published_or_final_version / Medicine / Doctoral / Doctor of Philosophy

Procyclic culture forms of Trypanosoma brucei species and antibodies to these parasites were used in developing antibody-detection and antigen-detection assays for diagnosis of African human sleeping sickness. An agglutination assay using live procyclic trypanosomes--the Procyclic Agglutination Trypanosomiasis Test (PATT) was developed for detecting anti-trypanosome antibodies in the sera of trypanosome-infected vervet monkeys and humans. Antibodies to procyclic surface antigens were detected by the PATT in sera of vervet monkeys as early as 7 days post-infection with T. b. rhodesiense. Positive agglutination titres were obtained with sera from monkeys with active, untreated infections and with sera taken soon after successful drug cure. Similar positive agglutination results were also observed using the PATT with sera from T. b. gambiense-infected patients from Cote d'Ivoire and Sudan and with documented sera from T. b. rhodesiense-infected patients from Kenya. No agglutination reactions were observed with preinfection sera from vervet monkeys, with sera from uninfected Canadians or with sera from Americans working in endemic areas. Together these results confirm the diagnostic value of using procyclic trypanosomes to detect anti-trypanosome antibodies in human African sleeping sickness. A double antibody sandwich ELISA using monoclonal antibodies and polyclonal rabbit antibodies to the surface membrane antigens of procyclic trypanosomes was developed. This assay detected circulating trypanosomal antigens in the sera of trypanosome-infected mice and in the sera from parasite-infected patients. However, limited success was obtained with this sandwich ELISA when tested on a larger repertoire of sera from infected humans. Rabbit antibodies made against whole lysates of T. b. rhodesiense procyclics were then employed in an antigen-trapping sandwich ELISA. The results demonstrated the effectiveness of this sandwich ELISA in revealing the infection status of vervet monkeys or humans infected with either T. b. rhodesiense or T. h. gambiense. Trypanosomal antigens were detected in the sera of parasitologically confirmed monkeys and patients but not in preinfection sera nor in control sera from uninfected North Americans. The PATT and the sandwich ELISA exhibited higher sensitivities than the currently employed diagnostic assay for human sleeping sickness, the Card Agglutination Trypanosomiasis Test (CATT), when tested with sera of parasitologically-confirmed humans. The sandwich ELISA was superior to the antibody-detecting PATT and CATT in monitoring trypanocidal drug-treated patients. The overall sensitivity of the PATT and sandwich ELISA was 94.3% and 97.4% and the specificity was 84.5% and 95.5%, respectively. These results thus confirm the diagnostic value of these tests for the diagnosis of human African sleeping sickness. Identification of diagnostically useful antigens was attempted in order to facilitate the adaptation of these diagnostic assays to a simpler format for field application. Pooled sera obtained from trypanosome-infected patients was used as a probe to detect trypanosome antigens separated by high performance liquid chromatography, immunoaffinity and immunoblotting techniques. Most of the antigens were detected in the higher molecular weight range (>62 Kd). Immunization of mice with the target antigens yielded six trypanosome-specific monoclonal antibodies. In a double antibody sandwich ELISA, these antibodies were successful in trapping circulating parasite antigens in sera from trypanosome-infected mice as early as 3 days post-infection. Some of these antigens have been partially biochemically characterized. Trypanosomal antigens were also detected by these antibodies in the urine of infected mice. The antigen-capture sandwich ELISA using either the selected monoclonal antibodies or the rabbit anti-procyclic whole lysate antibodies gave similar results with sera from trypanosome-infected mice, human sleeping sickness patients and uninfected humans from North America and Kenya. The results showed that these MAbs and their antigens were useful in the diagnosis of African human sleeping sickness. / Graduate

