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Fontes ND, Habib FL, Leony LM, Freitas NEM, Silva ÂAO, Dantas-Torres F, da Silva Sales KG, da Câmara ACJ, de Araújo-Neto VT, Amorim LDAF, Celedon PAF, Zanchin NIT, Santos FLN. Evaluation of chimeric recombinant antigens for the serodiagnosis of Trypanosoma cruzi in dogs: a promising tool for Chagas disease surveillance. Parasit Vectors 2024; 17:305. [PMID: 39010122 PMCID: PMC11251128 DOI: 10.1186/s13071-024-06376-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 06/25/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND Chagas disease (CD), a neglected parasitic disease caused by Trypanosoma cruzi, poses a significant health threat in Latin America and has emerged globally because of human migration. Trypanosoma cruzi infects humans and over 100 other mammalian species, including dogs, which are important sentinels for assessing the risk of human infection. Nonetheless, the serodiagnosis of T. cruzi in dogs is still impaired by the absence of commercial tests. In this study, we investigated the diagnostic accuracy of four chimeric recombinant T. cruzi IBMP antigens (IBMP-8.1, IBMP-8.2, IBMP-8.3, and IBMP-8.4) for detecting anti-T. cruzi antibodies in dogs, using latent class analysis (LCA). METHODS We examined 663 canine serum samples, employing indirect ELISA with the chimeric antigens. LCA was utilized to establish a latent variable as a gold standard for T. cruzi infection, revealing distinct response patterns for each antigen. RESULTS The IBMP (Portuguese acronym for the Molecular Biology Institute of Paraná) antigens achieved area under the ROC curve (AUC) values ranging from 90.9% to 97.3%. The highest sensitivity was attributed to IBMP-8.2 (89.8%), while IBMP-8.1, IBMP-8.3, and IBMP-8.4 achieved 73.5%, 79.6%, and 85.7%, respectively. The highest specificity was observed for IBMP-8.4 (98.6%), followed by IBMP-8.2, IBMP-8.3, and IBMP-8.1 with specificities of 98.3%, 94.4%, and 92.7%, respectively. Predictive values varied according to prevalence, indicating higher effectiveness in endemic settings. CONCLUSIONS Our findings underscore the remarkable diagnostic performance of IBMP-8.2 and IBMP-8.4 for the serodiagnosis of Trypanosoma cruzi in dogs, representing a promising tool for the diagnosis of CD in dogs. These chimeric recombinant antigens may not only enhance CD surveillance strategies but also hold broader implications for public health, contributing to the global fight against this neglected tropical disease.
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Affiliation(s)
- Natália Dantas Fontes
- Advanced Public Health Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Brazil
| | - Fernanda Lopes Habib
- Advanced Public Health Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Brazil
| | - Leonardo Maia Leony
- Advanced Public Health Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Brazil
- Interdisciplinary Research Group in Biotechnology and Epidemiology of Infectious Diseases (GRUPIBE), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ-BA), Salvador, Brazil
| | - Natália Erdens Maron Freitas
- Advanced Public Health Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Brazil
- Interdisciplinary Research Group in Biotechnology and Epidemiology of Infectious Diseases (GRUPIBE), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ-BA), Salvador, Brazil
| | - Ângelo Antônio Oliveira Silva
- Advanced Public Health Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Brazil
- Interdisciplinary Research Group in Biotechnology and Epidemiology of Infectious Diseases (GRUPIBE), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ-BA), Salvador, Brazil
| | - Filipe Dantas-Torres
- Laboratory of Immunoparasitology, Department of Immunology, Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Recife, Brazil
| | - Kamila Gaudêncio da Silva Sales
- Laboratory of Immunoparasitology, Department of Immunology, Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Recife, Brazil
| | - Antônia Cláudia Jácome da Câmara
- Department of Clinical and Toxicological Analysis, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Brazil
- Postgraduate Program in Pharmaceutical Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
| | | | | | | | - Nilson Ivo Tonin Zanchin
- Laboratory of Structural Biology & Protein Engineering, Carlos Chagas Institute, Oswaldo Cruz Foundation, Curitiba, Brazil
- Integrated Translational Program in Chagas disease from Fiocruz - Fio-Chagas, Rio de Janeiro, Brazil
| | - Fred Luciano Neves Santos
- Advanced Public Health Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Brazil.
