title: Correlation of antigenic expression with progress in antibiotic therapy of acute human brucellosis.
abstract: Human brucellosis is a zoonotic disease which is endemic in Saudi Arabia. The aim of this study was to investigate the humoral immune responses and identify the target antigens that persist at different stages in human brucellosis during antibiotic therapy. To do this, an acute case of accidental nosocomial infection was studied experimentally. Blood was collected from the patient at the time of diagnosis, and at weekly intervals during therapy until remission. IgG and IgM immunoblotting was used to characterize specific antigenic determinants, and ELISA antibody titration was performed to quantify the circulating antibodies. Results indicated that protein bands of 12-13.5 kDa bound IgG in the patient's sera but did not bind IgM on immunoblots and are probably not specific for, or important in, early stage infections. However, an 18 kDa band persisted during infection through remission. The pivotal and most important findings were that the number of protein bands seen on immunoblots, the magnitude of ELISA antibody titres and the concomitant changes in the intensity of the polypeptide bands of 42-43 kDa were positively correlated with the stage of infection. High numbers of anti-IgG and -IgM immunoblot bands coupled with high ELISA antibody titres and a concomitant increase in intensity of the 42-43 kDa bands were positively correlated with acute and severe infection. Conversely, a reduction in the number of polypeptide bands as well as a decrease in the intensity, until the complete disappearance of the 42-43 kDa bands, coupled with low (baseline) ELISA antibody titration values indicated successful treatment and remission. The routine use of the methods described here to ascertain the stage of the disease, assess the progress of antimicrobial therapy and monitor cases of relapse in human brucellosis is suggested.
authors.affiliation: Department of Comparative Medicine1, Department of Biological and Medical Research2, Department of Pathology and Laboratory Medicine3, Section of Family Medicine and Polyclinics4 and Section of Infectious Diseases5, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
authors.forename: A Aa
authors.initials: AA
authors.lastname: Kwaasi
authors.affiliation: Department of Comparative Medicine1, Department of Biological and Medical Research2, Department of Pathology and Laboratory Medicine3, Section of Family Medicine and Polyclinics4 and Section of Infectious Diseases5, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
authors.forename: F A
authors.initials: FA
authors.lastname: Al-Mohanna
authors.affiliation: Department of Comparative Medicine1, Department of Biological and Medical Research2, Department of Pathology and Laboratory Medicine3, Section of Family Medicine and Polyclinics4 and Section of Infectious Diseases5, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
authors.forename: S M
authors.initials: SM
authors.lastname: Nakeeb
authors.affiliation: Department of Comparative Medicine1, Department of Biological and Medical Research2, Department of Pathology and Laboratory Medicine3, Section of Family Medicine and Polyclinics4 and Section of Infectious Diseases5, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
authors.forename: G T
authors.initials: GT
authors.lastname: Roberts
authors.affiliation: Department of Comparative Medicine1, Department of Biological and Medical Research2, Department of Pathology and Laboratory Medicine3, Section of Family Medicine and Polyclinics4 and Section of Infectious Diseases5, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
authors.forename: S
authors.initials: S
authors.lastname: Al-Thawadi
authors.affiliation: Department of Comparative Medicine1, Department of Biological and Medical Research2, Department of Pathology and Laboratory Medicine3, Section of Family Medicine and Polyclinics4 and Section of Infectious Diseases5, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
authors.forename: A Y
authors.initials: AY
authors.lastname: Hassan
authors.affiliation: Department of Comparative Medicine1, Department of Biological and Medical Research2, Department of Pathology and Laboratory Medicine3, Section of Family Medicine and Polyclinics4 and Section of Infectious Diseases5, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
authors.forename: A
authors.initials: A
authors.lastname: Al-Hokail
authors.affiliation: Department of Comparative Medicine1, Department of Biological and Medical Research2, Department of Pathology and Laboratory Medicine3, Section of Family Medicine and Polyclinics4 and Section of Infectious Diseases5, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
authors.forename: M G
authors.initials: MG
authors.lastname: Elfaki
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D000907:Antibodies, Bacterial / Q000097:blood*; D000942:Antigens, Bacterial / Q000737:chemistry / Q000276:immunology* / Q000302:isolation & purification; D001426:Bacterial Proteins / Q000737:chemistry / Q000276:immunology / Q000302:isolation & purification; D017347:Brucella melitensis / Q000187:drug effects / Q000276:immunology* / Q000302:isolation & purification; D002006:Brucellosis / Q000097:blood / Q000188:drug therapy / Q000276:immunology*; D003428:Cross Infection; D004591:Electrophoresis, Polyacrylamide Gel; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D015151:Immunoblotting; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008970:Molecular Weight
chemical_list: D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D007074:Immunoglobulin G; D007075:Immunoglobulin M