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Zhou J, Chen J, Peng Y, Xie Y, Xiao Y. A Promising Tool in Serological Diagnosis: Current Research Progress of Antigenic Epitopes in Infectious Diseases. Pathogens 2022; 11:1095. [PMID: 36297152 PMCID: PMC9609281 DOI: 10.3390/pathogens11101095] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 09/20/2022] [Accepted: 09/23/2022] [Indexed: 07/30/2023] Open
Abstract
Infectious diseases, caused by various pathogens in the clinic, threaten the safety of human life, are harmful to physical and mental health, and also increase economic burdens on society. Infections are a complex mechanism of interaction between pathogenic microorganisms and their host. Identification of the causative agent of the infection is vital for the diagnosis and treatment of diseases. Etiological laboratory diagnostic tests are therefore essential to identify pathogens. However, due to its rapidity and automation, the serological diagnostic test is among the methods of great significance for the diagnosis of infections with the basis of detecting antigens or antibodies in body fluids clinically. Epitopes, as a special chemical group that determines the specificity of antigens and the basic unit of inducing immune responses, play an important role in the study of immune responses. Identifying the epitopes of a pathogen may contribute to the development of a vaccine to prevent disease, the diagnosis of the corresponding disease, and the determination of different stages of the disease. Moreover, both the preparation of neutralizing antibodies based on useful epitopes and the assembly of several associated epitopes can be used in the treatment of disease. Epitopes can be divided into B cell epitopes and T cell epitopes; B cell epitopes stimulate the body to produce antibodies and are therefore commonly used as targets for the design of serological diagnostic experiments. Meanwhile, epitopes can fall into two possible categories: linear and conformational. This article reviews the role of B cell epitopes in the clinical diagnosis of infectious diseases.
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Chirathaworn C, Janwitthayanan W, Suputtamongkol Y, Poovorawan Y. Leptospira collagenase and LipL32 for antibody detection in leptospirosis. J Immunol Methods 2021; 499:113168. [PMID: 34673004 DOI: 10.1016/j.jim.2021.113168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 09/21/2021] [Accepted: 10/11/2021] [Indexed: 11/29/2022]
Abstract
Various Leptospira components have been identified as candidate antigens for the detection of antibody to Leptospira. LipL32 is a Leptospira membrane protein which has been widely studied. The report of Leptospira whole-genome sequencing demonstrated that pathogenic Leptospira contained the nucleotide sequence (colA gene) coding for the collagenase. Expression of ColA protein and its enzymatic activity was demonstrated. In this study, cloned ColA protein, in comparison with LipL32, was used as an antigen for antibody detection. Thirty pairs of sera from human leptospirosis patients were tested. Sera from blood donors, and patients with scrub typhus and dengue virus infection (20 samples from each group) were tested for the specificity. All sera from leptospirosis patients tested in this study reacted with both ColA and LipL32 proteins. Sera from blood donors, patients with scrub typhus and dengue virus infection did not react with ColA protein. Data suggested that sensitivity and specificity of ColA protein for Leptospira antibody detection were 100%. In addition, ColA protein showed higher specificity than LipL32. Our data suggested that ColA protein could be another candidate antigen for antibody detection in leptospirosis diagnosis.
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Affiliation(s)
- Chintana Chirathaworn
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand; Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
| | - Weena Janwitthayanan
- Master of Science Program in Medical Sciences, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | | | - Yong Poovorawan
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Pissawong T, Maneewatchararangsri S, Ritthisunthorn N, Soonthornworasiri N, Reamtong O, Adisakwattana P, Kalambaheti T, Chaisri U, Doungchawee G. Immunodominance of LipL32 93-272 peptides revealed by leptospirosis sera and therapeutic monoclonal antibodies. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2018; 53:11-22. [PMID: 29500044 DOI: 10.1016/j.jmii.2017.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 10/30/2017] [Accepted: 12/12/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND/PURPOSE Leptospirosis is a neglected zoonosis, imposing significant human and veterinary public health burdens. In this study, recombinant LipL3293-147 and LipL32148-184 middle domain of LipL3293-184, and LipL32171-214, and LipL32215-272 of c-terminal LipL32171-272 truncations were defined for immunodominance of the molecule during Leptospira infections revealed by leptospirosis sera. RESULTS IgM-dominant was directed to highly surface accessible LipL32148-184 and Lipl32171-214. IgG dominance of LipL32148-184 revealed by rabbit anti-Leptospira sera and convalescent leptospirosis paired sera were mapped to highly accessible surface of middle LipL32148-184 truncation whereas two LipL32148-184 and LipL32215-272 truncations were IgG-dominant when revealed by single leptospirosis sera. The IgM-dominant of LipL32148-214 and IgG-dominant LipL32148-184 peptides have highly conserved amino acids of 70% identity among pathogenic and intermediate Leptospira species and were mapped to the highly surface accessible area of LipL32 molecule that mediated interaction of host components. IgG dominance of two therapeutic epitopes located at LipL32243-253 and LipL32122-130 of mAbLPF1 and mAbLPF2, respectively has been shown less IgG-dominant (<30%), located outside IgG-dominant regions characterized by leptospirosis paired sera. CONCLUSION The IgM- and IgG-dominant LipL32 could be further perspectives for immunodominant LipL32-based serodiagnosis and LipL32 epitope-based vaccine.