- Interdisciplinary Research Group in Biotechnology and Epidemiology of Infectious Diseases (GRUPIBE), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ-BA), Salvador, Brazil.
- Integrated Translational Program in Chagas disease from Fiocruz - Fio-Chagas, Rio de Janeiro, Brazil.
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Serrano IM, Ribeiro G, Santos RS, Cruz JS, Lanza FC, dos Santos EF, de Almeida MC, Soares JFDS, Luquetti AO, Celedon PAF, Zanchin NIT, Santos FLN, dos Reis MG. IgG Isotypes Targeting a Recombinant Chimeric Protein of Trypanosoma cruzi in Different Clinical Presentations of Chronic Chagas Disease. Am J Trop Med Hyg 2024; 110:669-676. [PMID: 38412539 PMCID: PMC10993828 DOI: 10.4269/ajtmh.23-0652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 11/24/2023] [Indexed: 02/29/2024] Open
Abstract
Chagas disease (CD) is caused by the protozoan Trypanosoma cruzi, which leads to a spectrum of clinical presentations that range from asymptomatic to severe cardiac involvement. The host immune response plays a pivotal role in disease progression. Ig isotypes may contribute to disease pathogenesis. Investigating these components can provide insights into the immunopathogenic mechanisms underlying CD. This cross-sectional study aims to establish a correlation between the Ig profile of individuals infected with T. cruzi with the clinical forms of chronic CD. Serum samples were collected from partner institutions in different states of Brazil. Individuals diagnosed with chronic CD were categorized based on the clinical form of the disease. The indirect ELISA method using the recombinant chimeric Molecular Biology Institute of Paraná membrane protein 8.4 as the antigen was used to determine the Ig profile, including total IgG, IgG1, IgG2, IgG3, and IgG4. Ninety-seven serum samples from patients classified as negative (NEG, n = 38), indeterminate (IND, n = 24), mild cardiac (MC, n = 20), and severe cardiac (SC, n = 15) forms were analyzed. IgG1 exhibited greater levels compared with the other isotypes, showing a significant difference between the MC and IND groups. IgG3 levels were greater in individuals from the MC group compared with the SC group. IgG1 and IgG3 isotypes can serve as biomarkers to evaluate the progression of CD because they exhibit variations across clinical groups. Additional longitudinal studies are necessary to explore the relationship between antibody kinetics and the development of tissue damage.
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Affiliation(s)
- Isabela Machado Serrano
- Laboratory of Pathology and Molecular Biology, Gonçalo Moniz Institute, Oswaldo Cruz Foundation–Bahia, Salvador, Brazil
- Advanced Health Public Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation–Bahia, Salvador, Brazil
| | - Gilmar Ribeiro
- Laboratory of Pathology and Molecular Biology, Gonçalo Moniz Institute, Oswaldo Cruz Foundation–Bahia, Salvador, Brazil
- Integrated Translational Program in Chagas Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Jaqueline Silva Cruz
- Laboratory of Pathology and Molecular Biology, Gonçalo Moniz Institute, Oswaldo Cruz Foundation–Bahia, Salvador, Brazil
| | - Fernanda Cardoso Lanza
- Laboratory of Pathology and Molecular Biology, Gonçalo Moniz Institute, Oswaldo Cruz Foundation–Bahia, Salvador, Brazil
| | - Emily Ferreira dos Santos
- Advanced Health Public Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation–Bahia, Salvador, Brazil
| | - Márcio Cerqueira de Almeida
- Laboratory of Pathology and Molecular Biology, Gonçalo Moniz Institute, Oswaldo Cruz Foundation–Bahia, Salvador, Brazil
| | | | | | - Paola Alejandra Fiorani Celedon
- Laboratory of Molecular and Systems Biology of Trypanosomatids, Carlos Chagas Institute, Oswaldo Cruz Foundation–Paraná, Curitiba, Brazil
| | - Nilson Ivo Tonin Zanchin
- Integrated Translational Program in Chagas Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
- Laboratory of Structural Biology and Protein Engineering Laboratory, Carlos Chagas Institute, Oswaldo Cruz Foundation–Paraná, Curitiba, Brazil
| | - Fred Luciano Neves Santos
- Advanced Health Public Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation–Bahia, Salvador, Brazil
- Integrated Translational Program in Chagas Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Mitermayer Galvão dos Reis
- Laboratory of Pathology and Molecular Biology, Gonçalo Moniz Institute, Oswaldo Cruz Foundation–Bahia, Salvador, Brazil
- Integrated Translational Program in Chagas Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
- Faculty of Medicine, Federal University of Bahia, Salvador, Brazil
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, Connecticut
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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.
