Native and recombinant antigens in the immunodiagnosis of human cystic echinococcosis.
To evaluate the diagnostic sensitivity and specificity of immunoelectrophoresis (IEP), indirect haemagglutination (IHA), enzyme-linked immunosorbent assay (ELISA) and immunoblotting (IB), we compared their ability in detecting IgG antibodies to a hydatid fluid fraction (HFF) and to native and recombinant antigen B of Echinococcus granulosus. We tested sera from patients who had cystic echinococcosis (CE) grouped according to their type of cysts (n = 204), from patients with other parasitic diseases (n = 21), lung or liver carcinomas (n = 6) or serous cysts (n = 26) and from healthy controls (n = 90). HFF-IB gave the highest sensitivity (80%) followed by ELISA (72%), IHA (54%) and IEP (31%), respectively. The diagnostic sensitivity significantly (P < 0.01) decreased as cysts matured from type I-II to type VII. Recombinant and native antigen B-IB yielded similar sensitivity (74%). A large number of clinically or surgically confirmed CE patients (20%) resulted negative. In these patients' sera, IB to assess the usefulness of the recombinant E. granulosus elongation factor-1 beta/delta in detecting IgE antibodies yielded 33% of positivity. Our findings underline the need to standardize techniques and antigenic preparations and to improve the performance of immunodiagnosis by characterizing new antigens and detecting distinct immunoglobulin classes.
Ortona
E
E
Laboratorio di Immunologia, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Roma, Italy.
Riganò
R
R
Margutti
P
P
Notargiacomo
S
S
Ioppolo
S
S
Vaccari
S
S
Barca
S
S
Buttari
B
B
Profumo
E
E
Teggi
A
A
Siracusano
A
A
D000818:Animals; D000909:Antibodies, Helminth / Q000097:blood*; D000947:Antigens, Helminth / Q000235:genetics / Q000276:immunology*; D004443:Echinococcosis / Q000175:diagnosis* / Q000276:immunology / Q000469:parasitology; D004446:Echinococcus / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D006386:Hemagglutination Tests; D006801:Humans; D015151:Immunoblotting; D007122:Immunoelectrophoresis; D011237:Predictive Value of Tests; D011994:Recombinant Proteins / Q000276:immunology; D012680:Sensitivity and Specificity
D000909:Antibodies, Helminth; D000947:Antigens, Helminth; D011994:Recombinant Proteins