Sensitive and specific immunohistochemical diagnosis of human alveolar echinococcosis with the monoclonal antibody Em2G11.
Sensitive and specific immunohistochemical diagnosis of human alveolar echinococcosis with the monoclonal antibody Em2G11.
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DOI：
10.1371/journal.pntd.0001877
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发表时间：
2012
影响因子：
3.8
通讯作者：
Deplazes P
中科院分区：
文献类型：
--
作者：
Barth TF;Herrmann TS;Tappe D;Stark L;Grüner B;Buttenschoen K;Hillenbrand A;Juchems M;Henne-Bruns D;Kern P;Seitz HM;Möller P;Rausch RL;Kern P;Deplazes P
泡状包虫病 (AE) 是由多房棘球绦虫的后绦虫阶段引起的。细粒棘球蚴病和 AE 引起的囊性包虫病 (CE) 的鉴别诊断具有挑战性。我们的目的是通过特定抗体的免疫组织化学测试来改进受感染人体组织石蜡切片上 AE 的诊断。我们使用针对多房艾美耳球虫 Em2 抗原的单克隆抗体 (mAb) Em2G11 分析了来自疑似 AE 或 CE 患者的 96 份石蜡存档标本，包括 6 份切针活检和 3 份细针抽吸样本。在人体组织中，mAb Em2G11 的染色对多房艾美耳球虫的高度特异性，而在 CE 病变中未检测到染色。此外，该抗体还可检测坏死组织、肝窦和淋巴组织中主要病灶外小于 1 µm 的多房艾美耳球虫（精液）小颗粒，这些颗粒很可能是由寄生虫物质脱落引起的。在96个样本中的90个中，基于苏木精和伊红以及PAS染色的常规组织学诊断与使用mAb Em2G11的免疫组织学诊断一致。在 6 个样本中，包虫病的传统亚型诊断在使用 mAb Em2G11 进行免疫组织学修正后必须进行调整。使用 mAb Em2G11 进行免疫组织化学是一种新型、高度特异且灵敏的 AE 诊断工具。主要病灶（包括淋巴结等免疫活性组织）外多房艾美耳球虫（精液）小颗粒的染色表明对宿主存在全身性影响。棘球蚴病是一种危及人类生命的疾病，由多房棘球绦虫和细粒棘球绦虫的幼虫阶段引起。寄生虫的卵随犬科动物的粪便排出，人类被异常感染。在人类中，寄生虫的幼虫阶段主要在肝脏和肺部引起肿瘤样病变。精确诊断导致人类疾病的寄生虫至关重要，因为囊性包虫病和泡状包虫病的治疗方案差异很大。诊断基于血清学、影像学和组织学，后者是金标准。然而，传统的组织学并不总能清楚地识别致病寄生虫，因为这两种寄生虫都会导致人体组织呈现相似的特征。因此，我们开发了单克隆抗体 Em2G11 和免疫组织学技术，即使在抽吸物和小型存档活检组织样本上也可以廉价、快速、明确地诊断多房艾美耳球虫。此外，这项技术还揭示了人类肺泡包虫病的一个未知特征，我们称之为“多房包虫病小颗粒”（spems）。我们认为这些小颗粒代表了多房艾美耳球虫的微碎片，因此表明了宿主与寄生虫相互作用的一种新形式。
Alveolar echinococcosis (AE) is caused by the metacestode stage of Echinococcus multilocularis. Differential diagnosis with cystic echinococcosis (CE) caused by E. granulosus and AE is challenging. We aimed at improving diagnosis of AE on paraffin sections of infected human tissue by immunohistochemical testing of a specific antibody. We have analysed 96 paraffin archived specimens, including 6 cutting needle biopsies and 3 fine needle aspirates, from patients with suspected AE or CE with the monoclonal antibody (mAb) Em2G11 specific for the Em2 antigen of E. multilocularis metacestodes. In human tissue, staining with mAb Em2G11 is highly specific for E. multilocularis metacestodes while no staining is detected in CE lesions. In addition, the antibody detects small particles of E. multilocularis (spems) of less than 1 µm outside the main lesion in necrotic tissue, liver sinusoids and lymphatic tissue most probably caused by shedding of parasitic material. The conventional histological diagnosis based on haematoxylin and eosin and PAS stainings were in accordance with the immunohistological diagnosis using mAb Em2G11 in 90 of 96 samples. In 6 samples conventional subtype diagnosis of echinococcosis had to be adjusted when revised by immunohistology with mAb Em2G11. Immunohistochemistry with the mAb Em2G11 is a new, highly specific and sensitive diagnostic tool for AE. The staining of small particles of E. multilocularis (spems) outside the main lesion including immunocompetent tissue, such as lymph nodes, suggests a systemic effect on the host. Echinococcosis is a life-threatening disease in humans that is caused by the larval stages of the tapeworms Echinococcus multilocularis and Echinococcus granulosus. The eggs of the parasites are released with faeces of canids, and humans are aberrantly infected. In humans, the larval stages of the parasites cause tumour-like lesions mainly in the liver and the lungs. Precise diagnosis of the parasite responsible for human disease is of utmost importance since therapy regimens largely differ between cystic and alveolar echinococcosis. Diagnosis is based on serology, imaging and histology, the latter being the gold standard. However, conventional histology cannot always clearly identify the causative parasite because both parasites can cause human tissue to present similar features. Therefore, we have developed the monoclonal antibody Em2G11 and an immunohistological technique that allows a cheap and fast clear-cut diagnosis of E. multilocularis even on aspirates and small archived bioptic tissue samples. Furthermore, this technique disclosed an unknown feature of human alveolar echinococosis we called "small particles of E. multilocularis" (spems). We argue that these small particles represent micro-fragments of E. multilocularis and thus point to a new form of host-parasite interaction.
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影响因子：
3.8
作者：
Nono JK;Pletinckx K;Lutz MB;Brehm K
通讯作者：
Brehm K
影响因子：
7.5
作者：
Schweiger, A.;Grimm, F.;Deplazes, P.
通讯作者：
Deplazes, P.
影响因子：
1.9
作者：
Kern, P;Wen, H;Bresson-Hadni, S
通讯作者：
Bresson-Hadni, S
影响因子：
3.1
作者：
Dai, WJ;Hemphill, A;Gottstein, B
通讯作者：
Gottstein, B
影响因子：
2.6
作者：
Deplazes, P;Grimm, F;Kapel, CMO
通讯作者：
Kapel, CMO