1
|
Ribeiro AJ, Silva KA, Lopes LDS, Resende CAA, Couto CAP, Gandra IB, Pereira IAG, Barcelos ICDS, Pereira SP, Xavier SR, Tavares GDSV, Machado JM, Da Paz MC, Chávez-Fumagalli MA, Coelho EAF, Giunchetti RC, Chaves AT, Dutra WO, Gonçalves AAM, Galdino AS. The use of peptides for immunodiagnosis of human Chagas disease. Amino Acids 2024; 56:35. [PMID: 38698213 PMCID: PMC11065921 DOI: 10.1007/s00726-024-03394-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 04/10/2024] [Indexed: 05/05/2024]
Abstract
Chagas disease, caused by the protozoa Trypanosoma cruzi, continues to be a serious public health problem in Latin America, worsened by the limitations in its detection. Given the importance of developing new diagnostic methods for this disease, the present review aimed to verify the number of publications dedicated to research on peptides that demonstrate their usefulness in serodiagnosis. To this end, a bibliographic survey was conducted on the PubMed platform using the keyword "peptide" or "epitope" combined with "Chagas disease" or "Trypanosoma cruzi"; "diagno*" or "serodiagnosis" or "immunodiagnosis", without period restriction. An increasing number of publications on studies employing peptides in ELISA and rapid tests assays was verified, which confirms the expansion of research in this field. It is possible to observe that many of the peptides tested so far originate from proteins widely used in the diagnosis of Chagas, and many of them are part of commercial tests developed. In this sense, as expected, promising results were obtained for several peptides when tested in ELISA, as many of them exhibited sensitivity and specificity values above 90%. Furthermore, some peptides have been tested in several studies, confirming their diagnostic potential. Despite the promising results observed, it is possible to emphasize the need for extensive testing of peptides, using different serological panels, in order to confirm their potential. The importance of producing an effective assay capable of detecting the clinical stages of the disease, as well as new immunogenic antigens that enable new serological diagnostic tools for Chagas disease, is evident.
Collapse
Affiliation(s)
- Anna Julia Ribeiro
- Laboratório de Biotecnologia de Microrganismos, Universidade Federal de São João Del-Rei, Divinópolis, e Instituto Nacional de Ciência e Tecnologia em Biotecnologia Industrial (INCT-BI), Divinópolis, MG, 35501-296, Brazil
| | - Kamila Alves Silva
- Laboratório de Biotecnologia de Microrganismos, Universidade Federal de São João Del-Rei, Divinópolis, e Instituto Nacional de Ciência e Tecnologia em Biotecnologia Industrial (INCT-BI), Divinópolis, MG, 35501-296, Brazil
| | - Lucas da Silva Lopes
- Laboratório de Biotecnologia de Microrganismos, Universidade Federal de São João Del-Rei, Divinópolis, e Instituto Nacional de Ciência e Tecnologia em Biotecnologia Industrial (INCT-BI), Divinópolis, MG, 35501-296, Brazil
| | - Carlos Ananias Aparecido Resende
- Laboratório de Biotecnologia de Microrganismos, Universidade Federal de São João Del-Rei, Divinópolis, e Instituto Nacional de Ciência e Tecnologia em Biotecnologia Industrial (INCT-BI), Divinópolis, MG, 35501-296, Brazil
| | - Carolina Alves Petit Couto
- Laboratório de Biotecnologia de Microrganismos, Universidade Federal de São João Del-Rei, Divinópolis, e Instituto Nacional de Ciência e Tecnologia em Biotecnologia Industrial (INCT-BI), Divinópolis, MG, 35501-296, Brazil
| | - Isadora Braga Gandra
- Laboratório de Biotecnologia de Microrganismos, Universidade Federal de São João Del-Rei, Divinópolis, e Instituto Nacional de Ciência e Tecnologia em Biotecnologia Industrial (INCT-BI), Divinópolis, MG, 35501-296, Brazil
| | - Isabela Amorim Gonçalves Pereira
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, 30130-100, Brazil
| | - Isabelle Caroline Dos Santos Barcelos
- Laboratório de Biotecnologia de Microrganismos, Universidade Federal de São João Del-Rei, Divinópolis, e Instituto Nacional de Ciência e Tecnologia em Biotecnologia Industrial (INCT-BI), Divinópolis, MG, 35501-296, Brazil
| | - Sabrina Paula Pereira
- Laboratório de Biotecnologia de Microrganismos, Universidade Federal de São João Del-Rei, Divinópolis, e Instituto Nacional de Ciência e Tecnologia em Biotecnologia Industrial (INCT-BI), Divinópolis, MG, 35501-296, Brazil
| | - Sandra Rodrigues Xavier
- Laboratório de Biotecnologia de Microrganismos, Universidade Federal de São João Del-Rei, Divinópolis, e Instituto Nacional de Ciência e Tecnologia em Biotecnologia Industrial (INCT-BI), Divinópolis, MG, 35501-296, Brazil
| | - Grasiele de Sousa Viera Tavares
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, 30130-100, Brazil
| | - Juliana Martins Machado
- Laboratório de Biotecnologia de Microrganismos, Universidade Federal de São João Del-Rei, Divinópolis, e Instituto Nacional de Ciência e Tecnologia em Biotecnologia Industrial (INCT-BI), Divinópolis, MG, 35501-296, Brazil
| | - Mariana Campos Da Paz
- Laboratório de Bioativos e Nanobiotecnologia, Universidade Federal de São João Del-Rei, Divinópolis, MG, 35501-296, Brazil
| | - Miguel Angel Chávez-Fumagalli
- Computational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Arequipa, 04000, Peru
| | - Eduardo Antonio Ferraz Coelho
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, 30130-100, Brazil
| | - Rodolfo Cordeiro Giunchetti
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, e Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais (INCT-DT), Belo Horizonte, MG, 31270-901, Brazil
| | - Ana Thereza Chaves
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, 30130-100, Brazil
| | - Walderez Ornelas Dutra
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, e Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais (INCT-DT), Belo Horizonte, MG, 31270-901, Brazil
| | - Ana Alice Maia Gonçalves
- Laboratório de Biotecnologia de Microrganismos, Universidade Federal de São João Del-Rei, Divinópolis, e Instituto Nacional de Ciência e Tecnologia em Biotecnologia Industrial (INCT-BI), Divinópolis, MG, 35501-296, Brazil
| | - Alexsandro Sobreira Galdino
- Laboratório de Biotecnologia de Microrganismos, Universidade Federal de São João Del-Rei, Divinópolis, e Instituto Nacional de Ciência e Tecnologia em Biotecnologia Industrial (INCT-BI), Divinópolis, MG, 35501-296, Brazil.
