Improved primary immunodiagnosis of alveolar echinococcosis in humans by an enzyme-linked immunosorbent assay using the Em2plus antigen

Gottstein, Bruno; Jacquier, P; Bresson‐Hadni, Solange; Eckert, Johannes

doi:10.1128/jcm.31.2.373-376.1993

Cited by 166 publications

(77 citation statements)

References 16 publications

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“…The sensitivity of the EgHF antigen ELISA for detecting AE has been reported as 97.1%, and experimental E. multilocularis infections in pigs can be detected 1 month after egg inoculation (Deplazes 2005). The specificity of Em2‐antigen approaches 100% (Gottstein 1993). However, a cut‐off of the mean plus three standard deviations of a sample of healthy Swiss blood donors was used.…”

Section: Discussionmentioning

confidence: 99%

Echinococcosis, toxocarosis and toxoplasmosis screening in a rural community in eastern Kazakhstan

Torgerson

Rosenheim

Tanner

et al. 2009

Tropical Med Int Health

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Summaryobjective To determine the extent of carnivore-transmitted parasitic zoonoses in a community in eastern Kazakhstan, a region where cystic echinococcosis (CE) re-emerged in recent years.methods Cross sectional ultrasound study of 3126 human subjects to determine the extent of human cystic and alveolar echinococcosis (AE). Blood samples were taken from each subject and analysed for antibodies against Echinococcus, Toxocara and Toxoplasma spp. Each subject was questioned about possible risk factors that might be associated with zoonotic transmission. Analysis employed a mixed modelling approach based on the results of the ultrasound study, the serological results and the results of the questionnaire. Bayesian techniques were employed to estimate diagnostic performance. A helminthological study of the local dog population was also undertaken.results A total of 23 subjects tested positive for CE on ultrasound and a further three individuals had strong serological evidence of infection. Another 24 reported treatment for CE. Ultrasound lesions or treatment for CE were associated with poverty. No ultrasound evidence of AE was found, but one individual had strong serological evidence of exposure to Echinococcus multilocularis. Toxoplasma seropositivity (16%; 504 individuals) increased with age. Household level Toxoplasma-seropositivity was associated with unsafe drinking water. Toxocara seropositivity (11%; 349 individuals) was more frequent in children and in individuals who disposed of dog faeces on the vegetable garden. A purgation study of dogs indicated that 13% of dogs in the community were infected with Echinococcus granulosus, 5% with E. multilocularis and 2% with Toxocara canis respectively.conclusions There is significant transmission of E. granulosus to humans in this community. Transmission may be associated with poverty. There is little evidence of E. multilocularis transmission to humans, despite the presence in the parasite in the domestic dog population. Toxoplasma is actively transmitted and there is evidence for transmission by the water supply. Children are at highest risk of exposure to Toxocara.

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Section: Discussionmentioning

confidence: 99%

Echinococcosis, toxocarosis and toxoplasmosis screening in a rural community in eastern Kazakhstan

Torgerson

Rosenheim

Tanner

et al. 2009

Tropical Med Int Health

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“…The EM10 homologous protein in E. granulosus, named EG10, has been shown to be expressed differentially in different parasite isolates, indicating that modifications during the maturation of the antigen, or post-transcriptional regulatory processing, may occur [46]. Em2 and II ⁄ 3-10 have been used simultaneously in an ELISA (known as Em2 plus ELISA), showing excellent specificity and only a minor loss in diagnostic sensitivity [47]. This test is currently available commercially for the serodiagnosis of AE in humans (Em2 plus ELISA; Bordier Affinity Products, Crissier, Switzerland).…”

Section: Metacestode Antigensmentioning

confidence: 99%

“…A differentiation rate of 95% was reported when Em2 was used simultaneously in an ELISA with the antigen Em1, which is a fraction rich in components common to E. multilocularis and E. granulosus. The sensitivity of the assay was improved using the Em2 plus antigen [47], which was also used successfully for differential serodiagnosis of AE and CE [17].…”

Section: S E R O L O G I C a L D I F F E R E N T I A T I O N B E T W mentioning

confidence: 99%

The immunodiagnosis of Echinococcus multilocularis infection

Carmena

Benito

Eraso

2007

Clinical Microbiology and Infection

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Alveolar echinococcosis (AE) is a severe zoonotic disease caused by the metacestode stage of Echinococcus multilocularis. The infection can have fatal consequences in humans if treatment is not provided, so early diagnosis is fundamental for initiating treatment and reducing morbidity and mortality. In addition, detection of the parasite in the definitive host plays a central role in epidemiological studies and surveillance programmes for control of AE. This review presents an overview of the present situation regarding the immunodiagnosis of E. multilocularis infection. Special attention is given to the description of the native, partially purified and recombinant antigens available currently for immunodiagnostic purposes. Recent advances in the primary serodiagnosis and follow-up of AE patients are highlighted, including the detection of specific cytokine profiles. Progress in the immunodiagnosis of intestinal E. multilocularis infection in definitive hosts, particularly the detection of excretory-secretory and integument products of the worm in faeces (copro-antigens) by ELISA, is also discussed.

