Immunodiagnosis of cystic echinocooccosis by antigen detection in serum, urine, and saliva samples

A simple and efficient purification method of native immunoreactive antigen for diagnosis of camel hydatidosis

BACKGROUND

Cystic echinococcosis (CE), a zoonotic disease that affects animal and human health, is of increasing economic importance due to high morbidity rates and high economic losses in the livestock industry.

AIM

The present study was conducted to purify the antigen from hydatid cyst fluid (HCF) with high diagnostic efficacy of camel hydatidosis using indirect enzyme-linked immunosorbent assay (ELISA).

MATERIALS AND METHODS

The HCF antigen was purified using Sephacryl S-300 column chromatography. Characterization of fractions was performed using reducing and non-reducing sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and Western blot analysis. Further, antibodies against Echinococcus granulosus cysts in camel serum were detected using indirect ELISA.

RESULTS

The purification process resulted in three fractions of antigens: FI, FII, and FIII. Indirect ELISA showed that higher diagnostic efficacy was observed in FI than in FII and FIII. Indirect ELISA, in which FI was utilized, showed 88% sensitivity and 91.7% specificity. Non-reducing SDS-PAGE showed that FI had two bands of molecular weights 120 and 60 kDa. Western blot analysis of FI demonstrated that 60, 38, and 22 kDa were antigenic bands when reacted with naturally infected camel sera with E. granulosus cysts. Using indirect ELISA, F1 recorded an infection percentage of 81.7% in randomly collected camel serum samples.

CONCLUSION

FI is a promising antigen for accurate diagnosis of camel CE using indirect ELISA.

Lateral flow dipstick antigen assay for human cystic echinococcosis

Cystic echinococcosis (CE) is a neglected zoonotic disease with a worldwide distribution and is a major public health problem in some areas. Diagnosis of CE is mainly based on clinical symptoms, imaging and serological testing, however, improvement in serodiagnosis is still needed. This study was aimed at detecting circulating Echinococcus antigen in CE patients using a lateral flow dipstick (LFD) assay. Three types of hydatid antigens i.e. hydatid cyst fluid (HCF), native antigen B (nAgB) and recombinant antigen B (rAgB) were prepared and polyclonal rabbit antiserum was raised against each antigen. Purified IgG fractions were prepared and a portion was conjugated to gold nanoparticles. After a series of optimizations, a final antigen detection LFD assay was developed using a combination of anti-nAgB-IgG and gold-conjugated anti-HCF-IgG. Evaluation of the assay showed that 27 out of 35 (77%) serum samples from CE patients gave positive results. Meanwhile, the test showed a diagnostic specificity of 82% when tested with sera from 38 healthy individuals and 13 patients with other parasitic diseases. In conclusion, the antigen detection LFD assay seemed to be useful for diagnosis of CE and possibly for post-treatment follow-up, and merit further evaluation studies. We foresee that it may improve serodiagnosis of CE when used in tandem with an antibody detection test.

Surgically managed human cystic echinococcosis in north-eastern Iran: a single center's experience from 2001 to 2008

Cystic echinococcosis (CE) is a zoonotic parasitic disease caused by the tapeworm Echinococcus granulosus. Although CE has a large geographic distribution, data are lacking on the frequency of infection and epidemiology of CE in many endemic areas of the world, including the Middle East. Demographic and clinical information on surgically managed human CE cases were evaluated from a referral hospital in north-eastern Iran for the years 2001-2008. Of the 400 CE cases, 218 (54.5%) were male. The median age of patients was 35 years (range 2-83 years). The lungs (41.0%) and liver (37.7%) were the most commonly infected organs. However, 12.7% of patients had multiple organ involvement. The majority of cases (54.3%) were diagnosed using ultrasound, with only 12.0% diagnosed with the help of serology. Total white blood cell count was elevated in 26.8% (107/400) of patients, neutrophil count was elevated in 24.0% (96/400) of patients, and eosinophil count was elevated in 13.3% (53/400) of patients. Lymphocyte count was the only complete blood count (CBC) value that differed based on organ location (P = 0.001). Despite some successes in the control of CE, the number of surgical CE cases in north-eastern Iran remains high. Although not diagnostic alone, CBC values allow for clinicians to obtain a more complete clinical picture of CE before, during, and after treatment. While serology has its place, the use of diagnostic imaging continues to be the most commonly used tool for the diagnosis of CE cases.

Laboratory Diagnosis of Echinococcus spp. in Human Patients and Infected Animals

Among the species composing the genus Echinococcus, four species are of human clinical interest. The most prevalent species are Echinococcus granulosus and Echinococcus multilocularis, followed by Echinococcus vogeli and Echinococcus oligarthrus. The first two species cause cystic echinococcosis (CE) and alveolar echinococcosis (AE) respectively. Both diseases have a complex clinical management, in which laboratory diagnosis could be an adjunctive to the imaging techniques. To date, several approaches have been described for the laboratory diagnosis and followup of CE and AE, including antibody, antigen and cytokine detection. All of these approaches are far from being optimal as adjunctive diagnosis particularly for CE, since they do not reach enough sensitivity and/or specificity. A combination of several methods (e.g., antibody and antigen detection) or of several (recombinant) antigens could improve the performance of the adjunctive laboratory methods, although the complexity of echinococcosis and heterogeneity of clinical cases make necessary a deep understanding of the host-parasite relationships and the parasite phenotype at different developmental stages to reach the best diagnostic tool and to make it accepted in clinical practice. Standardization approaches and a deep understanding of the performance of each of the available antigens in the diagnosis of echinococcosis for the different clinical pictures are also needed. The detection of the parasite in definitive hosts is also reviewed in this chapter. Finally, the different methods for the detection of parasite DNA in different analytes and matrices are also reviewed.

A review on diagnostic and preventive aspects of cystic echinococcosis and human cysticercosis

Cystic echinococcosis and human cysticercosis have recently been included in the list of "neglected tropical diseases" by the World Health Organization (WHO). Both are zoonoses which are prevalent throughout the world and lead to considerable mortality, morbidity, and economic losses as well. This review deals with the disease burden of these two neglected cestode infections. Diagnostic modalities with their specific advantages and disadvantages have also been discussed. Recent developments in immunodiagnostic assays for the two diseases have been dealt with. Various control strategies including the use of veterinary vaccines have been highlighted.