RESUMEN
First-void urine (FVU) samples, containing human papillomavirus (HPV)-specific IgG from female genital tract secretions, provide a non-invasive option for disease monitoring and vaccine impact assessment. This study explores the utility of FVU for IgG quantification, exploring stability and compatibility with DNA preservation methods, alongside various IgG enrichment methods. Healthy female volunteers provided FVU and serum samples. FVU was collected with or without urine conservation medium (UCM) and stored under different conditions before freezing at -80 °C. Four IgG enrichment methods were tested on FVU samples. All samples were analyzed using three total human IgG quantification assays and an in-house HPV16-specific IgG assay. Samples stored with UCM buffer had higher total and HPV16-specific IgG concentrations (p ≤ 0.01) and IgG remained stable for at least 14 days at room temperature. Among IgG enrichment methods, Amicon filtration (AM) and AM combined with Melon Gel purification (AM-MG) provided similar HPV16-IgG concentrations, correlating strongly with serum levels. Protein G magnetic beads methods were incompatible with time-resolved fluorescence-based assays. This study highlights FVU as a reliable and convenient sample for IgG quantification, demonstrating stability for at least 14 days at room temperature and compatibility with UCM DNA preservation. It emphasizes the need to select appropriate IgG enrichment methods and confirms the suitability of both AM and AM-MG methods, with a slightly better performance for AM-MG.
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Papillomavirus Humano 16 , Inmunoglobulina G , Humanos , Femenino , Papillomavirus Humano 16/inmunología , Inmunoglobulina G/sangre , Inmunoglobulina G/orina , Adulto , Anticuerpos Antivirales/sangre , Anticuerpos Antivirales/orina , Anticuerpos Antivirales/inmunología , Infecciones por Papillomavirus/orina , Infecciones por Papillomavirus/virología , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/inmunología , Adulto JovenRESUMEN
Tick-borne encephalitis (TBE) is usually diagnosed based on the presence of TBE virus (TBEV)-specific IgM and IgG antibodies in serum. However, antibodies induced by vaccination or cross-reactivity to previous flavivirus infections may result in false positive TBEV serology. Detection of TBEV RNA may be an alternative diagnostic approach to detect viral presence and circumvent the diagnostic difficulties present when using serology. Viral RNA in blood is commonly detectable only in the first viremic phase usually lasting up to two weeks, and not in the second neurologic phase, when the patients contact the health care system and undergo diagnostic work-up. TBEV RNA has previously been detected in urine in a few retrospective TBE cases in the neurologic phase, and furthermore RNA of other flaviviruses has been detected in patient saliva. In this study, blood, saliva and urine were collected from 31 hospitalised immunocompetent patients with pleocytosis and symptoms of aseptic meningitis and/or encephalitis, suspected to have TBE. We wanted to pursue if molecular testing of TBEV RNA in these patient materials may be useful in the diagnostics. Eleven of the 31 study patients were diagnosed with TBE based on ELISA detection of TBEV specific IgG and IgM antibodies. None of the study patients had TBEV RNA detectable in any of the collected patient material.
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Virus de la Encefalitis Transmitidos por Garrapatas , Encefalitis Transmitida por Garrapatas , Inmunoglobulina M , ARN Viral , Saliva , Humanos , Encefalitis Transmitida por Garrapatas/diagnóstico , Encefalitis Transmitida por Garrapatas/orina , Encefalitis Transmitida por Garrapatas/sangre , Encefalitis Transmitida por Garrapatas/virología , Encefalitis Transmitida por Garrapatas/inmunología , Virus de la Encefalitis Transmitidos por Garrapatas/aislamiento & purificación , Virus de la Encefalitis Transmitidos por Garrapatas/inmunología , Virus de la Encefalitis Transmitidos por Garrapatas/genética , Saliva/virología , ARN Viral/orina , Masculino , Femenino , Persona de Mediana Edad , Adulto , Anciano , Inmunoglobulina M/sangre , Inmunoglobulina M/orina , Inmunoglobulina G/sangre , Inmunoglobulina G/orina , Anticuerpos Antivirales/sangre , Anciano de 80 o más Años , Inmunocompetencia , HospitalizaciónRESUMEN
The first orientation test for proteinuria typing is electrophoresis. However, this technique has several drawbacks, such as delayed turnaround time and subjective readings. Some laboratories therefore use quantitative assays of glomerular markers combined with tubular markers. However, the cost of reagents and the instability of certain markers are significant drawbacks for some peripheral laboratories. The aim of this study is to evaluate the implementation of an algorithm based on parameters that can be used by all laboratories for proteinuria typing within a timeframe compatible with the urgency of the situation. Albuminuria and urinary IgG were determined on 161 urines. ROC curves were produced, using urine electrophoresis read by an expert center as the reference method. The decision thresholds used are: glomerular proteinuria is defined by a Albumin+IgGproteinsratio greater than 75.4% (100% specificity), and tubular or overload proteinuria is defined by by a Albuminproteinsratio less than 37.3% (100% sensitivity). Agreement between the results of the algorithm selected and the reference method used in our study was 88 %, with a kappa value of 0.807 (95% CI [0.729 to 0.885]). The algorithm's performance suggests that it can find its place in the diagnostic strategy for clinically significant proteinuria, despite its limited indications. It is up to each biologist to assess the value of this algorithm in relation to the recruitment, habits and needs of clinicians.
