Usefulness of recombinant Em18-ELISA to evaluate efficacy of treatment in patients with alveolar echinococcosis.
Alveolar echinococcosis (AE) is a rare parasitic disease caused by Echinococcus multicularis and most commonly involves the liver. Early diagnosis is essential to improve the prognosis of patients with AE of the liver. Em18, an 18-kD diagnostic antigen from Echinococcus multilocularis, is highly specific and sensitive to detect AE. We previously reported that an enzyme-linked immunosorbent assay (ELISA) system using a recombinant Em18 antigen (RecEm18) was highly useful in the differential serodiagnosis of AE. In this report, we present seven AE patients who showed dynamic changes in RecEm18-ELISA values in the course of long-term follow up of albendazole (ABZ) chemotherapy, and/or resections of the liver or bone metastasis. All seven AE patients revealed positive values, over the cutoff level, of the RecEm18-ELISA before the treatments. The values in six patients fell below the cutoff level after the treatments, but the value in a patient with recurrence never fell below the cutoff level, and increased again. From these results, it seems that the RecEm18-ELISA is useful to evaluate the efficacy of treatment and predict recurrence in patients with AE. RecEm18-ELISA may be an important examination for: (a) the mass screening of AE in Japan, (b) the confirmative diagnosis of AE prior to surgical and/or chemotherapeutic treatments, (c) the follow up of AE patients after treatments, and (d) for deciding on the discontinuation of chemotherapy in patients with an appropriate response.
Fujimoto
Yoshinori
Y
Third Department of Internal Medicine, 2-1 Midorigaoka-Higashi, Asahikawa 078-8510, Japan.
Ito
Akira
A
Ishikawa
Yuji
Y
Inoue
Mitsutaka
M
Suzuki
Yasuaki
Y
Ohhira
Masumi
M
Ohtake
Takaaki
T
Kohgo
Yutaka
Y
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D015766:Albendazole / Q000008:administration & dosage / Q000627:therapeutic use*; D000818:Animals; D000871:Anthelmintics / Q000008:administration & dosage / Q000627:therapeutic use*; D000947:Antigens, Helminth / Q000276:immunology*; D003937:Diagnosis, Differential; D004334:Drug Administration Schedule; D004444:Echinococcosis, Hepatic / Q000175:diagnosis* / Q000469:parasitology / Q000628:therapy; D048210:Echinococcus multilocularis / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000871:Anthelmintics; D000947:Antigens, Helminth; C117889:Em18 antigen; D015766:Albendazole