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Ramos RCF, Barbosa ADS, Aleixo ALQDC, Arruda IF, Amendoeira MRR. Comparison of immunological and molecular methods for laboratory diagnosis of ocular toxoplasmosis in blood, serum and tears in Brazil. PLoS One 2024; 19:e0298393. [PMID: 38319921 PMCID: PMC10846737 DOI: 10.1371/journal.pone.0298393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 01/23/2024] [Indexed: 02/08/2024] Open
Abstract
Ocular toxoplasmosis (OT) is caused by protozoan T. gondii. Ophthalmological examination is considered the gold standard for OT diagnosis, and laboratory tests are used for diagnostic confirmation. However, these tests can present different results, which change depending on their basis, on sample type and on patients' clinical alteration. Thus, the aim of the present study is to assess immunodiagnostic and molecular techniques applied in blood, serum and tear fluid to diagnose T. gondii infection in patients seen at an Ophthalmology Clinic. In total, 160 patients were included in the study, 40 of them had OT with active lesions (G1); 40 had OT with healed lesions (G2), 40 had non-toxoplasmic uveitis (G3) and 40 had no ocular alterations (G4). Serum samples were subjected to Immunoenzymatic Assay (ELISA) and to Indirect Immunofluorescence Reaction (IFAT) to search for anti-T. gondii IgM and IgG. Tear fluid samples were analyzed through ELISA for IgA research. All blood and tear fluid samples were subjected to conventional polymerase chain reaction (cPCR) and in a Nested PCR model for T. gondii DNA amplification with targets B1, GRA7 and REP 529. IgG and IgM anti-T. gondii was detected in serum samples from 106 and 15 patients, respectively, when combining ELISA and IFAT results. Anti-T.gondii IgA antibodies were detected in 9.2% of the tear material. Nested PCR with GRA7 target showed higher positivity in blood samples (24.4%); Nested PCR with B1 target showed a higher frequency of positivity in tears (15%). Biological samples of patients with active lesions showed the highest positivity frequencies in all immunodiagnostic assays, as well as in most PCR models. The present results highlighted the need of associating techniques with different fundamentals to confirm OT diagnosis. Furthermore, further tear fluid analyses should be performed to validate this biological material as lesser invasive alternative for the more accurate OT diagnosis.
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Affiliation(s)
| | - Alynne da Silva Barbosa
- Laboratory of Toxoplasmosis and Other Protozooses, Oswaldo Cruz/Fiocruz Institute, Rio de Janeiro, Brazil
- Department of Microbiology and Parasitology, Biomedical Institute / Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Ana Luisa Quintella do Couto Aleixo
- Laboratory of Clinical Research in Infectious Ophthalmology–Evandro Chagas National Institute of Infectology/Fiocruz, Rio de Janeiro, Brazil
| | - Igor Falco Arruda
- Laboratory of Toxoplasmosis and Other Protozooses, Oswaldo Cruz/Fiocruz Institute, Rio de Janeiro, Brazil
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Eidet JR, Akopian M, Olstad OK, Jørstad ØK, Moe MC, Petrovski G, Pepaj M. The acute phase response protein SERPINA3 is increased in tear fluid from the unaffected eyes of patients with unilateral acute anterior uveitis. J Ophthalmic Inflamm Infect 2021; 11:19. [PMID: 34212267 PMCID: PMC8249488 DOI: 10.1186/s12348-021-00249-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 05/28/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND To identify candidate tear fluid biomarkers in patients with unilateral acute anterior uveitis (AAU) that can aid in the differentiation between these patients and patients with bacterial keratitis or healthy controls. METHODS Thirteen patients (40.1 ± 16.2 years of age) with unilateral AAU, seven patients with unilateral bacterial keratitis (40.2 ± 15.3 years of age), and 14 healthy subjects (41.1 ± 11.6 years of age) were included. The tear proteome of affected eyes was compared with that of the unaffected eye or healthy controls. Proteins were identified by liquid chromatography tandem mass spectrometry and enzyme-linked immunosorbent assay. RESULTS Relative protein ratios were detected and calculated for 272 unique proteins. Compared with healthy controls and the unaffected eye, the top upregulated proteins in AAU eyes were submaxillary gland androgen regulated protein 3B (SMR3B) and SMR3A. Similarly, the top upregulated proteins in bacterial keratitis were S100 calcium-binding protein A9 and orosomucoid 2. The acute phase response protein Serpin Family A Member 3 (SERPINA3) was increased in the healthy eye of AAU patients (P = 0.019) compared with healthy controls. Laser flare measurements in affected eyes of AAU patients showed positive logarithmic correlation with SERPINA3 in tear samples of the unaffected eye (P = 0.022). The use of SERPINA3 as a tear biomarker yielded a sensitivity of 85% and a specificity of 71% in detecting patients with AAU in the study population. CONCLUSIONS The acute phase response protein SERPINA3 was increased in tear samples of unaffected eyes of patients with unilateral AAU compared with healthy controls. This study highlights SERPINA3 as a potential biomarker for AAU. Future research should explore the dynamic properties of SERPINA3 in the tear fluid of active and quiescent uveitis eyes.
