Basic and Operational Researches for The Global Elimination of Lymphatic Filariasis

我们建立了一种新的以尿液为样本的免疫诊断方法（尿液ELISA，灵敏度为96.5%，特异性为99.0%）。该方法在现场研究中的实用性进行了测试。1.尿液ELISA用于测量感染强度尿液ELISA的一个很大的优点是它易于将该方法应用于幼儿。他们是一个前哨人口，可以表明新的丝虫感染。(We已经证实，IgG 4从感染的母亲转移到他们的新生儿在一年内消失。在斯里兰卡的一个高流行区，IgG 4阳性出现在1岁时，抗体滴度在3岁时达到高水平。在泰国的低流行区，阳性出现在10岁左右，20岁后显示高滴度水平。在韩国的丝虫病消失地区，40岁以前没有阳性。2.尿液ELISA用于评估大规模药物管理（MDA）和确认丝虫病消除尿IgG ...更多信息 在MDA之前和之后，对斯里兰卡Deniyaya地区的学龄儿童进行了4个水平的研究。治疗后血清特异性IgG 4的阳性率和滴度明显降低，提示尿ELISA可用于MDA监测。3.根据当地居民提供的资料制作丝虫病分布图。将调查表邮寄给当地领导，询问他们所在村庄的象皮病和鞘膜积液病例的存在和数量。这项研究发现，许多村庄都有病例，以前没有报告过丝虫病。尿ELISA免疫流行病学研究表明，该地区存在丝虫病传播的可能性。4.重组蛋白诊断新方法的建立重组SXP-1蛋白和几丁质内切酶蛋白成功地用于本研究。5.一个以上象皮病家系的遗传分析本研究仍在进行中，并积累了一些有趣的发现。少

We have developed a new immunodiagnostic method that uses urine as samples (urine ELISA with the sensitivity of 96.5% and the specificity of 99.0%). The method was tested for the usefulness in field studies.1.Urine ELISA for measuring the intensity of infectionA big advantage of urine ELISA is its ease in applying the method to young children. They are a sentinel population that can indicate new filarial infections. (We have confirmed that IgG4 transferred from infected mothers to their new born babies disappeared within a year.) In a high endemic area in Sri Lanka, the IgG4 positive appeared at age 1 year, and the antibody titers reached a high level by age 3. In a low endemic area in Thailand, the positive appeared at around 10 years, and showed a high titer level after 20 years of age. In a filariasis-disappeared area in Korea, there was no positive before 40 years of age.2.Urine ELISA for evaluating Mass Drug Administration (MDA), and confirming elimination of filariasisUrinary IgG … More 4 levels were studied with schoolchildren in Deniyaya area, Sri Lanka, before and after MDA. After treatment, the positive rate and titers of specific IgG4 reduced clearly, suggesting that urine ELISA is useful to monitor a MDA program. Also in 2 Chinese villages, where filariasis elimination had been confirmed, all of more than 10,000 schoolchildren examined were confirmed negative with the ELISA.3.Making a filariasis distribution map based on information given by local peopleQuestionnaires were mailed to local leaders, asking the presence and the number of elephantiasis and hydrocele cases in their villages. The study revealed many villages with the cases, where filariasis had not been reported before. Immunoepidemiological studies using urine ELISA showed a possible filariasis transmission in such villages.4.Development of new diagnostic methods using recombinant proteins.Recombinant SXP-1 and endochitinase proteins were used for this study successfully. The former seems to be particularly promising.5.Genetic analysis of families with more than 1 elephantiasis caseThis study is going on and some interesting findings are being accumulated. Less