A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the degree of Master of Dentistry. Johannesburg, 2018. / Background: Accurate HIV diagnosis is critical and can be life-saving. A Rapid Test (RT) is considered key to HIV prevention and management. Some studies have found RT to be comparable with ELISA whilst others have reported on lower sensitivity. Aim and study design: The aim of this retrospective comparative descriptive study was to evaluate the sensitivity and specificity of the Tri-line HIV rapid test device in comparison to ELISA on patient records from Wits Oral Health Centre (WOHC) between 2014 and 2016 Method: The study population comprised records of patients older than18 months who had Tri-Line HIV RT and blood drawn for ELISA on the same day. Descriptive analysis of the data was carried out. Results: The sensitivity of Tri-line was 80% (CI: 59-93%) and specificity was 100% (CI: 83-100%). The PPV was 100% (CI: 83-100%) and NPV was 80% (CI: 65-90%). ROC area of 0.9 at 95% CI was determined. Conclusion: Due to a low sample size in this study a definitive conclusion could not be drawn. However on the basis of the results obtained, although the tri-line RT showed lower sensitivity it was shown to be a clinically useful test. / LG2018

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[ES] El objetivo de la presente tesis doctoral es el estudio, desarrollo y validación de diferentes métodos inmunoquímicos que permitan determinar contaminantes químicos en alimentos de origen vegetal y en agua, de manera que contribuyan a mejorar su calidad y por ende la seguridad del consumidor. Spirotetramat es un plaguicida de nueva generación altamente eficiente, comercializado mundialmente para su uso como insecticida en multitud de cultivos agrícolas. Tiene propiedades sistémicas, ya que después de la absorción se transloca tanto a través del xilema como del floema, gracias a que es transformado por la planta en spirotetramat-enol, mucho más polar. En consecuencia, la definición de residuo de este insecticida en alimentos de origen vegetal para fines analíticos incluye también dicho metabolito. Por otro lado, anatoxina-a es un alcaloide secundario con neurotoxicidad aguda que se pueden encontrar en agua dulce. Esta toxina es producida por siete géneros diferentes de cianobacterias, y se ha detectado en lagos y otras fuentes de agua de todos los continentes. El análisis de sustancias como spirotetramat y anatoxina-a se lleva a cabo actualmente mediante métodos cromatográficos como HPLC-MS. Estas técnicas presentan una elevada sensibilidad y fiabilidad; sin embargo, requieren personal altamente cualificado y un equipamiento caro y no portable. Una opción complementaria son los métodos inmunoquímicos, como el ELISA (Enzyme-Linked ImmunoSorbent Assay) o el inmunoensayo de flujo lateral (LFIA, Lateral Flow ImmunoAssay), ya que son métodos de análisis rápidos y económicos, y además son muy versátiles permitiendo adaptarlos a necesidades analíticas particulares, como los ensayos de cribado de numerosas muestras o los ensayos portátiles con lectura visual de los resultados. A partir de una colección de bioconjugados y de anticuerpos de spirotetramat y de anatoxina-a se caracterizó la afinidad y especificidad de los inmunorreactivos con el fin de seleccionar parejas conjugado/anticuerpo aptas para el desarrollo de inmunoensayos tipo ELISA y LFIA competitivos. Se optimizaron las condiciones de ensayo, y se llevó a cabo un estudio de la influencia de diferentes factores fisicoquímicos sobre los parámetros analíticos de los ensayos seleccionados. Posteriormente se evaluó la influencia de la matriz alimentaria, particularmente uva, zumo de uva y vino, así como de aguas de diferente procedencia, sobre la señal y la sensibilidad de los inmunoensayos. La diferente afinidad de los anticuerpos hacia spirotetramat y spirotetramat-enol nos llevó a optimizar el tratamiento de muestra, incluyendo una etapa de hidrólisis para transformar spirotetramat en spirotetramat-enol de manera controlada, rápida y cuantitativa. De este modo se hizo posible aportar resultados en forma de suma de la concentración de ambos compuestos en la muestra, tal y como exige