Thesis (MSc MedSc)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Background The QuantiFERON In-Tube (QFT IT) assay is an Interferon-gamma release assay (IGRA) which is currently used to detect Mycobacterium tuberculosis (M. tb) infection. It however cannot differentiate between latent infection and active tuberculosis (TB) disease. In an attempt to improve this tool to accurately diagnose active TB, the release of a variety of markers should be assessed in combination with Interferon gamma (IFN- γ). Luminex analysis was previously done on QFT plasma and promising candidates were identified which could be of great value in treatment response studies. IFN-γ ELISpot, are not only used to detect M.tb infection, but is also implicated in vaccine trails to assess immunogenicity. The IFN-γ ELISpot and flow cytometry are the most common assays to assess these phenomena during clinical trials. Our aim therefore was to develop a multi platform immune analysis assay using the QFT IT system. Study design and method The first approach of this study was to optimize the QFT IT assay for flow cytometry applications. The following questions formed part of the optimization study: How does the QFT whole blood assay (QFT-WBA) compare to the currently used WBA? Is antigen re-stimulation required after the initial incubation time and for how long should cells be re-stimulated in the presence of Brefeldin A? The second approach was to use the optimized QFT-WBA for community controls (CTRL), household contacts (HHC) and TB cases, which were recruited from the high TB incidence areas Ravensmead, Uitsig and Elsies River. The infection status of each participant was determined by IFN-γ ELISA and Luminex analysis was performed to measured wide range of cytokine expression. In addition immune cell markers like CD14, CD4, CD8, CD19, and T cell receptor gamma delta (TCRγδ) were characterized; polyfunctional characteristics (IFN-γ, Tumor necrosis factor-alpha (TNF-α) and Interleukin-2 (IL-2)) and proliferation (Ki-67+) of T cells determined by flow cytometry. Results After stimulating the whole blood of the study participants for 22 hours with the M. tb specific antigens, early secreted antigenic target 6 kDa (ESAT-6), culture filtrate protein-10 kDa (CFP-10) and TB7.7 the levels of TNF-α producing CD4 T cells were elevated in TB cases compared to HHCs. After stimulating the whole blood for 6 days TNF-α producing T cells declined in TB cases and HHC showed a higher expression. CD40L+CD4+ (p=0.0225) was increased in HHC while IL-9+CD8+ (0.3230) was decreased in HHC compared to TB cases. Other markers such as IL-5(AG-NIL), IL-13(Ag- NIL), FGF basicAg, GM-CSFNIL, VEGFNIL/(Ag-NIL), MIP-1βAg and MCP-1Ag/(Ag-NIL) showed significant differences between HHC and TB cases. Conclusions The responses in the QFT-based assay were generally comparable to the WBA that is routinely used. The differences of TNF-α expression seen in QFT-WBA and QFTLPA could be explained by the fact that effector T cell responses were measured in the short term assay and the central memory T cell responses in the long term assay. Our study therefore shows that the QFT-based tests can be used to simultaneously assess a wide range of immunological markers and not only IFN-γ expression. / AFRIKAANSE OPSOMMING: Agtergrond Die QuantiFERON In Tube (QFT IT) toets is ‘n Interferon-gamma vrystellingstoets (IGRA) wat huidiglik dien as ‘n maatstaf van Mycobacterium tuberculosis (M. tb) infeksie. Hierdie toets kan egter nie onderskei tussen latente infeksie en aktiewe tuberkulose (TB) nie. ‘n Noemenswaardige verbetering in die vermoë van hierdie toets om aktiewe TB te diagnoseer, berus op die studie van ‘n verskeidenheid vrygestelde merkers, insluitend Interferon gamma (IFN-γ). In vorige Luminex studies op QFT plasma, is belowende kandidate geïdentifiseer wat van groot waarde kan wees vir studies wat fokus op die reaksie tot behandeling. Die IFN-γ ELISpot dien nie net as ‘n maatstaf van M.tb infeksie nie, maar word ook in vaksienproewe betrek om die aard van immuniteit te ondersoek. Die IFN-γ ELISpot toets sowel as vloeisitometriese toetse, is van die mees algemene toetse om hierdie verskynsels te meet, tydens kliniese proewe. Die doel van hierdie studie was dus om die QFT IT sisteem