Sensitive solid-phase radioimmunoassay for detection of human immunoglobulin G antibodies to varicella-zoster virus

Detection of specific IgA antibodies to varicella zoster virus in serum of patients with Ramsay Hunt syndrome

Varicella zoster virus (VZV)-specific IgG and IgA antibody titers were determined in serial serum samples of 23 patients with Ramsay Hunt syndrome by the immunoperoxidase assay. Varicella zoster virus-specific IgG antibodies were found in the first serum samples of all the patients. In 80% of 20 patients in whom a serum sample was available within 5 days after the onset of the disease. VZV-specific IgA antibodies were detected. The second serum sample was VZV-specific IgA-positive in all of the patients. While all the healthy age- and sex-matched control subjects had VZV-specific IgG antibodies, VZV-specific IgA antibodies were detected in a low titer (dilution = 2) in only three of the subjects. By using VZV-specific IgA antibody titers greater than or equal to 2 and greater than or equal to 4 by the immunoperoxidase assay as a "cutoff" for younger and older patients with Ramsay Hunt syndrome, respectively, an early diagnosis of the disease can be obtained in 89% of the younger and in 64% of the older patients by a single serum sample.

Studies on HSV specific IgA antibodies in lacrimal fluid from patients with herpes keratitis by solid phase radioimmunoassay

A highly sensitive solid phase radioimmunoassay (RIA) was adapted for determination of herpes simplex virus (HSV) specific IgA antibodies in lacrimal fluids. The RIA procedure was applied to examine HSV IgA antibodies in serial samples of lacrimal fluid and in sera from 14 patients with herpes keratitis. HSV-specific IgA antibodies were detected in the lacrimal fluid of the affected eye in 12 of the 14 patients. HSV IgA antibodies were also detected in the lacrimal fluid of the unaffected eye of 7 of these patients in titers lower than those found in the corresponding affected eye. Evidence for local HSV antibody production in lacrimal fluid in herpes keratitis was supported by examination for antibodies to the unrelated measles antigen. Detection of lacrimal fluid HSV IgA antibodies might be a useful adjunct in rapid diagnosis of herpes keratitis. The advantage of characterizing the local immune response as well as viral expression in the affected vs. the unaffected eye in the same individual as a model for understanding the factors leading to subclinical vs. clinical manifestations of recurrent ocular herpes virus infections will be discussed.

The varicella-zoster virus: systemic and ocular features

Although the varicella-zoster virus infections are usually benign skin diseases, they can have serious systemic manifestations and complications. This article reviews the current concepts concerning the anatomy and physiology of the virus and the epidemiology, pathogenesis, pathology, immunology, and laboratory diagnosis of these infections. The information gained in these areas has improved our knowledge of the disease, permitted the detection of susceptible patients, allowed the earlier use of new antiviral treatment, and provided a background for the use of active and passive immunization. The clinical features and consequences of both varicella and herpes zoster are described. The prevention and treatment are underscored, especially with regard to the newer systemic antiviral therapy. Herpes zoster ophthalmicus is specifically detailed because of its frequency and because of serious ocular and systemic implications for both the dermatologist and the ophthalmologist. The nerve innervation of the eye and ocular adnexa as it pertains to herpes zoster ophthalmicus is outlined, and a description is given of the multiple ocular complications for the dermatologist. Data on the role of antiviral agents and of topical and systemic corticosteroids in herpes zoster ophthalmicus are presented. Postherpetic neuralgia, probably the most difficult management problem of herpes zoster ophthalmicus, is addressed from a descriptive, preventive, and treatment view.

Herpes simplex virus-specific serum immunoglobulin a: detection in patients with primary or recurrent herpes infections and in healthy adults

A sensitive radioimmunoassay was used to determine levels of herpes simplex virus (HSV)-specific immunoglobulin A (IgA) in serial serum samples drawn from patients with primary HSV infections and from persons with recurrent HSV infections, and in single samples from 90 healthy adults. Significantly rising HSV IgA titers were detected in patients with primary infections, whereas those with recurrent infections had nonfluctuating titers. Sera of IgG-seropositive healthy adults were all positive for HSV-specific IgA without special pretreatment.