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Affiliation(s)
- Tippawan Pissawong
- Chulabhorn International College of Medicine, Thammasat University, Pathumthani 12120, Thailand
| | - Santi Maneewatchararangsri
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand.
| | - Nonglucksanawan Ritthisunthorn
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Ngamphol Soonthornworasiri
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Onrapak Reamtong
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Poom Adisakwattana
- Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Thareerat Kalambaheti
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Urai Chaisri
- Department of Tropical Pathology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Galayanee Doungchawee
- Department of Pathobiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand
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Yaakob Y, Rodrigues KF, Opook F, William T, John DV. Recombinant LipL32 Protein Developed Using a Synthetic Gene Detects Leptospira-specific Antibodies in Human Serum Samples. Malays J Med Sci 2018; 24:44-51. [PMID: 29386971 DOI: 10.21315/mjms2017.24.5.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 07/13/2017] [Indexed: 10/18/2022] Open
Abstract
Background Synthetic biology is emerging as a viable alternative for the production of recombinant antigens for diagnostic applications. It offers a safe alternative for the synthesis of antigenic principles derived from organisms that pose a high biological risk. Methods Here, we describe an enzyme-linked immunosorbent assay (ELISA) using the synthetic recombinant LipL32 (rLipL32) protein expressed in Escherichia coli for the detection of Leptospira-specific antibodies in human serum samples. The rLipL32-based ELISA was compared with a microscopic agglutination test (MAT), which is currently used as the gold standard for the diagnosis of leptospirosis. Results Our results showed that all the MAT-positive serum samples were positive for Leptospira-specific IgG in an ELISA, while 65% (n = 13) of these samples were also positive for Leptospira-specific IgM. In the MAT-negative serum samples, 80% and 55% of the samples were detected as negative by an ELISA for Leptospira-specific IgM and IgG, respectively. Conclusion An ELISA using the synthetic rLipL32 antigen was able to distinguish Leptospira-specific IgM (sensitivity 65% and specificity 80%) and IgG (sensitivity 100% and specificity 55%) in human serum samples and has the potential to serve as a rapid diagnostic test for leptospirosis.
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Affiliation(s)
- Yuszniahyati Yaakob
- Biotechnology Research Institute, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | | | - Fernandes Opook
- Biotechnology Research Institute, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | | | - Daisy Vanitha John
- Biotechnology Research Institute, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
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Chaurasia R, Thresiamma KC, Eapen CK, Zachariah BJ, Paul R, Sritharan M. Pathogen-specific leptospiral proteins in urine of patients with febrile illness aids in differential diagnosis of leptospirosis from dengue. Eur J Clin Microbiol Infect Dis 2018; 37:423-433. [PMID: 29332210 DOI: 10.1007/s10096-018-3187-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 01/05/2018] [Indexed: 01/19/2023]
Abstract
Leptospirosis and dengue are two commonly seen infectious diseases of the tropics. Differential diagnosis of leptospirosis from dengue fever is often difficult due to overlapping clinical symptoms and lack of economically viable and easy-to-perform laboratory tests. The gold standard for diagnosis is the microscopic agglutination test (MAT). In this study, the diagnostic potential of screening for pathogen-specific leptospiral antigens in urine samples is presented as a non-invasive method of disease diagnosis. In a study group of 40 patients, the serum was tested for anti-leptospiral antibodies by MAT and enzyme-linked immunosorbent assay (ELISA). Urine of these patients was screened for leptospiral antigens by ELISA using specific antibodies against LipL32, LipL41, Fla1, HbpA and sphingomyelinase. Group I patients (n = 23) were classified as leptospirosis-positive based on MAT and high titres of circulating IgM-specific anti-leptospiral antibodies. All of these patients excreted all five leptospiral antigens in the urine. The 17 MAT-negative cases included six patients with pyrexia of unknown origin (PUO; Group II) and 11 confirmed dengue patients (Group III). The latter tested negative for both serum anti-leptospiral antibodies and urinary leptospiral antigens. A salient outcome of this study was highlighting the usefulness of screening for urinary leptospiral antigens in disease diagnosis, as their presence confirmed leptospiral aetiology in two PUO patients. Immunoblots of urinary antigens identified well-defined bands corresponding to LipL32, HbpA and sphingomyelinase; the significance of the 42- and 58-kDa sphingomyelinase bands is discussed.
