Antibodies to Schistosoma Mansoni in Human Cerebrospinal Fluid

Abstract

Cerebrospinal fluid (CSF) and serum samples from patients suspected of having neuroschistosomiasis (NS) were evaluated by an enzyme-linked immunosorbent assay. Monoclonal antibodies of various immunoglobulin isotypes (IgM, IgA, IgE, total IgG, IgG1, IgG2, IgG3, and IgG4) were used to detect antibodies against Schistosoma mansoni soluble egg antigen (SEA) and soluble worm adult preparation (SWAP). Of the 83 CSF samples tested, 55% were reactive to SEA (26% were reactive only to SEA and 29% to both SEA and SWAP), 34% were reactive to SWAP (5% only to SWAP and 29% to both SEA and SWAP), and 40% were not reactive with any antigen. Cases that tested positive for SWAP in CSF and negative in serum were not found. Samples with high specific IgG antibody titers were selected for immunoglobulin isotype profiling. In the CSF samples, the antibodies against SEA and SWAP were mainly IgM, IgG1, and IgG4, although other immunoglobulins were also detected. Interestingly, nine patients had high levels of IgG1 only in the CSF. These results suggest that there is local synthesis of IgG1, and that this isotype could be an important immunologic marker in the diagnosis of NS.

Brain Magnetic Resonance Imaging Findings in Young Patients with Hepatosplenic Schistosomiasis Mansoni without Overt Symptoms

“…1,2 Schistosomiasis is an infection caused by digenetic trematode platyhelminths of the genus Schistosoma, and the three main species are S. mansoni, S. japonicum, and S. hematobium. 3,4 The species S. mansoni infects approximately 12 million persons in Brazil, which characterizes this country as an endemic area.…”

“…Cerebral lesions are caused primarily by S. japonicum, whereas spinal cord lesions are usually caused by S. mansoni and S. haematobium. 2 In patients in Brazil with fatal HSM, autopsies showed that 26% have brain involvement. 7 Reports of magnetic resonance imaging (MRI) findings associated with CNS schistosomiasis have described expansive lesions with variable enhancement patterns, such as diffuse, spotty, nodular, or central linear and nodular.…”

Diagnosis of neuroschistosomiasis by antibody specificity index and semi-quantitative real-time PCR from cerebrospinal fluid and serum

“…Serological testing is one of the frequently used diagnostic criteria for neuroschistosomiasis (Ferrari et al , 1995; Magalhães-Santos et al , 2003; Gryseels et al , 2006; Ferrari, 2010) but it is prone to cross-reactivity with other helminths, even with aetiologically relevant species such as Taenia solium (Pammenter et al , 1992). Egg-antigen immune complexes are usually detectable in the CSF of neuroschistosomiasis patients but are not routinely assessed in diagnostic testing (Ferrari et al ., 2011).…”

Cerebral neuroschistosomiasis: a rare clinical presentation and review of the literature

“…The diagnosis is also supported by the analysis of CSF, which typically shows pleocytosis with increased lymphomonocytes, high CSF protein concentration and, in half of cases, eosinophilia 18. There are several recent studies on the role of CSF serology; antibodies are demonstrated in up to 60% of patients 19. Nevertheless, a definitive diagnosis can only be made by demonstrating eggs in the CNS on biopsy.…”