采用流式细胞术检测抗恰加斯利什曼原虫免疫球蛋白G,用于评估美洲内脏利什曼病化疗后的治愈情况。

Detection of anti-leishmania (Leishmania) chagasi immunoglobulin G by flow cytometry for cure assessment following chemotherapeutic treatment of American visceral leishmaniasis.

作者信息

Lemos Elenice Moreira, Gomes Izabelle Teixeira, Carvalho Sílvio Fernando Guimarães, Rocha Roberta Dias Rodrigues, Pissinate Jauber Fornaciari, Martins-Filho Olindo Assis, Dietze Reynaldo

机构信息

Núcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo, Av. Marechal Campos, 1648, Maruípe, Vitória ES 29040-091, Brazil.

出版信息

Clin Vaccine Immunol. 2007 May;14(5):569-76. doi: 10.1128/CVI.00354-06. Epub 2007 Mar 14.

Abstract

The residual serological reactivity observed in patients cured of visceral leishmaniasis (VL) represents the major factor underlying the low efficiency of most anti-Leishmania serological approaches to assess posttherapeutic cure in VL. Herein, we have described a detuned flow cytometry-based methodology to detect anti-live (FC-ALPA-immunoglobulin G [IgG]) and anti-fixed (FC-AFPA-IgG) L. chagasi promastigote IgG, along the titration curve (1:2,000 to 1:128,000), as a tool to assess late (12 months after treatment [12 mAT]) and early (2 and 6 mAT) posttherapeutic cure of pediatric American visceral leishmaniasis. Reactivities were reported as the percentage of positive fluorescent parasite (PPFP), using a PPFP of 50% as a cutoff to segregate positive and negative results. Our data demonstrated that both FC-ALPA-IgG at 1:4,000 and FC-ALPA-IgG at 1:32,000 are useful for late cure assessment in VL, with 100% specificity and outstanding likelihood ratio indices. Cure assessment at 6 mAT also showed promising performance indices, identifying 81% and 71.4% of the treated patients with negative results. However, new interpretation parameters were necessary to monitor cure at 2 mAT. We then introduced the differential PPFP (DeltaPPFP) of 25% as a new cutoff for early cure assessment at specific serum dilutions to analyze IgG reactivity by FC-ALPA-IgG and FC-AFPA-IgG. Our data demonstrated that at 2 mAT, DeltaPPFP was >25% in 60% and 57.1% of treated patients, whereas at 6 mAT, a DeltaPPFP of >25% was observed in 100% and 95.2% of samples assayed by FC-ALPA-IgG and FC-AFPA-IgG, respectively. Together, our findings showed the potential of both FC-ALPA-IgG and FC-AFPA-IgG regarding their applicability to detect differential serological reactivity and further contribution to posttherapeutic cure assessment in VL.

摘要

在治愈的内脏利什曼病(VL)患者中观察到的残留血清学反应性,是大多数抗利什曼原虫血清学方法评估VL治疗后治愈效果效率低下的主要因素。在此,我们描述了一种基于流式细胞术的调整方法,用于检测抗活(FC-ALPA-免疫球蛋白G [IgG])和抗固定(FC-AFPA-IgG)恰加斯利什曼原虫前鞭毛体IgG,沿着滴定曲线(1:2000至1:128000),作为评估儿童美洲内脏利什曼病治疗后期(治疗后12个月[12 mAT])和早期(治疗后2个月和6个月)治愈情况的工具。反应性以阳性荧光寄生虫百分比(PPFP)报告,使用50%的PPFP作为区分阳性和阴性结果的临界值。我们的数据表明,1:4000的FC-ALPA-IgG和1:32000的FC-ALPA-IgG都可用于VL后期治愈评估,特异性为100%,似然比指数出色。治疗后6个月的治愈评估也显示出有前景的性能指标,识别出81%和71.4%治疗结果为阴性的患者。然而,需要新的解释参数来监测治疗后2个月的治愈情况。然后,我们引入25%的差异PPFP(DeltaPPFP)作为在特定血清稀释度下早期治愈评估的新临界值,以通过FC-ALPA-IgG和FC-AFPA-IgG分析IgG反应性。我们的数据表明,在治疗后2个月,60%和57.1%的治疗患者中DeltaPPFP>25%,而在治疗后6个月,分别有100%和95.2%通过FC-ALPA-IgG和FC-AFPA-IgG检测的样本中观察到DeltaPPFP>25%。总之,我们的研究结果显示了FC-ALPA-IgG和FC-AFPA-IgG在检测差异血清学反应性方面的潜力,以及对VL治疗后治愈评估的进一步贡献。

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