Immunodiagnosis of cystic echinocooccosis by antigen detection in serum, urine, and saliva samples

Abstract

Background:Cystic echinococcosis (CE) being more common in rural areas, the collection of serum may not always be possible or may be hazardous in untrained hands. The alternative, noninvasive samples like saliva and urine which are non invasive and easy to collect need to be evaluated for diagnosis of CE.Aim:The aim of this study was to evaluate hydatid antigen detection by ELISA in urine and saliva samples by comparing them with antigen detection in serum for diagnosis of CE.Materials and Methods:Serum, saliva and urine samples were collected from 25 clinically and radiologically diagnosed CE patients, 25 clinically suspected cases of CE, 15 other parasitic disease controls and 25 healthy controls. Hydatid antigen detection was done in these samples by Enzyme linked immunosorbent assay using hyperimmune serum raised in rabbits immunized with hydatid antigen.Results and Conclusions:The sensitivity of ELISA for antigen detection in serum, saliva and urine was found to be 40%, 24% and 52% respectively. Urine showed significantly higher (p<0.05) sensitivity than that of saliva samples but not significantly higher (p>0.05) than that of serum samples. The specificity was highest for serum (92.5%) followed by saliva (87.5%) and urine (80%). There was no significant difference in antigen detection in patients with single vs multiple cysts. There was no significant difference in antigen detection in patients with hepatic vs extrahepatic cysts in serum or saliva samples but antigen positivity in urine was significantly higher (p<0.05) in hepatic cysts than that in extrahepatic cysts. The results showed that biological fluids like urine and saliva may be used as an alternative or as an adjunct to serum samples by virtue of their noninvasive, easy collection and similar sensitivity and specificity.

Surgically managed human cystic echinococcosis in north-eastern Iran: a single center’s experience from 2001 to 2008

“…In the current study, ELISA and IHA were used to diagnose CE in a sub-set of patients (n = 48). However, the usefulness of serology is limited due to poor sensitivity and the possibility of cross-reactions occurring with other parasitic infections (Chaya and Parija 2013;Dubey et al 2011;Schantz et al 1980;Swarna and Parija 2012;Wuestenberg et al 2014). Because of these reasons, patients are typically not diagnosed based on serology alone.…”

Rapid Discriminative Identification of the Two Predominant Echinococcus Species from Canine Fecal Samples in the Tibetan Region of China by Loop-Mediated Isothermal Amplification–Lateral Flow Dipstick Assay

“…The combination of LAMP with LFD was used to identify hepatopancreatic parvovirus in prawns. The study showed that the LAMP-LFD method is a remarkably sensitive, secure, and expeditious technique [ 24 ].…”

“…The type and purity of the antigen used influence the effectiveness of immunodiagnostic testing for cystic echinococcosis [ 25 ]. The presence of antigen–antibody immune complexes can also reduce the sensitivity of antigen detection tests for cystic echinococcosis [ 24 ]. A LAMP technique was devised to identify E. granulosus with a sensitivity of 100 fg per 200 μL of distilled water [ 26 ].…”

A review on diagnostic and preventive aspects of cystic echinococcosis and human cysticercosis

“…Besides, it has been seen that up to 40% of peroperatively confirmed cases of hydatid cyst may be negative for hydatid specific antibodies. [57] Detection of circulating hydatid antigen in the serum has been evaluated to be useful in the diagnosis of active infection as these antigen levels decrease after chemotherapy or surgical resection of the hydatid cysts. ELISA, countercurrent immunoelectrophoresis (CIEP), reverse passive haemagglutination (RPHA) and latex agglutination have all been evaluated for hydatid antigen detection in serum and other samples.…”