Role of circulating Fasciola antigens and IgG4 isotype in assessment of cure from fascioliasis.

Sixty-eight individuals were included in this study, 30 of them presented with Fasciola infection, 20 were infected with other parasites but not Fasciola (infected control group) and 18 individuals were parasite-free (normal control group). For all groups, stool analysis by modified formol-ether technique and Kato thick smears for egg counts and the circulating Fasciola antigens (CFAgs) and anti- Fasciola IgG4 isotype were estimated by ELISA technique. Complete blood count, liver functions tests and abdominal ultra-sonography were performed for all Fasciola-infected patients. Patients with fascioliasis received a myrrh-derived drug (Mirazid) in a dose of 10 mg/kg b.wt., one hour before breakfast for six consecutive days. Remeasuring of the above parameters was performed one and three months after therapy. Detection of CFAgs was found to be a useful marker for assessment of core. No cross reaction was observed between Fasciola and other parasites by using CFAg (100% specificity). The level of these antigens correlated positively with signs of cure; parasitologically, clinically or ultrasonographically. Detection of IgG4 isotype was found to be a more sensitive and accurate immunodignostic tool for fascioliasis, but it was not a useful marker for assessment of cure. Mirazid drug possesses high therapeutic efficacy (100% cure rate) on fascioliasis without remarkable side effects.