| |
Collapse
|
2
|
Pavan TBS, Leony LM, de Souza WV, Santos EF, Tavares Daltro R, Erdens Maron Freitas N, Medrado Vasconcelos LC, Lopes Habib F, Silva AAO, Alejandra Fiorani Celedon P, Dias Sampaio D, Tonin Zanchin NI, Longhi SA, Neves Santos FL. Post-therapeutic cure criterion in chronic Chagas disease using Trypanosoma cruzi chimeric proteins. Folia Parasitol (Praha) 2024; 71:2024.004. [PMID: 38526232 DOI: 10.14411/fp.2024.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 01/19/2024] [Indexed: 03/26/2024]
Abstract
Chagas disease (CD) is a neglected disease caused by Trypanosoma cruzi Chagas, 1909. Causative treatment can be achieved with two drugs: benznidazole or Nifurtimox. There are some gaps that hinder progress in eradicating the disease. There is no test that can efficiently assess cure control after treatment. Currently, the decline in anti-T. cruzi antibody titres is assessed with conventional serological tests, which can take years. However, the search for new markers of cure must continue to fill this gap. The present study aimed to evaluate the decline in serological titres using chimeric proteins after treatment with benznidazole in chronic patients diagnosed with CD. It was a prospective cross-sectional cohort study between 2000 and 2004 of T. cruzi-positive participants from the Añatuya region (Argentina) treated with benznidazole. Serum samples from ten patients were collected before treatment (day zero) and after the end of treatment (2, 3, 6, 12, 24 and 36 months). For the detection of anti-T. cruzi antibodies, an indirect ELISA was performed using two chimeric recombinant proteins (IBMP-8.1 and IBMP-8.4) as antigens. The changes in reactivity index within the groups before and after treatment were evaluated using the Friedman test. All participants experienced a decrease in serological titres after treatment with benznidazole, especially IBMP-8.1. However, due to the small number of samples and the short follow-up period, it is premature to conclude that this molecule serves as a criterion for sustained cure. Further studies are needed to validate tests based on these or other biomarkers to demonstrate parasitological cure.
Collapse
Affiliation(s)
- Tycha Bianca Sabaini Pavan
- Advanced Public Health Laboratory, Goncalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz-BA), Salvador, Bahia, Brazil
| | - Leonardo Maia Leony
- Advanced Public Health Laboratory, Goncalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz-BA), Salvador, Bahia, Brazil
| | - Wayner Vieira de Souza
- Department of Public Health, Aggeu Magalhaes Institute, Oswaldo Cruz Foundation (Fiocruz-PE), Recife, Pernambuco, Brazil
| | - Emily Ferreira Santos
- Advanced Public Health Laboratory, Goncalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz-BA), Salvador, Bahia, Brazil
| | - Ramona Tavares Daltro
- Advanced Public Health Laboratory, Goncalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz-BA), Salvador, Bahia, Brazil
| | - Natalia Erdens Maron Freitas
- Advanced Public Health Laboratory, Goncalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz-BA), Salvador, Bahia, Brazil
| | | | - Fernanda Lopes Habib
- Advanced Public Health Laboratory, Goncalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz-BA), Salvador, Bahia, Brazil
| | - Angelo Antonio Oliveira Silva
- Advanced Public Health Laboratory, Goncalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz-BA), Salvador, Bahia, Brazil
| | - Paola Alejandra Fiorani Celedon
- Molecular Biology of Trypanosomatids Laboratory, Carlos Chagas Institute, Oswaldo Cruz Foundation (Fiocruz-PR), Curitiba, Parana, Brazil
| | - Daniel Dias Sampaio
- Department Brazil's Family Health Strategy, Municipal Health Department, Tremedal, Bahia, Brazil
| | - Nilson Ivo Tonin Zanchin
- Structural Biology and Protein Engineering Laboratory, Carlos Chagas Institute, Oswaldo Cruz Foundation (Fiocruz-PR), Curitiba, Parana, Brazil
| | - Silvia Andrea Longhi
- Laboratory of Molecular Biology of Chagas Disease, Institute for Research on Genetic Engineering and Molecular Biology "Dr Hector Torres", National Scientific and Technological Research Council, Buenos Aires, Argentina
| | - Fred Luciano Neves Santos
- Advanced Public Health Laboratory, Goncalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz-BA), Salvador, Bahia, Brazil
- Chagas Disease Translational Research Program (Fio-Chagas), Oswaldo Cruz Foundation (Fiocruz-RJ), Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
3
|
Suescún-Carrero SH, Tadger P, Sandoval Cuellar C, Armadans-Gil L, Ramírez López LX. Rapid diagnostic tests and ELISA for diagnosing chronic Chagas disease: Systematic revision and meta-analysis. PLoS Negl Trop Dis 2022; 16:e0010860. [PMID: 36256676 PMCID: PMC9616215 DOI: 10.1371/journal.pntd.0010860] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 10/28/2022] [Accepted: 10/03/2022] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To determine the diagnostic validity of the enzyme-linked immunosorbent assay (ELISA) and Rapid Diagnostic Tests (RDT) among individuals with suspected chronic Chagas Disease (CD). METHODOLOGY A search was made for studies with ELISA and RDT assays validity estimates as eligibility criteria, published between 2010 and 2020 on PubMed, Web of Science, Scopus, and LILACS. This way, we extracted the data and assessed the risk of bias and applicability of the studies using the QUADAS-2 tool. The bivariate random effects model was also used to estimate the overall sensitivity and specificity through forest-plots, ROC space, and we visually assessed the heterogeneity between studies. Meta-regressions were made using subgroup analysis. We used Deeks' test to assess the risk of publication bias. RESULTS 43 studies were included; 27 assessed ELISA tests; 14 assessed RDTs; and 2 assessed ELISA and RDTs, against different reference standards. 51.2 % of them used a non-comparative observational design, and 46.5 % a comparative clinical design ("case-control" type). High risk of bias was detected for patient screening and reference standard. The ELISA tests had a sensitivity of 99% (95% CI: 98-99) and a specificity of 98% (95% CI: 97-99); whereas the Rapid Diagnostic Tests (RDT) had values of 95% (95% CI: 94-97) and 97% (95% CI: 96-98), respectively. Deeks' test showed asymmetry on the ELISA assays. CONCLUSIONS ELISA and RDT tests have high validity for diagnosing chronic Chagas disease. The analysis of these two types of evidence in this systematic review and meta-analysis constitutes an input for their use. The limitations included the difficulty in extracting data due to the lack of information in the articles, and the comparative clinical-type design of some studies.
