Evaluating the Recombinant T24H Enzyme-Linked Immunoelectrotransfer Blot Assay for the Diagnosis of Neurocysticercosis in a Panel of Samples from a Large Community-Based Randomized Control Trial in 60 Villages in Burkina Faso
Evaluating the Recombinant T24H Enzyme-Linked Immunoelectrotransfer Blot Assay for the Diagnosis of Neurocysticercosis in a Panel of Samples from a Large Community-Based Randomized Control Trial in 60 Villages in Burkina Faso
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DOI：
10.4269/ajtmh.17-0541
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发表时间：
2018-01-01
影响因子：
3.3
通讯作者：
Gabriel, Sarah
中科院分区：
文献类型：
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作者：
Dermauw, Veronique;Carabin, Helene;Gabriel, Sarah
目前神经囊尾蚴病 (NCC) 诊断指南建议使用扁豆凝集素结合糖蛋白酶联免疫电转移印迹测定 (LLGP-EITB) 作为血清学检测的参考标准。针对使用 LLGP-EITB 的缺点，开发了重组 T24H 抗原 (rT24H) EITB 检测方法，并取得了良好的结果。然而，该测试尚未在撒哈拉以南非洲 (SSA) 的个体中进行评估。本研究的目的是调查 rT24H EITB 检测在一组血清样本（N = 366，其中 173 名患者出现癫痫发作和/或严重慢性头痛，以及 193 名匹配的无症状参与者）中检测 NCC 病例的性能，这些样本是布基纳法索一项大型社区试验的一部分。发现 rT24H EITB 和天然 gp24（及其同二聚体 gp42）LLGP-EITB 之间完全一致（kappa 值为 1.0）。此外，在接受计算机断层扫描的具有感兴趣的神经系统表现的患者中，rT24H EITB和天然抗原LLGP-EITB在正确识别具有多个存活囊肿（rT24H：敏感性：80.0％）、单个存活囊肿（66.7％）和仅钙化/变性囊肿（25.0％）的NCC病例方面具有相当的能力，尽管对于多个存活和钙化囊肿，rT24H估计的敏感性似乎比之前报道的要低，但更不确定。 rT24H EITB 特异性很高 (98.2%)，与之前的研究一致。这项研究证实了重组 rT24H EITB 作为天然抗原 LLGP-EITB 的替代品在 SSA 社区环境中诊断 NCC 的价值。
Current guidelines for the diagnosis of neurocysticercosis (NCC) recommend the use of the lentil lectin-bound glycoprotein enzyme-linked immunoelectrotransfer blot assay (LLGP-EITB) as the reference standard for serological testing. In response to the drawbacks involved with the use of the LLGP-EITB, a recombinant T24H antigen (rT24H) EITB assay was developed, with promising results. However, the test has yet to be evaluated among individuals from sub-Saharan Africa (SSA). The aim of the present study was to investigate the performance of the rT24H EITB assay for the detection of NCC cases in a panel of serum samples (N=366, of which 173 patients presented with epileptic seizures and/or severe chronic headaches, and 193 matched manifestation-free participants) collected as part of a large community-based trial in Burkina Faso. A perfect agreement between the rT24H EITB and the native gp24 (and its homodimer, gp42) LLGP-EITB was found (kappa value of 1.0). Furthermore, among patients with the neurological manifestations of interest who underwent a computed tomography scan, the rT24H EITB and native antigen LLGP-EITB had a comparable ability to correctly identify NCC cases with multiple viable (rT24H: sensitivity: 80.0%), single viable (66.7%), and calcified/degenerating cysts only (25.0%), albeit for multiple viable and calcified cysts, the rT24H estimated sensitivity seemed lower, but more uncertain, than previously reported. The rT24H EITB specificity was high (98.2%) and in line with previous studies. This study confirms the value of the recombinant rT24H EITB as an alternative to the native antigen LLGP-EITB for the diagnosis of NCC in a SSA community setting.