Skip to main content
PMC home page
Clinical Microbiology Reviews logoLink to Clinical Microbiology Reviews
. 1990 Apr;3(2):132–152. doi: 10.1128/cmr.3.2.132

Immunoserology of infectious diseases.

K James 1
PMCID: PMC358148  PMID: 2187592

Abstract

The immune response to microorganisms not only participates in the elimination of unwanted organisms from the body, but also assists in diagnosis of infectious diseases. The nonspecific immune response is the first line of defense, assisting the body until the specific immune response can be mobilized to provide protective mechanisms. The specific immune response involves humoral or cell-mediated immunity or both, dependent on the nature of the organism and its site of sequestration. A variety of test systems have been developed to identify the causative organisms of infectious diseases. Test systems used in immunoserology have classically included methods of detecting antigen-antibody reactions which range from complement fixation to immunoassay methods. Relevant test systems for detecting antigens and antibodies are described. With numerous test systems available to detect antigens and antibodies, there can be confusion regarding selection of the appropriate system for each application. Methods for detecting antibody to verify immunity differ from immunologic methods to diagnose disease. Techniques to detect soluble antigens present in active infectious states may appear similar to those used to detect antibody, but their differences should be appreciated.

Full text

PDF
136

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barka N., Tomasi J. P., Stadtsbaeder S. ELISA using whole Legionella pneumophila cell as antigen. Comparison between monovalent and polyvalent antigens for the serodiagnosis of human legionellosis. J Immunol Methods. 1986 Oct 23;93(1):77–81. doi: 10.1016/0022-1759(86)90435-7. [DOI] [PubMed] [Google Scholar]
  2. Barnes R. C. Laboratory diagnosis of human chlamydial infections. Clin Microbiol Rev. 1989 Apr;2(2):119–136. doi: 10.1128/cmr.2.2.119. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Berman J. W., Basch R. S. Amplification of the biotin-avidin immunmofluorescence technique. J Immunol Methods. 1980;36(3-4):335–338. doi: 10.1016/0022-1759(80)90138-6. [DOI] [PubMed] [Google Scholar]
  4. Burgdorfer W., Barbour A. G., Hayes S. F., Benach J. L., Grunwaldt E., Davis J. P. Lyme disease-a tick-borne spirochetosis? Science. 1982 Jun 18;216(4552):1317–1319. doi: 10.1126/science.7043737. [DOI] [PubMed] [Google Scholar]
  5. Carter J. B., Carter S. L. Acute-phase, indirect fluorescent antibody procedure for diagnosis of Mycoplasma pneumoniae infection. Ann Clin Lab Sci. 1983 Mar-Apr;13(2):150–155. [PubMed] [Google Scholar]
  6. Cerami A., Beutler B. The role of cachectin/TNF in endotoxic shock and cachexia. Immunol Today. 1988 Jan;9(1):28–31. doi: 10.1016/0167-5699(88)91353-9. [DOI] [PubMed] [Google Scholar]
  7. Claus D. R., Osmand A. P., Gewurz H. Radioimmunoassay of human C-reactive protein and levels in normal sera. J Lab Clin Med. 1976 Jan;87(1):120–128. [PubMed] [Google Scholar]
  8. Claus D. R., Siegel J., Petras K., Osmand A. P., Gewurz H. Interactions of C-reactive protein with the first component of human complement. J Immunol. 1977 Jul;119(1):187–192. [PubMed] [Google Scholar]
  9. Clements M. L., Dumler J. S., Fiset P., Wisseman C. L., Jr, Snyder M. J., Levine M. M. Serodiagnosis of Rocky Mountain spotted fever: comparison of IgM and IgG enzyme-linked immunosorbent assays and indirect fluorescent antibody test. J Infect Dis. 1983 Nov;148(5):876–880. doi: 10.1093/infdis/148.5.876. [DOI] [PubMed] [Google Scholar]
  10. Coleman J. L., Benach J. L. Isolation of antigenic components from the Lyme disease spirochete: their role in early diagnosis. J Infect Dis. 1987 Apr;155(4):756–765. doi: 10.1093/infdis/155.4.756. [DOI] [PubMed] [Google Scholar]
