Comparison of several commercial serologic kits and Em18 serology for detection of human alveolar echinococcosis

doi:10.1016/j.diagmicrobio.2007.03.018

Diagnostic Microbiology and Infectious Disease

Volume 59, Issue 1, September 2007, Pages 93-95

https://doi.org/10.1016/j.diagmicrobio.2007.03.018 Get rights and content

Abstract

The aim of this study was to design the best serologic strategy for diagnosing human alveolar echinococcosis (AE) cases in medical laboratory routine procedures. By combining 2 screening techniques, indirect hemagglutination with Em^2plus-ELISA and/or recEm18-ELISA, 46 of 47 AE cases were detected. The necessary confirmation of results is then obtained by using immunoblot (LDBIO-IB® and/or recEm18-IB).

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Acknowledgments

The authors are grateful to Mrs. Sonoyo Itoh, Pascale Simon, and Florence Skana for their excellent technical support. We also thank Lois Rose for her editorial assistance. This work was supported in part by a grant-in-aid for Scientific Research (142556001, 17256002) from the Japan Society for Promotion of Science to AI.

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Imaging aspect and non-surgical interventional treatment in human alveolar echinococcosis
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Improved primary immunodiagnosis of alveolar echinococcosis in humans by an enzyme-linked immunosorbent assay using the Em2plus antigen
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A. Ito et al.
Evaluation of an enzyme-linked immunosorbent assay (ELISA) with affinity-purified Em18 and an ELISA with recombinant Em18 for differential diagnosis of alveolar echinococcosis: results of a blind test
J. Clin. Microbiol.
(2002)
M. Liance et al.
Immunodiagnosis of Echinococcus infections: confirmatory testing and species differentiation by a new commercial Western Blot
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There are more references available in the full text version of this article.

Cited by (24)