te ontwikkel as ‘n basis vir ‘n multiplatform immunologiese analiseringstoets. Studie ontwerp en metode Die inleidende benadering van hierdie studie was die optimisering van die QFT IT toets, vir vloeisitometrie doeleindes. Die volgende vrae het deel uitgemaak van die optimiseringstudie: Hoe vergelyk die QFT heelbloedtoets (QFT-WBA) met huidige WBAs wat in gebruik is? Word meermalige antigeenstimulasies benodig na die oorspronklike inkubasieperiode en hoe lank moet die tydperk wees vir sellulêre opvolgstimulasie, in die teenwoordigheid van Brefeldin A? As ‘n tweede benadering, was om die geoptimiseerde QFT-WBA te gebruik vir gemeenskapskontroles (CTRL), huishoudelike kontakte (HHC) en TB gevalle. Al drie hierdie groepe was opgeneem uit Ravensmead, Uitsig en Elsies Rivier, areas met betreklik hoë vlakke van TB infeksie. Elke persoon in die studie se vlak van infeksie is vasgestel met behulp van die IFN-γ ELISA en Luminex analiese was uitgevoer, om ‘n wye verskeidenheid uitdrukkingsvlakke van sitokiene te meet. Dies meer, was immuunselmerkers soos CD14, CD4, CD8, CD19 en T sel reseptor gamma delta (TCRγδ) gekarakteriseer. Meervuldige funskionele karakteristieke (IFN-γ, Tumor nekrose faktor-alpha (TNF-α) en Interleukin-2 (IL-2)) en vermenigvuldiging van T-selle, was vasgestel deur middel van vloeisitometrie. Resultate Nadat die heelbloed van studiedeelnemers gestimuleers was met M. tb spesifieke antigene, vroeë afskeidings antigeniese teiken 6kDa (ESAT-6), kultuurfiltraatproteïn 10kDa (CFP-10) en TB7.7, vir 22 uur, was gevind dat vlakke van TNF-α produserende CD4 T selle hoër was in TB pasïente, in vergelyking met HHCs. Nadat die heelbloed vir 6 dae gestimuleer was, het die vlak van TNF-α produserende T-selle afgeneem in TB pasïente, terwyl dit hoër was in HCC. CD40L+CD4+ (p=0.0225) het hoër vlakke bereik in HHC, terwyl IL-9+CD8+ (0.3230) vlakke afgeneem het, in vergelyking met TB pasïente. Ander merkers soos,onder andere, IL-5(AG-NIL), IL-13(Ag-NIL), FGF basicAg, GMCSFNIL, VEGFNIL/(Ag-NIL), MIP-1βAg and MCP-1Ag/(Ag-NIL), het noemenswaardige verskille geopenbaar tussen HHC en TB pasïente.

To personalize treatment for cancer, correct staging of the primary tumor, nodal disease and metastatic disease is of essence. By targeting tumor specific receptors with radiolabeled antibodies, specificity and accuracy of imaging may be improved. Radio-immunodiagnostics can potentially detect small volume disease, occult metastasis and recurrent cancer in treated tissue. This thesis focuses on evaluation of radio-immunoconjugates directed towards CD44v6, which is a surface receptor overexpressed in many head and neck squamous cell carcinomas. At the outset, the monoclonal chimeric antibody cMab U36 and its cleavage products Fab’ and F(ab’)2 were labeled with 125I and assessed in vitro and in vivo (paper I). The best distribution pattern and tumor to organ ratio was achieved with F(ab’)2. Due to the immunological responses humans can develop towards chimeric antibodies, they are not optimal for clinical use, and subsequently fully human antibody fragments were developed. AbD15179, which is a monovalent fragment, was labeled with 111In and 125I and evaluated in vitro and in mice bearing CD44v6-expressing tumors. Tumor to organ ratios were improved compared to cMab U36 derived fragments, and 111In-AbD15179 displayed a more favorable distribution compared to 125I-AbD15179 (Paper II). A bivalent Fab-dHXL, AbD19384 derived from AbD15179, was then constructed and labeled with 125I and evaluated in cell- and biodistribution studies. Furthermore, an imaging study in a small animal PET was performed with 124I-AbD19384 (Paper III). Uptake in kidneys was reduced and liver uptake increased compared to AbD15179 reflecting the larger molecule. The high CD44v6 expressing tumor was clearly visualized with maximum uptake at 48 hours post injection.In paper IV human single chain fragments towards CD44v6v were selected, and the top candidates A11 and H12 were further evaluated in vitro and in vivo. Single chain fragments are small molecules exhibiting fast clearance and high affinity to the target. The study proved this by demonstrating superior tumor to blood ratios of radiolabeled A11 and H12 compared to previously studied molecules.

