Improved Diagnosis of Viable Parenchymal Neurocysticercosis by Combining Antibody Banding Patterns on Enzyme-Linked Immunoelectrotransfer Blot (EITB) with Antigen Enzyme-Linked Immunosorbent Assay (ELISA)

the Cysticercosis Working Group in Peru (CWGP)

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1 Scopus citations

Abstract

The diagnosis of neurocysticercosis (NCC) depends on neuroimaging and serological confirmation. While antibody detection by enzyme-linked immunoelectrotransfer blot (EITB) fails to predict viable NCC, EITB banding patterns provide information about the host's infection course. Adding antigen enzyme-linked immunosorbent assay (Ag-ELISA) results to EITB banding patterns may improve their ability to predict or rule out of viable NCC. We assessed whether combining EITB banding patterns with Ag-ELISA improves discrimination of viable infection in imaging-confirmed parenchymal NCC. EITB banding patterns were grouped into classes using latent class analysis. True-positive and false-negative Ag-ELISA results in each class were compared using Fisher's exact test. Four classes were identified: 1, EITB negative or positive to GP50 alone (GP50 antigen family); 2, positive to GP42-39 and GP24 (T24/42 family), with or without GP50; and 3 and 4, positive to GP50, GP42-39, and GP24 and reacting to bands in the 8-kDa family. Most cases in classes 3 and 4 had viable NCC (82% and 88%, respectively) compared to classes 2 and 1 (53% and 5%, respectively). Adding positive Ag-ELISA results to class 2 predicted all viable NCC cases (22/22 [100%]), whereas 11/40 patients (27.5%) Ag-ELISA negative had viable NCC (P, 0.001). Only 1/4 patients (25%) Ag-ELISA positive in class 1 had viable NCC, whereas 1/36 patients (2.8%) Ag-ELISA negative had viable NCC (P = 0.192). In classes 3 and 4, adding Ag-ELISA was not contributory. Combining Ag-ELISA with EITB banding patterns improves discrimination of viable from nonviable NCC, particularly for class 2 responses. Together, these complement neuroimaging more appropriately for the diagnosis of viable NCC.

Original languageEnglish
Article numbere01550-21
JournalJournal of Clinical Microbiology
Volume60
Issue number2
DOIs
StatePublished - Feb 2022

Bibliographical note

Funding Information:
This study was partially supported by the Fogarty International Center/NIH (training grants D43TW001140 and D43TW007393) and NIAID/NIH grant U19 AI129909 (Peru TMRC program). G.A. is a doctoral student studying Epidemiological Research at Universidad Peruana Cayetano Heredia and is sponsored by the National Council of Science, Technology, and Innovation of Peru (CONCYTEC/CIENCIA ACTIVA, scholarship EF033-235-2015).

Funding Information:
Special thanks goes to the staff of the Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas, Lima, Peru (Karen Arteaga and Kathia Linares), for EITB processing and data organization, and the Laboratory of Parasite Immunology, Department of Microbiology, School of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Peru (Cindy Espinoza, Tatiana Razuri, and Catherine Apaza), for Ag-ELISA processing. Also, special thanks to Sukwan Handali and John Noh (Centers for Disease Control and Prevention [CDC], USA) for their advice in writing the manuscript. This study was partially supported by the Fogarty International Center/NIH (training grants D43TW001140 and D43TW007393) and NIAID/NIH grant U19 AI129909 (Peru TMRC program). G.A. is a doctoral student studying Epidemiological Research at Universidad Peruana Cayetano Heredia and is sponsored by the National Council of Science, Technology, and Innovation of Peru (CONCYTEC/CIENCIA ACTIVA, scholarship EF033-235-2015).

Publisher Copyright:
© 2022 American Society for Microbiology. All Rights Reserved.

Keywords

  • Ag-ELISA
  • EITB banding patterns
  • Taenia solium
  • viable NCC

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