Development of an Immunochromatographic Test To Detect Antibodies against Recombinant Em18 for Diagnosis of Alveolar Echinococcosis

Sako, Yasuhito; Fukuda, Kenta; Kobayashi, Yuki; Itō, Akira

doi:10.1128/jcm.01476-08

J Clin Microbiol

2009

DOI: 10.1128/jcm.01476-08

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Development of an Immunochromatographic Test To Detect Antibodies against Recombinant Em18 for Diagnosis of Alveolar Echinococcosis

Yasuhito Sako

Kenta Fukuda²,

Yuki Kobayashi³

et al.

Abstract: An immunochromatographic test (ICT) for the rapid detection of antibodies to Echinococcus multilocularis was developed. The ICT showed a sensitivity of 94% and a specificity of 95.4%. High degrees of agreement were observed between the ICT and an enzyme-linked immunosorbent assay ( ‫؍‬ 0.93) and between the ICT and immunoblot analysis ( ‫؍‬ 0.97). It is expected that the ICT developed in this study will be useful for the serodiagnosis of alveolar echinococcosis.

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Cited by 27 publications

(25 citation statements)

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“…These new antigens have a better performance than their predecessors and are more reproducible across populations, improving test reliability and allowing a better test standardization (6,9,11,13). Recombinant antigen B8/ 1(rAgB) seems to have a good diagnostic performance in an ELISA format with sensitivity between 94.6% and 95.8, and specificity between 93.9% and 100% (13,14).Immunochromatographic testing (ICT) has demonstrated good performance in comparison with the ELISA format for the diagnosis of alveolar echinococcosis (15,16). ICT is a simple, rapid, and reliable method which, unlike standard ELISA methods, does not require equipment and trained personal, both of which are difficult to find in remote areas (15).…”

mentioning

confidence: 99%

“…Immunochromatographic testing (ICT) has demonstrated good performance in comparison with the ELISA format for the diagnosis of alveolar echinococcosis (15,16). ICT is a simple, rapid, and reliable method which, unlike standard ELISA methods, does not require equipment and trained personal, both of which are difficult to find in remote areas (15).…”

mentioning

confidence: 99%

“…ICT is a simple, rapid, and reliable method which, unlike standard ELISA methods, does not require equipment and trained personal, both of which are difficult to find in remote areas (15). This study mainly attempted to compare an ICT using rAgB and an ELISA format using the same antigen in terms of sensitivity for the diagnosis of CE.…”

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confidence: 99%

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Evaluation of a New Immunochromatographic Test Using Recombinant Antigen B8/1 for Diagnosis of Cystic Echinococcosis

et al. 2015

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i Diagnosis of cystic echinococcosis (CE) is based on the identification of the cyst(s) by imaging, using immunodiagnostic tests mainly as complementary tools in clinical settings. Among the antigens used for immunodiagnosis, previous studies described a good performance of the recombinant antigen B8/1 (rAgB) in an enzyme-linked immunosorbent assay (ELISA) format; however, in remote parts of areas where the disease is endemic, the implementation of an ELISA is difficult, so a more simple, rapid, and reliable method such as the immunochromatographic test (ICT) is required. In this study, using a set of 50 serum samples from patients with surgically confirmed CE, we compared the performance of an ICT and that of an ELISA using the rAgB. The overall sensitivities of ICT and ELISA were not statistically different (78% versus 72%; P ‫؍‬ 0.36). The overall agreement between both tests was moderate ( ‫؍‬ 0.41; P < 0.01). Concordance between ICT and ELISA was substantial or almost perfect for patients with liver involvement ( ‫؍‬ 0.65; P < 0.001) and patients with more than one hydatid cyst ( ‫؍‬ 0.82; P < 0.001), respectively. Moreover, specificity analysis using a total of 88 serum samples from healthy individuals (n ‫؍‬ 20) and patients (n ‫؍‬ 68) with other parasitic infections revealed that ICT had a specificity of 89.8%. ICT and ELISA had similar performance for the detection of specific antibodies to E. granulosus, and ICT had a high specificity, opening the possibility of using ICT as a screening tool in rural settings. Cystic echinococcosis (CE) is a zoonotic disease caused by the larval stage of the dog tapeworm Echinococcus granulosus. This zoonosis has a worldwide distribution, being considered a public health problem in areas dedicated to the raising of livestock where CE is endemic (1). In these areas, risk factors such as access of dogs to contaminated viscera and close contact between infected dogs and humans facilitate and maintain the transmission of the disease (2, 3). Humans are infected by the accidental ingestion of the tapeworm eggs, which can develop to the larval stage (hydatid cyst) in any internal organ after several years. The organs more frequently involved are the liver and the lungs, representing ϳ70% and ϳ20% of cases, respectively (4). Diagnosis of CE is based on the identification of the hydatid cyst(s) by imaging methods (e.g., abdominal ultrasound, chest X ray, or computed tomography) (5). Immunodiagnostic tools are of use in clinical settings as a complementary diagnostic tool and have quite variable performance, which depends on the antigen or technique used and is affected by certain disease characteristics, such as cyst location and presence of cyst rupture or aggregated bacterial infection (6-9).Among the antigens used for immunodiagnostic, hydatid cyst fluid (HCF) has been the one most widely used. Antibody-detecting assays using HCF report sensitivities between 75% and 95% with poor specificity and frequent cross-reactions (5, 9-11). More recently, synthetic peptides or recombi...

