Evaluation of hemagglutinin protein-specific immunoglobulin M for diagnosis of measles by an enzyme-linked immunosorbent assay based on recombinant protein produced in a high-efficiency mammalian expression system.
Recombinant hemagglutinin (H) of the measles virus (MV) expressed in a mammalian high-expression system based on the Semliki Forest virus replicon was used in an enzyme-linked immunosorbent assay (ELISA) for the detection of specific immunoglobulin M (IgM) and IgG in patients with acute-phase measles. One hundred twelve serum specimens from 70 patients with measles were analyzed. Case definition was based on a commercial IgM ELISA that utilizes MV-infected cells (MV-ELISA) (Enzygnost; Behring Diagnostics); the clinical criteria of the Centers for Disease Control and Prevention (Atlanta, Ga.); and/or the increase in hemagglutinin test titers, neutralization test titers, and levels of MV-specific IgG whenever paired sera were available. The initial time courses of the IgM signal after the onset of rash are similar in the H- and MV-ELISAs. On days 0 to 19, both ELISAs detected IgM in 67 of 68 (98.5%) sera. Average maximal levels of IgM seem to persist, however, about 10 days longer in the MV-ELISA (up to day 25) than in the H-ELISA (day 15). From days 20 to 29 and 30 to 59, the H-ELISA detected only 64.3 (9 of 14) and 19.2% (5 of 26), respectively, of sera that were IgM positive by MV-ELISA. At least up to day 30, the performance of the H-ELISA seemed to be similar to that reported for commercial ELISAs based on whole MV. Our results demonstrate that MV H-specific IgM can be used to diagnose most measles cases from a single serum specimen collected within 19 days after the onset of rash and that the recombinant protein used in this study is suitable for this purpose.
Bouche
F B
FB
Laboratoire National de Santé, L-1011 Luxembourg, Luxembourg.
Brons
N H
NH
Houard
S
S
Schneider
F
F
Muller
C P
CP
D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D006389:Hemagglutinins, Viral / Q000276:immunology*; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood*; D007223:Infant; D008457:Measles / Q000175:diagnosis*; D008459:Measles virus / Q000276:immunology*; D011994:Recombinant Proteins / Q000276:immunology
D000914:Antibodies, Viral; D006389:Hemagglutinins, Viral; D007075:Immunoglobulin M; D011994:Recombinant Proteins