Garcia H H, Harrison L J, Parkhouse R M, Montenegro T, Martinez S M, Tsang V C, Gilman R H
Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru.
Trans R Soc Trop Med Hyg. 1998 Jul-Aug;92(4):411-4. doi: 10.1016/s0035-9203(98)91069-0.
An enzyme-linked immunosorbent assay (ELISA) for the detection of antigen secreted by viable Taenia solium metacestodes (Ag-ELISA) was applied to 43 pre-treatment and 47 follow-up cerebrospinal fluid (CSF) samples from Peruvian patients with neurocysticercosis demonstrated by computed tomography and enzyme-linked immunoelectrotransfer blot assay. The sensitivity of the assay was 86%. Negative pre-treatment results in the Ag-ELISA test were restricted to patients with only a single live cyst or only enhancing lesions. Patients with hydrocephalus had higher levels of circulating antigen. There was no difference between antigen levels in CSF taken before and immediately after treatment (day 14). Levels of parasite antigen were significantly positively correlated with the number of live cysts detected by tomography and were also proportional to the number and intensity of antibody reactions recognized by the immunoblot diagnostic test. In contrast, there was a negative correlation with the number of enhancing lesions revealed by tomography, supporting the hypothesis that enhancing lesions correspond to a terminal, moribund stage of the parasite. The use of antigen-detection tests specific for viable metacestodes has immediate utility in the clinical context, not only providing important information on the viability of the parasites but also leading to an improved understanding of the pathogenesis of neurocysticercosis before and after drug treatment.
一种用于检测猪带绦虫活囊尾蚴分泌抗原的酶联免疫吸附试验（Ag-ELISA），应用于43份治疗前和47份随访时的脑脊液（CSF）样本，这些样本来自经计算机断层扫描和酶联免疫电转移印迹试验证实患有神经囊尾蚴病的秘鲁患者。该试验的敏感性为86%。Ag-ELISA试验治疗前的阴性结果仅限于仅有单个活囊或仅有强化病灶的患者。脑积水患者循环抗原水平较高。治疗前和治疗后第14天立即采集的脑脊液中的抗原水平无差异。寄生虫抗原水平与断层扫描检测到的活囊数量显著正相关，也与免疫印迹诊断试验识别的抗体反应数量和强度成正比。相比之下，与断层扫描显示的强化病灶数量呈负相关，支持强化病灶对应于寄生虫终末期、濒死期的假说。使用针对活囊尾蚴的抗原检测试验在临床环境中具有直接用途，不仅提供有关寄生虫活力的重要信息，还能增进对药物治疗前后神经囊尾蚴病发病机制的理解。
