Anti-C1q Autoantibodies: Standard Quantification and Innovative ELISA.

Autoantibodies against complement C1q (anti-C1q) are an excellent marker for active nephritis in SLE patients. Here, we describe a typical protocol for the quantification of anti-C1q using immobilized C1q (important for the presentation of relevant cryptic epitopes) and a high salt buffer for the incubation steps (to prevent immune-complex binding to intact C1q). More recently, a linear epitope on the C1q A chain, that is targeted by anti-C1q, has been described (A08). The assay using this peptide seems to be more specific and more sensitive for the detection of active nephritis in SLE patients than the conventional anti-C1q assay, but further studies are required to establish the role of anti-A08 of C1q in the clinical routine.

Adapting to the Coronavirus Pandemic: Building and Incorporating a Diagnostic Pipeline in a Shared Resource Laboratory.

In March 2020, with lockdown due to the coronavirus pandemic underway, the Francis Crick Institute (the Crick) regeared its research laboratories into clinical testing facilities. Two pipelines were established, one for polymerase chain reaction and the other for Serology. This article discusses the Cricks Flow Cytometry Science Technology Platform (Flow STP) role in setting up the Serology pipeline. Pipeline here referring to the overarching processes in place to facilitate the receipt of human sera through to a SARs-CoV-2 enzyme-linked immunosorbent assay result. We examine the challenges that had to be overcome by a research laboratory to incorporate clinical diagnostics and the processes by which this was achieved. It describes the governance required to run the service, the design of the standard operating procedures (SOPs) and pipeline, the setting up of the assay, the validation required to show the robustness of the pipeline and reporting the results of the assay. Finally, as the lockdown started to ease in June 2020, it examines how this new service affects the daily running of the Flow STP. © 2020 The Authors. Cytometry Part A published by Wiley Periodicals LLC on behalf of International Society for Advancement of Cytometry.

Novel ELISAs to measure total and phosphorylated tau in cerebrospinal fluid.

Cerebrospinal fluid (CSF) total tau (t-tau) and tau protein phosphorylated at threonine 181 (p181tau) are established biomarkers for Alzheimer's disease (AD). Herein, we measured t-tau and p181tau to evaluate novel enzyme-linked immunosorbent assays (ELISAs) using 72 CSF samples including from patients with AD with dementia (ADD) and various neurodegenerative diseases. Our assay system showed good correlations with widely used ELISA systems for t-tau and p181tau and showed that serum and hemoglobin contamination in CSF samples did not decrease sensitivity. Significant increases in both t-tau and p181tau levels were observed in ADD. These findings suggested that our ELISAs were reliable assays for CSF t-tau and p181tau similar to commonly used ELISAs.

Second-Generation Biomarker Testing for Irritable Bowel Syndrome Using Plasma Anti-CdtB and Anti-Vinculin Levels.

BACKGROUND: ELISA testing for anti-CdtB and anti-vinculin can discriminate patients with irritable bowel syndrome with diarrhea (IBS-D) from those with inflammatory bowel disease (IBD). However, recent findings suggest the antigens can suffer from epitope instability. AIM: This study aimed to assess effects of incorporating epitope stabilization on test characteristics for distinguishing IBS-D from IBD subjects. METHODS: Plasma samples from IBS-D subjects from a large-scale clinical trial and subjects with endoscopically active IBD without concurrent immunomodulator therapy were used. After epitope stabilization, CdtB and vinculin were used in ELISA testing. Optical density readings were compared between IBS-D and IBD subjects. RESULTS: Samples from 100 IBS-D and 31 IBD (22 UC and 9 CD) subjects were tested. IBS-D subjects had higher anti-CdtB titers (P = 0.0001) and higher anti-vinculin titers (P = 0.004) than IBD subjects. The specificities of anti-CdtB and anti-vinculin to differentiate IBS-D from IBD were 93.5% and 90.9%, respectively, with sensitivities of 43.0% and 52.2%, respectively. The positive likelihood ratios of identifying IBS-D with anti-CdtB and anti-vinculin were 6.7 and 5.7, respectively. Assuming a pretest probability of 57% for diagnosis of IBS-D in patients with abdominal pain and change in bowel habits, testing positive for both antibodies resulted in a posttest probability of > 98%. CONCLUSIONS: Performing epitope stabilization for CdtB and vinculin enhances the test characteristics of ELISAs for anti-CdtB and anti-vinculin in discriminating IBS-D from IBD. Measurement of anti-CdtB and anti-vinculin with this second-generation methodology may further advance our understanding of the role of immunity in functional bowel diseases.