Este trabalho visa investigar a resposta sorológica para glicolipoproteína (GLP) de leptospiras com a finalidade de padronizar o uso deste antígeno em testes sorológicos para o diagnóstico da leptospirose humana. Dentre as proteínas envolvidas na patogenicidade das leptospiras, a GLP ainda não foi estudada quanto a imunogenicidade e quanto ao seu emprego como antígeno na detecção de anticorpos específicos. Assim, dot-ELISA para detecção de anticorpos IgG e IgM, com o emprego de GLP de leptospiras patogênica e não patogênica, foi padronizado. Foram testadas amostras pareadas de soros de 90 pacientes com leptospirose confirmada sorologicamente por MAT, sendo as primeiras amostras colhidas na fase aguda da doença e as segundas amostras após 10 a 15 dias. Foram testadas também amostras únicas de 30 pacientes de diferentes patologias, que apresentaram resultados negativos no MAT, pertencentes ao grupo controle. A detecção de anticorpos IgG não mostrou resultados satisfatórios, tendo sido, o seu estudo, descontinuado. Os resultados do dot-ELISA IgM mostraram sensibilidade de 100% nas amostras colhidas após soroconversão no MAT e a precocidade de detecção foi demonstrada pela alta positividade nas amostras colhidas na fase aguda da doença (76,6% para dot-ELISA com antígeno de Leptospira interrogans sorovar Copenhageni e 90% com antígeno de Leptospira biflexa sorovar Patoc). A especificidade foi alta (96,6%), porém o dot-ELISA utilizando ambos os antígenos apresentou 3,3% de resultados falso-positivos. Este estudo demonstrou a importância da resposta imune humoral ao antígeno GLP de leptospiras. A utilização da GLP, no teste dot-ELISA para detecção de anticorpos IgM permitiu realizar o diagnóstico sorológico de forma simples, rápida e com alta eficiência diagnóstica. / The aim of this work was the study of serologic response against leptospira glycolipoprotein (GLP) for the purpose of standardizing its use as an antigen on serological tests to diagnose human leptospirosis. Among the proteins involved in the pathogenicity, GLP is yet to be studied regarding its immunogenicity and its use as an antigen in the detection of specific antibodies. That led to our standardization of dot-ELISA for detecting IgG and IgM antibodies, using GLP extracted from either pathogenic Leptospira interrogans serovar Copenhageni or nonpathogenic Leptospira biflexa serovar Patoc. Paired serum samples were taken from 90 patients with serologically confirmed leptospirosis, by MAT, with the first samples collected on the disease\'s acute phase and the second samples after a period of 10 to 15 days. We also tested single samples taken from 30 patients with other diseases, MAT negative, belonging to the control group. Detection rates for IgG antibodies were unsatisfactory, so the study for that use was discontinued. The dot-ELISA IgM results yielded 100% sensitivity on the samples taken after MAT seroconversion. The early detection pattern was evidenced by the high positivity rate on the samples taken during the disease\'s acute phase (76,6% dot-ELISA using Leptospira interrogans serovar Copenhageni antigen and 90% using Leptospira biflexa sorovar Patoc antigen). Specificity rates were high (96.6%), although a 3.3% rate of false-positive results was observed for dot-ELISA using both antigens. The present study revealed the importance of the humoral immune response against the GLP antigen. The use of GLP, on the dot-ELISA test for IgM antibodies afforded a simple, quick and effective diagnosis.

