Administration of measles virus (MV)-specific IgG as post-exposure prophylaxis (PEP) is known to effectively prevent measles. Since the introduction of active immunization against measles, the levels ...of MV-specific IgG antibodies in the population have dropped. Therefore, the concentration of MV-specific antibodies in immunoglobulin products derived from human plasma donors has declined as the proportion of vaccinated donors has increased. Literature on the effectiveness of PEP with current available immunoglobulins is limited. Here we examine the effectiveness of 400 mg/kg intravenous immunoglobulin (IVIG) (IgVena®, Kendrion) as PEP in infants during a measles outbreak in Austria, 2019.
After exposure to a highly contagious measles patient, identified infants were evaluated for eligibility for IVIG PEP. Infants were tested for measles maternal antibodies, if the result was expected to be available within 72 h after exposure. IVIG was administered to eligible infants with negative maternal IgG antibody levels (
= 11), infants with protective levels but result beyond 72 h (
= 2) and infants not tested for maternal IgG antibodies (
= 52). Telephone enquiries were made asking for measles infection. Effectiveness was calculated using exact logistic regression. Samples of four out of seven used IVIG batches were tested for MV-neutralizing antibody capacity.
In 63 (96.9%) of 65 infants PEP with IVIG was administered. The parents of two infants declined IVIG PEP. None of the infants with IVIG PEP got measles or symptoms suggestive for measles, but both infants who did not receive PEP were infected. Effectiveness of IVIG PEP was calculated to be 99.3% (CI 95%: 88.7-100%). No serious adverse event of IVIG treatment was observed. The investigation on MV-neutralizing antibody capacity showed a geometric mean titer ranging from 10.0 to 12.7 IU/ml, resulting in a 1.57-2.26-fold higher concentration than postulated as minimum level for immunity.
Our findings suggest that the used IVIG preparation provided an at least non-inferior protection rate compared to IVIG preparations derived from donors before the global introduction of standard active immunization against measles.
The aim of the study was the evaluate the immunomodulating effect of a 1,2,4-triazole derivative liposome emulsion (Trifuzol) in puppies vaccinated against parvovirus enteritis and canine distemper. ...The used Trifuzol liposome emulsion led to a significant increase in the absolute number of lympho-cytes and their immunoregulatory subpopulations, phagocytic activity of neutrophils. The level of antibodies against parvovirus enteritis (CPV) and canine distemper (CDV) in vaccinated and Trifuzol-treated puppies reached zero values which were statistically significantly lower than those in vac-cinated-only puppies (21.0 U/mL and 27.0 U/mL, respectively). It was concluded that the tested liposome emulsion of Trifuzol had an positive effect on the humoral immunity in puppies and can be used in clinical practice as an immunomodulatory agent.
In 2010—2016, blood serum samples were examined from 5539 patients, aged 1—60 years, with clinically and laboratory confirmed measles. Primary or secondary type of immune response was determined for ...all measles cases. Studies were performed with children aged 1—14 years (2381), adolescents, 15—17 years old (189), and adults aged 18—60 years (2969). Serum measles-specific IgM antibodies were measured by “VektoKor’ IgM” ELISA test system (Russia), concentration and avidity of specific IgG — by using “Anti-Measles Viruses ELISA/IgG” and “Avidity: Anti-Measles Viruses ELISA/ IgG” (Euroimmun, Germany). Primary immune response was identified based on the presence of serum measles-specific low avidity IgM and IgG antibodies, whereas secondary immune response was characterized by detecting high avidity IgM and IgG antibodies at concentration of ≥ 5.0 IU/ml. Analyzing measles-specific IgM antibodies in 2010—2016 demonstrated that measles morbidity was mainly due to children, aged 1—2 years reaching up to 39.9% of the total number of children with measles aged 1—14 years as well as adults aged 18—40 years old comprising as high as 80.1% total number of patients aged 15—60 years. Serum measles-specific IgG testing showed that in 15.0% of cases they were detected at concentration of ≥ 5.0 IU/ml. Further serum dilution resulted in finding IgG titer ranging within 8.5—45.0 IU/ml (21.4+0.36) and high avidity antibodies in 80—100% (92.5+0.2) cases. The remaining 85.0% cases found low avidity measles-specific IgG antibodies ( 30%) at concentration of 0.2—3.46 IU/ml (1.73+0.03). An age-related analysis of our data demonstrated that all children under 14 with laboratory-confirmed measles developed primary immune response. Moreover, in 73.7% of measles patients aged 15—60 with primary immune response measles might be prevented by timely vaccination, whereas persons with “vaccine failure” comprised 26.3%. In 2010 (0.09 per 100,000 subjects) and 2016 (0.12 per 100,000 subjects), frequency of patients with “vaccine failure” during relative epidemic well-being was 35.3% and 18.2%, respectively, exceeding 9.9% (p 0.001) serving as a hallmark 2014 high measles incidence rate (3.24 per 100,000 subjects).The data obtained indicate that measles virus circulate among people with “vaccine failure,” which may account for potential to spread and infect unprotected population cohorts as well as cause measles outbreaks during periods of epidemic well-being.
