Long-term serological evaluation of patients with cystic echinococcosis treated with benzimidazole carbamates

Abstract

SUMMARY Seeking better immunological markers indicating the long‐term outcome of cystic echinococcosis (CE) after chemotherapy we studied 23 patients receiving albendazole, clinically followed for 8 years, and grouped ultrasonographically according to therapeutic outcome. Antibody responses against a partially purified fraction of hydatid fluid (HFF) and antigen B (AgB) were evaluated by indirect haemagglutination (IHA), ELISA and immunoblotting (IB). Although IHA titres varied over the course of treatment, differences in mean antibody titres to HFF between groups were significant only at 4 years (P = 0·031). IgG isotype expression remained unchanged during follow‐up whereas IgE expression decreased in patients with cured or stable disease. AgB disclosed higher IgG4 expression (P < 10–4; P = 0·025) and lower IgG1 expression than HFF (P < 10–4; P = 0·022). IHA antibody titres were higher in patients with progressive than in those with cured or stable disease, even in those with the same cyst type. ELISA isotype profiles differed between groups, particularly for type CE 3, 4 and 5 cysts: higher serum IgG1 and IgG3, lower IgG4 and IgE in patients with cured or stable disease. Although combined serological testing provides scarce information on the long‐term outcome of CE after chemotherapy it may be useful for reviewing in a retrospective study the outcome of a cyst and for assessing the host‐parasite relationship.

Assessment of Echinococcus granulosus Somatic Protoscolex Antigens for Serological Follow-Up of Young Patients Surgically Treated for Cystic Echinococcosis

“…¥, sera taken 1 month after a second surgery. their usefulness as a marker for parasite development has already been discussed (7,8,33,35). In conclusion, serology with PSSA appears to be a useful approach for postsurgical follow-up, especially when applied in immunoblotting based upon the detection of the 27-and 28-kDa doublet.…”

Factors Influencing the Serological Response in Hepatic Echinococcus granulosus Infection

“…Specific antibodies may be detectable for years in the presence of stably inactive cysts and even after radical surgery and do not imply the presence of active infection. [16][17][18][19] As a result, clinicians with little experience with this disease infer that positive serology always means presence of active infection, a wrong assumption often resulting in unnecessary treatment, with attendant side effects, cost, and patient (and physician) anxiety. A good understanding of the behavior of serology and its influencing variables, beyond stage of cysts, is crucial for the diagnosis and clinical management of CE, and allows clinicians to evaluate serology results in the context of each patient's condition.…”

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

“…In alveolar echinococcosis, the affected organ cannot be used, as it is infiltrated by the disease. There are no reported cases of donors infected with E. multilocularis, but should the situation arise, an infected organ should not be used in transplantation, and a CT scan should be performed to search for disease at other sites (311).…”