Determination of specific IGA antibodies to varicella zoster virus by immunoperoxidase assay

An indirect peroxidase technique was developed for determination of IgA antibodies to varicella zoster virus (VZV). The antigen consisted of acetone-fixed trypsinised VZV-infected cells. Rabbit antihuman IgA peroxidase conjugate was used to detect human IgA antibodies bound to viral antigen. In parallel IgG antibodies to VZV were determined by an immunoperoxidase antibody to membrane antigen (IPAMA) technique. Varicella zoster virus IgA antibodies were detected in all five varicella and seven zoster patients. No VZV IgA antibodies (less than 2) were detected in 45 healthy control sera. Neither were they found in paired sera of five patients with herpes simplex infection, five patients with human cytomegalovirus infection and two patients with Epstein-Barr virus infection. Application of immunoperoxidase IgA technique in serodiagnosis of primary and reactivated VZV infections is discussed.

Detection of virus-specific IgA antibodies in serum of kidney transplant patients with recurrent cytomegalovirus infection by enzymeimmuno and radioimmunoassay techniques

The feasibility of using human cytomegalovirus (CMV)-specific IgA antibody determinations as a signal for early detection of recurrent CMV infections in eight renal transplant recipients was analyzed. Solid phase radioimmunoassay (RIA), enzyme-liked immunosorbent assay (ELISA) and immunoperoxidase assay (IPA) techniques were used for IgA antibody determinations. In parallel, IgG antibodies to CMV were studied by immunoperoxidase assay. A significant rise of CMV-specific IgG antibody titre was observed in all of these patients between 5 and 53 weeks post-transplantation. CMV-specific IgA antibody production was detected close to the time a rise in CMV IgG antibody was observed in seven out of eight patients studied by RIA and ELISA, and in six out of eight patients studied by IPA. In two patients specific CMV IgA antibodies were detected by all three methods before a significant rise of CMV IgG antibody titre was demonstrated. In these patients CMV IgA was detected by RIA earlier than by ELISA and IPA. The potential application of CMV-specific IgA antibody determination for early detection of recurrent CMV infection in renal transplant patients is discussed.

Enzyme-linked immunosorbent assay for detection of antibody to varicella-zoster virus

Primary varicella-zoster virus (VZV) infection is a serious illness in immunocompromised individuals, and a rapid, sensitive, and reliable assay to identify high-risk VZV-susceptible patients would be clinically useful. An enzyme-linked immunosorbent assay (ELISA) for antibody to VZV was compared with the fluorescent antibody-to-membrane antigen (FAMA) assay and found to be similar in both sensitivity and specificity. The antibody titers determined by both assays were also similar. The absence of antibody detected by ELISA correlated with susceptibility to VZV infection. Because it is simple to perform and has equivalent sensitivity to FAMA, ELISA should be useful for VZV antibody testing in diagnostic and research laboratories.

Detection of human cytomegalovirus- specific IgA antibodies in colostrum by enzyme-linked immunosorbent assay (ELISA)

Fifty women were examined after delivery for the prevalence of antibodies to human cytomegalovirus in colostrum and sera. Eighty percent of them had specific CMV IgG antibodies in the sera, as determined by the immunoperoxidase antibody to membrane antigen (IPAMA) technique. Of the CMV-seropositive women, 60% had specific CMV IgA antibodies in high titer in the colostrum as determined by enzyme-linked immunosorbent assay (ELISA). In only two of the seropositive women were specific CMV IgA antibodies detected in the sera as well. The significance of specific CMV IgA antibodies in colostrum as protection against perinatal infection and the mechanism of this production will be discussed.

