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. 1993 Feb;31(2):373–376. doi: 10.1128/jcm.31.2.373-376.1993

Improved primary immunodiagnosis of alveolar echinococcosis in humans by an enzyme-linked immunosorbent assay using the Em2plus antigen.

B Gottstein 1, P Jacquier 1, S Bresson-Hadni 1, J Eckert 1
PMCID: PMC262768  PMID: 8432825

Abstract

Alveolar echinococcosis (AE) in humans is generally a fatal disease when not diagnosed early enough to provide curative treatment such as radical surgery. Immunodiagnosis for early detection of AE was improved by the isolation of an affinity-purified metacestode Em2 antigen and by the synthesis of recombinant Echinococcus multilocularis antigen II/3-10. Both antigens were individually assessed by enzyme-linked immunosorbent assay (ELISA) and demonstrated high specificities and diagnostic sensitivities, although both missed approximately 4 to 11% of diagnostic cases of AE. To provide an optimal serodiagnostic test, we investigated the two purified antigens by using a test employing a mixture of both purified antigens (designated Em2plus antigen) in one assay. For comparative purposes, crude E. multilocularis and Echinococcus granulosus metacestode antigens were investigated as well. The Em2plus ELISA proved to be the optimal diagnostic test with the highest diagnostic sensitivity, 97%, in serum samples from 140 patients with AE and an overall specificity of 99% for infections due to other Echinococcus and non-Echinococcus parasites. The new test combination (Em2plus ELISA) is suggested for the serodiagnosis of AE in patients and for seroepidemiological surveys.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ammann R. W., Hirsbrunner R., Cotting J., Steiger U., Jacquier P., Eckert J. Recurrence rate after discontinuation of long-term mebendazole therapy in alveolar echinococcosis (preliminary results). Am J Trop Med Hyg. 1990 Nov;43(5):506–515. doi: 10.4269/ajtmh.1990.43.506. [DOI] [PubMed] [Google Scholar]
  2. Bresson-Hadni S., Franza A., Miguet J. P., Vuitton D. A., Lenys D., Monnet E., Landecy G., Paintaud G., Rohmer P., Becker M. C. Orthotopic liver transplantation for incurable alveolar echinococcosis of the liver: report of 17 cases. Hepatology. 1991 Jun;13(6):1061–1070. [PubMed] [Google Scholar]
  3. Gottstein B. Echinococcus multilocularis infection: immunology and immunodiagnosis. Adv Parasitol. 1992;31:321–380. doi: 10.1016/s0065-308x(08)60024-x. [DOI] [PubMed] [Google Scholar]
  4. Gottstein B. Echinococcus multilocularis: antigenic variance between different parasite isolates. Parasitol Res. 1991;77(4):359–361. doi: 10.1007/BF00930916. [DOI] [PubMed] [Google Scholar]
  5. Gottstein B., Eckert J., Fey H. Serological differentiation between Echinococcus granulosus and E. multilocularis infections in man. Z Parasitenkd. 1983;69(3):347–356. doi: 10.1007/BF00927876. [DOI] [PubMed] [Google Scholar]
  6. Gottstein B., Eckert J., Michael S. A., Thompson R. C. Echinococcus granulosus antigens: immunoelectrophoretic and Western blot analysis of hydatid cyst fluids. Parasitol Res. 1987;73(2):186–189. doi: 10.1007/BF00536480. [DOI] [PubMed] [Google Scholar]
  7. Gottstein B., Lengeler C., Bachmann P., Hagemann P., Kocher P., Brossard M., Witassek F., Eckert J. Sero-epidemiological survey for alveolar echinococcosis (by Em2-ELISA) of blood donors in an endemic area of Switzerland. Trans R Soc Trop Med Hyg. 1987;81(6):960–964. doi: 10.1016/0035-9203(87)90365-8. [DOI] [PubMed] [Google Scholar]
  8. Gottstein B., Mesarina B., Tanner I., Ammann R. W., Wilson J. F., Eckert J., Lanier A. Specific cellular and humoral immune responses in patients with different long-term courses of alveolar echinococcosis (infection with Echinococcus multilocularis). Am J Trop Med Hyg. 1991 Dec;45(6):734–742. doi: 10.4269/ajtmh.1991.45.734. [DOI] [PubMed] [Google Scholar]
  9. Gottstein B. Purification and characterization of a specific antigen from Echinococcus multilocularis. Parasite Immunol. 1985 May;7(3):201–212. doi: 10.1111/j.1365-3024.1985.tb00070.x. [DOI] [PubMed] [Google Scholar]
  10. Gottstein B., Schantz P. M., Todorov T., Saimot A. G., Jacquier P. An international study on the serological differential diagnosis of human cystic and alveolar echinococcosis. Bull World Health Organ. 1986;64(1):101–105. [PMC free article] [PubMed] [Google Scholar]
  11. Gottstein B., Schantz P. M., Wilson J. F. Serological screening for Echinococcus multilocularis infections with ELISA. Lancet. 1985 May 11;1(8437):1097–1098. doi: 10.1016/s0140-6736(85)92394-3. [DOI] [PubMed] [Google Scholar]
  12. Gottstein B., Tschudi K., Eckert J., Ammann R. Em2-ELISA for the follow-up of alveolar echinococcosis after complete surgical resection of liver lesions. Trans R Soc Trop Med Hyg. 1989 May-Jun;83(3):389–393. doi: 10.1016/0035-9203(89)90512-9. [DOI] [PubMed] [Google Scholar]
  13. Jacquier P., Gottstein B., Stingelin Y., Eckert J. Immunodiagnosis of toxocarosis in humans: evaluation of a new enzyme-linked immunosorbent assay kit. J Clin Microbiol. 1991 Sep;29(9):1831–1835. doi: 10.1128/jcm.29.9.1831-1835.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Lanier A. P., Trujillo D. E., Schantz P. M., Wilson J. F., Gottstein B., McMahon B. J. Comparison of serologic tests for the diagnosis and follow-up of alveolar hydatid disease. Am J Trop Med Hyg. 1987 Nov;37(3):609–615. doi: 10.4269/ajtmh.1987.37.609. [DOI] [PubMed] [Google Scholar]
  15. Miguet J. P., Bresson-Hadni S. Alveolar echinococcosis of the liver. J Hepatol. 1989 May;8(3):373–379. doi: 10.1016/0168-8278(89)90037-8. [DOI] [PubMed] [Google Scholar]
  16. Müller N., Gottstein B., Vogel M., Flury K., Seebeck T. Application of a recombinant Echinococcus multilocularis antigen in an enzyme-linked immunosorbent assay for immunodiagnosis of human alveolar echinococcosis. Mol Biochem Parasitol. 1989 Sep;36(2):151–159. doi: 10.1016/0166-6851(89)90187-4. [DOI] [PubMed] [Google Scholar]
  17. Vogel M., Gottstein B., Müller N., Seebeck T. Production of a recombinant antigen of Echinococcus multilocularis with high immunodiagnostic sensitivity and specificity. Mol Biochem Parasitol. 1988 Nov;31(2):117–125. doi: 10.1016/0166-6851(88)90162-4. [DOI] [PubMed] [Google Scholar]

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