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Affiliation(s)
- Jon Roger Eidet
- Department of Ophthalmology, Center for Eye Research, Oslo University Hospital and University of Oslo, Oslo, Norway.
| | - Maja Akopian
- Department of Ophthalmology, Center for Eye Research, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Ole K Olstad
- Department of Medical Biochemistry, Blood Cell Research Group, Section for Research, Oslo University Hospital, Oslo, Norway
| | - Øystein Kalsnes Jørstad
- Department of Ophthalmology, Center for Eye Research, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Morten C Moe
- Department of Ophthalmology, Center for Eye Research, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Goran Petrovski
- Department of Ophthalmology, Center for Eye Research, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Milaim Pepaj
- Department of Medical Biochemistry, Hormone Laboratory, Oslo University Hospital, Oslo, Norway
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de Jesus LNNP, de Castro Zacche Tonini A, Barros GB, Coelho-dos-Reis JGA, Béla SR, do Valle Antonelli LR, Machado AS, Carneiro ACAV, Andrade GMQ, Vasconcelos-Santos DV, Januário JN, Teixeira-Carvalho A, Vitor RWA, Ferro EA, Mineo JR, Bahia-Oliveira LMG, Martins-Filho OA, Lemos EM. IgA and IgG1 reactivities assessed by flow cytometry mirror clinical aspects of infants with ocular congenital toxoplasmosis. J Immunol Methods 2016; 428:1-8. [DOI: 10.1016/j.jim.2015.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 11/11/2015] [Indexed: 11/26/2022]
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Lynch LF, Lynch MI, Ferreira RSDN, Vasconcelos MSL, Melo N, Ferreira S, Malagueño E. Ocular toxoplasmosis: evaluation of lacrimal-specific secretory IgA levels in both patients with active and inactive phases of the disease. Mem Inst Oswaldo Cruz 2012; 106:625-8. [PMID: 21894386 DOI: 10.1590/s0074-02762011000500017] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2011] [Accepted: 07/14/2011] [Indexed: 11/22/2022] Open
Abstract
Ocular toxoplasmosis can result in recurrent uveitis. Studies have shown that a correlation between active ocular toxoplasmosis and the presence of anti-Toxoplasma gondii secretory IgA (SIgA) in tears. This study compares anti-T. gondii SIgA levels in patients' tears during the acute and inactive phases of toxoplasmic uveitis. Twenty-nine positive tear specific SIgA for T. gondii patients with acute toxoplasmic uveitis were selected and were followed-up for at least two years, when the anti-T. gondii SIgA tears levels were determined. Specific SIgA for T. gondii was negative in 22 patients (75.86%) and positive in seven patients (24.13%) of whom six (85.7%) were followed over three years. Average SIgA levels during the acute phase are 1.54 and decrease significantly to 0.72 (p = 0.0001) during the inactive phase of disease. Because anti-T. gondii SIgA in the tear is negative in 75.86% of patients after the acute phase of infection, T. gondii SIgA levels may be used as a complementary diagnostic marker for active ocular toxoplasmosis.
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Affiliation(s)
- Luiz Felipe Lynch
- Departamento de Oftalmologia, Laboratório de Imunopatologia Keizo Asami, Universidade Federal de Pernambuco, Recife, PE, Brasil, 50670-901.
