Li Tiaoying, Ito Akira, Chen Xingwang, Sako Yasuhito, Qiu Jiamin, Xiao Ning, Qiu Dongchuan, Nakao Minoru, Yanagida Tetsuya, Craig Philip S
Institute of Parasitic Diseases, Sichuan Centers for Disease Control and Prevention, Chengdu 610041, Sichuan Province, China.
Clin Vaccine Immunol. 2010 Mar;17(3):470-5. doi: 10.1128/CVI.00466-09. Epub 2009 Dec 30.
An understanding of the correlation of the specific antibody responses and the disease phase is essential in evaluating diagnostic values of immunological tests in human echinococcosis. In this study, 422 echinococcosis patients diagnosed by ultrasonography, including 246 with cystic echinococcosis (CE), 173 with alveolar echinococcosis (AE), and 3 with dual infection, were tested for specific IgG in sera against recombinant AgB (rAgB) and recombinant Em18 (rEm18) in an enzyme-linked immunosorbent assay. As a result, rAgB-specific antibody was detected in 77.6% of CE and 86.1% of AE patients, while rEm18-specific antibody was present in 28.9% of CE and 87.3% of AE patients. Additionally, all three patients with dual infection exhibited specific antibodies responding to rAgB and rEm18. Further analysis revealed that rAgB-specific antibody was elevated in a significantly greater proportion (87.3%) of CE patients with cysts at active or transitional stages (CE1, CE2, or CE3), compared to 54.8% of other patients with cysts at an early or an inactive stage (CL or CE4 or CE5). Furthermore, rAgB-specific antibody was detected in 95.6% of CE2 cases, which was statistically greater than that (73.7%) in CE1 patients. Although rEm18-specific antibody was elevated in 28.9% of CE patients, the positive reaction was much weaker in CE than in AE cases. Serum levels and concentrations of rEm18-specific antibody were further indicated to be strongly disease phase correlated in AE patients, with positive rates of 97.4% in cases with alveolar lesions containing central necrosis and 66.7% in patients with early alveolar lesions that measured </=5 cm.
了解特异性抗体反应与疾病阶段的相关性对于评估免疫检测在人体棘球蚴病中的诊断价值至关重要。在本研究中，对422例经超声检查确诊的棘球蚴病患者进行了检测，其中包括246例囊型棘球蚴病（CE）患者、173例泡型棘球蚴病（AE）患者以及3例双重感染患者，采用酶联免疫吸附测定法检测血清中针对重组AgB（rAgB）和重组Em18（rEm18）的特异性IgG。结果显示，77.6%的CE患者和86.1%的AE患者检测到rAgB特异性抗体，而28.9%的CE患者和87.3%的AE患者检测到rEm18特异性抗体。此外，所有3例双重感染患者均表现出对rAgB和rEm18的特异性抗体反应。进一步分析表明，与处于早期或非活动期（CL或CE4或CE5）囊肿的其他患者（54.8%）相比，处于活动期或过渡期囊肿（CE1、CE2或CE3）的CE患者中，rAgB特异性抗体升高的比例显著更高（87.3%）。此外，在95.6%的CE2病例中检测到rAgB特异性抗体，在统计学上高于CE1患者中的比例（73.7%）。尽管28.9%的CE患者中rEm18特异性抗体升高，但CE患者中的阳性反应比AE患者弱得多。进一步表明，AE患者中rEm18特异性抗体的血清水平和浓度与疾病阶段密切相关，在含有中央坏死的肺泡病变患者中的阳性率为97.4%，在早期肺泡病变≤5 cm的患者中的阳性率为66.7%。