la legislación vigente. Además, para la extracción de residuos de este insecticida a partir de muestras de uva se puso a punto un procedimiento empleando la tecnología QuEChERS, y para la reducción de interferencias de vinos y zumos se utilizó polivinilpolipirrolidona. En el caso de las aguas, se aplicó una simple filtración para eliminar partículas en suspensión. Los inmunoensayos enzimáticos en microplaca optimizados para determinar de manera competitiva residuos de spirotetramat presentaron valores de IC50 para spirotetramat-enol en torno a 0.1 ng/mL, y límites de detección alrededor de 0.02 ng/mL. El estudio de la precisión y exactitud del método empleando muestras de alimentos dopados reflejó límites de cuantificación de 2.5 ng/mL para uva, zumos de uva y vinos, tanto blancos como tintos, muy por debajo de los límites máximos de residuos autorizados en la Unión Europea para este insecticida en dichos alimentos. / [EN] The aim of this doctoral thesis is the study, development and validation of different immunochemical methods for determining chemical contaminants in produce and water, in a way that they may contribute to improving food quality and therefore to assure consumer safety. Spirotetramat is a highly efficient new-generation pesticide, marketed worldwide for use as insecticide in many agricultural crops. It has systemic properties, since short after absorption it translocates through both the xylem and the phloem, thanks to the fact that it is transformed by the plant into the much more polar spirotetramat-enol. Consequently, the residue definition for this insecticide in foods of plant origin with analytical purposes also includes said metabolite. On the other hand, anatoxin-a is a secondary alkaloid with acute neurotoxicity that can be found in fresh water. This toxin is produced by seven different genera of cyanobacteria, and has been detected in lakes and other water resources on all continents. The analysis of substances like spirotetramat and anatoxin-a is currently carried out by chromatographic methods like HPLC-MS. These techniques are highly sensitive and reliable; however, they require highly qualified personnel and expensive, non-portable equipment. Nowadays, the immunochemical methods, such as the ELISA (Enzyme-Linked ImmunoSorbent Assay) or the LFIA (Lateral Flow ImmunoAssay), constitute excellent complementary analytical options to instrumental strategies, since they are fast and inexpensive analytical methods, and are also very versatile so they can be adapted to particular analytical needs, such as screening assays for large numbers of samples or portable tests with visual reading of the results. The antibody affinity and specificity from a collection of spirotetramat and anatoxin-a immunoreagents was characterized in order to select conjugate/antibody pairs suitable for the development of competitive ELISA and LFIA tests. The assay conditions were optimized, and a study of the influence of different physicochemical factors over the analytical parameters of the selected immunoassays was carried out. Subsequently, the influence of the food matrix, particularly grape, grape juice and wine, as well as water from different sources, over the assay signal and sensitivity was evaluated. The different affinity of the available antibodies towards spirotetramat and spirotetramat-enol led us to optimize the sample treatment procedure, so a hydrolysis step to transform spirotetramat into spirotetramat-enol in a controlled, rapid and quantitative way, was included. Thus, it was possible to provide results in the form of the sum of the concentration of both compounds in the sample, as required by current legislation. In addition, a procedure using QuEChERS technology was developed to extract residues of this insecticide from grape samples, and polyvinylpolypyrrolidone was used to reduce interferences from wines and juices. In the case of waters, a simple filtration was applied to remove suspended particles. Microplate enzyme immunoassays that were optimized to competitively determine spirotetramat residues showed IC50 values for spirotetramat-enol around 0.1 ng/mL, and limits of detection around 0.02 ng/mL. Precision