Collapse
Affiliation(s)
| | - Philippe Tadger
- Universidad de Boyacá, Tunja, Colombia
- Real World Solutions, IQVIA, Zaventem, Belgium
| | | | - Lluis Armadans-Gil
- Epidemiology and Preventive Medicine Service, Hospital Universitari Vall d’Hebron—Universitat Autónoma de Barcelona, Barcelona, Spain
| | | |
Collapse
|
4
|
Freitas NEM, Habib FL, Santos EF, Silva ÂAO, Fontes ND, Leony LM, Sampaio DD, de Almeida MC, Dantas-Torres F, Santos FLN. Technological advances in the serological diagnosis of Chagas disease in dogs and cats: a systematic review. Parasit Vectors 2022; 15:343. [PMID: 36167575 PMCID: PMC9516836 DOI: 10.1186/s13071-022-05476-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 09/10/2022] [Indexed: 11/12/2022] Open
Abstract
Background Chagas disease (CD) is caused by Trypanosoma cruzi, which is transmitted mainly through the feces/urine of infected triatomine bugs. The acute phase lasts 2–3 months and is characterized by high parasitemia and nonspecific symptoms, whereas the lifelong chronic phase features symptoms affecting the heart and/or digestive tract occurring in 30–40% of infected individuals. As in humans, cardiac abnormalities are observed in T. cruzi-infected dogs and cats. We reviewed the technological advances in the serological diagnosis of CD in dogs and cats. Methods A review of the published literature during the last 54 years (1968–2022) on the epidemiology, clinical features, diagnosis, treatment and prevention of CD in dogs and cats was conducted. Results Using predefined eligibility criteria for a search of the published literature, we retrieved and screened 436 publications. Of these, 84 original studies were considered for inclusion in this review. Dogs and cats are considered as sentinels, potentially indicating an active T. cruzi transmission and thus the risk for human infection. Although dogs and cats are reputed to be important for maintaining the T. cruzi domestic transmission cycle, there are no commercial tests to detect past or active infections in these animals. Most published research on CD in dogs and cats have used in-house serological tests prepared with native and/or full-length recombinant antigens, resulting in variable diagnostic performance. In recent years, chimeric antigens have been used to improve the diagnosis of chronic CD in humans with encouraging results. Some of them have high performance values (> 95%) and extremely low cross-reactivity rates for Leishmania spp., especially the antigens IBMP-8.1 to IBMP-8.4. The diagnostic performance of IBMP antigens was also investigated in dogs, showing high diagnostic performance with negligible cross-reactivity with anti-Leishmania infantum antibodies. Conclusions The development of a commercial immunodiagnostic tool to identify past or active T. cruzi infections in dogs and cats is urgently needed. The use of chimeric recombinant T. cruzi antigens may help to fill this gap and is discussed in this review. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13071-022-05476-4.
Collapse
Affiliation(s)
- Natália Erdens Maron Freitas
- Advanced Health Public Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Waldemar Falcão Street, 121, Candeal, Bahia, Salvador, 40296-710, Brazil
| | - Fernanda Lopes Habib
- Advanced Health Public Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Waldemar Falcão Street, 121, Candeal, Bahia, Salvador, 40296-710, Brazil
| | - Emily Ferreira Santos
- Advanced Health Public Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Waldemar Falcão Street, 121, Candeal, Bahia, Salvador, 40296-710, Brazil
| | - Ângelo Antônio Oliveira Silva
- Advanced Health Public Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Waldemar Falcão Street, 121, Candeal, Bahia, Salvador, 40296-710, Brazil
| | - Natália Dantas Fontes
- Advanced Health Public Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Waldemar Falcão Street, 121, Candeal, Bahia, Salvador, 40296-710, Brazil
| | - Leonardo Maia Leony
- Advanced Health Public Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Waldemar Falcão Street, 121, Candeal, Bahia, Salvador, 40296-710, Brazil
| | - Daniel Dias Sampaio
- Brazil's Family Health Strategy, Municipal Health Department, Tremedal City Hall, Bahia, Tremedal, Brazil
| | - Marcio Cerqueira de Almeida
- Pathology and Molecular Biology Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - Filipe Dantas-Torres
- Laboratory of Immunoparasitology, Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Recife, Pernambuco, Brazil
| | - Fred Luciano Neves Santos
- Advanced Health Public Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Waldemar Falcão Street, 121, Candeal, Bahia, Salvador, 40296-710, Brazil. .,Integrated Translational Program in Chagas Disease From Fiocruz (Fio-Chagas), Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
| |
Collapse
|
5
|
Medina-Rivera M, Cárdenas WB, Erickson D, Mehta S. Gold Nanoshells-Based Lateral Flow Assay for the Detection of Chagas Disease at the Point-of-Care. Am J Trop Med Hyg 2022; 107:323-327. [PMID: 35895419 PMCID: PMC9393437 DOI: 10.4269/ajtmh.21-1119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 04/11/2022] [Indexed: 08/03/2023] Open
Abstract
Chagas disease is a neglected parasitic infection and a major public health problem in the Americas. It remains underdiagnosed in the United States and internationally due to the lack of affordable testing and disparities in healthcare, particularly for those most at risk. We describe a proof-of-concept lateral flow immunoassay employing a recombinant Chagas multiantigen conjugated to gold nanoshells (AuNS) to detect circulating human anti-Chagas IgG antibodies. This is one of the first lateral flow immunoassays to capitalize on the larger surface area of AuNS compared with nanoparticles that can help amplify low-magnitude signals. Results were compared with 42 positive and negative Chagas serum samples, of which a subset of 27 samples was validated against an ELISA (Hemagen®). The sensitivity and specificity of our assay were 83% and 95%, respectively. These results suggest that an AuNS-based rapid testing for Chagas disease could facilitate in-field screening/diagnosis with a performance comparable to commercial methods.
Collapse
Affiliation(s)
- Melisa Medina-Rivera
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
- Institute for Nutritional Sciences, Global Health, and Technology (INSiGHT), Cornell University, Ithaca, New York
| | - Washington B. Cárdenas
- Laboratorio para Investigaciones Biomédicas, Escuela Superior Politécnica del Litoral, Guayaquil, Guayas, Ecuador
| | - David Erickson
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
- Institute for Nutritional Sciences, Global Health, and Technology (INSiGHT), Cornell University, Ithaca, New York
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, New York
| | - Saurabh Mehta
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
- Institute for Nutritional Sciences, Global Health, and Technology (INSiGHT), Cornell University, Ithaca, New York
| |
Collapse
|
6
|
Imai K, Murakami T, Misawa K, Fujikura Y, Kawana A, Tarumoto N, Maesaki S, Maeda T. Optimization and evaluation of the ARCHITECT Chagas assay and in-house ELISA for Chagas disease in clinical settings in Japan. Parasitol Int 2020; 80:102221. [PMID: 33137505 DOI: 10.1016/j.parint.2020.102221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 09/12/2020] [Accepted: 09/21/2020] [Indexed: 11/16/2022]
Abstract
Approximately 250,000 immigrants from Latin America live in Japan and it is estimated that 1500-3000 of them are potentially infected with Trypanosoma cruzi, the cause of Chagas disease. Therefore, the establishment of a standardized diagnostic method for Chagas disease in Japan is urgently needed. In this study, we optimized and evaluated the ARCHITECT Chagas assay and in-house ELISA for Chagas disease in clinical settings. In particular, we evaluated the performance of ARCHITECT Chagas as well as ELISA with whole-cell lysates and three recombinant proteins (TcF, TcBCDE, and CP1 + CP3) using 93 Chagas disease-positive serum samples and 108 Chagas disease-positive samples. The sensitivities of ARCHITECT Chagas, whole-cell lysate, TcF, TcBCDE, and CP1 + CP3 ELISA were respectively 100%, 100%, 98.9%, 98.9%, and 89.2% and the corresponding specificities were 100%, 99.1%, 99.1%, 100%, and 99.1%. False-positive results were obtained for whole-cell lysate, TcF, and CP1 ± CP3 ELISA. This is the first evidence that OD cut-off values optimized for in-house ELISA are similar in terms of sensitivity and specificity to those of the ARCHITECT Chagas test, supporting the use of these in-house assays as diagnostic tests for Chagas disease in the clinical setting in Japan.