Large-scale evaluation of a rapid diagnostic test for human cystic echinococcosis
2017, Diagnostic Microbiology and Infectious Disease
Citation Excerpt :
If at least one first-line test was positive or equivocal, an immunoblot test (Echinococcus Western Blot IgG, LDBIO Diagnostic, Lyon, France) was used to confirm the positive result, as proposed in French National Health Ministry recommendations (available on the website from French National Health Insurance at http://www.codage.ext.cnamts.fr/f_mediam/fo/nabm/DOC043.pdf) and WHO-IWGE guidelines (Brunetti et al., 2010). The combination of the tests and the use of lowered cut-off values, for IHA (Bart et al., 2007) as well for Echinococcus granulosus and Em2plus ELISA (unpublished data) optimize the sensitivity of first-line analyses. A positive immunoblot is then required to confirm a positive sample or eliminate a false positive sample.
Cystic echinococcosis (CE) is a neglected zoonotic disease, diagnosed through clinical findings, imaging techniques, and serology, for which many serological tests are available. Here we report a rapid unit assay, the immunochromatographic VIRapid® HYDATIDOSIS test (Vircell, Granada, Spain), potentially suitable for laboratories in low-prevalence or poorly equipped areas. This test was evaluated with a large retrospective cohort (224 sera), including patients suffering from CE or from other parasitic or liver diseases. The test was also assessed in routine conditions with a prospective cohort (115 sera) in areas where both cystic and alveolar echinococcoses have been diagnosed. Its performance (in terms of sensitivity, specificity, and both positive and negative likelihood ratios) was similar to an ELISA based on a crude antigen. Our study shows that this test performs adequately in the diagnostic process, when used with caution, especially regarding cross-reactivity with other parasitic diseases.
Development of a colloidal gold immunochromatographic strip based on HSP70 for the rapid detection of Echinococcus granulosus in sheep
2017, Veterinary Parasitology
Citation Excerpt :
However, specialized equipment are required in most of these diagnosis methods, on the other hand, immunochromatographic strip is a rapid, cheap and specific detection technique that can be completed within 30 min. The application of the various recombinant antigens such as Em18, antigen B and antigen 5 has been reported in the serodiagnosis of echinococcosis (Bart et al., 2007; Ito et al., 2007; Reiterova et al., 2014). HSP70 was first identified by Colebrook and Lightowlers (1997) as an immunogen; Ortona et al. (2003) also found HSP70 of E. granulosus (Eg2HSP70) as an antigenic molecule inducing both B and T cell responses.
Echinococcus granulosus is the causative pathogen of cystic echinococcosis, a serious disease endangering human and animal health. In this study, an immunochromatographic strip was developed based on the recombinant protein Heat shock protein 70 (HSP70) for the serological detection of E. granulosus. The protocol completes within 20 min requiring no specialized equipment or chemical reagents, while specificity tests confirmed no cross-reactivity with positive serum of Fasciola hepatica, Haemonchus contortus, Peste des petits ruminants virus (PPRV) and Foot-and-mouth disease virus (FMDV). The strips remained stable after storage at 4 °C for up to 8 months. Both immunochromatographic strip and ELISA tests were applied to detect E. granulosus antibody in a total of 728 serum samples obtained from slaughter houses in Zhejiang Province. Our data revealed positive rates of 2.61 and 1.65% by immunochromatographic strip and ELISA methods, respectively. The immunochromatographic strip test developed in this study provides a simple, specific and rapid method of E. granulosus antibody detection and infected sheep monitoring.
Diagnosis of alveolar echinococcosis
2014, Revue Francophone des Laboratoires
L’échinococcose alvéolaire est une cestodose larvaire due à Echinococcus multilocularis. Les carnivores (renards, chiens), hôtes définitifs, transmettent les œufs du parasite via leurs fèces contaminées. Les hôtes intermédiaires (rongeurs, accidentellement l’homme) ingèrent les œufs puis la larve parasitaire se développe dans le foie tel un cancer à marche lente. La lésion peut ensuite s’étendre par contiguïté et/ou s’accompagner de métastases. L’accroissement des populations de renards, leur urbanisation, et l’extension vers l’ouest de la zone d’endémie vulpine du parasite en France augmentent le risque de contamination humaine. Les patients infectés sont désormais fréquemment détectés à un stade précoce, asymptomatique. Des formes « opportunistes » chez les patients immunodéprimés sont apparues, leurs modalités de présentation inhabituelles sont source d’errance et de retard diagnostiques. Le diagnostic repose sur les données d’imagerie et est confirmé par la sérologie spécifique, l’anatomie pathologique des lésions, et/ou la PCR sur biopsies. La prise en charge des patients est multidisciplinaire. Elle repose sur l’administration d’albendazole : pour une durée de 2 ans post-chirurgie, si la résection totale des lésions est réalisable, ou administré a priori à vie si la chirurgie radicale est impossible. Une surveillance des taux plasmatiques d’albendazole sulfoxyde, et des effets secondaires (transaminases, numération sanguine), est nécessaire. Les résections chirurgicales incomplètes ou « palliatives » sont déconseillées, la prise en charge des complications biliaires ou vasculaires hépatiques par radiologie ou endoscopie interventionnelles est favorisée.
Chez les patients non opérés, l’évolution des images en tomodensitométrie par émission de positon (TEP-TDM) et de la sérologie spécifique aident à évaluer l’activité fonctionnelle parasitaire et, parfois, à arrêter le traitement en maintenant la surveillance du patient. La transplantation hépatique est réservée aux patients en impasse thérapeutique. Les avancées dans le diagnostic et le management thérapeutique des cas ont permis d’évoluer progressivement vers des traitements personnalisés et d’améliorer la survie et la qualité de vie des patients.
Alveolar echinococcosis is a larval cestodosis due to Echinococcus multilocularis. Eggs of parasite are excreted in feces of definitive hosts (carnivores: foxes, dogs). These eggs are eaten by intermediate hosts (rodents, and accidentally humans) and parasite larva develops in the liver of intermediate hosts like a slow-growing cancer. Then it may grow progressively to neighboring tissues and organs, and be associated with metastases. An unprecedented increase in fox populations, fox urbanization and, in France, an extension of the endemic area with infected foxes towards western regions of the country led to an increased risk of contamination. E. multilocularis-infected patients are now more frequently diagnosed at an early asymptomatic stage. Recently, cases of “opportunistic” AE, in immune suppressed patients, have been more frequently diagnosed. Unusual modes of presentation of these infections led to a delayed diagnosis. Diagnosis of alveolar echinococcosis relies on imaging. It is confirmed by specific serology, pathological examination of the lesions, and/or PCR on biopsies. Care management of patients is multidisciplinary, based on administration of albendazole: during a 2-year period after surgery, if total resection of the lesions is possible, or potentially administered for life, if radical surgery is impossible. Partial resection (“palliative surgery”) should be avoided and complications should be alleviated by interventional radiology or endoscopy. Monitoring of albendazole treatment lies on hepatic tests and blood cell count (for adverse effects), and plasma levels of albendazole sulfoxide. In cases with long-term albendazole treatment, course of Positron-Emission-Tomography (PET-CT) images and of specific serology are of help to evaluate the functional activity of parasitic lesions and to withdraw the treatment in rare cases, under close patient's follow-up. Liver transplantation is only indicated in those patients with advanced cases and therapeutic cul-de-sac. Advances in diagnosis and care management of cases have allowed clinicians to design personalized treatments and to considerably improve survival and quality of life of patients.