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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
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Soares NM, Barreto NMPV, Farias MMB, de Lima Oliveira C, Araújo WAC, de Souza JN, Teixeira MCA, Gonçalves NLS, Sampaio DD, Pavan TBS, Celedon PAF, Zanchin NIT, Santos FLN. Seroepidemiological Survey of Chronic Chagas Disease in a Rural Community in Southern Bahia, Brazil, Using Recombinant Chimeric Antigens. Pathogens 2023; 12:1222. [PMID: 37887738 PMCID: PMC10609786 DOI: 10.3390/pathogens12101222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 09/08/2023] [Accepted: 09/13/2023] [Indexed: 10/28/2023] Open
Abstract
Chagas disease (CD), caused by the parasite Trypanosoma cruzi, is a neglected tropical disease with life-threatening implications. In this study, we conducted a seroepidemiological survey to determine the prevalence and clinical profiles of CD in 217 individuals from an impoverished rural community in Southern Bahia, Brazil. The overall prevalence of CD in the studied community was 0.92%, detected through latent class analysis (LCA). Two individuals tested positive for anti-T. cruzi IgG, both being male farmers. One case was a 22-year-old man born in Camamu, with no evidence of congenital transmission, suggesting other routes of transmission such as vector-borne transmission due to migratory activities. The other case was a 69-year-old man born in São Felipe, who had lived in an adobe/brick house and had a pacemaker due to cardiac involvement caused by CD. The prevalence in this community was lower than expected, given the socioeconomic conditions and environmental factors that contribute to T. cruzi transmission. This could be attributed to the implementation of preventive measures and vector control programs by the Brazilian Government. However, continuous monitoring and surveillance are essential to sustain control efforts and detect any potential re-emergence of the disease. While the overall prevalence was low, the detection of positive cases underscores the need for continued surveillance and control measures in vulnerable populations, such as rural communities. Active surveillance, early diagnosis, and timely treatment are crucial in preventing disease progression and complications, thereby enhancing the effectiveness of screening and treatment programs.
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Affiliation(s)
- Neci Matos Soares
- Department of Clinical and Toxicological Analysis, Faculty of Pharmaceutical Sciences, Federal University of Bahia, Salvador 40170-115, Bahia, Brazil; (N.M.S.); (N.M.P.V.B.); (M.M.B.F.); (C.d.L.O.); (W.A.C.A.); (J.N.d.S.); (M.C.A.T.)
| | - Nilo Manoel Pereira Vieira Barreto
- Department of Clinical and Toxicological Analysis, Faculty of Pharmaceutical Sciences, Federal University of Bahia, Salvador 40170-115, Bahia, Brazil; (N.M.S.); (N.M.P.V.B.); (M.M.B.F.); (C.d.L.O.); (W.A.C.A.); (J.N.d.S.); (M.C.A.T.)
