Multiple-bead assay for the differential serodiagnosis of neglected human cestodiases: Neurocysticercosis and cystic echinococcosis

Abstract

Background Neurocysticercosis (NCC), and cystic echinococcosis (CE) are two neglected diseases caused by cestodes, co-endemic in many areas of the world. Imaging studies and serological tests are used in the diagnosis of both parasitic diseases, but cross-reactions may confound the results of the latter. The novel multiplex bead-based assay with recombinant antigens has been reported to increases the diagnostic accuracy of serological techniques. Methodology We set-up an immunoassay based on the multiplex bead-based platform (MBA), using the rT24H (against Cysticercus cellulosae, causing cysticercosis) and r2B2t (against Echinococcus granulosus sensu lato, causing CE) recombinant antigens, for simultaneous and differential diagnosis of these infections. The antigens were tested on 356 sera from 151 patients with CE, 126 patients with NCC, and 79 individuals negative for both diseases. Specificity was calculated including sera from healthy donors, other neurological diseases and the respective NCC or CE sera counterpart. The diagnostic accuracy of this assay was compared with two commercial ELISA tests, Novalisa and Ridascreen, widely used in the routine diagnosis of cysticercosis and CE, respectively. Main findings For the diagnosis of NCC, sensitivity ranged from 57.94–63.49% for the rT24H-MBA, and 40.48–46.03% for Novalisa ELISA depending on exclusion or inclusion of sera having equivocal results on ELISA from the analysis; specificities ranged from 90.87–91.30% and 70.43–76.96%, respectively. AUC values of the ROC curve were 0.783 (rT24H) and 0.619 (Novalisa) (p-value < 0.001). For the diagnosis of CE, the sensitivity of the r2B2t-MBA ranged from 68.87–69.77% and of Ridascreen ELISA from 50.00–57.62%; specificities from 92.47–92.68% and from 74.15–80.98%, respectively. AUC values were 0.717 and 0.760, respectively. Conclusions/Significance Overall, the recombinant antigens tested with the bead-based technology showed better diagnostic accuracy than the commercial assays, particularly for the diagnosis of NCC. The possibility of testing the same serum sample simultaneously for the presence of antibodies against both antigens is an added value particularly in seroprevalence studies for cysticercosis linked to control programs in endemic areas where these two parasites coexist.

Palliative Treatment for the Management of Advanced Pelvic Hydatid Bone Disease

“… 15 , 16 The development of pelvic hydatid bone disease is slow and its symptoms are also often concealed, ranging from chronic pain, swelling, claudication, sinus formation, abdominal pain, or nerve compression symptoms (e.g., sciatica). Therefore, the diagnosis of pelvic hydatid bone disease should be comprehensive, taking into account factors such as living environment, serological tests (whole blood tests), 17 parasite-specific antibody examinations (ELISA and DIGFA), 18 , 19 imaging examinations, and clinical manifestations. This approach can help to avoid misdiagnosis or missed diagnosis, which may prevent the occurrence of delayed treatment and may worsen symptoms.…”

Evaluation of the Local and Peripheral Immune Responses in Patients with Cystic Echinococcosis

“…The “transitional” group includes the CE3a stage, as CE3a cysts have equal probability to be viable and non-viable, while the “inactive” group includes the CE4 and CE5 cysts [ 22 ]. To simplify group classification, patients with more than one cyst at different stages were classified according to the more active stage [ 20 , 23 , 24 , 25 ]. Routine serology tests performed at INMI were the NovaLisa Echinococcus IgG ELISA (NovaTec Immunodiagnostica GmbH, Dietzenbach, Germany) and the Western Blot IgG (Euroimmun Labordiagnostika, Luebeck, Germany).…”

Insights into the diagnosis, vaccines, and control of Taenia solium, a zoonotic, neglected parasite

“…In one study, this assay was used for evaluating two recombinant antigens, rT24H ( T. solium -specific) and r2B2t ( Echinococcus granulosus -specific) for simultaneous and differential diagnosis of NCC and cystic echinococcosis. For the diagnosis of NCC, the sensitivity and specificity of this assay ranged from 57.94 to 63.49% and 90.87–91.30%, respectively [ 34 ].…”