ABSTRACT
Conventional IgG-ELISA methods for diagnosing cat scratch disease (CSD) caused by Bartonella hensela are still poor in sensitivity and specificity, which generally employ bacterial whole-cell proteins or N-lauroyl-sarcosine-insoluble proteins as the antigen. By Western blot analysis, we found that sarcosine-soluble fraction of proteins (SSP) showed highly specific reaction to immunofluorescence assay (IFA)-positive sera obtained from CSD patients compared with the above antigens. Clinical utility of the new ELISA employing SSP was evaluated using sera from 118 patients with clinically suspected CSD (sera positive by IFA: titers ≥ 1:256, n = 46; negative: titers <128, n = 72) and 88 sera from healthy individuals. Sensitivity and specificity of distinguishing IFA-positive patients from healthy individuals were 95.7% and 97.7%, respectively. Fifteen discordant results were observed (13 ELISA(+)/IFA(-); 2 ELISA(-)/IFA(+)). However, all 15 sera reacted with SSP by Western blot analysis, indicating superiority of the new ELISA over IFA. The ELISA employing SSP greatly improved the accuracy of diagnosing CSD.
Subject(s)
Antibodies, Bacterial/blood , Antigens, Bacterial , Bacterial Proteins , Bartonella henselae/immunology , Cat-Scratch Disease/diagnosis , Immunoglobulin G/blood , Adult , Antigens, Bacterial/isolation & purification , Bacterial Proteins/isolation & purification , Child , Child, Preschool , Detergents/metabolism , Enzyme-Linked Immunosorbent Assay/methods , Humans , Sarcosine/analogs & derivatives , Sarcosine/metabolism , Sensitivity and Specificity , Serologic Tests/methodsABSTRACT
The reduction of 6-alkoxy-5-bromo-5,6-dihydrothymine derivatives ( 1a, b) by hydrated electrons (e aq (-)) generated in the radiolysis of deoxygenated aqueous solution was investigated. As the major products, 1-(6'-alkoxy-5',6'-dihydrothymin-5'-yl)thymines ( 6a, b), 5-(hydroxymethyl)uracil ( 8), 6-alkoxy-5,6-dihydrothymines ( 9a, b), and thymine ( 10) were produced in sufficient yields. This product distribution is indicative of the generation of 6-alkoxy-5,6-dihydrothymin-5-yl radicals ( 2a, b) as primary intermediates that undergo elimination of alkoxide ions (RO (-)) into thymine radical cations ( 3) followed by deprotonation at the N1 to form N-centered thymine radicals ( 4). The transient absorption spectra of the 5-yl radicals 2a- c were observed by means of nanosecond laser flash photolysis of 1a, b and 5-bromo-6-ethoxy-5,6-dihydrothymidine ( 1c) in deoxygenated aqueous solution, in which homolytic C5-Br bond dissociation occurred. In contrast to the reaction characteristics in aqueous solutions, the dimeric products were not obtained in acetonitrile, probably because in-cage hydrogen abstraction from the C5 methyl group by bromine atom leads to formation of methide type intermediates 20.
