Document Detail


Intraocular anti-Toxoplasma gondii IgA antibody production in patients with ocular toxoplasmosis.
MedLine Citation:
PMID:  10088739     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To investigate the immunoglobulin classes associated with the intraocular anti-Toxoplasma gondii antibody response during clinical ocular toxoplasmosis and to determine which immunoglobulin class is most helpful in the diagnosis of this disease. METHODS: Paired serum and intraocular fluid samples from 155 patients who had uveitis were tested for intraocular anti-T. gondii IgG, IgA, and IgM antibody production. The presence of T. gondii DNA was determined by polymerase chain reaction. Patients were divided into two groups, based on the initial clinical diagnosis; group 1 included 78 patients with presumed ocular toxoplasmosis, and group 2 included 77 patients with uveitis that was not clinically suspected to be ocular toxoplasmosis. Samples from 27 nonuveitis patients who underwent intraocular surgery were used as control subjects. The final diagnosis was based on the clinical course and interpretation of laboratory tests. RESULTS: A final diagnosis of ocular toxoplasmosis was made in 88 of 155 patients (group 1, 68; group 2, 20). Among these patients, 65% had intraocular IgG production, 52% had intraocular IgA production, 37.5% had both IgG and IgA production, 27% had IgG production only, and 15% had IgA production only. Of the 13 patients tested, only one had intraocular IgM production. Intraocular IgA could not be detected in patients who had final diagnoses other than ocular toxoplasmosis or in control subjects. A positive polymerase chain reaction combined with a test that was positive for intraocular IgG production had a sensitivity of 77%, which increased to 91% after the detection of intraocular IgA production was added. CONCLUSIONS: Immunoglobulin G is the major class involved in the humoral immune response against the T. gondii parasite, followed by IgA. The determination of IgA production is useful as an additional test in the diagnosis of ocular toxoplasmosis.
Authors:
M J Ronday; J V Ongkosuwito; A Rothova; A Kijlstra
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of ophthalmology     Volume:  127     ISSN:  0002-9394     ISO Abbreviation:  Am. J. Ophthalmol.     Publication Date:  1999 Mar 
Date Detail:
Created Date:  1999-03-24     Completed Date:  1999-03-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370500     Medline TA:  Am J Ophthalmol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  294-300     Citation Subset:  AIM; IM    
Affiliation:
Netherlands Ophthalmic Research Institute, Amsterdam.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Animals
Antibodies, Protozoan / analysis,  biosynthesis*
Antibody Formation
Child
DNA, Protozoan / analysis
Enzyme-Linked Immunosorbent Assay
Female
Fluorescent Antibody Technique, Indirect
Humans
Immunoglobulin A / analysis,  biosynthesis*
Immunoglobulin G / analysis
Immunoglobulin M / analysis
Male
Middle Aged
Polymerase Chain Reaction
Sensitivity and Specificity
Toxoplasma / genetics,  immunology*
Toxoplasmosis, Ocular / diagnosis,  immunology*,  parasitology
Uveitis / immunology
Chemical
Reg. No./Substance:
0/Antibodies, Protozoan; 0/DNA, Protozoan; 0/Immunoglobulin A; 0/Immunoglobulin G; 0/Immunoglobulin M

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