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Direct detection of Strongyloides infection via molecular and antigen detection methods

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Abstract

Laboratory diagnosis of Strongyloides infections can be grouped into direct and indirect detection methods, and a combination of the two methods is often needed to reach an accurate and timely diagnosis. This review focuses on non-conventional direct detection via molecular and antigen detection assays. Conventional PCR is the most commonly used molecular diagnostic for Strongyloides. Real-time PCR is accurate and highly sensitive for quantitative and qualitative analysis. Meanwhile, PCR-RFLP can efficiently distinguish human and dog isolates of S. stercoralis, S. fuelleborni (from monkey), and S. ratti (from rodent). Loop-mediated isothermal amplification (LAMP) amplifies DNA isothermally with high specificity, efficiency, and rapidity, and has potential for point-of-care (POC) translation. As for antigen detection assay, coproantigen detection ELISAs for strongyloidiasis traditionally relied on raising rabbit polyclonal antibodies against the parasite antigens for use as capture or detection reagents. Subsequently, hybridoma technology using animals has enabled the discovery of monoclonal antibodies specific to Strongyloides antigens and was utilised to develop antigen detection assays. In recent times, phage display technology has facilitated the discovery of scFv antibody against Strongyloides protein that can accelerate the development of such assays. Improvements in both direct detection methods are being made. Strongyloides molecular diagnostics is moving from the detection of a single infection to the simultaneous detection of soil-transmitted helminths. Meanwhile, antigen detection assays can also be multiplexed and aptamers can be used as antigen binders. In the near future, these two direct detection methods may be more widely used as diagnostic tools for strongyloidiasis.

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Funding

Some of the authors are supported by funding from the Malaysian Ministry of Education through the Higher Institution Centre of Excellence (HICoE) Program (Grant No. 311/CIPPM/4401005) and FRGS Grant (No. 203/CIPPM/6711636).

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  1. Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Penang, Malaysia

    Dinesh Balachandra, Hussain Ahmad, Norsyahida Arifin & Rahmah Noordin

  2. Department of Microbiology, Abdul Wali Khan University Mardan, KPK, Pakistan

    Hussain Ahmad

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  1. Dinesh Balachandra
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  2. Hussain Ahmad
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  4. Rahmah Noordin
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Balachandra, D., Ahmad, H., Arifin, N. et al. Direct detection of Strongyloides infection via molecular and antigen detection methods. Eur J Clin Microbiol Infect Dis 40, 27–37 (2021). https://doi.org/10.1007/s10096-020-03949-x

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