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利用尿液样本通过酶联免疫吸附测定法诊断内脏利什曼病。

Diagnosis of visceral leishmaniasis by enzyme-linked immunosorbent assay using urine samples.

作者信息

Islam Mohammad Zahidul, Itoh Makoto, Shamsuzzaman S M, Mirza Rusella, Matin Farzana, Ahmed Iftikhar, Shamsuzzaman Choudhury A K M, Hossain M Akram, Qiu Xu-Guang, Begam Nilufar, Furuya Masato, Leafasia Judson L, Hashiguchi Yoshihisa, Kimura Eisaku

机构信息

Department of Parasitology, Aichi Medical University School of Medicine, Nagakute, Japan.

出版信息

Clin Diagn Lab Immunol. 2002 Jul;9(4):789-94. doi: 10.1128/cdli.9.4.789-794.2002.

Abstract

A diagnostic method has been developed to detect anti-Leishmania donovani immunoglobulin G (IgG) in urine by enzyme-linked immunosorbent assay (ELISA). In measuring anti-L. donovani IgG, IgA, and IgM in urine, the method performed best in the detection of IgG. The sensitivity and specificity of the assay were determined with panels of urine samples from 62 visceral leishmaniasis (VL) patients, 59 healthy controls from areas of endemicity, 53 healthy controls from areas of nonendemicity, 59 malaria patients, 13 tuberculosis patients, 23 cutaneous leishmaniasis patients, and 7 patients with other diseases. Using L. donovani promastigote crude antigen, the test had 93.5% sensitivity (58 positives of 62 VL patient samples) and 89.3% specificity (191 negatives of 214 non-VL patient samples). The ELISA with acetone-treated L. donovani promastigote antigen raised the sensitivity and specificity to 95.0 and 95.3%, respectively. Western blot analysis revealed that most of the samples that cross-reacted with crude antigen in ELISA did not recognize any antigenic component of L. donovani crude antigen. We also checked 40 serum samples from the same group of VL patients for anti-L. donovani IgG and got 90.0% sensitivity with both crude and acetone-treated antigens. As collection of urine is much easier than collection of serum, the detection of anti-L. donovani IgG in urine with acetone-treated antigen will be useful in epidemiological studies. It could be an adjunct of laboratory diagnosis.

摘要

已开发出一种诊断方法,通过酶联免疫吸附测定(ELISA)检测尿液中的抗杜氏利什曼原虫免疫球蛋白G(IgG)。在检测尿液中的抗杜氏利什曼原虫IgG、IgA和IgM时,该方法在检测IgG方面表现最佳。使用来自62名内脏利什曼病(VL)患者、59名来自流行区的健康对照、53名来自非流行区的健康对照、59名疟疾患者、13名结核病患者、23名皮肤利什曼病患者和7名其他疾病患者的尿液样本组来确定该检测方法的敏感性和特异性。使用杜氏利什曼原虫前鞭毛体粗抗原,该检测方法的敏感性为93.5%(62份VL患者样本中有58份呈阳性),特异性为89.3%(214份非VL患者样本中有191份呈阴性)。使用经丙酮处理的杜氏利什曼原虫前鞭毛体抗原的ELISA将敏感性和特异性分别提高到了95.0%和95.3%。蛋白质印迹分析表明,大多数在ELISA中与粗抗原发生交叉反应的样本未识别出杜氏利什曼原虫粗抗原的任何抗原成分。我们还检测了同一组VL患者的40份血清样本中的抗杜氏利什曼原虫IgG,使用粗抗原和经丙酮处理的抗原时敏感性均为90.0%。由于尿液采集比血清采集容易得多,使用经丙酮处理的抗原检测尿液中的抗杜氏利什曼原虫IgG将在流行病学研究中发挥作用。它可以作为实验室诊断的辅助手段。

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