Background: Helicobacter pylori (H. pylori) infection may play a role in Alzheimer's disease (AD). Aim: A prospective, nonrandomized, comparative study was car- ried out to examine the levels of ...anti-H. pylori-specific IgG antibodies in the cerebrospinal fluid (CSF) and serum of AD patients, compared with those of age-matched cognitively normal controls. Patients: CSF was aspirated from 27 AD patients and 27 age-matched cognitively normal patients with prostate hyperplasia or long-bone fractures necessitating surgery after epidural anesthesia. Serum samples were obtained from AD patients and the day before surgery from controls. Methods: CSF and serum anti-H. pylori IgG concentrations were measured by means of an enzyme-linked immunosorbent assay. Results: The mean concentration of anti-H. pylori-specific IgG was significantly greater in (a) the CSF of AD patients (10.53 ± 12.54 U/mL) than in controls (8.63 ± 8.01 U/mL, p = 0.047), and (b) the serum of AD patients (30.44 ± 33.94 U/mL) than in controls (16.24 ± 5.77 U/mL, p = 0.041). CSF anti-H. pylori IgG antibodies correlated with the degree of severity of the disease. Conclusion: H. pylori-specific IgG antibody levels are significantly increased in CSF and serum of AD; its titer in CSF might reflect the AD severity, thereby supporting a role for this common infection in the pathobiology of the disease.
Purpose
Early recognition improves the prognosis of isocyanate asthma. A major unanswered question is whether IgE-dependent mechanisms are of diagnostic value? Our objective was to appraise ...serological methods using various methylenediphenyl diisocyanate (MDI)-albumin conjugates and weigh up the data versus the outcome of standardized comprehensive clinical diagnostics to evaluate the viability of immunological analysis in supportive MDI-asthma diagnosis (OA
I
).
Methods
Specific IgE (sIgE) and IgG (sIgG) binding was measured with fluorescence enzyme immunoassay in 43 study subjects (using conjugates prepared in-vapor, in-solution and commercial preparations). The differential clinical diagnosis included standardized measurement of pulmonary function, non-specific bronchial hyper-responsiveness, specific MDI-prick test (MDI-SPT) and specific inhalation challenge (MDI-SIC).
Results
Detailed diagnostic scheme allows the differential OA
I
and MDI-induced hypersensitivity pneumonitis (P
I
). The presumed OA
I
diagnoses were confirmed in 84 % (45 % cases having demonstrable sIgE antibodies) with RR 5.7,
P
> 0.001, when OA
I
diagnosis is correlated with MDI-SIC/MDI-SPT (RR 1.28 for MDI-SIC alone); sIgG antibodies were clinically relevant for P
I
and not for the OA diagnosis. MDI-specific IgE data generated with commercial ImmunoCAP preparations show high correlation with our in-vapor generated MDI conjugates.
Conclusions
Isocyanate-specific IgE antibodies are not always detectable but their presence is strongly predictive of OA
I
and supportive for the diagnosis. MDI-SPT can be a valuable parameter differentiating OA
I
and P
I
. We have confirmed and extended published data showing that isocyanate-albumin conjugates perform better in specific antibody assays when prepared with volatile phase formulations and would like to stress additionally the necessity for further refinements and standardization in clinical diagnostics procedures.
Zusammenfassung
Hintergrund
Das Masernvirus ist ein impfpräventabler Erreger, der durch globale Impfprogramme eliminiert werden kann. Als Ziel für Europa hat die WHO das Jahr 2015 als ...Eliminationszeitpunkt benannt. Für den Nachweis 95%iger Impfquoten für 2 Masernimpfungen als Hauptkriterium für das Erreichen des Ziels kann sich Deutschland nicht auf ein bevölkerungsweites System zur regelmäßigen Ermittlung des Impf- und Immunstatus stützen.
Ziel der Arbeit
Masernimpfquoten und die Zeitgerechtigkeit von Impfungen sollen für die Geburtsjahrgänge 1989 bis 2008 abgeschätzt und Determinanten für Impfdefizite herausgearbeitet werden.
Methoden
Primärdaten aus den jährlichen Schuleingangsuntersuchungen und aus dem Kinder- und Jugendgesundheitssurvey (KiGGS) zur Durchimpfung und zur Prävalenz Masern-spezifischer IgG-Antikörper und entsprechende Sekundärdaten (Auswertungen von Abrechnungsdaten der Kassenärztlichen Vereinigungen) werden dargestellt und diskutiert.
