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Ehmen C, Medialdea-Carrera R, Brown D, de Filippis AMB, de Sequeira PC, Nogueira RMR, Brasil P, Calvet GA, Blessmann J, Mallmann AM, Sievertsen J, Rackow A, Schmidt-Chanasit J, Emmerich P, Schmitz H, Deschermeier C, Mika A. Accurate detection of Zika virus IgG using a novel immune complex binding ELISA. Trop Med Int Health 2020; 26:89-101. [PMID: 33012038 DOI: 10.1111/tmi.13505] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVES Accurate serological assays are urgently needed to support public health responses to Zika virus (ZIKV) infection with its potential to cause foetal damage during pregnancy. Current flavivirus serology for ZIKV infections lacks specificity due to cross-reacting antibodies from closely related other flaviviruses. In this study, we evaluated novel serological tests for accurate ZIKV IgG detection. METHODS Our ELISAs are based on immune complex binding. The high specificity is achieved by the simultaneous incubation of labelled ZIKV antigen and unlabelled flavivirus homolog protein competitors. Two assays were validated with a panel of 406 human samples from PCR-confirmed ZIKV patients collected in Brazil (n = 154), healthy blood donors and other infections from Brazil, Europe, Canada and Colombia (n = 252). RESULTS The highest specificity (100% [252/252, 95% confidence interval (CI) 98.5-100.0]) was shown by the ZIKV ED3 ICB ELISA using the ED3 antigen of the ZIKV envelope. A similar test using the NS1 antigen (ZIKV NS1 ICB ELISA) was slightly less specific (92.1% [232/252, 95% CI 88.0-95.1]). The commercial Euroimmun ZIKV ELISA had a specificity of only 82.1% (207/252, 95% CI 76.8-86.7). Sensitivity was high (93-100%) from day 12 after onset of symptoms in all three tests. Seroprevalence of ZIKV IgG was analysed in 87 samples from Laos (Asia) confirming that the ED3 ELISA showed specific reactions in other populations. CONCLUSIONS The novel ED3 ICB ELISA will be useful for ZIKV-specific IgG detection for seroepidemiological studies and serological diagnosis for case management in travellers and in countries where other flavivirus infections are co-circulating.
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Affiliation(s)
- C Ehmen
- Diagnostics Development Laboratory, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - R Medialdea-Carrera
- Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, UK
| | - D Brown
- Flavivirus Reference Laboratory, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | | | - R M Ribeiro Nogueira
- Flavivirus Reference Laboratory, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - P Brasil
- Acute Febrile Illnesses Laboratory, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - G A Calvet
- Acute Febrile Illnesses Laboratory, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - J Blessmann
- Department for Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - A-M Mallmann
- Diagnostics Development Laboratory, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - J Sievertsen
- Diagnostics Development Laboratory, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - A Rackow
- Diagnostics Development Laboratory, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - J Schmidt-Chanasit
- Department for Virology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - P Emmerich
- Department for Virology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.,Department of Tropical Medicine and Infectious Diseases, Center of Internal Medicine II, University of Rostock, Rostock, Germany
| | - H Schmitz
- Department for Virology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - C Deschermeier
- Diagnostics Development Laboratory, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - A Mika
- Diagnostics Development Laboratory, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
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Rackow A, Ehmen C, von Possel R, Medialdea-Carrera R, Brown D, Bispo de Filippis AM, Carvalho de Sequeira P, Ribeiro Nogueira RM, Halili B, Jakupi X, Berisha L, Ahmeti S, Sherifi K, Schmidt-Chanasit J, Schmitz H, Mika A, Emmerich P, Deschermeier C. Immunoglobulin-like Domain of HsFcμR as a Capture Molecule for Detection of Crimean-Congo Hemorrhagic Fever Virus- and Zika Virus-Specific IgM Antibodies. Clin Chem 2019; 65:451-461. [PMID: 30709812 DOI: 10.1373/clinchem.2018.294819] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 12/07/2018] [Indexed: 11/06/2022]
Abstract
BACKGROUND The cellular surface molecule HsTOSO/FAIM3/HsFcμR has been identified as an IgM-specific Fc receptor expressed on lymphocytes. Here, we show that its extracellular immunoglobulin-like domain (HsFcμR-Igl) specifically binds to IgM/antigen immune complexes (ICs) and exploit this property for the development of novel detection systems for IgM antibodies directed against Crimean-Congo hemorrhagic fever virus (CCHFV) and Zika virus (ZIKV). METHODS His-tagged HsFcμR-Igl was expressed in Escherichia coli and purified by affinity chromatography, oxidative refolding, and size-exclusion chromatography. Specific binding of HsFcμR-Igl to IgM/antigen ICs was confirmed, and 2 prototypic ELISAs for the detection of anti-CCHFV and anti-ZIKV IgM antibodies were developed. Thereby, patient sera and virus-specific recombinant antigens directly labeled with horseradish peroxidase (HRP) were coincubated on HsFcμR-Igl-coated ELISA plates. Bound ICs were quantified by measuring turnover of a chromogenic HRP substrate. RESULTS Assay validation was performed using paired serum samples from 15 Kosovar patients with a PCR-confirmed CCHFV infection and 28 Brazilian patients with a PCR-confirmed ZIKV infection, along with a panel of a priori CCHFV/ZIKV-IgM-negative serum samples. Both ELISAs were highly reproducible. Sensitivity and specificity were comparable with or even exceeded in-house gold standard testing and commercial kits. Furthermore, latex beads coated with HsFcμR-Igl aggregated upon coincubation with an IgM-positive serum and HRP-labeled antigen but not with either component alone, revealing a potential for use of HsFcμR-Igl as a capture molecule in aggregation-based rapid tests. CONCLUSIONS Recombinant HsFcμR-Igl is a versatile capture molecule for IgM/antigen ICs of human and animal origin and can be applied for the development of both plate- and bead-based serological tests.
