A Coproantigen Diagnostic Test for Strongyloides Infection

Sykes, Alex M.; McCarthy, James S.

doi:10.1371/journal.pntd.0000955

Cited by 56 publications

(38 citation statements)

References 33 publications

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“…Among the 'new' methods, a particularly useful tool for epidemiological surveys would be the antigen detection test in stools, which has the potential to be developed as a rapid immunochromatographic dipstick test [39]. However, further research on the accuracy of this technique is needed [13,14].…”

Section: Prevalence Studiesmentioning

confidence: 99%

Novel approaches to the diagnosis of Strongyloides stercoralis infection

Buonfrate

Formenti

Perandin

et al. 2015

Clinical Microbiology and Infection

190

168

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Strongyloides stercoralis differs from the other soil-transmitted helminths because it puts infected subjects at risk of a fatal syndrome (in cases of immunosuppression for medical conditions, immunosuppressant therapies, or both). Chronic strongyloidiasis is often a non-severe condition, or is sometimes even asymptomatic, but diagnosis and effective therapy are essential in order to eradicate the infection and the life-long risk involved. Therefore, diagnostic methods need to be highly sensitive. Stool microscopy and the Kato-Katz technique are commonly used in prevalence studies, but they are inadequate for S. stercoralis detection. This is probably the main reason why the global prevalence has long been underestimated. Concentration methods, the Baermann technique and Koga agar plate culture have better, but still unsatisfactory, sensitivity. Serological tests have demonstrated higher sensitivity; although some authors have concerns about their specificity, it is possible to define cut-off values over which infection is almost certain. In particular, the luciferase immunoprecipitation system technique combined with a recombinant antigen (NIE) demonstrated a specificity of almost 100%. ELISA coproantigen detection has also shown promising results, but still needs full evaluation. Molecular diagnostic methods are currently available in a few referral centres as in-house techniques. In this review, on the basis of the performance of the different diagnostic methods, we outline diagnostic strategies that could be proposed for different purposes, such as: prevalence studies in endemic areas; individual diagnosis and screening; and monitoring of cure in clinical care and clinical trials.

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Section: Prevalence Studiesmentioning

confidence: 99%

Novel approaches to the diagnosis of Strongyloides stercoralis infection

Buonfrate

Formenti

Perandin

et al. 2015

Clinical Microbiology and Infection

190

168

View full text Add to dashboard Cite

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“…There have been several capture ELISA assays developed for S. stercoralis coproantigen detection (El-Badry, 2009; Sykes and McCarthy, 2011), and both of these assays have been performed on relatively few samples and are only available in a research setting.…”

Section: Diagnosismentioning

confidence: 99%

Human infection withStrongyloides stercoralisand other related Strongyloides species

2016

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SUMMARY The majority of the 30–100 million people infected with Strongyloides stercoralis, a soil transmitted intestinal nematode, have subclinical (or asymptomatic) infections. These infections are commonly chronic and longstanding because of the autoinfective process associated with its unique life cycle. A change in immune status can increase parasite numbers, leading to hyperinfection syndrome, dissemination, and death if unrecognized. Corticosteroid use and HTLV-1 infection are most commonly associated with the hyperinfection syndrome. Strongyloides adult parasites reside in the small intestine and induce immune responses both local and systemic that remain poorly characterized. Definitive diagnosis of S. stercoralis infection is based on stool examinations for larvae, but newer diagnostics – including new immunoassays and molecular tests – will assume primacy in the next few years. Although good treatment options exist for infection and control of this infection might be possible, S. stercoralis remains largely neglected.

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“…The suggested mechanisms by which IgA modulates the removal of host larvae include reductions of female fertility and of the intensity of the autoinfection [108]. ELISAs can also be applied for the detection of S. stercoralis antigens in stool samples (coproantigen), even though these tests have not yet been standardized [109, 110]. …”

Section: S Stercoralis Diagnosis and Treatmentmentioning

confidence: 99%

Strongyloides stercoralisInfection in Alcoholic Patients

Teixeira

Pacheco

Souza

et al. 2016

BioMed Research International

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The course of Strongyloides stercoralis infection is usually asymptomatic with a low discharge of rhabditoid larva in feces. However, the deleterious effects of alcohol consumption seem to enhance the susceptibility to infection, as shown by a fivefold higher strongyloidiasis frequency in alcoholics than in nonalcoholics. Moreover, the association between S. stercoralis infection and alcoholism presents a risk for hyperinfection and severe strongyloidiasis. There are several possible mechanisms for the disruption of the host-parasite equilibrium in ethanol-addicted patients with chronic strongyloidiasis. One explanation is that chronic ethanol intake stimulates the hypothalamic-pituitary-adrenal (HPA) axis to produce excessive levels of endogenous cortisol, which in turn can lead to a deficiency in type 2 T helper cells (Th2) protective response, and also to mimic the parasite hormone ecdysone, which promotes the transformation of rhabditiform larvae to filariform larvae, leading to autoinfection. Therefore, when untreated, alcoholic patients are continuously infected by this autoinfection mechanism. Thus, the early diagnosis of strongyloidiasis and treatment can prevent serious forms of hyperinfection in ethanol abusers.

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A Coproantigen Diagnostic Test for Strongyloides Infection

Cited by 56 publications

References 33 publications

Novel approaches to the diagnosis of Strongyloides stercoralis infection

Novel approaches to the diagnosis of Strongyloides stercoralis infection

Human infection withStrongyloides stercoralisand other related Strongyloides species

Strongyloides stercoralisInfection in Alcoholic Patients

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