Analysis of the proficiency of single radial immunodiffusion assays for quality control of influenza vaccines in Korea

Influenza vaccine potency, which is determined by quantitatively measuring the content of Hemagglutinin (HA), is an essential index representing the efficacy of the vaccine. Standardization of the single radial immunodiffusion (SRID) assay, a method for measuring HA content, and proficiency of the testing institutions are crucial for influenza vaccine quality control. Herein, we assessed the proficiency of SRID assays at the National Control Laboratory (NCL) of Korea and several vaccine manufacturers. Eight laboratories participated in this study, and the proficiencies of all laboratories yielded satisfactory results in overall SRID assays. In contrast, there were some unsatisfactory results in measuring with different types of agarose gel plates produced by other laboratories. Overall, our findings demonstrated that the proficiency of SRID assay in the tested laboratories is acceptable for quality control of influenza vaccines and that detailed review on the validation reports regarding the test methods will be helpful for better control.

Application of recombinant hemagglutinin proteins as alternative antigen standards for pandemic influenza vaccines

OBJECTIVES

The single radial immunodiffusion (SRID) assay, used to quantify hemagglutinin (HA) in influenza vaccines, requires reference reagents; however, because centralized production of reference reagents may slow the emergency deployment of vaccines, alternatives are needed.

RESULTS

We investigated the production of HA proteins using recombinant DNA technology, rather than a traditional egg-based production process. The HA proteins were then used in an SRID assay as a reference antigen. We found that HA can be quantified in both egg-based and cell-based influenza vaccines when recombinant HAs (rHAs) are used as the reference antigen. Furthermore, we confirmed that rHAs obtained from strains with pandemic potential, such as H5N1, H7N3, H7N9, and H9N2 strains, can be utilized in the SRID assay. The rHA production process takes just one month, in contrast to the traditional process that takes three to four months.

CONCLUSIONS

The use of rHAs may reduce the time required to produce reference reagents and facilitate timely introduction of vaccines during emergencies.

Third Trimester Maternal Plasma Total Fibronectin Levels in Pregnancy-Induced Hypertension: Results of a Tertiary Center

The aim of this study was to evaluate maternal plasma total fibronectin values in pregnancy-associated hypertension in women in the third trimester of pregnancy. A total of 125 pregnant women at the 24th week of gestation participated in this study. Nonpregnant normotensive women were included as control group (n = 30). Plasma samples for fibronectin were obtained at the 24th, 28th, and 32nd weeks of gestation from all pregnant patients. From this cohort, 10 patients met the criteria for the diagnosis of gestational hypertension and 15 women met the stringent requirements of preeclampsia, whereas 100 patients were normotensive later in gestation. Plasma total fibronectin levels were determined by radial immunodiffusion technique. Data were analyzed using the SPSS program. The mean plasma fibronectin levels of the pregnant women in whom gestational hypertension and preeclampsia developed were significantly higher at the 24th, 28th, and 32nd weeks in comparison to normotensive pregnant women (p < 0.001). However, throughout the period from the 24th to 32nd weeks of pregnancy, plasma total fibronectin levels did not exhibit a significant change in normotensive pregnant patients or in patients with preeclampsia and gestational hypertension. There was also no correlation between plasma fibronectin levels and gestational age, mean arterial pressure, birth weight, and 5-minute Apgar scores in all groups (p < 0.05). The elevated maternal plasma fibronectin level over 40 mg/dL is capable of predicting preeclampsia with a sensitivity of 73% and a specificity of 92%. These results suggest that serial plasma fibronectin measurements before 24 weeks’ of gestation may be helpful in the early detection of preeclampsia in normotensive gravid women who are destined to become clinically preeclamptic.

Evaluation of various methods for the detection of meticillin-resistant Staphylococcus aureus strains and susceptibility patterns

Meticillin-resistant Staphylococcus aureus (MRSA) has been recognized as one of the major pathogens in hospital as well as community settings. In India, the mean isolation rate of MRSA is 20-40 % and many studies have suggested an escalating rate of infections caused by this organism. Despite pharmaceutical and technological advancement, infections caused by MRSA still remain difficult to diagnose. The present study was undertaken to compare five phenotypic methods for the detection of MRSA. This involved examining 200 isolates of S. aureus by oxacillin disc diffusion, cefoxitin disc diffusion, oxacillin screen agar test, the latex agglutination test and growth on CHROMagar. PCR for mecA gene detection was taken as the gold standard. It was found that 35 % of all S. aureus infections were caused by MRSA. The cefoxitin disc diffusion method, as recommended by the Clinical and Laboratory Standards Institute, was found to be a reliable method for MRSA detection but it should be supplemented with some other method like latex agglutination, CHROMagar or oxacillin screen agar testing so that no MRSA is missed. We recommend that along with cefoxitin disc diffusion, another method, preferably latex agglutination, should be routinely used in all hospitals to detect MRSA.

