Midzi N, Ndhlovu P D, Nyanga L, Kjetland E F, Reimert C M, Vennervald B J, Gomo E, Mudenge G, Friis H, Gundersen S G, Mduluza T
Blair Research Institute, Harare, Zimbabwe.
Parasite Immunol. 2003 Nov-Dec;25(11-12):581-8. doi: 10.1111/j.0141-9838.2004.00670.x.
Eosinophil cationic protein (ECP) levels were measured in vaginal lavage extracts from 518 Zimbabwean reproductive women, age range 15-49 years, to assess the potential use of ECP as a diagnostic marker for female genital schistosomiasis (FGS). One hundred and fifty women had confirmed FGS status. These included 77 (cases) women who had ova in genital tissue and 73 (controls) women who had no ova in genital tissue. Participants were examined at baseline, 3 and 15 months post-treatment with praziquantel. ECP levels were determined using the enzyme linked immunosorbent assay (ECP-ELISA). ECP levels from 18 Norwegian women were used to calculate the diagnostic values of the test. FGS was diagnosed from the study population using genital biopsy and smears. Women were also diagnosed for urinary schistosomiasis using the urine filtration technique. The prevalence of urinary schistosomiasis was 39 % at baseline and this declined to 8% and 6% at 3 and 15 month post-treatment surveys, respectively. There was a higher mean ECP level in women with FGS, 889.3 ng/mL (95% CI: 457.0-1327.5) compared to the endemic control group, 359.1 ng/mL (95%, CI: 227.3-490.9), P = 0.027. Mean ECP levels declined at 3 months following treatment of infected individuals. There was no correlation between ECP levels and tissue ova density, and urine egg intensity. The sensitivity, specificity, positive and negative predictive values for the ECP-ELISA test were 35%, 80%, 65% and 53%, respectively. Our results indicate that FGS causes an inflammatory immune response that increases ECP levels in genital fluid. Treatment of schistosomiasis results in a regression of pathology and a decline in ECP levels. However, other factors such as allergy and microbial infection could also be responsible for increased ECP levels in genital mucosa. These conditions will affect the validity of the test in diagnosis of FGS.
对518名年龄在15至49岁之间的津巴布韦育龄妇女的阴道灌洗提取物进行了嗜酸性粒细胞阳离子蛋白（ECP）水平检测，以评估ECP作为女性生殖器血吸虫病（FGS）诊断标志物的潜在用途。150名妇女的FGS状况得到确诊。其中包括77名（病例组）生殖器组织中有虫卵的妇女和73名（对照组）生殖器组织中无虫卵的妇女。在基线期、使用吡喹酮治疗后3个月和15个月对参与者进行了检查。使用酶联免疫吸附测定法（ECP-ELISA）测定ECP水平。用18名挪威妇女的ECP水平来计算该检测的诊断值。通过生殖器活检和涂片从研究人群中诊断FGS。还使用尿液过滤技术诊断妇女是否患有泌尿血吸虫病。基线期泌尿血吸虫病的患病率为39%，在治疗后3个月和15个月的调查中分别降至8%和6%。与地方性对照组（359.1 ng/mL，95% CI：227.3 - 490.9）相比，FGS患者的平均ECP水平更高，为889.3 ng/mL（95% CI：457.0 - 1327.5），P = 0.027。感染个体治疗后3个月时平均ECP水平下降。ECP水平与组织虫卵密度及尿卵强度之间无相关性。ECP-ELISA检测的敏感性、特异性、阳性预测值和阴性预测值分别为35%、80%、65%和53%。我们的结果表明，FGS会引发炎症免疫反应，从而增加生殖器分泌物中的ECP水平。血吸虫病的治疗会使病理状况消退且ECP水平下降。然而，过敏和微生物感染等其他因素也可能导致生殖器黏膜中ECP水平升高。这些情况会影响该检测在FGS诊断中的有效性。
