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. 1989 Mar;27(3):529–535. doi: 10.1128/jcm.27.3.529-535.1989

Indirect enzyme-linked immunosorbent assay for immunoglobulin G and four immunoassays for immunoglobulin M to Toxoplasma gondii in a series of heart transplant recipients.

J F Sluiters 1, A H Balk 1, C E Essed 1, B Mochtar 1, W Weimar 1, M L Simoons 1, E P Ijzerman 1
PMCID: PMC267352  PMID: 2654182

Abstract

Toxoplasma gondii infections in heart transplant recipients were monitored by indirect enzyme-linked immunosorbent assay for immunoglobulin G (ELISA-IgG), indirect ELISA-IgM in serum IgM fractions, antibody capture ELISA-IgM, IgM-immunosorbent agglutination assay (ISAGA), and IgM immunoblotting. Basic immunosuppression consisted of cyclosporine and low-dose steroids. Before transplantation, 26 of 43 recipients showed serological evidence of infection. In serum samples from 15 (35%) recipients, specific antibodies were not detected. Approximately 50% of the heart donors, were toxoplasma seropositive. Eight of the fifteen seronegative recipients received hearts from toxoplasma-seropositive donors. In four of the eight recipients, seroconversion could be demonstrated with all tests used. In three of these four patients, clinical disease developed. One patient with strong serological evidence of toxoplasmosis died, but toxoplasma parasites and antigens were not detected at autopsy. In two patients, toxoplasma cysts were found in cardiac biopsies. Seroconversion was not prevented by the use of spiramycin prophylaxis in two recipients. Reactivations of latent infections or reinfections were detected by indirect ELISA in six (23%) seropositive recipients, but symptoms and signs of active T. gondii infection were not seen. Seroconversion and reactivation of infection were readily found by a combined use of indirect ELISA-IgG and ELISA-IgM and antibody capture ELISA-IgM. Discrepancies in results could be examined by immunoblotting. IgM-ISAGA retained stable positive values longer than IgM-ELISAs did. Cyclosporine treatment did not hamper detection of seroconversion but could cause antibody levels to remain relatively low in primary infections. Seronegative recipients should receive antitoxoplasma treatment on seroconversion.

