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Fasogbon IV, Aja PM, Ondari EN, Adebayo I, Ibitoye OA, Egesa M, Tusubira D, Sasikumar S, Onohuean H. UCP-LF and other assay methods for schistosome circulating anodic antigen between 1978 and 2022. Biol Methods Protoc 2023; 8:bpad006. [PMID: 37197579 PMCID: PMC10185406 DOI: 10.1093/biomethods/bpad006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/27/2023] [Accepted: 03/31/2023] [Indexed: 04/05/2023] Open
Abstract
Detection of circulating anodic antigen (CAA) is known for its high sensitivity in diagnosing schistosomiasis infection, even in low-prevalence settings. The Up-Converting Phosphor-Lateral Flow (UCP-LF) assay developed in 2008 presented greater sensitivity than other assay methods in use for CAA detection. Our study aims to comprehensively review all studies conducted in this area and thus generate informed conclusions on the potential for adopting the UCP-LF assay for diagnosing this important yet neglected tropical disease. Using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, we generated search criteria to capture all studies in English journals available in the Scopus and PubMed databases on 20 December 2022. A total of 219 articles were identified, and 84 that met the inclusion criteria were retrieved and eventually included in the study. Twelve different assay methods were identified with a noteworthy transition from enzyme-linked immunosorbent assay (ELISA) to the UCP-LF assay, a laboratory-based assay that may be applicable as a point-of-care (POC) diagnostic test for schistosomiasis. Reducing the time, cost, and dependence on specialized laboratory skills and equipment, especially relating to the trichloroacetic acid extraction step and centrifugation in the UCP-LF CAA assay may go a long way to aid its potential as a POC tool. We also propose the development of a CAA-specific aptamer (short protein/antigen-binding oligonucleotide) as a possible alternative to monoclonal antibodies in the assay. UCP-LF has great potential for POC application.
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Affiliation(s)
| | - Patrick Maduabuchi Aja
- Department of Biochemistry, Kampala International University-Western Campus, Kampala, Uganda
| | - Erick Nyakundi Ondari
- Department of Biochemistry, Kampala International University-Western Campus, Kampala, Uganda
- Department of Biological Sciences, School of Pure & Applied Sciences, Kisii University, Kisii, Kenya
| | - Ismail Adebayo
- Department of Microbiology, Kampala International University-Western Campus, Kampala, Uganda
| | | | - Moses Egesa
- MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Deusdedit Tusubira
- Department of Biochemistry, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Hope Onohuean
- Department of Pharmacology and Toxicology, Biopharmaceutics Unit, Kampala International University-Western Campus, Kampala, Uganda
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Koulali H, Zazour A, Khannoussi W, Kharrasse G, Ismaili Z. Colonic schistosomiasis: A case report. World J Gastrointest Endosc 2022; 14:789-794. [PMID: 36567820 PMCID: PMC9782564 DOI: 10.4253/wjge.v14.i12.789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/20/2022] [Accepted: 11/19/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Schistosomiasis is a chronic parasitic infection endemic in many countries. Colonic schistosomiasis is a rare entity with no specific clinical manifestations or endoscopic aspects, which delays the diagnosis. Diagnosis is primarily dependent on histopathological analysis, and treatment with antihelminthics typically resolves the infection.
CASE SUMMARY We present the case of a 21-year-old male who suffered from chronic diarrhea and abdominal pain. Physical examination found no abnormalities, blood tests were normal, and stool examination was negative. A colonoscopy revealed a nodular terminal ileal mucosa, two cecal polypoid lesions with no particular surface pattern, and millimetric erosions in the rectum. The presence of Schistosoma eggs with thick peripheral capsules and viable embryos inside and numerous eosinophils surrounding the egg capsule were observed on histopathological examination. The patient received praziquantel, and his symptoms were resolved.
CONCLUSION Colonic schistosomiasis should be considered as a differential diagnosis, especially in endemic countries. Endoscopy and histopathological examination can confirm the diagnosis, and antihelminthics are an effective treatment.