| | - Marina Morena Brito Farias
- Department of Clinical and Toxicological Analysis, Faculty of Pharmaceutical Sciences, Federal University of Bahia, Salvador 40170-115, Bahia, Brazil; (N.M.S.); (N.M.P.V.B.); (M.M.B.F.); (C.d.L.O.); (W.A.C.A.); (J.N.d.S.); (M.C.A.T.)
| | - Cíntia de Lima Oliveira
- Department of Clinical and Toxicological Analysis, Faculty of Pharmaceutical Sciences, Federal University of Bahia, Salvador 40170-115, Bahia, Brazil; (N.M.S.); (N.M.P.V.B.); (M.M.B.F.); (C.d.L.O.); (W.A.C.A.); (J.N.d.S.); (M.C.A.T.)
| | - Weslei Almeida Costa Araújo
- Department of Clinical and Toxicological Analysis, Faculty of Pharmaceutical Sciences, Federal University of Bahia, Salvador 40170-115, Bahia, Brazil; (N.M.S.); (N.M.P.V.B.); (M.M.B.F.); (C.d.L.O.); (W.A.C.A.); (J.N.d.S.); (M.C.A.T.)
| | - Joelma Nascimento de Souza
- Department of Clinical and Toxicological Analysis, Faculty of Pharmaceutical Sciences, Federal University of Bahia, Salvador 40170-115, Bahia, Brazil; (N.M.S.); (N.M.P.V.B.); (M.M.B.F.); (C.d.L.O.); (W.A.C.A.); (J.N.d.S.); (M.C.A.T.)
| | - Márcia Cristina Aquino Teixeira
- Department of Clinical and Toxicological Analysis, Faculty of Pharmaceutical Sciences, Federal University of Bahia, Salvador 40170-115, Bahia, Brazil; (N.M.S.); (N.M.P.V.B.); (M.M.B.F.); (C.d.L.O.); (W.A.C.A.); (J.N.d.S.); (M.C.A.T.)
| | - Noilson Lázaro Sousa Gonçalves
- Advanced Public Health Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz-BA), Salvador 40296-710, Bahia, Brazil; (N.L.S.G.); (T.B.S.P.)
| | - Daniel Dias Sampaio
- Brazil’s Family Health Strategy, Municipal Health Department, Tremedal City Hall, Tremedal 45170-000, Bahia, Brazil;
| | - Tycha Bianca Sabaini Pavan
- Advanced Public Health Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz-BA), Salvador 40296-710, Bahia, Brazil; (N.L.S.G.); (T.B.S.P.)
| | - Paola Alejandra Fiorani Celedon
- Molecular Biology of Trypanosomatids Laboratory, Carlos Chagas Institute, Oswaldo Cruz Foundation (Fiocruz-PR), Curitiba 81310-020, Paraná, Brazil;
| | - Nilson Ivo Tonin Zanchin
- Structural Biology and Protein Engineering Laboratory, Carlos Chagas Institute, Oswaldo Cruz Foundation (Fiocruz-PR), Curitiba 81310-020, Paraná, Brazil;
- Integrated Translational Program in Chagas Disease from Fiocruz (Fio-Chagas), Oswaldo Cruz Foundation (Fiocruz-RJ), Rio de Janeiro 21040-360, Rio de Janeiro, Brazil
| | - Fred Luciano Neves Santos
- Advanced Public Health Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz-BA), Salvador 40296-710, Bahia, Brazil; (N.L.S.G.); (T.B.S.P.)