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Selected References

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  1. Beauvais B., Garin J. F., Lariviere M., Languillat G., Galal H. Toxoplasmose et transfusion. Ann Parasitol Hum Comp. 1976 Nov-Dec;51(6):625–635. [PubMed] [Google Scholar]
  2. Britt R. H., Enzmann D. R., Remington J. S. Intracranial infection in cardiac transplant recipients. Ann Neurol. 1981 Feb;9(2):107–119. doi: 10.1002/ana.410090203. [DOI] [PubMed] [Google Scholar]
  3. Conley F. K., Jenkins K. A., Remington J. S. Toxoplasma gondii infection of the central nervous system. Use of the peroxidase-antiperoxidase method to demonstrate toxoplasma in formalin fixed, paraffin embedded tissue sections. Hum Pathol. 1981 Aug;12(8):690–698. doi: 10.1016/s0046-8177(81)80170-0. [DOI] [PubMed] [Google Scholar]
  4. Couvreur J., Nottin N., Desmonts G. La toxoplasmose congénitale traitée. Résultats cliniques et biologiques. Ann Pediatr (Paris) 1980 Dec;27(10):647–652. [PubMed] [Google Scholar]
  5. Derouin F., Debure A., Godeaut E., Lariviere M., Kreis H. Toxoplasma antibody titers in renal transplant recipients. Pretransplant evaluation and posttransplant follow-up of 73 patients. Transplantation. 1987 Oct;44(4):515–518. doi: 10.1097/00007890-198710000-00011. [DOI] [PubMed] [Google Scholar]
  6. Descotes J., Simonet R., Evreux J. C. Absence d'interaction spiramycine-antipyrine. Presse Med. 1986 Jul 5;15(27):1283–1283. [PubMed] [Google Scholar]
  7. Desmonts G., Naot Y., Remington J. S. Immunoglobulin M-immunosorbent agglutination assay for diagnosis of infectious diseases: diagnosis of acute congenital and acquired Toxoplasma infections. J Clin Microbiol. 1981 Nov;14(5):486–491. doi: 10.1128/jcm.14.5.486-491.1981. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Erlich H. A., Rodgers G., Vaillancourt P., Araujo F. G., Remington J. S. Identification of an antigen-specific immunoglobulin M antibody associated with acute Toxoplasma infection. Infect Immun. 1983 Aug;41(2):683–690. doi: 10.1128/iai.41.2.683-690.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Frenkel J. K., Escajadillo A. Cyst rupture as a pathogenic mechanism of toxoplasmic encephalitis. Am J Trop Med Hyg. 1987 May;36(3):517–522. doi: 10.4269/ajtmh.1987.36.517. [DOI] [PubMed] [Google Scholar]
  10. Frenkel J. K., Nelson B. M., Arias-Stella J. Immunosuppression and toxoplasmic encephalitis: clinical and experimental aspects. Hum Pathol. 1975 Jan;6(1):97–111. doi: 10.1016/s0046-8177(75)80111-0. [DOI] [PubMed] [Google Scholar]
  11. Hakim M., Esmore D., Wallwork J., English T. A., Wreghitt T. Toxoplasmosis in cardiac transplantation. Br Med J (Clin Res Ed) 1986 Apr 26;292(6528):1108–1108. doi: 10.1136/bmj.292.6528.1108. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Harris C., Salgo M. P., Tanowitz H. B., Wittner M. In vitro assessment of antimicrobial agents against Toxoplasma gondii. J Infect Dis. 1988 Jan;157(1):14–22. doi: 10.1093/infdis/157.1.14. [DOI] [PubMed] [Google Scholar]
  13. Herbrink P., van Loon A. M., Rotmans J. P., van Knapen F., van Dijk W. C. Interlaboratory evaluation of indirect enzyme-linked immunosorbent assay, antibody capture enzyme-linked immunosorbent assay, and immunoblotting for detection of immunoglobulin M antibodies to Toxoplasma gondii. J Clin Microbiol. 1987 Jan;25(1):100–105. doi: 10.1128/jcm.25.1.100-105.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Hughes H. P., Van Knapen F., Atkinson H. J., Balfour A. H., Lee D. L. A new soluble antigen preparation of Toxoplasma gondii and its use in serological diagnosis. Clin Exp Immunol. 1982 Jul;49(1):239–246. [PMC free article] [PubMed] [Google Scholar]
  15. Kernbaum S. La spiramycine. Utilisation en thérapeutique humaine. Sem Hop. 1982 Feb 4;58(5):289–297. [PubMed] [Google Scholar]
  16. Lehtonen O. P., Eerola E. The effect of different antibody affinities on ELISA absorbance and titer. J Immunol Methods. 1982 Oct 29;54(2):233–240. doi: 10.1016/0022-1759(82)90064-3. [DOI] [PubMed] [Google Scholar]
  17. Leport C., Vilde J. L., Katlama C., Regnier B., Matheron S., Saimot A. G. Failure of spiramycin to prevent neurotoxoplasmosis in immunosuppressed patients. JAMA. 1986 May 2;255(17):2290–2290. doi: 10.1001/jama.1986.03370170054013. [DOI] [PubMed] [Google Scholar]
  18. Luft B. J., Billingham M., Remington J. S. Endomyocardial biopsy in the diagnosis of toxoplasmic myocarditis. Transplant Proc. 1986 Dec;18(6):1871–1873. [PubMed] [Google Scholar]
