly in 2023 (75.2%). Most participants were females (58.6%), residing (24.3%) and passing their daytime (23.1%) in Saaba. The overall prevalence of dengue was estimated at 15.1% [95% confidence interval (CI): 12.0–18.6%], representing cases not seeking care in hospitals. Asymptomatic cases represented 2.9% (95% CI: 1.6–4.8%). Subclinical and symptomatic cases accounted for 6.0% (95% CI: 4.1–8.5%) and 6.2% (95% CI: 4.2–8.7%), respectively. Of the 58 samples tested by RT-PCR, 10 were confirmed for serotype 3 in 2023. Malaria cases were estimated at 5.6% (95% CI: 3.7–8.0%). After adjustment, participants claiming that a virus transmits dengue were likelier to have asymptomatic dengue [adjusted odds ratio (aOR) = 7.1, 95% CI: 2.4–21.0]. From the multivariable analysis, subclinical dengue was statistically associated with being included in the study in 2023 (aOR = 30.2, 95% CI: 2.0–455.5) and spending the daytime at Arrondissement 4 (aOR = 11.5, 95% CI: 1.0–131.0). After adjustment, symptomatic dengue was associated with living less than 50 m away from cultivated land (aOR = 2.8, 95% CI: 1.1–6.9) and living less than 50 m from a stretch of water (aOR = 0.1, 95% CI: 0.0–0.6).ConclusionsThe overall burden of dengue among populations not seeking care in hospitals was quite high, with few asymptomatic cases. Efforts to manage dengue cases should also target non-hospital cases and raise population awareness. The 2023 epidemic could be due to dengue virus (DENV)-3.Graphical

Diagnostic Significance Vasoendothelial Growth Factor Depending on the Severity and Duration of Atopic Dermatitis, as Well as Taking into Account the Presence of Markers of Herpes Virus Infection

Currently, the problem of diagnosis and treatment of diseases associated with disorders of the angiogenesis process, as well as regenerative processes, is acute. Factors regulating the processes of angiogenesis in allergic diseases, including atopic dermatitis, play a key role in maintaining chronic inflammation and can have a significant impact on the course of the disease. Materials and methods: The study is analytical cross-sectional and presented by a comprehensive examination of 140 patients with AtD aged 2 to 12 years (median age 4.2 years), divided into 2 groups: 70 children with an established diagnosis of AtD; 70 children with atopic dermatitis infected with herpes simplex virus (AtD+HVI). The control group consisted of 70 somatically healthy children. A special laboratory examination included the determination of specific IgM and/or IgG class antibodies to herpes simplex virus type 1-2 antigens by enzyme immunoassay (ELISA); determination of the DNA of the studied herpesviruses in blood samples by polymerase chain reaction; determination of vascular endothelial growth factor A (VEGF-A) in the blood plasma of patients by ELISA. The results of our own research: A statistically significant (p &lt;0.001) increase in the level of vascular endothelial growth factor A in blood serum was found in children with AtD compared with the control group. Against the background of infection with the herpes simplex virus, an increase in the level of vascular endothelial growth factor A in blood serum was revealed compared with patients with atopic dermatitis (p &lt; 0.001). There was also a statistically significant increase in serum VEGF-A levels in patients with AtD (p &lt; 0.001) and AtD+HVI (p &lt; 0.001) with an increase in the severity of AtD. This was confirmed by the results of a correlation analysis that revealed the relationship between the level of VEGF-A and the severity of clinical symptoms of the disease.The addition of herpesvirus infection to AtD worsens the clinical symptoms of this disease.