Serodiagnosis of equine infectious anemia by agar gel immunodiffusion and ELISA using a recombinant p26 viral protein expressed in Escherichia coli as antigen

We used a p26 recombinant protein (p26r) from equine infectious-anemia virus (EIAV) expressed in Escherichia coli as antigen to standardize an agar-gel immunodiffusion (AGIDp26r) test and an indirect ELISA (ELISAp26r) for the detection of antibodies against EIAV in 720 equine sera from Brazil. We evaluated the tests's relative diagnostic sensitivities (relSe) and relative diagnostic specificities (relSp) against a commercial AGID kit (Idexx, USA). We used three sera panels: panel A--196 AGID-negative sera from an AIE non-endemic controlled area; panel B--194 AGID-negative sera from an AIE endemic area and panel C--330 AGID-positive sera from an AIE endemic area. ELISAp26r cut-off value was defined with TG-ROC using sera from panels A and C. AGIDp26r showed an agreement of 100% with the commercial kit. When applied to sera from panels A and C, ELISAp26r showed an agreement of 100% with the kit, but, although relSe was 100% for panel C, the ELISAp26r had relSp of 93.3%.

Standardization and validation of an agar gel immunodiffusion test for the diagnosis of equine infectious anemia using a recombinant p26 antigen

We developed and validated an agar gel immunodiffusion test (AGID) test for the diagnosis of equine infectious anemia (EIA) using as antigen the p26 protein of equine infectious anemia virus (EIAV) produced in the Escherichia coli expression system. The developed rp26-AGID test showed an excellent diagnostic relative sensitivity (100%) and specificity (100%) compared to a commercial AGID assay when 1855 field serum samples were analyzed. In addition, the rp26-AGID demonstrated to be a precise assay with excellent repeatability and reproducibility. In the analytical sensitivity trial, positive sera showed nearly the same endpoint dilutions for both compared tests. No positive-reactions were observed with 35 serum samples with antibodies related to other endemic agents and also with severely hemolysed samples, demonstrating that the rp26-AGID has an excellent analytical specificity. Complete concordance with blind previous results from five proficiency test panels confirmed the capability of the assay of accurate detection of EIAV antibodies. This is the first time that a recombinant AGID assay able to identify EIAV infections has been standardized and validated in Argentina according to international guidelines. Taking into account the results obtained, the p26-AGID could be adopted as an official test method for the diagnosis and control of EIA in this country.

Prevalence of maedi-visna infection in culled ewes in Alberta

Maedi-visna (MV) is a relatively common chronic infection of sheep in North America resulting in economic loss to the sheep industry. The objectives of this study were to: 1) measure the prevalence of MV infection in culled ewes in Alberta, by histologic examination (lungs and udder) and serologic testing using an agar gel immunodiffusion (AGID) test, 2) examine any geographic differences in its prevalence in the province, 3) evaluate the level of agreement between histopathologic examination and serologic testing, 4) grade the lesions and correlate the serologic results with the presence of severe histological lesions, and 5) correlate the presence of histological lesions in the lungs and udder in the same animal. Based on histologic findings, the prevalence of MV was 26.8%, compared with 13.0% using serologic testing. There were no significant geographical differences in prevalence, fair agreement (kappa = 42.0%) between histopathologic and serologic results, and poor agreement (kappa = 11.5%) between the presence of lung and udder histological lesions within the same animal. This study indicates that MV is relatively common in culled ewes in Alberta, with no significant geographic variation. The poor sensitivity of the AGID test, compared with histologic examination, should be taken into consideration when interpreting serologic results.

Evaluation of a Pourquier ELISA kit in relation to agar gel immunodiffusion (AGID) test for assessment of the humoral immune response in sheep and goats with and without Mycobacterium paratuberculosis infection

The present study was designed to evaluate a commercial ELISA kit (Institut Pourquier) for the diagnosis of ovine and caprine paratuberculosis under Australian conditions and to compare its accuracy with the existing AGID test. The sensitivity of the ELISA in sheep and goats was 34.9% and 56.4%, with a specificity of 98.8% and 100.0%, respectively. Sensitivity of AGID was 13.8% for sheep and 39.5% for goats, with specificity of 100.0% for both species. The sensitivity of the ELISA in sheep depended on the category of histological lesions. AGID and ELISA were conditionally independent, and appeared to detect overlapping but distinct subgroups of infected animals. The ELISA was significantly more sensitive than the AGID. The ELISA was simple to perform, robust and repeatable. Coefficients of variation of <12.0% were observed for positive and negative controls included on 193 plates over a 10-month period and there was a high level of intraassay repeatability with 12.0% of the duplicate samples having CV of >15.0%.

