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Toribio L, Guzman C, Noazin S, Zimic-Sheen A, Zimic M, Gonzales I, Saavedra H, Pretell EJ, Bustos JA, Handali S, García HH. Multiantigen print immunoassay (MAPIA) for the diagnosis of neurocysticercosis: a single-center diagnostic optimization and accuracy study in Lima, Peru. J Clin Microbiol 2023; 61:e0076023. [PMID: 37966225 PMCID: PMC10729656 DOI: 10.1128/jcm.00760-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/21/2023] [Indexed: 11/16/2023] Open
Abstract
Neurocysticercosis (NCC) is the most common helminthic infection of the human central nervous system. The antibody detection assay of choice is the enzyme-linked immunoelectrotransfer blot assay using lentil-lectin purified parasite antigens (LLGP-EITB, Western blot), an immunoassay with exceptional performance in clinical samples. However, its use is mainly restricted to a few research laboratories because the assay is labor-intensive and requires sophisticated equipment, expertise, and large amounts of parasite material for preparation of reagents. We report a new immunoprint assay (MAPIA) that overcomes most of these barriers. We initially compared the performance of five different antigen combinations in a subset of defined samples in the MAPIA format. After selecting the best-performing assay format (a combination of rGP50 + rT24H + sTs14 antigens), 148 archived serum samples were tested, including 40 from individuals with parenchymal NCC, 40 with subarachnoid NCC, and 68 healthy controls with no evidence of neurologic disease. MAPIA using three antigens (rGP50 + rT24H + sTs14) was highly sensitive and specific for detecting antibodies in NCC. It detected 39 out of 40 (97.5%) parenchymal NCC cases and 40/40 (100%) subarachnoid cases and was negative in 67 out of 68 (98.53%) negative samples. MAPIA using three recombinant and synthetic antigens is a simple and economical tool with a performance equivalent to the LLGP-EITB assay for the detection of specific antibodies to NCC. The MAPIA overcomes existing barriers to adoption of the EITG LLGP and is a candidate for worldwide use.
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Affiliation(s)
- L. Toribio
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - C. Guzman
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - S. Noazin
- Department of International Health, Bloomberg School of Public Health. Johns Hopkins University, Baltimore, Maryland, USA
| | - A. Zimic-Sheen
- Bioinformatics Laboratory, Molecular Biology and Technological Developments, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, San Martín de Porres, Peru
| | - M. Zimic
- Bioinformatics Laboratory, Molecular Biology and Technological Developments, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, San Martín de Porres, Peru
| | - I. Gonzales
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - H. Saavedra
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - E. J. Pretell
- Hospital Nacional Alberto Sabogal Sologuren, ESSALUD, Callao, Peru
| | - J. A. Bustos
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - S. Handali
- Parasitic Diseases Branch, Division of Parasitic Diseases & Malaria, Center for Global Health, Centers for Disease Control & Prevention, Atlanta, Georgia, USA
| | - H. H. García
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of International Health, Bloomberg School of Public Health. Johns Hopkins University, Baltimore, Maryland, USA
| | - on behalf of The Cysticercosis Working Group in Peru
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of International Health, Bloomberg School of Public Health. Johns Hopkins University, Baltimore, Maryland, USA
- Bioinformatics Laboratory, Molecular Biology and Technological Developments, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, San Martín de Porres, Peru
- Hospital Nacional Alberto Sabogal Sologuren, ESSALUD, Callao, Peru
- Parasitic Diseases Branch, Division of Parasitic Diseases & Malaria, Center for Global Health, Centers for Disease Control & Prevention, Atlanta, Georgia, USA
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