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Albuminuria , Algoritmos , Inmunoglobulina G , Proteinuria , Humanos , Albuminuria/diagnóstico , Albuminuria/orina , Proteinuria/diagnóstico , Proteinuria/orina , Masculino , Femenino , Inmunoglobulina G/orina , Persona de Mediana Edad , Adulto , Anciano , Glomérulos Renales , Urinálisis/métodos , Urinálisis/normas , Adulto Joven , Sensibilidad y Especificidad , Anciano de 80 o más Años , Adolescente , Biomarcadores/orinaRESUMEN
The purpose of this study was to assess the role of urinary IgG, serum CX3CL1 and miRNA 152-3p levels as predictors of nephropathy in type 2 Egyptian diabetic patients. Sixty type 2 diabetic patients and twenty healthy controls were enrolled in a cross-sectional study. Then they were grouped into: three groups based upon urine albumin excretion (UAE). The expression of miRNA 152-3p in serum was measured using quantitative polymerase chain reaction (RTq-PCR). Serum CX3CL1 and urinary IgG concentrations were measured by ELISA. RTq-PCR revealed that serum miRNA-152-3p levels in patients were significantly higher than in controls. There was significant differences between group with normoalbuminuria and groups with diabetic nephropathy DN as regard to age, duration of nephropathy, Albumin/Creatinine ratio (A/C ratio), creatinine, urine IgG, CX3CL1 and HbA1c. In diabetic patients, there was a significant positive correlation between miRNA-152-3p levels and disease duration only as well as significant positive correlations between urinary IgG levels and age, disease duration, serum creatinine, A/C ratio, and urea. Positive correlation between serum fractalkine CX3CL1 level and age, duration of disease, urea, creatinine, A/C ratio, HbA1C and IgG in patient with DN. Serum CX3CL1 level, urinary IgG were significantly increased with the progress of nephropathy so these integrated biomarkers could be used as good predictors for early identification of nephropathy. But miRNA- 152-3p has inadequate prognostic indicator for ESRD progression.
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Quimiocina CX3CL1 , Diabetes Mellitus Tipo 2 , Nefropatías Diabéticas , MicroARNs , Albúminas , Quimiocina CX3CL1/sangre , Creatinina/orina , Estudios Transversales , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/orina , Nefropatías Diabéticas/genética , Nefropatías Diabéticas/orina , Egipto , Hemoglobina Glucada , Humanos , Inmunoglobulina G/orina , MicroARNs/sangre , UreaRESUMEN
BACKGROUND: IgA nephropathy (IgAN), the most common glomerulonephritis in the world, is an important cause of end-stage renal disease (ESRD). It is necessary to explore new prognostic markers for predicting the activity and progress of IgAN. There are few studies on new prognostic markers in IgAN patients with high proportion of glomerulosclerosis. This study aims to explore the value of urine IgG in predicting the prognosis of IgAN patients. METHODS: The primary end point of this retrospective study was a composite event with a reduction in estimated glomerular filtration rate (eGFR) of ≥ 50% or ESRD or death. This study assessed the association between urinary IgG and clinicopathological parameters, as well as the prognosis of a high proportion of patients with global glomerulosclerotic IgAN. RESULTS: This study included 105 IgAN patients with high proportion of global glomerulosclerotic. The level of urinary protein IgG was significantly correlated with clinical prognostic factors. The level of urinary protein IgG was positively correlated with urinary protein excretion (rs = 0.834, P < 0.001), CRP (rs = 0.375, P < 0.001), and C4 (rs = 0.228, P = 0.019), and negatively correlated with eGFR (rs = - 0.307, P = 0.001). In addition, the level of urinary IgG increased with the increase of tubulointerstitial injury rate, which was positively correlated with endothelial cell proliferation and crescent (all P < 0.05). Prognostic analysis using the Cox proportional hazard regression model and Kaplan-Meier survival curve further determined that urine IgG is an independent risk factor for the prognosis of IgAN with high proportion of global glomerulosclerosis. CONCLUSIONS: This study determined that urine IgG can be used as a useful predictor of the prognosis of IgAN patients with high proportion global glomerulosclerosis. The mechanism of urine IgG trends in IgAN with high proportion of glomerulosclerosis needs further study.
