Infectious Diseases Division, Washington University School of Medicine, St Louis, MO, USA.
Acta Trop. 2011 Sep;120 Suppl 1(Suppl 1):S19-22. doi: 10.1016/j.actatropica.2010.04.010. Epub 2010 Apr 27.
Antibody tests are useful for mapping the distribution of lymphatic filariasis (LF) in countries and regions and for monitoring progress in elimination programs based on mass drug administration (MDA). Prior antibody tests have suffered from poor sensitivity and/or specificity or from a lack of standardization. We conducted a multicenter evaluation of a new commercial ELISA that detects IgG4 antibodies to the recombinant filarial antigen Bm14. Four laboratories tested a shared panel of coded serum or plasma samples that included 55 samples from people with microfilaremic Wuchereria bancrofti or Brugia infections and 26 control samples. Qualitative results were identical in all four test sites. In addition, each laboratory tested samples from their own serum banks. The test detected antibodies in 32 of 36 samples (91%) from people with Brugian filariasis and in 96 of 98 samples (98%) from people with Bancroftian filariasis. Specificity testing showed that many serum or plasma samples from patients with other filarial infections such as onchocerciasis had positive antibody tests. Specificity was otherwise excellent, although 3 of 30 samples from patients with ascariasis and 4 of 51 with strongyloidiasis had positive antibody tests; it is likely that some or all of these people had previously lived in filariasis-endemic areas. Antibody test results obtained with eluates from blood dried on filter paper were similar to those obtained with plasma tested at the same dilution. This test may be helpful for diagnosing LF in patients with clinical signs of filariasis. It may also be a useful tool for use in LF endemic countries to monitor the progress of filariasis elimination programs and for post-MDA surveillance.
抗体检测对于绘制淋巴丝虫病（LF）在国家和地区的分布以及监测基于大规模药物治疗（MDA）的消除计划的进展非常有用。以前的抗体检测存在敏感性和/或特异性差或缺乏标准化的问题。我们对一种新的商业 ELISA 进行了多中心评估，该 ELISA 检测针对重组丝虫抗原 Bm14 的 IgG4 抗体。四个实验室测试了一个共享的编码血清或血浆样本面板，其中包括 55 份微丝蚴血症的班氏丝虫或盘尾丝虫感染患者样本和 26 份对照样本。在所有四个测试地点，定性结果都是相同的。此外，每个实验室都测试了自己血清库中的样本。该测试在 36 份布氏丝虫病患者样本中的 32 份（91%）和 98 份班氏丝虫病患者样本中的 96 份（98%）中检测到了抗体。特异性测试表明，许多来自患有其他丝虫感染（如盘尾丝虫病）的患者的血清或血浆样本的抗体检测呈阳性。特异性非常好，尽管 30 份旋毛虫病患者样本和 51 份钩虫病患者样本中的 4 份抗体检测呈阳性；可能是这些人中的一些或全部人以前曾生活在丝虫病流行地区。从滤纸干燥血液洗脱物获得的抗体检测结果与以相同稀释度测试的血浆获得的结果相似。该检测可能有助于诊断具有丝虫病临床症状的 LF 患者。它也可能是 LF 流行国家用于监测丝虫病消除计划进展和 MDA 后监测的有用工具。