Collapse
Affiliation(s)
- Kazuo Imai
- Department of Infectious Disease and Infection Control, Saitama Medical University, Saitama, Japan; Center for Clinical Infectious Diseases and Research, Saitama Medical University, Saitama, Japan
| | - Takashi Murakami
- Department of Microbiology, Saitama Medical University, Saitama, Japan
| | - Kazuhisa Misawa
- Department of Infectious Diseases and Respiratory Medicine, National Defense Medical College, Saitama, Japan
| | - Yuji Fujikura
- Department of Infectious Diseases and Respiratory Medicine, National Defense Medical College, Saitama, Japan
| | - Akihiko Kawana
- Department of Infectious Diseases and Respiratory Medicine, National Defense Medical College, Saitama, Japan
| | - Norihito Tarumoto
- Department of Infectious Disease and Infection Control, Saitama Medical University, Saitama, Japan; Center for Clinical Infectious Diseases and Research, Saitama Medical University, Saitama, Japan
| | - Shigefumi Maesaki
- Department of Infectious Disease and Infection Control, Saitama Medical University, Saitama, Japan; Center for Clinical Infectious Diseases and Research, Saitama Medical University, Saitama, Japan
| | - Takuya Maeda
- Center for Clinical Infectious Diseases and Research, Saitama Medical University, Saitama, Japan; Department of Laboratory Medicine, Saitama Medical University, Saitama, Japan.
| |
Collapse
|
7
|
Escandon P, Heatley JJ, Berghman LR, Tizard I, Musser JM. Comparison Of Four Anti-Avian IgY Secondary Antibodies Used In Western Blot And Dot-Blot ELISA To Detect Avian Bornavirus Antibodies In Four Different Bird Species. VETERINARY MEDICINE-RESEARCH AND REPORTS 2019; 10:141-150. [PMID: 31815098 PMCID: PMC6858837 DOI: 10.2147/vmrr.s227616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Accepted: 10/24/2019] [Indexed: 11/23/2022]
Abstract
Purpose This study evaluated the specificity of different avian secondary antibodies used in Western blot and dot-blot ELISA to detect avian bornavirus antibodies in bird plasma. Methods Plasma samples were collected from: two Blue and gold macaws, one positive and one negative for avian bornavirus by RT-PCR; a Cockatiel and a Monk parakeet prior to and following experimental infection; and, two Mallards, one positive and one negative for avian bornavirus by RT-PCR Samples were analyzed by Western blot and dot-blot ELISA that incorporated recombinant avian bornavirus nucleoprotein as the target analyte. Four species-specific anti-IgY secondary antibodies were used in the assays: goat anti-macaw IgY, goat anti-bird IgY, goat anti-duck IgY, and rabbit anti-chicken IgY. Results In the Western blot, anti-macaw IgY secondary antibody produced strong signals with Blue and gold macaw and Cockatiel positive plasma, but no signal with Mallard positive plasma. Anti-bird IgY secondary antibody produced strong signals with Blue and gold macaw, Cockatiel, and Mallard positive plasma. Anti-duck and anti-chicken IgY secondary antibody produced a strong and moderate signal, respectively, only with Mallard positive plasma. In the dot-blot ELISA, there was a distinct and significant difference (P<0.05) in the signal intensity between the different secondary antibodies within a bird species. Anti-macaw IgY secondary antibody produced significantly (P<0.05) stronger signals than the other secondary antibodies in Blue and gold macaw, Cockatiel, and Monk parakeet positive plasma, while anti-duck IgY secondary antibody produced significantly (P<0.05) stronger signals than the other secondary antibodies in Mallard positive plasma. Conclusion In testing psittacines with immunoassays, and especially in assays that incorporate short incubation reaction times such as a dot-blot ELISA, species-specific anti-IgY secondary antibodies provided more accurate results.
Collapse
Affiliation(s)
- Paulina Escandon
- Schubot Exotic Bird Health Center, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843, USA.,Department of Veterinary Pathobiology, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843, USA
| | - J Jill Heatley
- Schubot Exotic Bird Health Center, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843, USA.,Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843, USA
| | - Luc R Berghman
- Department of Veterinary Pathobiology, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843, USA.,Department of Poultry Science, College of Agriculture & Life Sciences, Texas A&M University, College Station, TX 77843, USA
| | - Ian Tizard
- Schubot Exotic Bird Health Center, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843, USA.,Department of Veterinary Pathobiology, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843, USA
| | - Jeffrey Mb Musser
- Schubot Exotic Bird Health Center, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843, USA.,Department of Veterinary Pathobiology, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843, USA
| |
Collapse
|
8
|
Chain CY, Pires Souto DE, Sbaraglini ML, Labriola CA, Daza Millone MA, Ramirez EA, Cisneros JS, Lopez-Albizu C, Scollo K, Kubota LT, Ruiz AM, Vela ME. Trypanosoma cruzi Virulence Factors for the Diagnosis of Chagas' Disease. ACS Infect Dis 2019; 5:1813-1819. [PMID: 31538468 DOI: 10.1021/acsinfecdis.9b00269] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
trans-Sialidase and cruzipain are important virulence factors from Trypanosoma cruzi, the etiological agent of Chagas disease, that have highly antigenic domains in their structure and were reported as potential tools for diagnosis of the illness. The aim of the present study is to assess the possibility of using cruzipain and the catalytic domain of trans-sialidase in a Surface Plasmon Resonance-based immunosensor for the diagnosis of chronic Chagas disease. Immunoassays carried out with canine sera verified that cruzipain allows the detection of anti-Trypanosoma cruzi antibodies whereas recombinant trans-sialidase did not yield specific detections, due to the high dilutions of serum used in the immunoassays that hinder the possibility to sense the specific low titer antibodies. The developed cruzipain-based biosensor, whose price per assay is comparable to a commercial enzyme-linked immunosorbent assay (ELISA), was successfully applied for the rapid quantification of specific antibodies against Trypanosoma cruzi in fresh human sera showing an excellent agreement with ELISA.
