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Differential diagnosis of cystic and alveolar echinococcosis using an immunochromatographic test based on the detection of specific antibodies

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Abstract

Human cystic and alveolar echinococcoses are zoonotic diseases caused by the larval stages of Echinococcus granulosus and Echinococcus multilocularis, respectively. As the diseases are co-endemic in many areas of the world, a simple and rapid test for the differential diagnosis of cystic echinococcosis (CE) and alveolar echinocoocosis (AE) is needed. Here, we describe the development of an immunochromatographic test (ICT) using crude hydatid cyst fluid and a recombinant 18-kDa protein (rEm18) as antigens for the detection of E. granulosus and E. multilocularis antibodies in serum samples. The ICT was evaluated with serum samples from 195 echinococcosis patients from different endemic areas in northwestern China. These included 144 from CE patients, 51 from AE patients, 67 from patients with other parasitic diseases, 13 from patients with serous hepatic cysts, and 60 from healthy individuals. The sensitivity and specificity of the ICT for CE were 91.0 and 96.9 % and for AE were 98.0 and 99.3 % with diagnostic efficiencies of 94.1 and 99.1 %, respectively. No significant differences and high degrees of agreement were found between the ICT and an enzyme-linked immunosorbent assay for both CE and AE. Five serum samples from cysticercosis patients and one serum sample from a healthy control were found positive for CE with the ICT. These findings indicate that this test allows for discrimination between both forms of human echinococcosis. In conclusion, the ICT developed in this study is a promising tool for the simultaneous detection and discrimination of CE and AE. This test will be useful for serodiagnosis of CE and AE in clinical settings and screening programs.

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Acknowledgments

We would like to thank Dr. Wei Jiao (Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi) for kindly providing E. multilocularis protoscoleces, HCF, and serum samples, and Dr Darren Sexton (BioMedical Research Centre, Norwich) for critical reading of the manuscript. This work was supported by the National S & T Major Program (grant nos. 2012ZX10004-220 and 2012-ZX10004-201).

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Authors and Affiliations

  1. Key Laboratory of Parasite and Vector Biology of the Chinese Ministry of Health, WHO Collaborating Center for Malaria, Schistosomiasis and Filariasis, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, People’s Republic of China

    Jun-yun Wang, Chun-hua Gao, Feng Shi & Yue-tao Yang

  2. BioMedical Research Centre, Norwich Medical School, Norwich Research Park, University of East Anglia, Norwich, NR4 7TJ, UK

    Dietmar Steverding & Xia Wang

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  1. Jun-yun Wang
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  2. Chun-hua Gao
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  4. Xia Wang
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  5. Feng Shi
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Correspondence to Jun-yun Wang or Dietmar Steverding.

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Wang, Jy., Gao, Ch., Steverding, D. et al. Differential diagnosis of cystic and alveolar echinococcosis using an immunochromatographic test based on the detection of specific antibodies. Parasitol Res 112, 3627–3633 (2013). https://doi.org/10.1007/s00436-013-3550-9

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  • DOI: https://doi.org/10.1007/s00436-013-3550-9

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