Ergebnisse und Diskussion
Im Jahr 2010 waren 91,5 % der einzuschulenden Kinder zweimal gegen Masern geimpft. Die Impfquoten liegen in den einzelnen Bundesländern zwischen 87,6 und 95,3 %. Auf Landkreisebene sind die diesbezüglichen regionalen Unterschiede noch deutlicher. Der Anteil an zeitgerecht zweimal immunisierten Kindern ist bei den Geburtsjahrgängen 2001/02 bzw. 2006 bis 2008 von 41 auf 66 % gestiegen. Trotz positiver Entwicklung bei den Masernimpfquoten bestehen vor allem bei Jugendlichen, jungen Erwachsenen und Kleinkindern Immunitätslücken. Die großen regionalen Unterschiede und die Impflücken bei Personengruppen, die sich durch soziodemografische Determinanten beschreiben lassen, sind von hoher infektionsepidemiologischer Bedeutung und zeigen, dass Bemühungen zur Steigerung der Masernimpfquoten auf verschiedenen Ebenen stattfinden müssen. Die STIKO-Empfehlung, alle nach 1970 geborenen über 17-Jährigen ohne oder mit nur einmaliger Masernimpfung mit einem MMR-Kombinationsimpfstoff zu immunisieren, muss umgesetzt und verstärkte Anstrengungen müssen unternommen werden, um die Zeitgerechtigkeit der Masernimpfungen zu verbessern.
Plastic resins are complex chemicals that contain toluene diisocyanate (TDI) and/or trimellitic anhydride (TMA), which cause occupational allergies (OA), including respiratory allergies. Serum IgGs ...against TDI and TMA have been suggested as potential markers of the exposure status and as exploring cause of OA. Although TDI-specific IgG has been examined for suspected OA, TMA-specific IgG is not commonly evaluated in a urethane foam factory. This study therefore investigated both TDI- and TMA-specific IgGs in suspected OA patients and to evaluate the usefulness of the measurement of multiple chemical-specific IgG measurement for practical monitoring.
Blood samples were collected from two male workers who developed respiratory allergies supposedly caused by occupational exposure to TDI and/or TMA for the presence of TDI- and TMA-specific IgGs. In addition, blood samples from 75 male workers from a urethane foam factory, along with 87 male control subjects, were collected in 2014 and tested for the same IgGs in 2014. The presence and levels of TDI- and TMA-specific serum IgGs were measured using dot blot assays.
We found that controls had mean concentrations of TDI- and TMA-specific IgGs of 0.98 and 2.10 μg/mL, respectively. In the two workers with respiratory allergies, the TDI-specific IgG concentrations were 15.6 and 9.51 μg/mL, and TMA-specific IgG concentrations were 4.56 and 14.4 μg/mL, which are clearly higher than those in controls. Mean concentrations of TDI- and TMA-specific IgGs in the factory workers were 1.89 and 2.41 μg/mL, respectively, and are significantly higher than those of the controls (P < 0.001 and P < 0.026 for TDI- and TMA-specific IgGs, respectively).
The workers suspected of OA showed an evidently high level of TDI- and TMA-specific IgG, and these levels in workers at the urethane foam factory were also significantly higher than those in controls. In conclusion, the measurement of TDI- and TMA-specific IgG among workers using plastic resins is helpful to monitor their exposure status.
Enzyme immunoassay has been successfully used for the diagnosis of hypersensitivity pneumonitis (HP), but there are difficulties in standardising this method because of the difficulty in obtaining ...stable solid phases from a huge variety of heterogeneous antigenic sources. With this in mind, the aim of this work was to demonstrate the usefulness of the standard available fluoro-enzyme-immuno-assay (FEIA) to measure specific IgG to uncommon, commercially unavailable HP-causing antigens.
Serum samples from patients suffering from HP caused by canary and pigeon protein exposure with positive immunoprecipitation values, as well as cystic fibrosis patients, patients with respiratory allergies, asymptomatic subjects exposed to canary proteins (canary breeders) and healthy unexposed individuals were evaluated by FEIA using biotinylated serum proteins coupled to streptavidin-activated solid phases. Statistical analyses were performed to compare the different groups and to evaluate the performance of this technique.
The group of patients with hypersensitivity pneumonitis caused by exposure to canary proteins showed the highest value of specific IgG (35.70
mg IgG/mL).
ROC analysis demonstrated an optimal cut-off value of 8.44
mg IgG/mL with a sensitivity of 100% and a specificity of 91.76%. Comparisons with other groups revealed statistically significant differences. Comparison between ELISA and FEIA results revealed a strong positive relationship between values obtained in both assays.
The results demonstrate that Streptavidin ImmunoCAP® is a sensitive, specific and efficient laboratory method for routine diagnostic testing of HP caused by protein antigens that are not commercially available.
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