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Affiliation(s)
- R Chaurasia
- Department of Animal Biology, School of Life Sciences, University of Hyderabad, Prof. CR Rao Road, Gachibowli, Hyderabad, 500 046, India
| | - K C Thresiamma
- Departments of Biochemistry and Medicine, MOSC Medical College, Kerala, India
| | - C K Eapen
- Departments of Biochemistry and Medicine, MOSC Medical College, Kerala, India
| | - B J Zachariah
- Departments of Biochemistry and Medicine, MOSC Medical College, Kerala, India
| | - R Paul
- Departments of Biochemistry and Medicine, MOSC Medical College, Kerala, India
| | - M Sritharan
- Department of Animal Biology, School of Life Sciences, University of Hyderabad, Prof. CR Rao Road, Gachibowli, Hyderabad, 500 046, India.
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Rosa MI, Reis MFD, Simon C, Dondossola E, Alexandre MC, Colonetti T, Meller FO. IgM ELISA for leptospirosis diagnosis: a systematic review and meta-analysis. CIENCIA & SAUDE COLETIVA 2017; 22:4001-4012. [DOI: 10.1590/1413-812320172212.14112016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 08/25/2016] [Indexed: 11/22/2022] Open
Abstract
Abstract A systematic review with meta-analysis was performed to estimate the accuracy of IgM ELISA for Leptospirosis diagnosis. A search of Medline, Lilacs, Embase, Cochrane Central Register of Controlled Trials and Grey literature (Google Scholar and British Library) was conducted. The medical subject headings (MeSHs) and the words “leptospirosis”, “human leptospirosis” and “IgM ELISA” were used. Fifty-two studies were analyzed, which included 10,775 samples. The pooled sensitivity of all the studies was 86% (CI 95%, 85%-87%) and specificity was 90% (CI 95%, 89%-91%). In studies of the acute phase, the sensitivity and specificity were 84% (CI 95%, 82%-85%) and 91% (CI 95%, 90%-91%), respectively. In conclusion, IgM ELISA is sensitive for use as an initial screen for leptospiral infections.