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Affiliation(s)
- Hajar Koulali
- Department of Gastro-enterology, Mohammed VI University Hospital, Oujda 60050, Morocco
| | - Abdelkrim Zazour
- Department of Gastro-enterology, Mohammed VI University Hospital, Oujda 60050, Morocco
| | - Wafaa Khannoussi
- Department of Gastro-enterology, Mohammed VI University Hospital, Oujda 60050, Morocco
| | - Ghizlane Kharrasse
- Department of Gastro-enterology, Mohammed VI University Hospital, Oujda 60050, Morocco
| | - Zahi Ismaili
- Department of Gastro-enterology, Mohammed VI University Hospital, Oujda 60050, Morocco
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Cavalcanti MG, Cunha AFA, Peralta JM. The Advances in Molecular and New Point-of-Care (POC) Diagnosis of Schistosomiasis Pre- and Post-praziquantel Use: In the Pursuit of More Reliable Approaches for Low Endemic and Non-endemic Areas. Front Immunol 2019; 10:858. [PMID: 31191512 PMCID: PMC6546849 DOI: 10.3389/fimmu.2019.00858] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 04/03/2019] [Indexed: 12/22/2022] Open
Abstract
Like soil-transmitted helminth infections, schistosomiasis is an important neglected tropical disease (NTD) related to poverty with a major impact on public health in developing countries. Diagnosis of active infection is crucial for surveillance of controlled or post-elimination schistosomiasis areas. In addition, the use of conventional diagnostic tools in non-exposed populations (such as travelers) results in misdiagnoses in the prepatent period of infection. Also, the accuracy of standard tests applied in low-endemicity areas (LEAs) decreases after several rounds of treatment. We aimed to determine whether it would be necessary to replace schistosomiasis conventional diagnostic tests such as parasitological methods in LEAs. Also, we evaluate the use of new tools in non-endemic areas. Reliable, cheap and easy-to-use diagnostic tools are needed to respond to the demands of a new era of elimination and eradication of schistosomiasis. To this end, molecular diagnosis-including nucleic acid-based assays (loop-mediated isothermal amplification, polymerase chain reaction) and circulating cathodic and anodic antigen detection tests have become promising strategies. In this review, we attempt to address the use of alternative diagnostic tests for active infection detection and drug-monitoring after specific schistosomiasis treatment.
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Affiliation(s)
- Marta G Cavalcanti
- Serviço de Doenças Infecciosas e Parasitárias, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.,Departmento de Imunologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Aline Fernandes Araujo Cunha
- Departmento de Imunologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - José Mauro Peralta
- Departmento de Imunologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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Seidelman J, Hendershot EF, Henshaw N, Rein M. Caught on Colonoscopy: Schistosomiasis Manifesting as a Single Colonic Polyp. Am J Med 2018; 131:e441-e443. [PMID: 30059655 DOI: 10.1016/j.amjmed.2018.06.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 06/29/2018] [Indexed: 11/24/2022]
Affiliation(s)
- Jessica Seidelman
- Division of Infectious Diseases and International Health, Department of Medicine.