  11. Corrall C. J., Pepple J. M., Moxon E. R., Hughes W. T. C-reactive protein in spinal fluid of children with meningitis. J Pediatr. 1981 Sep;99(3):365–369. doi: 10.1016/s0022-3476(81)80319-8. [DOI] [PubMed] [Google Scholar]
  12. Coyle P. K. Borrelia burgdorferi antibodies in multiple sclerosis patients. Neurology. 1989 Jun;39(6):760–761. doi: 10.1212/wnl.39.6.760. [DOI] [PubMed] [Google Scholar]
  13. Deacon W. E., Lucas J. B., Price E. V. Fluorescent treponemal antibody-absorption (FTA-ABS) test for syphilis. JAMA. 1966 Nov 7;198(6):624–628. [PubMed] [Google Scholar]
  14. Edelstein P. H., Beer K. B., Sturge J. C., Watson A. J., Goldstein L. C. Clinical utility of a monoclonal direct fluorescent reagent specific for Legionella pneumophila: comparative study with other reagents. J Clin Microbiol. 1985 Sep;22(3):419–421. doi: 10.1128/jcm.22.3.419-421.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Emanuel D., Peppard J., Stover D., Gold J., Armstrong D., Hammerling U. Rapid immunodiagnosis of cytomegalovirus pneumonia by bronchoalveolar lavage using human and murine monoclonal antibodies. Ann Intern Med. 1986 Apr;104(4):476–481. doi: 10.7326/0003-4819-104-4-476. [DOI] [PubMed] [Google Scholar]
  16. Facklam R. R. Specificity study of kits for detection of group A streptococci directly from throat swabs. J Clin Microbiol. 1987 Mar;25(3):504–508. doi: 10.1128/jcm.25.3.504-508.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Fiore M., Mitchell J., Doan T., Nelson R., Winter G., Grandone C., Zeng K., Haraden R., Smith J., Harris K. The Abbott IMx automated benchtop immunochemistry analyzer system. Clin Chem. 1988 Sep;34(9):1726–1732. [PubMed] [Google Scholar]
  18. Fischer C. L., Gill C., Forrester M. G., Nakamura R. Quantitation of "acute-phase proteins" postoperatively. Value in detection and monitoring of complications. Am J Clin Pathol. 1976 Nov;66(5):840–846. doi: 10.1093/ajcp/66.5.840. [DOI] [PubMed] [Google Scholar]
  19. Fung J. C., Donta S. T., Tilton R. C. Candida detection system (CAND-TEC) to differentiate between Candida albicans colonization and disease. J Clin Microbiol. 1986 Oct;24(4):542–547. doi: 10.1128/jcm.24.4.542-547.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Fung J. C., Tilton R. C. TORCH serologies and specific IgM antibody determination in acquired and congenital infections. Ann Clin Lab Sci. 1985 May-Jun;15(3):204–211. [PubMed] [Google Scholar]
  21. Garcia L. S., Brewer T. C., Bruckner D. A. Fluorescence detection of Cryptosporidium oocysts in human fecal specimens by using monoclonal antibodies. J Clin Microbiol. 1987 Jan;25(1):119–121. doi: 10.1128/jcm.25.1.119-121.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Gerber M. A., Wright L. L., Randolph M. F. Streptozyme test for antibodies to group A streptococcal antigens. Pediatr Infect Dis J. 1987 Jan;6(1):36–40. doi: 10.1097/00006454-198701000-00010. [DOI] [PubMed] [Google Scholar]
  23. Goding J. W. Conjugation of antibodies with fluorochromes: modifications to the standard methods. J Immunol Methods. 1976;13(3-4):215–226. doi: 10.1016/0022-1759(76)90068-5. [DOI] [PubMed] [Google Scholar]
  24. Guesdon J. L., Ternynck T., Avrameas S. The use of avidin-biotin interaction in immunoenzymatic techniques. J Histochem Cytochem. 1979 Aug;27(8):1131–1139. doi: 10.1177/27.8.90074. [DOI] [PubMed] [Google Scholar]
  25. Hackman R. C., Myerson D., Meyers J. D., Shulman H. M., Sale G. E., Goldstein L. C., Rastetter M., Flournoy N., Thomas E. D. Rapid diagnosis of cytomegaloviral pneumonia by tissue immunofluorescence with a murine monoclonal antibody. J Infect Dis. 1985 Feb;151(2):325–329. doi: 10.1093/infdis/151.2.325. [DOI] [PubMed] [Google Scholar]
