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免疫层析点检测试剂盒用于华支睾吸虫病和肝吸虫病血清学诊断的研究进展

Development of an Immunochromatographic Point-of-Care Test for Serodiagnosis of Opisthorchiasis and Clonorchiasis.

机构信息

Department of Parasitology, Faculty of Medicine and Research and Diagnostic Center for Emerging Infectious Diseases, Mekong Health Science Research Institute, Khon Kaen University, Khon Kaen, Thailand.

Department of Parasitology, National Institute of Infectious Diseases, Ministry of Health, Labour and Welfare, Tokyo, Japan.

出版信息

Am J Trop Med Hyg. 2019 Nov;101(5):1156-1160. doi: 10.4269/ajtmh.19-0446.

Abstract

Chronic infections with the food-borne liver flukes, or , associate with cholangiocarcinoma, bile duct cancer, which generally has a poor prognosis. We have produced a rapid and simple immunochromatographic test (ICT) kit for the diagnosis of opisthorchiasis and clonorchiasis by the detection of IgG antibodies in human infection sera. Sera from volunteers with proven opisthorchiasis and several other parasitic diseases and from healthy controls were evaluated for the presence of liver fluke infection-specific antibodies using a preparation of excretory-secretory antigen from adult stage absorbed onto ICT strips. Diagnostic values were compared with an ELISA. The diagnostic sensitivity, specificity, and positive and negative predictive values of the ELISA were 100%, 98.3%, 97.9%, and 100%, whereas those for the ICT were 94.6%, 91.2%, 89.7%, and 95.4%, respectively. There was 91.7% concordance between the ICT with ELISA, and differences in performance between the tests were not statistically significant ( > 0.05). Twenty-seven of 30 (90%) of the clonorchiasis sera also were positive by ICT. This new ICT provides a facile, rapid test for point-of-care testing tool, which can be used at the bedside without the need for sophisticated equipment. Moreover, the ICT can be anticipated to supplement stool examination as a screening tool in the clinic for the diagnosis of opisthorchiasis and clonorchiasis, and in addition, it may be useful in screens of populations at risk of liver fluke infection-associated cholangiocarcinoma.

摘要

慢性感染食源性肝吸虫,或华支睾吸虫,与胆管癌有关,后者通常预后不良。我们已经开发出一种快速简单的免疫层析检测试剂盒(ICT),通过检测人感染血清中的 IgG 抗体来诊断肝吸虫病和华支睾吸虫病。用从成虫阶段吸收到 ICT 条上的排泄分泌抗原制备物,评估来自已证实的肝吸虫病和其他几种寄生虫病志愿者以及健康对照者血清中是否存在肝吸虫感染特异性抗体。将诊断值与 ELISA 进行比较。ELISA 的诊断灵敏度、特异性、阳性预测值和阴性预测值分别为 100%、98.3%、97.9%和 100%,而 ICT 的分别为 94.6%、91.2%、89.7%和 95.4%。ICT 与 ELISA 之间的一致性为 91.7%,两种检测方法的性能差异无统计学意义(>0.05)。27 份华支睾吸虫病血清也通过 ICT 呈阳性。这种新的 ICT 提供了一种简便、快速的即时检测工具,无需复杂的设备即可在床边使用。此外,ICT 有望补充粪便检查作为临床诊断肝吸虫病和华支睾吸虫病的筛查工具,此外,它可能对肝吸虫感染相关胆管癌高危人群的筛查有用。

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