| | - Edward F Hendershot
- Division of Infectious Diseases and International Health, Department of Medicine
| | | | - Matthew Rein
- Division of Gastroenterology, Department of Medicine, Duke University School of Medicine, Duke University, Durham, NC
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Stenstad T. En mann med feber, urticaria, periorbitalt ødem og tørrhoste. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2015; 135:1860-4. [DOI: 10.4045/tidsskr.15.0518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Issa I, Osman M, Aftimos G. Schistosomiasis manifesting as a colon polyp: a case report. J Med Case Rep 2014; 8:331. [PMID: 25296942 PMCID: PMC4196203 DOI: 10.1186/1752-1947-8-331] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2014] [Accepted: 08/19/2014] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Schistosomiasis is a rare disease with a common intestinal involvement. However, colon polyps associated with Schistosoma in the absence of inflammation have rarely been reported, especially in young people; this is the first case with the following presentation. CASE PRESENTATION We describe the case of a 20-year-old Ethiopian woman living in Lebanon who presented with nonspecific abdominal symptoms. Her biochemical profile was normal in addition to the results of her stool and urine tests. A colonoscopy showed normal colonic mucosa but surprisingly a large pedunculated polyp was found in her ascending colon. Pathology revealed a hamartomatous polyp but it was full of partially calcified parasitic eggs of Schistosoma mansoni compatible with chronic schistosomiasis. CONCLUSIONS She was treated with two doses of praziquantel and showed immediate marked clinical improvement. This unusual case will give us the opportunity to discuss schistosomiasis, its occurrence in colon polyps, clinical significance and the various means of management.
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Affiliation(s)
- Iyad Issa
- Department of Gastroenterology and Hepatology, Rafic Hariri University Hospital (RHUH), Beirut, Lebanon.
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Wichmann D, Poppert S, Von Thien H, Clerinx J, Dieckmann S, Jensenius M, Parola P, Richter J, Schunk M, Stich A, Zanger P, Burchard GD, Tannich E. Prospective European-wide multicentre study on a blood based real-time PCR for the diagnosis of acute schistosomiasis. BMC Infect Dis 2013; 13:55. [PMID: 23363565 PMCID: PMC3563621 DOI: 10.1186/1471-2334-13-55] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2012] [Accepted: 01/21/2013] [Indexed: 01/20/2023] Open
Abstract
Background Acute schistosomiasis constitutes a rare but serious condition in individuals experiencing their first prepatent Schistosoma infection. To circumvent costly and time-consuming diagnostics, an early and rapid diagnosis is required. So far, classic diagnostic tools such as parasite microscopy or serology lack considerable sensitivity at this early stage of Schistosoma infection. To validate the use of a blood based real-time polymerase chain reaction (PCR) test for the detection of Schistosoma DNA in patients with acute schistosomiasis who acquired their infection in various endemic regions we conducted a European-wide prospective study in 11 centres specialized in travel medicine and tropical medicine. Methods Patients with a history of recent travelling to schistosomiasis endemic regions and freshwater contacts, an episode of fever (body temperature ≥38.5°C) and an absolute or relative eosinophil count of ≥700/μl or 10%, were eligible for participation. PCR testing with DNA extracted from serum was compared with results from serology and microscopy. Results Of the 38 patients with acute schistosomiasis included into the study, PCR detected Schistosoma DNA in 35 patients at initial presentation (sensitivity 92%). In contrast, sensitivity of serology (enzyme immunoassay and/or immunofluorescence assay) or parasite microscopy was only 70% and 24%, respectively. Conclusion For the early diagnosis of acute schistosomiasis, real-time PCR for the detection of schistosoma DNA in serum is more sensitive than classic diagnostic tools such as serology or microscopy, irrespective of the region of infection. Generalization of the results to all Schistosoma species may be difficult as in the study presented here only eggs of S. mansoni were detected by microscopy. A minimum amount of two millilitre of serum is required for sufficient diagnostic accuracy.
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Affiliation(s)
- Dominic Wichmann
- Department of Intensive Care Medicine, University Medical Centre Hamburg-Eppendorf, 20246, Hamburg, Germany.
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Abstract
The liver plays an important role in host defense against invasive microorganisms. The effect of microbial pathogens on the liver can vary greatly, presenting with a wide variety of manifestations from asymptomatic increases in aminotransaminases, acute liver failure, hepatic fibrosis, and cirrhosis. In evaluating the liver manifestations of a potential infectious pathogen, diagnosis of some of the less common infectious pathogens is dependent on a high level of suspicion and recognition of some of the key diagnostic clues. Successful diagnosis can only be accomplished through a careful history, including travel and exposures, physical examination, and appropriate microbiologic studies. This article reviews the involvement of the liver during systemic infections with organisms that are not considered to be primarily hepatotropic.