Alveolar echinococcosis: Epidemiology, survey and management
2013, Journal des Anti-Infectieux
L’échinococcose alvéolaire (EA) humaine est une zoonose parasitaire. Son cycle repose sur des hôtes intermédiaires (rongeurs, lagomorphes) et définitif (carnivores : renards essentiellement, chiens). L’hôte définitif transmet le parasite à l’homme via ses fèces, contaminées par les oncosphères d’Echinococcus multilocularis, dont la larve va se développer au niveau hépatique à la manière d’un cancer à marche lente. L’échinococcose alvéolaire peut progressivement s’étendre aux structures biliaires et vasculaires, aux tissus et organes voisins, et s’accompagner de métastases à distance. Les patients infectés sont actuellement détectés fréquemment à un stade précoce, asymptomatique. L’augmentation des populations de renards, leur implantation croissante dans les villes et l’extension de la zone d’endémie du parasite chez les renards modifient l’épidémiologie de la maladie. La prise en charge des patients doit être multidisciplinaire et repose sur des points clés : chirurgie radicale si réalisable ; pas de gestes chirurgicaux palliatifs ; si possible radiologie interventionnelle ou endoscopie pour traiter les complications biliaires ou vasculaires ; transplantation hépatique indiquée uniquement chez les patients avec complications majeures, en impasse thérapeutique ; traitement médical de tous les patients sans exception par albendazole en continu, au moins deux ans après une chirurgie radicale et au long cours chez les patients non opérés ; tomographie par émission de positons couplée à la tomodensitométrie (TEP-TDM) et sérologie spécifique pour évaluer l’activité fonctionnelle parasitaire et monitorer le traitement ; suivi régulier des taux plasmatiques d’albendazole. La survie et la qualité de vie des patients se sont considérablement améliorées grâce à l’optimisation de cette prise en charge.
Human alveolar echinococcosis (AE) is a parasitic zoonosis with intermediate (rodents and lagomorphs) and final hosts (carnivores, mainly fox but also dogs). The latter can transmit the parasite to humans, by their feces, which are contaminated by the oncospheres of Echinococcus multilocularis, the larvae of which develop in the liver like a slow cancer. This chronically progressive disease may involve adjacent tissues and organs. Distant metastases may also be observed. Infected patient are frequently detected at earlier asymptomatic stage. Increasing fox populations, their invasion of the cities and the detection of the parasite in foxes from previously parasite-free areas seem to currently modify the epidemiology of AE. Patients’ management must be multidisciplinary and includes (i) radical liver resection whenever possible, (ii) avoidance of palliative surgical procedures, (iii) use of interventional radiology or endoscopy to treat biliary and vascular complications whenever possible, (iv) indication of liver transplantation only in patients with life-threatening complications, (v) treatment of all patients without exception by albendazole for at least two years after radical surgery and long-term (at least several years) in non operated cases, (vi) use of positron-emission tomography combined with computed tomography (PET-CT) and specific serological tools to assess the functional activity of the lesions and monitor treatment, (vii) regular monitoring of albendazole plasmatic levels. Patients’ survival and quality of life have improved very substantially, due to optimized care strategy.
Comparison of the usefulness of hydatid cyst fluid, native antigen B and recombinant antigen B8/1 for serological diagnosis of cystic echinococcosis
2012, Transactions of the Royal Society of Tropical Medicine and Hygiene
Citation Excerpt :
This is consistent with results of other studies which have used this antigen for sero-diagnosis of CE.9,13,22 Through our previous studies,9,12,13,19,23–26 we expected that native antigens might include many non-specific components which may cause cross reactivity with other parasitic or even non-parasitic infections. Therefore, the positive reaction of non-CE patients and Iranian healthy subjects might be due to infection with some other diseases but not CE, since healthy controls from Japan showed no such positive reactivity.
For serodiagnosis of cystic echinococcosis (CE), the usefulness of three native antigens, a hydatid cyst fluid (HCF) obtained from infected sheep in China, two types of antigen B prepared from each HCF obtained in Iran and China, and one recombinant antigen B8/1 (RAgB), were evaluated by ELISA using a total of 155 serum samples from Iran, Turkey, China and Japan. Both the Iranian native antigen B and RAgB had high sensitivity, but RAgB showed an excellent specificity in comparison with native antigens because none of the serum samples of healthy people from Iran and Japan became positive with this antigen except one case of taeniasis. The taeniasis case exceptionally showing cross reactivity with all antigens was considered to be co-infected with Echinococcus granulosus and Taenia saginata. The recombinant antigen showing a high diagnostic odds ratio in comparison with other evaluated antigens might be recommended for diagnosis of CE in different CE-endemic areas.
Role of surgery in the management of pulmonary parasitosis
2012, Revue de Pneumologie Clinique
Les parasitoses pulmonaires sont des pathologies rares en France et de diagnostic difficile. Si de nombreux parasites peuvent être responsables de manifestations respiratoires, seuls quelques uns peuvent se développer dans le parenchyme et y entraîner des complications relevant d’une prise en charge chirurgicale. L’exemple le plus commun est le kyste hydatique du poumon. Les auteurs passent en revue les cycles, les formes cliniques, le diagnostic et les principes thérapeutiques des principaux parasites pulmonaires qui relèvent d’une prise en charge chirurgicale.
Pulmonary parasitosis is scarcely encountered in France, and its diagnosis is quite difficult. If numerous parasites can be responsible for respiratory symptoms, only few of them can develop in the lung parenchyma and lead to complications necessitating a surgical treatment. The most common example is the hydatic disease of the lung. The authors review the biological cycles, clinical forms, diagnostic and treatment principles of those main lung parasites, which deserve surgical consideration.

