A new ELISA and western blot technique based on recombinant TES antigen and/or larval antigen for the detection of toxocariasis in humans

Seroprevalence of Toxocara spp. in Pregnant Women: A Systematic Review and Meta-Analysis

Background

Toxocariasis is an important health problem caused by the parasitic species Toxocara canis (T. canis) and Toxocara cati (T. cati). Prevalence of toxocariasis in pregnant women as a vulnerable population is doubly important, and the aim of this study is to estimate the overall prevalence of toxocariasis infection in pregnant women according to the available reports.

Methods

The present study followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) checklists. A systematic search was carried out in international scientific databases (Google Scholar, Web of Science, ScienceDirect, Scopus, and PubMed) between 1990 and 2023. The overall prevalence of parasitic infection was estimated with a random-effects model. All analyses (overall prevalence, heterogeneity, publication bias, and sensitivity analysis) were performed with comprehensive meta-analysis (V2.2, Bio stat) software.

Results

Amid the final eleven included studies, based on the random-effects model, the estimation of the pooled prevalence of Toxocara spp. was 20.8% (95% CI, 9.8-38.7%). The association between the risk factors of toxocariasis and the prevalence of the disease was not statistically significant.

Conclusions

In the present study, significant prevalence was reported; however, considering the limited number of studies, it seems that the actual prevalence of the disease is higher. Therefore, it seems necessary to monitor this health problem in pregnant women.

Toxocara cati Infection in Cats (Felis catus): A Systematic Review and Meta-Analysis

Introduction: Toxocariasis is an infection caused in canines, felines, humans, and other vertebrates by species of the genus Toxocara, such as T. canis and T. cati. The embryonated eggs of these parasites are the primary means of acquiring the infection for both definitive hosts, dogs and cats, respectively, and for intermediates, such as humans and other vertebrates. When deposited on park soils, environmental contamination becomes a risk to environmental, human, and animal health. Objective: To determine the global prevalence of Toxocara cati in cats (Felis catus). Methods: A systematic review of the literature was carried out in six databases (Scopus, PubMed, ScienceDirect, SciELO and Google Scholar) to evaluate the global prevalence of Toxocara cati in cats, defined by coproparasitological, histological, and molecular techniques. A meta-analysis was performed using a random effects model to calculate pooled prevalence and 95% confidence intervals (95% CI). A two-tailed 5% alpha level was used for hypothesis testing. Results: Two hundred and eighty-nine studies were included. The global pooled prevalence of Toxocara cati in cats using coproparasitological methods was 17.0% (95.0% CI: 16.2-17.8%). In the subgroup analysis according to country, Nepal had the highest prevalence of T. cati infection (94.4%; 95% CI 89.7-99.2%). The pooled prevalence of T. cati infection by PCR in four studies was 4.9% (95.0% CI: 1.9-7.9%). Conclusions: This systematic review underscores the need for preventive action against toxocariasis due to its widespread prevalence. The interplay between animal and human health should be emphasised, necessitating measures like deworming cats, hygiene practices, and public education to mitigate risks. Safeguarding feline health can also reduce human transmission, benefiting both species.

Deglycosylation of Excretory-Secretory Antigens of the Second-Stage Larvae of Toxocara cati Improves Its Efficacy in the Diagnosis of Human Toxocariasis

Background

Toxocariasis is an important zoonotic infection, especially in tropical areas. One of the significant challenges in the serodiagnosis of human toxocariasis is the cross-reaction of Toxocara antigens with other parasites due to their relatively similar glycan structures. Removing the glycan structure from Toxocara excretory-secretory (TES) antigens may increase the efficacy of these antigens in the diagnosis of toxocariasis. The current study aimed to assess the efficacy of deglycosylated Toxocara cati excretory-secretory (dTES) antigens for the serodiagnosis of human toxocariasis.

Methods

Toxocara ES antigens were prepared from T. cati second-stage larvae and deglycosylated using sodium hydroxide (NaOH). The TES antigens, along with the dTES antigens, were used in an ELISA as well as a western blotting system for the detection of anti-Toxocara antibodies. Sera samples collected from 30 confirmed cases of toxocariasis, 30 patients with other diseases, and 30 healthy subjects were evaluated by both systems.

Results

The sensitivity of TES and dTES ELISA for the diagnosis of human toxocariasis was 96.67% (95% CI = 82.78-99.92) and 93.33% (95% CI = 77.93-99.18), respectively, while the specificity of dTES (88.33%; 95% CI = 77.43-95.18) increased significantly compared to the TES (80.00%; 95% CI = 67.67-89.22). The sensitivity of both antigens was 100% (95% CI = 88.43-100) by the western blotting system. Moreover, the specificity of TES and dTES antigens was 95% (95% CI = 86.08-98.96) and 98.33% (95% CI = 91.06-99.96), respectively, when using the western blotting system.