Effectiveness of different methods for anti-Sm antibody identification. A multicentre study

Methods for the measurement of autoantibodies frequently provide controversial results. The objective of the present study was to evaluate the performance of Spanish Clinical Laboratories in the measurement of anti-Sm antibodies. A total of 23 laboratories participated, analysing 30 serum samples from patients with systemic lupus erythematosus and other autoimmune and non-autoimmune diseases. The laboratories used four extractable nuclear antigen screens, eight enzyme-linked immunosorbent assays (ELISAs) specific for anti-Sm, one line-blot, one dot-blot and one double immunodiffusion assay, from 15 different manufacturers. A total of 871 results were obtained. In general, very good sensitivity was obtained (95-100%), but specificity was moderate (52-86%) and must be improved. Most ELISAs and the line-blot were valid assays for anti-Sm detection and could serve as tests both for analysis and/or confirmation. The likelihood ratios indicated that both methods can be considered very useful or useful for the determination of anti-Sm antibodies. Nevertheless, the analytical quality of the methods for the measurement of anti-Sm antibodies could probably be improved by standardisation of the methods and the participation of laboratories in external quality control programs.

Mass value assignment of total and subclass immunoglobulin G in a human standard anthrax reference serum

An anti-Anthrax Vaccine Adsorbed (anti-AVA) standard human reference serum pool, AVR414, has been prepared, and the total and protective antigen (PA)-specific immunoglobulin G (IgG) were quantified. AVR414 was prepared by plasmapheresis of healthy adults who had received a minimum of four subcutaneous injections of AVA. Mass values (in milligrams per milliliter) for total IgG and IgG subclasses 1 to 4 were determined by radial immunodiffusion. Anti-PA-specific IgG assignment (in micrograms per milliliter) was done by consensus of two complementary approaches: homologous enzyme-linked immunosorbent assay (ELISA) with affinity-purified anti-PA IgG as a calibrator and summation of mean PA-specific IgG subclass concentrations determined by IgG subclass-specific ELISA using the United States National Reference Preparation for Human Serum Proteins as a standard. The total IgG concentration assigned to AVR414 reference serum was 8.33 mg/ml. IgG subclass concentrations were the following: for IgG1, 4.48 mg/ml; for IgG2, 3.35 mg/ml; for IgG3, 0.37 mg/ml; and for IgG4, 0.30 mg/ml. The assigned mass value for total anti-PA-specific IgG was 141.2 microg/ml. Anti-PA-specific IgG subclass concentrations were the following: for IgG1, 79.6 microg/ml; for IgG2, 35.3 microg/ml; for IgG3, 3.2 microg/ml; and for IgG4, 25.3 microg/ml. Human reference serum pool AVR414 will have direct application in the standardization of anthrax serological assays, in reagent qualification, and as a standard for quantification of PA-specific IgG in humans who have been vaccinated with or otherwise exposed to Bacillus anthracis PA.

[Analytic study of dot blotting for the detection of anti-Jo-1, anti-M2, anti-ribosomes and anti-LKM]

The Cyto-Dot 4 HM043 kit commercialised by BMD, has replaced the Cyto-Dot HM010 kit that allowed three auto-antibodies detection (anti-Jo-1, anti-M2 and anti-ribosomal protein). Detection of anti-LKM1 auto-antibody was added. These four auto-antibodies have in common only the intracytoplasmic localisation of their respective antigen. The aim of our study was to evaluate this new kit using 104 sera and to compare our results with reference techniques (indirect immunofluorescence IF for anti-M2, anti-ribosomal protein and anti-LKM1, double immunodiffusion ID for anti-Jo-1 and anti-LKM1, western blotting WB for anti-M2) and with Cyto-Dot HM010. The one hundred and four sera were divided into five groups: Group I (n = 12) with anti-Jo-1 detected by ID; Group II (n = 28) with 26 anti-M2 positive by IF and WB, 2 anti-M2 positive only by WB; Group III (n = 10) with anti-ribosomal protein detected by IF 5 of which precipitated by ID; Group IV (n = 32) with anti-LKM1 by IF and ID divided into 18 AIH2 and 14 HCV; Group V (n = 22) consisting of 14 healthy individuals and 8 patients with hypergammaglobulinemia. Results of this study are similar to those of Cyto-Dot HM010 for the three auto-antibodies already in use. Cyto-Dot 4 is a very good anti-LKM1 confirmation method as it is ID.

Evaluation of an absorbed ELISA and an agar-gel immuno-diffusion test for ovine paratuberculosis in sheep in Australia

The sensitivities and specificities of an absorbed enzyme-linked immunosorbent assay (ELISA) and an agar-gel immuno-diffusion (AGID) test for the detection of Johne's disease in sheep were estimated using data from six known infected and 12 assumed uninfected sheep flocks. Sensitivities were estimated for all histologically positive sheep, as well as by histological lesion score, lesion type (paucibacillary or multibacillary) and sheep body-condition score, with ELISA sensitivities estimated at 95 and 99% specificity. Logistic-regression analysis was used to test for significant effects of lesion score and condition score, with flock included in the model as a random effect. Estimated specificities were 95% (95% CI: 93.4, 95.6%) and 99% (98.4, 99.4%) for ELISA cut-point ratios of 2.4 and 3.6, respectively, and 100% (99.7, 100.0%) for the AGID. Estimated sensitivities for all infected sheep were 41.5% (35.0, 48.3%), 21.9% (16.6, 27.9%) and 24.6% (19.1, 30.7%) for ELISA cut-point ratios of 2.4 and 3.6 and for AGID, respectively. Sensitivities of all tests and cut-points varied significantly between flocks and between categories of lesion score and condition score. Sensitivity ranged from 25 to 73, 10 to 47 and 9.2 to 63% between flocks, for the ELISA with cut-points of 2.4 and 3.6, and for the AGID, respectively. Sensitivity was highest in thin sheep and in sheep with multibacillary lesions. The effects of lesion type and condition score on test sensitivity were significant in the logistic regressions for the AGID and ELISA at both cut-points and the flock effect was significant for the AGID but not for the ELISA at either cut-point.

