title: Anti-Toxoplasma gondii secretory IgA in tears of patients with ocular toxoplasmosis: immunodiagnostic validation by ELISA.
abstract: Toxoplasma gondii causes posterior uveitis and the specific diagnosis is based on clinical criteria. The presence of anti-T. gondii secretory IgA (sIgA) antibodies in patients' tears has been reported and an association was found between ocular toxoplasmosis and the anti-T. gondii sIgA isotype in Brazilian patients. The purpose of this study was to provide an objective validation of the published ELISA test for determining the presence of anti-T. gondii sIgA in the tears of individuals with ocular toxoplasmosis. Tears from 156 patients with active posterior uveitis were analysed; 82 of them presented characteristics of ocular toxoplasmosis (standard lesion) and 74 patients presented uveitis due to other aetiologies. Cases of active posterior uveitis were considered standard when a new inflammatory focus satellite to old retinochoroidal scars was observed. The determination of anti-T. gondii sIgA was made using an ELISA test with crude tachyzoite antigenic extracts. Tears were collected without previous stimulation. Detection of sIgA showed 65.9% sensitivity (95% CI = 54.5-74.4), 71.6% specificity (95% CI = 59.8-81.2), a positive predictive value of 72% (95% CI = 60.3-81.5) and a negative predictive value of 65.4% (95% CI = 54.0-75.4). sIgA reactivity was higher in the tears of patients with active posterior uveitis due to T. gondii (p < 0.05). The test is useful for differentiating active posterior uveitis due to toxoplasmosis from uveitis caused by other diseases.
authors.affiliation: Centro de Ciências da Saúde, Brasil. malynch@nlink.com.br
authors.forename: Maria Isabel
authors.initials: MI
authors.lastname: Lynch
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Malagueño
authors.forename: Luiz Felipe
authors.initials: LF
authors.lastname: Lynch
authors.forename: Silvana
authors.initials: S
authors.lastname: Ferreira
authors.forename: Raphael
authors.initials: R
authors.lastname: Stheling
authors.forename: Fernando
authors.initials: F
authors.lastname: Oréfice
mesh_terms: D000293:Adolescent; D000328:Adult; D000913:Antibodies, Protozoan / Q000032:analysis; D002648:Child; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007071:Immunoglobulin A, Secretory / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013666:Tears / Q000276:immunology* / Q000469:parasitology; D014122:Toxoplasma / Q000276:immunology*; D014126:Toxoplasmosis, Ocular / Q000175:diagnosis*; D015866:Uveitis, Posterior / Q000469:parasitology*; D055815:Young Adult
chemical_list: D000913:Antibodies, Protozoan; D007071:Immunoglobulin A, Secretory