and accuracy studies with these immunoassays using fortified food samples reflected limits of quantification of 2.5 ng/mL for grapes, grape juices and wines, both white and red, well below the maximum residue limits authorized by the European Union for this insecticide in such foodstuffs. Finally, a comparative study with HPLC-MS/MS validated the studied immunoassay for analyzing spirotetramat residues in grape samples within a wide range of concentrations. / [CA] L’objectiu de la present tesi doctoral és l’estudi, desenvolupament i validació de diferents mètodes immunoquímics que permeten determinar contaminants químics en aliments d’origen vegetal i en aigua, de manera que contribuïsquen a millorar la seua qualitat i per tant la seguretat dels consumidors. Spirotetramat és un plaguicida de nova generació altament eficient, comercialitzat mundialment per a l’ús com insecticida en multitud de cultius agrícoles. Té propietats sistèmiques, ja que en ser absorbit es transloca tant a través del xilema com del floema, gràcies a que és transformat per la planta en spirotetramat-enol, molt més polar. Conseqüentment, la definició de residu d’aquest insecticida en aliments d’origen vegetal amb finalitats analítiques inclou també l’esmentat metabòlit. D’una altra banda, anatoxina-a és un alcaloide secundari amb neurotoxicitat aguda que es pot trobar en aigua dolça. Aquesta toxina és produïda per set gèneres de cianobacteris diferents, i s’ha detectat en llacs i altres fonts d’aigua de tots els continents. L’anàlisi de substàncies com spirotetramat i anatoxina-a es duu a terme actualment mitjançant mètodes cromatogràfics, com HPLC-MS. Aquestes tècniques presenten una elevada sensibilitat i fiabilitat; tanmateix, requereixen personal altament qualificat i un equipament car i no portable. Una opció complementària són els mètodes immunoquímics, com l’ELISA (Enzyme-Linked ImmunoSorbent Assay) o l’immunoassaig de flux lateral (LFIA, Lateral Flow Immunoassay), ja que són mètodes d’anàlisi ràpids i econòmics, i a més són molt versàtils, la qual cosa permet adaptar-los a necessitats analítiques particulars, com són els assaigs per destriar nombroses mostres o els assaigs portàtils amb lectura visual dels resultats. A partir d’una col·lecció de bioconjugats i d’anticossos de spirotetramat i d’anatoxina-a es va caracteritzar l’afinitat i especificitat dels immunorreactius amb la finalitat de seleccionar parelles conjugat/anticòs aptes per desenvolupar immunoassaigs tipus ELISA i LFIA competitius. S’optimitzaren les condicions d’assaig, i es va dur a terme un estudi de la influència de diferents factors fisicoquímics sobre els paràmetres analítics dels assaigs seleccionats. Posteriorment, es va avaluar la influència de la matriu alimentària, particularment raïm, suc de raïm i vi, així com d’aigües de diferent procedència, sobre el senyal i la sensibilitat dels assaigs. La diferent afinitat dels anticossos cap a spirotetramat i spirotetramat-enol ens va dur a optimitzar el tractament de mostra mitjançant la inclusió d’una etapa d’hidròlisi per transformar spirotetramat en spirotetramat-enol de manera ràpida, controlada i quantitativa. D’aquesta manera es va fer possible aportar resultats en forma de suma de la concentració d’ambdós composts en la mostra, tal i com exigeix la legislació vigent. A més a més, per extraure residus d’aquest insecticida a partir de mostres de raïm es va posar a punt un procediment emprant la tecnologia QuEChERS, i per reduir interferències de vins i sucs es va utilitzar polivinilpolipirrolidona. En el cas de les aigües, es va aplicar una simple filtració per eliminar partícules en suspensió. Els immunoassaigs enzimàtics en microplaca optimitzats per determinar de manera competitiva residus de spirotetramat presentaren valors d’IC50 per spirotetramat-enol al voltant de 0.1 ng/mL, i límits de detecció propers a 0.02 ng/mL. L’estudi de la precisió i exactitud del mètode emprant mostres d’aliments dopats va reflectir límits de quantificació de 2.5 ng/mL per raïm, sucs de raïm i vins, tant blancs com negres, molt per sota dels límits màxims de residus autoritzats per la Unió Europea per a aquest insecticida en els esmentats