Juvenil idiopatisk artrit (JIA) är en autoimmun reumatisk sjukdom som drabbar barn före 16 års ålder. Den vanligaste varianten är oligoartikulär JIA, vilket innebär att den påverkar två till fyra leder med symptom så som svullnad, ömhet, stelhet, rodnad eller nedsatt motorik. Oligoartikulär JIA är även associerad med uveit, vilket är en autoimmun ögonsjukdom som förstör synen. Sjukdomen är i nuläget dåligt förstådd och forskning behövs för att kunna identifiera markörer som kan användas för diagnostik. Enzymkopplad immunadsorberande analys (ELISA) är inom vårdens laborativa arbete en mycket vanlig metod för att undersöka patienters serum och identifiera specifika markörer som tyder på sjukdom. En ELISA kan utföras på olika sätt beroende på om den letar efter antigen eller antikroppar. Syftet med denna studie var att optimera en indirekt ELISA för detektion av autoantikroppar och genomföra en metodjämförelse med en redan väl undersökt kulbaserad autoantikroppsmetod. Studien omfattar 14 serumprov från olika patienter och använder sig av rekombinant framställda protein epitope signature tag (PrEST)-antigener för att identifiera autoantikroppar. PrEST-antigener består av ett humant variabelt proteinsegment och en protein-tag som består av ett albuminbindande protein (ABP) med en N-terminal HIS-tag (His6ABP). För att förhindra ospecifik inbindning till His6ABP-delen av PrEST-antigenerna så framställdes His6ABP, med vilket serum inkuberades innan de undersöktes med ELISA. Då resultatet tolkades binärt kunde stor likhet ses mellan de två olika metoderna för samtliga PrEST-antigener som undersöktes, vilket innebär att metoden kan fortsätta utforskas. Resultatet visade också att His6ABP-delen skulle kunna orsaka korsreaktivitet, vilket dock inte är något negativt för metodens validitet. / Juvenile idiopathic arthritis (JIA) is an autoimmune rheumatic disease that affects children before the age of 16. The most common variant is oligoarticular JIA, which means it affects two to four joints with symptoms such as swelling, tenderness, stiffness, redness, or reduced mobility. Oligoarticular JIA is also associated with uveitis, an autoimmune eye disease which damage eyesight. The disease is currently poorly understood, and research is needed to identify markers that can be used for diagnostics. Enzyme-linked immunosorbent assay (ELISA) is a very common method in healthcare laboratory work to examine patients' serum and identify specific markers that indicate disease. An ELISA method can be performed in different ways depending on whether it is looking for antigen or antibodies. The aim of this study was to optimize an indirect ELISA for detection of autoantibodies and conduct a method comparison with an already well established bead-based autoantibody array method. The study included 14 sera samples from different patients and used recombinantly produced protein epitope signature tag (PrEST) antigens to identify autoantibodies. PrEST antigens consist of a human variable protein segment and a protein tag consisting of albumin binding protein (ABP) with an N-terminal HIS-tag (His6ABP). To prevent non-specific binding to the His6ABP portion of the PrEST antigens, His6ABP were recombinantly produced and used for pre-absorption of serum before being examined by ELISA. When the result was interpreted binary, great similarity could be seen between the two different methods for all PrEST antigens examined, which calls for further exploring of the method. The result also showed that the His6ABP part could possibly cause cross-reactivity, which is interesting but doesn’t affect the validity of the method.