  26. Hancock K., Tsang V. C. Development and optimization of the FAST-ELISA for detecting antibodies to Schistosoma mansoni. J Immunol Methods. 1986 Sep 27;92(2):167–176. doi: 10.1016/0022-1759(86)90162-6. [DOI] [PubMed] [Google Scholar]
  27. Hechemy K. E., Anacker R. L., Philip R. N., Kleeman K. T., MacCormack J. N., Sasowski S. J., Michaelson E. E. Detection of Rocky Mountain spotted fever antibodies by a latex agglutination test. J Clin Microbiol. 1980 Aug;12(2):144–150. doi: 10.1128/jcm.12.2.144-150.1980. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Hostetler C. L., Sawyer K. P., Nachamkin I. Comparison of three rapid methods for detection of antibodies to streptolysin O and DNase B. J Clin Microbiol. 1988 Jul;26(7):1406–1408. doi: 10.1128/jcm.26.7.1406-1408.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Hyde F. W., Johnson R. C., White T. J., Shelburne C. E. Detection of antigens in urine of mice and humans infected with Borrelia burgdorferi, etiologic agent of Lyme disease. J Clin Microbiol. 1989 Jan;27(1):58–61. doi: 10.1128/jcm.27.1.58-61.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Jackson J. B., Balfour H. H., Jr Practical diagnostic testing for human immunodeficiency virus. Clin Microbiol Rev. 1988 Jan;1(1):124–138. doi: 10.1128/cmr.1.1.124. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Joassin L., Reginster M. Elimination of nonspecific cytomegalovirus immunoglobulin M activities in the enzyme-linked immunosorbent assay by using anti-human immunoglobulin G. J Clin Microbiol. 1986 Mar;23(3):576–581. doi: 10.1128/jcm.23.3.576-581.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Jodal U., Hanson L. A. Sequential determination of C-reactive protein in acute childhood pyelonephritis. Acta Paediatr Scand. 1976 May;65(3):319–322. doi: 10.1111/j.1651-2227.1976.tb04892.x. [DOI] [PubMed] [Google Scholar]
  33. Kangro H. O., Booth J. C., Bakir T. M., Tryhorn Y., Sutherland S. Detection of IgM antibodies against cytomegalovirus: comparison of two radioimmunoassays, enzyme-linked immunosorbent assay and immunofluorescent antibody test. J Med Virol. 1984;14(1):73–80. doi: 10.1002/jmv.1890140111. [DOI] [PubMed] [Google Scholar]
  34. Kaufmann S. H. CD8+ T lymphocytes in intracellular microbial infections. Immunol Today. 1988 Jun;9(6):168–174. doi: 10.1016/0167-5699(88)91292-3. [DOI] [PubMed] [Google Scholar]
  35. Knisley C. V., Bednarz-Prashad A. J., Pickering L. K. Detection of rotavirus in stool specimens with monoclonal and polyclonal antibody-based assay systems. J Clin Microbiol. 1986 May;23(5):897–900. doi: 10.1128/jcm.23.5.897-900.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Kohler R. B., Winn W. C., Jr, Wheat L. J. Onset and duration of urinary antigen excretion in Legionnaires disease. J Clin Microbiol. 1984 Oct;20(4):605–607. doi: 10.1128/jcm.20.4.605-607.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. Kraus S. J., Haserick J. R., Lantz M. A. Fluorescent treponemal antibody-absorption test reactions in lupus erythematosus. N Engl J Med. 1970 Jun 4;282(23):1287–1290. doi: 10.1056/NEJM197006042822303. [DOI] [PubMed] [Google Scholar]
  38. Krishna R. V., Meurman O. H., Ziegler T., Krech U. H. Solid-phase enzyme immunoassay for determination of antibodies to cytomegalovirus. J Clin Microbiol. 1980 Jul;12(1):46–51. doi: 10.1128/jcm.12.1.46-51.1980. [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. Kushner I. The phenomenon of the acute phase response. Ann N Y Acad Sci. 1982;389:39–48. doi: 10.1111/j.1749-6632.1982.tb22124.x. [DOI] [PubMed] [Google Scholar]
  40. Köhler G., Milstein C. Continuous cultures of fused cells secreting antibody of predefined specificity. Nature. 1975 Aug 7;256(5517):495–497. doi: 10.1038/256495a0. [DOI] [PubMed] [Google Scholar]
  41. Lyons M. Immune function in spinal cord-injured males. J Neurosci Nurs. 1987 Feb;19(1):18–23. doi: 10.1097/01376517-198702000-00004. [DOI] [PubMed] [Google Scholar]