aliments. Finalment, un estudi comparatiu amb HPLC-MS/MS va validar l’immunoassaig estudiat per analitzar residus de spirotetramat en mostres de raïm en un ampli rang de concentracions. En el cas d’anatoxina-a, es van optimitzar dos immunoassaigs tipus ELISA competitiu, els valors d’IC50 dels quals van estar entre 0.5 i 1.0 ng/mL, amb límits de detecció per davall de 0.1 ng/mL. L’anàlisi de diferents tipus d’aigües fortificades amb anatoxina-a ens va revelar que els immunoassaigs desenvolupats permeten quantificar aquesta cianotoxina entre 0.5 i 500 ng/mL. Addicionalment es van optimitzar i caracteritzar assaigs immunocromatogràfics, tipus tires reactives, tant per spirotetramat com per anatoxina-a, vàlids com a tècniques portables i ràpides per determinar semi-quantitativament aquestes substàncies tòxiques en vi i aigües, respectivament. Seguint la normativa europea per a mètodes ràpids front a petites molècules orgàniques, es va determinar el senyal indicatiu del llindar per distingir les mostres positives, que superen la concentració de destriament establerta, de les negatives. En el cas de spirotetramat, el mètode desenvolupat permet el triatge, tant instrumental com visual, amb un interval de confiança del 99%, de mostres de vi amb una concentració de residu de 1000 ng/mL, equivalent al límit màxim de residus, expressada como la suma de spirotetramat més spirotetramat-enol. Per anatoxina-a, les tires immunocromatográfiques desenvolupades van poder detectar mostres d’aigua amb 2 ng/mL de l’esmentada cianotoxina amb una fiabilitat del 99%, i mostres amb 1 ng/mL amb una probabilitat del 40%, mentre que el límit de detecció visual va ser de 3 ng/mL. / A la Secretaría Nacional de Educación Superior, Ciencia, Tecnología e Innovación (SENESCYT), del gobierno de la República de Ecuador que al adjudicarme la beca bajo el “PROGRAMA DE BECAS PARA DOCTORADO (PHD) PARA DOCENTES DE UNIVERSIDADES Y DE ESCUELAS POLITÉCNICAS 2015”, permitió formarme como persona y profesional en mis estudios de doctorado. / Cevallos Cedeño, RE. (2020). Desarrollo de métodos inmunoquímicos para la determinación de sustancias tóxicas en alimentos y aguas [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/149570

Background: In recent years, several new ELISAs for the detection of antibodies against the porcine reproductive and respiratory disease virus (PRRSV) in pig serum have been developed. To interpret the results, specificity and sensitivity data as well as agreement to a reference ELISA must be available. In this study, three commercial ELISAs (INgezim PRRS 2.0 - ELISA II, Priocheck® PRRSV Ab porcine – ELISA III and CIVTEST suis PRRS E/S PLUS - ELISA IV, detecting PRRSV type 1 antibodies) were compared to a standard ELISA (IDEXX PRRS X3 Ab Test - ELISA I). The serum of three pigs vaccinated with an attenuated PRRSV live vaccine (genotype 2) was tested prior to and several times after the vaccination. Furthermore, serum samples of 245 pigs of PRRSV positive herds, 309 pigs of monitored PRRSV negative herds, 256 fatteners of assumed PRRSV negative herds with unknown herd history and 92 wild boars were tested with all four ELISAs. Results: ELISAs II and III were able to detect seroconversion of vaccinated pigs with a similar reliability. According to kappa coefficient, the results showed an almost perfect agreement between ELISA I as reference and ELISA II and III (kappa > 0.8), and substantial agreement between ELISA I and ELISA IV (kappa = 0.71). Sensitivity of ELISA II, III and IV was 96.0%, 100% and 91.5%, respectively. The specificity of the ELISAs determined in samples of monitored PRRSV negative herds was 99.0%, 95.1% and 96.4%, respectively. In assumed negative farms that were not continually monitored, more positive samples were found with ELISA II to IV. The reference ELISA I had a specificity of 100% in this study. Conclusions: All tested ELISAs were able to detect a PRRSV positive herd. The specificity and sensitivity of the tested commercial ELISAs, however, differed. ELISA II had the highest specificity an ELISA III had the highest sensitivity in comparison to the reference ELISA. ELISA IV had a lower sensitivity and specificity than the other ELISAs.

