[Detection of anti-Candida antibodies of the classes IgM, IgG and IgA using enzyme immunoassay in sequential serum samples of hospitalized patients]

Abstract

Anti-Candida antibodies were determined in 2053 sera with an indirect hemagglutination test (HAT; Labor Diagnostika, Heiden, Germany) and with an enzyme immunoassay (ELISA) which detects IgG antibodies (Institut Virion, Würzburg, Germany). Antigen diagnostics was performed with the Cand-Tec-test (Ramco, Houston, USA). Eighty-eight sera from sixteen patients which were positive for IgG antibodies were screened for IgA and IgM antibodies by ELISA. A humoral immune response during the hospital stay of the sixteen patients was detected first by the HAT. The HAT was also reactive when the IgG and/or IgA antibodies rose above the upper reference value and the IgM antibody level remained unchanged. Synchronous changes of IgG, IgM and IgA antibody concentrations even within the normal range are detected by the HAT several days before one or more of these antibodies rose above the upper reference value. In most patients the IgM immune response preceded an increase in IgG and/or IgA antibody concentration by several days. In patients in whom the serum HAT titer remains constant as a consequence of a decreasing IgM antibody level and an increasing IgG antibody concentration, the selective determination of IgM antibodies by ELISA may yield additional information, e.g. a drop in IgM antibodies may be due to a successful therapy. In several patients antigen detection and antibody screening by HAT should be complemented by an immunoglobulin specific measurement of anti-Candida antibodies.