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A diagnostic method for herpes simplex keratitis by simultaneous measurement of viral DNA and virus-specific secretory IgA in tears: an evaluation.
Jpn J Ophthalmol 2016; 60(4):294-301JJ

Abstract

PURPOSE

We performed simultaneous measurement of herpes simplex virus (HSV) DNA by real-time polymerase chain reaction (real-time PCR) and of HSV-specific secretory IgA antibody (HSV-sIgA) by enzyme-linked immunosorbent assay (ELISA) in tears obtained using Schirmer strips in order to investigate its diagnostic efficacy for herpes simplex keratitis (HSK).

METHODS

A total of 59 affected eyes from 59 patients with clinically suspected HSK (HSK group) and 23 eyes from 23 healthy volunteers (control group) were enrolled in this study. The HSK group was divided into five subgroups: dendritic/geographic keratitis, disciform keratitis, necrotizing keratitis, atypical keratitis, and others. The tear samples were taken using Schirmer strips to determine the HSV DNA and HSV-sIgA levels.

RESULTS

The overall sensitivity and specificity were 55.8 and 100 % for HSV DNA and 49.2 and 82.6 % for HSV-sIgA. The HSV DNA levels in the disciform keratitis subgroup (median, 3.1 × 10(2) copies/sample) were significantly lower than those in the dendritic/geographic keratitis subgroup (median, 2.3 × 10(4) copies/sample) (P < 0.05, Mann-Whitney test). The HSV-sIgA levels in the disciform keratitis subgroup (median, 50.0 NU/ml) were significantly higher than those in the control group (median, 18.0 NU/ml) (P < 0.05, Steel test). The positive and negative predictive values obtained by simultaneous measurement of HSV DNA and sIgA were 90.9 and 61.3 %, respectively.

CONCLUSION

The combination of laboratory detection of HSV DNA by real-time PCR and of HSV-sIgA by ELISA using tear samples enables higher reliability in diagnosing the subgroups of HSK, although the HSV DNA value is relatively lower in disciform HSK than in dendritic/geographic HSK.

Authors+Show Affiliations

Division of Ophthalmology, Department of Visual Sciences, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo, 173-8610, Japan. shojig3589eye@athena.ocn.ne.jp.Division of Ophthalmology, Department of Visual Sciences, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo, 173-8610, Japan.Division of Ophthalmology, Department of Visual Sciences, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo, 173-8610, Japan.Department of Ophthalmology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.Department of Ophthalmology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.Department of Ophthalmology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.Division of Ophthalmology, Department of Visual Sciences, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo, 173-8610, Japan.

Pub Type(s)

Evaluation Studies
Journal Article

Language

eng

PubMed ID

27126382

Citation

Shoji, Jun, et al. "A Diagnostic Method for Herpes Simplex Keratitis By Simultaneous Measurement of Viral DNA and Virus-specific Secretory IgA in Tears: an Evaluation." Japanese Journal of Ophthalmology, vol. 60, no. 4, 2016, pp. 294-301.
Shoji J, Sakimoto T, Inada N, et al. A diagnostic method for herpes simplex keratitis by simultaneous measurement of viral DNA and virus-specific secretory IgA in tears: an evaluation. Jpn J Ophthalmol. 2016;60(4):294-301.
Shoji, J., Sakimoto, T., Inada, N., Kamei, Y., Matsubara, M., Takamura, E., & Sawa, M. (2016). A diagnostic method for herpes simplex keratitis by simultaneous measurement of viral DNA and virus-specific secretory IgA in tears: an evaluation. Japanese Journal of Ophthalmology, 60(4), pp. 294-301. doi:10.1007/s10384-016-0448-y.
Shoji J, et al. A Diagnostic Method for Herpes Simplex Keratitis By Simultaneous Measurement of Viral DNA and Virus-specific Secretory IgA in Tears: an Evaluation. Jpn J Ophthalmol. 2016;60(4):294-301. PubMed PMID: 27126382.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A diagnostic method for herpes simplex keratitis by simultaneous measurement of viral DNA and virus-specific secretory IgA in tears: an evaluation. AU - Shoji,Jun, AU - Sakimoto,Tohru, AU - Inada,Noriko, AU - Kamei,Yuko, AU - Matsubara,Masao, AU - Takamura,Etsuko, AU - Sawa,Mitsuru, Y1 - 2016/04/28/ PY - 2015/09/13/received PY - 2016/03/23/accepted PY - 2016/4/30/entrez PY - 2016/4/30/pubmed PY - 2017/3/23/medline KW - Herpes simplex virus KW - Keratitis KW - Real-time polymerase chain reaction KW - Secretory IgA KW - Tear fluid SP - 294 EP - 301 JF - Japanese journal of ophthalmology JO - Jpn. J. Ophthalmol. VL - 60 IS - 4 N2 - PURPOSE: We performed simultaneous measurement of herpes simplex virus (HSV) DNA by real-time polymerase chain reaction (real-time PCR) and of HSV-specific secretory IgA antibody (HSV-sIgA) by enzyme-linked immunosorbent assay (ELISA) in tears obtained using Schirmer strips in order to investigate its diagnostic efficacy for herpes simplex keratitis (HSK). METHODS: A total of 59 affected eyes from 59 patients with clinically suspected HSK (HSK group) and 23 eyes from 23 healthy volunteers (control group) were enrolled in this study. The HSK group was divided into five subgroups: dendritic/geographic keratitis, disciform keratitis, necrotizing keratitis, atypical keratitis, and others. The tear samples were taken using Schirmer strips to determine the HSV DNA and HSV-sIgA levels. RESULTS: The overall sensitivity and specificity were 55.8 and 100 % for HSV DNA and 49.2 and 82.6 % for HSV-sIgA. The HSV DNA levels in the disciform keratitis subgroup (median, 3.1 × 10(2) copies/sample) were significantly lower than those in the dendritic/geographic keratitis subgroup (median, 2.3 × 10(4) copies/sample) (P < 0.05, Mann-Whitney test). The HSV-sIgA levels in the disciform keratitis subgroup (median, 50.0 NU/ml) were significantly higher than those in the control group (median, 18.0 NU/ml) (P < 0.05, Steel test). The positive and negative predictive values obtained by simultaneous measurement of HSV DNA and sIgA were 90.9 and 61.3 %, respectively. CONCLUSION: The combination of laboratory detection of HSV DNA by real-time PCR and of HSV-sIgA by ELISA using tear samples enables higher reliability in diagnosing the subgroups of HSK, although the HSV DNA value is relatively lower in disciform HSK than in dendritic/geographic HSK. SN - 1613-2246 UR - https://www.unboundmedicine.com/medline/citation/27126382/A_diagnostic_method_for_herpes_simplex_keratitis_by_simultaneous_measurement_of_viral_DNA_and_virus_specific_secretory_IgA_in_tears:_an_evaluation_ L2 - https://dx.doi.org/10.1007/s10384-016-0448-y DB - PRIME DP - Unbound Medicine ER -