The detection by serology of nematode-transmitted polyhedral viruses (nepoviruses) in grapevines is often unreliable. Nepoviruses were detected by enzyme-linked immunosorbent assay (ELISA) in tissue-cultured and field-grown grapevines. Nepovirus detection in in vitro plants (plantlets) was affected by virus distribution and growth room temperature. The reliability of virus detection in field-grown grapevines was improved when modified grinding buffers were used. Arabis mosaic virus (AMV) was detected by ELISA, for the first time, in in vitro grapevines initiated from field-and screenhouse-grown plants throughout the summer. The virus was not reliably and repeatedly detected in in vitro plantlets grown at 25°C. AMV and grapevine fanleaf virus (GFLV) distribution was not uniform throughout the plantlets. This distribution was affected by the culture room temperature. The best plant parts to sample for virus detection came from the zones of rapidly proliferating shoots. The viruses were sometimes not detected in samples taken from other tissues. Growth room temperature had an important effect on virus detection in plantlets. The highest virus titres were found in plants growing at 15°C. Temperature increases in 5°C steps to 30°C reduced virus titre. AMV became undetectable in nearly all plantlets growing at 30°C for as little as 30 days. Growth at 30°C reduced ELISA absorbance values by 76% after 8 days and after 21 days the values were at 4% of pre-treatment levels. The virus titre dropped below detectable levels in most plantlets. AMV could not be detected in plantlets or rooted explants after being placed in a 30°C treatment for 2 months. Tomato ringspot virus was detected by ELISA, for the first time, in in vitro grapevine plants. The virus was repeatedly detected in in vitro plants growing at 20°C. Under the typical summer conditions experienced at Sidney, B.C., modifying the standard ELISA grinding buffer (0.01 M phosphate buffered saline, pH 7.4, 0.05% Tween-20, 0.2% ovalbumin, 2% polyvinylpyrrolidone) was essential for reliable detection of AMV or GFLV. AMV was reliably detected by ELISA in foliar samples from field or screenhouse plants throughout the summer when the grinding buffer was modified by increasing the pH to at least 8.2 and adding 1% nicotine or 0.15 M phosphate buffered saline. The most reliable results with GFLV were obtained with the nicotine enhanced buffers. In comparison, because of the increased workload associated with growing plants in vitro and the unreliable detection of viruses in these plants, it remained preferable to detect nepoviruses in field plants by ELISA. / Land and Food Systems, Faculty of / Graduate

Background: In recent years, several new ELISAs for the detection of antibodies against the porcine reproductive and respiratory disease virus (PRRSV) in pig serum have been developed. To interpret the results, specificity and sensitivity data as well as agreement to a reference ELISA must be available. In this study, three commercial ELISAs (INgezim PRRS 2.0 - ELISA II, Priocheck® PRRSV Ab porcine – ELISA III and CIVTEST suis PRRS E/S PLUS - ELISA IV, detecting PRRSV type 1 antibodies) were compared to a standard ELISA (IDEXX PRRS X3 Ab Test - ELISA I). The serum of three pigs vaccinated with an attenuated PRRSV live vaccine (genotype 2) was tested prior to and several times after the vaccination. Furthermore, serum samples of 245 pigs of PRRSV positive herds, 309 pigs of monitored PRRSV negative herds, 256 fatteners of assumed PRRSV negative herds with unknown herd history and 92 wild boars were tested with all four ELISAs. Results: ELISAs II and III were able to detect seroconversion of vaccinated pigs with a similar reliability. According to kappa coefficient, the results showed an almost perfect agreement between ELISA I as reference and ELISA II and III (kappa > 0.8), and substantial agreement between ELISA I and ELISA IV (kappa = 0.71). Sensitivity of ELISA II, III and IV was 96.0%, 100% and 91.5%, respectively. The specificity of the ELISAs determined in samples of monitored PRRSV negative herds was 99.0%, 95.1% and 96.4%, respectively. In assumed negative farms that were not continually monitored, more positive samples were found with ELISA II to IV. The reference ELISA I had a specificity of 100% in this study. Conclusions: All tested ELISAs were able to detect a PRRSV positive herd. The specificity and sensitivity of the tested commercial ELISAs, however, differed. ELISA II had the highest specificity an ELISA III had the highest sensitivity in comparison to the reference ELISA. ELISA IV had a lower sensitivity and specificity than the other ELISAs.