Revision of linezolid disk diffusion quality control guidelines for testing Staphylococcus aureus ATCC 25923: an independent seven-laboratory trial

The accuracy of the published disk diffusion quality control (QC) range for linezolid for Staphylococcus aureus ATCC 25923 has been reported to be problematic, prompting a multicenter study to determine if revision was necessary. Five out of seven laboratories reported values outside the current QC range. Three participants had significant (13.3-60.0%) 'unacceptable' results with zones smaller than the established range. Overall, a range of 21-32 mm was shown (82.4% within the NCCLS published range). A revision (25-31 mm; 95.7% of results) of the QC range is necessary when testing S. aureus ATCC 25923 against linezolid.

Enzyme-linked immunosorbent assay for the diagnosis of bovine leukosis: comparison with the agar gel immunodiffusion test approved by the Canadian Food Inspection Agency

Four commercially available bovine leukemia virus (BLV)-ELISA kits from Europe or the United States were compared to the agar gel immunodiffusion (AGID) test officially approved by the Canadian Food Inspection Agency (CFIA). A total of 1200 cattle serum samples were used. Three ELISA kits based on the envelope glycoprotein (gp51) gave an excellent correlation with the AGID test. The kappa values were 0.998, 0.984, and 0.986 for the ELISA kits #1, #2, and #3, respectively. The ELISA kit based on the p24 core protein was found to be less sensitive than the officially approved AGID test and detected 5.13% of false negatives. Forty BLV AGID strongly positive serum samples were diluted. Based on the dilution experiment, the gp51 ELISA kits were found to be more sensitive than the AGID test kits. They were capable of detecting antibodies in samples diluted up to 1/5000 (kit #1), 1/20 800 (kit #2) and 1/4000 (kit #3), whereas the AGID kit was only capable of detecting antibodies in samples diluted up to 1/100. Based on these observations, the gp51 BLV-ELISA was recognized as an official test method for the serodiagnosis of bovine leukosis in Canada.

[Improvements from the reference material CRM 470 in the standardization of the determination of serum proteins]

The introduction of the CRM 470 in 1993 (certified reference material for 14 serum proteins) and its utilization by industrial companies for cross-calibrating their commercial standards has been an important break-through in protein standardization. This improvement has been clearly illustrated by the last national quality control survey performed in France in may 1995. At this time, about 60% of the 1,870 participants have already adopted the new standardization. The between-run precision (interlaboratory and intertechnique) has been considerably improved by the use of the new international standard (5.8 to 12.2% versus 10 to 24.1% before standardization); the same is true for accuracy. These results should convince the last reluctant laboratories to adopt the new standardization. Thus, it seems now possible to define reference ranges for serum proteins: this is the new task assigned to the Committee for Plasma Protein Standardization of the IFCC.

Evaluation of polymerase chain reaction (PCR) application in diagnosis of bovine leukaemia virus (BLV) infection in naturally infected cattle

The practical application of polymerase chain reaction (PCR) for the diagnosis of bovine leukaemia virus (BLV) infections in naturally infected cattle was evaluated. Compared to serological tests the PCR was definitely found to be a more sensitive method, yielding the highest number of positive results (10% more compared to enzyme-linked immunosorbent assay, (ELISA), and 17.7% more compared to agar-gel immunodiffusion, (AGID)). In testing cattle from herds with BLV incidence under 5%, out of 52 provirus positive cattle only 43 were correctly identified by ELISA. When compared to AGID only 37 of the 52 PCR positive animals were correctly identified. Of 18 cattle imported from the Slovak Republic and kept in a quarantine stable, four were found to be BLV provirus positive by PCR, while serological tests indicated one animal positive and three negative. Therefore, it is impossible to prevent the spread of the infection from one country to another by serological testing only. Moreover, it is feasible to identify animals with changing antibody titres correctly by PCR. Using PCR we were also able to distinguish BLV infected from uninfected calves that were serologically positive due to colostral antibodies. Higher sensitivity of BLV provirus detection by PCR was achieved using env gene rather than tax gene specific primers. Negative results by PCR in cases of positive serological reactions are still possible, as shown in case of one adult animal. These findings indicate that PCR is a highly sensitive method and might be successfully used and economically advantageous for different practical applications in detection of BLV infection in naturally infected cattle.

