Immunoglobulin G and immunoglobulin M polar staining of Toxoplasma gondii in the indirect immunofluorescence test

Polar staining (PS) of Toxoplasma gondii in the indirect immunofluorescence test has been considered a nonspecific reaction caused exclusively by certain immunoglobulin M (IgM) antibodies and confined to the anterior end of the parasite. After we observed a patient with positive serology for Chagas' disease who presented an IgG PS reaction, we studied sera from 120 patients with Chagas' disease, 20 sera from patients with Leishmania donovani infection, and 30 sera from patients with Leishmania braziliensis infection. When only those specimens having no detectable anti-Toxoplasma activity were considered, a significantly (P less than 0.01) higher prevalence of IgG PS was found in the Chagas' disease and L. donovani groups than in sera from normal American and Brazilian adults. Those sera also showed higher PS titers (1:64 to 1:1,024) when compared with controls (1:16 to 1:64). IgG PS titers did not decrease after serum treatment with 2-mercaptoethanol. However, the same treatment removed completely IgM PS. IgG PS, but not IgM PS, could be removed by adsorption with Trypanosoma cruzi epimastigotes. IgM PS was found in all samples studied, except in 41 of a group of 43 umbilical cord sera. It was found that the antigen source and the microscopy system can influence the detection of PS. It is proposed that after finding an intense IgG PS reaction, the laboratory should screen such serum also for anti-T. cruzi antibodies which may be undetected in the sample.