Intraocular anti–Toxoplama gondii IgA antibody production in patient with ocular toxoplamoi Original Reearch Article

PURPOE: To invetigate the immunoglobulin clae aociated with the intraocular anti–Toxoplama gondii antibody repone during clinical ocular toxoplamoi and to determine which immunoglobulin cla i mot helpful in the diagnoi of thi dieae. METHOD: Paired erum and intraocular fluid ample from 155 patient who had uveiti were teted for intraocular anti–T. gondii IgG, IgA, and IgM antibody production. The preence of T. gondii DNA wa determined by polymerae chain reaction. Patient were divided into two group, baed on the initial clinical diagnoi; group 1 included 78 patient with preumed ocular toxoplamoi, and group 2 included 77 patient with uveiti that wa not clinically upected to be ocular toxoplamoi. ample from 27 nonuveiti patient who underwent intraocular urgery were ued a control ubject. The final diagnoi wa baed on the clinical coure and interpretation of laboratory tet. REULT: A final diagnoi of ocular toxoplamoi wa made in 88 of 155 patient (group 1, 68; group 2, 20). Among thee patient, 65% had intraocular IgG production, 52% had intraocular IgA production, 37.5% had both IgG and IgA production, 27% had IgG production only, and 15% had IgA production only. Of the 13 patient teted, only one had intraocular IgM production. Intraocular IgA could not be detected in patient who had final diagnoe other than ocular toxoplamoi or in control ubject. A poitive polymerae chain reaction combined with a tet that wa poitive for intraocular IgG production had a enitivity of 77%, which increaed to 91% after the detection of intraocular IgA production wa added. CONCLUION: Immunoglobulin G i the major cla involved in the humoral immune repone againt the T. gondii paraite, followed by IgA. The determination of IgA production i ueful a an additional tet in the diagnoi of ocular toxoplamoi.