A tool for mass-screening of paragonimiasis: an enzyme-linked immunosorbent assay with urine samples

Abstract

BackgroundParagonimiasis is one of the foodborn trematodiases and number of the patients was estimated to be about 23 million around the world. To obtain good compliance of people for the surveillance of paragonimiasis, an enzyme-linked immunosorbent assay (ELISA) for the diagnosis of paragonimiasis with unconcentrated urine samples was developed.ResultsParagonimus westermani antigen specific IgG and IgG4 were detected in urine samples from paragonimiasis patients and the levels correlated well with those detected in the paired serum samples. Cross-reactions observed among other trematodiasis and a tuberculosis patient with the antigen specific IgG were much reduced by detecting the antigen specific IgG4; 9.2 % to 2.3 %.Conclusions The ELISA with urine samples, which are collected safely and easily, will be a useful tool for a mass-screening of paragonimiasis.

One delayed diagnosis of paragonimiasis case and literature review

“…IgG-serology (enzyme-linked immunosorbent assay (ELISA)), an immunodiagnostic method that can detect and measure antibodies in the blood, although not widely available, is actually the best diagnostic method, reaching a sensitivity of 92% and specificity of 97% [34]. As previously reported, ELISA with urine samples is much more easy, safe, and non-invasive [35]. Despite the fact that 13 cases in our data were serum Paragonimus sp.…”

Detection of Urinary Antibodies and Its Application in Epidemiological Studies for Parasitic Diseases

“…The urinary RV-specific IgA/IgG ratio peaks 4 weeks after vaccination, suggesting the possibility of early diagnosis of RV infection [ 6 ]. It is also interesting to find that the detection of parasite-specific IgG4 is superior in specificity to IgG with urine [ 12 , 14 ] as compared with serum [ 55 , 56 , 57 ] that is, detecting parasite-specific IgG4 might reduce a nonspecific reaction.…”

“…A urine ELISA method has also been reported to detect the parasite-specific IgG against adult worms of P. westermani with a high sensitivity of 100%. Although the sensitivity became slightly low at 90%, measuring antigen-specific IgG4 antibodies can reduce cross-reactivity with other trematodes compared to IgG [ 12 ] ( Table 1 ).…”

“…Urine antibody detections were strongly interfered with by extremely low or high pH urine (data not shown). Therefore, urine samples for ELISA are commonly added to sodium azide to a final concentration of 0.1% ( w / v ) to avoid a change of urine pH as an effect of contamination and growth of bacteria [ 2 , 4 , 10 , 11 , 12 , 15 , 28 , 30 , 35 , 52 ]. However, as the addition of sodium azide does not completely inhibit the growth of bacteria [ 54 ], the development of new preservatives that keep the antibodies in urine stable for a long period is needed.…”

“…Urine ELISA methods have been reported to detect specific antibodies against viruses and bacteria such as Helicobacter pylori [ 2 , 3 , 5 ], rubella virus (RV) [ 6 ], dengue virus [ 7 ], hepatitis C virus (HCV) [ 8 ], and human immunodeficiency virus-1 (HIV-1) [ 9 ] and also against parasites such as Leishmania donovani [ 10 ], Wuchereria bancrofti [ 4 ], Schistosoma japonicum [ 11 ], Paragonimus westermani [ 12 ], Echinococcus granulosus [ 13 ], Echinococcus multilocularis [ 14 ], Strongyloides stercoralis [ 15 ], and Opisthorchis viverrini [ 16 ]. These are almost all of the parasitic diseases for which antibody detection methods in urine have been reported.…”