Comparison of in vivo and in vitro methods for determining unitage of diphtheria antitoxin in adsorbed diphtheria-tetanus (DT) and diphtheria-tetanus-pertussis (DTP) vaccines

In view of the current efforts to find a reliable in vitro method which can suitably act as an alternative for determining the potency of the diphtheria component in a combined vaccine, we have analysed experimental batches by the method proposed by WHO [1] i.e. challenge method in guinea pigs. The same batches were also analysed by the alternative antibody induction method as suggested in the Indian Pharmacopoeia (I.P.) [2] which is similar to the old method suggested in the British Pharmacopoeia (B.P.) 1973. As per I.P. the initial part of raising the antibodies remains unaltered but the actual titration of diphtheria antitoxin from the immunised guinea pigs was performed by using the following in vitro methods: a) indirect haemagglutination test using human "O" red blood cells to coat diphtheria toxoid using chromic chloride as the coupling agent [3]; b) toxin neutralisation test using Vero cells [4]; c) a double diffusion technique in agar gel for titration of diphtheria antitoxin [5]. Our findings show clearly that the results of two in vivo methods i.e. Challenge Test, Alternative I.P. Method and the above-mentioned three in vitro methods are comparable and would certainly reduce the number of animals required by making a combination of in vivo and in vitro techniques to give us an assessment of the potency of the vaccine to be tested.

Evaluation of crude and purified Toxocara canis antigens in serodiagnosis of human toxocariasis

Three serological tests: Immunodiffusion (ID), Counterimmunoelectrophoresis (CIEP) and Enzyme-linked immunosorbent assay (ELISA) were used to study the role of crude adult worm antigen (CAWA) of Toxocara canis and each of its purified fractions in the serodiagnosis of human toxocariasis. Sensitivities of the three tests were lower in the ocular than in the visceral group, using different antigens. Purified fraction 1 showed more sensitive and specific reactions in the three tests, compared to CAWA or purified fraction 2 (P-F2) antigen. The other purified fractions (P-F3, P-F4 and P-F5) gave no positive reactions in any of the three tests. Using P-F1 antigen, ELISA was the most sensitive technique for diagnosis of both visceral and ocular toxocariasis followed by CIEP and then ID and the difference was statistically significant. However, CIEP was the most specific test followed by ELISA and lastly ID test. The ELISA test using Excretory-Secretory (E-S) larval antigen of Toxocara canis was less sensitive than the ELISA test using P-F1, although it was 100% specific. Thus, ELISA test using P-F1 is the test of choice for diagnosis of human toxocariasis, but when the specificity of a reaction is in doubt, CIEP test using the same antigen can be of value.

[The outlook for improving the immunoglobulin preparations for the detection and identification of the causative agents of glanders and melioidosis]

The paper summarizes the data concerning the production and study of monoclonal antibodies (MAb) to the diagnostically significant glanders and melioidosis bacillus antigens. It evaluates the efficiency of using MAb in the gel immunodiffusion and agglutination tests as a basis of new-generation preparations for fluorescent antibody assay, indirect hemagglutination test which are used while detecting and identifying pathogenic pseudomonads. The paper defines the quality indices for monoclonal luminescent immunoglobulins and provides evidence for the benefits of monoclonal diagnostic agents over polyclonal analogues.

Single radial immunodiffusion potency test for standardization of indigenous equine influenza vaccine

Single radial immunodiffusion (SRD) assays were used for measuring the haemagglutinin antigen contents of equine influenza vaccine prepared from an Indian virus isolate. A/Equine-2/Ludhiana/1/87 (H3N8). Five different preparations of the vaccine were standardized by SRD to prepare 913 doses, each containing 20 micrograms HA/ml-1 dose-1. This test also showed influenza virus subtype specificity as no cross reaction was observed between subtype 1 (H7N7) and subtype 2 (H3N8) viruses.

Unpredictability of commercially available exoantigen culture confirmation tests in confirming the identity of five Blastomyces dermatitidis isolates

Colonial and microscopic features of five fungal isolates from three patients suggested Blastomyces dermatitidis. Extracts from the mold forms of all isolates were tested on several occasions with commercially available Exoantigen immunodiffusion culture-confirmation test reagents and Nolan reagents. All three isolates from patient 1 were negative on four separate attempts with Exoantigen reagents using conventional ("slant") and "broth" extraction methods, and were also negative on one attempt with the Nolan reagents. The isolate from patient 3 was negative on three attempts using both reagent kits. The isolate from patient 2 was negative on four of five attempts with Exoantigen test reagents and positive on one attempt with Nolan reagents. Commercially prepared chemiluminescence-labeled DNA probes (Gen-Probe, San Diego, CA) directed at ribosomal RNA from B. dermatitidis and Histoplasma capsulatum confirmed all five isolates as B. dermatitidis. The cost and labor of the exoantigen and DNA Probe culture confirmation tests were evaluated. New methods for confirming the identity of cultural isolates of B. dermatitidis that are sensitive, specific, and commercially available are greatly needed.