<p>Försämrat immunförsvar och ökad risk att drabbas av bakterie- och virusinfektioner förekommer hos patienter med blodsjukdomarna multipelt myelom, Waldenströms makroglobulinemi samt hos vissa patienter med blodsjukdomen monoklonal gammopati av oklar signifikans. Infektionerna kräver ofta antibiotikabehandling och behandling med antivirala medel. I dagsläget är det svårt att förutsäga vilka av patienterna som kommer att drabbas av svåra och ibland livshotande infektioner. Därför ges många av patienterna förebyggande antibiotikabehandling.</p><p>I studiens början sattes en enzyme-linked immunosorbent assay (ELISA) för detektion av antikroppar mot <em>Moraxella catarrhalis </em>upp. I studien undersöktes om antikroppstitrar i serum mot bakterien <em>Moraxella catarrhalis</em> var lägre hos patientgrupperna än hos friska kontrollpersoner i samma ålder och om variationer förekom mellan patientgrupperna samt hur kontrollgrupper i olika åldrar skiljde sig från varandra. Kontrollgrupperna som undersöktes var mellan 20-40 år, 40-60 år samt 60 år och äldre.</p><p>Resultatet var att patienterna med multipelt myelom hade lägst antikroppstitrar, patienter med monoklonal gammopati av oklar signifikans hade något högre och patienter med Waldenströms makroglobulinemi hade ännu högre antikroppstitrar. Kontrollgruppen äldre än 60 år hade högre antikroppstitrar än både kontrollgruppen 20-40 år och 40-60 år. Lägst antikroppstitrar hade kontrollgrupp 40-60 år men ingen signifikant skillnad påvisades mellan kontrollgrupp 20-40 år och 40-60 år.</p>

Improved diagnosis, prognosis and disease follow-up is a fundamental procedure and a constant challenge in medicine.  Among the different molecular biomarkers, proteins are the essential regulatory component in blood; hence, by developing enhanced specific and sensitive molecular tools will gives great insight into the different processes in disease treatment.  In this thesis, we build on the proximity ligation assay to develop and apply new adaptable methods to facilitate protein detection. In paper I, I present a variant of the proximity ligation assay (we call PLARCA) using micro titer plate for detection and quantification of protein using optical density as readout in the fluorometer. PLARCA detected femtomolar levels of these proteins in patient samples, which was considerably below the detection threshold for ELISA. In paper II, we developed and adapted a new method into the in situ PLA methods for detection and identification of extracellular vesicles (EVs) using flow cytometry as readout (a method we call ExoPLA).  We identified five target proteins on the surface of the Evs and using three colors, we identified the EV using flow cytometer. In paper III, we aim to improve the efficiency of in situ PLA by creating and developing new designs and versions of the assay we called Unfold probes Through comparison of detection of protein using in situ PLA versus Unfold probes, we observed considerable decrease in non-specific signals, and also a lower detection threshold. In paper IV, we describe the development of a solid phase proximity extension (sp-PEA) assay for protein detection and quantification. We compared detection of IL-8, TNF-alpha, IL-10 and IL-6 using spPEA and PEA; spPEA demonstrations over 2 orders of magnitudes in the lower detection concentrations by decreased in background noise.

Au cours des dernières années, Salmonella Enteritidis est devenus les sérotypes les plus souvent isolés chez les patients canadiens, les cas étant liés à la consommation de viande de poulet et d’œufs crus. Les vaccins tués commercialement disponibles pour la volaille, stimulent mal l'immunité mucosale, tandis que l'utilisation de vaccins vivants reste controversée. Par conséquent, un vaccin sous-unitaire par voie orale peut être une solution. Cinq protéines bactériennes ont été choisies comme candidates potentielles et identifiées, soit Glyceraldehyde-3-phosphate dehydrogenase, Enolase, Lipoamide dehydrogenase, DNA protection during starvation protein et Elongation factor-Tu. Notre objectif a été de produire et de purifier ces protéines et de démontrer leur immunogénicité. Les gènes des protéines ont été amplifiés et clonés dans le vecteur pQE-30 pour expression dans Escherichia coli M15. La purification a été effectuée par FPLC. Des poules pondeuses SPF ont été séparées en 6 groupes et injectées par voie intramusculaire à different âges avec une des 5 protéines, ou le PBS chez le groupe témoin. Les œufs ont été ramassés pendant l'expérience et du sang a été prélevé à 36 semaines d'âge. Les anticorps IgY ont été extraits à partir du jaune d'oeuf et du sérum, et les IgA à partir du