Immunoblotting with Human Native Antigen Shows Stage-Related Sensitivity in the Serodiagnosis of Hepatic Cystic Echinococcosis

Mara Mariconti Policlinico San Matteo Hospital Foundation, Pavia, Italy; Department of Veterinary Science and Public Health, University of Milan, Milan, Italy; Department of Clinical Surgical Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy; World Health Organization Collaborating Centre for Clinical Management of Cystic Echinococcosis, Pavia, Italy

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Chiara Bazzocchi Policlinico San Matteo Hospital Foundation, Pavia, Italy; Department of Veterinary Science and Public Health, University of Milan, Milan, Italy; Department of Clinical Surgical Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy; World Health Organization Collaborating Centre for Clinical Management of Cystic Echinococcosis, Pavia, Italy

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Francesca Tamarozzi Policlinico San Matteo Hospital Foundation, Pavia, Italy; Department of Veterinary Science and Public Health, University of Milan, Milan, Italy; Department of Clinical Surgical Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy; World Health Organization Collaborating Centre for Clinical Management of Cystic Echinococcosis, Pavia, Italy

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Valeria Meroni Policlinico San Matteo Hospital Foundation, Pavia, Italy; Department of Veterinary Science and Public Health, University of Milan, Milan, Italy; Department of Clinical Surgical Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy; World Health Organization Collaborating Centre for Clinical Management of Cystic Echinococcosis, Pavia, Italy

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Francesca Genco Policlinico San Matteo Hospital Foundation, Pavia, Italy; Department of Veterinary Science and Public Health, University of Milan, Milan, Italy; Department of Clinical Surgical Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy; World Health Organization Collaborating Centre for Clinical Management of Cystic Echinococcosis, Pavia, Italy

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Roberta Maserati Policlinico San Matteo Hospital Foundation, Pavia, Italy; Department of Veterinary Science and Public Health, University of Milan, Milan, Italy; Department of Clinical Surgical Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy; World Health Organization Collaborating Centre for Clinical Management of Cystic Echinococcosis, Pavia, Italy

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Enrico Brunetti Policlinico San Matteo Hospital Foundation, Pavia, Italy; Department of Veterinary Science and Public Health, University of Milan, Milan, Italy; Department of Clinical Surgical Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy; World Health Organization Collaborating Centre for Clinical Management of Cystic Echinococcosis, Pavia, Italy

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The diagnosis of hepatic cystic echinococcosis is based on ultrasonography and confirmed by serology. However, no biological marker of cyst viability is currently available implying years-long patient follow-up, which is not always feasible in endemic areas. We characterized the performance of an immunoblotting test based on human hydatid cyst fluid with particular regard to its ability to distinguish between cyst stages. Sera from patients with cysts in different stages showed distinctive band pattern recognition. Most importantly, the test discriminated in 80% of cases CE3a from CE3b transitional cysts, known to have different viability profiles. Interestingly, we observed a rapid change in band pattern recognition of sera from one patient at time points when his cyst passed from active to transitional to inactive stages. Further identification of different antigens expressed by different cyst stages will support the development of diagnostic tools that could early define cyst viability, to guide clinical decision making, and shorten patient follow-up.

Author Notes

* Address correspondence to Enrico Brunetti, University of Pavia, Via Taramelli 5, 27100 Pavia, Italy. E-mail: enrico.brunetti@unipv.it

Financial support: This work was partially funded by a grant “Ricerca Corrente” from the Italian Ministry of Health through the “San Matteo” Hospital Foundation (to E.B.).

Authors' addresses: Mara Mariconti, University of Milan, Milan, Italy, Policlinico San Matteo Hospital Foundation, Pavia, Italy, and WHO Collaborating Centre for Clinical Management of Cystic Echinococcosis Pavia, Italy, E-mail: maramariconti@libero.it. Chiara Bazzocchi, University of Milan, Milan, Italy, E-mail: chiara.bazzocchi@unimi.it. Francesca Tamarozzi, WHO Collaborating Centre for Clinical Management of Cystic Echinococcosis Pavia, Italy, and University of Pavia, Pavia, Italy, E-mail: f_tamarozzi@yahoo.com. Valeria Meroni, Francesca Genco, and Roberta Maserati, Policlinico San Matteo Hospital Foundation, Pavia, Italy, E-mails: v.meroni@smatteo.pv.it, gencofrancesca@gmail.com, and r.maserati@smatteo.pv.it. Enrico Brunetti, Policlinico San Matteo Hospital Foundation, Pavia, Italy, WHO Collaborating Centre for Clinical Management of Cystic Echinococcosis Pavia, Italy, and University of Pavia, Pavia, Italy, E-mail: enrico.brunetti@unipv.it.

