Recombinant AgB8/1 ELISA test vs. commercially available IgG ELISA test in the diagnosis of cystic echinococcosis

Abstract

The diagnosis and clinical management of cystic echinococcosis (CE) rely on imaging and serology, the latter still having a complementary role as its accuracy in assessing cyst viability is unsatisfactory. We used an experimental IgG ELISA test based on the recombinant antigen rEgAgB8/1 cloned from Echinococcus granulosus to differentiate active from inactive/cured CE infection, comparing its performance to that of a commercially available ELISA test used routinely in our hospital laboratory. Both tests were performed on sera from 88 patients with hepatic echinococcal cysts, grouped according to cyst stage based on ultrasonographical morphology, and on 17 patients surgically treated for echinococcosis and 18 patients with nonparasitic hepatic cysts included as controls. Tests' performances did not differ significantly, but the overall concordance between tests drastically dropped when groups were analysed separately. Further longitudinal studies should evaluate whether these discrepancies reflect the different ability of either test to predict the evolution of cysts over time. Although the recombinant-AgB8/1-based ELISA test seems to have no clinical advantage over the commercially available ELISA test in the assessment of hepatic CE cyst viability, the easiness of production and reproducibility of high-quality recombinant antigens makes rEgAgB8/1 a valid candidate for use in CE ELISA diagnostic tests.

Performance of the commercially available SERION ELISA classic Echinococcus IgG test for the detection of cystic echinococcosis in clinical practice

“…Outcomes of our other serological tests are presented in supplementary table S1. Our results suggest that the SERION ELISA classic Echinococcus IgG test performs adequately, with characteristics at least comparable to other serological methods for CE (Se 69.5-93.14% , Sp 76.0-98.42%) (Kalantari et al, 2010;Marinova et al, 2011;Tamarozzi et al, 2013Tamarozzi et al, , 2016Tamer et al, 2015;Pagnozzi et al, 2016).…”

Evaluation of a New Immunochromatographic Test Using Recombinant Antigen B8/1 for Diagnosis of Cystic Echinococcosis

“…These new antigens have a better performance than their predecessors and are more reproducible across populations, improving test reliability and allowing a better test standardization (6,9,11,13). Recombinant antigen B8/ 1(rAgB) seems to have a good diagnostic performance in an ELISA format with sensitivity between 94.6% and 95.8, and specificity between 93.9% and 100% (13,14).…”

“…These new antigens have a better performance than their predecessors and are more reproducible across populations, improving test reliability and allowing a better test standardization (6,9,11,13). Recombinant antigen B8/ 1(rAgB) seems to have a good diagnostic performance in an ELISA format with sensitivity between 94.6% and 95.8, and specificity between 93.9% and 100% (13,14).Immunochromatographic testing (ICT) has demonstrated good performance in comparison with the ELISA format for the diagnosis of alveolar echinococcosis (15,16). ICT is a simple, rapid, and reliable method which, unlike standard ELISA methods, does not require equipment and trained personal, both of which are difficult to find in remote areas (15).…”

Basic and applied problems in developmental biology and immunobiology of cestode infections: Hymenolepis,Taenia and Echinococcus

“…or E. multilocularis , the majority of CE or AE can be correctly diagnosed. Approximately 96% of both CE2‐3 and AE cases >3–5 cm in size are easily confirmed as antibody positive to recAgB8/1 and recEm18 , respectively. However, early stages of both CE (CL) and AE with cyst sizes <1 cm are difficult to be confirmed.…”