Dengue virus: a review on advances in detection and trends - from conventional methods to novel biosensors.

Dengue virus is an important arbovirus infection which transmitted by the Aedes female mosquitoes. The attempt to control and early detection of this infection is a global public health issue at present. Because of the clinical importance of its detection, the main focus of this review is on all of the methods that can offer the new diagnosis strategies. The advantages and disadvantages of reported methods have been discussed comprehensively from different aspects like biomarkers type, sensitivity, accuracy, rate of detection, possibility of commercialization, availability, limit of detection, linear range, simplicity, mechanism of detection, and ability of usage for clinical applications. The optical, electrochemical, microfluidic, enzyme linked immunosorbent assay (ELISA), and smartphone-based biosensors are the main approaches which developed for detection of different biomarkers and serotypes of Dengue virus. Future efforts in miniaturization of these methods open the horizons for development of commercial biosensors for early-diagnosis of Dengue virus infection. Graphical abstract Transmission of Dengue virus by the biting of an Aedes aegypti mosquito, the symptoms of Dengue hemorrhagic fever and the structure of Dengue virus and application of biosensors for its detection.

The effectiveness of serum midkine in detecting esophageal squamous cell carcinoma.

BACKGROUND: Studies investigating serum midkine (s-MK) concentrations have employed a polyclonal antibody enzyme-linked immunosorbent assay system (ELISA), because the targeted polyclonal antibody has low specificity. We used a newly developed monoclonal antibody ELISA to investigate the prognostic and diagnostic capabilities of s-MK in patients with esophageal squamous cell carcinoma. METHODS: Serum samples from 102 patients with esophageal squamous cell carcinoma were analyzed using a newly developed monoclonal antibody ELISA specifically developed to detect s-MK. s-MK cutoff value was set at 421 pg/mL (mean + 2 SD) based on data from healthy controls. Clinicopathological characteristics, including tumor stage and positivity rates for two conventional tumor markers, serum p53 (s-p53-Abs) antibodies and SCC-antigen, were evaluated to assess a possible correlation with s-MK. The prognostic capability of a high s-MK level was evaluated using univariate and multivariate methods. RESULTS: Overall positive rate for s-MK concentrations: 21%. Large tumors (> 50 mm) showed significantly higher concentrations than smaller specimens, but other clinicopathological factors were not associated with s-MK. A combination assay using SCC-antigen together with s-p53-Abs and s-MK clearly increased our capability to detect esophageal squamous cell carcinoma. Although the difference was not statistically significant (P = 0.310), the high s-MK group experienced worse overall survival than our low s-MK group. CONCLUSIONS: s-MK and conventional tumor marker combination increased our capability to detect esophageal squamous cell carcinoma. Although s-MK might be associated with esophageal squamous cell carcinoma progression, it was not an independent risk factor reducing patient survival. This study was registered as UMIN000014530.

Translating Current Bioanalytical Techniques for Studying Corona Activity.

The recent discovery of the biological corona is revolutionising our understanding of the in vivo behaviour of nanomaterials. Accurate analysis of corona bioactivity is essential for predicting the fate of nanomaterials and thereby improving nanomedicine design. Nevertheless, current biotechniques for protein analysis are not readily adaptable for analysing corona proteins, given that their conformation, activity, and interaction may largely differ from those of the native proteins. Here, we introduce and propose tailor-made modifications to five types of mainstream bioanalytical methodologies. We specifically illustrate how these modifications can translate existing techniques for protein analysis into competent tools for dissecting the composition, bioactivity, and interaction (with both nanomaterials and the tissue) of corona formed on specific nanomaterial surfaces.

Innovative and New Approaches to Laboratory Diagnosis of Zika and Dengue: A Meeting Report.