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confidence: 99%

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confidence: 99%

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Evaluation of a New Immunochromatographic Test Using Recombinant Antigen B8/1 for Diagnosis of Cystic Echinococcosis

et al. 2015

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“…11 , 12 Case 4 showed very strong antibody responses to RecEm18, the highly specific diagnostic antigen for detection of active AE by both IB and ICT. [10][11][12][13][14][15] This finding indicates that this woman still had active lesions, because serology becomes negative within 1 year of successful radical resection. 12 , 13 A pre-surgical serum sample from case 5 also showed very strong antibody responses to RecEm18 in IB and ICT, suggesting that AE could have been easily confirmed if serology was introduced for diagnosis before surgery.…”

mentioning

confidence: 81%

“…Among the five confirmed AE cases in Mongolia, three patients (cases 1-3) died before, during, or within 1 week of surgery because of the advanced stage of disease. Figure 2A ) and a commercially available rapid immunochromatography (ICT) kit 10 ( Figures 2B-C ) using a recombinant Em18 (RecEm18). 11 , 12 Case 4 showed very strong antibody responses to RecEm18, the highly specific diagnostic antigen for detection of active AE by both IB and ICT.…”

mentioning

confidence: 99%

Histopathological, Serological, and Molecular Confirmation of Indigenous Alveolar Echinococcosis Cases in Mongolia

Itō

Agvaandaram²,

Bat-Ochir³

et al. 2010

The American Society of Tropical Medicine and Hygiene

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Alveolar echinococcosis cases diagnosed histopathologically in 2002, 2006, 2007, and 2009 in Ulaanbaatar, Mongolia were reconfirmed by evaluating the cytochrome c oxidase subunit I gene of mitochondrial DNA. The most recent three cases using paraffin-embedded and ethanol-fixed specimens revealed that one was of the “Asian” haplotype, whereas two others were of the “Inner Mongolian” type. All patients were born in the western provinces of Mongolia, they never resided outside of Mongolia, and they were given a preliminary diagnosis of malignant hepatic tumor or abscess. The most recent two cases were also confirmed serologically to be active alveolar echinococcosis.

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Differential diagnosis of cystic and alveolar echinococcosis using an immunochromatographic test based on the detection of specific antibodies

et al. 2013

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Human cystic and alveolar echinococcoses are zoonotic diseases caused by the larval stages of Echinococcus granulosus and Echinococcus multilocularis, respectively. As the diseases are co-endemic in many areas of the world, a simple and rapid test for the differential diagnosis of cystic echinococcosis (CE) and alveolar echinocoocosis (AE) is needed. Here, we describe the development of an immunochromatographic test (ICT) using crude hydatid cyst fluid and a recombinant 18-kDa protein (rEm18) as antigens for the detection of E. granulosus and E. multilocularis antibodies in serum samples. The ICT was evaluated with serum samples from 195 echinococcosis patients from different endemic areas in northwestern China. These included 144 from CE patients, 51 from AE patients, 67 from patients with other parasitic diseases, 13 from patients with serous hepatic cysts, and 60 from healthy individuals. The sensitivity and specificity of the ICT for CE were 91.0 and 96.9% and for AE were 98.0 and 99.3% with diagnostic efficiencies of 94.1 and 99.1%, respectively. No significant differences and high degrees of agreement were found between the ICT and an enzyme-linked immunosorbent assay for both CE and AE. Five serum samples from cysticercosis patients and one serum sample from a healthy control were found positive for CE with the ICT. These findings indicate that this test allows for discrimination between both forms of human echinococcosis. In conclusion, the ICT developed in this study is a promising tool for the simultaneous detection and discrimination of CE and AE. This test will be useful for serodiagnosis of CE and AE in clinical settings and screening programs.

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Development of an Immunochromatographic Test To Detect Antibodies against Recombinant Em18 for Diagnosis of Alveolar Echinococcosis

Cited by 27 publications

References 18 publications

Evaluation of a New Immunochromatographic Test Using Recombinant Antigen B8/1 for Diagnosis of Cystic Echinococcosis

Evaluation of a New Immunochromatographic Test Using Recombinant Antigen B8/1 for Diagnosis of Cystic Echinococcosis

Histopathological, Serological, and Molecular Confirmation of Indigenous Alveolar Echinococcosis Cases in Mongolia

Differential diagnosis of cystic and alveolar echinococcosis using an immunochromatographic test based on the detection of specific antibodies

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