Em2-ELISA for the follow-up of alveolar echinococcosis after complete surgical resection of liver lesions

Gottstein, Bruno; Tschudi, K.; Eckert, Johannes; Ammann, Rudolf W.

doi:10.1016/0035-9203(89)90512-9

Cited by 41 publications

(29 citation statements)

References 12 publications

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“…The preliminary use of Em2 ELISA indicated that anti-Em2 antibody concentrations declined dramatically within months after a successful radical operation (77). These findings were confirmed in subsequent larger studies (59).…”

Section: Immunology Definitive Hostssupporting

confidence: 74%

Molecular and immunological diagnosis of echinococcosis

Gottstein

1992

Clin Microbiol Rev

125

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Echinococcosis is an infectious disease of humans caused by the larval (metacestode) stage of the cestode species Echinococcus granulosus (cystic echinococcosis or hydatid disease) or Echinococcus multilocularis (alveolar echinococcosis or alveolar hydatid disease). Clinical manifestations depend primarily on localization and size of hepatic lesions and may include hepatomegaly, obstructive jaundice, or cholangitis. Prognostically, alveolar echinococcosis is considered similar to liver malignancies, including a lethality rate of 90% for untreated cases. Diagnosis is based on imaging techniques coupled with immunodiagnostic procedures. Antibody detection tests for E. multilocularis have markedly improved with the use of affinity-purified Em2 antigen and recombinant antigen II/3-10 in enzyme immunoassays. Antigens of corresponding quality for E. granulosus are still unavailable. The detection of circulating antigens and immune complexes in the sera of patients with cystic echinococcosis, the demonstration of in vitro lymphocyte proliferation in response to stimulation with Echinococcus antigens, and the discrimination of serum immunoglobulin isotype activity to various Echinococcus antigens in both cystic and alveolar echinococcosis have been suggested for diagnostic purposes as well as for monitoring patients after treatment. New diagnostic molecular tools include DNA probes for Southern hybridization tests and polymerase chain reaction for the amplification of E. multilocularis and E. granulosus species-specific DNA fragments.

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Section: Immunology Definitive Hostssupporting

confidence: 74%

Molecular and immunological diagnosis of echinococcosis

Gottstein

1992

Clin Microbiol Rev

125

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“…E. granulosus and E. multilocularis share many common antigens, but for the differential diagnosis the specific E. multilocularis antigens Em2+ and Em18 are recommended for diagnosis of human AE (Gottstein et al, 1989;Ito et al 1995). In our study, the concentration of total IgG antibodies (expressed as antibody units in %) to Em2+ antigen was in a high correlation with IgG to EmP antigen during the follow up of all patients.…”

Section: Discussionsupporting

confidence: 47%

“…The standard control values for IgG and IgG4 to EmP antigen were the highest ratios between the positive and negative controls. Finally, the recorded OD values were used to calculate antibody units (AU) as the percentage of the positive standard control values accord-ing to Gottstein et al (1989). Levels of specific IgG and IgG4 antibodies obtained with EmP antigen are presented in Table 1.…”

Section: Antigens and Serological Testsmentioning

confidence: 99%

Clinical and serological study of human alveolar echinococcosis in Slovakia in relation to the outcome of chemotherapy

Kinčeková

Hrčková

Auer³

et al. 2006

Helminthologia

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SummaryAlveolar echinococcosis (AE), caused by proliferating metacestodes of the parasitic fox tapeworm Echinococcus multilocularis, is a life-threatening disease in humans. In this study we report four human cases of AE in Slovak Republic with regard to various clinical manifestations and susceptibility to chemotherapy with albendazole or mebendazole. Patients were monitored serologically by ELISA test and Western Blots within 2 -5 years after initiation of chemotherapy/surgery. Using computerized tomography (CT) we compared morphological changes of the parasitic lesions in the liver during the course of treatment. The parasitic lesions in the CT were manifested as nodular hyperplasia with hyper or hypodense zones and calcified foci within the lesion. In other cases the lesion was visualised as a hypodense poorly-delineated septated focus without calcifications. In the last case, the diagnosis of AE was confirmed only at surgery. Calcified foci found inside the main parasitic lesions were the only abnormality that was detected in two cases and were absent in other two cases. The levels of specific anti-parasitic antibodies followed the pathomorphological changes in the livers. Total IgG levels to Em2+ and EmP antigen declined gradually during the follow-up (1 -5 years) and disappeared only in the patient receiving radical surgery (cured). In comparison with total IgG, concentration of the IgG4 antibody subclass seemed to correlate more adequately with the outcome of therapy as their levels decreased in improved/stabilised patients, but were elevated in "aggravated" patients. We showed that, in patients with AE in Slovakia, radical surgery of parasitic foci proved to be the most successful treatment and, in inoperable cases, albendazole and mebendazole were differently effective. Moreover, IgG4 levels rather than total IgG to protoscoleces antigens proved to be more sensitive serological marker of the progress of therapy.

