Specific circulating immune complexes in acute chagas' disease

Corral, Ricardo; Freilij, Héctor; Grinstein, Saúl

doi:10.1590/S0036-46651987000100004

Abstracts

The presence of circulating immune complexes formed by IgM and IgG (CIC-IgM and CIC-IgG) was investigated, using antigen-specific enzyme-immunoassays (ELISA), in 30 patients with acute Chagas' disease who showed parasitemia and inoculation chagoma. Control population consisted of patients with chronic T. cruzi infection (30), acute toxoplasmosis 10), leishmaniasis (8), rheumatoid arthritis (3) and healthy individuals with negative serology for Chagas* disease (30). Acute chagasic patients were 100% CIC-IgG and 96.66% CIC-IgM positive whereas immunofluorescence tests yielded 90% and 86.66% of positivity for specific IgG and IgM antibodies, respectively. Chronic patients were 68% CIC-IgG and 0% CIC-IgM positive. The 30 negative and the 21 cross-reaction controls proved negative for ELISA (CIC-IgM and CIC-IgG). The high sensitivity of ELISA assays would allow early immunologic diagnosis, as well as prompt treatment, of acute T. cruzi infection, thus eliminating the problem of the false-positive and false-negative results which affects traditional methods for detection of circulating antibodies.

Acute Chagas' disease; Circulating immune complexes; ELISA

Se investigo la presencia de complejos inmunes circulantes formados por IgM e IgG (CIC-IgM y CIC-IgG), utilizando enzimoinmu-noensayos ELISA) antígeno-específicos, en 30 pacientes con enfermedad de Chagas aguda que presentaban parasitemia y chagoma de inocu-lación. La población control estaba formada por pacientes con infección crônica por T. cruzi (30), toxoplasmosis aguda (10), leishmaniasis (8), artritis reumatoidea (3) e individuos sanos con serología negativa para Chagas (30). Los pacientes chagásicos agudos fueron 100% CIC-IgG y 96,66% CIC-IgM positivos, mientras que Ias pruebas de inmunofluorescencia para anti-cuerpos específicos de tipo IgG e IgM mostra-ron 90% y 86,66% de positividad, respectivamente. Los pacientes crônicos fueron 68% CIC-IgG y 0% CIC-IgM positivos. El resto de los controles arrojaron resultados negativos por ELISA CIC-IgM y CIC-IgG). La alta sensibilidad dei ELISA permitiria un diagnóstico inmunológico temprano, como así también un tra-tamiento inmediato, de la infeccin aguda por T. cruzi, eliminando así el problema de resultados falsos-positivos y falsos-negativos que afecta a los métodos tradicionales para detección de anticuerpos circulantes.

ARTIGOS ORIGINAIS

Ricardo Corral; Héctor Freilij; Saúl Grinstein

Hospital de Niños "Ricardo Gutierrez"; Laboratório de Virología; Gallo 1330, (1425) Buenos Aires, Argentina. R.C. is a fellow of C.I.C. (Comisión de Investigaciones Científicas de la Provincia de Buenos Aires,. Argentina

SUMMARY

The presence of circulating immune complexes formed by IgM and IgG (CIC-IgM and CIC-IgG) was investigated, using antigen-specific enzyme-immunoassays (ELISA), in 30 patients with acute Chagas' disease who showed parasitemia and inoculation chagoma. Control population consisted of patients with chronic T. cruzi infection (30), acute toxoplasmosis 10), leishmaniasis (8), rheumatoid arthritis (3) and healthy individuals with negative serology for Chagas* disease (30). Acute chagasic patients were 100% CIC-IgG and 96.66% CIC-IgM positive whereas immunofluorescence tests yielded 90% and 86.66% of positivity for specific IgG and IgM antibodies, respectively. Chronic patients were 68% CIC-IgG and 0% CIC-IgM positive. The 30 negative and the 21 cross-reaction controls proved negative for ELISA (CIC-IgM and CIC-IgG). The high sensitivity of ELISA assays would allow early immunologic diagnosis, as well as prompt treatment, of acute T. cruzi infection, thus eliminating the problem of the false-positive and false-negative results which affects traditional methods for detection of circulating antibodies.

Key words: Acute Chagas' disease; Circulating immune complexes; ELISA.

RESUMEN

Se investigo la presencia de complejos inmunes circulantes formados por IgM e IgG (CIC-IgM y CIC-IgG), utilizando enzimoinmu-noensayos ELISA) antígeno-específicos, en 30 pacientes con enfermedad de Chagas aguda que presentaban parasitemia y chagoma de inocu-lación. La población control estaba formada por pacientes con infección crônica por T. cruzi (30), toxoplasmosis aguda (10), leishmaniasis (8), artritis reumatoidea (3) e individuos sanos con serología negativa para Chagas (30). Los pacientes chagásicos agudos fueron 100% CIC-IgG y 96,66% CIC-IgM positivos, mientras que Ias pruebas de inmunofluorescencia para anti-cuerpos específicos de tipo IgG e IgM mostra-ron 90% y 86,66% de positividad, respectivamente. Los pacientes crônicos fueron 68% CIC-IgG y 0% CIC-IgM positivos. El resto de los controles arrojaron resultados negativos por ELISA CIC-IgM y CIC-IgG). La alta sensibilidad dei ELISA permitiria un diagnóstico inmunológico temprano, como así también un tra-tamiento inmediato, de la infeccin aguda por T. cruzi, eliminando así el problema de resultados falsos-positivos y falsos-negativos que afecta a los métodos tradicionales para detección de anticuerpos circulantes.

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ACKNOWLEDGEMENTS

This work was supported by grant 3-P-81-0014-03 from the IDRC (International Development Research Centre), Canada.

Recebido para publicação em 18/2/1986.

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