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Glomerulonefritis por IGA/orina , Inmunoglobulina G/orina , Glomérulos Renales/patología , Adulto , Biomarcadores/orina , Progresión de la Enfermedad , Femenino , Glomerulonefritis por IGA/complicaciones , Humanos , Masculino , Estudios Retrospectivos , Esclerosis/complicacionesRESUMEN
Chronic lithium treatment for bipolar disease causes mainly side effects in the kidney. A subset of lithium users develops nephrogenic diabetes insipidus (NDI), a urinary concentrating disorder, and chronic kidney disease (CKD). Age, lithium dose, and duration of treatment are important risk factors, whereas genetic background might also play an important role. To investigate the role of genetics, female mice of 29 different inbred strains were treated for 1 year with control or lithium chow and urine, blood, and kidneys were analyzed. Chronic lithium treatment increased urine production and/or reduced urine osmolality in 21 strains. Renal histology showed that lithium increased interstitial fibrosis and/or tubular atrophy in eight strains, whereas in none of the strains glomerular injury was induced. Interestingly, lithium did not elevate urinary albumin-creatinine ratio (ACR) in any strain, whereas eight strains even demonstrated a lowered ACR. The protective effect on ACR coincided with a similar decrease in urinary IgG levels, a marker of glomerular function, whereas the adverse effect of lithium on interstitial fibrosis/tubular atrophy coincided with a severe increase in urinary ß2-microglobulin (ß2M) levels, an indicator of proximal tubule damage. Genetic background plays an important role in the development of lithium-induced NDI and chronic renal pathology in female mice. The strong correlation of renal pathology with urinary ß2M levels indicates that ß2M is a promising biomarker for chronic renal damage induced by lithium.
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Diabetes Insípida Nefrogénica/inducido químicamente , Diabetes Insípida Nefrogénica/genética , Antecedentes Genéticos , Litio/efectos adversos , Insuficiencia Renal Crónica/inducido químicamente , Insuficiencia Renal Crónica/genética , Animales , Biomarcadores/orina , Trastorno Bipolar/tratamiento farmacológico , Diabetes Insípida Nefrogénica/sangre , Diabetes Insípida Nefrogénica/orina , Modelos Animales de Enfermedad , Femenino , Inmunoglobulina G/orina , Litio/sangre , Litio/uso terapéutico , Ratones , Ratones Endogámicos , Insuficiencia Renal Crónica/sangre , Insuficiencia Renal Crónica/orina , Microglobulina beta-2/orinaRESUMEN
The majority of urinary tract infections (UTIs) are caused by uropathogenic Escherichia coli (UPEC). Designing a vaccine will certainly reduce the occurrence of infection and antibiotic resistance of the isolates. Antigen 43 (Ag43) and autotransporter H (UpaH) have been associated with the virulence of UPEC. In the present study, the efficacy of different formulations of a hybrid protein composed of Ag43 and UpaH with and without alum and 1,25(OH)2D3 (Vitamin D3) adjuvants were evaluated in mice model. A significant increase in IgG and cellular responses was developed against Ag43::UpaH as compared to the control mice. The addition of alum or a mixture of alum and Vitamin D3 to the protein significantly enhanced the serum IgG responses and tended to remain in a steady state until 6 months. In addition, the mentioned formulations produced significant amounts of IgG1, IL-4, and IL-17 as compared to the fusion protein alone. In addition to the mentioned formulations, the combination of protein with Vitamin D3 also resulted in significantly higher serum IgA and IFN-γ levels as compared to the fusion protein alone. Mice immunized with fusion plus alum and formulation protein admixed with both alum and Vitamin D3 significantly reduced the bacterial load in the bladders and kidneys of mice as compared to the control. In this study, for the first time, the ability of a novel hybrid protein in combination with adjuvants alum and Vitamin D3 was evaluated against UPEC. Our results indicated that fusion Ag43::UpaH admixed with alum and Vitamin D3 could be a promising candidate against UTIs.
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Compuestos de Alumbre/farmacología , Colecalciferol/farmacología , Proteínas de Escherichia coli/inmunología , Proteínas Recombinantes de Fusión/inmunología , Infecciones Urinarias/prevención & control , Escherichia coli Uropatógena/inmunología , Factores de Virulencia/inmunología , Adyuvantes Inmunológicos/farmacología , Adyuvantes Inmunológicos/uso terapéutico , Compuestos de Alumbre/administración & dosificación , Animales , Anticuerpos Antibacterianos/sangre , Anticuerpos Antibacterianos/orina , Antígenos Bacterianos/inmunología , Carga Bacteriana/efectos de los fármacos , Carga Bacteriana/inmunología , Vacunas Bacterianas/administración & dosificación , Vacunas Bacterianas/inmunología , Vacunas Bacterianas/aislamiento & purificación , Colecalciferol/administración & dosificación , Citocinas/metabolismo , Inmunidad Humoral/efectos de los fármacos , Inmunización/métodos , Inmunoglobulina G/sangre , Inmunoglobulina G/orina , Inyecciones Intravenosas , Ratones Endogámicos BALB C , Membrana Mucosa/inmunología , Proteínas Recombinantes de Fusión/administración & dosificación , Proteínas Recombinantes de Fusión/aislamiento & purificación , Infecciones Urinarias/inmunologíaRESUMEN
Recent work has found urine analysis to be as sensitive as serology for diagnosis of strongyloidiasis. Here, we examined the daily variation of Strongyloides-specific IgG in urine by qualitative and quantitative ELISA and its effects on diagnostic accuracy and reliability. In the first part of the study, matched urine and fecal samples were collected from project participants in northeast Thailand for three consecutive days. Urine samples were analyzed for Strongyloides-specific IgG by ELISA using Strongyloides ratti as the antigen source. Performance of urine ELISA was compared with parasitological diagnosis by agar plate culture technique (APCT) and formalin-ethyl acetate concentration technique (FECT). In the second part of the study, urine IgG levels were compared daily for thirty consecutive days. The prevalence of Strongyloides infection, as measured by urine ELISA for three consecutive days, was significantly higher than that found using parasitological methods (63.1% vs. 22%). There was slight daily variation in prevalence estimates according to urine ELISA while there were significant variations according to parasitological examination methods over three consecutive days. For the 3-day experiment, urine ELISA had 83-86% diagnostic sensitivity when compared with the fecal examination method or with a composite standard (combined results from fecal examination methods (APCT or FECT) and/or urine ELISA). The levels of parasite-specific IgG in urine were stable throughout both the 3-day and the 30-day studies. In conclusion, diagnosis of strongyloidiasis by urine ELISA is more sensitive than by fecal methods, with minimal daily variation for qualitative and quantitative diagnosis. Urine ELISA has potential for clinical diagnosis and population screening of strongyloidiasis.