blanc d'oeuf. Des immunodots, westernblots et ELISA ont évalué l'immunogénicité des protéines et les niveaux d'anticorps induits . Nous avons constaté que ces cinq protéines pourraient stimuler la production d'anticorps spécifiques in vivo. GAPDH, Enolase et DPS ont induit des titres d'anticorps plus élevés que LpdA et EF-Tu. / Over the past years, Salmonella Enteritidis (SE) has become the most prevalent serovars isolated in Canadian patients. Most cases in humans are associated with consumption of chicken meat, raw egg and related products. For controlling Salmonella transmission and infection in poultry, available commercially killed vaccines poorly stimulate mucosal immunity, while the use of live vaccines remains controversial. Therefore an oral subunit vaccine may be a solution. Five bacterial proteins were chosen as potential candidates and identified as Glyceraldehyde-3-phosphate dehydrogenase, Enolase, Lipoamide dehydrogenase, DNA protection during starvation protein and Elongation factor-Tu. Our objectives were to produce and purify these proteins and study their immunogenicity. The proteins genes were amplified and cloned into pQE-30 vector, then transformed into Escherichia coli M15 for expression. Purification was performed using FPLC. SPF laying hens were separated into 6 groups and injected intramuscularly 3 times at 16, 20 and 28 weeks of age. Five groups were injected with a single protein respectively while the sixth group was injected with PBS as control. Eggs were collected during the duration of the experiment and blood was collected when hens were sacrificed at 36 weeks of age. IgY was extracted from egg yolk and serum and IgA from egg white. Immunodot, westernblot and ELISA were used to evaluate the immunogenicity of proteins and antibody levels they induced. We found that these five proteins could stimulate production of specific antibody in vivo. GAPDH, Enolase and DPS induced higher antibody titer than LpdA and Ef-Tu.

The goal of this study was to map the glycosylation pattern and antigenic properties of the salivary proteins of two closely related sand fly species, Phlebotomus perniciosus and P. orientalis. Affinity blotting with commercially available lectins revealed that many salivary proteins of these species are N-glycosylated, while the presence of O-glycosylation could not be confirmed. The level of N-glycosylation of most of these proteins is quite low, a larger number of potential N-glycosylation sites were found only in the amino acid sequences of P. orientalis hyaluronidase and endonucleases of both species tested. Four antigens from P. perniciosus salivary glands were selected for expression in a bacterial expression system; two of these proteins (PpeSP01 and PpeSP01B) were not glycosylated and the glycosylation level of the remaining two (PpeSP03B and PpeSP07) was low. The antigenic properties of the four chosen recombinant proteins were subsequently tested using immunoblot and ELISA. During the initial experiments with the sera of dogs experimentally bitten by P. perniciosus, two proteins (rSP07 and rSP01B) were proven unsuitable and they were excluded from further experiments. Recombinant proteins rSP03B and rSP01 were recognized by the same IgG antibodies as the native forms of these proteins...

<p>Rapporten laddas upp av lärare om detta godkänns av handledare.</p>

The aim of this study is to analyse a genetic and proteomic aspects that could play an important role in development of chosen cardiovascular disease. Matrix metalloproteinases are enzymes that contribute strongly to the degradation of extracellular matrix components. In this study the serological levels of MMP-2 and MMP-9 were investigated using immunological testing in patients with aortic valve disease and in patients with myocardial infarction. Significantly higher levels of MMP-2 and MMP-9 were determined in both above mentioned groups of patients. Association of serum levels of MMP-2 and MMP-9 and development of concomitant aortic dilatation was not confirmed in patients with aortic valve disease. Changes in serum levels within 24 hours and after 6 months post myocardial infarction were characterized. About 10 % of patients operated for aortic valve disease suffer simultaneously from ascending aortic dilatation. The current study did not reveal any significant genetic variation in TGFBR2 gene and in chosen exons of FBN1 gene in these patients. Further genetic research is needed to identify the cause of the pathology in aortic wall. Gene expression of selected genes was measured by microarray screening in patients with myocardial infarction. These genes were related to MMPs and did not show...

