Meira Wendell S F, Galvão Lúcia M C, Gontijo Eliane D, Machado-Coelho George L L, Norris Karen A, Chiari Egler
Instituto de Ciências Biológicas, Departamento de Parasitologia, Laboratório de Biologia do Trypanosoma cruzi, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 31270-901 Belo Horizonte, Minas Gerais, Brazil.
J Clin Microbiol. 2002 Oct;40(10):3735-40. doi: 10.1128/JCM.40.10.3735-3740.2002.
Currently, diagnosis of Chagas' disease is based on serological methods, but due to the high occurrence of inconclusive results, more reliable methods are needed. The use of recombinant antigens for serodiagnosis of Chagas' disease is recommended in order to increase the sensitivity and specificity of the serological tests. The Trypanosoma cruzi complement regulatory protein (CRP) is a surface glycoprotein present on the trypomastigote forms of the parasite, and the recombinant CRP (rCRP) was cloned in a mammalian expression system and purified by affinity chromatography. The purified recombinant protein was used as an antigen in an enzyme-linked immunosorbent assay (rCRP ELISA) in order to verify its sensitivity and specificity compared with other established methods. In this evaluation, a panel of 184 serum samples distributed among chronic chagasic patients (n = 65), blood bank donors (n = 100), and patients infected with Leishmania spp. (n = 19) was used. The sensitivity and specificity of the rCRP ELISA were 100% when compared to conventional serology and complement-mediated lysis tests from these groups. When hemoculture and PCR tests were evaluated for diagnosis of chronic chagasic patients, using the rCRP ELISA as a reference test, the positivities were found to be 64.62 and 81.54%, respectively, showing a higher degree of sensitivity of the test. The data demonstrate that rCRP ELISA was able to discriminate between chronic chagasic patients and nonchagasic individuals, such as blood donors and patients with leishmaniasis. Thus, the rCRP is an excellent antigen for use in Chagas' disease diagnosis, due to the absence of false-negative or false-positive results.
目前,恰加斯病的诊断基于血清学方法,但由于不确定结果的发生率较高,因此需要更可靠的方法。为了提高血清学检测的敏感性和特异性,建议使用重组抗原进行恰加斯病的血清学诊断。克氏锥虫补体调节蛋白(CRP)是该寄生虫锥鞭毛体形式表面存在的一种糖蛋白,重组CRP(rCRP)在哺乳动物表达系统中克隆,并通过亲和层析进行纯化。将纯化的重组蛋白用作酶联免疫吸附测定(rCRP ELISA)中的抗原,以验证其与其他既定方法相比的敏感性和特异性。在该评估中,使用了一组184份血清样本,这些样本分布在慢性恰加斯病患者(n = 65)、血库献血者(n = 100)和感染利什曼原虫属的患者(n = 19)中。与这些组的传统血清学和补体介导的溶解试验相比,rCRP ELISA的敏感性和特异性均为100%。当以rCRP ELISA作为参考试验评估慢性恰加斯病患者的血培养和PCR试验的诊断时,阳性率分别为64.62%和81.54%,表明该试验具有更高程度的敏感性。数据表明,rCRP ELISA能够区分慢性恰加斯病患者和非恰加斯病个体,如献血者和利什曼病患者。因此,由于不存在假阴性或假阳性结果,rCRP是用于恰加斯病诊断的一种优秀抗原。