Studies on ocular microsporidia

Sera from six ocular microsporidiosis patients and eight individuals with no history of microsporidiosis were assayed by enzyme-linked immunosorbent assay (ELISA) and by Western blot immunodetection. Microsporidia used as antigen include Nosema corneum, Encephalitozoon hellem, Encephalitozoon cuniculi, and Nosema algerae. Three AIDS patients with known E. hellem infections displayed ELISA antibody titers to E. hellem ranging from 1:400 to 1:12,800. Two patients with unclassified microsporidial infections displayed highest antibody titers to N. algerae (1:1,600 and 1:3,200), a mosquito microsporidian which, reportedly, cannot infect man. A sixth patient with a known N. corneum infection displayed the same ELISA antibody titer (1:1,600) to all four microsporidia. Western blot patterns also were variable among the patient sera; however, the most intense and complex antibody-binding patterns corresponded with the higher ELISA antibody titers. Sera from eight HIV-seronegative individuals with no history of microsporidiosis reacted variably to the four microsporidia. These results suggest that diagnosis of microsporidiosis may depend upon direct detection of the organisms using species-specific antibodies or molecular probes rather than conventional serology.