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Prochetto SD, Gonzalez VDG, Garcia VS, Vanasco NB, Lottersberger J, Gugliotta LM. Latex particles sensitized with proteins ofLeptospira interrogansfor application in immunoagglutination assays. INT J POLYM MATER PO 2017. [DOI: 10.1080/00914037.2016.1276058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Santiago D. Prochetto
- INTEC, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad Nacional del Litoral, Santa Fe, Argentina
| | - Verónica D. G. Gonzalez
- INTEC, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad Nacional del Litoral, Santa Fe, Argentina
- Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina
| | - Valeria S. Garcia
- INTEC, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad Nacional del Litoral, Santa Fe, Argentina
| | - Norma B. Vanasco
- Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina
- Administración Nacional de Laboratorios e Institutos de Salud “Dr. Carlos G. Malbran,” Instituto Nacional de Enfermedades Respiratorias “Dr. Emilio Coni,” Santa Fe, Argentina
| | - Javier Lottersberger
- Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina
| | - Luis M. Gugliotta
- INTEC, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad Nacional del Litoral, Santa Fe, Argentina
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Andre-Fontaine G, Aviat F, Marie JL, Chatrenet B. Undiagnosed leptospirosis cases in naïve and vaccinated dogs: Properties of a serological test based on a synthetic peptide derived from Hap1/LipL32 (residues 154–178). Comp Immunol Microbiol Infect Dis 2015; 39:1-8. [DOI: 10.1016/j.cimid.2014.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 11/27/2014] [Accepted: 12/19/2014] [Indexed: 01/05/2023]
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Rajapakse S, Rodrigo C, Handunnetti SM, Fernando SD. Current immunological and molecular tools for leptospirosis: diagnostics, vaccine design, and biomarkers for predicting severity. Ann Clin Microbiol Antimicrob 2015; 14:2. [PMID: 25591623 PMCID: PMC4299796 DOI: 10.1186/s12941-014-0060-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 12/22/2014] [Indexed: 12/18/2022] Open
Abstract
Leptospirosis is a zoonotic spirochaetal illness that is endemic in many tropical countries. The research base on leptospirosis is not as strong as other tropical infections such as malaria. However, it is a lethal infection that can attack many vital organs in its severe form, leading to multi-organ dysfunction syndrome and death. There are many gaps in knowledge regarding the pathophysiology of leptospirosis and the role of host immunity in causing symptoms. This hinders essential steps in combating disease, such as developing a potential vaccine. Another major problem with leptospirosis is the lack of an easy to perform, accurate diagnostic tests. Many clinicians in resource limited settings resort to clinical judgment in diagnosing leptospirosis. This is unfortunate, as many other diseases such as dengue, hanta virus, rickettsial infections, and even severe bacterial sepsis, can mimic leptospirosis. Another interesting problem is the prediction of disease severity at the onset of the illness. The majority of patients recover from leptospirosis with only a mild febrile illness, while a few others have severe illness with multi-organ failure. Clinical features are poor predictors of potential severity of infection, and therefore the search is on for potential biomarkers that can serve as early warnings for severe disease. This review concentrates on these three important aspects of this neglected tropical disease: diagnostics, developing a vaccine, and potential biomarkers to predict disease severity.
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Affiliation(s)
- Senaka Rajapakse
- Department of Clinical Medicine, Faculty of Medicine, University of Colombo, 25, Kynsey Road, Colombo, 08, Sri Lanka.
| | - Chaturaka Rodrigo
- Department of Clinical Medicine, Faculty of Medicine, University of Colombo, 25, Kynsey Road, Colombo, 08, Sri Lanka.
| | - Shiroma M Handunnetti
- Institute of Biochemistry, Molecular Biology and Biotechnology, University of Colombo, Colombo, Sri Lanka.
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Maneewatch S, Adisakwattana P, Chaisri U, Saengjaruk P, Srimanote P, Thanongsaksrikul J, Sakolvaree Y, Poungpan P, Chaicumpa W. Therapeutic epitopes of Leptospira LipL32 protein and their characteristics. Protein Eng Des Sel 2014; 27:135-44. [DOI: 10.1093/protein/gzu006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Rapid tests for diagnosis of leptospirosis: current tools and emerging technologies. Diagn Microbiol Infect Dis 2013; 78:1-8. [PMID: 24207075 DOI: 10.1016/j.diagmicrobio.2013.09.012] [Citation(s) in RCA: 104] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 09/09/2013] [Accepted: 09/15/2013] [Indexed: 11/23/2022]
Abstract
Leptospirosis is an emerging zoonosis with a worldwide distribution but is more commonly found in impoverished populations in developing countries and tropical regions with frequent flooding. The rapid detection of leptospirosis is a critical step to effectively manage the disease and to control outbreaks in both human and animal populations. Therefore, there is a need for accurate and rapid diagnostic tests and appropriate surveillance and alert systems to identify outbreaks. This review describes current in-house methods and commercialized tests for the rapid diagnosis of acute leptospirosis. It focuses on diagnostic tests that can be performed with minimal training and limited equipment in less-developed and newly industrialized countries, particularly in resource-limited settings and with results in minutes to less than 4 hours. We also describe recent technological advances in the field of diagnostic tests that could allow for the development of innovative rapid tests in the near future.