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¹: Both authors contributed equally to the work.

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Diagnostic Microbiology and Infectious Disease

Abstract

Section snippets

Acknowledgments

References (8)

Imaging aspect and non-surgical interventional treatment in human alveolar echinococcosis

Parasitol. Int.

Improved primary immunodiagnosis of alveolar echinococcosis in humans by an enzyme-linked immunosorbent assay using the Em2plus antigen

J. Clin. Microbiol.

Evaluation of an enzyme-linked immunosorbent assay (ELISA) with affinity-purified Em18 and an ELISA with recombinant Em18 for differential diagnosis of alveolar echinococcosis: results of a blind test

J. Clin. Microbiol.

Immunodiagnosis of Echinococcus infections: confirmatory testing and species differentiation by a new commercial Western Blot

J. Clin. Microbiol.

Cited by (24)

Large-scale evaluation of a rapid diagnostic test for human cystic echinococcosis

Development of a colloidal gold immunochromatographic strip based on HSP70 for the rapid detection of Echinococcus granulosus in sheep

Diagnosis of alveolar echinococcosis

Alveolar echinococcosis: Epidemiology, survey and management

Comparison of the usefulness of hydatid cyst fluid, native antigen B and recombinant antigen B8/1 for serological diagnosis of cystic echinococcosis

Role of surgery in the management of pulmonary parasitosis

NotesComparison of several commercial serologic kits and Em18 serology for detection of human alveolar echinococcosis

Abstract

Section snippets

Acknowledgments

Parasitol. Int.

Improved primary immunodiagnosis of alveolar echinococcosis in humans by an enzyme-linked immunosorbent assay using the Em2plus antigen

J. Clin. Microbiol.

Evaluation of an enzyme-linked immunosorbent assay (ELISA) with affinity-purified Em18 and an ELISA with recombinant Em18 for differential diagnosis of alveolar echinococcosis: results of a blind test

J. Clin. Microbiol.

Immunodiagnosis of Echinococcus infections: confirmatory testing and species differentiation by a new commercial Western Blot

J. Clin. Microbiol.

Notes
Comparison of several commercial serologic kits and Em18 serology for detection of human alveolar echinococcosis