Parkhouse R Michael E, Carpio Arturo, Campoverde Alfredo, Sastre Patricia, Rojas Glenda, Cortez María Milagros
Institute Gulbenkian de Ciência, Rua da Quinta Grande, 6, 2780-156 Oeiras, Portugal.
Escuela de Medicina, Universidad de Cuenca, Cuenca, Av. 12 de Abril y Av. Loja, Ecuador; GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Acta Trop. 2018 Feb;178:119-123. doi: 10.1016/j.actatropica.2017.11.005. Epub 2017 Nov 16.
To evaluate diagnosis of active neurocysticercosis, paired cerebral spinal fluid (CSF) and serum samples from 24 neurocysticercosis (NCC) patients and 17 control neurological patients were assayed in the HP10 Taenia antigen (Ag) ELISA. The CSF samples were also tested with an HP10 Lateral Flow Assay (LFA). The HP10 Ag was detected by ELISA in the CSF of 5/5 patients with Definitive extraparenchymal NCC, and in 4/5 of the corresponding sera. In the Definitive parenchymal group, on the other hand, the HP10 Ag was absent in 2/3 CSF (with a very low value in the one positive sample) and all the corresponding serum samples. Samples of CSF from 4/7 patients in the Probable parenchymal group, were also significantly HP10 Ag positive, suggesting the presence of extraparenchymal cysts not identified by the imaging studies. With the possible exception of one patient, the corresponding serum samples of the Probable parenchymal NCC group, were all HP10 Ag negative. Samples of CSF from 9 NCC patients diagnosed with Mixed parenchymal and extraparenchymal NCC were all significantly HP10 Ag positive, confirming the presence of extraparenchymal cysts, with only 7/9 of the corresponding serum samples being HP10 positive. Thus detection of the HP10 Ag indicates extraparenchymal and not parenchymal cyst localization and is more sensitive with CSF than serum. Three neurological patients clinically diagnosed as subarachnoid cyst, hydrocephalus and tuberculoma, respectively, were clearly positive for HP10 Ag. Of these, two were confirmed as NCC by subsequent imaging; the third died prior to further examination. Thus, a total of 8 patients had their clinical diagnosis questioned. Finally, there was good agreement between the HP10 Ag ELISA and LFA with CSF samples giving an optical density ≥0.4 in the ELISA assay. In conclusion, the HP10 Ag assay should provide a valuable and reciprocal tool in the clinical diagnosis and follow up of extraparenchymal NCC.
为评估活动性神经囊尾蚴病的诊断，采用HP10猪带绦虫抗原（Ag）酶联免疫吸附测定（ELISA）对24例神经囊尾蚴病（NCC）患者及17例对照神经科患者的配对脑脊液（CSF）和血清样本进行检测。CSF样本还采用HP10侧向流动分析法（LFA）进行检测。在确诊的脑实质外NCC患者的CSF中，5/5患者通过ELISA检测到HP10 Ag，相应血清中4/5患者检测到该抗原。另一方面，在确诊的脑实质内组中，2/3的CSF样本中未检测到HP10 Ag（1份阳性样本的值非常低），且所有相应血清样本中均未检测到。可能的脑实质内组中4/7患者的CSF样本HP10 Ag也呈显著阳性，提示存在影像学检查未发现的脑实质外囊肿。除1例患者可能例外，可能的脑实质内NCC组的相应血清样本HP10 Ag均为阴性。9例诊断为混合型脑实质内和脑实质外NCC的NCC患者的CSF样本HP10 Ag均呈显著阳性，证实存在脑实质外囊肿，相应血清样本中仅7/9为HP10阳性。因此，HP10 Ag的检测表明囊肿位于脑实质外而非脑实质内，且CSF检测比血清检测更敏感。3例分别临床诊断为蛛网膜囊肿、脑积水和结核瘤的神经科患者HP10 Ag明显呈阳性。其中，2例随后经影像学检查确诊为NCC；第3例在进一步检查前死亡。因此，共有8例患者的临床诊断受到质疑。最后，HP10 Ag ELISA与LFA对CSF样本的检测结果具有良好的一致性，ELISA检测中光密度≥0.4的CSF样本结果相符。总之，HP10 Ag检测在脑实质外NCC的临床诊断和随访中应是一种有价值的相互验证工具。
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