Human African trypanosomiasis: quantitative and qualitative assessment of intrathecal immune response
(2003) European Journal of Neurology — Vol. 10, n° 6, p. 711-719 (2003)
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- Quantitative and qualitative techniques for assessment of the intrathecal humoral immune response in human African trypanosomiasis were compared, and their diagnostic potential for detection of the meningo-encephalitic stage of the disease was evaluated. Total and trypanosome specific immunoglobulin G (IgG) and IgM intrathecal synthesis were studied in paired cerebrospinal fluid (CSF) and blood samples of 38 trypanosomiasis patients and in three controls using Reiber's formulae. The presence of CSF-specific oligoclonal IgG and of trypanosome-specific antibodies was determined using iso-electric focusing followed by immunoblotting and antigen-driven immunoblots. The intrathecal IgG fraction (16% positive) and oligoclonal IgG detection (24% positive) were insensitive for detection of an intrathecal humoral immune response. Trypanosome-specific IgG synthesis, reflected by the IgG antibody index (AI) (26% positive), was confirmed by the presence of oligoclonal specific IgG (47% positive), but the latter was more sensitive. Although the detection technique failed for oligoclonal IgM, the intrathecal IgM fraction (42% positive) and the IgM AI (32% positive) indicated that the meningo-encephalitic stage of the disease is characterized by a dominant intrathecal IgM response, which was higher than the IgG response. The highest combination of diagnostic sensitivity and specificity for the meningo-encephalitic stage of trypanosomiasis was observed for quantitative IgM determinations.
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Lejon, V., Sindic, C., Van Antwerpen, M.-P., Doua, F., Dje, N., Solano, P., Jamonneau, V., Wouters, I., & Buscher, P. (2003). Human African trypanosomiasis: quantitative and qualitative assessment of intrathecal immune response. European Journal of Neurology, 10(6), 711-719. https://doi.org/10.1046/j.1468-1331.2003.00660.x (Original work published 2003)