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“…22 Conventional CHD serology is based primarily on a screening test such as an EgHF-ELISA and a subsequent confirmation test such as arc-5-electrosyneresis or immunoblotting for the 8-kD antigen. 9 In contrast to AE or cysticercosis serology, [23][24][25] relatively few immunodiagnostic studies have been reported that reliably address routine application and evaluation of the diagnostic test. In central Europe, these include primarily the differential diagnosis of AE, cysticercosis, and other parasitic infections with potential cross-reactivity, other hepatic disorders including malignancies that may mimic cyst-like structures in imaging procedures, and malignancies that may putatively lead to false-positive reactions such as those described by Dar and others.…”

Section: Discussionmentioning

confidence: 99%

Differential immunodiagnosis between cystic hydatid disease and other cross-reactive pathologies.

Poretti

Felleisen²,

Grimm³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

109

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Abstract.We assessed an Echinococcus granulosus hydatid fluid antigen-ELISA (EgHF-ELISA) as a serologic prescreening test for E. granulosus infections, supplemented by more specific confirmatory tests, including arc-5 immunoprecipitation and antigen B subunit 8-kD immunoblotting. The diagnostic sensitivity of the EgHF-ELISA was 91%. With regard to the test specificity of the EgHF-ELISA (overall ϭ 82%), we observed relatively frequent crossreactions in tumor patients (6%) and in patients with other parasitic diseases. Cestode-related cross-reactivity can be resolved by the complementary use of E. multilocularis-specific antigens or Taenia solium cysticercosis-specific immunoblotting. Immunoblotting based upon the detection of antibody reactivity to the 8-kD antigen of EgHF, or if appropriately detectable, to the 29-kD and 34-kD bands exhibited a 91% diagnostic sensitivity and an overall specificity of 97% or 94%, respectively. Thus, immunoblotting provided a 99% discrimination between seropositive preoperative cystic hydatid disease cases and cross-reactive non-cestode parasitic infections or malignancies.For primary serologic diagnosis and for support of clinical diagnosis of cystic echinococcosis (cystic hydatid disease [CHD]), the selection of a particular immunodiagnostic test involves consideration of the diagnostic operating characteristics of the technique and the purpose for which it will be used. The diagnostic sensitivity and specificity of the tests vary according to the nature and quality of the antigen and the methodologic sensitivity of the selected technology. A concise definition of the sera used for the assessment of test parameters is essential, with special attention paid to the definition of pre-or post-operative situations respective to CHD serum sampling time point. One of the most specific conventional immunodiagnostic approaches for CHD relies upon the demonstration of serum antibodies precipitating an antigen called antigen 5 by immunoelectrophoresis or similar techniques.1 Diagnostic sensitivities with respect to hepatic CHD have been reported to vary between 50% and 80%. Antibodies to antigen 5 also occurred in serum of human patients with neurocysticercosis 3 and alveolar echinococcosis (AE). 4 Comparative studies showed that 58% of Swiss patients with AE were arc 5-positive compared with 74% of patients with CHD. 5 Resolution of E. granulosus hydatid cyst fluid by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), followed by immunoblotting, resulted in the identification of the arc-5 subunits, including two subunits with relative molecular masses estimated by different laboratories to be between 37 and 38 kD and 20-22-24 kD, respectively. 2 Diagnostic assessment of these two antigens by immunoblotting performed in different laboratories have resulted in the publication of discrepant sensitivity and specificity parameters. 2,6,7 The second major parasite antigen in hydatid cyst fluid is a thermostable lipoprotein called antigen B. The major components of antigen B r...

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Em2-ELISA for the follow-up of alveolar echinococcosis after complete surgical resection of liver lesions

Cited by 41 publications

References 12 publications

Molecular and immunological diagnosis of echinococcosis

Molecular and immunological diagnosis of echinococcosis

Clinical and serological study of human alveolar echinococcosis in Slovakia in relation to the outcome of chemotherapy

Differential immunodiagnosis between cystic hydatid disease and other cross-reactive pathologies.

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