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Anticuerpos Antihelmínticos/orina , Heces/parasitología , Estrongiloidiasis/diagnóstico , Orina/parasitología , Adulto , Animales , Reacciones Cruzadas , Ensayo de Inmunoadsorción Enzimática , Femenino , Formaldehído , Humanos , Inmunoglobulina G/orina , Masculino , Persona de Mediana Edad , Prevalencia , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Manejo de Especímenes/métodos , Strongyloides ratti , Strongyloides stercoralis , Tailandia/epidemiologíaRESUMEN
The intracellular protozoan parasite Neospora caninum is incriminated to induce drastic economic losses in both livestock and pet animal industries. Neosporosis is primarily characterized by abortion in cattle and paralytic symptoms in dogs. Because there are no effective treatments or vaccines, diagnosis is critical for Neospora control. Thus, diversification of laboratory tests and specimens used for diagnosis of N. caninum is an essential scientific endeavor to judge and select the most appropriate diagnostic tool. Herein, we provide the first evidence for the utility of urine samples for demonstration of specific antibodies against N. caninum employing an experimentally infected murine model. Specific antibodies to recombinant N. caninum dense granule 7, surface antigen 1, and lysate antigen were assayed using different antibodies-based ELISAs. Urine based IgG ELISA efficiently discriminated between infected mice (acute or chronic infection), and those of non-infected mice. This effect was also noticed for IgG1 and IgG2a suggesting the utility of urine for assessment of T-helper 2- and T-helper 1-mediated immunities, respectively. In addition, reactivity of specific antibody in urine was also confirmed against parasites when indirect fluorescent antibody test was employed. Usefulness of urine as an additional clinical sample for Neospora diagnosis was confirmed via comparison with the relevant control non-infected and infected mouse sera as reference samples. Because of minimum invasiveness and ease of urine collection, this approach might offer new diagnostic opportunities for N. caninum either for the field or research purposes. However, further studies are required to extrapolate this preliminary study and results in the animal species of interest particularly in dogs.
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Anticuerpos Antiprotozoarios/orina , Coccidiosis/diagnóstico , Neospora/inmunología , Análisis de Varianza , Animales , Anticuerpos Antiprotozoarios/sangre , Chlorocebus aethiops , Coccidiosis/inmunología , Coccidiosis/parasitología , Ensayo de Inmunoadsorción Enzimática , Femenino , Técnica del Anticuerpo Fluorescente Indirecta , Inmunoglobulina G/sangre , Inmunoglobulina G/orina , Inmunoglobulina M/sangre , Inmunoglobulina M/orina , Ratones , Ratones Endogámicos BALB C , Neospora/aislamiento & purificación , Células VeroRESUMEN
Towards the development of vaccines against urinary tract infections (UTI), we determined the ability of intramuscular (i.m.) immunization to result in antigen-specific antibodies in urine. As a model antigen/vaccine, levels of total and vaccine-specific antibodies were determined in urine as a spin-out study of a phase 1 trial. Non-muscle-invasive bladder cancer (NMIBC) patients at different risks of progression, undergoing intravesical bacillus Calmette-Guérin (BCG) immunotherapy or not, received an adjuvanted recombinant protein vaccine that resulted in high titers of vaccine-specific serum immunoglobulin G (IgG) in all patients, regardless of the risk group. Vaccine-specific IgG and immunoglobulin A (IgA) were detected in urine of half of the patients at low risk of progression NMIBC and in all the intermediary/high- (int/high) risk patients. Vaccine-specific IgG titers were correlated to total urinary IgG levels, the latter being higher in the int/high-risk patients. In contrast, vaccine-specific IgA did not correlate to urinary IgA levels. Furthermore, vaccine-specific antibodies were transiently increased by intravesical BCG instillations. Altogether, our data show that a standard i.m. immunization can effectively induce antigen-specific antibodies in urine, which, upon selection of optimal vaccine targets, may provide protection against UTI. Vaccine-specific IgG titers were dependent on conditions affecting total urinary IgG levels, while production of vaccine-specific IgA in situ might independently contribute to protection against infections in the bladder. PATIENT SUMMARY: Towards the development of vaccines able to protect against urinary tract infections, we examined the potential of the intramuscular vaccination using a model antigen. We found two types of specific antibodies in the urine, which together may locally contribute to protection against infections, thus supporting the use of such a standard immunization route.
