Detection of Immunoglobulin G1 Against rK39 Improves Monitoring of Treatment Outcomes in Visceral Leishmaniasis

Autor: Michael A. Miles, Tegwen Marlais, Sayda El-Safi, Shyam Sundar, Tapan Bhattacharyya, Andrew K. I. Falconar, Guy Mollett, Bruno C Bremer Hinckel, Om Prakash Singh, Pascal Mertens
Přispěvatelé: Clinical sciences, Medical Genetics
Rok vydání: 2018
Předmět:
0301 basic medicine
Antibodies
Protozoan
rapid diagnostic test
Gastroenterology
Immunoglobulin G
0302 clinical medicine
Recurrence
visceral leishmaniasis
030212 general & internal medicine
Articles and Commentaries
Leishmania
relapse
Rapid diagnostic test
biology
cure
3. Good health
Treatment Outcome
Infectious Diseases
Leishmaniasis
Visceral
Antibody
Microbiology (medical)
medicine.medical_specialty
030106 microbiology
Antiprotozoal Agents
Antigens
Protozoan
Enzyme-Linked Immunosorbent Assay
Leishmaniasis
Visceral/blood
Leishmania/immunology
03 medical and health sciences
Pharmacotherapy
Antigen
Antiprotozoal Agents/therapeutic use
Internal medicine
parasitic diseases
medicine
Humans
Antibodies
Protozoan/blood
Biology
Diagnostic Tests
Routine
business.industry
IgG1
Tropical disease
Leishmaniasis
medicine.disease
Visceral leishmaniasis
Immunoglobulin G/blood
biology.protein
Antigens
Protozoan/immunology
Human medicine
business
Zdroj: Clinical infectious diseases
Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
ISSN: 1537-6591
1058-4838
DOI: 10.1093/cid/ciy1062
Popis: Background Visceral leishmaniasis (VL), caused by the Leishmania donovani complex, is a fatal, neglected tropical disease that is targeted for elimination in India, Nepal, and Bangladesh. Improved diagnostic tests are required for early case detection and for monitoring the outcomes of treatments. Previous investigations using Leishmania lysate antigen demonstrated that the immunoglobulin (Ig) G1 response is a potential indicator of a patient’s clinical status after chemotherapy. Methods IgG1 or IgG enzyme-linked immunosorbent assays (ELISAs) with rK39 or lysate antigens and novel IgG1 rK39 rapid diagnostic tests (RDTs) were assessed with Indian VL serum samples from the following clinical groups: paired pre- and postchemotherapy (deemed cured); relapsed; other infectious diseases; and endemic, healthy controls. Results With paired pre- and post-treatment samples (n = 37 pairs), ELISAs with rK39- and IgG1-specific conjugates gave a far more discriminative decrease in post-treatment antibody responses when compared to IgG (P < .0001). Novel IgG1 rK39 RDTs provided strong evidence for decreased IgG1 responses in patients who had successful treatment (P < .0001). Furthermore, both IgG1 rK39 RDTs (n = 38) and ELISAs showed a highly significant difference in test outcomes between cured patients and those who relapsed (n = 23; P < .0001). RDTs were more sensitive than corresponding ELISAs. Conclusions We present strong evidence for the use of IgG1 in monitoring treatment outcomes in VL, and the first use of an IgG1-based RDT using the rK39 antigen for the discrimination of post-treatment cure versus relapse in VL. Such an RDT may have a significant role in monitoring patients and in targeted control and elimination of this devastating disease.
Immunoglobulin (Ig) G1 enzyme-linked immunosorbent assays and a IgG1-based rapid diagnostic test (RDT) using rK39 antigen provide enhanced discrimination between post-treatment cure versus relapse in visceral leishmaniasis (P < .0001). This RDT may have a role in targeted disease control.
Databáze: OpenAIRE
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