A importância em conhecer o padrão alimentar em mosquitos da Família Culicidae permite esclarecer alguns aspectos relacionados à transmissão de zoonoses e estimar o grau de contato humano-vetor que é fator relevante em estudos epidemiológicos. Com o objetivo de explorar o comportamento alimentar dessa Família, em área epizoótica de febre amarela silvestre, foram coletados exemplares nos municípios de Santo Antônio das Missões e Garruchos, Estado do Rio Grande do Sul. Fêmeas ingurgitadas foram obtidas por aspiração em ambiente de mata, no período de setembro de 2005 a abril de 2007 e identificadas segundo fonte de sangue ingerido através da técnica imunoenzimática ELISA de captura no sistema avidinabiotina. Foram testadas seis fontes de alimento: ave, bovino, eqüino, humano, macaco e rato. Os resultados obtidos mediante a padronização de anticorpos monoclonais possibilitaram demonstrar pela primeira vez o reconhecimento de sangue humano ingerido nesses mosquitos pelo emprego da subclasse IgG1 e comprovar a sensibilidade e especificidade da técnica ELISA de captura. No município de Santo Antônio das Missões, de um total de 190 amostras, 60,9% reagiram para sangue de boi, 23,6% para humano, 9,9% para ave, 1,9% para macaco e 3,7% para combinações de dois hospedeiros. Quanto às amostras referentes ao município de Garruchos, das 158 fêmeas capturadas na área Cachoeirinha pode-se observar reatividade para ave (16%), boi (29,6%), humano (36,8%), cavalo (4%), macaco (0,8%) e combinações de hospedeiros (12,8%), enquanto que para as 149 fêmeas pertencentes à área de São José, detectou-se sangue ingerido de boi em (51,5%), ave e humano (11,5%), macaco (6,2%), cavalo (0,8%) e mistos (18,5%). Aedes scapularis, Aedes crinifer, Culex (Culex) spp., Haemagogus leucocelaenus apresentaram maior número de fêmeas ingurgitadas nos dois municípios. Os resultados obtidos com Aedes scapularis sugerem ecletismo, conforme combinações detectadas em amostras de sangue de diferentes fontes. Haemagogus leucocelaenus apresentou a maior proporção de amostras contendo sangue humano em relação às demais fontes e essa característica traz implicações, por ser espécie incriminada na transmissão e por se tratar de área de ocorrência de epizootias de febre amarela. / The knowledge of mosquitoes Culicidae host feeding patterns permits to clarify some aspects related to zoonosis transmission and to estimate the degree of human-vector contact which is relevant in epidemiological studies. Aiming to explore the feeding behavior of these mosquitoes, specimens were collected in the municipalities of Santo Antônio das Missões and Garruchos, Rio Grande do Sul, an epizootic area of sylvatic yellow fever. Engorged females were collected by aspiration from forested areas from September 2005-April 2007 and their blood meals were identified using the avidin-biotin system of immunoenzymatic ELISA capture. Six blood meal sources were tested: bird, cattle, horse, human, monkey and rat. The result achieved with the species-specific IgG1 mAb was unprecedented for mosquito blood meal identification and reinforced the sensibility and specificity of the immunoenzymatic ELISA capture. Of the 190 samples from Santo Antônio das Missões, 60.9% reacted to cattle, 23.6% to human, 9.9% to bird, 1.9% to monkey and 3.7% to mixed blood meals. In Garruchos, of the 158 females collected in Cachoeirinha, 16.0% reacted to bird, 29.6% to cattle, 36.8% to human, 4.0% to horse, 0.8% to monkey and 12.8% to mixed blood, while of the 149 engorged females from São José, blood from cattle accounted for 51.5%, of blood identified, bird and human 11.5%, monkey 6.2%, horse 0.8% and mixed blood 18.5%. Blood engorged females of Aedes scapularis, Aedes crinifer, Culex (Culex) spp., Haemagogus leucocelaenus predominated in the two municipalities. The results obtained with Aedes scapularis suggests its eclecticism, according to the combinations of blood which were detected from different sources. Haemagogus leucocelaenus was found to have the highest proportion of samples containing human blood in comparison with other sources, which has implications, on account of being incriminated in the transmission and also for taking into consideration the outbreaks reported that underline the risk of yellow fever.

