The Serum and Conjunctival Antibody Response to Trachoma in Gambian Children

Ninety-nine young Gambian children were studied for 61 weeks. About half of them had trachoma at the outset, and 80% of the remainder acquired the disease while under observation. IgG trachoma antibody in the serum and IgG and IgA antibodies in the conjunctival secretions (CS) were titrated by an indirect immunofluorescence method. In serum samples obtained in capillary tubes the mean titre was slightly higher than in samples collected on filter paper. Serum antibody at titres >/= 1/10 was invariably associated with a clinical diagnosis of trachoma; it increased both in frequency and titre as the disease progressed, and was present in about half of those with Tr II. In CS, IgG antibody was present less often and at lower titres than in serum, and IgA antibody was detected even less frequently. There was some evidence of correlation between the titres of IgG and IgA antibodies in CS, but none for a relationship between the titres of the antibodies in serum and those in CS. Antibodies were almost never present in the absence of conjunctival follicles, but their titres were unrelated to the degree of follicular hyperplasia; there was no obvious relationship between the serological findings and corneal lesions. In children diagnosed clinically as trachoma, serum antibody was present in almost all those with conjunctival inclusions, and in a proportion of inclusion-negative subjects; the mean titre was much higher in the inclusion-positive group.These findings do not settle whether CS antibodies are made locally, or are derived partly or wholly from the blood. They suggest that the indirect immunofluorescence test may be a useful diagnostic aid in trachoma, particularly in view of the rarity of false positive reactions; but there is at present little to choose between it and complement-fixation tests in terms of sensitivity.