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Affiliation(s)
- Rohit Talwani
- Assistant Professor of Medicine, Institute of Human Virology, Division of Infectious Diseases, Department of Medicine, University of Maryland School of Medicine, Baltimore MD
| | - Bruce L. Gilliam
- Associate Professor of Medicine, Institute of Human Virology, Division of Infectious Diseases, Department of Medicine, University of Maryland School of Medicine, Baltimore MD
| | - Charles Howell
- Profesor of Medicine, Division of Gastroenterology and Hepatology, Department of Medicine, University of Maryland School of Medicine, Baltimore MD
- Director of Hepatology Research University of Maryland School of Medicine, Baltimore, MD
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Clerinx J, Van Gompel A. Schistosomiasis in travellers and migrants. Travel Med Infect Dis 2011; 9:6-24. [DOI: 10.1016/j.tmaid.2010.11.002] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2010] [Revised: 11/09/2010] [Accepted: 11/18/2010] [Indexed: 02/07/2023]
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van Lieshout L, Polderman AM, Deelder AM. Immunodiagnosis of schistosomiasis by determination of the circulating antigens CAA and CCA, in particular in individuals with recent or light infections. Acta Trop 2000; 77:69-80. [PMID: 10996122 DOI: 10.1016/s0001-706x(00)00115-7] [Citation(s) in RCA: 156] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
In the present paper, we evaluate determination of circulating anodic (CAA) and cathodic (CCA) antigen for the diagnosis of an active Schistosoma infection in humans, in comparison to the diagnostic performance of parasitological examination and the demonstration of specific antibodies. Illustrated by three different studies, which all deal with the diagnosis of either recent or low intensity infections, we further discuss our experiences with these diagnostic methods. For the diagnosis of recent infections, specific antibody determination showed to be very sensitive, particularly in individuals originating from non-endemic areas. For the assessment of cure and for the diagnosis of active infections in endemic areas, the methods of choice are parasitological examination and CAA or CCA determination. Depending on infection levels of the target population and on logistic conditions, CAA and CCA determination may either replace parasitological examination or, in the case of light infections, may be used as a complementary diagnostic tool.
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Affiliation(s)
- L van Lieshout
- Department of Parasitology, Leiden Univerity Medical Centre, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
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Nibbeling HA, Van Etten L, Fillié YE, Deelder AM. Enhanced detection of Schistosoma circulating antigens by testing 1 ml urine samples using immunomagnetic beads. Acta Trop 1997; 66:85-92. [PMID: 9227801 DOI: 10.1016/s0001-706x(97)00039-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The potential advantage of increasing the sample volume for enhanced detection of two Schistosoma circulating antigens in urine has been evaluated. Two different, monoclonal antibody based, immunomagnetic beads assays detecting circulating anodic antigen (CAA) and circulating soluble egg antigen (CSEA), respectively, were investigated. By increasing the sample volume to 1.0 ml, the lower detection limit of antigen dilution series was improved six eight-fold in both immunomagnetic beads assays. Indeed, an improvement could be shown when testing the urine of Schistosoma-infected individuals with these magnetic beads assays. To compare the sensitivity of the immunomagnetic beads method with the standard ELISA, urine was experimentally adjusted to mirror low natural infection intensities. CSEA-positive urine samples were adjusted to levels below the detection limit of the corresponding ELISA and indeed were still found positive by the CSEA immunomagnetic beads assay. These results demonstrate that by using immunomagnetic beads, an assay method which can utilise larger sample volumes than an ELISA, enhanced detection can be achieved. This might be particularly valuable in areas with low prevalence of schistosomiasis or for the assessment of cure after chemotherapy.
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Affiliation(s)
- H A Nibbeling
- Laboratory of Parasitology, University of Leiden, The Netherlands
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