本研究旨在评估先天性弓形虫病(CT)产后诊断的不同血清学策略,并建立CT诊断的生物学算法。该研究分析了免疫球蛋白M的血清学数据,A,和G(IgM,IgA,IgG)通过免疫酶和比较免疫谱(CIP)测定在四个测试期进行CT诊断的668名新生儿:P1(D0-D10),P2(D11-D35),P3(D36-D45),和P4(>D45)。在668例CT病例中,有49%在P1期间被诊断为34%,4%,在P2、P3和P4期间分别为12%。CIP测定在P1期间诊断的98%的CT病例中检测到新合成的IgM/IgG,而在P2期间诊断的90%和57%的CT病例中检测到IgM和IgA,在P3期间诊断的88%和67%。新合成的IgM/IgG的检测,IgMs,免疫分析和IgA对CT诊断的贡献为81%,77%,60%的病例,分别。总的来说,46%的血清样本对所有三个参数均为阳性,27%为两个,和27%的三个。该研究建议在P1期间使用CIP测定作为标准,用于CT诊断以及P1后的IgM和IgA免疫测定。强烈建议在生物学家和临床医生之间密切合作的专业中心进行临床和生物学随访,以增加早期诊断的机会。总的来说,这项研究为CT诊断的生物算法的发展提供了有用的信息,这可以帮助早期发现和适当治疗这种疾病。
This
study aimed to evaluate different serological strategies for the postnatal diagnosis of congenital toxoplasmosis (CT) and establish a biological algorithm for CT diagnosis. The
study analyzed serological data of immunoglobulins M, A, and G (IgM,
IgA, IgG) performed by immunoenzymatic and compared immunological profile (CIP) assays in 668 newborns with CT diagnosis across four testing periods: P1 (D0- D10), P2 (D11-D35), P3 (D36-D45), and P4 (>D45). Forty-nine percent of the 668 CT cases were diagnosed during P1 and 34%, 4%, and 12% during P2, P3, and P4, respectively. CIP assays detected neosynthetized IgMs/IgGs in 98% of CT cases diagnosed during P1, while IgMs and IgAs were detected in 90% and 57% of CT cases diagnosed during P2 and in 88% and 67% of diagnoses made during P3, respectively. Detection of neosynthesized IgMs/IgGs, IgMs, and IgAs by immunoassay contributed to CT diagnosis in 81%, 77%, and 60% of cases, respectively. In total, 46% of serum samples were positive for all three parameters, 27% for two, and 27% for one of the three. The
study recommends using the CIP assay as standard during P1 for CT diagnosis and IgM and
IgA immunoassays after P1. A clinical and biological follow-up in a specialized center with a close collaboration between biologists and clinicians is highly recommended to increase the chances of early diagnosis. Overall, this
study provides useful information for the development of a biological algorithm for CT diagnosis, which can aid in early detection and appropriate treatment of this disease.