Submitted by Jorge Silva (jorgelmsilva@ufrrj.br) on 2017-05-11T19:12:48Z No. of bitstreams: 1 2012 - F?bio Jorge Moreira da Silva.pdf: 1417566 bytes, checksum: a168314142bf607a64227972ff4c85e8 (MD5) / Made available in DSpace on 2017-05-11T19:12:48Z (GMT). No. of bitstreams: 1 2012 - F?bio Jorge Moreira da Silva.pdf: 1417566 bytes, checksum: a168314142bf607a64227972ff4c85e8 (MD5) Previous issue date: 2012-06-06 / CNPq / Activities in high productivity systems to dairy cattle contribute to imbalance health and disease, and increase the possibility of illness compatible with the infestation and infections transmitted by arthropods vectors. The objectives were to evaluate the prevalence and the seroepidemiological condition for Anaplasma marginale in 41calves from birth to completed 180 days. The animals belonged to ?Centro Estadual de Pesquisa em Agricultura Org?nica? ? Pesagro-Rio, Serop?dica-RJ. There are few reports of molecular diagnostic techniques for this agent. The study was conducted during the rainy and dry seasons and collected a total of 1607 blood samples, initially every three days and processed using indirect ELISA test and PCR. Percent values for A. marginale seroprevalence as function of age were tested using the ?2 test at 5% significance level. The prevalence of anti-A. marginale antibodies were 39.8% in calves aged less than 30 days, 23.3% between 30 and 60 days, 27.3% between 60 and 120 days and 38.2% between 120 and 180 days, with 31.4% for samples of all age group (180 days). Calves aged between 30 and 60, 60 and 120 and 120 and 180 days were respectively 1.90, 1.75 and 1.55 more likely to be seronegative for A. marginale than newborn ones. All calves were positive to PCR until 13 days old. The values show that during the study calves had low levels of antibodies to A. marginale, a condition that predisposes them to the development of clinical anaplasmosis. In addition, the herd was considered unstable epidemiologically to A. marginale infection. The results show that animals had low antibody titers of IgG anti-A. marginale, being more susceptible to develop clinical anaplasmosis from 30 to 60 days. The results of the PCR method confirmed A. marginale in all animals before they are 15 days old and suggest the possibility of transplacental transmission occurs in the herd. / As atividades relacionadas a bovinocultura leiteira em sistemas de alta produtividade contribuem cada dia mais com o desequil?brio sa?de-doen?a, e aumentam a probabilidade de enfermidades compat?veis com as ectoparasitoses e as infec??es transmitidas por estes vetores. Os objetivos do trabalho foram detectar a infec??o por Anaplasma marginale de forma precoce e avaliar o n?vel de anticorpos IgG anti-A. marginale em bezerros nativos e naturalmente parasitados por Rhipicephalus microplus na Baixada Fluminense, estado do Rio de Janeiro. S?o escassos os relatos sobre t?cnicas de diagn?stico molecular para este agente. Um total de 41 bezerras foi acompanhado do nascimento aos 180 dias de idade. Os animais pertenciam ao Centro Estadual de Pesquisa em Agricultura Org?nica da Pesagro-RJ. O estudo foi conduzido nas esta??es chuvosa e seca, e foram coletados um total de 1607 amostras, com intervalo inicial de tr?s dias e processados utilizando o teste ELISA indireto e a t?cnica PCR. Os valores percentuais de soropreval?cia para A. marginale em fun??o da idade foram submetidos ao teste ?2 a 5% de signific?ncia. A preval?ncia de anticorpos anti-A. marginale nos bezerros, em fun??o da idade, foi de 39,8% do soro de animais com idade inferior a 30 dias, 23,3% entre 30 e 60 dias, 27,3% entre 60 e 120 dias e 38,2% entre 120 e 180 dias, com um percentual de 31,4% para as amostras de todo o grupo et?rio (180 dias). Bezerros com idade 30 - 60, 60 - 120 e 120 - 180 dias apresentaram respectivamente 1,90, 1,75 e 1,55 mais risco de serem soronegativos para A. marginale do que os animais rec?m nascidos. Os bezerros foram diagnosticados positivos a PCR em no m?ximo 13 dias de idade. Os valores demonstram que os animais estudados apresentaram baixos t?tulos de anticorpos da classe IgG anti-A. marginale, sendo mais suscet?veis a desenvolverem anaplasmose cl?nica entre 30 a 60 dias de vida. Os resultados do m?todo PCR comprovaram a circula??o de A. marginale em todos os animais antes de completarem 15 dias de vida e sugerem a possibilidade de ocorrer transmiss?o transplacent?ria no rebanho estudado.