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Antígenos de Neoplasias/administración & dosificación , Antígenos de Neoplasias/inmunología , Inmunización/métodos , Inmunoglobulina A/orina , Inmunoglobulina G/orina , Proteínas de Neoplasias/administración & dosificación , Proteínas de Neoplasias/inmunología , Vacunas Sintéticas/administración & dosificación , Vacunas Sintéticas/inmunología , Adyuvantes Inmunológicos/uso terapéutico , Vacuna BCG/uso terapéutico , Humanos , Inyecciones Intramusculares , Neoplasias de la Vejiga Urinaria/tratamiento farmacológico , Infecciones Urinarias/prevención & controlRESUMEN
OBJECTIVE: To investigate the association between immunogobulin G (IgG) in urine and serum, and disease severity in patients with idiopathic membranous nephropathy (IMN). METHODS: A total of 280 patients with IMN were enrolled in this study. Serum and urine IgG levels were measured, and the relationship between IgG levels and parameters suggestive of disease severity in these patients were explored. Patients were placed into one of three groups based on urine protein levels. RESULTS: Urine IgG levels in most patients (99%) increased, while serum IgG in 74% patients decreased. Higher urine and lower serum IgG levels were associated with a more advanced-stage disease, based on the pathology assessment. Urine IgG positively correlated with 24-h urinary albumin, urinary α1- and ß2-microglobulin, serum anti-phospholipase A2 receptor (PLA2R) antibody, and erythrocyte sedimentation rate (ESR). However, urine IgG negatively correlated with serum albumin and the estimated glomerular filtration rate (eGFR). Serum IgG positively correlated with serum albumin, but negatively correlated with 24-h urine protein, albumin, urinary α1- and ß2-microglobulin, and anti-PLA2R antibody levels. Multivariate regression analyses showed that the 24-h urine protein, urinary α1-microglobulin, eGFR, and ESR were associated with urine IgG levels, independent of age, sex, urinary albumin, urinary ß2-microglobulin, or serum anti-PLA2R antibody levels. In addition, serum albumin and age were significant determinants of serum IgG levels. CONCLUSIONS: Serum and urine IgG levels are significantly associated with disease severity in patients with IMN and can be useful indicators of IMN incidence.
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Glomerulonefritis Membranosa/etiología , Inmunoglobulina G/sangre , Inmunoglobulina G/orina , Adolescente , Adulto , Anciano , Sedimentación Sanguínea , Estudios de Casos y Controles , Femenino , Tasa de Filtración Glomerular , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
Rapid point-of-care testing is a megatrend in infectious disease diagnosis. We have introduced a homogeneous immunoassay concept, which is based on the simultaneous binding of antigen and protein L to a given immunoglobulin molecule. The complex formation is detected utilizing time-resolved Förster resonance energy transfer between antigen-attached donor and acceptor-labeled protein L, hence the name LFRET. Here, we demonstrate that urine can be used as a sample matrix in LFRET-based serodiagnostics. We studied urine samples collected during the hospitalization and recovery of patients with acute Puumala orthohantavirus (PUUV) infection. We compared PUUV antibody-specific LFRET signals in urine to those in plasma, and found excellent correlation in the test outcomes The LFRET test from urine was positive in 40/40 patients with acute PUUV infection. PUUV causes a mild form of hemorrhagic fever with renal syndrome, characterized by acute kidney injury and proteinuria. Immunofluorescence and western blotting demonstrated PUUV-IgG and -IgA in urine, however, the presence of intact immunoglobulins did not fully explain the LFRET signals. We purified free light chains (FLCs) from both urine and serum of healthy volunteers and patients with acute PUUV infection, and verified the presence of antigen-specific FLCs. Antigen-specific FLCs provide a new means for non-invasive antibody detection and disease diagnosis.
