Dreweck C M, Lüder C G, Soboslay P T, Kern P
Section of Infectious Diseases and Clinical Immunology, University Hospitals and Medical Clinic of Ulm, Germany.
Trop Med Int Health. 1997 Aug;2(8):779-87. doi: 10.1046/j.1365-3156.1997.d01-385.x.
Immunoglobulin (Ig) subclass-specific antibody responses and isotype-specific recognition of E. multilocularis (Em) and E. granulosus (Eg) antigens (Ag) were evaluated in both alveolar echinococcosis (AE) and cystic echinococcosis (CE). AE patients were divided into 3 groups by clinical and therapeutic criteria according to their actual state of infection, i.e. elimination of parasite, and regression or progression of disease, CE patients were either before or after surgery, of in continuous chemotherapy due to parasite persistence. Total IgE was highly elevated in progressive AE cases (7/11), but not in the cases with eliminated infection or regression. In AE patients with active disease, EmAg-specific IgE, total IgG, IgG1, IgG2 and IgG4 were particularly high. Similarly, in 9 of 30 CE patients, total IgE was raised above reference values, indicating progressive disease. CE patients" sera antibody cross-reacted with crude EmAg, and detectable Ig levels of the same isotype were also measured by ELISA. In both AE and CE, parasite-specific antigen recognition was dominated by IgG1 and IgG4. In AE patients with progressive disease, IgG4 distinctively recognized low molecular weight EmAg of Ar 26 kD, 18 kD, 16 kD and 12 kD. As prominent IgG4 and IgE responses develop with chronic helminth infections only, these serological parameters may indicate successful parasite infestation and severe outcome of disease. In summary, analyses of immunoglobulin isotype responses in AE patients by ELISA in combination with immunoblotting are a useful approach for post-treatment follow-up of patients at risk of developing recrudescent disease.
在肺泡型包虫病（AE）和囊型包虫病（CE）中，评估了免疫球蛋白（Ig）亚类特异性抗体反应以及对多房棘球绦虫（Em）和细粒棘球绦虫（Eg）抗原（Ag）的同种型特异性识别。根据实际感染状态，即寄生虫的清除情况以及疾病的消退或进展情况，AE患者按临床和治疗标准分为3组；CE患者则分为手术前或手术后，或因寄生虫持续存在而接受持续化疗的患者。在进展性AE病例中（7/11），总IgE水平显著升高，但在感染已清除或病情消退的病例中则未升高。在患有活动性疾病的AE患者中，EmAg特异性IgE、总IgG、IgG1、IgG2和IgG4特别高。同样，在30例CE患者中有9例，总IgE升高至参考值以上，表明疾病进展。CE患者的血清抗体与粗制EmAg发生交叉反应，并且还通过ELISA测量了相同同种型的可检测Ig水平。在AE和CE中，寄生虫特异性抗原识别均以IgG1和IgG4为主。在患有进展性疾病的AE患者中，IgG4特异性识别分子量为26 kD、18 kD、16 kD和12 kD的低分子量EmAg。由于仅在慢性蠕虫感染时才会出现显著的IgG4和IgE反应，因此这些血清学参数可能表明寄生虫感染成功且疾病预后严重。总之，通过ELISA结合免疫印迹分析AE患者的免疫球蛋白同种型反应，是对有复发疾病风险的患者进行治疗后随访的一种有用方法。