A prova sorológica de referência na leptospirose ainda é a soroaglutinação microscópica (SAM). Devido à complexidade desta prova avaliamos alguns testes rápidos para triagem dos anticorpos anti-leptospiras na fase aguda da infecção. Na década de 80, uma hemaglutinação passiva, utilizando frações polissacarídicas de leptospiras, foi considerada apropriada ao diagnóstico precoce, porém esta preparação antigênica incluía muitos “antígenos comuns" reconhecidos por anticorpos de 4% dos indivíduos normais. Um novo ELISA (enzyme-linked immunosorbent assay) utilizando uma suspensão de antígenos imunodominantes, resistentes à proteinase K, foi padronizado e avaliado quanto ao seu valor diagnóstico. Com 89,9% de sensibilidade e 97,4% de especificidade, esta técnica, referida como PK-ELISA, satisfaz os requisitos necessários para as provas de triagem da leptospirose humana. No entanto, em virtude de alguns reagentes usados nesta preparação antigênica serem importados e muito instáveis, foi proposta a introdução de novos métodos empregando-se anticorpos monoclonais. Em um “Acordo de Pesquisa Cooperativa" entre o Instituto Adolfo Lutz e o Laboratório Fleury foram produzidos hibridomas contra leptospiras. Dois deles foram selecionados para dar continuidade ao estudo: um, secretando anticorpos monoclonais (AcM) para um epítopo detectado em 16 de 23 sorovares do gênero Leptospira mais freqüentes em nosso meio (clone A12P4), e outro específico a somente um sorogrupo patogênico, icterohaemorragiae (clone H7P1). O AcM A12P4, uma imunoglobulina G2B (IgG2B), reagiu com epítopo presente nos componentes de pesos moleculares (PM) de 16-18 kDa dos lisados de leptospiras das cepas RGA e M-20, quando separados na eletroforese em gel de poliacrilamida, e com componentes de PM de 75-84kDa dos sorovares copenhageni e canicola. Por sua vez, o AcM H7P1, uma imunoglobulina G, reagiu com um epítopo comum a várias frações de PM acima de 21 kDa da cepa RGA e com componentes de PM de 21-22 kDa e de 75-82 kDa da cepa M-20. Os monoclonais foram empregados em provas imunoenzimáticas para a detecção de anticorpos específicos em amostras séricas pareadas coletadas de 52 pacientes com leptospirose, e do grupo controle que incluiu amostras séricas de 57 pacientes com outras doenças consideradas no diagnóstico diferencial, e de 68 indivíduos normais. Estas provas, no entanto, não foram satisfatórias. Finalmente, um novo ELISA foi desenvolvido no presente estudo que utiliza a suspensão de antígenos “AgMc", purificados por cromatografia de afinidade utilizando a Sepharose 4B ativada com CNBr acoplada aos anticorpos monoclonais descritos acima. Os resultados obtidos com esta prova foram comparados aos obtidos com outros testes disponíveis em nosso meio, como a SAM e o ELISA clássico (ELISA c). Este novo método, o “ELISA AgMc", com 80,70 % e 83,33 % de sensibilidade e especifidade, respectivamente, em relação à SAM; valores preditivos positivo e negativo de 69,70% e 90,10% respectivamente e índice de concordância geral de 82,49%, não parece ser um protocolo promissor para o diagnóstico rápido na leptospirose humana. Além disso, tomando-se a SAM como diagnóstico verdadeiro, os resultados obtidos no novo teste, após a conclusão diagnóstica do grupo de pacientes com a leptospirose, mostrou uma discordância significativa. São discutidas as possíveis explicações para os resultados encontrados. / The best serological test for leptospirosis laboratory diagnosis remains the microscopic agglutination test (MAT). Because of the complexity of MAT, we have been developed some rapid screening tests for leptospiral antibodies detection in the acute phase of infection. In the decade of 80, a passive hemagglutination test employing polysaccharide fractions of leptospires was considered appropriate for early diagnosis, but its antigen preparation included “common antigens" recognized by antibodies from 4% of healthy individuals. A new ELISA (enzyme-linked immunosorbent assay) employing proteinase K resistant immunodominant antigens was developed and its potential diagnosis evaluated. This technique, the PK-ELISA, presented 89.9% sensitivity and 97.4% specificity, and satisfied the requeriments needed for serological screening tests of human leptospirosis. However, some of the reagents used in its antigen preparation are imported and very unstable. So, it was proposed, in a “Cooperative Research Accordance" between Instituto Adolfo Lutz and Laboratório Fleury, to try new approaches with monoclonal antibodies. Two hibridomas secreting specific monoclonal antibodies (MAb) were selected: one, against an epitope detected in 16 of 23 members of the genus Leptospira (clone A12P4) and the other, specific to the icterohaemorragiae serogroup (clone H7P1). The MAb A12P4, a G2 (IgG2B) immunoglobulin, reacted with an epitope present in the 16-18 kDa components of icterohaemorragiae serogroup and with