Collapse
Affiliation(s)
- Cecilia Yamil Chain
- Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas (INIFTA), Universidad Nacional de La Plata-CONICET, Diagonal 113 y 64 S/N, La Plata 1900, Argentina
| | - Dênio Emanuel Pires Souto
- Department of Chemistry, Federal University of Paraná (UFPR), Avenida Coronel Francisco Heráclito dos Santos, 100; Jardim das Américas, Curitiba, Paraná 81530-000, Brazil
| | - María Laura Sbaraglini
- Laboratorio de Investigación y Desarrollo de Bioactivos (LIDeB), Departamento de Ciencias Biológicas, Facultad de Ciencias Exactas, Universidad Nacional de La Plata, calle 47 200-236, La Plata ARB1900AJJ, Argentina
| | - Carlos A. Labriola
- Fundación Instituto Leloir, Instituto de Investigaciones Bioquímicas de Buenos Aires (IIBBA-CONICET), Universidad Nacional de Buenos Aires, Av. Patricias Argentinas 435, Ciudad de Buenos Aires AR C1405BWE, Argentina
| | - María Antonieta Daza Millone
- Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas (INIFTA), Universidad Nacional de La Plata-CONICET, Diagonal 113 y 64 S/N, La Plata 1900, Argentina
| | - Eduardo Alejandro Ramirez
- Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas (INIFTA), Universidad Nacional de La Plata-CONICET, Diagonal 113 y 64 S/N, La Plata 1900, Argentina
| | - José Sebastián Cisneros
- Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas (INIFTA), Universidad Nacional de La Plata-CONICET, Diagonal 113 y 64 S/N, La Plata 1900, Argentina
| | - Constanza Lopez-Albizu
- Instituto Nacional de Parasitología “Dr. Mario Fatala Chabén”-Administración Nacional de Institutos y Laboratorios de Salud (ANLIS), Avenida Paseo Colón 568, Ciudad Autónoma de Buenos Aires C1063ACR, Argentina
| | - Karenina Scollo
- Instituto Nacional de Parasitología “Dr. Mario Fatala Chabén”-Administración Nacional de Institutos y Laboratorios de Salud (ANLIS), Avenida Paseo Colón 568, Ciudad Autónoma de Buenos Aires C1063ACR, Argentina
| | - Lauro T. Kubota
- Instituto Nacional de Ciência e Tecnologia em Bioanalítica, Unicamp, Rua Josué de Castro s/n°, Cidade Universitária-Barão Geraldo, Campinas, São Paulo 13083-861, Brazil
| | - Andrés Mariano Ruiz
- Instituto Nacional de Parasitología “Dr. Mario Fatala Chabén”-Administración Nacional de Institutos y Laboratorios de Salud (ANLIS), Avenida Paseo Colón 568, Ciudad Autónoma de Buenos Aires C1063ACR, Argentina
| | - María Elena Vela
- Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas (INIFTA), Universidad Nacional de La Plata-CONICET, Diagonal 113 y 64 S/N, La Plata 1900, Argentina
| |
Collapse
|
9
|
Immune reactivity to Trypanosoma cruzi chimeric proteins for Chagas disease diagnosis in immigrants living in a non-endemic setting. BMC Infect Dis 2019; 19:251. [PMID: 30871504 PMCID: PMC6419348 DOI: 10.1186/s12879-019-3872-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 03/04/2019] [Indexed: 02/06/2023] Open
Abstract
Background Chronic Chagas Disease (CD) diagnosis is based on serological methods employing crude, semipurified or recombinant antigens, which may result in low sensitivity or cross-reactivity. To reduce these restrictions, we developed a strategy involving use of molecules containing repetitive fragments of Trypanosoma cruzi conserved proteins. Diagnostic performance of IBMP-8.1 and IBMP-8.4 chimeric antigens (Molecular Biology Institute of Paraná - IBMP in Portuguese acronym) was assessed to diagnose T. cruzi-infected and non-infected immigrants living in Barcelona (Spain), a non-endemic setting for Chagas disease. Methods Reactivity of IBMP-8.1 and IBMP-8.4 was assessed using an in-house automated ELISA with 347 positive and 331 negative individuals to Chagas disease. Antigenic cross-reactivity was measured with sera samples from pregnant women with Toxoplasma gondii (n = 98) and Zika virus (n = 75) antibodies. Results The area under the curve values was 1 and 0.99 for the IBMP-8.1 and IBMP-8.4 proteins, respectively, demonstrating excellent diagnostic accuracy. The reactivity index was higher for IBMP-8.1 than IBMP-8.4 in positive samples and no significant difference in reactivity index was observed in negative samples. Sensitivity ranged from 99.4% for IBMP-8.1 to 99.1% for IBMP-8.4 and was not statistically different. Specificity for IBMP-8.1 reached 100 and 99.7% for IBMP-8.4, both nearly 100% accurate. No antigenic cross-reactivity was observed and reactivity index was similar to that for negative Chagas disease individuals. Conclusions Our results showed an outstanding performance of IBMP-8.1 and IBMP-8.4 chimeric antigens by ELISA and suggest both chimeric antigens could also be used for Chagas disease diagnosis in immigrants living in non-endemic settings.
Collapse
|
10
|
Evaluation of the Elecsys Chagas Assay for Detection of Trypanosoma cruzi-Specific Antibodies in a Multicenter Study in Europe and Latin America. J Clin Microbiol 2018; 56:JCM.01446-17. [PMID: 29444836 PMCID: PMC5925710 DOI: 10.1128/jcm.01446-17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 02/08/2018] [Indexed: 01/15/2023] Open
Abstract
Serology is the preferred method to confirm a Chagas disease diagnosis and to screen blood donors. A battery of assays is often required due to the limited accuracy of single assays. The Elecsys Chagas assay is a newly developed, double-antigen sandwich assay for use on the Elecsys and cobas e immunoassay analyzers, intended to identify individuals infected with Trypanosoma cruzi, for diagnosis and screening. The performance of the Elecsys Chagas assay was evaluated in comparison with those of other widely used T. cruzi antibody assays, at multiple sites (Europe/Latin America). Relative sensitivity and specificity were assessed by using samples from blood donors, pregnant women, and hospitalized patients from regions where Chagas disease is endemic and from regions of nonendemicity. The Elecsys Chagas assay had an overall relative sensitivity of 100% (n = 674). Overall relative specificities were 99.90% (n = 14,681), 100% (n = 313), and 100% (n = 517) for samples from blood donors, pregnant women, and hospitalized patients, respectively. The analytical specificity was 99.83% (n = 594). The Elecsys Chagas assay detected T. cruzi antibodies in two World Health Organization (WHO) standard T. cruzi reference panels (panels 09/188 and 09/186) at a 1:512 dilution, corresponding to a cutoff sensitivity of approximately 1 mIU/ml. The Elecsys Chagas assay demonstrated robust performance under routine conditions at multiple sites in Europe and Latin America. In contrast to other available Chagas assays, the Elecsys assay uses a reduced number of recombinant T. cruzi antigens, resulting in a significantly smaller number of cross-reactions and improved analytical specificity while being highly sensitive.
Collapse
|
11
|
Santos FLN, Celedon PAF, Zanchin NIT, de Souza WV, da Silva ED, Foti L, Krieger MA, Gomes YDM. Accuracy of chimeric proteins in the serological diagnosis of chronic chagas disease - a Phase II study. PLoS Negl Trop Dis 2017; 11:e0005433. [PMID: 28273127 PMCID: PMC5358787 DOI: 10.1371/journal.pntd.0005433] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 03/20/2017] [Accepted: 02/23/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The performance of current serologic tests for diagnosing chronic Chagas disease (CD) is highly variable. The search for new diagnostic markers has been a constant challenge for improving accuracy and reducing the number of inconclusive results. METHODOLOGY/PRINCIPAL FINDINGS Here, four chimeric proteins (IBMP-8.1 to -8.4) comprising immunodominant regions of different Trypanosoma cruzi antigens were tested by enzyme-linked immunosorbent assay. The proteins were used to detect specific anti-T. cruzi antibodies in the sera of 857 chagasic and 689 non-chagasic individuals to evaluate their accuracy for chronic CD diagnosis. The antigens were recombinantly expressed in Escherichia coli and purified by chromatographic methods. The sensitivity and specificity values ranged from 94.3% to 99.3% and 99.4% to 100%, respectively. The diagnostic odds ratio (DOR) values were 6,462 for IBMP-8.1, 3,807 for IBMP-8.2, 32,095 for IBMP-8.3, and 283,714 for IBMP-8.4. These chimeric antigens presented DORs that were higher than the commercial test Pathozyme Chagas. The antigens IBMP-8.3 and -8.4 also showed DORs higher than the Gold ELISA Chagas test. Mixtures with equimolar concentrations were tested in order to improve the diagnosis accuracy of negative samples with high signal and positive samples with low signal. However, no gain in accuracy was observed relative to the individual antigens. A total of 1,079 additional sera were used to test cross-reactivity to unrelated diseases. The cross-reactivity rates ranged from 0.37% to 0.74% even for Leishmania spp., a pathogen showing relatively high genome sequence identity to T. cruzi. Imprecision analyses showed that IBMP chimeras are very stable and the results are highly reproducible. CONCLUSIONS/SIGNIFICANCE Our findings indicate that the IBMP-8.4 antigen can be safely used in serological tests for T. cruzi screening in blood banks and for chronic CD laboratory diagnosis.