Epidemics of dengue, Zika, and other arboviral diseases are increasing in frequency and severity. Current efforts to rapidly identify and manage these epidemics are limited by the short diagnostic window in acute infection, the extensive serologic cross-reactivity among flaviviruses, and the lack of point-of-care diagnostic tools to detect these viral species in primary care settings. The Partnership for Dengue Control organized a workshop to review the current landscape of Flavivirus diagnostic tools, identified current gaps, and developed strategies to accelerate the adoption of promising novel technologies into national programs. The rate-limiting step to bringing new diagnostic tools to the market is access to reference materials and well-characterized clinical samples to facilitate performance evaluation. We suggest the creation of an international laboratory-response consortium for flaviviruses with a decentralized biobank of well-characterized samples to facilitate assay validation. Access to proficiency panels are needed to ensure quality control, in additional to in-country capacity building.

IgE reactivity to polcalcins varies according to pollen source

Background: Polcalcins are highly cross-reactive pollen panallergens. Less than 10% of allergic patients are sensitized to polcalcins. All pollen species are considered able to sensitize patients to this panallergen. Objective: We aimed to assess the presence of polcalcins in various pollen extracts used in allergen immunotherapy. Methods: ELISA inhibition experiments were performed with sera from patients sensitized to polcalcin and rPhl p 7 and rBet v 4. Recombinant polcalcin was used as the substrate and freshly prepared pollen extracts as inhibitors. Results: All pollen extracts induced significant inhibition of IgE reactivity to rBet v 4, whereas only grass pollen extract induced marked inhibition of IgE reactivity to rPhl p 7. Conclusion: Grass polcalcin probably contains more epitopes than polcalcins from other pollen sources. Grass pollen could be responsible for sensitization to polcalcins, and grass pollen immunotherapy is likely to be an option for polcalcin-hypersensitive patients (AU)

Antecedentes: Las polcalcinas son panalérgenos de alta reactividad cruzada en pólenes capaces de sensibilizar a un 10% de los pacientes alérgicos. Todas las especies de pólenes se consideran capaces de sensibilizar pacientes mediante este panalérgeno. Objetivo: El objetivo de este trabajo fue analizar la presencia de esta polcalcina en diferentes extractos de pólenes que se utilizan en inmunoterapia. Método: El suero de pacientes reactores a polcalcina, así como frente a rPhl p 7 y a rBet v 4 fue analizado mediante ensayo de ELISA inhibición, utilizando polcalcina recombinante como sustrato y extracto de pólenes como inhibidores. Resultados: En cuanto a los resultados obtenidos, todos los extractos de pólenes indujeron una inhibición significativa de la reactividad de la IgE frente a rBet v 4, mientras que solo el extracto de polen de gramíneas inducía una marcada inhibición de la reactividad de la IgE frente a rPhl p 7. Conclusión: La polcalcina de gramíneas probablemente contiene más epítopes que las polcalcinas de otras fuentes. El polen de gramíneas podría ser responsable de la sensibilización a la polcalcina y la inmunoterapia con polen de gramíneas es probablemente una opción para los pacientes hipersensibles a polcalcina (AU)

Results of the National External Quality Assessment for Toxoplasmosis Serological Testing in China.

BACKGROUND: Toxoplasmosis is typically diagnosed by serologic testing. External quality assessment (EQA) of clinical laboratories could ensure the accuracy and reliability of serological tests. We assessed the quality of toxoplasma serological assays in Chinese clinical laboratories by an EQA performed between 2004 and 2013 by the National Center for Clinical Laboratories. METHODOLOGY AND FINDINGS: EQA panels were prepared and shipped at room temperature to participating laboratories that employed toxoplasma IgG and IgM serological detection. By 2013, 5,384 EQA test reports for toxoplasma-specific IgM and 2,666 reports for toxoplasma-specific IgG were collected. Enzyme-linked immunosorbent (ELISA) and chemical immunofluorescent assays were the most commonly used detection methods. The overall coincidence rates of negative samples were better than those of positive samples. The overall EQA score for toxoplasma-specific IgM detection ranged between 84.3% and 99.6%. The ratio of laboratories that achieved correct IgG detection ranged from 61.1% to 99.3%. However, the inter- and intra-assay variabilities were found to be considerable. The most common problem was failure to detect low titers of antibody. CONCLUSION: The EQA scheme showed an improvement in toxoplasma serological testing in China. However, further optimization of assay sensitivity to detect challenging samples remains a future challenge.

