Assessment of a 27‐kDa antigen in Enzyme‐Linked Immunosorbent Assay for the diagnosis of fasciolosis in Vietnamese patients

• Published in: Tropical medicine & international health 2010-04, Vol.15 (4), p.462-467
• Main Authors: Nguyen, T. G. T., Le, T. H., De, N. V., Doan, T. T., Dao, T. H. T., Vercruysse, J., Dorny, P.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Animals; Anthelmintics - therapeutic use; Antibodies, Helminth - blood; Antigens, Helminth - blood; Antigens, Helminth - immunology; Benzimidazoles - therapeutic use; Biological and medical sciences; diagnosis; Diagnosis, Differential; diagnostic; diagnóstico; Diseases caused by trematodes; Distomatoses; ELISA; enfermedad hepática; Enzyme-Linked Immunosorbent Assay - methods; Enzyme‐linked immunosorbent assay; Fasciola - immunology; Fasciola hepatica - immunology; Fascioliasis - diagnosis; Fascioliasis - drug therapy; Fascioliasis - immunology; Fasciolose; Fasciolosis; Feces - parasitology; Female; General aspects; Helminthic diseases; hepatic disease; Humans; Infectious diseases; inmunoensayo enzimático; Liver; Liver Diseases - diagnosis; maladie hépatique; Male; Medical diagnosis; Medical sciences; Middle Aged; Parasites; Parasitic diseases; Proteins; Sensitivity and Specificity; Tropical diseases; Vietnam; Young Adult
• ISSN: 1360-2276; 1365-3156
• DOI: 10.1111/j.1365-3156.2010.02468.x

Summary Fasciolosis has emerged as an important zoonotic disease in many parts of the world. In recent years, an increasing number of human cases were reported in Vietnam. In this study, the 27‐kDa component protein from the excretory/secretory production of adult Fasciola gigantica, purified by high performance liquid chromatography, was assessed in an enzyme‐linked immunosorbent assay (ELISA) to detect antibodies against Fasciola spp. for diagnosis of human fasciolosis. The ELISA showed a high sensitivity (100%) and specificity (97.67%) when tested on patients with fasciolosis, other parasitic infections, cholangiocarcinoma and on healthy controls. The assay was applied for diagnosis on 143 patients in the Viet Duc‐Hanoi hospital who presented with clinical signs of liver disease and lesions in their livers as shown by imaging techniques. Antibodies were found in 37 (25.9%) of these patients, of whom only 3 shed Fasciola eggs in their stools (2.1%). The excellent response to triclabendazole treatment of 37 sero‐positive patients confirmed the diagnosis of fasciolosis. This study demonstrated the diagnostic potential for human fasciolosis of the 27‐kDa antigen ELISA. Fasciolosis should be considered in the differential diagnosis of hepatic disease in Vietnam. Évaluation d’un antigène de 27 kDa dans un test ELISA pour le diagnostic de la fasciolose chez des patients vietnamiens La fasciolose a émergé comme une zoonose importante dans de nombreuses régions du monde. Ces dernières années, un nombre croissant de cas humains ont été signalés au Vietnam. Dans cette étude, la composante protéine de 27 kDa du système de production excrétion/sécrétion des adultes de Fasciola gigantica, purifiée par chromatographie liquide haute performance, a étéévaluée dans un test ELISA afin de détecter les anticorps contre Fasciola spp. dans le diagnostic de la fasciolose humaine. Le test ELISA a montré une sensibilité (100%) et spécificité (97.67%) élevées lorsqu’il est testé sur des patients présentant la fasciolose, d’autres infections parasitaires, le cholangiocarcinome et sur des contrôles sains. Le test a été appliqué pour le diagnostic de 143 patients à l’hôpital de Viet Duc‐Hanoi qui présentait des signes cliniques de maladie du foie et des lésions dans le foie tel que le montraient les techniques d’imagerie. Des anticorps ont été retrouvés chez 37 (25,9%) de ces patients, dont seuls 3 libéraient des oeufs de Fasciola dans leurs selles (2,1%). L’excellente réponse au tr