Collaborative study on antigens for immunodiagnosis of schistosomiasis.

Eight research laboratories in Europe and the United States of America were selected on the basis of having published data on Schistosoma mansoni and S. japonicum antigens to participate in a study of various antigen/test combinations for immunodiagnosis of schistosomiasis. The serum bank consisted of 395 well documented sera from four endemic areas in Brazil (2 areas), Kenya, and the Philippines. Altogether, 21 S. mansoni and four S. japonicum antigen and immunoassay combinations were evaluated.S. mansoni egg antigens yielded a higher combined sensitivity than adult worm antigens, irrespective of their purity, in active S. mansoni infections before and after specific treatment. Quantitative seroreactivity of characterized S. mansoni egg antigens showed good correlation with faecal egg counts in the 5-14 year age group. No correlation between morbidity related to S. mansoni and seroreactivity was observed in any test system.Three S. japonicum egg antigens showed high sensitivity and specificity in relation to the presence or absence of eggs in the stool. The quantitative seroreactivity of the characterized S. japonicum egg antigens correlated directly with the intensity of S. japonicum infection in all age groups.The enzyme-linked immunosorbent assay (ELISA), using several different procedures, performed well with the antigens used in the study. The indium slide immunoassay (ISI), a simple qualitative visual test system using an S. mansoni egg antigen, demonstrated a high degree of sensitivity and specificity.The results did not indicate the superiority of any particular immunodiagnostic method for detecting antischistosome antibodies. This collaborative study is considered a first step towards developing and standardizing antigens for immunodiagnosis of schistosomiasis.