Development of mature BDNF-specific sandwich ELISA.

Mature brain-derived neurotrophic factor (mBDNF) plays a vital role in the nervous system, whereas proBDNF elicits neurodegeneration and neuronal apoptosis. Although current enzyme-linked immunosorbent assay (ELISA) has been widely used to measure BDNF levels, it cannot differentiate mBDNF from proBDNF. As the function of proBDNF differs from mBDNF, it is necessary to establish an ELISA assay specific for the detection of mBDNF. Therefore, we aimed to establish a new mBDNF-specific sandwich ELISA. In this study, we have screened and found a combination of antibodies for a sandwich ELISA. A monoclonal antibody and sheep anti-BDNF were chosen as capture and detection antibody for sandwich ELISA respectively. The new ELISA showed no cross-reactivity to human recombinant NT-3, NT-4, nerve growth factor and negligible cross-reactivity (0.99-4.99%) for proBDNF compared to commercial ELISA kits (33.18-91.09%). The application of the new mBDNF ELISA was shown through the measurement of mBDNF levels in different brain regions of rats and in the brain of ß-site amyloid precursor protein cleaving enzyme 1 (BACE1)(-/-) and WT mice and compared to western blot. Overall, this new ELISA will be useful for the measurement of mBDNF levels with high specificity. As the function of proBDNF differs from mBDNF (mature BDNF), it is necessary to establish an ELISA specific for the detection of mBDNF. Here, we present a novel sandwich ELISA which detects mBDNF with high specificity. This new ELISA will be useful for the measurement of mBDNF levels with high specificity in various human and animal tissues. proBDNF, precursor of BDNF; BDNF, brain-derived neurotrophic factor; NT-3, neurotrophin-3; NT-4, neurotrophin-4; NGF, nerve growth factor.

A new sandwich immunoassay for detection of the α-secretase cleaved, soluble amyloid-ß protein precursor in cerebrospinal fluid and serum.

Alzheimer's disease (AD) is the most common neurodegenerative disorder. Frequently used diagnostic biomarkers are amyloid-ß42 (Aß42), tau, and phospho-tau, which are measured in cerebrospinal fluid (CSF), and allow a reasonable, but not full, separation of AD patients and controls. Besides Aß42, additional proteolytic cleavage products of the amyloid-ß protein precursor (AßPP) have been investigated as potential biomarkers. This includes the α-secretase cleaved soluble AßPP ectodomain (sAßPPα). However, some studies found a reduction of sAßPPα, whereas other studies reported an increase of sAßPPα in the CSF of AD patients. The divergent findings may result from the detection of sAßPPα with antibodies, such as 6E10, which do not exclusively detect sAßPPα, but also the alternative ß-secretase cleavage product sAßPPß'. Here, we used the sAßPPα-specific antibody 14D6 and developed an ELISA-like sandwich immunoassay. The assay specifically detected sAßPPα in cell culture supernatants, in human CSF and even in serum, which is more readily accessible than CSF. The assay was used to analyze sAßPPα levels in CSF and serum of AD patients and controls. The assay detected a mild, but significant increase in sAßPPα in the CSF of AD patients compared to non-demented controls, while a mild reduction was observed in serum. The 14D6 assay in CSF allowed a better separation of AD patients from controls compared to the 6E10 antibody. Taken together, the new assay is widely applicable for specific sAßPPα measurement in culture media, CSF, and serum.

Developments in diagnosis and treatment of visceral leishmaniasis during the last decade and future prospects.

Human visceral leishmaniasis (VL) continues to be a life-threatening neglected tropical disease, with close to 200 million people at risk of infection globally. Epidemics and resurgence of VL are associated with negligence by the policy makers, economic decline and population movements. Control of the disease is hampered by the lack of proficient vaccination, rapid diagnosis in a field setting and severe side effects of current drug therapies. The diagnosis of VL relied largely on invasive techniques of detecting parasites in splenic and bone marrow aspirates. rK39 and PCR, despite problems related to varying sensitivities and specificities and field adaptability, respectively, are considered the best options for VL diagnosis today. No single therapy of VL currently offers satisfactory efficacy along with safety. The field of VL research only recently shifted toward actively identifying new drugs for safe and affordable treatment. Oral miltefosine and safe AmBisome along with better use of amphotericin B have been rapidly implemented in the last decade. A combination therapy will substantially reduce the required dose and duration of drug administration and reduce the chance of the development of resistance. In addition, identification of asymptomatic cases, vector control and treatment of post-kala-azar dermal leishmaniasis would allow new perspectives in VL control and management.