INTRODUÇÃO E OBJETIVOS: A a-Glutathiona-S-transferase (aGST) vem sendo proposta como um marcador sensível e não-invasivo de lesão hepática em pacientes com Hepatite pelo vírus C. Avaliamos neste trabalho como a (aGST) se correlaciona com características bioquímicas e histológicas em pacientes com HCV. MATERIAL E MÉTODOS: Realizamos a determinação da concentração plasmática das aGST, alanina aminotransferase (ALT), aspartato aminotransferase (AST) e gama-glutamyltransferase (gGT) em 114 pacientes com HCV, dos quais 97 foram submetidos à biópsia hepática em até 6 meses da realização dos testes bioquímicos. Avaliamos também os níveis de aGST em 66 doadores de sangue sadios, que serviram como controles. Comparamos os níveis de aGST com as demais provas bioquímicas e a histologia hepática. RESULTADOS: A aGST estava elevada em 85.96% dos pacientes com HCV e mostrou associação com a elevação das aminotransferases (p<0.01). O valor de 4mg/dL mostrou as melhores sensibilidade (85,96%) e especificidade (92,42%) para determinar a normalidade do teste aGST. aGST ³ 8mg/dL mostrou a melhor especificidade para determinar lesão histológica hepática mais agressiva e o melhor valor preditivo positivo e razão de verossimilhança positiva para inflamação portal e atividade parenquimatosa mais agressiva nos pacientes com HCV. CONCLUSÕES: A aGST está relacionada à lesão hepática na infecção pelo HCV (valor de corte = 4mg/dL) e lesões histológicas hepáticas mais agressivas (valor de corte = 8mg/dL). Neste contexto, a aGST poderia ser utilizada em pacientes com Hepatite pelo HCV com ALT elevada, como um indicador complementar de lesão histopatológica mais agressiva. Entretanto, seu valor preditivo positivo não é suficientemente elevado para evitar a necessidade de realizar a biópsia hepática, mesmo quando está acima de 8mg/dL. / BACKGROUND/AIMS: a-Glutathione-S-transferase (aGST) has been proposed as a sensitive non-invasive indicator of hepatocellular injury due to Hepatitis C virus (HCV) infection. In this work, we evaluate how alpha-GST concentration correlates with biochemical and histological features in HCV patients. METHODS: We assayed plasma aGST, alanine aminotransferase (ALT), spartate aminotransferase (AST) and gama-glutamyl-transferase (gGT) in 114 HCV+ patients, among whom liver biopsy was performed in 97, within 6 months of the biochemical evaluation. We also assessed aGST levels in 66 health blood donors, aimed to serve as control. We compared aGST levels with other biochemical tests and liver histology. RESULTS: In 85.96% of HCV patients aGST was elevated and showed association with serum aminotransferases (p<0.01). The value of 4mg/dL (or lower) showed the best sensitivity (85.96%) and specificity (92.42%) to determine normality on the aGST test. aGST levels 8mg/dL and higher showed the best specificity to determine the presence of more aggressive liver histological damage among HCV patients and the best predictive positive value and positive likelihood for more aggressive portal inflammation and lobular activity. CONCLUSION: aGST is related to HCV infection (cut-off = 4mg/dL) and more aggressive liver histological damage (cut-off = 8mg/dL). In this sense, aGST could be used in HCV patients with altered ALT levels as an indicator of more aggressive hystopathological damage. However, its positive predictive value (PPV) is not high enough to preclude the decision of performing hepatic biopsy, even when it is above 8mg/dL.

