Petray P, Bonardello N, Clark R, Agranatti M, Corral R, Grinstein S
Laboratorio de Virología, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina.
Rev Inst Med Trop Sao Paulo. 1992 Mar-Apr;34(2):141-7.
The ELISA technique for detection of T. cruzi circulating antigens (cAg) and immune complexes (CIC) in the sera of chronic chagasic patients was field-tested in a well-known endemic area of Argentina (San Luis province). Of 215 individuals screened, 51 were positive for ELISA-CIC and 45 for ELISA-cAg. Seventy four subjects were considered por T. cruzi-infected, as they showed serologic reactivity at least by two different techniques. In this group, 49 (66.21%) were ELISA-CIC positive, whereas in 43 (58.11%) of them cAg was found by ELISA. Unspecific reactions were observed in only 2 cases with reactive serology for Chagas disease. Within the group considered as noninfected, a false-positive outcome was obtained at low dilution by one of the serologic tests in 16 (11.35%) of 141 individuals. These sera yielded consistently negative results by ELISA-CIC and cAg, showing the utility of antigen detection in situations of conflictive serology. While antibody determination merely provides an indirect proof of infection, our ELISA tests for demonstration of T. cruzi-specific antigenic fractions in the host's circulation allow a parasitologic diagnosis in chronic patients, with higher sensitivity than that exhibited by traditional methods for detection of the whole parasite.
用于检测慢性恰加斯病患者血清中克氏锥虫循环抗原(cAg)和免疫复合物(CIC)的酶联免疫吸附测定(ELISA)技术在阿根廷一个著名的流行地区(圣路易斯省)进行了现场测试。在筛查的215人中,51人ELISA-CIC检测呈阳性,45人ELISA-cAg检测呈阳性。74名受试者被认为感染了克氏锥虫,因为他们至少通过两种不同技术表现出血清学反应。在这一组中,49人(66.21%)ELISA-CIC呈阳性,而其中43人(58.11%)通过ELISA检测到cAg。仅在2例恰加斯病血清学反应阳性的病例中观察到非特异性反应。在被视为未感染的组中,141名个体中有16人(11.35%)的一项血清学检测在低稀释度下出现假阳性结果。这些血清通过ELISA-CIC和cAg检测始终呈阴性结果,表明在血清学结果存在冲突的情况下抗原检测的实用性。虽然抗体检测仅提供感染的间接证据,但我们用于检测宿主循环中克氏锥虫特异性抗原成分的ELISA检测能够对慢性患者进行寄生虫学诊断,其灵敏度高于传统的检测整个寄生虫的方法。