Marija Stojkovic1, Hans-Micha Adt1, Kerstin Rosenberger1, Ghalia Boubaker2,3,4, Ana Hernandez-Gonzalez5, Thomas Junghanss1, Marcel Zwahlen6, Mar Siles-Lucas5. 1. Section Clinical Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany. 2. Institute of Parasitology, University of Bern, Bern, Switzerland. 3. Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland. 4. Department of Clinical Biology B, Laboratory of Parasitology and Mycology, University of Monastir, Monastir, Tunisia. 5. Instituto de Recursos Naturales y Agrobiología de Salamanca, Consejo Superior de Investigaciones Científicas, Salamanca, Spain. 6. Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
Abstract
OBJECTIVE: To compare the performance of two novel recombinant antigens (EgP29, 2B2t) with imaging in a well-defined cohort of surgically treated cystic echinococcosis (CE) patients to determine whether serology reflects surgical cure as defined by imaging. METHODS: From a cohort of 223 CE-confirmed patients of a national clinical center for echinococcosis, 36 surgically treated patients were eligible for analysis. Sera were tested by enzyme-linked immunosorbent assay (ELISA) for specific IgG and IgG4 antibodies against the EgP29 and 2B2t antigens. We used a hierarchical linear regression model to examine the course of antibody levels over time for each patient. A meta-analysis of the patient-specific estimates of the time to negativity was performed using the metan command in Stata. RESULTS: The range of positive serological results at the beginning of post-surgical monitoring was 34-60%: 2B2t 51%, 2B2t-IgG4 34%, EgP29 60% and EgP29-IgG4 40%. The pooled estimates of time to seronegativity were as follows: 2B2t-ELISA 3.92 (3.24, 4.61) years; 2B2t-IgG4-ELISA 4.60 (3.91, 5.29) years; EgP29-ELISA 3.94 (3.50, 4.39) years; EgP29-IgG4-ELISA 2.55 (1.93, 3.18) years. CONCLUSION: After surgical treatment, antibodies to the recombinant antigens 2B2t and EgP29 become negative in the majority of CE-confirmed, surgically cured patients. The major drawback is the fact that only around half of the CE-confirmed, surgically treated patients were at all responsive to the test antigens, so they are of limited benefit for documenting primary cure. Equally, these antigens do not appear to be sensitive to recurrences.
OBJECTIVE: To compare the performance of two novel recombinant antigens (EgP29, 2B2t) with imaging in a well-defined cohort of surgically treated cystic echinococcosis (CE) patients to determine whether serology reflects surgical cure as defined by imaging. METHODS: From a cohort of 223 CE-confirmed patients of a national clinical center for echinococcosis, 36 surgically treated patients were eligible for analysis. Sera were tested by enzyme-linked immunosorbent assay (ELISA) for specific IgG and IgG4 antibodies against the EgP29 and 2B2t antigens. We used a hierarchical linear regression model to examine the course of antibody levels over time for each patient. A meta-analysis of the patient-specific estimates of the time to negativity was performed using the metan command in Stata. RESULTS: The range of positive serological results at the beginning of post-surgical monitoring was 34-60%: 2B2t 51%, 2B2t-IgG4 34%, EgP29 60% and EgP29-IgG4 40%. The pooled estimates of time to seronegativity were as follows: 2B2t-ELISA 3.92 (3.24, 4.61) years; 2B2t-IgG4-ELISA 4.60 (3.91, 5.29) years; EgP29-ELISA 3.94 (3.50, 4.39) years; EgP29-IgG4-ELISA 2.55 (1.93, 3.18) years. CONCLUSION: After surgical treatment, antibodies to the recombinant antigens 2B2t and EgP29 become negative in the majority of CE-confirmed, surgically cured patients. The major drawback is the fact that only around half of the CE-confirmed, surgically treated patients were at all responsive to the test antigens, so they are of limited benefit for documenting primary cure. Equally, these antigens do not appear to be sensitive to recurrences.
Authors: Mohammed Al-Saeedi; Elias Khajeh; Katrin Hoffmann; Omid Ghamarnejad; Marija Stojkovic; Tim F Weber; Mohammad Golriz; Oliver Strobel; Thomas Junghanss; Markus W Büchler; Arianeb Mehrabi Journal: PLoS Negl Trop Dis Date: 2019-06-21
Authors: Carlos Sánchez-Ovejero; Eylem Akdur; Raúl Manzano-Román; Ana Hernández-González; María González-Sánchez; David Becerro-Recio; Javier González-Miguel; Okan Akhan; Carmen M Cretu; Kamenna Vutova; Francesca Tamarozzi; Mara Mariconti; Enrico Brunetti; Ambra Vola; Massimo Fabiani; Adriano Casulli; Mar Siles-Lucas Journal: PLoS Negl Trop Dis Date: 2020-11-30
Authors: Ana Hernández-González; Carlos Sánchez-Ovejero; Raúl Manzano-Román; María González Sánchez; José Manuel Delgado; Teresa Pardo-García; Francisco Soriano-Gálvez; Okan Akhan; Carmen M Cretu; Kamenna Vutova; Francesca Tamarozzi; Mara Mariconti; Enrico Brunetti; Ambra Vola; Massimo Fabiani; Adriano Casulli; Mar Siles-Lucas Journal: PLoS Negl Trop Dis Date: 2018-09-06