Serodiagnosis of paratuberculosis in sheep by use of agar gel immunodiffusion

An agar gel immunodiffusion (AGID) test was used over a 3-year period to examine 1,871 serum samples from sheep representing 5 Mycobacterium paratuberculosis-infected flocks and 4 flocks presumed to be uninfected. Of 1,032 sheep, 31 had positive AGID test results (scoring 1 to 5), and 23 of these 31 were necropsied. Infection with M paratuberculosis was confirmed by 1 or more of the following findings: observation of typical lesions on histologic examination of sections of ileum or ileocecal lymph nodes, observation of clumps of acid-fast bacteria in mucosal smears of ileum, and isolation of the organism from feces or tissue. False-positive results on AGID testing were not found in sheep from flocks known to have exposure to Corynebacterium pseudotuberculosis. Diarrhea in infected sheep was observed infrequently; chronic, severe weight loss was the most common sign observed. On histologic examination of tissues from 20 infected sheep, 16 (80%) had diffuse lesions of the ileum and 13 (65%) had acid-fast bacteria in areas of ileal inflammation; 4 had discrete granulomas and peripheral lymphocytic infiltrates in the ileum. Sheep with diffuse lesions tended to have higher mean scores on AGID testing and examination for acid-fast bacteria, compared with those from sheep with more discrete lesions. Bacteriologic culture yielded M paratuberculosis from only 3 sheep with paratuberculosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Rabies vaccine standardization: International Collaborative Study for the Characterization of the fifth International Standard for Rabies Vaccine

A collaborative study was carried out to establish a replacement for the International Standard for Rabies Vaccine, the stocks of which are exhausted. Three rabies vaccines for human use derived from different rabies virus strains and prepared on different cell culture substrates were compared with the International Standard for Rabies Vaccine using in vivo and in vitro assay methods in a collaborative study involving 14 participants. The proposed fifth International Standard (PISRAV) which was derived from the same virus strain as the present international standard preparation, the Pitman Moore (PM) strain, was found to be approximately twice as potent relative to the International Standard in immunogenicity assays as in antigenicity assays. On the other hand another vaccine, derived from the LEP strain, was considerably more potent in antigenicity assays than in immunogenicity assays. The glycoprotein of the proposed replacement standard measured in antigenicity assays appeared to be stable at +37 degrees C for 245 days, whereas the immunogenicity of the proposed replacement vaccine was sensitive to this heat treatment and the vaccine lost 66% of its immunogenic potency. The results of this study indicate that the NIH protection test should continue to form the primary basis for potency assay of rabies vaccine as glycoprotein content does not appear to correlate with immunogenic potency for different types of vaccine. The vaccine coded PISRAV has been established as the fifth International Standard for Rabies Vaccine and a potency of 16 International Units of Rabies Vaccine (based on the immunogenicity assays) assigned to the contents of each ampoule. Each ampoule has also been assigned a unitage of 10 IU of PM Rabies Virus Glycoprotein and 135 IU of PM Rabies Virus Ribonucleoprotein.

IgG subclass determination in human sera with commercially available reagents: comparison of different assay systems

IgG subclass determinations are of increasing importance for the diagnosis of humoral immunodeficiencies. The search for a method which is accurate, reliable and suitable for the clinical routine, while utilizing commercially available reagents, was the aim of this study. Different assay systems for determination of IgG subclasses were compared. Radial immunodiffusion with polyclonal antisera (RIDpoly) proved to be a reliable method for subclass determination in individual human sera. Sera deficient in one or several IgG subclasses as well as several myeloma proteins were readily and reliably detected. The RID method with monoclonal antibodies (RIDmono) yielded results comparable to those obtained with RIDpoly in the IgG1 and IgG2 determination. Differences between RIDpoly and RIDmono were observed, however, in the determination of IgG3 and IgG4. These discrepancies were shown to be due to differences in the calibration of the standards as given by the manufacturers, and not to different recognition of distinct allotypes. The results of an enzyme immunoassay (EIA) using commercially available IgG reagents without further purification did not compare satisfactorily with the results of the RIDpoly method. These discrepancies, however, were assay-inherent rather than monoclonal reagent-inherent.

Assay of apolipoproteins A-1 and B by immunoturbidimetry: detection of individuals at risk for atherosclerotic artery disease

Recent evidence has suggested that the levels of Apolipoprotein A-1 and B in plasma are better indicators of the risk of atherosclerotic artery disease than plasma lipids. This study describes the measurement of plasma Apolipoprotein A-1 and B by immunoturbidimetry in patients with atherosclerotic artery disease and in normal controls. Apoprotein B and the ratio of Apoprotein A-1/Apoprotein B were found to be the best discriminators between the two groups.

Evaluation of the measurement of B protein of plasma low density lipoprotein by radial immunodiffusion

Radial immunodiffusion (RID) has been used for determination of low density lipoprotein (LDL) B protein in plasma. During measurement of B protein in plasma and the d less than and d greater than 1.019 g/ml plasma fractions by RID in 1.0%, 1.5%, 2.0%, and 2.5% agarose, the d less than 1.019 g/ml lipoproteins diffuse in the agarose and produce precipitin rings. Among normotriglyceridemic subjects, the B protein values in whole plasma obtained by RID using 1.5 to 2.5% agarose were only slightly higher than the values in the d greater than 1.019 g/ml fraction obtained by RID and closely approximated the values obtained in the d greater than 1.019 g/ml fraction by radioimmunoassay. However, among the hypertriglyceridemic subjects, the RID measurement of B protein in plasma using 1.0 to 2.5% agarose overestimated the LDL B protein levels in plasma. The RID procedure at agarose concentrations of 1.5% to 2.5% can be used to estimate plasma LDL B protein levels in normotriglyceridemic subjects. However, measurement of LDL B protein by RID in plasma of hypertriglyceridemic subjects must be interpreted with caution; the LDL B protein is overestimated by this procedure because of the contribution by the d less than 1.019 g/ml lipoproteins to the B protein value.