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Schreier S, Doungchawee G, Chadsuthi S, Triampo D, Triampo W. Leptospirosis: current situation and trends of specific laboratory tests. Expert Rev Clin Immunol 2013; 9:263-80. [PMID: 23445200 DOI: 10.1586/eci.12.110] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Leptospirosis is re-emerging as a worldwide zoonosis and is caused by bacteria of the genus Leptospira. Human leptospirosis is associated with high temperature and humidity. Laboratory tests are indispensible for the early diagnosis and proper disease management. The demand for suitable leptospirosis point-of-care diagnostic tests grows with the awareness and number of incidences. Confirmation is achieved by the microscopic agglutination test, bacterial cultivation, PCR or histopathologic methods. However, high costs, poor standardization and/or elaborate sample preparation prevent routine use at the point of care. Cost-efficient, but insensitive serological methods dominate the diagnostic landscape and, likewise, urgently need improvement toward greater compliance with some of the point-of-care criteria. Combined application of antigen and antibody detection methods increases accuracy, but also new development or transfer of diagnostic technologies should be considered useful. Nano- and microparticle technology may play a key role in improving future antigen detection methods.
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Affiliation(s)
- Stefan Schreier
- Department of Pathobiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand
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Goarant C, Bourhy P, D'Ortenzio E, Dartevelle S, Mauron C, Soupé-Gilbert ME, Bruyère-Ostells L, Gourinat AC, Picardeau M, Nato F, Chanteau S. Sensitivity and Specificity of a New Vertical Flow Rapid Diagnostic Test for the Serodiagnosis of Human Leptospirosis. PLoS Negl Trop Dis 2013; 7:e2289. [PMID: 23826401 PMCID: PMC3694835 DOI: 10.1371/journal.pntd.0002289] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Accepted: 04/11/2013] [Indexed: 01/25/2023] Open
Abstract
Background: Leptospirosis is a growing public health concern in many tropical and subtropical countries. However, its diagnosis is difficult because of non-specific symptoms and concurrent other endemic febrile diseases. In many regions, the laboratory diagnosis is not available due to a lack of preparedness and simple diagnostic assay or difficult access to reference laboratories. Yet, an early antibiotic treatment is decisive to the outcome. The need for Rapid Diagnostic Tests (RDTs) for bedside diagnosis of leptospirosis has been recognized. We developed a vertical flow immunochromatography strip RDT detecting anti-Leptospira human IgM and evaluated it in patients from New Caledonia, France, and French West Indies. Methodology/Principal Findings: Whole killed Leptospira fainei cells were used as antigen for the test line and purified human IgM as the control line. The mobile phase was made of gold particles conjugated with goat anti-human IgM. Standards for Reporting of Diagnostic Accuracy criteria were used to assess the performance of this RDT. The Microscopic Agglutination Test (MAT) was used as the gold standard with a cut-off titer of ≥400. The sensitivity was 89.8% and the specificity 93.7%. Positive and negative Likelihood Ratios of 14.18 and 0.108 respectively, and a Diagnostic Odds Ratio of 130.737 confirmed its usefulness. This RDT had satisfactory reproducibility, repeatability, thermal tolerance and shelf-life. The comparison with MAT evidenced the earliness of the RDT to detect seroconversion. When compared with other RDT, the Vertical Flow RDT developed displayed good diagnostic performances. The major burden of leptospirosis happens in low-income populations from tropical or subtropical regions. Because of nonspecific symptoms in human leptospirosis, the biological confirmation is needed to ascertain the disease. However, this biological diagnosis relies on sophisticated and time-consuming techniques that are most often hardly (if ever) available to clinicians in peripheral health centers. Yet, the outcome of leptospirosis in humans largely depends on an early antibiotic treatment. Taken together, these factors highlight the need of rapid simple diagnostic tests for leptospirosis that could be used directly on the bedside even in remote health centers. In this study, we developed and evaluated a prototype point of care strip test for the serological diagnosis of human leptospirosis in New Caledonia, mainland France, and the French West Indies. The sensitivity was 89.8% [95% CI, 84.7–93.4] and the specificity 93.7% [95% CI, 89.65–96.2]. This easy, early and portable diagnostic test will be evaluated in other epidemiological conditions and under field conditions.