- Integrated Translational Program in Chagas Disease from Fiocruz (Fio-Chagas), Oswaldo Cruz Foundation (Fiocruz-RJ), Rio de Janeiro 21040-360, Rio de Janeiro, Brazil
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Iturra JAD, Leony LM, Medeiros FAC, de Souza Filho JA, Siriano LDR, Tavares SB, Luquetti AO, Belo VS, de Sousa AS, Santos FLN. A multicenter comparative study of the performance of four rapid immunochromatographic tests for the detection of anti- Trypanosoma cruzi antibodies in Brazil. Front Med (Lausanne) 2023; 10:1031455. [PMID: 36936214 PMCID: PMC10017777 DOI: 10.3389/fmed.2023.1031455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 02/10/2023] [Indexed: 03/06/2023] Open
Abstract
Diagnosis of Trypanosoma cruzi (T. cruzi) infection in the chronic phase of Chagas disease (CD) is performed by serologic testing. Conventional tests are currently used with very good results but require time, laboratory infrastructure, and expertise. Rapid diagnostic tests (RDTs) are an alternative as the results are immediate and do not require specialized knowledge, making them suitable for epidemiologic studies and promising as a screening tool. Nevertheless, few studies conducted comparative evaluations of RDTs to validate the results and assess their performance. In this study, we analyzed four trades of rapid tests (OnSite Chagas Ab Combo Rapid Test-United States, SD Bioline Chagas AB-United States, WL Check Chagas-Argentina, and TR Chagas Bio-Manguinhos-Brazil) using a panel of 190 samples, including sera from 111 infected individuals, most of whom had low T. cruzi antibody levels. An additional 59 samples from uninfected individuals and 20 sera from individuals with other diseases, mainly visceral leishmaniasis, were included. All tests were performed by three independent laboratories in a blinded manner. Results showed differences in sensitivity from 92.8 to 100%, specificity from 78.5 to 92.4%, and accuracy from 90.5 to 95.3% among the four assays. The results presented here show that all four RDTs have high overall diagnostic ability. However, WL Check Chagas and TR Chagas Bio-Manguinhos were considered most suitable for use in screening studies due to their high sensitivity combined with good performance. Although these two RDTs have high sensitivity, a positive result should be confirmed with other tests to confirm or rule out reactivity/positivity, especially considering possible cross-reactivity with individuals with leishmaniasis or toxoplasmosis.
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Affiliation(s)
| | - Leonardo Maia Leony
- Advanced Public Health Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ-BA), Salvador, Bahia, Brazil
| | | | - Job Alves de Souza Filho
- Parasitic Diseases Service, Ezequiel Dias Foundation (FUNED), Belo Horizonte, Minas Gerais, Brazil
| | - Liliane da Rocha Siriano
- Chagas Disease Study Center (NEDoC), University Hospital, Federal University of Goiás (UFG), Goiânia, Goiás, Brazil
| | - Suelene Brito Tavares
- Chagas Disease Study Center (NEDoC), University Hospital, Federal University of Goiás (UFG), Goiânia, Goiás, Brazil
| | | | - Vinícius Silva Belo
- Department of Health Sciences, Federal University of São João Del-Rei (UFSJ), Divinópolis, Minas Gerais, Brazil
| | - Andréa Silvestre de Sousa
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (FIOCRUZ-RJ), Rio de Janeiro, Brazil
- Integrated Translational Program in Chagas Disease from FIOCRUZ (Fio-Chagas), Oswaldo Cruz Foundation (FIOCRUZ-RJ), Rio de Janeiro, Brazil
| | - Fred Luciano Neves Santos
- Advanced Public Health Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ-BA), Salvador, Bahia, Brazil
- Integrated Translational Program in Chagas Disease from FIOCRUZ (Fio-Chagas), Oswaldo Cruz Foundation (FIOCRUZ-RJ), Rio de Janeiro, Brazil
- *Correspondence: Fred Luciano Neves Santos,