Interpretive criteria for cefamandole and cephalothin disk diffusion susceptibility tests

A multi-center study of 1,838 clinical isolates established the accuracy of diffusion susceptibility tests with 30-mug cephalothin disks and 30-mug cefamandole disks. The same interpretive zone standards can be applied to tests with either disk but the two drugs cannot be tested interchangeably.

[Relationship between MIC and Zone Size (author's transl)]

The one antibiotic-one disk agar diffusion test for susceptibility testing of clinical isolates, though technically similar to that used for determining antibiotic concentrations in body fluids, lacks the exactness of the latter. In correlating zone diameters to MICs, stochastic linearity should be evaluated besides the regression lines and the correlation coefficient.

Increasing the predictive value positive of the precipitin test for the diagnosis of deep-seated candidiasis

Three hundred fifty human sera were tested by double immunodiffusion, crossed-line electrophoresis, and crossed immuno-affinoelectrophoresis with a concanavalin A intermediate gel for precipitating antibodies to antigens present in cytoplasmic extracts of Candida albicans. Sera from 48 of 287 hospitalized patients at risk of invasive candidiasis contained precipitating antibodies to Candida antigens. Of these 48 sera, 27 had precipitating antibodies only to cell-wall antigens present in the cytoplasmic extract, and 21 sera had precipitating antibodies to both cytoplasmic and cell-wall antigens. The latter sera came from patients who were 2.5 times as likely to have deep-seated candidiasis as those patients with precipitins exclusively to cell-wall antigens. Sera from seven of 22 patients with vaginal candidiasis and 10 of 41 patients with other fungal infections had precipitating antibodies to C. albicans cell-wall antigens; only two of these sera also contained precipitating antibodies to the cytoplasmic antigens. Crossed immunoaffinoelectrophoresis with concanavalin A reduced the number of false-positive results and increased the predictive value positive of the precipitin test for deep-seated candidiasis from 31% to 71%.

Serum immunoglobulins: methods for the determination of normal values in international units

This paper describes the proper statistical methods for the determination of the range of normal values of serum immunoglobulins in any population and for the conversion of those ranges, or any serum immunoglobulin value, from mg per ml to World Health Organization International Units. In determining the normal range, it is argued that the analysis should be based upon the logarithms of the serum immunoglobulin values and that the range of normal values about the mean should be determined by the application of tolerance limits, rather than the more familar but incorrect confidence limits. For converting normal ranges from mg per ml to International Units, methods of parallel line bioassay (for IgG and IgA) and non-linear bioassay (for IgM and IgD) are used. For both bioassay methods, graphical techniques are described.

Blastomycosis: specificity of antigens reflecting the mating types of Ajellomyces dermatitidis

In a study of sera from patients with proven or suspected blastomycosis, positive immunodiffusion tests were obtained in all active cases when fresh sera were tested with a cell sap (CS) antigen. False negatives occurred on occasion when an ethanol precipitate (EPF) antigen was used alone. No false positives were found. The CS antigen from the (+) mating type had in common two lines of identity with the (CS) antigen of the (-) type. In addition, other lines were present when the patient was infected with the same mating type as was used for the preparation of the antigen. No differences in the electrophoretic patterns of the enzymes leucine amino peptidase or phosphatase were noted when preparations from the two mating types were compared. However, a distinct pattern was noted when the alpha esterases of the (+) and (-) mating types were examined. Specific alpha esterase antibodies were present in patients' sera.

A quantitative study of the distribution of IgG sub-classes in a group of normal human sera

The radial immunodiffusion method of Mancini has been applied to quantitative study of IgG subclasses in a normal population. The method was assessed in terms of both reproducibility and antiserum consumption. The distribution of IgG subclasses in a group of normal individuals was studied, and compared with their incidence in a series of monoclonal proteins investigated by previous workers and particularly with other quantitative studies on groups of normal individual's sera.

[Determination of serum acid alpha 1 glycoprotein by means of 2 immunological comparison between normal values and results]

In 227 healthy subjects, serum concentrations of acid-alpha-glicoprotein were measured by two different immunologic methods: electroimmunodiffusion by Laurell's technique and single radial immunodiffusion. The results obtained using the two methods were compared and the range of normal refeprence values was determined.