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Infecciones por Hantavirus/diagnóstico , Cadenas Ligeras de Inmunoglobulina/orina , Orthohantavirus/aislamiento & purificación , Pruebas Serológicas/métodos , Anticuerpos Antivirales/orina , Proteínas de la Cápside/inmunología , Orthohantavirus/inmunología , Infecciones por Hantavirus/orina , Fiebre Hemorrágica con Síndrome Renal/diagnóstico , Fiebre Hemorrágica con Síndrome Renal/orina , Humanos , Inmunoensayo , Inmunoglobulina A/orina , Inmunoglobulina G/orina , Cadenas Ligeras de Inmunoglobulina/inmunología , Pruebas en el Punto de Atención , Virus Puumala/inmunología , Virus Puumala/aislamiento & purificación , Proteínas del Núcleo Viral/inmunologíaRESUMEN
BACKGROUND: Strongyloides stercoralis is a neglected soil-transmitted helminth that occurs worldwide, though it is particularly endemic in tropical and subtropical areas. It can cause long-lasting and potentially fatal infections due to its ability to replicate within its host. S. stercoralis causes gastrointestinal and dermatological morbidity. The objective of this study was to assess the S. stercoralis infection risk and, using geostatistical models, to predict its geographical distribution in Cambodia. METHODOLOGY / PRINCIPAL FINDINGS: A nation-wide, community-based parasitological survey was conducted among the Cambodian population, aged 6 years and older. S. stercoralis was diagnosed using a serological diagnostic test that detects IgG antibodies in urine. Data on demography, hygiene and knowledge about helminth infection were collected. S. stercoralis prevalence among 7,246 participants with a complete data record was 30.5%, ranging from 10.9% to 48.2% across provinces. The parasite was ubiquitous in Cambodia; only five south-eastern provinces had prevalence rates below 20%. Infection risk increased with age for both men and women, although girls under the age of 13 and women aged 50 years and over had lower odds of infection than their male counterparts. Open defecation was associated with higher odds of infection, while having some knowledge of the health problems caused by worms was a protective factor. Infection risk was positively associated with nighttime maximum temperature, minimum rainfall, and distance to water; it was negatively associated with land occupied by rice fields. CONCLUSIONS / SIGNIFICANCE: S. stercoralis infection is rampant in Cambodia. Control programs delivering ivermectin are needed to manage the parasite. However, the high cost of this drug in Cambodia currently precludes the implementation of control initiatives. Donations, subsidies or affordable generics are needed so that S. stercoralis, which infects almost a third of the Cambodian population, can be addressed through an adequate control program.
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Anticuerpos Antihelmínticos/orina , Strongyloides stercoralis/inmunología , Estrongiloidiasis/epidemiología , Topografía Médica , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Animales , Cambodia/epidemiología , Niño , Femenino , Humanos , Inmunoglobulina G/orina , Masculino , Persona de Mediana Edad , Medición de Riesgo , Estudios Seroepidemiológicos , Encuestas y Cuestionarios , Adulto JovenRESUMEN
BACKGROUND/AIMS: Previous studies reported that fractional clearance of urinary proteins is better than total proteinuria in predicting chronic kidney disease (CKD) progression. However, the role of sodium in the fractional excretion of proteins has not been established. We aimed to evaluate the association between sodium intake and fractional albumin and immunoglobulin G (IgG) excretion in nondialytic CKD. METHODS: We did a longitudinal, observational, and prospective study that included CKD patients aged 18-80. Included patients performed basal routine laboratory evaluations, urinary sodium excretion, and fractional albumin and IgG excretion that were repeated after 6-month of follow-up. RESULTS: We evaluated 84 patients, mean age 55 ± 15.6 years, 40 women, and 74 whites. The change of estimated sodium intake had an association with the change of fractional albumin (R = 0.54; p < 0.001) and IgG (R = 0.56; p < 0.001) excretion in univariate analysis (increases in sodium intake were paralleled by increases in albumin and IgG excretion fractions). This association was maintained in a multiple generalized linear model even after adjusting for age and for changes in blood pressure, urinary potassium, protein intake, and blood glucose. CONCLUSION: In CKD patients, changes in estimated sodium intake were associated with changes in the fractional albumin and IgG excretion regardless of confounding factors. Findings of this study support the idea that reducing salt intake, and consequently, albumin and IgG fractional excretions could help to slow CKD progression. This hypothesis must be tested in long-term interventional studies.
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Albuminuria/orina , Inmunoglobulina G/orina , Insuficiencia Renal Crónica/metabolismo , Sodio en la Dieta/administración & dosificación , Anciano , Creatinina/metabolismo , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Estudios ProspectivosRESUMEN
IgG4 and its role in immune tolerance has been investigated widely. Symptom reduction and improved clinical outcomes in immunotherapy trials are associated with significant increases in allergen-specific IgG4 antibodies. Natural immune tolerance observed in beekeepers and cat owners has also been associated with elevated levels of bee venom and cat allergen-specific IgG4, respectively. Functionally, allergen-specific IgG4 has been shown to reduce the binding of IgE-allergen complexes to B cells, a key step in the initiation of the type 1 hypersensitivity allergic response. In laboratory animal allergy, IgG4 has been described as a "protective/blocking" antibody. However, a consensus on the exact relationship between exposure, IgG4, and tolerance has yet to be reached. In this chapter, we review the factors that require consideration when developing an ELISA for the quantification of allergen-specific IgG4.