  42. Magnarelli L. A., Anderson J. F., Johnson R. C. Cross-reactivity in serological tests for Lyme disease and other spirochetal infections. J Infect Dis. 1987 Jul;156(1):183–188. doi: 10.1093/infdis/156.1.183. [DOI] [PubMed] [Google Scholar]
  43. Mahony J. B., Chernesky M. A., Bromberg K., Schachter J. Accuracy of immunoglobulin M immunoassay for diagnosis of chlamydial infections in infants and adults. J Clin Microbiol. 1986 Nov;24(5):731–735. doi: 10.1128/jcm.24.5.731-735.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
  44. Matthews H. M., Yang T. K., Jenkin H. M. Unique lipid composition of Treponema pallidum (Nichols virulent strain). Infect Immun. 1979 Jun;24(3):713–719. doi: 10.1128/iai.24.3.713-719.1979. [DOI] [PMC free article] [PubMed] [Google Scholar]
  45. McCabe R. E., Remington J. S. C-reactive protein in patients with bacteremia. J Clin Microbiol. 1984 Sep;20(3):317–319. doi: 10.1128/jcm.20.3.317-319.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  46. McCartney A. C., Orange G. V., Pringle S. D., Wills G., Reece I. J. Serum C reactive protein in infective endocarditis. J Clin Pathol. 1988 Jan;41(1):44–48. doi: 10.1136/jcp.41.1.44. [DOI] [PMC free article] [PubMed] [Google Scholar]
  47. Michie H. R., Manogue K. R., Spriggs D. R., Revhaug A., O'Dwyer S., Dinarello C. A., Cerami A., Wolff S. M., Wilmore D. W. Detection of circulating tumor necrosis factor after endotoxin administration. N Engl J Med. 1988 Jun 9;318(23):1481–1486. doi: 10.1056/NEJM198806093182301. [DOI] [PubMed] [Google Scholar]
  48. Minamoto G. Y., Gold J. W., Scheinberg D. A., Hardy W. D., Chein N., Zuckerman E., Reich L., Dietz K., Gee T., Hoffer J. Infection with human T-cell leukemia virus type I in patients with leukemia. N Engl J Med. 1988 Jan 28;318(4):219–222. doi: 10.1056/NEJM198801283180405. [DOI] [PubMed] [Google Scholar]
  49. Mold C., Du Clos T. W., Nakayama S., Edwards K. M., Gewurz H. C-reactive protein reactivity with complement and effects on phagocytosis. Ann N Y Acad Sci. 1982;389:251–262. doi: 10.1111/j.1749-6632.1982.tb22141.x. [DOI] [PubMed] [Google Scholar]
  50. Morley J. J., Kushner I. Serum C-reactive protein levels in disease. Ann N Y Acad Sci. 1982;389:406–418. doi: 10.1111/j.1749-6632.1982.tb22153.x. [DOI] [PubMed] [Google Scholar]
  51. Nielsen C. M., Hansen K., Andersen H. M., Gerstoft J., Vestergaard B. F. An enzyme labelled nuclear antigen immunoassay for detection of cytomegalovirus IgM antibodies in human serum: specific and non-specific reactions. J Med Virol. 1987 May;22(1):67–76. doi: 10.1002/jmv.1890220109. [DOI] [PubMed] [Google Scholar]
  52. Okano M., Thiele G. M., Davis J. R., Grierson H. L., Purtilo D. T. Epstein-Barr virus and human diseases: recent advances in diagnosis. Clin Microbiol Rev. 1988 Jul;1(3):300–312. doi: 10.1128/cmr.1.3.300. [DOI] [PMC free article] [PubMed] [Google Scholar]
  53. Peltola H. O. C-reactive protein for rapid monitoring of infections of the central nervous system. Lancet. 1982 May 1;1(8279):980–982. doi: 10.1016/s0140-6736(82)91989-4. [DOI] [PubMed] [Google Scholar]
  54. Pollak R., Barber P. L., Prusak B. F., Mozes M. F. Cytomegalovirus as a risk factor in living-related renal transplantation. A prospective study. Ann Surg. 1987 Mar;205(3):302–304. doi: 10.1097/00000658-198703000-00014. [DOI] [PMC free article] [PubMed] [Google Scholar]
  55. Preissner C. M., Steinberg S. P., Gershon A. A., Smith T. F. Evaluation of the anticomplement immunofluorescence test for detection of antibody to varicella-zoster virus. J Clin Microbiol. 1982 Aug;16(2):373–376. doi: 10.1128/jcm.16.2.373-376.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
  56. Pruneda R. C., Dover J. C. A comparison of two passive agglutination procedures with enzyme-linked immunosorbent assay for rubella antibody status. Am J Clin Pathol. 1986 Dec;86(6):768–770. doi: 10.1093/ajcp/86.6.768. [DOI] [PubMed] [Google Scholar]
