Llano Mónica, Pavía Paula, Flórez Astrid Carolina, Cuéllar Adriana, González John M, Puerta Concepción
Laboratorio de Parasitología Molecular, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana.
Grupo de Parasitología, Instituto Nacional de Salud.
Biomedica. 2014 Apr-Jun;34(2):228-36. doi: 10.1590/S0120-41572014000200009.
The diagnosis of Chagas' disease is essential to provide early treatment and improve patients' prognosis . The discriminatory efficiency of the serological tests varies according to the disease prevalence and the test- antigen used .
To evaluate the discriminatory efficiency of the commercial kit Chagas ( Trypanosoma cruzi ) IgG-ELISA ® (Nova Tec Immunodiagnostica GmbBH) in a group of Colombian individuals, using indirect immunofluorescence antibody testing (IFAT) and enzyme immunoassay (ELISA) tests as references.
Seventy-eight samples from chronic chagasic patients (36 asymptomatic and 42 symptomatic) and 21 healthy controls were included. Seventeen samples from non-infected people with Chagas' disease epidemiological risk, seven with leishmaniasis and nine with non-chagasic cardiomyopathy were also analyzed. Real time PCR was performed on four individuals whose results differed among tests.
Significant differences at 450 nm optical absorbance were found (p<0.0001) when the median absorbance values of healthy controls (0.143), asymptomatic (2.401) and symptomatic (2.776) chagasic patients were compared, as well as when asymptomatic and symptomatic patients (p=0.0408) and seronegative people with epidemiological risk (0.232), cardiomyopathy (0.367) or leishmaniasis (0.337) were compared with chagasic patients (p<0.0001). Finally, there were differences among healthy controls and non-infected people with epidemiological risk (p=0.0264), patients with non-chagasic cardiomyopathy (p=0.0015) and patients with leishmaniasis (p=0.002). Real-time PCR was positive in three out of four analyzed cases.
The commercial ELISA test allowed us to discriminate the chagasic patients from the controls. A phase II study of diagnostic tests for determining field reliability of this test is required.
恰加斯病的诊断对于提供早期治疗和改善患者预后至关重要。血清学检测的鉴别效率因疾病流行率和所使用的检测抗原而异。
以间接免疫荧光抗体检测(IFAT)和酶免疫测定(ELISA)检测为参照,评估商用试剂盒恰加斯(克氏锥虫)IgG - ELISA®(诺华泰免疫诊断有限公司)在一组哥伦比亚个体中的鉴别效率。
纳入78份慢性恰加斯病患者的样本(36例无症状,42例有症状)以及21名健康对照。还分析了17份来自有恰加斯病流行病学风险的未感染人群、7份来自利什曼病患者和9份来自非恰加斯性心肌病患者的样本。对4例检测结果存在差异的个体进行了实时PCR检测。
比较健康对照(吸光度中位数为0.143)、无症状(2.401)和有症状(2.776)恰加斯病患者的吸光度中位数时,在450nm光吸收处发现显著差异(p<0.0001);比较无症状和有症状患者(p = 0.0408)以及有流行病学风险的血清阴性人群(0.232)、心肌病患者(0.367)或利什曼病患者(0.337)与恰加斯病患者时(p<0.0001)也发现显著差异。最后,健康对照与有流行病学风险的未感染人群(p = 0.0264)、非恰加斯性心肌病患者(p = 0.0015)和利什曼病患者(p = 0.002)之间存在差异。4例分析病例中有3例实时PCR检测呈阳性。
商用ELISA检测使我们能够区分恰加斯病患者与对照。需要进行一项关于该检测现场可靠性的诊断试验的II期研究。