  • 1.

    Budke CM, Deplazes P, Torgerson PR, 2006. Global socioeconomic impact of cystic echinococcosis. Emerg Infect Dis 12: 296303.

  • 2.

    McManus DP, 2010. Echinococcosis with particular reference to Southeast Asia. Adv Parasitol 72: 267303.

  • 3.

    WHO Informal Working Group, 2003. International classification of ultrasound images in cystic echinococcosis for application in clinical and field epidemiological settings. Acta Trop 85: 253261.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Hosch W, Junghanss T, Stojkovic M, Brunetti E, Heye T, Kauffmann GW, Hull WE, 2008. Metabolic viability assessment of cystic echinococcosis using high-field 1H MRS of cyst contents. NMR Biomed 21: 734754.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Brunetti E, Kern P, Vuitton DA, 2010. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop 114: 116.

  • 6.

    Stojkovic M, Rosenberger K, Kauczor HU, Junghanss T, Hosch W, 2012. Diagnosing and staging of cystic echinococcosis: how do CT and MRI perform in comparison to ultrasound? PLoS Negl Trop Dis 6: e1880.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Carmena D, Benito A, Eraso E, 2006. Antigens for the immunodiagnosis of Echinococcus granulosus infection: an update. Acta Trop 98: 7486.

  • 8.

    Zhang W, McManus DP, 2006. Recent advances in the immunology and diagnosis of echinococcosis. FEMS Immunol Med Microbiol 47: 2441.

  • 9.

    Lightowlers MW, Liu DY, Haralambous A, Rickard MD, 1989. Subunit composition and specificity of the major cyst fluid antigens of Echinococcus granulosus. Mol Biochem Parasitol 37: 171182.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Lorenzo C, Salinas G, Brugnini A, Wernstedt C, Hellman U, Gonzalez-Sapienza G, 2003. Echinococcus granulosus antigen 5 is closely related to proteases of the trypsin family. Biochem J 369: 191198.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Ben Nouir N, Gianinazzi C, Gorcii M, Muller N, Nouri A, Babba H, Gottstein B, 2009. Isolation and molecular characterization of recombinant Echinococcus granulosus P29 protein (recP29) and its assessment for the post-surgical serological follow-up of human cystic echinococcosis in young patients. Trans R Soc Trop Med Hyg 103: 355364.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Hernandez-Gonzalez A, Santivanez S, Garcia HH, Rodriguez S, Munoz S, Ramos G, Orduna A, Siles-Lucas M, 2012. Improved serodiagnosis of cystic echinococcosis using the new recombinant 2B2t antigen. PLoS Negl Trop Dis 6: e1714.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    McManus DP, 1986. The Biology of Echinococcus and Hydatid Disease. London, UK: RCA Thompson.

  • 14.

    Oriol C, Oriol R, 1975. Physiocochemical properties of a lipoprotein antigen of Echinococcus granulosus. Am J Trop Med Hyg 24: 96100.

  • 15.

    Oriol R, Williams JF, Perez Esandi MV, Oriol C, 1971. Purification of lipoprotein antigens of Echinococcus granulosus from sheep hydatid fluid. Am J Trop Med Hyg 20: 569574.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Zhang W, Li J, Jones MK, Zhang Z, Zhao L, Blair D, McManus DP, 2010. The Echinococcus granulosus antigen B gene family comprises at least 10 unique genes in five subclasses which are differentially expressed. PLoS Negl Trop Dis 4: e784.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Chemale G, Ferreira HB, Barrett J, Brophy PM, Zaha A, 2005. Echinococcus granulosus antigen B hydrophobic ligand binding properties. Biochim Biophys Acta 1747: 189194.

  • 18.