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Alérgenos/inmunología , Inmunoglobulina G/orina , Animales , Modelos Animales de Enfermedad , Ensayo de Inmunoadsorción Enzimática , Humanos , Tolerancia Inmunológica , Inmunoglobulina E/inmunología , RatonesRESUMEN
BACKGROUND: Monitoring HPV antibodies non-invasively would be a major advantage for large epidemiological studies and follow-up of vaccinees. OBJECTIVES: This study investigated the presence of HPV-specific antibody transudates from systemic circulation in first-void urine of (un)vaccinated subjects and the agreement with paired sera. STUDY DESIGN: In this case-control study, 55 paired first-void urine and serum samples were included from 19- to 26-year-old women, unvaccinated (n = 19) or vaccinated (n = 36) with the bi- or quadrivalent HPV vaccine during adolescence (NCT02714114). Human IgA, total human IgG, and HPV6/11/16/18-Ig(M/G/A) were measured in paired samples. RESULTS: Significant positive Spearman rank correlations (rs) were found in HPV-specific antibody levels between paired samples (HPV6: rs = 0.777; HPV11: rs = 0.757; HPV16: rs = 0.876; HPV18: rs = 0.636 (p < 0.001)). In both first-void urine and serum, significantly higher HPV6/11/16/18 antibody levels were observed in vaccinated compared with unvaccinated women (p ≤ 0.017). CONCLUSIONS: The present study provides the first proof that vaccine-induced HPV antibodies are detectable in the first-void urine of young women. Moreover, significant positive correlations were observed between HPV6/11/16/18-antibodies in first-void urine and paired sera. Further optimization and validation are required to demonstrate its potential use in epidemiological studies and follow-up of HPV vaccination.
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Anticuerpos Antivirales/orina , Secreciones Corporales/virología , Papillomaviridae/inmunología , Infecciones por Papillomavirus/prevención & control , Vacunas contra Papillomavirus/inmunología , Anticuerpos Antivirales/sangre , Estudios de Casos y Controles , Cuello del Útero/virología , Femenino , Papillomavirus Humano 11/inmunología , Papillomavirus Humano 16/inmunología , Papillomavirus Humano 18/inmunología , Humanos , Inmunoglobulina A/sangre , Inmunoglobulina A/orina , Inmunoglobulina G/sangre , Inmunoglobulina G/orina , Biopsia Líquida , Infecciones por Papillomavirus/inmunología , Infecciones por Papillomavirus/orina , Vacunación , Vagina/virología , Adulto JovenRESUMEN
Lymphatic filariasis (LF) has been declared eliminated in Sri Lanka in September 2016. To maintain elimination status, a surveillance system to detect hidden endemic foci or LF resurgence is of highest priority. In this paper, we have reported an investigation of LF transmission in Trincomalee district where a surveillance program was not carried out due to 30â¯years of civil unrest. Proposed surveillance system included, measurement of anti-filarial IgG4 in urine of schoolchildren in areas where LF transmission could exist and assessment of circulating filarial antigen (CFA) and microfilaria (mf) in all urine antibody positive schoolchildren, their family members and 10-15 neighbours of each urine antibody positive household. Spatial distribution of the anti-filarial antibody titers in urine in a high antibody suspected area was analyzed using GPS logger data. Among 2301 school children from 11 schools studied, 41 (1.8%) urine antibody positives were found. The antibody positive rates of the schools ranged between 0 and 4.0%. Nine of the 630 (1.4%) examined became positive for CFA but were negative for mf. Although there were no mf positives, positive CFA and antibody results indicated the existence of Wuchereria bancrofti in Trincomalee. Highest antibody titres in an area correlated with the prevalences of urine antibodies and CFA. Spatial analysis showed LF transmission foci. Therefore, a combination of the non-invasive methods, urine ELISA and GPS mapping, will be a new effective surveillance system to identify hidden LF transmission foci.
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Antígenos Helmínticos/orina , Erradicación de la Enfermedad/estadística & datos numéricos , Filariasis Linfática/epidemiología , Filariasis Linfática/transmisión , Monitoreo Epidemiológico , Vigilancia de la Población , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Anticuerpos Antihelmínticos/orina , Antígenos Helmínticos/inmunología , Niño , Preescolar , Filariasis Linfática/diagnóstico , Filariasis Linfática/orina , Ensayo de Inmunoadsorción Enzimática/métodos , Familia , Composición Familiar , Femenino , Sistemas de Información Geográfica/estadística & datos numéricos , Humanos , Inmunoglobulina G/orina , Masculino , Persona de Mediana Edad , Población , Vigilancia de la Población/métodos , Prevalencia , Análisis Espacial , Sri Lanka/epidemiología , Adulto JovenRESUMEN
BACKGROUND: The endocapillary proliferative (EP) lesion is not included in the International Study of Kidney Disease in Children (ISKDC) pathological classification of Henoch-Schönlein purpura nephritis (HSPN). The main objective of the study was to determine the pathological importance of EP in the development of proteinuria in children with Henoch-Schönlein purpura nephritis (HSPN). METHODS: The pathological features of 148 HSPN children with nephrotic-range proteinuria were investigated retrospectively. Urinary IgG, transferrin, and albumin levels were measured by immunonephelometry. The correlations between EP lesion and 24-h proteinuria, urinary IgG, urinary transferrin, and urinary albumin were analyzed. Renal biopsy specimens were immunohistochemically stained for nephrin and podocalyxin. RESULTS: Of the total 581 cases of children with HSPN who underwent renal biopsy, 148 cases (25.5%) presented with nephrotic-range proteinuria. The pathological types of HSPN with nephrotic-range proteinuria were categorized as IIb, IIIa, IIIb, IIIb with diffuse EP, IVb, pure focal EP type, and pure diffuse EP type. Among these types, pure diffuse EP type accounted for 7.4%. The levels of 24-h proteinuria and urinary albumin were the highest in pure diffuse EP type among all pathological types, and the percentage of EP correlated with 24-h proteinuria and urinary albumin levels. 24-h proteinuria was significantly higher in pure diffuse EP type relative to HSPN IIb type, and significantly higher in IIIb with EP, compared with HSPN IIIb. Nephrin, but not podocalyxin, was downregulated in EP segment. CONCLUSIONS: EP is an independent pathogenic factor in HSPN with nephrotic-range proteinuria. Downregulation of nephrin in EP segment is a potential molecular mechanism of nephrotic-range proteinuria. Albumin is the major urinary protein component in HSPN with EP.