Divergent results in radial immunodiffusion with antisera differing in precipitation properties with respect to individual immunoglobulin subclass. II. The antiserum factor

Differences in the antibody composition of antisera influence results obtained by radial immunodiffusion. If more than one subclass of the same immunoglobulin class is present in an antigen mixture, the occurrence of one or more subclass specific antibody species in antisera used for radial immunodiffusion leads to the production of precipitation rings smaller than rings produced by comparable antisera without subclass activity. The presence of antibodies against common immunoglobulin determinants only leads to production of larger precipitation areas. If one or more subclass specific antibody species are present in the antiserum this may further lead to production of double precipitation rings in radial immunodiffusion, depending on the subclass ratio in the antigen mixture. The production of antisera suitable for radial immunodiffusion is discussed.

Detection of Candida precipitins. a comparison of double diffusion and counter immunoelectrophoresis

The optimum conditions for detection of Candida precipitins by double diffusion and counter immunoelectrophoresis have been established. Counter immunoelectrophoresis was shown to be more sensitive than double diffusion, and its application to routine tests for Candida precipitins to cytoplasmic antigen is recommended.

Divergent results in radial immunodiffusion with antisera differing in precipitation properties with respect to individual immunoglobulin subclass. I. The antigen factor

Two bovine IgG subclasses were used as reference antigens to study subclass influence on radial immunodiffusion results with total bovine IgG. In combination with some of eight anti-bovine IgG sera tested the use of the same antiserum with one subclass furnished values which were about twice as high as values obtained with the other subclass. It is concluded that immunoglobulin determinations by radial immunodiffusion are influenced by the chosen reference antigen and by subclass ratios in the samples tested. The composition of immunoglobulin subclass mixtures for testing antisera used in radial immunodiffusion is discussed.

Evaluation of histoplasmin for the presence of H and M antigens: some difficulties encountered in the production and evaluation of a product suitable for the immunodiffusion test

The development of a single histoplasmin suitable for use in immunodiffusion testing of a variety of human histoplasmosis sera depends not only upon the presence of both antigens, but on relative concentration of one to the other, and perhaps on the chemical characteristics of the H and M antigens of a given strain.

Evaluation of immunological specificity of flurescein-conjugated antisera with agarose-antigen sections

Purified immunoglobulins were conjugated to agarose beads; the beads were frozen, and used to establish the specificity of fluorescein-conjugated antisera.

A comparison of differenct extracts of Candida albicans in agar gel double diffusion techniques

A preliminary comparative study, by 4 independent groups, of certain extracts of Candida albicans, showed variation in their antigenicity. Different agar gel double diffusion tests were used by each group; two groups used micro-methods and two used macro-methods. The number of positive precipitin reactions detected by these methods was shown to vary greatly.

Comparison of commercially available radial immunodiffusion kits for the determination of serum alpha 1-antitrypsin concentrations

Six commercially available radial immunodiffusion kits for the determination of serum alpha1-antitrypsin concentrations were compared. Test samples were prepared by diluting purified human alpha1-antitrypsin to 2 different concentrations approximating heterozygous and homozygous deficiency concentrations. Significant variation in results was noted using the higher concentration of alpha1-antitrypsin. A greater degree of accuracy was demonstrated when testing the sample with the lower concentration. This further emphasizes the need for specific phenotyping in detecting patients with protease inhibitor types other than ZZ.

Comparative sensitivity of gel-diffusion and tube agglutination tests for the detection of Brucella canis antibodies in experimentally infected dogs

The microslide gel-diffusion and macro-tube agglutination techniques to detect Brucella canis antibodies in dogs were compared. Sera from dogs experimentally infected with B. canis and a random sample of dog sera with unknown histories of exposure to this organism were examined. The results of the gel-diffusion method employing specific rough Brucella saline-extract antigens of B. canis and Brucella ovis were comparable to those obtained by the tube agglutination test. The easily prepared, stable R antigen in the freeze-dried form offers a convenient, simple, and reliable diagnostic method for the serological detection of canine brucellosis by the gel-diffusion test.

Characterization of the precipitin bands detected in the immunodiffusion test for paracoccidioidomycosis

In order to characterize the precipitin bands detected in the immunodiffusion test for paracoccidioidomycosis, a study was undertaken in 54 patients with the disease. On the basis of the pattern of known control sera, the three commonly observed lines of precipitate were designated as 1, 2, and 3 according to their location in the immunodiffusion plate. At time of diagnosis, 28 of the patients exhibited all three bands, 16 gave two bands, and 10 showed only one precipitin line. Over 50 of the sera with three bands had high complement fixation titers (above 1:512), whereas those with one band exhibited lower titers. A similar picture was obtained with the quantitative agar-gel techniques, where titers of 1:64 and above were more commonly observed in sera with three precipitin lines. Follow-up studies carried out in 18 patients revealed that band 3 disappeared first, followed by band 2, and, finally, by band 1. At the end of 2 to 3 years, 85.7% of the patients had lost band 3, 75% band 2, and only 27.7% band 1. Cross-reactions with histoplasmin were found in eight patients who gave the M precipitin line with this antigen. It was found that the latter band and our paracoccidioidin band 3 fused, producing lines of identity. Bands 1 and 2 were specific. The implications of these findings are discussed.