菲律宾优化日本血吸虫病血清学诊断抗原候选物的平行比较

A Parallel Comparison of Antigen Candidates for Development of an Optimized Serological Diagnosis of Schistosomiasis Japonica in the Philippines.

机构信息

Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Queensland, Australia.

Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Queensland, Australia.

出版信息

EBioMedicine. 2017 Oct;24:237-246. doi: 10.1016/j.ebiom.2017.09.011. Epub 2017 Sep 18.

Abstract

Schistosoma japonicum is stubbornly persistent in China and the Philippines. Fast and accurate diagnostic tools are required to monitor effective control measures against schistosomiasis japonica. Promising antigen candidates for the serological diagnosis of schistosomiasis japonica have generally been identified from the Chinese strain of S. japonicum. However, the Chinese (SjC) and Philippine (SjP) strains of S. japonicum express a number of clear phenotypic differences, including aspects of host immune responses. This feature thereby emphasized the requirement to determine whether antigens identified as having diagnostic value for SjC infection are also suitable for the diagnosis of SjP infection. In the current study, 10 antigens were selected for comparison of diagnostic performance of the SjP infection using ELISA. On testing of sera from 180 subjects in the Philippines, SjSAP4 exhibited the best diagnostic performance with 94.03% sensitivity and 98.33% specificity using an optimized serum dilution. In another large scale testing with 412 serum samples, a combination (SjSAP4+Sj23-LHD (large hydrophilic domain)) provided the best diagnostic outcome with 87.04% sensitivity and 96.67% specificity. This combination could be used in future for serological diagnosis of schistosomiasis in the Philippines, thereby representing an important component for monitoring integrated control measures.

摘要

日本血吸虫在中国和菲律宾都顽固存在。需要快速准确的诊断工具来监测针对日本血吸虫病的有效控制措施。从中国株日本血吸虫中已经确定了一些有希望的抗原候选物,用于日本血吸虫病的血清学诊断。然而,日本血吸虫的中菲株(SjP)表达了许多明显的表型差异,包括宿主免疫反应的各个方面。这一特征强调了需要确定被鉴定为对 SjC 感染具有诊断价值的抗原是否也适用于 SjP 感染的诊断。在本研究中,选择了 10 种抗原,通过 ELISA 比较 SjP 感染的诊断性能。在对菲律宾 180 名受试者的血清进行检测时,优化血清稀释后,SjSAP4 的灵敏度为 94.03%,特异性为 98.33%,表现出最佳的诊断性能。在另一项对 412 份血清样本的大规模检测中,组合(SjSAP4+Sj23-LHD(大亲水性结构域))的诊断效果最佳,灵敏度为 87.04%,特异性为 96.67%。该组合可用于未来菲律宾的血吸虫病血清学诊断,是监测综合控制措施的重要组成部分。

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