Serological Diagnosis and Follow-Up of Human Cystic Echinococcosis: A New Hope for the Future?
Cystic echinococcosis (CE) is an important helminthic zoonotic disease caused by the Echinococcus granulosus complex. In humans, CE is a chronic disease driven by the growth of echinococcal cysts in different organs. Prognosis of this disease depends on multiple factors, including location, number, size, and stage of the cysts, making CE a disease of complex management. CE is usually asymptomatic for years and attracts limited attention from funding organizations and health authorities. For this reason, only experts' recommendations are available but no evidence-based conclusions have been drawn for CE clinical management. One of those pitfalls refers to the lack of evidence to support the use of serological tools for the diagnosis and follow-up of CE patients. In this respect, crude antigens are used to detect specific antibodies in patients, giving rise to false positive results. The advent of molecular techniques allowing the production of recombinant proteins has provided a number of candidate antigens that could overcome the problems associated with the use of crude parasite extracts in the serological assays. In this review, we present the last advances in this field, proposing the use of serology to support cyst stage-specific diagnosis and follow-up.
Instituto de Recursos Naturales y Agrobiología de Salamanca (IRNASA-CSIC), Cordel de Merinas 40-52, 37008 Salamanca, Spain.
Raúl
R
Manzano-Román
Instituto de Recursos Naturales y Agrobiología de Salamanca (IRNASA-CSIC), Cordel de Merinas 40-52, 37008 Salamanca, Spain.
Carlos
C
Sánchez-Ovejero
Instituto de Salud Carlos III, Centro Nacional de Microbiología, Majadahonda, 28220 Madrid, Spain.
Ana
A
Hernández-González
Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
Adriano
A
Casulli
Instituto de Recursos Naturales y Agrobiología de Salamanca (IRNASA-CSIC), Cordel de Merinas 40-52, 37008 Salamanca, Spain.
Mar
M
Siles-Lucas
D000818:Animals; D000909:Antibodies, Helminth / Q000032:analysis; D000947:Antigens, Helminth / Q000235:genetics / Q000302:isolation & purification; D004443:Echinococcosis / Q000175:diagnosis* / Q000276:immunology / Q000469:parasitology; D048209:Echinococcus granulosus / Q000235:genetics / Q000276:immunology; D005500:Follow-Up Studies; D015801:Helminth Proteins / Q000235:genetics / Q000276:immunology; D006801:Humans; D011379:Prognosis; D011994:Recombinant Proteins / Q000235:genetics / Q000276:immunology; D012698:Serologic Tests / Q000639:trends; D015047:Zoonoses / Q000175:diagnosis / Q000276:immunology / Q000469:parasitology
D000909:Antibodies, Helminth; D000947:Antigens, Helminth; D015801:Helminth Proteins; D011994:Recombinant Proteins