Master of Science / Department of Diagnostic Medicine/ Pathobiology / Lisa M. Pohlman / Background: Iron storage disease has proven to be a serious health concern for captive toucans. Physiologic mechanisms to efficiently extract iron from naturally iron-deficient diets appear the likely cause of iron overload when fed iron-sufficient diets in captivity. Iron overload can result in diabetes, heart failure, and even death. Serum ferritin concentrations are considered the most reliable screening tool to predict total body iron stores in many species, but an assay has not been available to measure serum ferritin in toucans. Objective: The purpose of this study was to develop an enzyme-linked immunosorbent assay (ELISA) to measure serum ferritin in toucans using a polyclonal antibody in a sandwich arrangement. Methods: Ferritin was isolated from toucan liver and used as a standard. A rabbit polyclonal anti-toucan antibody was used as the capture antibody and as a detection antibody conjugated to horseradish peroxidase. Linearity of toucan ferritin standards, effect of serum dilution, recovery of added ferritin standards, and intra- and inter-assay variability were determined. Results: Ferritin standards were linear from 0 to 50 ng/ml. The relationship between serum dilution and serum ferritin concentration was also linear. When 10, 20, 30, 40, or 50 ng/ml of purified toucan ferritin were added to diluted serum, the recoveries varied from 69% to 104%. The intra-assay variability for four test serum samples averaged 11% and the inter-assay variability for the same four samples averaged 11%. Conclusions: Although the results from the linearity and recovery studies are promising for assay development when viewed independently, preliminary ferritin concentrations from all toucans studied are much higher than expected. Upon further evaluation including Dot blot assays, Western blot assays, SDS-PAGE, and protein determination of the ferritin stock solution, it was determined that the ferritin stock solution did not contain a pure protein and therefore likely renders the assay invalid. Further testing is needed to confirm these findings.

A quantitative competitive binding "triple sandwich" enzyme immunoassay was used to evaluate pathogen/class-specific antibody responses in Holstein-Friesian calves vaccinated against Clostridium perfringens B-toxin at various ages postpartum. Vaccination of dams at six weeks and again at two weeks prepartum increased pathogen-specific antibody levels in their colostrum and respective calf's serum. Calves initially vaccinated at three days produced both a primary and secondary pathogen-specific antibody response, whereas calves initially vaccinated at 12 and 21 days produced only secondary responses. Maternally-derived antibodies were found to suppress neonatal antibody production following primary immunization. They were also found to influence secondary humoral immune responses, although in a diminished capacity. Pathogen-specific IgG and IgM concentrations in dams' sera and colostra were found related to subsequent pathogen-specific IgG and IgM neonatal serum concentrations. Only pathogen-specific IgA in dams' colostra was correlated to neonatal levels, possibly owing to a different origin and role of this immunoglobulin class. All class-specific colostral immunoglobulin levels were related to subsequent neonatal concentrations. Based on results from this experiment, it is recommended that calves be vaccinated at three days postpartum with a booster administered at 63 days.

Introduction: Pulmonary Surfactant reduces surface tension in the terminal airways thus facilitating breathing and contributes to host's innate immunity. Surfactant Proteins (SP) A, B, C and D were recently identified as inherent proteins of the CNS. Aim of the study was to investigate cerebrospinal fluid (CSF) SP levels in hydrocephalus patients compared to normal subjects. Patients and methods: CSF SP A-D levels were quantified using commercially available ELISA kits in 126 patients (0±84 years, mean 39 years). 60 patients without CNS pathologies served as a control group. Hydrocephalus patients were separated in aqueductal stenosis (AQS, n = 24), acute hydrocephalus without aqueductal stenosis (acute HC w/o AQS, n = 16) and idiopathic normal pressure hydrocephalus (NPH, n = 20). Furthermore, six patients with pseudotumor cerebri were investigated. Results: SP AÐD are present under physiological conditions in human CSF. SP-A is elevated in diseases accompanied by ventricular enlargement (AQS, acute HC w/o AQS) in a significant manner (0.67, 1.21 vs 0.38 ng/ml in control, p<0.001). SP-C is also elevated in hydrocephalic conditions (AQS, acute HC w/o AQS; 0.87, 1.71 vs. 0.48 ng/ml in controls, p<0.001) and in Pseudotumor cerebri (1.26 vs. 0.48 ng/ml in controls, p<0.01). SP-B and SP-D did not show significant alterations. Conclusion: The present study confirms the presence of SPs in human CSF. There are significant changes of SP-A and SP-C levels in diseases affecting brain water circulation and elevation of intracranial pressure. Cause of the alterations, underlying regulatory mechanisms, as well as diagnostic and therapeutic consequences of cerebral SP's requires further thorough investigations.