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Albuminuria/etiología , Capilares/patología , Glomerulonefritis/etiología , Vasculitis por IgA/complicaciones , Glomérulos Renales/irrigación sanguínea , Neovascularización Patológica , Adolescente , Albuminuria/patología , Albuminuria/orina , Niño , Femenino , Glomerulonefritis/patología , Glomerulonefritis/orina , Humanos , Vasculitis por IgA/diagnóstico , Inmunoglobulina G/orina , Glomérulos Renales/metabolismo , Masculino , Proteínas de la Membrana/metabolismo , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , Sialoglicoproteínas/metabolismo , Transferrina/orinaRESUMEN
To evaluate the accuracy and reliability of urine assay for the diagnosis of strongyloidiasis, three different immunoassays were used to assess the diagnostic accuracy of anti-Strongyloides immunoglobulin G (IgG) in urine and compared with those in serum samples. Analyses by InBios enzyme-linked immunosorbent assay (ELISA) kit (recombinant NIE antigen), SciMedx ELISA kit (Strongyloides stercoralis antigen), and our in-house ELISA (Strongyloides ratti antigen) yielded comparable diagnostic performances between urine and serum assays. Levels of Strongyloides-specific IgG in urine significantly correlated with those in serum. Tests for diagnostic agreement between urine and serum IgG assays showed substantial to fair agreement (κ = 0.207-0.615). The observed quantitative and qualitative concordance between urine and serum assays in strongyloidiasis suggests that urine has similar diagnostic value to that for serum. Because of the ease and noninvasiveness of clinical sample collection, urine assay has a high potential for the initial diagnosis and mass screening of strongyloidiasis.
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Anticuerpos Antihelmínticos/sangre , Anticuerpos Antihelmínticos/orina , Ensayo de Inmunoadsorción Enzimática/normas , Inmunoglobulina G/sangre , Inmunoglobulina G/orina , Strongyloides stercoralis/aislamiento & purificación , Estrongiloidiasis/diagnóstico , Anciano , Animales , Estudios Transversales , Ensayo de Inmunoadsorción Enzimática/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Reproducibilidad de los Resultados , Strongyloides stercoralis/inmunología , Estrongiloidiasis/sangre , Estrongiloidiasis/orinaRESUMEN
Dogs with naturally occurring canine parvovirus (CPV) infection are at risk of developing acute kidney injury (AKI) due to several factors, including severe dehydration, hypotension and sepsis. Serum creatinine (sCr) and serum urea are insensitive markers for the assessment of early kidney injury. Therefore, the aim of this study was to investigate potential kidney injury in dogs with CPV infection using both routine renal functional parameters and several kidney injury biomarkers. Twenty-two dogs with CPV infection were prospectively enrolled and compared with eight clinically healthy control dogs. Urinary immunoglobulin G (uIgG) and C-reactive protein (uCRP) were measured to document glomerular injury, whereas urinary retinol-binding protein (uRBP) and neutrophil gelatinase-associated lipocalin (uNGAL) served as markers for tubular injury. These biomarkers were compared to routine renal functional parameters, including sCr, serum urea, urinary protein:creatinine ratio (UPC) and urine specific gravity (USG). Dogs with CPV infection had significantly higher concentrations of uIgG, uCRP, uRBP and uNGAL compared to healthy dogs. In contrast, sCr was significantly lower in dogs with CPV infection compared to controls, while serum urea was not significantly different. UPC and USG were both significantly higher in CPV-infected dogs. This study demonstrated that dogs with CPV infection had evidence of AKI, which remained undetected by the routine functional markers sCr and serum urea, but was revealed by UPC, uIgG, uCRP, uRBP and uNGAL. These results emphasize the added value of novel urinary kidney injury biomarkers to detect canine patients at risk of developing AKI.