Realizou-se revisão bibliográfica sobre a utilização do teste imunoenzimático, ELISA (enzyme-linked immunosorbent assay) na Vigilância Epidemiológica de infecções causadas por arbovírus da Família Flaviviridae, gênero Flavivirus e da Família Togaviridae, gênero Alphavirus. Foram consultados trabalhos publicados a partir de 1979, ano da introdução do teste em pesquisas de arboviroses. Observou-se que o teste tem sido empregado na pesquisa de anticorpos em humanos, de anticorpos e antígenos em reservatórios não humanos e na identificação de antígenos e da fonte alimentar de mosquitos vetores. Analisou-se o desempenho de ELISA comparando-o a técnicas tradicionalmente empregadas para identificação de anticorpos e antígenos de arbovírus. O teste apresentou 100,0 por cento de sensibilidade e especificidade média de 84,5 por cento na identificação de anticorpos anti-Alphayirus em humanos. A técnica também foi muito sensível para Flavivirus, com valor médio de 95,2 por cento e apresentou especificidade média de 77,6 por cento. Na identificação de anticorpos anti-arbovírus em resevatórios não humanos, ELISA mostrou sensibilidade de 100,0 por cento e especificidade de 97,4 por cento. Na pesquisa de antígenos vir ais em mosquitos vetores a técnica apresentou especificidade média de 93,6 por cento e sensibilidade média de 76,5 por cento. A técnica apresentou alto valor preditivo positivo, o que foi observado quando calculou-se a média dos valores apresentados em cada um dos trabalhos em que esse parâmetro foi pesquisado e obteve-se um resultado de 89,0 por cento. Nos trabalhos em que foi estudada a reprodutibilidade do teste observou-se coeficiente de variação de 3,0 a 14,0 por cento nos resultados. Observou-se grande diversidade quanto aos critérios de positividade adotados, impossibilitando a comparação dos resultados. Notou-se uma tendência a encurtar o tempo de realização do teste e torná-lo factível em condições de trabalho de campo. Verificou-se que o teste já está incorporado à rotina da Vigilância Epidemiológica de algumas arboviroses como encefalite Japonesa nos países asiáticos e encefalites do Leste, Oeste e de St.Louis, nos Estados Unidos da América. Os autores estudados foram unânimes em concluir que trata-se de teste rápido, apresenta simplicidade dos procedimentos técnicos e permite diagnóstico presuntivo de infecção aguda com apenas uma amostra de soro, características que o capacitam para uso na Vigilância Epidemiológica de arboviroses. / The author makes a review of the use of enzyme-linked immunosorbent assay, ELISA, in the surveillance of infections caused by arbovirus belonging to the Flaviviridae family (genus Flavivirus) and to the Togaviridae family (genus Alphavirus). Publications dating since 1979, when the use of ELISA in arbovirus research began, were consulted. It was noted that this assay was used for antibody identification on not human reservoirs, and for antigen and blood meal identification on mosquito vectors. ELISA\'s perfomance was compared to standard tests used for laboratorial diagnosis of arboviruses. The test presented 100.0 per cent sensitivity and an average specificity of 84.5 per cent in Alphavirus antibody identification in humans; and was also sensitive for Flavivirus with average values of 95.2 per cent and specificity average values of 77.6 per cent. ELISA furthermore showed 100.0 per cent sensitivity and 97.4 per cent specificity for antibody identification in not human reservoirs. For the antigen identification in mosquito vectors, the assay presented an average specificity of 93.6 per cent and an average sensitivity of 76.5 per cent. The immunoassay presented high predictive values (average of 89.0 per cent) and it was reproducible when this characteristic was studied with a coefficient variation index ranging from 3.0 to 14.0 per cent There was a great variety in the positivity criteria, making the comparison of results difficult. An attempt to process the test in the shortest time and in field conditions is noted in many publications. The assay is used routinely on surveillance of Japanese encephalitis in Asian countries and in eastern and western equine encephalitis and St.Louis encephalitis in the USA. ELISA was considered a rapid assay with sirnple procedures when it is cornpared to tradicional tests and provides presuntive diagnosis of an acute infection with a single serurn sarnple. These characteristics suggest that the test is a useful tool for arbovirus surveillance.