Secretory IgM and IgA antibodies to respiratory syncytial virus in nasopharyngeal aspirates: a diagnostic supplement to antigen detection

• Published in: Clinical and diagnostic virology 1997-11, Vol.8 (3), p.219-226
• Main Authors: Jensen, Inge Panum, Thisted, Ebbe, Glikmann, Graciela, Obel, Niels, Kofoed, Poul-Erik, Sambo, Manuel, Valerius, Niels H., Mordhorst, Carl-Heinrich
• Format: Article
• Language: English
• Subjects: Antibodies, Viral - analysis; Antibodies, Viral - immunology; Antigens, Viral - analysis; ELISA; Enzyme-Linked Immunosorbent Assay - methods; Evaluation Studies as Topic; Humans; IgA; IgM; Immunoglobulin A, Secretory - analysis; Immunoglobulin A, Secretory - immunology; Immunoglobulin M - analysis; Immunoglobulin M - immunology; Infant; Infant, Newborn; Nasopharyngeal aspirates antibodies; Nasopharyngeal Diseases - diagnosis; Nasopharyngeal Diseases - virology; Respiratory Syncytial Virus Infections - diagnosis; Respiratory Syncytial Virus Infections - immunology; Respiratory Syncytial Virus Infections - pathology; Respiratory Syncytial Virus, Human - immunology; RSV
• ISSN: 0928-0197; 1873-4901
• DOI: 10.1016/S0928-0197(97)10002-2

Background: RSV-shedding during an RSV-infection declines dramatically after the first week of infection. It could be of interest to be able to diagnose RSV-infection for a longer period of time by detection of specific RSV-IgM and RSV-IgA in nasopharyngeal aspirates (NPA) in order to minimize unnecessary antibiotics. Objectives: To evaluate an ELISA to detect specific RSV-IgM and RSV-IgA in NPA as a supplement to RSV-antigen detection. Study design: A total of 104 NPA from 101 children (median age 9 months) with acute respiratory disease (group 1) admitted to hospital and consecutive NPA (collected on day 0, 7, 14, 30 and 60) from 11 children (median age 3 months) with a proven RSV infection (group 2) were collected. All NPA from group 1 were analysed for RSV-antigen, RSV-IgM and RSV-IgA. NPA from group 2 were analysed for RSV-IgM and RSV-IgA. Results: Thirty-five NPA in group 1 were positive for RSV-antigen and 64 were positive for RSV-IgM. When ‘true’ RSV infection was defined by the detection of RSV-antigen and/or RSV-IgM the RSV-antigen test alone found 44% and the RSV-IgM test alone found 80%. In group 2 8 11 (73%) had an excellent RSV-IgM response day 7, the rest responded later. Only 5 11 (46%) had a less pronounced RSV-IgA response on day 7, three cases responded later and three did not respond at all. RSV-IgM disappeared in 8 11 (73%) and RSV-IgA in 7 8 (88%) between day 30–60. Conclusions: Specific RSV-IgM is a valuable supplement to RSV-antigen detection for the diagnosis of acute and recent RSV infection.