the 75-84 kDa components of serovars copenhageni and canicola, after whole-cell lysates of the leptospires were separated by sodium dodecyl sulfate- polyacrylamide gel electrophoresis. The MAb H7P1, which is an IgG, reacted with an epitope common to several fractions of molecular weight above 21 kDa of strain RGA and with the 21-22 kDa and the 75-82 kDa components of strain M-20. Both monoclonal antibodies were employed in enzyme immunoassays for detecting specific antibodies in serum samples serially colleted from 52 patients with leptospirosis, and from the control group, which consisted of sera from 57 patients with other diseases included in the differential diagnosis, and from 68 healthy individuals. These tests, however, were not satisfactory. A new ELISA was developed in the present study employing an antigen suspension “AgMc", purified by affinity chromatography with CNBr-activated Sepharose 4B coupled to the monoclonal antibodies described above. The results obtained with this test were compared to the MAT and to the classical IgM ELISA (ELISA c). The new method, “AgMc ELISA", presented serological indices, relatively to reference test MAT, of 80.70 % and 83.33 % of sensitivity and specificity, respectively; positive and negative predictive values of 69.70 % and 90.10 %, respectively, and general agreement index of 82.49 %. So, this test was not considered a promising approach to rapid diagnosis of human leptospirosis. Moreover, the proportion of patients diagnosed as having leptospirosis by the “AgMc ELISA" and the MAT differ significantly. The possible explanations for the results obtained are discussed.

This thesis describes the development of serum and whole blood immunodiagnostic assays for Maedi-Visna virus (MVV). All previously described recombinant MVV ELISA assays utilised either the core p25 or transmembrane (TM) proteins alone, or combined, but as individual proteins. The p25 and TM genes of MVV were cloned individually into the pGEX-2T expression vector. Both proteins were expressed as a combined fusion protein in frame with glutathione S-transferase (GST). The purified recombinant antigens (GST-TM and GST-TM-p25) were used to develop a MVV ELISA. Sera from 46 positive and 46 negative sheep were tested using the GST-TM and GST-TM-p25 ELISAs and a commercial p25 EIA kit. A two-graph receiver operating characteristic (TG-ROC) analysis program was used to interpret the data. The GST-TM-p25 ELISA was more sensitive than the commercial assay which is based on the p25 antigen alone and more specific than the GST-TM ELISA. The GST-TM-p25 ELISA showed a sensitivity and specificity of 100%. The human AIDS lentivirus transmembrane (TM) glycoprotein portion of the envelope viral protein has been identified as the antigen most consistently recognised by antibodies. There is suggestive evidence that the same applies to MVV as the GST-TM fusion protein, expressed in E. coli, has comparable sensitivity to the GST-TM-p25 fusion protein, but lacks specificity. However, due to the hydrophobic nature of the MVV TM protein, purification of the expressed fusion protein required lengthy purification protocols. This was despite the fact that only a truncated version of the TM protein was expressed. This prompted investigating an alternative expression system that could possibly circumvent the above mentioned problems. The yeast Pichia pastoris is known to be suitable for the high-level expression of heterologous proteins which are secreted into the culture supernatant. These features made P. pastoris an attractive host for the expression of the hydrophobic TM protein of MVV. However, limited success was achieved as only low expression levels were obtained and detection and quantification was only accomplished by means of ELISA. Evaluation of the diagnostic performance of the P. pastoris expressed MVV TM-polypeptide was performed using a panel of 36 confirmed negative and positive sera, and evaluated using a TG-ROC analysis programme, which yielded an equal Se and Sp of 83%. The use of a novel rapid immunoassay system, which allows the detection of circulating antibodies in whole blood, has been investigated for use as a MVV diagnostic assay. The central feature of this immunoassay lies in a monoclonal antibody against a glycophorin epitope present on all sheep erythrocytes. A Fab'-peptide conjugate was constructed by coupling a synthetic peptide, corresponding to a sequence from MVV TM protein, to the hinge region of the Fab' fragment of the antisheep erythrocyte antibody. Within the limited number of 10 seronegative and 10 seropositive samples the autologous red blood cell agglutination assay had a sensitivity of 90% and a specificity of 80%. Despite the limitations and difficulties encountered, the use of such rapid whole blood immunodiagnostic assays for MVV holds promise. / Thesis (Ph.D.)-University of Natal, Durban, 1997.