Immunoglobulins M and G to varicella-zoster virus measured by solid-phase radioimmunoassay: antibody responses to varicella and herpes zoster infections

Both immunoglobulin M (IgM) and IgG antibodies to varicella-zoster virus (VZV) were detectable in a solid-phase radioimmunoassay with 125I-labeled goat antisera to human immunoglobulins. Primary infection with VZV was associated with early production of IgM and IgG antibodies and rapid development of lymphocyte transformation to VZV antigen. Among eight subjects with varicella tested 1 to 4 days after onset, seven patients had IgG and six patients had IgM antibodies; all patients had both IgG and IgM antibodies within 7 days. An IgM response was documented by radioimmunoassay in 18 of 26 patients with herpes zoster. VZV antibodies could be assayed by radioimmunoassay in unfractionated serum with commercial goat antisera to human immunoglobulins and commercial VZV antigen. VZV-specific IgG binding was present in all sera from 42 subjects with a VZB antibody titer of greater than or equal to 1:8 as determined by indirect immunofluorescence and cellular immunity to VZV as determined by lymphocyte transformation and who had had varicella at least 20 years before testing. The geometric mean titer was 1:6,309, and titers were greater than or equal to 1:16,384 in 20 subjects. Antibody was present as determined by radioimmunoassay in 14 samples negative by complement fixation and in five samples negative by complement fixation and immune adherence hemagglutination. No specific binding was observed in 21 sera from subjects who were not immune to VZV as determined by indirect immunofluorescence or lymphocyte transformation despite the presence of herpes simplex or cytomegalovirus antibody indicated by complement fixation in 15 sera. High titers of VZV IgM antibody were detected in unfractionated sera despite the presence of high titers of VZV IgG antibody. The VZV radioimmunoassay provided a sensitive and practical method for measuring VZV IgG and IgM antibodies.

Detection of human cytomegalovirus-specific IgG antibodies by a sensitive solid-phase radioimmunoassay and by a rapid-screening test

A radioimmunoassay (RIA) for the detection of human IgG antibodies to cytomegalovirus (CMV) which utilizes extracts of CMV-infected cells as antigen is described. Sera of 66 healthy adults were titered by the RIA and by the complement fixation (CF) test. These same subjects were also used in the evaluation of a rapid screening radioimmunoassay (RSRIA) developed to detect IgG antibodies to CMV in small serum samples. The specificity of the RIA was evaluated by testing sera of seven CMV patients and ten patients with heterotypic titer rises to herpes simplex virus or varicella zoster virus (HSV or VZV). The RIA proved to be sensitive and specific. Possible applications of the RSRIA modification are discussed.

Determination of IgA antibodies to human cytomegalovirus by enzyme-linked immunosorbent assay (ELISA)

A sensitive enzyme-linked immunosorbent assay (ELISA) is described for detection of IgA antibodies cytomegalovirus (CMV). The antigen consisted of a sonicated extract of CMV infected human embryo cells. The tested sera were absorbed with staphylococcus aureus (strain Cowan 1) before analysis. Rabbit antihuman IgA peroxidase conjugate was used to detect human IgA bound to viral antigen. In parallel, Igm and IgG antibodies to CMV were studied by ELISA and by the immunoperoxidase antibody to membrane antigen (IPAMA) technique, respectively. CMV IgA was detected in high titers by ELISA in eight of nine CMV patients. The maximal IgA titers were generally lower than the IgM titers detected by ELISA. No CMV IgA antibodies (titer less than 20) were detected by ELISA in 57 control sera (healthy adults, hospitalized patients with various other diseases), paired sera of five patients with acute herpes simplex, infection, two patients with Epstein-Barr infections, one patients with varicella, and one with zoster infections. The potential application of the ELISA CMV IgA technique in serodiagnosis of CMV infections is discussed.

Infection and persistence of varicella-zoster virus in lymphoblastoid Raji cell line

Infection of Raji cells by varicella-zoster virus (VZV) resulted in permissive infection with establishment of a persistently infected lymphoblastoid cell line. VZV antigens of the membrane and nuclear type, as detected by the indirect immunofluorescence membrane antigen (IFAMA) and anticomplement immunofluorescence (ACIF) tests, were observed. Minute amounts of infectious virus were detected by co-cultivation of VZV-infected Raji cells (Raji-VZV), with permissive human embryo fibroblasts (HEF). The virus isolated was found to be similar to the parent strain. Transient induction of Epstein-Barr viral capsid antigen (EB-VCA) was also observed. The persistently infected Raji-VZV cell line, when free of EB-VCA, was found suitable for measuring antibodies to varicella-zoster virus. The possible interaction in the infected Raji cells between EBV, which is implicated in human malignancy, and VZV which belongs also to the herpes group of viruses, is discussed.