用重组汉坦病毒NP、GP检测急性期HFRS患者血清中特异性IgG、IgM、IgA抗体

Using recombinant antigens of Hantavirus to study the kinetics of serum IgA, IgG, IgM antibodies in the acute-phase of hemorrhagic fever renal syndrome

目的 探讨肾综合征出血热 (HFRS)患者急性期IgA、IgG、IgM抗体的变化规律。方法 使用套式RT PCR检测此次病毒感染情况。用杆状病毒表达的汉坦病毒重组核蛋白 (rNP)和糖蛋白(rGP)为抗原 ,使用ELISA方法检测了 14例急性期肾综合征出血热患者的 6 1份系列血清中的IgA、IgG、IgM抗体。结果 14例肾综合征出血热患者中 ,11例患者的血清用RT PCR检出家鼠型汉坦病毒核酸。几乎所有肾综合征出血热患者早期即有IgA、IgM、IgG抗体的迅速升高 ,抗rNP抗体滴度明显高于rGP。 3种抗rNP抗体中早期IgG上升趋势最为显著 ,IgM与IgA次之 ,IgM与IgA上升趋势相近 ,但IgA的滴度明显高于IgM。抗rGP抗体中IgA变化最显著 ,IgG次之。IgM发病 2周内总的变化趋势不明显 ,但是发病 1周内滴度上升趋势明显 ,而发病第 2周内则呈下降趋势。其中 1例RT PCR阳性的患者 ,早期IgM未测出 ,IgA的滴度却较高。 1例重度患者 ,抗糖蛋白IgG、IgM和IgA抗体滴度均低于其他患者 ,且整个急性期一直维持较低水平。结论 肾综合征出血热急性期IgA、IgG、IgM变化具有明显的规律 ,抗糖蛋白和核蛋白抗体病患规律不同 ,检测IgM的同时检测IgA 。

Objective To observe the features of serum specific IgA, IgG, IgM antibodies in the acute phase of hemorrhagic fever renal syndrome (HFRS). Methods The nucleocapsid (NP) protein and glycproteins (GP) of Hantavirus were expressed by recombinant baculovirus, and used as ELISA antigens to test 61 serial sera of 14 acute phase HFRS patients. Results Seoul like virus RNA were detected from 11 of 14 patients. An early and strong IgA, IgG and IgM antibody response to recombinant NP (rNP) was observed in almost all HFRS cases. The titers of antibody to rNP was apparently higher than that to rGP. In the early stage, titer of IgG antibody elevated most drastically among all the three classes of antibodies to rNP, followed by IgM and IgA antibody responses. The elevation trend of IgM and IgA antibodies to rNP stayed nearly at the same level, but the IgA titers to rNP were apparently higher than that of IgM. Among the antibodies to rGP, IgA changed distinctly greater than IgG. The elevation trend of IgM could be found during first week after the onset, and the titers dropped gradually after the second week. IgM antibodies of one case who was viral RNA positive were not detected at early stage, but IgA titers were high. The only severe case of the 14 patients kept the lower IgA, IgG and IgM during the whole acute phase. Conclusion HFRS patients kept an early and strong humoral response to NP and GPs in acute phase of HFRS. IgA could be used together with IgM to improve the diagnostic accuracy.