Assay of IgA to Shigella flexneri during shigellosis

An enzyme-linked immunosorbent assay (ELISA) to Shigella flexneri 2a whole bacterium was used to determine IgM, IgG and IgA serum titers in 50 acute-phase shigellosis patients and 37 controls, i.e., hospital patients without known recent infections. Compared to controls, the shigellosis patients displayed statistically raised average serum titers to S. flexneri in all 3 above immunoglobulin classes, most notably IgA, which displayed an average 42-fold increase. Specific IgM and IgG were 5- and 16-fold higher, respectively. All sera displayed statistically raised titers in at least one immunoglobulin class. A Widal agglutination detected a 7-fold increase in serum titers; this was comparable to the IgM ELISA. Statistical analysis showed that the intra-assay error of the ELISA varied from 5 to 14%, depending on the absorbance from which titers were calculated. A second ELISA was performed on the above shigellosis sera to determine titers to purified lipopolysaccharide (LPS): a statistical correlation was found between these and the above values for all 3 immunoglobulin classes. We conclude that the use of S. flexneri whole bacterium as an antigen in an IgA ELISA is a statistically valid and convenient parameter for monitoring shigellosis, comparable to the use of LPS as antigen, and more sensitive than IgM or IgG ELISAs or agglutinations.