Evaluation of cysticercus-specific IgG (total and subclasses) and IgE antibody responses in cerebrospinal fluid samples from patients with neurocysticercosis showing intrathecal production of specific IgG antibodies

Abstract

In the present study, an enzyme-linked immunosorbent assay (ELISA) standardized with vesicular fluid of Taenia solium cysticerci was used to screen for IgG (total and subclasses) and IgE antibodies in cerebrospinal fluid (CSF) samples from patients with neurocysticercosis showing intrathecal production of specific IgG antibodies and patients with other neurological disorders. The following results were obtained: IgG-ELISA: 100% sensitivity (median of the ELISA absorbances (MEA)=1.17) and 100% specificity; IgG 1 -ELI-SA: 72.7% sensitivity (MEA=0.49) and 100% specificity; IgG 2 -ELISA: 81.8% sensitivity (MEA=0.46) and 100% specificity; IgG 3 -ELISA: 63.6% sensitivity (MEA=0.12) and 100% specificity; IgG 4 -ELISA: 90.9% sensitivity (MEA=0.85) and 100% specificity; IgE-ELISA 93.8% sensitivity (MEA=0.60) and 100% specificity. There were no significant differences between the sensitivities and specificities in the detection of IgG-ELISA and IgE-ELISA, although in CSF samples from patients with neurocysticercosis the MEA of the IgG-ELISA was significantly higher than that of the IgE-ELISA. The sensitivity and MEA values of the IgG 4 -ELISA were higher than the corresponding values for the other IgG subclasses. Future studies should address the contribution of IgG 4 and IgE antibodies to the physiopathology of neurocysticercosis.Key words: IgG, IgE, enzyme-linked immunosorbent assay, neurocysticercosis. RESUMONo presente estudo, uma reação imunoenzimática (ELISA) padronizada com o fluido vesicular de cisticercos de Taenia solium foi utilizada para avaliar as respostas de anticorpos anti-cisticercos IgG (total e subclasses) e IgE em amostras de líquido cefalorraquidiano (LCR) de pacientes com neurocisticercose apresentando produção intratecal de anticorpos específicos IgG e pacientes com outras desordens neurológicas. Os seguintes resultados foram obtidos: ELISA-IgG: 100% de sensibilidade (mediana das absorbâncias das reações ELISA (MAE)=1,17) e especificidade 100%; ELISA-IgG 1 : sensibilidade 72,7% (MAE=0,49) e especificidade 100%; ELISA-IgG 2 : sensibilidade 81,8% (MAE=0,46) e especificidade 100%; ELISA-IgG 3 : sensibilidade 63,6% (MAE=0,12) e especificidade 100%; ELISA-IgG 4 : sensibilidade 90,9% (MAE=0,85) e especificidade 100%; ELISA-IgE: sensibilidade 93,8% (MAE=0,60) e especificidade 100%. Não foram encontradas diferenças significativas entre as sensibilidades e especificidades das reações ELISA-IgG e ELISA-IgE, embora a MAE da reação ELISA-IgG em amostras de LCR de pacientes com neurocisticercose tenha sido significativamente maior que a obtida com ELISA-IgE. Os valores de sensibilidade e MAE da reação ELISA-IgG 4 foram maiores que os valores correspondentes para as outras subclasses da IgG. Estudos futuros deverão abordar a contribuição dos anticorpos IgG 4 e IgE na fisiopatologia da neurocisticercose.Palavras-Chave: IgG, IgE, ensaio de imunoadsorção enzimática, neurocisticercose.

Different clinical allergological features of Taenia solium infestation

“…However, the detection of specific antibodies against T. solium cysticercal antigens in cerebrospinal fluid may be a useful adjunctive diagnostic test. A high rate of patients with neurocysticercosis presents specific IgE and IgG (especially IgG4) that is indicative of intrathecal antibody production [5]. …”