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Affiliation(s)
- Cyrille Goarant
- Institut Pasteur de Nouvelle-Calédonie, Association Pasteur International Network, Nouméa, New Caledonia
- * E-mail:
| | - Pascale Bourhy
- Institut Pasteur, Biology of Spirochetes Unit, National Reference Center and WHO Collaborating Center for Leptospirosis, Paris, France
| | - Eric D'Ortenzio
- Institut Pasteur de Nouvelle-Calédonie, Association Pasteur International Network, Nouméa, New Caledonia
| | | | - Carine Mauron
- Institut Pasteur de Nouvelle-Calédonie, Association Pasteur International Network, Nouméa, New Caledonia
| | | | - Lilian Bruyère-Ostells
- Institut Pasteur de Nouvelle-Calédonie, Association Pasteur International Network, Nouméa, New Caledonia
| | - Ann-Claire Gourinat
- Institut Pasteur de Nouvelle-Calédonie, Association Pasteur International Network, Nouméa, New Caledonia
| | - Mathieu Picardeau
- Institut Pasteur, Biology of Spirochetes Unit, National Reference Center and WHO Collaborating Center for Leptospirosis, Paris, France
| | | | - Suzanne Chanteau
- Institut Pasteur de Nouvelle-Calédonie, Association Pasteur International Network, Nouméa, New Caledonia
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Bourhy P, Vray M, Picardeau M. Evaluation of an in-house ELISA using the intermediate species Leptospira fainei for diagnosis of leptospirosis. J Med Microbiol 2013; 62:822-827. [PMID: 23493028 DOI: 10.1099/jmm.0.054304-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Leptospirosis is recognized as an emerging zoonotic disease generally affecting urban slums in developing countries and tropical regions. A combination of non-specific symptoms, low awareness among the medical community and a lack of readily available diagnostic tests have made leptospirosis an underdiagnosed disease. In this study, we tested an in-house ELISA with formalin-treated and boiled bacteria from the intermediate species Leptospira fainei as an antigen to detect Leptospira-specific IgM antibodies. A total of 819 serum samples, tested by a microscopic agglutination test (MAT) as a reference test, were used to evaluate the ELISA. Compared with positive and negative sera, the ELISA showed 94 % sensitivity and 99 % specificity. Positive and negative likelihood ratios were 94 and 0.06, respectively. No cross-reactivity was observed in sera from subjects with dengue and syphilis infections. The kappa value was 0.92 (95 % confidence interval 0.88-0.96), which indicated excellent agreement between the MAT and ELISA. The overall performance of this in-house ELISA suggests applicability as a rapid screening test for the diagnosis of leptospirosis in resource-limited settings and in hospitals and laboratories where a MAT is not available.
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Affiliation(s)
- Pascale Bourhy
- Institut Pasteur, Biology of Spirochetes Unit, National Reference Center and WHO Collaborating Center for Leptospirosis, Paris, France
| | - Muriel Vray
- Institut Pasteur, Unité de Recherche et d'Expertise Epidémiologie des Maladies Emergentes, Paris, France
| | - Mathieu Picardeau
- Institut Pasteur, Biology of Spirochetes Unit, National Reference Center and WHO Collaborating Center for Leptospirosis, Paris, France
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15
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Picardeau M. Diagnosis and epidemiology of leptospirosis. Med Mal Infect 2013; 43:1-9. [DOI: 10.1016/j.medmal.2012.11.005] [Citation(s) in RCA: 134] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Accepted: 11/27/2012] [Indexed: 12/28/2022]
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Enzyme-linked immunosorbent assay to diagnose human leptospirosis: a meta-analysis of the published literature. Epidemiol Infect 2012; 141:22-32. [PMID: 22953720 DOI: 10.1017/s0950268812001951] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We report an evaluation of the accuracy of ELISA for the detection of Leptospira-specific antibodies in humans. Eighty-eight studies published in 35 articles met all inclusion criteria and were submitted to meta-analysis. Pooled sensitivity and specificity were 0·779 (95% CI 0·770-0·789) and 0·913 (95% CI 0·908-0·917), respectively, and the area under the curve was 0·964. Heterogeneity across studies was statistically significant, but none of the sources of heterogeneity (disease stage, antigen used, antibody detected) could fully explain this finding. Although the convalescent stage of disease was significantly associated with higher diagnostic accuracy, IgM ELISA was the best choice, regardless of the stage of disease. Negative ELISAs (IgG or IgM) applied in the acute phase do not rule out leptospirosis due to the possibility of false-negative results. In this case it is advisable to request a second blood sample or to apply a direct method for leptospiral DNA.
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