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Affiliation(s)
- Anne Rackow
- Diagnostics Development Laboratory, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Christa Ehmen
- Diagnostics Development Laboratory, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Ronald von Possel
- Department for Virology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Raquel Medialdea-Carrera
- National Institute for Health Research/Institute of Infections and Global Health, University of Liverpool, Health Protection Research Unit in Emerging and Zoonotic Infections, Liverpool, UK
| | - David Brown
- Instituto Oswaldo Cruz/Fiocruz, Laboratório de Flavivirus, Rio de Janeiro, Brazil
| | | | | | | | - Barie Halili
- University Clinical Center of Kosovo, Infectious Diseases Clinic, Pristhina, Kosovo
| | - Xhevat Jakupi
- Department of Microbiology, National Institute for Public Health of Kosova, Prishtina, Kosovo
| | - Lindita Berisha
- University Clinical Center of Kosovo, Infectious Diseases Clinic, Pristhina, Kosovo
| | - Salih Ahmeti
- University of Prishtina "Hasan Prishtina," Medical Faculty and University Clinical Center of Kosovo, Infectious Diseases Clinic, Prishtina, Kosovo
| | - Kurtesh Sherifi
- Faculty of Agricultural and Veterinary Medicine, University of Pristhina "Hasan Prishtina," Pristhina, Kosovo
| | - Jonas Schmidt-Chanasit
- Department for Virology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Herbert Schmitz
- Department for Virology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Angela Mika
- Diagnostics Development Laboratory, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Petra Emmerich
- Department for Virology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.,Department of Tropical Medicine and Infectious Diseases, Center of Internal Medicine II, University of Rostock, Rostock, Germany
| | - Christina Deschermeier
- Diagnostics Development Laboratory, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany;
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Emmerich P, Mika A, von Possel R, Rackow A, Liu Y, Schmitz H, Günther S, Sherifi K, Halili B, Jakupi X, Berisha L, Ahmeti S, Deschermeier C. Sensitive and specific detection of Crimean-Congo Hemorrhagic Fever Virus (CCHFV)-Specific IgM and IgG antibodies in human sera using recombinant CCHFV nucleoprotein as antigen in μ-capture and IgG immune complex (IC) ELISA tests. PLoS Negl Trop Dis 2018; 12:e0006366. [PMID: 29579040 PMCID: PMC5892944 DOI: 10.1371/journal.pntd.0006366] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 04/10/2018] [Accepted: 03/05/2018] [Indexed: 11/22/2022] Open
Abstract
As the most widespread tick-borne arbovirus causing infections in numerous countries in Asia, Africa and Europe, Crimean-Congo Hemorrhagic Fever Virus (CCHFV, family Nairoviridae) was included in the WHO priority list of emerging pathogens needing urgent Research & Development attention. To ensure preparedness for potential future outbreak scenarios, reliable diagnostic tools for identification of acute cases as well as for performance of seroprevalence studies are necessary. Here, the CCHFV ortholog of the major bunyavirus antigen, the nucleoprotein (NP), was recombinantly expressed in E.coli, purified and directly labeled with horseradish peroxidase (HRP). Employing this antigen, two serological tests, a μ-capture ELISA for the detection of CCHFV-specific IgM antibodies (BLACKBOX CCHFV IgM) and an IgG immune complex (IC) ELISA for the detection of CCHFV-specific IgG antibodies (BLACKBOX CCHFV IgG), were developed. Test performance was evaluated and compared with both in-house gold standard testing by IgM/IgG indirect immunofluorescence (IIF) and commercially available ELISA tests (VectoCrimean-CHF-IgM/IgG, Vector-Best, Russia) using a serum panel comprising paired samples collected in Kosovo during the years 2013–2016 from 15 patients with an acute, RT-PCR-confirmed CCHFV infection, and 12 follow-up sera of the same patients collected approximately one year after having overcome the infection. Reliably detecting IgM antibodies in all acute phase sera collected later than day 4 after onset of symptoms, both IgM ELISAs displayed excellent diagnostic and analytical sensitivity (100%, 95% confidence interval (CI): 85.2%–100.0%). While both IgG ELISAs readily detected the high IgG titers present in convalescent patients approximately one year after having overcome the infection (sensitivity 100%, 95% CI: 73.5%–100.0%), the newly developed BLACKBOX CCHFV IgG ELISA was superior to the commercial IgG ELISA in detecting the rising IgG titers during the acute phase of the disease. While all samples collected between day 11 and 19 after onset of symptoms tested positive in both the in-house gold standard IIFT and the BLACKBOX CCHFV IgG ELISA (sensitivity 100%, 95% CI: 71.5%–100.0%), only 27% (95% CI: 6.0%–61.0%) of those samples were tested positive in the commercial IgG ELISA. No false positive signals were observed in either IgM/IgG ELISA when analyzing a priori CCHFV IgM/IgG negative serum samples from healthy blood donors, malaria patients and flavivirus infected patients as well as CCHFV IgM/IgG IIFT negative serum samples from healthy Kosovar blood donors (for BLACKBOX CCHFV IgM/IgG: n = 218, 100% specificity, 95% CI: 98.3%–100.0%, for VectoCrimean-CHF-IgM/IgG: n = 113, 100% specificity, 95% CI: 96.8%–100.0%). Being endemic in several countries in Asia, Africa, the Middle East and Southeastern Europe, the Crimean-Congo Hemorrhagic Fever Virus (CCHFV) is the geographically most widespread tick-borne arbovirus. As evidenced by the recent occurrence of an autochthonous CCHFV infection in Spain, it possesses also a significant potential to spread to as yet non-endemic regions. Due to the severity of the disease caused by this bunyavirus, the lack of specific prophylactic and therapeutic measures and the infection’s epidemic potential, CCHFV was included in the WHO priority list of diseases needing urgent R&D attention, in particular the development and improvement of diagnostic tools. Here we present the development and validation of two novel ELISAs (BLACKBOX CCHFV IgM, BLACKBOX CCHFV IgG) for the detection of CCHFV-specific IgM and IgG antibodies employing recombinant CCHFV nucleoprotein (NP) as antigen. Test performance in comparison to both in-house gold standard testing (CCHFV IgM/IgG immunofluorescence test (IIFT)) and commercial ELISA kits (VectoCrimean-CHF-IgM/IgG; Vector-Best) was evaluated using a thoroughly characterized serum panel that was obtained from 15 Kosovar patients with an RT-PCR-confirmed CCHFV-infection collected during the years 2013–2016 and that comprised samples from both the acute and convalescent phase of the disease. While both IgM ELISAs, like the CCHFV IgM IIFT, detected CCHFV-specific IgM antibodies in all sera collected during the acute phase of the disease on day 5 after onset of symptoms or later, the BLACKBOX CCHFV IgG ELISA and the CCHFV IgG IIFT were found to be significantly more sensitive than the VectoCrimean-CHF-IgG ELISA in detecting the rising IgG antibody titers in samples collected between days 11 and 19 after onset of symptoms.
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Affiliation(s)
- Petra Emmerich
- Department for Virology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- Department of Tropical Medicine and Infectious Diseases, Center of Internal Medicine II, University of Rostock, Rostock, Germany
| | - Angela Mika
- Diagnostics Development Laboratory, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Ronald von Possel
- Department for Virology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Anne Rackow
- Diagnostics Development Laboratory, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Yang Liu
- Diagnostics Development Laboratory, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Herbert Schmitz
- Department for Virology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Stephan Günther
- Department for Virology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Kurtesh Sherifi
- Faculty of Agricultural and Veterinary Medicine, University of Pristhina “Hasan Prishtina”, Pristhina, Kosovo
| | - Barie Halili
- University Clinical Center of Kosovo, Infectious Diseases Clinic, Pristhina, Kosovo
| | - Xhevat Jakupi
- Department of Microbiology, National Institute for Public Health of Kosova, Prishtina, Kosovo
| | - Lindita Berisha
- University Clinical Center of Kosovo, Infectious Diseases Clinic, Pristhina, Kosovo
| | - Salih Ahmeti
- University of Prishtina “Hasan Prishtina”, Medical Faculty & University Clinical Center of Kosovo, Infectious Diseases Clinic, Prishtina, Kosovo
| | - Christina Deschermeier
- Diagnostics Development Laboratory, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- * E-mail:
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