Noya O, Patarroyo M E, Guzmán F, Alarcón de Noya B
Sección de Biohelmintiasis, Instituto de Medicina Tropical, Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela.
Curr Protein Pept Sci. 2003 Aug;4(4):299-308. doi: 10.2174/1389203033487153.
Parasitic diseases remain as a major public health problem worldwide, not only based on their historically high morbidity and mortality rates, but also because risk factors associated with their transmission are increasing. Laboratory diagnosis and particularly immunodiagnosis is a basic tool for the demonstration, clinical management and control of these infections. Classically, the serological tests for the detection of antibodies or antigens are based on the use of crude and purified antigens. Synthetic peptides have opened a new field and perspectives, as the source of pure epitopes and molecules for diagnosis of malaria, Chagas' disease, leishmaniasis, schistosomiasis, hidatidosis, cysticercosis and fasciolosis based on the detection of antibodies and circulating antigens. Herein, are critically reviewed the relevant advances and applications of the synthetic peptides on immunodiagnosis of parasitic diseases. A variety of sequences, constructs (monomers, polymers, MAPs), immunological methods and samples have been used, demonstrating their diagnostic potential. However, in most parasitic infections it is necessary to use more than a single peptide in order to avoid the genetic restriction against certain epitopes, as well as to test them in well characteized groups of patients, in order to confirm their sensitivity and specificity. The concept of multidiagnosis with synthetic peptides, using a novel multi-dot blot assay is introduced. Finally, the chemical imitation of antigens, offers a tremendous posibilities in the diagnosis of parasitic infections in developing countries since this strategy is cheaper, simpler, reproducible, useful for large scale testing and in most cases, specific and sensitive.
寄生虫病仍然是全球主要的公共卫生问题，这不仅是基于其历史上较高的发病率和死亡率，还因为与其传播相关的风险因素在不断增加。实验室诊断尤其是免疫诊断是这些感染的诊断、临床管理和控制的基本工具。传统上，用于检测抗体或抗原的血清学检测基于使用粗制和纯化抗原。合成肽作为纯表位和分子的来源，为疟疾、恰加斯病、利什曼病、血吸虫病、包虫病、囊尾蚴病和肝片吸虫病的诊断开辟了一个新领域和前景，其基于抗体和循环抗原的检测。本文对合成肽在寄生虫病免疫诊断中的相关进展和应用进行了批判性综述。已经使用了多种序列、构建体（单体、聚合物、多抗原肽）、免疫方法和样本，证明了它们的诊断潜力。然而，在大多数寄生虫感染中，为了避免对某些表位的基因限制，以及在特征明确的患者群体中对它们进行测试以确认其敏感性和特异性，有必要使用不止一种肽。引入了使用新型多点印迹分析的合成肽多重诊断概念。最后，抗原的化学模拟在发展中国家的寄生虫感染诊断中提供了巨大的可能性，因为这种策略更便宜、更简单、可重复，适用于大规模检测，并且在大多数情况下具有特异性和敏感性。
