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- Title
Improved Serodiagnosis of Cystic Echinococcosis Using the New Recombinant 2B2t Antigen.
- Authors
Hernández-González, Ana; Santivañez, Saúl; García, Héctor H.; Rodríguez, Silvia; Muñoz, Santiago; Ramos, Guillermo; Orduña, Antonio; Siles-Lucas, Mar
- Abstract
A standardized test for the serodiagnosis of human cystic echinococcosis (CE) is still needed, because of the low specificity and sensitivity of the currently available commercial tools and the lack of proper evaluation of the existing recombinant antigens. In a previous work, we defined the new ELISA-B2t diagnostic tool for the detection of specific IgGs in CE patients, which showed high sensitivity and specificity, and was useful in monitoring the clinical evolution of surgically treated CE patients. Nevertheless, this recombinant antigen gave rise to false-negative results in a percentage of CE patients. Therefore, in an attempt to improve its sensitivity, we constructed B2t-derived recombinant antigens with two, four and eight tandem repeat of B2t units, and tested them by ELISA on serum samples of CE patients and patients with related parasites. The best diagnostic values were obtained with the two tandem repeat 2B2t antigen. The influence of several clinical variables on the performance of the tests was also evaluated. Finally, the diagnostic performance of the 2B2t-ELISA was compared with that of an indirect haemagglutination commercial test. The 2B2t recombinant antigen performed better than the HF and B2t antigens, and the IHA commercial kit. Therefore, this new 2B2t-ELISA is a promising candidate test for the serodiagnosis of CE in clinical settings. Author Summary: Cystic echinococcosis (CE) is a widespread zoonotic disease. Its complex clinical presentation precludes a "one-size-fits-all" approach to clinical management, particularly with regard to serodiagnosis. While CE is often detected incidentally by imaging, imaging findings may be inconclusive. Therefore, there is a need for standardised and approachable diagnostic tools that may complement imaging data. In this regard, serological tests based in the use of native antigens like hydatid fluid present a low specificity and sensitivity. Although recombinant antigens with potential to replace native antigens have been proposed in the literature, none has been systematically tested for diagnostic performance. Here, we describe the new recombinant antigen 2B2t, derived from the previously described recombinant B2t, and determine its usefulness for the serodiagnosis of CE by ELISA in patients with a complete set of clinical data. The influence of clinical variables on the performance of 2B2t was evaluated and compared with the hydatid fluid (the most commonly used antigen for CE serology) and a commercial diagnostic kit based on the haemagglutination reaction. Our results show that the 2B2t antigen has potential to be routinely used for the standardised diagnosis of CE in clinical settings.
- Subjects
SERODIAGNOSIS; ANTIGENS; TANDEM repeats; ECHINOCOCCOSIS; DIAGNOSTIC reagents &; test kits; Q fever
- Publication
PLoS Neglected Tropical Diseases, 2012, Vol 6, Issue 7, p1
- ISSN
1935-2727
- Publication type
Article
- DOI
10.1371/journal.pntd.0001714