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首页> 外文期刊>Clinical and diagnostic laboratory immunology >Evaluation of an Immunoglobulin G Enzyme-Linked Immunosorbent Assay for Pertussis Toxin and Filamentous Hemagglutinin in Diagnosis of Pertussis in Senegal
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Evaluation of an Immunoglobulin G Enzyme-Linked Immunosorbent Assay for Pertussis Toxin and Filamentous Hemagglutinin in Diagnosis of Pertussis in Senegal

机译：百日咳毒素和丝状血凝素的免疫球蛋白G酶联免疫吸附测定在塞内加尔百日咳诊断中的价值评估

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The enzyme-linked immunosorbent assay is widely employed for the serological diagnosis of pertussis. It is generally concluded that a significant increase in specific immunoglobulin G (IgG) or IgA against the pertussis toxin (PT) or against filamentous hemagglutinin (FHA) in paired sera correlates with Bordetella pertussis infection. However, this type of diagnosis of pertussis has mainly been applied to unvaccinated children, with timely sampling of acute- and convalescent-phase sera. In current practice and in epidemiological studies, such criteria are not always fulfilled. The aim of this study was to analyze the significance of decreases in IgG antibody titers against PT and FHA between paired sera observed in suspected cases of pertussis infection. Serological results from paired sera were available for 460 children experiencing at least 8 days of cough. An anti-PT IgG decrease was observed in 25% of the children, more frequently than the anti-FHA IgG decrease. Fourteen percent of the serologic decreases were observed in children with culture-confirmed infection, and 59% of the decreases were observed in children with confirmation criteria according to World Health Organization recommendations. Most of the decreases were observed when serum samples were collected according to a standard recommended schedule. Serologic decreases were observed more frequently among vaccinated children than among unvaccinated children. This difference, which was highly significant (P < 0.00001), was explained by the different kinetics of the antibody responses between vaccinated and unvaccinated children. The importance of the antibody response for the evaluation of vaccine efficacy, namely a bias toward higher absolute vaccine efficacy when this response is not taken into account, is discussed. This study supports an earlier recommendation that a significant decrease in PT or FHA should be added to the diagnostic criteria for pertussis.
机译：酶联免疫吸附测定法被广泛用于百日咳的血清学诊断。通常得出结论，成对血清中针对百日咳毒素（PT）或针对丝状血凝素（FHA）的特异性免疫球蛋白G（IgG）或IgA的显着增加与百日咳博德特氏菌感染有关。但是，这种百日咳的诊断方法主要适用于未接种疫苗的儿童，并及时取样急性期和恢复期血清。在当前的实践和流行病学研究中，并不总是满足这样的标准。这项研究的目的是分析在疑似百日咳感染病例中配对血清之间针对PT和FHA的IgG抗体滴度降低的意义。配对血清的血清学结果可用于460名至少咳嗽8天的儿童。在25％的儿童中观察到抗PT IgG降低的频率高于抗FHA IgG降低的频率。根据世界卫生组织的建议，在培养确诊的患儿中，血清学下降了14％，在确诊标准的患儿中，下降了59％。当按照标准推荐的时间表收集血清样品时，观察到了大多数减少。接种疫苗的儿童比未接种疫苗的儿童更经常观察到血清学下降。这种差异非常显着（ P <0.00001），可以通过接种疫苗的儿童和未接种疫苗的儿童之间抗体反应的动力学不同来解释。讨论了抗体反应对于评估疫苗效力的重要性，即当不考虑该反应时，偏向更高的绝对疫苗效力。这项研究支持较早的建议，即应将百日咳或PTA的显着降低添加到百日咳的诊断标准中。

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