Impact of solid phase antibody testing on organ allocation in the United States.

The implementation of the solid phase antibody assays has allowed for the detection and characterization of human leukocyte antigen (HLA) specific antibodies with greater sensitivity and specificity. This information can then be used along with the donor's HLA typing to predict crossmatch results (a virtual crossmatch). Using these data and the level of immunological risk assessed to the antibodies detected, the determination of unacceptable antigens can be made. The calculated panel reactive antibody (CPRA) provides for a means to determine the frequency of these unacceptable antigens in the donor population and thereby predict the probability of a positive crossmatch. In 2009, the Organ Procurement Transplant Network administered by the United Network for Organ Sharing adopted the CPRA as the means to define sensitization and to assign allocation points. Follow-up studies have shown that the number of organ offers refused due to a positive crossmatch has decreased significantly and has saved money through the elimination of unnecessary testing. An additional benefit has been the increased number of sensitized patients being transplanted successfully. Through technical improvements and the refined interpretation of the solid phase antibody assays, continual progress is being made in the definition of the unacceptable antigens and the ability to transplant sensitized patients.

Uncinariasis como causa de anemia ferropénica en población penitenciaria / Hookworm as cause of iron deficiency anemia in the prison population

Presentamos un caso clínico de parasitosis por uncinarias en un paciente de origen español, interno en el centro penitenciario, que residió en Brasil. El diagnóstico se estableció a partir de un cuadro de astenia progresiva con una importante pérdida de peso. La analítica mostró anemia ferropénica y eosinofilia, por lo que fue ingresado para estudio hospitalario por Medicina interna, encontrándose huevos de uncinarias en heces. Se realizó tratamiento con Albendazol y hierro consiguiéndose la curación clínica, la normalización de los parámetros bioquímicos y la negativización de las muestras de heces. Creemos que es necesario por parte del médico de prisiones pensar en esta y otras parasitosis ante internos procedentes de países tropicales, donde estas helmintosis son endémicas. Además, quizá sería oportuno por parte de Sanidad Penitenciaria instaurar programas de cribado de parásitos en población inmigrante, incluso si son asintomáticos (AU)

We report a case of hookworm parasitosis in a Spanish patient who before imprisonment had lived in Brazil. The diagnosis was established from a progressive manifestation of asthenia, together with significant weight loss. Laboratory tests showed hypochromic microcytic anemia and eosinophilia. Consequently, the patient was admitted to hospital in order to complete the study, where several hookworm eggs were later found in feces. The patient was subsequently treated with Albendazole and iron, achieving clinical cure, normalization of biochemical parameters and eventual eradication of the parasite. We believe it is important for the prison doctor to bear this and other parasitosis in mind when facing the case of inmates who are originally from tropical countries, where these parasites are endemic. In addition, it might be appropriate to implement parasite screening programs in the immigrant population headed by the Prison Health Service, even when said population is asymptomatic (AU)

Experiencia en el diagnóstico de hepatitis E en una unidad de enfermedades infecciosas tropicales / Experience in the diagnosis of hepatitis e in a tropical infectious diseases unit

El virus de la hepatitis E (VHE) es endémico en algunos países en vías de desarrollo. Produce cuadros de hepatitis aguda con casos esporádicos o epidemias. La principal vía de transmisión es fecal-oral sobre todo por aguas contaminadas. En países desarrollados cada vez se describen más casos debido fundamentalmente a los movimientos poblacionales (viajeros, inmigrantes, adopciones internacionales) aunque también han aumentado los casos autóctonos. Actualmente disponemos de técnicas serológicas y moleculares para el diagnóstico de la infección. Describimos la experiencia diagnóstica de la infección por VHE en una Unidad de Patología Infecciosa y Tropical Pediátrica de Madrid(AU)

The hepatitis E virus (HEV) is endemic in some developing countries. It produces acute hepatitis in sporadic cases or epidemics. The main transmission route is faecal-oral by contaminated waters. In developed countries the cases described are more and more frequent, mainly due to population movement (travellers, immigrants, international adoptions), although there have also been increases in the local population. We currently have serological and molecular techniques for the diagnosis of this infection. We describe the experience in the diagnosis of the infection by HEV in a Paediatric Tropical Infectious Diseases Unit in Madrid(AU)

New trends in quantification of acrylamide in food products.

