J Korean Med Sci.
2013 May;28(5):672-679. 10.3346/jkms.2013.28.5.672.
Improvement of the Diagnostic Sensitivity of Scrub Typhus Using a Mixture of Recombinant Antigens Derived from Orientia tsutsugamushi Serotypes
- Affiliations
-
- 1Immunemed, Chuncheon, Korea. ywkim@hallym.ac.kr
- 2Medical Science Institute, Hallym University, Chuncheon, Korea.
- 3Department of Microbiology, College of Medicine, Hallym University, Chuncheon, Korea.
- 4Department of Life Science, Hallym University, Chuncheon, Korea.
- 5Department of Microbiology, College of Medicine, Korea University, Seoul, Korea.
- 6Division of Pulmonology, Department of Internal Medicine, Medical Center, Hallym University, Chuncheon, Korea.
- 7Department of Microbiology, College of Medicine, Seoul National University, Seoul, Korea.
- KMID: 1777553
- DOI: http://doi.org/10.3346/jkms.2013.28.5.672
Abstract
- Diagnosis of scrub typhus is difficult because its symptoms are very similar to other acute febrile illnesses, such as leptospirosis, murine typhus, and other viral hemorrhagic fevers. To differentiate scrub typhus from other acute febrile diseases, a rapid and reliable serological diagnosis is important. We have developed a chimeric recombinant antigen cr56 and two other recombinant antigens, r21 and kr56, from various serotypes of Orientia tsutsugamushi. They were tested for the detection of antibodies against O. tsutsugamushi in the patient's serum samples using enzyme-linked immunosorbent assay (ELISA) and dot-blot analyses. As of conventional immunofluorescence assay (IFA), when the mixture of these three recombinant antigens was used, both sensitivity and specificity of the recombinant antigens were increased up to 98% in IgM and IgG at ELISA and dot blotting. Additionally, both sensitivity and specificity by detection of IgM and IgG antibodies at rapid diagnostic test (RDT), using the mixture of three antigens and gold conjugated antibodies, were 99%. Our results suggest the use of mixture of these recombinant antigen proteins in ELISA or RDT is suitable as a diagnostic test for scrub typhus.
Keyword
MeSH Terms
-
Antibodies, Bacterial/blood/chemistry/immunology
Antigens, Bacterial/diagnostic use/genetics/metabolism
Enzyme-Linked Immunosorbent Assay
Fluorescent Antibody Technique, Indirect
Gold/chemistry
Humans
Immunoassay
Immunoglobulin G/blood
Immunoglobulin M/blood
Orientia tsutsugamushi/immunology/*metabolism
Recombinant Proteins/biosynthesis/diagnostic use/genetics
Scrub Typhus/*diagnosis
Sensitivity and Specificity
Serotyping
Antibodies, Bacterial
Antigens, Bacterial
Immunoglobulin G
Immunoglobulin M
Recombinant Proteins
Gold
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