THE ROLE OF RUBELLA-IMMUNOBLOT AND RUBELLA-PEPTIDE-EIA FOR THE DIAGNOSIS OF THE CONGENITAL-RUBELLA SYNDROME DURING THE PRENATAL AND NEWBORNPERIODS

Rubella infection during the first trimester of pregnancy can cause th e congenital rubella syndrome (CRS). Patients with CRS were shown to h ave a decreased humoral and cellular immunity. It is not known whether asymptomatic newborns who had experienced intrauterine infection with rubella virus (RV) differ in their antibody response from newborns wi th CRS. In this study we compared both groups for a difference which m ight be a useful diagnostic criterion for CRS during the prenatal and newborn periods. We used the nonreducing Rubella-Immunoblot and the Ru bella-lgG-Peptide-Enzyme Immunoassay (EIA) to determine the antibodies directed to rubella proteins E1, E2 and C. The results showed that on ly newborns with CRS who had experienced RV infection during the first 12 weeks of gestation showed significantly reduced levels of antibodi es directed to both the linear RV E1 epitope (SP 15) and the topograph ic RV E2 epitope. Asymptomatic newborns infected mostly later than wee k 10 of gestation showed normal levels of antibodies. These data sugge st that the lack of antibody response in CRS is linked to the immaturi ty of the fetal immune system during the first trimester of gestation. Rubella-IgG-Peptide-EIA and Rubella-Immunoblot should be used additio nally for CRS diagnosis in the prenatal/newborn periods. These results may have an impact on the early treatment of late-onset symptoms of C RS patients. (C) 1997 Wiley-Liss, Inc.