检测耶尔森氏菌抗体的western blot方法的评价:耶尔森氏菌外膜蛋白与伯氏疏螺旋体之间血清学交叉反应的证据。

Mindy L Rawlins, Cecilia Gerstner, Harry R Hill, Christine M Litwin
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引用次数: 25

摘要

小肠结肠炎耶尔森菌和假结核耶尔森菌已被确定为人类反应性关节炎的致病生物。我们评估了一种使用耶尔森氏菌外膜蛋白作为抗原检测耶尔森氏菌抗体的Western blot方法,以替代补体固定(CF)方法。通过CF法、Western blot法和酶联免疫吸附法(ELISA)检测19例阳性和21例阴性血清样本,确定临床一致性、敏感性和特异性。CF法和ELISA法与Western blot法进行比较,Western blot法是本研究的参考方法。含有可能与耶尔森氏菌发生交叉反应的抗体的血清也通过Western blot检测。CF法的一致性、敏感性和特异性分别为61%、26%和95%;ELISA检测的阳性率分别为89%、95%和82%。50名健康供者的耶尔森氏菌抗体阳性率为免疫球蛋白G (IgG) 6%, IgA和IgM分别为2%和2%。经Western blot检测,亨塞拉巴尔通体、布鲁氏菌、肺炎衣原体和立克次体抗体阳性的血清显示交叉反应性。与伯氏疏螺旋体的交叉反应性最高;11个样本中有5个(45%)通过igm特异性检测呈交叉反应。总的来说,Western blot检测的效果是可以接受的,而且比CF检测更敏感,因此可以在实验室中替换CF检测。由于交叉反应性的证据,特别是伯氏疏螺旋体,它可以引起类似于反应性关节炎的寡关节炎,反应性关节炎的诊断应基于临床表现和对潜在致病感染性病原体的完整血清学分析。
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Evaluation of a western blot method for the detection of Yersinia antibodies: evidence of serological cross-reactivity between Yersinia outer membrane proteins and Borrelia burgdorferi.

Yersinia enterocolitica and Yersinia pseudotuberculosis have been identified as causative organisms of reactive arthritis in humans. We evaluated a Western blot assay which uses Yersinia outer membrane proteins as antigens for the detection of Yersinia antibodies as a replacement for the complement fixation (CF) assay. Clinical agreement, sensitivity, and specificity were determined by testing 19 positive and 21 negative serum samples by the CF assay, Western blot assay, and enzyme-linked immunosorbent assay (ELISA). The CF assay and ELISA were compared to the Western blot assay, which was the reference method used in this study. Sera with antibodies that could potentially cross-react with Yersinia were also tested by the Western blot assay. The agreement, sensitivity, and specificity of the CF method were 61%, 26%, and 95%, respectively; and those for the ELISA were 89%, 95%, and 82%, respectively. The prevalences of Yersinia antibodies in 50 healthy donors were 6% for immunoglobulin G (IgG), 2% for IgA, and 2% for IgM. Sera positive for Bartonella henselae, Brucella, Chlamydia pneumoniae, and Rickettsia rickettsii antibodies showed cross-reactivity by the Western blot assay. The highest cross-reactivity was observed with Borrelia burgdorferi; 5 of 11 (45%) specimens were cross-reactive by the IgM-specific assay. Overall, the Western blot assay performs acceptably and is more sensitive than the CF assay, warranting replacement of the CF assay in the laboratory. Due to the evidence of cross-reactivity, particularly with B. burgdorferi, which can cause an oligoarthritis similar to reactive arthritis, the diagnosis of reactive arthritis should be based on clinical findings and complete serologic analysis of the potential causative infectious pathogens.

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