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Akiyama T, Ohta N. Parasite-specific antibody profile in the aqueous humor of rabbits with ocular toxocariasis. Parasitol Int 2010; 59:112-20. [DOI: 10.1016/j.parint.2009.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2009] [Revised: 11/08/2009] [Accepted: 11/17/2009] [Indexed: 10/20/2022]
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Lynch MI, Malagueño E, Lynch LF, Ferreira S, Stheling R, Oréfice F. Anti-Toxoplasma gondii secretory IgA in tears of patients with ocular toxoplasmosis: immunodiagnostic validation by ELISA. Mem Inst Oswaldo Cruz 2009; 104:818-22. [DOI: 10.1590/s0074-02762009000600003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2009] [Accepted: 08/18/2009] [Indexed: 11/21/2022] Open
Affiliation(s)
| | | | | | - Silvana Ferreira
- Universidade Federal de Pernambuco, Brasil; Universidade de Pernambuco, Brasil
| | - Raphael Stheling
- Centro de Ciências da Saúde; Universidade Federal de Minas Gerais, Brasil
| | - Fernando Oréfice
- Centro de Ciências da Saúde; Universidade Federal de Minas Gerais, Brasil
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Sahu PS, Parija SC, Sahu PK. Tear IgA-ELISA: a novel and sensitive method for diagnosis of ophthalmic cysticercosis. Acta Trop 2008; 106:168-74. [PMID: 18462701 DOI: 10.1016/j.actatropica.2008.03.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2007] [Revised: 03/09/2008] [Accepted: 03/11/2008] [Indexed: 11/29/2022]
Abstract
For the first time, presence of locally secreted specific IgA antibodies in tear specimen from human with ophthalmic cysticercosis is documented in the present study. The ELISA using Taenia solium metacestode excretory secretory (ES) antigen demonstrated a diagnostic level of IgA antibodies in tears with 100% sensitivity (6 out of 6 confirmed cases of ophthalmic cysticercosis) whereas, 25 of 34 (73.52%) clinically suspected cases were diagnosed positive. The ELISA using T. solium metacestode somatic antigen detected a diagnostic titre of IgA antibody in tears with a sensitivity of 50% (3 out of 6 confirmed cases). The specificity of the tear IgAELISA using T. solium metacestode somatic and ES antigens is observed to be 94.87% and 92.3%, respectively. Overall in tears, the ELISA using T. solium metacestode ES antigens for detection of IgA antibodies shows a higher diagnostic efficiency (93.33%) compared to that using T. solium metacestode somatic antigen (88.88%). The sensitivities of the ELISA for detection of IgA antibodies in tears is observed to be higher than that for detection of IgG antibodies in serum using either somatic or ES antigens of the parasite.
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Affiliation(s)
- Priyadarshi S Sahu
- Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.
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CORREA D, CAÑEDO-SOLARES I, ORTIZ-ALEGRÍA LB, CABALLERO-ORTEGA H, RICO-TORRES CP. Congenital and acquired toxoplasmosis: diversity and role of antibodies in different compartments of the host. Parasite Immunol 2007; 29:651-60. [DOI: 10.1111/j.1365-3024.2007.00982.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rozanova EB, Teplinskaia LE, Kaliberdina AF, Barisani-Asenbauer T. Cytomegalovirus antibodies in tear fluid of patients with retinitis. Arch Virol 2006; 151:2407-17. [PMID: 16830070 DOI: 10.1007/s00705-006-0813-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2006] [Accepted: 06/01/2006] [Indexed: 10/24/2022]
Abstract
The diagnosis of cytomegalovirus retinitis (CMV-R) is difficult and usually based on clinical criteria or invasive diagnostic procedures. The purpose of this study was to investigate a possible association between CMV-R and specific anti-CMV antibodies in tears. Paired tear and serum samples were obtained from 96 individuals, which included 20 children with congenital CMV infection and chorioretinitis, 56 adults with retinitis with clinical signs suggestive of viral infection, and 20 healthy control subjects, and were tested for CMV antibodies using ELISA. The prevalence of anti-CMV antibodies in tears was found to be 80% (16/20) in children, 35% (20/56) in adults, and 5% (1/20) in control subjects. Furthermore, high antibody levels were detected in 35% (7/20) of children and 10.7% (6/56) of adults with retinitis, and were not found in control subjects. There was a strong association between high tear levels of anti-CMV antibodies and active ocular infection. No correlations were found between tear and serum antibodies. ELISA sensitivity was 80% and specificity 95%. Further studies are needed to compare the tear and intraocular levels of CMV-specific antibodies in patients with retinitis to find out if CMV antibody testing in tear fluid could substitute for more invasive diagnostic procedures.
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Affiliation(s)
- E B Rozanova
- Department of Immunology and Virology, Helmholtz Research Institute of Eye Diseases, Sadovaya-Chernogriazskaya, Moscow, Russia.
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