Includes an appendix of author's previously published papers. / Bibliography: leaves 123-160. / 160, [105] leaves, [30] leaves of plates : ill. ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (Ph.D.)--University of Adelaide, Dept. of Microbiology and Immunology, 1990

Este trabalho visa investigar a resposta sorológica para glicolipoproteína (GLP) de leptospiras com a finalidade de padronizar o uso deste antígeno em testes sorológicos para o diagnóstico da leptospirose humana. Dentre as proteínas envolvidas na patogenicidade das leptospiras, a GLP ainda não foi estudada quanto a imunogenicidade e quanto ao seu emprego como antígeno na detecção de anticorpos específicos. Assim, dot-ELISA para detecção de anticorpos IgG e IgM, com o emprego de GLP de leptospiras patogênica e não patogênica, foi padronizado. Foram testadas amostras pareadas de soros de 90 pacientes com leptospirose confirmada sorologicamente por MAT, sendo as primeiras amostras colhidas na fase aguda da doença e as segundas amostras após 10 a 15 dias. Foram testadas também amostras únicas de 30 pacientes de diferentes patologias, que apresentaram resultados negativos no MAT, pertencentes ao grupo controle. A detecção de anticorpos IgG não mostrou resultados satisfatórios, tendo sido, o seu estudo, descontinuado. Os resultados do dot-ELISA IgM mostraram sensibilidade de 100% nas amostras colhidas após soroconversão no MAT e a precocidade de detecção foi demonstrada pela alta positividade nas amostras colhidas na fase aguda da doença (76,6% para dot-ELISA com antígeno de Leptospira interrogans sorovar Copenhageni e 90% com antígeno de Leptospira biflexa sorovar Patoc). A especificidade foi alta (96,6%), porém o dot-ELISA utilizando ambos os antígenos apresentou 3,3% de resultados falso-positivos. Este estudo demonstrou a importância da resposta imune humoral ao antígeno GLP de leptospiras. A utilização da GLP, no teste dot-ELISA para detecção de anticorpos IgM permitiu realizar o diagnóstico sorológico de forma simples, rápida e com alta eficiência diagnóstica. / The aim of this work was the study of serologic response against leptospira glycolipoprotein (GLP) for the purpose of standardizing its use as an antigen on serological tests to diagnose human leptospirosis. Among the proteins involved in the pathogenicity, GLP is yet to be studied regarding its immunogenicity and its use as an antigen in the detection of specific antibodies. That led to our standardization of dot-ELISA for detecting IgG and IgM antibodies, using GLP extracted from either pathogenic Leptospira interrogans serovar Copenhageni or nonpathogenic Leptospira biflexa serovar Patoc. Paired serum samples were taken from 90 patients with serologically confirmed leptospirosis, by MAT, with the first samples collected on the disease\'s acute phase and the second samples after a period of 10 to 15 days. We also tested single samples taken from 30 patients with other diseases, MAT negative, belonging to the control group. Detection rates for IgG antibodies were unsatisfactory, so the study for that use was discontinued. The dot-ELISA IgM results yielded 100% sensitivity on the samples taken after MAT seroconversion. The early detection pattern was evidenced by the high positivity rate on the samples taken during the disease\'s acute phase (76,6% dot-ELISA using Leptospira interrogans serovar Copenhageni antigen and 90% using Leptospira biflexa sorovar Patoc antigen). Specificity rates were high (96.6%), although a 3.3% rate of false-positive results was observed for dot-ELISA using both antigens. The present study revealed the importance of the humoral immune response against the GLP antigen. The use of GLP, on the dot-ELISA test for IgM antibodies afforded a simple, quick and effective diagnosis.