RESUMEN
Neurocysticercosis accounts for approximately 30% of all epilepsy cases in most developing countries. The immunodiagnosis of cysticercosis is complex and strongly influenced by the course of infection, the disease burden, the cyst location, and the immune response of the host. The main approach to immunodiagnosis should thus be to evaluate whether the serological results are consistent with the diagnosis suggested by imaging. Antibody detection is performed using lentil lectin-purified parasite antigens in an enzyme-linked immunoelectrotransfer blot format, while antigen detection uses a monoclonal antibody-based enzyme-linked immunosorbent assay (ELISA). Promising new assay configurations have been developed for the detection of both antibody and antigen, including assays based on synthetic or recombinant antigens that may reduce costs and improve assay reproducibility and multiplex bead-based assays that may provide simultaneous quantitative results for several target antigens or antibodies.
Asunto(s)
Cysticercus/inmunología , Inmunoensayo , Pruebas Inmunológicas , Neurocisticercosis/diagnóstico , Taenia solium/inmunología , Animales , Anticuerpos Antihelmínticos/sangre , Anticuerpos Antihelmínticos/líquido cefalorraquídeo , Anticuerpos Antihelmínticos/inmunología , Antígenos Helmínticos/sangre , Antígenos Helmínticos/inmunología , Cysticercus/aislamiento & purificación , Humanos , Neurocisticercosis/parasitología , Neurocisticercosis/patología , Reproducibilidad de los Resultados , Taenia solium/aislamiento & purificaciónRESUMEN
One of the most well-characterized tests for diagnosing neurocysticercosis (NCC) is the enzyme-linked immunoelectrotransfer blot (EITB) assay developed at the CDC, which uses lentil lectin-bound glycoproteins (LLGP) extracted from Taenia solium cysticerci. Although the test is very reliable, the purification process for the LLGP antigens has been difficult to transfer to other laboratories because of the need for expensive equipment and technical expertise. To develop a simpler assay, we previously purified and cloned the diagnostic glycoproteins in the LLGP fraction. In this study, we evaluated three representative recombinant or synthetic antigens from the LLGP fraction, individually and in different combinations, using an immunoblot assay (recombinant EITB). Using a panel of 249 confirmed NCC-positive and 401 negative blood serum samples, the sensitivity of the recombinant EITB assay was determined to be 99% and the specificity was 99% for diagnosing NCC. We also tested a panel of 239 confirmed NCC-positive serum samples in Lima, Peru, and found similar results. Overall, our data show that the performance characteristics of the recombinant EITB assay are comparable to those of the LLGP-EITB assay. This new recombinant- and synthetic antigen-based assay is sustainable and can be easily transferred to other laboratories in the United States and throughout the world.
Asunto(s)
Immunoblotting/métodos , Neurocisticercosis/diagnóstico , Péptidos/inmunología , Proteínas Recombinantes/inmunología , Animales , Anticuerpos Antihelmínticos/sangre , Anticuerpos Antihelmínticos/inmunología , Antígenos Helmínticos/sangre , Antígenos Helmínticos/inmunología , Glicoproteínas/inmunología , Humanos , Neurocisticercosis/sangre , Neurocisticercosis/inmunología , Perú , Sensibilidad y Especificidad , Taenia solium/inmunología , Teniasis/sangre , Teniasis/diagnóstico , Teniasis/inmunologíaRESUMEN
We examined 87 Brazilian individuals of a group of 132 that, on July and November 1994, participated in a peace mission in Mozambique. They served in an endemic area for haematobic schistosomiasis, where they swam in Licungo river during leisure time. Their arithmetic mean age was 31 year and all of them were male. Their urine test showed that 30 (34.5%) eliminated S. haematobium eggs and 55 (63.2%) presented positive serology by the enzyme-linked immunoelectrotransfer blot test with purified microsomal antigen of S. haematobium adult worms. Eosinophilia was found in 30 (34.5%), haematuria in 26 (29.9%), dysuria in 32 (36.8%) and lumbar pain in 36 (41.4%). All of those that eliminated eggs through urine had positive serology. Among the 25 patients with positive serology and without S. haematobium eggs in the urine test, 13 were symptomatic and 12 asymptomatic. The treatment with praziquantel for the 30 patients, with urine positive to S. haematobium eggs, presented 70% of parasitological cure.
Asunto(s)
Antihelmínticos/uso terapéutico , Antígenos Helmínticos/inmunología , Praziquantel/uso terapéutico , Schistosoma haematobium/aislamiento & purificación , Esquistosomiasis Urinaria/diagnóstico , Adulto , Animales , Brasil , Ensayo de Inmunoadsorción Enzimática/métodos , Humanos , Cooperación Internacional , Masculino , Personal Militar , Mozambique , Recuento de Huevos de Parásitos , Schistosoma haematobium/inmunología , Esquistosomiasis Urinaria/tratamiento farmacológicoRESUMEN
Nós examinamos 87 brasileiros de um grupo de 132 que, entre julho e novembro de 1994, participaram de um missão de paz em Moçambique. Eles serviram em uma área endêmica de esquistossomose haematóbica e nadaram no rio Licungo em períodos de lazer. A idade aritmética deles era 31 anos e todos eram do gênero masculino. O exame de urina revelou que 30 (34,5%) eliminavam ovos de S. haematobium e 55 (63,2%) tinham sorologia positiva pelo teste enzyme-linked immunoelectrotransfer blot com antígeno microsomal purificado de vermes adultos de S. haematobium. Eosinofilia foi encontrada em 30 (34,5%), haematuria em 26(29,9%), disúria em 32(36,8%) e dor lombar em 36(41,4%). Todos que eliminavam ovos pela urina tiveram sorologia positiva. Entre os 25 pacientes com sorologia positiva e sem ovos de S. haematobium no exame de urina, 13 eram sintomáticos e 12 assintomáticos. O tratamento pelo Prazinquantel nos 30 pacientes com urina positiva para ovos de S. haematobium apresentou 70% de cura parasitológica.