  57. Russell H., Sampson J. S., Schmid G. P., Wilkinson H. W., Plikaytis B. Enzyme-linked immunosorbent assay and indirect immunofluorescence assay for Lyme disease. J Infect Dis. 1984 Mar;149(3):465–470. doi: 10.1093/infdis/149.3.465. [DOI] [PubMed] [Google Scholar]
  58. Schmidt N. J., Gallo D., Devlin V., Woodie J. D., Emmons R. W. Direct immunofluorescence staining for detection of herpes simplex and varicella-zoster virus antigens in vesicular lesions and certain tissue specimens. J Clin Microbiol. 1980 Nov;12(5):651–655. doi: 10.1128/jcm.12.5.651-655.1980. [DOI] [PMC free article] [PubMed] [Google Scholar]
  59. Schmidt P. J., Leparc G. F., Samia C. T. Comparison of assays for anti-HBc in blood donors. Transfusion. 1988 Jul-Aug;28(4):389–391. doi: 10.1046/j.1537-2995.1988.28488265275.x. [DOI] [PubMed] [Google Scholar]
  60. Schmutzhard E., Pohl P., Stanek G. Borrelia burgdorferi antibodies in patients with relapsing/remitting form and chronic progressive form of multiple sclerosis. J Neurol Neurosurg Psychiatry. 1988 Sep;51(9):1215–1218. doi: 10.1136/jnnp.51.9.1215. [DOI] [PMC free article] [PubMed] [Google Scholar]
  61. Sissons J. G., Oldstone M. B. Antibody-mediated destruction of virus-infected cells. Adv Immunol. 1980;29:209–260. doi: 10.1016/S0065-2776(08)60045-0. [DOI] [PMC free article] [PubMed] [Google Scholar]
  62. Sissons J. G., Oldstone M. B. Killing of virus-infected cells by cytotoxic lymphocytes. J Infect Dis. 1980 Jul;142(1):114–119. doi: 10.1093/infdis/142.1.114. [DOI] [PubMed] [Google Scholar]
  63. Smith T. F. Mycoplasma pneumoniae infections: diagnosis based on immunofluorescence titer of IgG and IgM antibodies. Mayo Clin Proc. 1986 Oct;61(10):830–831. doi: 10.1016/s0025-6196(12)64825-3. [DOI] [PubMed] [Google Scholar]
  64. Stagno S., Pass R. F., Reynolds D. W., Moore M. A., Nahmias A. J., Alford C. A. Comparative study of diagnostic procedures for congenital cytomegalovirus infection. Pediatrics. 1980 Feb;65(2):251–257. [PubMed] [Google Scholar]
  65. Steere A. C., Grodzicki R. L., Kornblatt A. N., Craft J. E., Barbour A. G., Burgdorfer W., Schmid G. P., Johnson E., Malawista S. E. The spirochetal etiology of Lyme disease. N Engl J Med. 1983 Mar 31;308(13):733–740. doi: 10.1056/NEJM198303313081301. [DOI] [PubMed] [Google Scholar]
  66. Steere A. C., Malawista S. E., Hardin J. A., Ruddy S., Askenase W., Andiman W. A. Erythema chronicum migrans and Lyme arthritis. The enlarging clinical spectrum. Ann Intern Med. 1977 Jun;86(6):685–698. doi: 10.7326/0003-4819-86-6-685. [DOI] [PubMed] [Google Scholar]
  67. Waage A., Halstensen A., Espevik T. Association between tumour necrosis factor in serum and fatal outcome in patients with meningococcal disease. Lancet. 1987 Feb 14;1(8529):355–357. doi: 10.1016/s0140-6736(87)91728-4. [DOI] [PubMed] [Google Scholar]
  68. White J. M., Poupard J. A., Knight R. A., Miller L. A. Evaluation of two commercially available test methods to determine the feasibility of testing for respiratory syncytial virus in a community hospital laboratory. Am J Clin Pathol. 1988 Aug;90(2):175–180. doi: 10.1093/ajcp/90.2.175. [DOI] [PubMed] [Google Scholar]
  69. Yother J., Volanakis J. E., Briles D. E. Human C-reactive protein is protective against fatal Streptococcus pneumoniae infection in mice. J Immunol. 1982 May;128(5):2374–2376. [PubMed] [Google Scholar]
  70. Zimmerman S. E., French M. L., Allen S. D., Wilson E., Kohler R. B. Immunoglobulin M antibody titers in the diagnosis of Legionnaires disease. J Clin Microbiol. 1982 Dec;16(6):1007–1011. doi: 10.1128/jcm.16.6.1007-1011.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Clinical Microbiology Reviews are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES