Immunodiagnosis for echinococcosis: international standardization, early diagnosis and evaluation of prognosis

本课题对泡球蚴病患者进行血清学鉴定的主要结果如下：1.使用重组Em 18（RecEm 18）建立一种新的血清学诊断方法，用于鉴定泡状棘球蚴病（Sako et al. 2002. Journal of Clinical Microbiology 40，2769-2765）和亲和纯化的Em 18（Xiao等提交出版），并证明Em 18是半胱氨酸蛋白酶降解EM 10的产物，与人EMR蛋白具有最小的同源性，并预期在所有其他候选蛋白抗原中具有最高的B细胞表位活性。RecEm 18的有用性已作为法国组的盲法试验进行了评价（Ito et al. 2002. Journal of Clinical Microbiology 40，4161-4165）。法国和瑞士小组刚刚开始使用RecEm 18确认AE的其他工作。3.另一种棘球蚴病，囊型棘球蚴病（CE）的血清学分化也已取得很大进展（Mamuti et al. 2002.临床和诊断实验室免疫学9，573-576）。重组抗原B（RecAg B）的生产已经成功（Mamuti等，准备中）。已经使用重组嵌合抗原建立了鉴定猪带绦虫脑囊虫病（NCC）的血清学（Sako et al. 2000. Journal of Clinical Microbiology 38，4439-4444）。这些鉴定AE、CE和NCC的血清学方法是世界上最好的，已被应用于国际合作项目，并已在多个期刊和书籍中进行了综述。区分棘球绦虫和带绦虫的分子工作已经建立。在过去的三年里，我们发表了29篇原创论文，14篇论文集和5章英文书籍。建立快速的血清学诊断和分子诊断体系是下一步的研究方向。

The main results from this project to identify patients of alveolar echinococcosis (AE) serologically are as followings.1. The establishment of a new serodiagnosis for identification of alveolar echinococcosis using a recombinant Em18 (RecEm18) (Sako et al. 2002. Journal of Clinical Microbiology 40, 2769-2765) and affinity-purified Em18 (Xiao et al. submitted for publication) and demonstration that Em18 is the product of degradation of EM10 by cysteine proteinase and has the least homology with human EMR proteins and be expected to have the highest B cell epitope activity among all other candidate protein antigens.2. The usefulness of RecEm18 has been evaluated as a blind test with French group (Ito et al. 2002. Journal of Clinical Microbiology 40, 4161-4165). Additional work to confirm AE using RecEm18 has just started with French and Swiss groups.3. Serological differentiation of another echinococcosis, cystic echinococcosis (CE) has also been well advanced (Mamuti et al. 2002. Clinical and Diagnostic Laboratory Immunology 9, 573-576). Production of a recombinant Antigen B (RecAgB) has been succeeded (Mamuti et al. in preparation).4. Serology to identify neurocysticercosis (NCC) of Taenia solium has been established using a recombinant chimeric antigen (Sako et al. 2000. Journal of Clinical Microbiology 38, 4439-4444).5. These serological methods to identify AE, CE and NCC are the best in the world and have been applied for international collaboration projects and have been reviewed in several journals and books.6. Molecular work to differentiate Echinococcus species and Taenia species has been established.7. We have published 29 original papers, 14 proceedings and 5 chapters in three books in English last three years. To establish rapid system for these serodiagnosis and molecular diagnosis is the next step of our research.