Echinococcosis: Serological Detection of Patients and Molecular Identification of Parasites

Abstract

Alveolar (AE) and cystic echinococcosis (CE) are two of the most dangerous helminthic zoonoses worldwide, representing chronic hepatic diseases, often with lethal outcome. Since early diagnosis of echinococcosis is essential for effective treatment, an overview of serological methods for the detection of echinococcosis and differentiation between AE and CE is given. Recombinant antigens Em18 and Antigen B8/1 are highly recommended for patient screening and identification of AE and CE, respectively, in combination with imaging techniques. Novel aspects of molecular phylogenetic studies on the genus Echinococcus will also be addressed, including the description of Echinococcus shiquicus as a new sister-species of Echinococcus multilocularis. Both the serological detection of the disease and molecular phylogeny will be discussed in perspective.

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

“…This is not an incomprehensible result, because it is known that a few CE patient sera react to rEm18 even though rEm18 is highly specific antigen for AE (11,12,16,18). These results indicated that the ICT is a sensitive and specific method for the diagnosis of E. multilocularis infection.…”

“…Moreover, these imaging techniques are unsuitable for diagnosis in isolated communities. Therefore, immunological tests have been considered important methods to confirm clinical findings, to give diagnostic help by providing information on the parasite in case of unclear images, or to survey in areas of endemicity where imaging techniques are not readily available (4,9,11). Previously, we have reported an enzyme-linked immunosorbent assay (ELISA) and an immunoblot analysis (IB) by using recombinant E. multilocularis 18-kDa antigen (Em18), the breakdown product of ezrin-radixin-moesin-like protein (2) that is also known as EM10 (8), EM II/3 (7), or EM4 (10) by the cysteine peptidase, and demonstrated that these two tests have a high potential for differentially diagnosing AE (1,12,16,18).…”

Serological Monitoring of Progression of Alveolar Echinococcosis with Multiorgan Involvement by Use of Recombinant Em18

“…It is one of the most lethal parasitic infections, and areas contaminated with this parasite are becoming wider and wider in the majority of the Northern Hemisphere, other than tropical and subtropical areas (10,11,19,20,24). When local people living in contaminated areas accidentally ingest eggs of this parasite expelled from foxes and dogs, the embryos develop into metacestodes, so-called alveolar echinococcus, by asexual proliferation, mainly in the liver (in more than 97% of cases of AE).…”

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

“…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.…”