Conclusion

Results of the current study indicate that the chemical removal of the glycan epitopes of T. cati ES antigens significantly reduces cross-reactivity rates with other parasitic infections. Considering the findings of the present study, the dTES antigens seem to be suitable antigens for the serodiagnosis of human toxocariasis.

Dog and Cat Contact as Risk Factor for Human Toxocariasis: Systematic Review and Meta-Analysis

Toxocariasis, a neglected parasitic zoonosis with worldwide distribution, has been reportedly associated to different risk factors in several epidemiological and meta-analysis studies. However, dog and cat contact (environmental and animal exposure) as isolated associated risk factor for children and adults remains to be fully established. Accordingly, the present meta-analysis has aimed to directly assess dog and cat contact for toxocariasis seropositivity in under-18 and adult persons, using a survey strategy of PubMed/Medline, Embase, Scopus and Scielo Databases, from January 2009 to December 2021. A meta-analysis model of random effects was applied to estimate odds ratio (OR) with 95% Confidence Interval (CI). The statistical heterogeneity was evaluated by the Cochran Q-Test and I² values. A total of 41 transversal studies (n = 20.515 individuals) from different geographic regions (classified by the World Health Organization) were included herein. In overall, 1,882/13,496 (13.95%; 95% IC = 13.4–14.5) youngers and 513/7.019 (7.3%; 95% CI = 6.7–7.9) adults in contact with dogs or cats were serologically reagent for anti-Toxocara antibodies. Association of dog and cat contact was observed only in youngers, with both dogs (OR = 1.53; p < 0.0001) and cats (OR = 1.64; p = 0.0001). In addition, association of dog and contact and serology was statistically significant in populations of Americas (OR = 1.37; 95% CI = 1.1–1.7), Middle East (OR = 2.9; 95% CI = 1.6–5.1) and West Pacific (OR = 1.6; 95% IC = 1.3–1.9). In conclusion, contact with dogs and cats, particularly by younger individuals and in regions such as Americas, Middle East, and West Pacific, should be always a public health concern for toxocariasis. Moreover, dogs and cats should be periodically dewormed, washed and hair cleaned prior to contact with youngers. Finally, robust statistical results herein may serve as basis for future strategies and preventive measures for safer dog and cat contact.

Antigenic Proteins from the Excretory-Secretory Products of Toxocara canis Larvae and Evaluation of Their Potential for Immunodiagnostics of Larval Toxocarosis

BACKGROUND

Larval toxocarosis is a zoonosis caused by larvae of Toxocara canis and T. cati, a gastrointestinal nematode of canids and felids, respectively. Diagnosis is usually performed by ELISA IgG using Toxocara excretory-secretory products as an antigen. Due to laboriousness of isolation of the products and subsequent process of standardization of antigenic compounds, routine use of this method is limited and can produce inaccurate diagnostical results. The purpose of this study was to discover new specific antigenic proteins that could be used in routine serological methods of larval toxocarosis.

MATERIALS AND METHODS

Toxocara excretory-secretory products were collected and separated by SDS-PAGE. Proteins from the gel were electro-transferred to a membrane and incubated with mouse sera. Antigenic proteins were analyzed using the liquid chromatography-tandem mass spectrometry approach. Selected proteins were prepared in recombinant form and tested with mice and human sera by ELISA and Western blot.

RESULTS

A total of four recombinant protein antigens were prepared (rTc-TES-26, rTc-ASA, rTc-PDP, and rTc-ASP). They were analyzed by ELISA and Western blot using mice and human sera. For all sera, three of the four recombinant antigens correlated with Toxocara excretory-secretory products in ELISA analysis. By Western blot, the infection was confirmed in all experimentally infected mice and two out of seven human patients.

CONCLUSION

Combination of the presented methods and analyses represents a possible method of effective identification of Toxocara protein antigens for the purpose of routine serodiagnosis.

Therapy and Prevention for Human Toxocariasis

For the last four decades, knowledge about human toxocariasis with regard to its epidemiology, pathophysiology, clinical spectrum, and imaging or laboratory diagnosis has substantially progressed. Knowledge about specific therapy with anthelmintics has lagged behind. To date, only four drugs are registered for human use, and their efficacy has rarely been assessed in prospective controlled trials. It is likely that the repurposing of potent anthelmintics from veterinary medicine will improve this situation. Due to its wide availability and a lack of major side effects during short regimens, albendazole has become the drug of choice. However, its efficacy should be more precisely assessed. The role of anthelmintics in the treatment of neurological or ocular toxocariasis remains to be clarified. Prophylactic measures in humans or companion animals are efficient and represent first-line treatments for the control of this zoonosis. Unfortunately, their implementation in areas or countries where toxocariasis epidemiology is driven by poverty is quite difficult or unrealistic.