Deplazes P, Dinkel A, Mathis A
Institute of Parasitology, University of Zürich, 8057 Zürich, Switzerland.
Parasitology. 2003;127 Suppl:S53-61. doi: 10.1017/s0031182003003500.
Two novel approaches for diagnosis of intestinal Echinococcus multilocularis infection, the detection of E. multilocularis-specific coproantigens in ELISA and of copro-DNA by PCR, have been successfully implemented. These methods have proven their value for the post mortem and the intra vitam diagnosis of E. multilocularis in definitive hosts. They have also made novel approaches possible to study the transmission biology of the parasite as they allow detection of the infection in faecal samples collected in the environment. Coproantigen detection is the diagnostic method of choice as it is sensitive, fast and cheap. Studies on faecal samples collected in the field revealed that coproantigen detection did reflect the different prevalences in fox populations as assessed from foxes at necropsy and also the effect of deworming efforts in foxes as achieved by long-term distribution of praziquantel-containing baits. The use of PCR for routine diagnostic or large-scale purposes is hampered by the fact that DNA extraction from faecal material is a very laborious task. Therefore, PCR is rationally used for confirmatory purposes of copro-antigen-positive samples. As taeniid eggs cannot further be differentiated morphologically, PCR is the method of choice to identify E. multilocularis infections in faecal or environmental samples containing taeniid eggs. In intermediate rodent hosts, PCR is routinely used in epidemiological studies for identifying E. multilocularis from liver lesions which are often very small, atypical or calcified.
两种诊断肠道多房棘球绦虫感染的新方法已成功实施,即通过酶联免疫吸附测定法(ELISA)检测多房棘球绦虫特异性粪抗原以及通过聚合酶链反应(PCR)检测粪DNA。这些方法已证明其在终末宿主中对多房棘球绦虫死后诊断和生前诊断的价值。它们还为研究该寄生虫的传播生物学提供了新方法,因为它们能够检测从环境中收集的粪便样本中的感染情况。粪抗原检测是首选的诊断方法,因为它灵敏、快速且成本低。对野外收集的粪便样本进行的研究表明,粪抗原检测确实反映了从尸检狐狸评估得出的狐狸种群中不同的感染率,以及通过长期分发含吡喹酮的诱饵在狐狸身上实现的驱虫效果。将PCR用于常规诊断或大规模检测受到以下事实的阻碍:从粪便材料中提取DNA是一项非常费力的任务。因此,PCR合理地用于对粪抗原阳性样本进行确证。由于带绦虫卵无法在形态上进一步区分,PCR是鉴定含有带绦虫卵的粪便或环境样本中多房棘球绦虫感染的首选方法。在中间啮齿动物宿主中,PCR常用于流行病学研究,以从通常非常小、不典型或钙化的肝脏病变中鉴定多房棘球绦虫。