Collapse
Affiliation(s)
- Fred Luciano Neves Santos
- Aggeu Magalhães Research Center, Oswaldo Cruz Foundation, Recife, Pernambuco, Brazil
- Chagas Disease Integrated Program, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
- * E-mail:
| | | | | | | | - Edimilson Domingos da Silva
- Chagas Disease Integrated Program, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
- Biomanguinhos, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Leonardo Foti
- Molecular Biology Institute of Paraná, Curitiba, Paraná, Brazil
- Carlos Chagas Institute, Oswaldo Cruz Foundation, Curitiba, Paraná, Brazil
| | - Marco Aurélio Krieger
- Chagas Disease Integrated Program, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
- Molecular Biology Institute of Paraná, Curitiba, Paraná, Brazil
- Carlos Chagas Institute, Oswaldo Cruz Foundation, Curitiba, Paraná, Brazil
| | - Yara de Miranda Gomes
- Aggeu Magalhães Research Center, Oswaldo Cruz Foundation, Recife, Pernambuco, Brazil
- Chagas Disease Integrated Program, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
12
|
Characterization and Diagnostic Application of Trypanosoma cruzi Trypomastigote Excreted-Secreted Antigens Shed in Extracellular Vesicles Released from Infected Mammalian Cells. J Clin Microbiol 2016; 55:744-758. [PMID: 27974541 DOI: 10.1128/jcm.01649-16] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 11/11/2016] [Indexed: 01/05/2023] Open
Abstract
Chagas disease, caused by Trypanosoma cruzi, although endemic in many parts of Central and South America, is emerging as a global health threat through the potential contamination of blood supplies. Consequently, in the absence of a gold standard assay for the diagnosis of Chagas disease, additional antigens or strategies are needed. A proteomic analysis of the trypomastigote excreted-secreted antigens (TESA) associated with exosomal vesicles shed by T. cruzi identified ∼80 parasite proteins, with the majority being trans-sialidases. Mass spectrometry analysis of immunoprecipitation products performed using Chagas immune sera showed a marked enrichment in a subset of TESA proteins. Of particular relevance for diagnostic applications were the retrotransposon hot spot (RHS) proteins, which are absent in Leishmania spp., parasites that often confound diagnosis of Chagas disease. Interestingly, serological screens using recombinant RHS showed a robust immunoreactivity with sera from patients with clinical stages of Chagas ranging from asymptomatic to advance cardiomyopathy and this immunoreactivity was comparable to that of crude TESA. More importantly, no cross-reactivity with RHS was detected with sera from patients with malaria, leishmaniasis, toxoplasmosis, or African sleeping sickness, making this protein an attractive reagent for diagnosis of Chagas disease.
Collapse
|
13
|
Balouz V, Agüero F, Buscaglia CA. Chagas Disease Diagnostic Applications: Present Knowledge and Future Steps. ADVANCES IN PARASITOLOGY 2016; 97:1-45. [PMID: 28325368 PMCID: PMC5363286 DOI: 10.1016/bs.apar.2016.10.001] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Chagas disease, caused by the protozoan Trypanosoma cruzi, is a lifelong and debilitating illness of major significance throughout Latin America and an emergent threat to global public health. Being a neglected disease, the vast majority of Chagasic patients have limited access to proper diagnosis and treatment, and there is only a marginal investment into R&D for drug and vaccine development. In this context, identification of novel biomarkers able to transcend the current limits of diagnostic methods surfaces as a main priority in Chagas disease applied research. The expectation is that these novel biomarkers will provide reliable, reproducible and accurate results irrespective of the genetic background, infecting parasite strain, stage of disease, and clinical-associated features of Chagasic populations. In addition, they should be able to address other still unmet diagnostic needs, including early detection of congenital T. cruzi transmission, rapid assessment of treatment efficiency or failure, indication/prediction of disease progression and direct parasite typification in clinical samples. The lack of access of poor and neglected populations to essential diagnostics also stresses the necessity of developing new methods operational in point-of-care settings. In summary, emergent diagnostic tests integrating these novel and tailored tools should provide a significant impact on the effectiveness of current intervention schemes and on the clinical management of Chagasic patients. In this chapter, we discuss the present knowledge and possible future steps in Chagas disease diagnostic applications, as well as the opportunity provided by recent advances in high-throughput methods for biomarker discovery.
Collapse
Affiliation(s)
- Virginia Balouz
- Instituto de Investigaciones Biotecnológicas - Instituto Tecnológico de Chascomús (IIB-INTECH), Universidad Nacional de San Martín (UNSAM) - Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), San Martín, B 1650 HMP, Buenos Aires, Argentina
| | - Fernán Agüero
- Instituto de Investigaciones Biotecnológicas - Instituto Tecnológico de Chascomús (IIB-INTECH), Universidad Nacional de San Martín (UNSAM) - Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), San Martín, B 1650 HMP, Buenos Aires, Argentina
| | - Carlos A. Buscaglia
- Instituto de Investigaciones Biotecnológicas - Instituto Tecnológico de Chascomús (IIB-INTECH), Universidad Nacional de San Martín (UNSAM) - Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), San Martín, B 1650 HMP, Buenos Aires, Argentina
| |
Collapse
|
14
|
Santos FLN, Celedon PAF, Zanchin NIT, Brasil TDAC, Foti L, de Souza WV, Silva ED, Gomes YDM, Krieger MA. Performance Assessment of Four Chimeric Trypanosoma cruzi Antigens Based on Antigen-Antibody Detection for Diagnosis of Chronic Chagas Disease. PLoS One 2016; 11:e0161100. [PMID: 27517281 PMCID: PMC4982698 DOI: 10.1371/journal.pone.0161100] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 07/31/2016] [Indexed: 11/18/2022] Open
Abstract
The performance of serologic tests in chronic Chagas disease diagnosis largely depends on the type and quality of the antigen preparations that are used for detection of anti-Trypanosoma cruzi antibodies. Whole-cell T. cruzi extracts or recombinant proteins have shown variation in the performance and cross-reactivity. Synthetic chimeric proteins comprising fragments of repetitive amino acids of several different proteins have been shown to improve assay performances to detect Chagasic infections. Here, we describe the production of four chimeric T. cruzi proteins and the assessment of their performance for diagnostic purposes. Circular Dichroism spectra indicated the absence of well-defined secondary structures, while polydispersity evaluated by Dynamic Light Scattering revealed only minor aggregates in 50 mM carbonate-bicarbonate (pH 9.6), demonstrating that it is an appropriate buffering system for sensitizing microplates. Serum samples from T. cruzi-infected and non-infected individuals were used to assess the performance of these antigens for detecting antibodies against T. cruzi, using both enzyme-linked immunosorbent assay and a liquid bead array platform. Performance parameters (AUC, sensitivity, specificity, accuracy and J index) showed high diagnostic accuracy for all chimeric proteins for detection of specific anti-T. cruzi antibodies and differentiated seropositive individuals from those who were seronegative. Our data suggest that these four chimeric proteins are eligible for phase II studies.