    Rigano R, Buttari B, Profumo E, Ortona E, Delunardo F, Margutti P, Mattei V, Teggi A, Sorice M, Siracusano A, 2007. Echinococcus granulosus antigen B impairs human dendritic cell differentiation and polarizes immature dendritic cell maturation towards a Th2 cell response. Infect Immun 75: 16671678.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Rigano R, Profumo E, Bruschi F, Carulli G, Azzara A, Ioppolo S, Buttari B, Ortona E, Margutti P, Teggi A, Siracusano A, 2001. Modulation of human immune response by Echinococcus granulosus antigen B and its possible role in evading host defenses. Infect Immun 69: 288296.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Siracusano A, Margutti P, Delunardo F, Profumo E, Rigano R, Buttari B, Teggi A, Ortona E, 2008. Molecular cross-talk in host-parasite relationships: the intriguing immunomodulatory role of Echinococcus antigen B in cystic echinococcosis. Int J Parasitol 38: 13711376.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Gonzalez G, Nieto A, Fernandez C, Orn A, Wernstedt C, Hellman U, 1996. Two different 8 kDa monomers are involved in the oligomeric organization of the native Echinococcus granulosus antigen B. Parasite Immunol 18: 587596.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Monteiro KM, Cardoso MB, Follmer C, da Silveira NP, Vargas DM, Kitajima EW, Zaha A, Ferreira HB, 2012. Echinococcus granulosus antigen B structure: subunit composition and oligomeric states. PLoS Negl Trop Dis 6: e1551.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Di Felice G, Pini C, Afferni C, Vicari G, 1986. Purification and partial characterization of the major antigen of Echinococcus granulosus (antigen 5) with monoclonal antibodies. Mol Biochem Parasitol 20: 133142.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Jones MK, Zhang LH, Leggatt GR, Stenzel DJ, McManus DP, 1996. The ultrastructural localization of Echinococcus granulosus antigen 5. Parasitology 113: 213222.

  • 25.

    Li Y, Xu H, Chen J, Gan W, Wu W, Hu X, 2012. Gene cloning, expression, and localization of antigen 5 in the life cycle of Echinococcus granulosus. Parasitol Res 110: 23152323.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Mohammadzadeh T, Sako Y, Sadjjadi SM, Sarkari B, Ito A, 2012. Comparison of the usefulness of hydatid cyst fluid, native antigen B and recombinant antigen B8/1 for serological diagnosis of cystic echinococcosis. Trans R Soc Trop Med Hyg 106: 371375.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Tawfeek GM, Elwakil HS, El-Hoseiny L, Thabet HS, Sarhan RM, Awad NS, Anwar WA, 2011. Comparative analysis of the diagnostic performance of crude sheep hydatid cyst fluid, purified antigen B and its subunit (12 Kda), assessed by ELISA, in the diagnosis of human cystic echinococcosis. Parasitol Res 108: 371376.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Ortona E, Rigano R, Margutti P, Notargiacomo S, Ioppolo S, Vaccari S, Barca S, Buttari B, Profumo E, Teggi A, Siracusano A, 2000. Native and recombinant antigens in the immunodiagnosis of human cystic echinococcosis. Parasite Immunol 22: 553559.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Liance M, Janin V, Bresson-Hadni S, Vuitton DA, Houin R, Piarroux R, 2000. Immunodiagnosis of Echinococcus infections: confirmatory testing and species differentiation by a new commercial Western Blot. J Clin Microbiol 38: 37183721.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Parkinson J, Wasmuth JD, Salinas G, Bizarro CV, Sanford C, Berriman M, Ferreira HB, Zaha A, Blaxter ML, Maizels RM, Fernandez C, 2012. A transcriptomic analysis of Echinococcus granulosus larval stages: implications for parasite biology and host adaptation. PLoS Negl Trop Dis 6: e1897.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Celik T, Akarsu GA, Gungor C, Colak C, Ormeci N, 2009. Evaluation of antibodies against hydatid cyst fluid antigens in the post-treatment follow-up of cystic echinococcosis patients. Med Sci Monit 15: CR170CR176.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Doiz O, Benito R, Sbihi Y, Osuna A, Clavel A, Gomez-Lus R, 2001. Western blot applied to the diagnosis and post-treatment monitoring of human hydatidosis. Diagn Microbiol Infect Dis 41: 139142.

    • PubMed
    • Search Google Scholar
    • Export Citation
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