Review: Molecular tools for the diagnosis of cystic and alveolar echinococcosis

Abstract

SummaryIn the past years, the diagnostic tools applied to identify alveolar (AE) and cystic echinococcosis (CE) in human patients have not only increased in number but also substantially improved in quality. The identi®cation and characterization of species-speci®c parasite proteins/antigens allowed to generate subsequently recombinant or synthetic polypeptide antigens, as well as corresponding monoclonal antibodies. Some of these new tools have already demonstrated operating characteristics superior to conventional tests used for the immunodiagnosis of CE and AE, and thus may be suggested for routine laboratory application. Powerful molecular techniques, such as the polymerase chain reaction (PCR), have been developed and adapted to advance laboratory diagnosis of AE and CE. Detecting minute amounts of parasite DNA and mRNA, not only to identify but also to characterize the biological status of parasite material, thus becomes a complementary method to synergize immunodiagnostic techniques. This review focuses on recent developments of molecular tools, discussing their potential use as a primary or a supporting diagnostic element. We also outline some future developments to be undertaken in the ®eld of molecular diagnosis, linked to clinical and laboratory problems.keywords alveolar echinococcosis, cystic echinococcosis, immunodiagnosis, molecular diagnosis correspondence Dr B. Gottstein,

Serological diagnosis of echinococcosis: the diagnostic potential of native antigens

“…The most commonly used tests for the diagnosis of CE are based on hydatid fluid antigens of E. granulosus. These tests have relatively high sensitivities for hepatic (85-95%) and multiple organ cysts (90-100%), but lower sensitivities for lung cysts (50-60%) [33][34][35]. Additionally, tests based on the partially purified lipoproteins antigen B (AgB) and antigen 5 (both found in the germinal membrane, protoscolex parenchyma and cyst fluid [36]) are used either in ELISA or immunoblot assays.…”

Differential Diagnosis and Management of a Recurrent Hepatic Cyst: A Case Report and Review of Literature

“…This procedure is useful as a diagnostic method in doubtful cases of cystic echinococcosis, in the absence of detectable anti-Echinococcus antibodies, in patients with small lesions resembling hepatic cysts, and in patients with lesions that are difficult to distinguish from liver abscess, neoplasms, or other conditions. 14,25 Clinical management of hepatic cysts includes albendazole or mebendazole therapy in combination with either surgical resection or the PAIR procedure. Larger cysts (diameter >10 cm) preferably undergo surgical resection.…”

Recent Advances in the Immunology and Serological Diagnosis of Echinococcosis

“…Over the past decade, diagnosis of CE has improved due to the use of new or more optimal methods for purification of Echinococcus antigens from somatic materials, by the application of molecular tools for parasite identification and the synthesis of recombinant diagnostic antigens and immunogenic peptides. These approaches have not only improved the sensitivity and specificity of tests for diagnosis of CE but they have also allowed more reliable characterization of the biological status of parasite materials Siles-Lucas and Gottstein, 2001). …”