Collapse
Affiliation(s)
| | | | - Nilson Ivo Tonin Zanchin
- Molecular Biology Institute of Paraná, Curitiba, PR, Brazil
- Carlos Chagas Institute, FIOCRUZ-PR, Curitiba, PR, Brazil
| | | | - Leonardo Foti
- Molecular Biology Institute of Paraná, Curitiba, PR, Brazil
- Carlos Chagas Institute, FIOCRUZ-PR, Curitiba, PR, Brazil
| | | | | | | | - Marco Aurélio Krieger
- Molecular Biology Institute of Paraná, Curitiba, PR, Brazil
- Carlos Chagas Institute, FIOCRUZ-PR, Curitiba, PR, Brazil
| |
Collapse
|
15
|
Santos FLN, de Souza WV, Barros MDS, Nakazawa M, Krieger MA, Gomes YDM. Chronic Chagas Disease Diagnosis: A Comparative Performance of Commercial Enzyme Immunoassay Tests. Am J Trop Med Hyg 2016; 94:1034-9. [PMID: 26976886 DOI: 10.4269/ajtmh.15-0820] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Accepted: 01/29/2016] [Indexed: 11/07/2022] Open
Abstract
There is a significant heterogeneity in reported performance of serological assays for Chagas disease diagnosis. The conventional serology testing in laboratory diagnosis and in blood banks is unsatisfactory because of a high number of inconclusive and misclassified results. We aimed to assess the quality of four commercially available enzyme-linked immunosorbent assay tests for their ability to detect Trypanosoma cruzi antibodies in 685 sera samples. Cross-reactivity was assessed by using 748 sera from patients with unrelated diseases. Initially, we found that the reactivity index against T. cruzi antigen was statistically higher in sera from Chagas disease patients compared with those from non-chagasic patients, supporting the notion that all evaluated tests have a good discriminatory ability toward the diagnosis of T. cruzi infection in patients in the chronic phase of the disease. Although all tests were similarly sensitive for diagnosing T. cruzi infection, there were significant variations in terms of specificity and cross-reactivity among them. Indeed, we obtained divergent results when testing sera from patient with unrelated diseases, particularly leishmaniasis, with the levels of cross-reactivity being higher in tests using whole T. cruzi extracts compared with those using recombinant proteins. Our data suggest that all four tests may be used for the laboratory diagnosis and routine blood screening diagnose for Chagas disease. We also emphasize that, despite their general good performance, caution is needed when analyzing the results when these tests are performed in areas where other diseases, particularly leishmaniasis, are endemic.
Collapse
Affiliation(s)
- Fred Luciano Neves Santos
- Reference Laboratory for Chagas Disease, Aggeu Magalhães Research Center, Fundação Oswaldo Cruz, Recife, Brazil; Department of Public Health, Aggeu Magalhães Research Center, Fundação Oswaldo Cruz, Recife, Brazil; Carlos Chagas Institute-Molecular Biology Institute of Paraná, Fundação Oswaldo Cruz, Curitiba, Brazil
| | - Wayner Vieira de Souza
- Reference Laboratory for Chagas Disease, Aggeu Magalhães Research Center, Fundação Oswaldo Cruz, Recife, Brazil; Department of Public Health, Aggeu Magalhães Research Center, Fundação Oswaldo Cruz, Recife, Brazil; Carlos Chagas Institute-Molecular Biology Institute of Paraná, Fundação Oswaldo Cruz, Curitiba, Brazil
| | - Michelle da Silva Barros
- Reference Laboratory for Chagas Disease, Aggeu Magalhães Research Center, Fundação Oswaldo Cruz, Recife, Brazil; Department of Public Health, Aggeu Magalhães Research Center, Fundação Oswaldo Cruz, Recife, Brazil; Carlos Chagas Institute-Molecular Biology Institute of Paraná, Fundação Oswaldo Cruz, Curitiba, Brazil
| | - Mineo Nakazawa
- Reference Laboratory for Chagas Disease, Aggeu Magalhães Research Center, Fundação Oswaldo Cruz, Recife, Brazil; Department of Public Health, Aggeu Magalhães Research Center, Fundação Oswaldo Cruz, Recife, Brazil; Carlos Chagas Institute-Molecular Biology Institute of Paraná, Fundação Oswaldo Cruz, Curitiba, Brazil
| | - Marco Aurélio Krieger
- Reference Laboratory for Chagas Disease, Aggeu Magalhães Research Center, Fundação Oswaldo Cruz, Recife, Brazil; Department of Public Health, Aggeu Magalhães Research Center, Fundação Oswaldo Cruz, Recife, Brazil; Carlos Chagas Institute-Molecular Biology Institute of Paraná, Fundação Oswaldo Cruz, Curitiba, Brazil
| | - Yara de Miranda Gomes
- Reference Laboratory for Chagas Disease, Aggeu Magalhães Research Center, Fundação Oswaldo Cruz, Recife, Brazil; Department of Public Health, Aggeu Magalhães Research Center, Fundação Oswaldo Cruz, Recife, Brazil; Carlos Chagas Institute-Molecular Biology Institute of Paraná, Fundação Oswaldo Cruz, Curitiba, Brazil
| |
Collapse
|
16
|
Guzmán-Gómez D, López-Monteon A, de la Soledad Lagunes-Castro M, Álvarez-Martínez C, Hernández-Lutzon MJ, Dumonteil E, Ramos-Ligonio A. Highly discordant serology against Trypanosoma cruzi in central Veracruz, Mexico: role of the antigen used for diagnostic. Parasit Vectors 2015; 8:466. [PMID: 26384317 PMCID: PMC4573690 DOI: 10.1186/s13071-015-1072-2] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 09/04/2015] [Indexed: 12/20/2022] Open
Abstract
Background Chagas disease is a parasitic disease caused by the protozoan parasite Trypanosoma cruzi. In Mexico, the burden of the disease is difficult to estimate and improving surveillance for Chagas disease is an important priority. We aimed here at determining the seroprevalence of T. cruzi infection in humans in a rural community in Veracruz. Methods Serum samples (196) were analyzed for T. cruzi infection using five enzyme-linked immunosorbent assay (ELISA) tests: two in-house tests based on crude parasite extract and three commercial ELISA kits. Because of highly discordant results, we further explored the importance of parasite antigens and strains by western-blot analysis. Results A total of 74 samples (37.7 %) were reactive with at least one ELISA, but discordance among tests was very high. The best agreement was between Chagatest recombinant and Chagatek ELISA (Kappa index = 0.798). The agreement between other combinations of tests ranged from 0.038 to 0.518. Discordant samples were confirmed by western-blot analysis using up to nine parasite strains, giving a seroprevalence of 33.7 %. Conclusions Commercial tests had a very limited ability to detect T. cruzi infection in the study population. In-house tests based on crude parasite antigens showed a greater sensitivity but were still unable to detect all cases of T. cruzi infection, even when based on a local parasite strain. The high seroprevalence confirmed the hyper-endemicity of T. cruzi infection in the region. Reliable epidemiological surveillance of Chagas disease will require the development of improved diagnostic tests. Electronic supplementary material The online version of this article (doi:10.1186/s13071-015-1072-2) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Daniel Guzmán-Gómez
- Doctorado en Ciencias Biomédicas, Universidad Veracruzana, Xalapa, Veracruz, Mexico. .,LADISER Inmunología y Biología Molecular, Facultad de Ciencias Químicas, Universidad Veracruzana, Orizaba, Veracruz, Mexico.