Methods applied in acrylamide quantification in foods have been reviewed in this paper. Novel analytical techniques like capillary electrophoresis (CE), immunoenzymatic test (ELISA) and electrochemical biosensors, which can replace traditional methods like high performance liquid chromatography (HPLC) and gas chromatography (GC) were presented. Short time of analysis and high resolution power of electrophoretic techniques caused that they became routinely used in food analysis apart from high performance liquid chromatography and gas chromatography. Application of modern chromatography methods like ultra performance liquid chromatography (UPLC) in acrylamide quantification considerably shortened the time of analysis and decreased the consumption of indispensable reagents. The most promising approaches to acrylamide quantification in foods are electrochemical biosensors and immunoenzymatic tests. In contrast to chromatography and electrophoretic methods they require neither expensive equipment nor time consuming sample preparation and allow for fast screening of numerous samples without the usage of sophisticated apparatuses. Because of many advantages such as miniaturization, rapid and simple analysis, and high sensitivity and selectivity, biosensors are thought to replace conventional methods of acrylamide quantification in food.

An overview on ELISA techniques for FMD.

BACKGROUND: FMD is one of the major causes of economic loss of cloven-hoofed animals in the world today. The assessment of dominant genotype/lineage and prevalent trends and confirmation the presence of infection or vaccination not only provides scientific basis and first-hand information for appropriate control measure but also for disease eradication and regaining FMD free status following an outbreak. Although different biological and serological approaches are still applied to study this disease, ELISA test based on the distinct format, antigen type and specific antibody reinforce its predominance in different research areas of FMD, and this may replace the traditional methods in the near future. This review gives comprehensive insight on ELISA currently available for typing, antigenic analysis, vaccination status differentiation and surveillance vaccine purity and content at all stages of manufacture in FMDV. Besides, some viewpoint about the recent advances and trends of ELISA reagent for FMD are described here. METHODS: More than 100 studies regarding ELISA method available for FMD diagnosis, antigenic analysis and monitor were thoroughly reviewed. We investigated previous sagacious results of these tests on their sensitivity, specificity. RESULTS: We found that in all ELISA formats for FMD, antibody-trapping and competitive ELISAs have high specificity and RT-PCR (oligoprobing) ELISA has extra sensitivity. A panel of monoclonal antibodies to different sites or monoclonal antibody in combination of antiserum is the most suitable combination of antibodies in ELISA for FMD. Even though from its beginning, 3ABC is proven to be best performance in many studies, no single NSP can differentiate infected from vaccinated animals with complete confidence. Meanwhile, recombinant antigens and peptide derived from FMDV NPs, and NSPs have been developed for use as an alternative to the inactivated virus antigen for security. CONCLUSIONS: There is a need of target protein, which accurately determines the susceptible animal status based on the simple, fast and reliable routine laboratory test. A further alternative based on virus-like particle (VLP, also called empty capsids) in combination of high throughput antibody technique (Phage antibody library/antibody microarray) may be the powerful ELISA diagnostic reagents in future.

[GM1-dot-EIA for the detection of toxin-producing Vibrio cholerae strains].

A new variant of enzyme immunoassay (EIA) has been developed on the basis of GM1 gangliosides to detect the toxin-producing Vibrio cholerae strains--GM1-dot-EIA. Experiments were run using a nitrocellulose membrane to bind GM1 gangliosides and polyclonal antitoxic serum to detect cholerogen. GM1-dot-EIA testing identified cholera toxin in 11 of 13 supernatants of V. cholerae eltor ctx(+) strains isolated from man and in 3 of 7 supernatants of V. cholerae eltor ctx(+) strains isolated from water. These data agree with those obtained in CM1-EIA. There was no reaction with the supernatants of other microorganisms. The sensitivity of the technique was 10 ng/ml. Thus, the simple and specific GM1-dot-EIA may be recommended to detect toxin-producing V cholerae strains isolated from man and water.