Journal of Diabetes and Its Complications 29 (2015) 970
Contents lists available at ScienceDirect
Journal of Diabetes and Its Complications journal homepage: WWW.JDCJOURNAL.COM
Ad36: skip serology, NAT we need To the Editor:
Recently, Olga Dubuisson discussed accurate identification of neutralizing antibodies to adenovirus type 36 (Ad36), a putative contributor of obesity in humans (Dubuisson, Day, & Dhurandhar, 2015). In their manuscript, the authors indicate a problem of false positive results obtained by an EIA supposedly specific for Ad36 antibody. However, from a clinical, epidemiological and public health point of view, there may be another important problem regarding the detection of Ad36 infections in humans. More precisely, there is a still unresolved paradox in Ad36 literature based on high Ad36 seroprevalences indicating high human Ad36 infection rates in different geographic areas in the world, despite a quasi total non-detection of Ad36 in humans by viral culture and/or nucleic acid testing (NAT) methods (Goossens, 2013). Few additional Ad36 data are available. Recently in Turkey, Ad36 DNA was not detected in any of the adipose tissue samples of the patient or control groups (Ergin et al., 2015). In line with results of Dubuisson et al. the possibility of problematic Ad36 serology must be considered in at least some available assays supposedly specific for Ad36 antibodies. In some way, this is an illustration that for some assays, among other methods including ‘golden standards’, actual positive results for Ad36 antibodies are not as specific as assumed. Besides potential cross-reactivity with other adeno(and adeno-like) viruses, other possibilities have to be considered. Especially in diabetics and in overweight/obese individuals, aberrant lipid fractions, growth factors and hormonal substances, inflammatory factors, glycated (end) products and (auto-) immunity marks are subject of ongoing research. As such, and by the nature of these
Conflict of interest: none.
http://dx.doi.org/10.1016/j.jdiacomp.2015.03.012 1056-8727/© 2015 Elsevier Inc. All rights reserved.
products, the consequences of disturbing factors are more likely to be found in SNA-serology as performed in highly vulnerable living cell systems. In contrast, remaining disturbing factors are most unlikely in robust and validated NAT diagnostics performed on samples highly pretreated for DNA/RNA isolation. From that point of view, and although SNA is considered as ‘golden standard’ for Ad36 serology, there still remains an ongoing discussion concerning Ad36 as a putative contributor of obesity in humans. The results of Dubuisson et al. illustrate some difficulties in false positive Ad36 serology, and indirectly advocate the need of NAT data in future Ad36-related obesity and diabetes research. Are human Ad36 infections really that frequent, or are they almost non- or hardly existing? With ongoing specificity problems in AD36 serology, one may be attempted to say: “Ad36: skip serology, NAT we need”. Valère J. Goossens Windmolenstraat 17, B-3690 Zutendaal, Belgium E-mail address: [email protected] References Dubuisson, O., Day, R. S., & Dhurandhar, N. V. (2015). Accurate identification of neutralizing antibodies to adenovirus Ad36, -a putative contributor of obesity in humans. Journal of Diabetes and its Complications, 29, 83–87. http://dx.doi.org/10. 1016/j.jdiacomp.2014.09.004. Ergin, S., Altan, E., Pilanci, O., Sirekbasan, S., Cortuk, O., Cizmecigil, U., et al. (2015). The role of adenovirus 36 as a risk factor in obesity: The first clinical study made in the fatty tissues of adults in Turkey. Microbial Pathogenesis. http://dx.doi.org/10.1016/j. micpath.2015.02.008 (pii: S0882-4010(15)00027-3). Goossens, V. J. (2013). Adenovirus-36 prevalence paradox in development. Journal of Clinical Virology, 56(1), 5–6. http://dx.doi.org/10.1016/j.jcv.2012.09.009.
Contents lists available at ScienceDirect
Journal of Diabetes and Its Complications journal homepage: WWW.JDCJOURNAL.COM
Ad36: skip serology, NAT we need To the Editor:
Recently, Olga Dubuisson discussed accurate identification of neutralizing antibodies to adenovirus type 36 (Ad36), a putative contributor of obesity in humans (Dubuisson, Day, & Dhurandhar, 2015). In their manuscript, the authors indicate a problem of false positive results obtained by an EIA supposedly specific for Ad36 antibody. However, from a clinical, epidemiological and public health point of view, there may be another important problem regarding the detection of Ad36 infections in humans. More precisely, there is a still unresolved paradox in Ad36 literature based on high Ad36 seroprevalences indicating high human Ad36 infection rates in different geographic areas in the world, despite a quasi total non-detection of Ad36 in humans by viral culture and/or nucleic acid testing (NAT) methods (Goossens, 2013). Few additional Ad36 data are available. Recently in Turkey, Ad36 DNA was not detected in any of the adipose tissue samples of the patient or control groups (Ergin et al., 2015). In line with results of Dubuisson et al. the possibility of problematic Ad36 serology must be considered in at least some available assays supposedly specific for Ad36 antibodies. In some way, this is an illustration that for some assays, among other methods including ‘golden standards’, actual positive results for Ad36 antibodies are not as specific as assumed. Besides potential cross-reactivity with other adeno(and adeno-like) viruses, other possibilities have to be considered. Especially in diabetics and in overweight/obese individuals, aberrant lipid fractions, growth factors and hormonal substances, inflammatory factors, glycated (end) products and (auto-) immunity marks are subject of ongoing research. As such, and by the nature of these
Conflict of interest: none.
http://dx.doi.org/10.1016/j.jdiacomp.2015.03.012 1056-8727/© 2015 Elsevier Inc. All rights reserved.
products, the consequences of disturbing factors are more likely to be found in SNA-serology as performed in highly vulnerable living cell systems. In contrast, remaining disturbing factors are most unlikely in robust and validated NAT diagnostics performed on samples highly pretreated for DNA/RNA isolation. From that point of view, and although SNA is considered as ‘golden standard’ for Ad36 serology, there still remains an ongoing discussion concerning Ad36 as a putative contributor of obesity in humans. The results of Dubuisson et al. illustrate some difficulties in false positive Ad36 serology, and indirectly advocate the need of NAT data in future Ad36-related obesity and diabetes research. Are human Ad36 infections really that frequent, or are they almost non- or hardly existing? With ongoing specificity problems in AD36 serology, one may be attempted to say: “Ad36: skip serology, NAT we need”. Valère J. Goossens Windmolenstraat 17, B-3690 Zutendaal, Belgium E-mail address: [email protected] References Dubuisson, O., Day, R. S., & Dhurandhar, N. V. (2015). Accurate identification of neutralizing antibodies to adenovirus Ad36, -a putative contributor of obesity in humans. Journal of Diabetes and its Complications, 29, 83–87. http://dx.doi.org/10. 1016/j.jdiacomp.2014.09.004. Ergin, S., Altan, E., Pilanci, O., Sirekbasan, S., Cortuk, O., Cizmecigil, U., et al. (2015). The role of adenovirus 36 as a risk factor in obesity: The first clinical study made in the fatty tissues of adults in Turkey. Microbial Pathogenesis. http://dx.doi.org/10.1016/j. micpath.2015.02.008 (pii: S0882-4010(15)00027-3). Goossens, V. J. (2013). Adenovirus-36 prevalence paradox in development. Journal of Clinical Virology, 56(1), 5–6. http://dx.doi.org/10.1016/j.jcv.2012.09.009.
