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Eamudomkarn C, Sithithaworn P, Kamamia C, Yakovleva A, Sithithaworn J, Kaewkes S, Techasen A, Loilome W, Yongvanit P, Wangboon C, Saichua P, Itoh M, M. Bethony J. Diagnostic performance of urinary IgG antibody detection: A novel approach for population screening of strongyloidiasis. PLoS One 2018; 13:e0192598. [PMID: 29985913 PMCID: PMC6037348 DOI: 10.1371/journal.pone.0192598] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 05/25/2018] [Indexed: 11/18/2022] Open
Abstract
The diagnosis of strongyloidiasis by coprological methods has a low sensitivity, underestimating the prevalence of Strongyloides stercoralis in endemic areas. Serodiagnostic tests for strongyloidiasis have shown robust diagnostic properties. However, these methods require a blood draw, an invasive and labor-intensive sample collection method, especially in the resource-limited settings where S. stercoralis is endemic. Our study examines a urine-based assay for strongyloidiasis and compares its diagnostic accuracy with coprological and serological methods. Receiver operating characteristic (ROC) curve analyses determined the diagnostic sensitivity (D-Sn) and specificity (D-Sp) of the urine ELISA, as well as estimates its positive predictive value and diagnostic risk. The likelihood ratios of obtaining a positive test result (LR+) or a negative test result (LR-) were calculated for each diagnostic positivity threshold. The urine ELISA assay correlated significantly with the serological ELISA assay for strongyloidiasis, with a D-Sn of 92.7% and a D-Sp of 40.7%, when compared to coprological methods. Moreover, the urine ELISA IgG test had a detection rate of 69%, which far exceeds the coprological method (28%). The likelihood of a positive diagnosis of strongyloidiasis by the urine ELISA IgG test increased significantly with increasing units of IgG detected in urine. The urine ELISA IgG assay for strongyloidiasis assay has a diagnostic accuracy comparable to serological assay, both of which are more sensitive than coprological methods. Since the collection of urine is easy and non-invasive, the urine ELISA IgG assay for strongyloidiasis could be used to screen populations at risk for strongyloidiasis in S. stercoralis endemic areas.
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Affiliation(s)
- Chatanun Eamudomkarn
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Cholangiocarcinoma Research Institute (CARI), Khon Kaen University, Khon Kaen, Thailand
| | - Paiboon Sithithaworn
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Cholangiocarcinoma Research Institute (CARI), Khon Kaen University, Khon Kaen, Thailand
- * E-mail: ,
| | - Christine Kamamia
- Department of Microbiology, Immunology & Tropical Medicine, George Washington University, Washington, D.C., United States of America
| | - Anna Yakovleva
- Department of Microbiology, Immunology & Tropical Medicine, George Washington University, Washington, D.C., United States of America
| | - Jiraporn Sithithaworn
- Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
- Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand
| | - Sasithorn Kaewkes
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Anchalee Techasen
- Cholangiocarcinoma Research Institute (CARI), Khon Kaen University, Khon Kaen, Thailand
- Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Watcharin Loilome
- Cholangiocarcinoma Research Institute (CARI), Khon Kaen University, Khon Kaen, Thailand
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Puangrat Yongvanit
- Cholangiocarcinoma Research Institute (CARI), Khon Kaen University, Khon Kaen, Thailand
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Chompunoot Wangboon
- Biomedical Science Program, Graduate School, Khon Kaen University, Khon Kaen, Thailand
| | - Prasert Saichua
- Tropical Medicine Program, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Makoto Itoh
- Department of Infection and Immunology, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Jeffrey M. Bethony
- Department of Microbiology, Immunology & Tropical Medicine, George Washington University, Washington, D.C., United States of America
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Griffith QK, Liang Y, Onguru DO, Mwinzi PN, Ganley-Leal LM. CD23-bound IgE augments and dominates recall responses through human naive B cells. THE JOURNAL OF IMMUNOLOGY 2010; 186:1060-7. [PMID: 21160045 DOI: 10.4049/jimmunol.1002709] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Human peripheral blood BCRμ(+) B cells express high levels of CD23 and circulate preloaded with IgE. The Ag specificity of CD23-bound IgE presumably differs from the BCR and likely reflects the Ag-specific mix of free serum IgE. CD23-bound IgE is thought to enhance B cell Ag presentation to T cells raising the question of how a B cell might respond when presented with a broad mix of Ags and CD23-bound IgE specificities. We recently reported that an increase in CD23(+) B cells is associated with the development of resistance to schistosomiasis, highlighting the potential importance of CD23-bound IgE in mediating immunity. We sought to determine the relationship between BCR and CD23-bound IgE-mediated B cell activation in the context of schistosomiasis. We found that crude schistosome Ags downregulate basal B cell activation levels in individuals hyperexposed to infectious worms. Schistosome-specific IgE from resistant, occupationally exposed Kenyans recovered responses of B cells to schistosome Ag. Furthermore, cross-linking of CD23 overrode intracellular signals mediated via the BCR, illustrating its critical and dominating role in B cell activation. These results suggest that CD23-bound IgE augments and dominates recall responses through naive B cells.
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Affiliation(s)
- Qyana K Griffith
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA 02118, USA
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Abstract
Reviews of the immunology of human schistosomiasis generally address the host's protective responses against infection or the factors associated with development of severe pathology. However, there is a growing recognition that the high number of patients expressing moderate morbidity, rather than the few patients with severe morbidity, accounts for the greatest public health impact of schistosomiasis. Therefore, other aspects of the host immune response that have received relatively little attention may actually provide pivotal answers in our understanding and management of the morbidity associated with human schistosomiasis. This review highlights lines of investigation that focus on how immune responses to schistosomiasis may affect schistosomiasis-associated anaemia, alter susceptibility or disease progression during co-infections, and influence effective execution of mass treatment programmes.
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Affiliation(s)
- W E Secor
- Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Public Health Service, Department of Health and Human Services, Atlanta, GA 30341-3724, USA.
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