Development of a new cytomegalovirus (CMV) immunoglobulin M (IgM) immunoblot for detection of CMV-specific IgM

Abstract

We developed a new cytomegalovirus (CMV) immunoglobulin M (IgM) immunoblot to detect CMV-specific IgM in human sera. The new test contains four viral proteins (vp150, vp82, vp65, and vp28) purified from viral particles and four recombinant proteins (rp150, rp130, rp52, and rp38) purified from Escherichia coli. These antigens were individually loaded onto nitrocellulose strips, and the strips were then used to detect CMV-specific IgM by using a mu-specific conjugate. The new assay was evaluated in parallel with one or two IgM enzyme-linked immunosorbent assays (ELISAs) to test 592 serum samples from different groups of latently or acutely infected individuals. The sensitivity of the new assay with respect to the consensus of two ELISAs was 100%, the specificity was 98.6%, the positive predictive value was 96.9%, and the negative predictive value was 100%. We also evaluated the new test by testing sera from pregnant women and transplant recipients with a known clinical history. Our results suggest that the new test combines high sensitivity with high specificity, characteristics that are mutually exclusive with the other commercially available tests. Furthermore, a statistically significant correlation was observed between the number of IgM-reactive bands and the elevated risk of transmission from CMV-infected pregnant women to their offspring.

FIG. 1

Side-by-side display of the old (left) and new (right) blots. The same serum sample, at the same dilution, was used for both blots.

FIG. 2

Representative examples of serum reactivity with the new immunoblot. Viral and recombinant proteins are identified on the right. CKS is the negative control, and μ is the IgM heavy chain and represents the positive control. Lanes: 1 to 8, IgM-positive sera from pregnant women; 9 and 10, IgM-negative sera from pregnant women. Sera 1 to 4 preferentially reacted with recombinant proteins, while sera 5 to 8 reacted with both viral and recombinant proteins. Sera 5 and 6 were from pregnant women who transmitted the infection.

FIG. 3

Distribution of the number of IgM-reactive bands in different groups of pregnant women. Groups: I, infected pregnant women who transmitted the infection; II, infected pregnant women who did not transmit the infection; III, uninfected pregnant women.