Urine Antigen Detection for the Diagnosis of Human Neurocysticercosis
Urine Antigen Detection for the Diagnosis of Human Neurocysticercosis
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DOI：
10.4269/ajtmh.2009.80.379
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发表时间：
2009-03-01
影响因子：
3.3
通讯作者：
Dorny, Pierre
中科院分区：
文献类型：
--
作者：
Castillo, Yesenia;Rodriguez, Silvia;Dorny, Pierre
神经囊尾蚴病（NCC）是癫痫发作和癫痫的主要原因。诊断基于脑成像，并以血清或脑脊液 (CSF) 免疫诊断为支持。 Lumbar puncture is invasive and painful. Blood sampling is slightly painful and poorly accepted.尿抗原检测已用于其他寄生虫检测，并在 NCC 中进行了尝试，但性能欠佳。我们使用基于单克隆抗体的 ELISA 检测了 87 名秘鲁神经囊尾蚴病患者（活囊肿，N = 34；蛛网膜下囊尾蚴病，N = 10；退化寄生虫，N = 7；钙化病变，N = 36）和来自秘鲁非流行地区的 32 名志愿者尿液中的猪带绦虫抗原。尿液抗原检测对活寄生虫的总体敏感性为 92%，在单囊肿患者中下降至 62.5%。大多数仅患有钙化囊尾蚴病的患者（30/36，83%）尿抗原呈阴性。配对血清/尿液样本中的抗原水平（在 19 名患者中进行评估）密切相关。无创尿液检测 T solium 抗原为 NCC 诊断提供了一种有用的替代方法。
Neurocysticercosis (NCC) is a major cause of seizures and epilepsy. Diagnosis is based on brain imaging, supported by immunodiagnosis in serum or cerebrospinal fluid (CSF). Lumbar puncture is invasive and painful. Blood sampling is slightly painful and poorly accepted. Urine antigen detection has been used for other parasites and tried in NCC with suboptimal performance. We used a monoclonal antibody-based ELISA to detect Taenia solium antigens in urine from 87 Peruvian neurocysticercosis patients (viable cysts,N = 34;subarachnoid cysticercosis, N = 10;degenerating parasites, N = 7; calcified lesions, N = 36) and 32 volunteers from a non-endemic area of Peru. Overall sensitivity of urine antigen detection for viable parasites was 92%, which decreased to 62.5% in patients with a single cyst. Most patients (30/36, 83%) with only calcified cysticercosis were urine antigen negative. Antigen levels in paired serum/urine samples (evaluated in 19 patients) were strongly correlated. Non-invasive urine testing for T solium antigens provides a useful alternative for NCC diagnosis.