Olli Meurman

Chlamydial serology in infertile women by immunofluorescence.

The chlamydial serum immunoglobulin G antibodies of 128 infertile women were determined by a single-antigen (L2) immunofluorescence test. The antibody titers were compared with those of female contacts of men with nonspecific urethritis and with those of normal pregnant women. Among infertile women, 43% lacked chlamydial antibodies (titer less than or equal to 8). The corresponding proportion for contacts of men with nonspecific urethritis was 14% and that for pregnant women 71%. A very high titer (greater than or equal to 256) was recorded in 25 infertile women and in 7% of pregnant women. Among women with positive chlamydial isolation, 46% had titers greater than or equal to 256. Bilateral tubal obstruction was demonstrated in 23 infertile women (18%). The geometric mean titer of these patients was higher than that of patients with normal hysterosalpingograms. In nine cases with bilateral tubal obstruction and very high chlamydial antibody titers, there was no history of pelvis infections. The operative findings were typical of previous salpingo-oophoritis.

C-reactive protein in respiratory virus infections

Les recherches effectuees chez 176 enfants atteints de diverses infections virales ont mis en evidence des taux de CRP superieurs a 40 mg/l et une leucocytose superieure a 15×10 9 /l dans la plupart des infections a adenovirus tandis que dans la plupart des infections a virus grippal, parainfluenza ou syncytial respiratoire, la CRP etait <40 mg/l et la leucocytose < a 15×10 9 /l, ce qui est typique des maladies virales et les oppose classiquement aux infections bacteriennes ou le taux serique de CRP est notablement eleve

Detection of Viral Antigens by Time-Resolved Fluoroimmunoassay

Highly sensitive immunoassays have proved to be valuable in the diagnosis of viral infections because viral antigens can be directly detected in clinical specimens by these assays. This technology was first widely used in the radioimmunoassay of hepatitis B surface antigen in serum (Ling and Overby 1972) and later applied to the detection of gastroenteritis viruses in stool (Halonen and Meurman 1982). Our group has also developed assays for the detection of seven respiratory viruses in nasopharyngeal secretions (Sarkkinen et al. 1981a-c), and these assays have now been successfully applied on a routine basis in our diagnostic laboratory. Immuno-assays are now widely used in the detection of antiviral antibodies and particularly in the assay of IgM antibodies.

Detection of Antiviral IgM Antibodies and its Problems — A Review

The presence of antibody activity in various serum immunoglobulin fractions was discovered as early as the 1930s (Heidelberger and Pedersen 1937; Kabat 1939), but it took another 20 years before the specific characteristics of antibodies having different molecular weights were recognized (Stelos 1958). Subsequent studies conducted in experimental animals and in man using various antigens, including viruses, indicated that the first immunoglobulins which appear after a primary antigenic stimulus are of the IgM class. These then disappear rapidly, usually within a few weeks, and are replaced by IgG antibodies that persist for a longer period. IgG is also the predominant antibody class in secondary immune responses (Bauer and Stavitsky 1961; Uhr and Finkelstein 1963; Svehag and Mandel 1964). The precedence of IgM antibodies observed in these early studies was later criticized as being a methodological error (Osler 1978), and in some more recent studies IgM and IgG (and IgA) antibodies have been shown to appear almost simultaneously but with individual variation (Cradock-Watson et al. 1979a; Halonen et al. 1979a).

C-reactive protein in the differentiation of adenoviral, Epstein-Barr viral and streptococcal tonsillitis in children

Sixty-two children with febrile exudative tonsillitis were studied to explore whether quantitative measurements of serum C-reactive protein (CRP) are useful in differentiating viral from streptococcal tonsillitis. There were 23 cases of adenoviral tonsillitis, 21 of EB viral tonsillitis and 18 of streptococcal tonsillitis. Measurements of CRP, WBC counts and erythrocyte sedimentation rates (ESR) were not useful in distinguishing viral from streptococcal tonsillitis. Seventy-four percent of patients with adenoviral tonsillitis were under the age of 3 years and 71% of the patients with Epstein-Barr (EB) viral tonsillitis were under the age of 6 years whereas 72% of the patients with streptococcal tonsillitis were over the age of 6 years. Age was clearly the most important factor in distinguishing between viral and bacterial tonsillitis in children.

The Significance of Chlamydial Genital Infection in Male Infertility

Chlamydia trachomatis (C.tr.) is recognized as an aetiological agent in most cases of male nonspecific urethritis, post-gonococcal urethritis, and epididymitis. According to the recent view, C.tr. is considered capable of causing infertility in women, but up to date the significance of C.tr. in male infertility is unknown. According to our study, chlamydial genital infection seems to play a role in male infertility, but in lesser degree than in females. Male chlamydial infection seems to be less intense and more distal than female infection. The infection is apparently often quite symptomless. The incidence of genital chlamydial infection in male population evidently increases with age and promiscuity at least from the age of 20 to 30 years.

Influenza A and B virus IgG and IgM serology by enzyme immunoassays.

Enzyme immunoassays (EIA) for IgG and IgM antibodies against influenza A and B virus are described. One hundred and seven subjects with a clinical diagnosis of acute respiratory infection (influenza, bronchitis or pneumonia) were selected for this study during two epidemics of influenza A which occurred in Finland in 1983 and 1985. Paired sera and nasopharyngeal secretions were obtained from all subjects. The sera were tested for influenza A and B antibodies by IgG and IgM EIAs and by complement fixation tests. The nasopharyngeal secretions were tested by an indirect EIA for influenza A and B antigens. The IgG EIA was found to be better than complement fixation for the diagnosis of influenza A infections: only 22% of the significant increases detected by this test were also positive by complement fixation. The additional contribution of the IgM EIA to the number of positives was minimal. It was also found that testing a single 1/1000 dilution of serum for influenza A and 1/100 dilution for influenza B in the IgG EIA gave as many positives as the conventional method of testing several dilutions.

Local IgA-class antibodies against respiratory viruses in middle ear and nasopharyngeal secretions of children with secretory otitis media.

The presence of antibodies against some important respiratory viruses in the middle ear and nasopharyngeal secretions of 52 children with secretory otitis media (SOM) was investigated in order to find out about the role of these viruses in the development of SOM.The method employed was a sensitive radioimmunoassay test.

Enzyme immunoassays for detection of IgG and IgM antibodies to parainfluenza types 1, 2 and 3

Quantitative enzyme immunoassays for parainfluenza type 1, 2 and 3 IgG antibodies were developed. Serum specimens were tested at a single dilution of 1:1000 and results expressed in units by the use of a standard curve. The unit values correlated well with titres obtained by testing the same specimens in serial dilutions. All serum pairs with significant titre rises also showed significant rises in unit values. Parainfluenza IgG and IgM serology was evaluated in 66 patients with a proven parainfluenza infection. Diagnostic IgG antibody increases were detected in 70, 69 and 87% of parainfluenza type 1, 2 and 3 infections, respectively. Heterologous titre rises between parainfluenza types 1 and 3 were common. IgM antibodies were detected in 42% of the patients, most commonly in those below two years of age and rarely in adults.

Polyclonal activation of B cells during rubella infection

Intensive spontaneous production of IgG by peripheral blood lymphocytes in vitro is detected at the onset of rash in patients with rubella virus infection. The IgG synthesized consists not only of antibodies against rvihella virus specific antigens bul also of antibodies to unrelated viruses.