  19. Luft B. J., Naot Y., Araujo F. G., Stinson E. B., Remington J. S. Primary and reactivated toxoplasma infection in patients with cardiac transplants. Clinical spectrum and problems in diagnosis in a defined population. Ann Intern Med. 1983 Jul;99(1):27–31. doi: 10.7326/0003-4819-99-1-27. [DOI] [PubMed] [Google Scholar]
  20. Luft B. J., Remington J. S. AIDS commentary. Toxoplasmic encephalitis. J Infect Dis. 1988 Jan;157(1):1–6. doi: 10.1093/infdis/157.1.1. [DOI] [PubMed] [Google Scholar]
  21. McCabe R. E., Luft B. J., Remington J. S. The effects of cyclosporine on Toxoplasma gondii in vivo and in vitro. Transplantation. 1986 May;41(5):611–615. doi: 10.1097/00007890-198605000-00012. [DOI] [PubMed] [Google Scholar]
  22. Nye F. J. Treating toxoplasmosis. J Antimicrob Chemother. 1979 May;5(3):244–246. doi: 10.1093/jac/5.3.244. [DOI] [PubMed] [Google Scholar]
  23. Potasman I., Araujo F. G., Desmonts G., Remington J. S. Analysis of Toxoplasma gondii antigens recognized by human sera obtained before and after acute infection. J Infect Dis. 1986 Oct;154(4):650–657. doi: 10.1093/infdis/154.4.650. [DOI] [PubMed] [Google Scholar]
  24. Pyndiah N., Krech U., Price P., Wilhelm J. Simplified chromatographic separation of immunoglobulin M from G and its application to toxoplasma indirect immunofluorescence. J Clin Microbiol. 1979 Feb;9(2):170–174. doi: 10.1128/jcm.9.2.170-174.1979. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Rotmans J., Duchenne W., Linschooten C., In't Veld N., Polderman A. Comparative study of three immunoassays for detection of immunoglobulin M antibodies against Toxoplasma gondii. Eur J Clin Microbiol Infect Dis. 1988 Aug;7(4):535–538. doi: 10.1007/BF01962609. [DOI] [PubMed] [Google Scholar]
  26. Ruitenberg E. J., van Knapen F. The enzyme-linked immunosorbent assay and its application to parasitic infections. J Infect Dis. 1977 Oct;136 (Suppl):S267–S273. doi: 10.1093/infdis/136.supplement_2.s267. [DOI] [PubMed] [Google Scholar]
  27. Ruskin J., Remington J. S. Toxoplasmosis in the compromised host. Ann Intern Med. 1976 Feb;84(2):193–199. doi: 10.7326/0003-4819-84-2-193. [DOI] [PubMed] [Google Scholar]
  28. Ryning F. W., McLeod R., Maddox J. C., Hunt S., Remington J. S. Probable transmission of Toxoplasma gondii by organ transplantation. Ann Intern Med. 1979 Jan;90(1):47–49. doi: 10.7326/0003-4819-90-1-47. [DOI] [PubMed] [Google Scholar]
  29. Siegel J. P., Remington J. S. Circulating immune complexes in toxoplasmosis: detection and clinical correlates. Clin Exp Immunol. 1983 Apr;52(1):157–163. [PMC free article] [PubMed] [Google Scholar]
  30. Siegel S. E., Lunde M. N., Gelderman A. H., Halterman R. H., Brown J. A., Levine A. S., Graw R. G., Jr Transmission of toxoplasmosis by leukocyte transfusion. Blood. 1971 Apr;37(4):388–394. [PubMed] [Google Scholar]
  31. Towbin H., Staehelin T., Gordon J. Electrophoretic transfer of proteins from polyacrylamide gels to nitrocellulose sheets: procedure and some applications. Proc Natl Acad Sci U S A. 1979 Sep;76(9):4350–4354. doi: 10.1073/pnas.76.9.4350. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Wreghitt T. G., Gray J. J., Balfour A. H. Problems with serological diagnosis of Toxoplasma gondii infections in heart transplant recipients. J Clin Pathol. 1986 Oct;39(10):1135–1139. doi: 10.1136/jcp.39.10.1135. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. van Knapen F., Panggabean S. O. Detection of circulating antigen during acute infections with Toxoplasma gondii by enzyme-linked immunosorbent assay. J Clin Microbiol. 1977 Dec;6(6):545–547. doi: 10.1128/jcm.6.6.545-547.1977. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. van Knapen F., Panggabean S. O. Detection of toxoplasma antigen in tissues by means of enzyme-linked immunosorbent assay (ELISA). Am J Clin Pathol. 1982 Jun;77(6):755–757. doi: 10.1093/ajcp/77.6.755. [DOI] [PubMed] [Google Scholar]
  35. van Knapen F., Panggabean S. O., van Leusden J. Demonstration of Toxoplasma antigen containing complexes in active toxoplasmosis. J Clin Microbiol. 1985 Oct;22(4):645–650. doi: 10.1128/jcm.22.4.645-650.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. van Loon A. M., van der Logt J. T., Heessen F. W., van der Veen J. Enzyme-linked immunosorbent assay that uses labeled antigen for detection of immunoglobulin M and A antibodies in toxoplasmosis: comparison with indirect immunofluorescence and double-sandwich enzyme-linked immunosorbent assay. J Clin Microbiol. 1983 Jun;17(6):997–1004. doi: 10.1128/jcm.17.6.997-1004.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]

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