| | - Aracely López-Monteon
- LADISER Inmunología y Biología Molecular, Facultad de Ciencias Químicas, Universidad Veracruzana, Orizaba, Veracruz, Mexico. .,Centro de Investigaciones Biomédicas, Universidad Veracruzana, Xalapa, Veracruz, Mexico.
| | - María de la Soledad Lagunes-Castro
- Doctorado en Ciencias Biomédicas, Universidad Veracruzana, Xalapa, Veracruz, Mexico. .,LADISER Inmunología y Biología Molecular, Facultad de Ciencias Químicas, Universidad Veracruzana, Orizaba, Veracruz, Mexico.
| | - Carolina Álvarez-Martínez
- LADISER Inmunología y Biología Molecular, Facultad de Ciencias Químicas, Universidad Veracruzana, Orizaba, Veracruz, Mexico.
| | - Manuel Jesús Hernández-Lutzon
- LADISER Inmunología y Biología Molecular, Facultad de Ciencias Químicas, Universidad Veracruzana, Orizaba, Veracruz, Mexico.
| | - Eric Dumonteil
- Laboratorio de Parasitología, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, Mérida, Yucatán, Mexico. .,Department of Tropical Medicine, Tulane University, School of Public Health and Tropical Medicine, New Orleans, LA, USA.
| | - Angel Ramos-Ligonio
- LADISER Inmunología y Biología Molecular, Facultad de Ciencias Químicas, Universidad Veracruzana, Orizaba, Veracruz, Mexico. .,Centro de Investigaciones Biomédicas, Universidad Veracruzana, Xalapa, Veracruz, Mexico.
| |
Collapse
|
17
|
Izquierdo L, Marques AF, Gállego M, Sanz S, Tebar S, Riera C, Quintó L, Aldasoro E, Almeida IC, Gascon J. Evaluation of a chemiluminescent enzyme-linked immunosorbent assay for the diagnosis of Trypanosoma cruzi infection in a nonendemic setting. Mem Inst Oswaldo Cruz 2015; 108:928-31. [PMID: 24271047 PMCID: PMC3970649 DOI: 10.1590/0074-0276130112] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2012] [Accepted: 06/19/2013] [Indexed: 11/22/2022] Open
Abstract
The disappearance of lytic, protective antibodies (Abs) from the serum of patients with Chagas disease is accepted as a reliable indicator of parasitological cure. The efficiency of a chemiluminescent enzyme-linked immunosorbent assay based on a purified, trypomastigote-derived glycosylphosphatidylinositol-anchored mucin antigen for the serologic detection of lytic Abs against Trypanosoma cruzi was evaluated in a nonendemic setting using a panel of 92 positive and 58 negative human sera. The technique proved to be highly sensitive {100%; 95% confidence interval (CI) = 96-100} and specific (98.3%; 95% CI = 90.7-99.7), with a kappa score of 0.99. Therefore, this assay can be used to detect active T. cruzi infection and to monitor trypanosomicidal treatment.
Collapse
Affiliation(s)
- Luis Izquierdo
- Barcelona Centre for International Health Research, Hospital Clinic
| | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Characterization of an immunodominant antigenic epitope from Trypanosoma cruzi as a biomarker of chronic Chagas' disease pathology. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2011; 19:167-73. [PMID: 22155766 DOI: 10.1128/cvi.05566-11] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Nowadays, the techniques available for chronic Chagas' disease diagnosis are very sensitive; however, they do not allow discrimination of the patient's clinical stages of the disease. The present paper describes that three out of the five different repeats contained in the Trypanosoma cruzi TcCA-2 membrane protein (3972-FGQAAAGDKPPP, 6303-FGQAAAGDKPAP, and 3973-FGQAAAGDKPSL) are recognized with high sensitivity (>90%) by sera from chronic Chagas' disease patients and that they are not recognized by sera from patients in the acute phase of the disease. A total of 133 serum samples from chagasic patients and 50 serum samples from healthy donors were tested. In addition, sera from 15 patients with different autoimmune diseases, 43 serum samples from patients suffering an infectious disease other than Chagas' disease, and 38 serum samples from patients with nonchagasic cardiac disorders were also included in this study. The residue 3973 peptide shows a specificity of >98%, as it is not recognized by individuals with autoimmune and inflammatory processes or by patients with a nonchagasic cardiomyopathy. Remarkably, the levels of antibody against the 3973 epitope detected by the sera from Chagas' disease patients in the symptomatic chronic phase, involving cardiac or digestive alterations, are higher than those detected by the sera from Chagas' disease patients in the indeterminate phase of the disease. It is suggested that the diagnostic technique described could also be used to indicate the degree of pathology. The amino acids F, Q, and DKP located in the peptide at positions 1, 3, and 8 to 10, respectively, are essential to conform to the immunodominant antigenic epitope.
Collapse
|
19
|
Tandem repeat protein as potential diagnostic antigen for Trypanosoma evansi infection. Parasitol Res 2011; 110:733-9. [PMID: 21927872 DOI: 10.1007/s00436-011-2632-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2011] [Accepted: 07/01/2011] [Indexed: 12/24/2022]
Abstract
Trypanosoma evansi infection (surra) causes significant losses in livestock production in tropical and sub-tropical areas. The current ELISA recommended by OIE for diagnosis of the disease is based on trypanosome lysate antigen. However, antigenic variation and unstable nature of cell lysate antigen make it difficult to standardize the assay. Thus, there are needs to develop recombinant antigen-based ELISA that improve stability, sensitivity, and specificity of the test. Since tandem repeat (TR) proteins of trypanosomatid parasites generally possess high antigenicity, they have been considered to be the promising antigens for trypanosomosis and leishmaniosis. In this study, IgG responses against 14 recombinant TR proteins of trypanosomes were examined by ELISA. Serum samples were obtained from three water buffaloes experimentally infected with T. evansi. Since Trypanosoma congolense GM6 (TcoGM6) elicited highest IgG responses to all water buffaloes, we further bioinformatically and molecular biologically identified Trypanosoma brucei brucei GM6 (TbbGM6) and T. evansi GM6 (TeGM6) TR genes, respectively. As expected, predicted amino acid sequences of TbbGM6 and TeGM6 were identical while the nucleic acid sequence homology between TbbGM6 and TcoGM6 was 63.8%. All buffaloes became clearly positive in recombinant TbbGM6 (rTbbGM6)-based ELISA at 48 days post-infection, suggesting that rTbbGM6 is usable as a serodiagnostic antigen for chronic T. evansi infection.
Collapse
|