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“…Early detection of proliferating parasite lesions and appropriate intervention will increase chances of a favourable outcome; however, this is hampered by the delayed clinical manifestation such that in most cases curative liver resection can not be performed. For epidemiological studies, serology is very efficient, as immunodiagnostic tests of high sensitivity and specificity are available now (Schantz & Gottstein 1986) and the use of affinity-purified and recombinant antigens of Em has successfully been evaluated (Gottstein et al 1993). However, additional information on the humoural immune response during the course of infection and during different chemotherapeutical regimens are clearly needed.…”

Section: Introductionmentioning

confidence: 99%

Subclass‐specific serological reactivity and IgG₄‐specific antigen recognition in human echinococcosis

Dreweck

Lüder

Soboslay

et al. 1997

Tropical Med Int Health

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SummaryImmunglobulin (Ig) subclass-specific antibody responses and isotype-specific recognition of E. multilocularis (Em) and E. granulosus (Eg) antigens (Ag) were evaluated in both alveolar echinococcosis (AE) and cystic echinococcosis (CE). AE patients were divided into 3 groups by clinical and therapeutic criteria according to their actual state of infection, i.e. elimination of parasite, and regression or progression of disease. CE patients were either before or after surgery, or in continuous chemotherapy due to parasite persistence. Total IgE was highly elevated in progressive AE cases (7/11), but not in the cases with eliminated infection or regression. In AE patients with active disease, EmAg-specific IgE, total IgG, IgG 1 , IgG 2 and IgG 4 were particularly high. Similarly, in 9 of 30 CE patients, total IgE was raised above reference values, indicating progressive disease. CE patients' sera antibody cross-reacted with crude EmAg, and detectable Ig levels of the same isotype were also measured by ELISA. In both AE and CE, parasite-specific antigen recognition was dominated by IgG 1 and IgG 4 . In AE patients with progressive disease, IgG 4 distinctively recognized low molecular weight EmAg of Mr 26 kD, 18 kD, 16 kD and 12 kD. As prominent IgG 4 and IgE responses develop with chronic helminth infections only, these serological parameters may indicate successful parasite infestation and severe outcome of disease. In summary, analyses of immunoglobulin isotype responses in AE patients by ELISA in combination with immunoblotting are a useful approach for post-treatment follow-up of patients at risk of developing recrudescent disease.keywords human alveolar and cystic echinococcosis, antibody response, immunoglobulin isotype-specific antigen recognition correspondence Prof.

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Improved primary immunodiagnosis of alveolar echinococcosis in humans by an enzyme-linked immunosorbent assay using the Em2plus antigen

Abstract: Alveolar echinococcosis (AE) in humans is generally a fatal disease when not diagnosed early enough to provide curative treatment such as radical surgery. Immunodiagnosis for early detection of AE was improved * Corresponding author.

Cited by 166 publications

References 16 publications

Echinococcosis, toxocarosis and toxoplasmosis screening in a rural community in eastern Kazakhstan

Echinococcosis, toxocarosis and toxoplasmosis screening in a rural community in eastern Kazakhstan

The immunodiagnosis of Echinococcus multilocularis infection

Subclass‐specific serological reactivity and IgG₄‐specific antigen recognition in human echinococcosis

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Improved primary immunodiagnosis of alveolar echinococcosis in humans by an enzyme-linked immunosorbent assay using the Em2plus antigen

Abstract: Alveolar echinococcosis (AE) in humans is generally a fatal disease when not diagnosed early enough to provide curative treatment such as radical surgery. Immunodiagnosis for early detection of AE was improved * Corresponding author.

Cited by 166 publications

References 16 publications

Echinococcosis, toxocarosis and toxoplasmosis screening in a rural community in eastern Kazakhstan

Echinococcosis, toxocarosis and toxoplasmosis screening in a rural community in eastern Kazakhstan

The immunodiagnosis of Echinococcus multilocularis infection

Subclass‐specific serological reactivity and IgG4‐specific antigen recognition in human echinococcosis

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Product

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Subclass‐specific serological reactivity and IgG₄‐specific antigen recognition in human echinococcosis