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ANTIBODIES TO SCHISTOSOMA MANSONI IN HUMAN CEREBROSPINAL FLUID

Cerebrospinal fluid (CSF) and serum samples from patients suspected of having neuroschistosomiasis (NS) were evaluated by an enzyme-linked immunosorbent assay. Monoclonal antibodies of various immunoglobulin isotypes (IgM, IgA, IgE, total IgG, IgG1, IgG2, IgG3, and IgG4) were used to detect antibodies against Schistosoma mansoni soluble egg antigen (SEA) and soluble worm adult preparation (SWAP). Of the 83 CSF samples tested, 55% were reactive to SEA (26% were reactive only to SEA and 29% to both SEA and SWAP), 34% were reactive to SWAP (5% only to SWAP and 29% to both SEA and SWAP), and 40% were not reactive with any antigen. Cases that tested positive for SWAP in CSF and negative in serum were not found. Samples with high specific IgG antibody titers were selected for immunoglobulin isotype profiling. In the CSF samples, the antibodies against SEA and SWAP were mainly IgM, IgG1, and IgG4, although other immunoglobulins were also detected. Interestingly, nine patients had high levels of IgG1 only in the CSF. These results suggest that there is local synthesis of IgG1, and that this isotype could be an important immunologic marker in the diagnosis of NS.

Received September 10, 2001. Accepted for publication September 25, 2002.

Acknowledgments: We thank the patients and the volunteers for their cooperation, the CPqGM-FIOCRUZ and the Federal University of Bahia for institutional support, and Craig Milroy and Ronald Blanton for help with the revision of this manuscript.

Financial support: This work was supported by CNPq (grants 350052/95-6 NV and 135100/95-0), Programa de Apoio ao Núcleo de Excelência (grant 261/96), and the National Institutes of Health (grant 5U01-AI-16305-17).

Authors’ addresses: Isis F. Magalhães-Santos, Theomira M. A. Carmo, Isadora C. Siqueira, and Mitermayer G. Reis, Centro de Pesquisas Gonçalo Moniz-FIOCRUZ, Rua Waldemar Falcão 121 Brotas, Salvador, Bahia, Brazil, CEP-40295-001. Denise C. Lemaire, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Bahia, Brazil. Antonio S. Andrade-Filho, Departamento de Neurologia, Hospital Professor Edgar Santos, Universidade Federal da Bahia, Salvador, Bahia, Brazil. Aristides C. Queiroz, Departamento de Patologia, Hospital Professor Edgar Santos, Universidade Federal da Bahia, Salvador, Bahia, Brazil. Otávio M. Carvalho, Hospital Santo Amaro, Salvador, Bahia, Brazil. Débora M. Andrade, Michely F. Rego and Ana Paula T. Guedes, Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Bahia, Brazil.

Reprint requests: Mitermayer G. Reis, Centro de Pesquisas Gonçalo Moniz-FIOCRUZ, Rua Waldemar Falcão 121 Brotas, Salvador, Bahia, Brazil CEP-40295-001, Telephone: 55-71-356-0129, Fax: 55-71-356-2155, E-mail: miter{at}cpqgm.fiocruz.br

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