Monitoring treatment of Taenia solium- neurocysticercosis by detection of circulating antigens: a case report

Abstract

Background Parenchymal neurocysticercosis is a frequent cause of seizures in areas endemic for Taenia solium. At present there is scarce data on the evolution of the levels of circulating metacestodal antigen before, during and after treatment with anthelmintic drugs. Case presentation A patient with paucisymptomatic neurocysticercosis (NCC) diagnosed by Ag-ELISA, and confirmed by MRI images, was treated with praziquantel, albendazole and dexamethasone. The level of circulating T. solium antigen was determined weekly. Circulating antigen disappeared from his blood within 14 days after the start of the treatment and correlated with the involution of the cysticerci in the brain shown by imaging. Seventeen years later, the patient has not shown any side effect nor symptoms related to the treatment or to NCC. Conclusions If this encouraging finding is confirmed in a larger series of patients, this technique could be used to determine parasitological cure after treatment and might complement or sometimes replace sequential MRI-imaging of the brain.

Consistent Measurement of Parasite-Specific Antigen Levels in Sera of Patients with Neurocysticercosis Using Two Different Monoclonal Antibody (mAb)-Based Enzyme-Linked Immunosorbent Assays

“…While assays that detect antibody responses are generally more sensitive due to the amplification by the host immune system, antigen assays are more specific to viable infections since antigen levels correlate with the burden of viable parasitic lesions. Detection of circulating parasite antigens is useful to monitor the patient's response to antiparasitic treatment, and it could also be used to screen endemic populations when aiming to detect individuals with a high burden of parenchymal cysts or with subarachnoid NCC, conditions with a high risk of future neurological complications [12,13,19,24,31]. A screening approach could facilitate early diagnosis and intervention, including referral for imaging and the specialized care as needed [32,33].…”

“…Assays to detect circulating parasite antigens have the advantage of demonstrating the presence of viable infection and may correlate with the parasite burden and severity [17,18]. Further, antigen levels drop immediately after cysticidal treatment, for which antigen detection is preferred to monitor the efficacy of treatment in NCC patients [19,20].…”

Scientific Research in Ecuador: A Bibliometric Analysis

“…The publications related to Neurocysticercosis and Chagas disease, caused by the parasites Taenia Solium and Trypanosoma cruzi, respectively. Studies for the former have established criteria for its diagnosis [243][244][245]; it has been determined that it produces antibodies if it is extraparenchymal [246], treatments [247,248] and other studies of a general nature [249,250]. Regarding Chagas disease, its life cycle [251,252], alterations it generates in the human body [253], treatments [254] and controls [255] have been considered.…”

An Asymptomatic Case of Radiologically Active Neurocysticercosis

“…Ultimately, the neurologic manifestations of NCC are dependent on where the cortical lesions are present and the degree of the inflammatory response [6]. Rodriguez-Hidalgo et al point out that the typical incubation period for intestinal T. solium is 83 days alone [7]. Between the primary date of ingestion of the tapeworm and when symptoms arise, it could be between three to as many as 30 or more years [1].…”

“…Overall, Gripper and Wilburn explain that the parenchymal variant of this disease has a better prognosis than its extra-parenchymal counterpart [4]. Patients should be screened for persistence of larval antigens using the antigen-enzyme linked immunosorbent assay (Ag-ELISA) test within two months of completing treatment [7].…”