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Daltro RT, Santos EF, Silva ÂAO, Maron Freitas NE, Leony LM, Vasconcelos LCM, Luquetti AO, Celedon PAF, Zanchin NIT, Regis-Silva CG, Santos FLN. Western blot using Trypanosoma cruzi chimeric recombinant proteins for the serodiagnosis of chronic Chagas disease: A proof-of-concept study. PLoS Negl Trop Dis 2022; 16:e0010944. [PMID: 36441769 PMCID: PMC9731424 DOI: 10.1371/journal.pntd.0010944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 12/08/2022] [Accepted: 11/13/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Chagas disease (CD) is caused by Trypanosoma cruzi. The chronic phase of CD is characterized by the presence of IgG anti-T. cruzi antibodies; and diagnosis is performed by serological methods. Because there is no reliable test that can be used as a reference test, WHO recommends the parallel use of two different tests for CD serodiagnosis. If results are inconclusive, samples should be subjected to a confirmatory test, e.g., Western blot (WB) or PCR. PCR offers low sensitivity in the chronic phase, whereas few confirmatory tests based on the WB method are commercially available worldwide. Therefore, new diagnostic tools should be evaluated to fill the gap in CD confirmatory tests. In recent years, four chimeric recombinant antigens (IBMP-8.1, IBMP-8.2, IBMP-8.3 and IBMP-8.4) have been evaluated in phase I, II and III studies using ELISA, liquid microarray and immunochromatography with 95-100% accuracy. Given the high diagnostic performance of these antigens, the present study investigated the ability of these molecules to diagnose chronic CD using a WB testing platform. METHODOLOGY/PRINCIPAL FINDINGS In this study, we analyzed the diagnostic potential of four chimeric antigens using 40 T. cruzi-positive, 24-negative, and three additional positive samples for visceral leishmaniasis (i.e., potentially cross-reactive) using WB as the diagnostic platform. Checkerboard titration with different dilutions of antigens, conjugated antigens, and serum samples was performed to standardize all assays. All IBMP antigens achieved 100% sensitivity, specificity, and accuracy, with the exception of IBMP-8.3, which had 100% specificity despite lack of significance, but lower sensitivity (95%) and accuracy (96.9%). No cross-reactivity was observed in samples positive for leishmaniasis. CONCLUSIONS/SIGNIFICANCE The present phase I (proof-of-concept) study demonstrated the high diagnostic potential of these four IBMP antigens to discriminate between T. cruzi-positive and -negative samples, making them candidates for phase II and confirmatory testing with WB.
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Affiliation(s)
- Ramona Tavares Daltro
- Advanced Public Health Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Brazil
| | - Emily Ferreira Santos
- Advanced Public Health Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Brazil
| | | | | | - Leonardo Maia Leony
- Advanced Public Health Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Brazil
| | | | | | - Paola Alejandra Fiorani Celedon
- Laboratory of Molecular and Systems Biology of Trypanosomatids, Carlos Chagas Institute, Oswaldo Cruz Foundation, Curitiba, Brazil
| | - Nilson Ivo Tonin Zanchin
- Structural Biology and Protein Engineering Laboratory, Carlos Chagas Institute, Oswaldo Cruz Foundation, Curitiba, Brazil
| | | | - Fred Luciano Neves Santos
- Advanced Public Health Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Brazil
- Integrated Translational Program in Chagas disease from FIOCRUZ (Fio-Chagas), Oswaldo Cruz Foundation (FIOCRUZ-RJ), Rio de Janeiro, Rio de Janeiro, Brazil
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Candia-Puma MA, Machaca-Luque LY, Roque-Pumahuanca BM, Galdino AS, Giunchetti RC, Coelho EAF, Chávez-Fumagalli MA. Accuracy of Diagnostic Tests for the Detection of Chagas Disease: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2022; 12:2752. [PMID: 36359595 PMCID: PMC9689806 DOI: 10.3390/diagnostics12112752] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 11/02/2023] Open
Abstract
The present systematic review and meta-analysis about the accuracy of diagnostic tests aim to describe the findings of literature over the last thirty years for the diagnosis of Chagas disease (CD). This work aimed to determine the accuracy of diagnostic techniques for CD in the disease's acute and chronic phases. The PubMed database was searched for studies published between 1990 and 2021 on CD diagnostics. Fifty-six published studies that met the criteria were analyzed and included in the meta-analysis, evaluating diagnostic accuracy through sensitivity and specificity. For Enzyme-Linked Immunosorbent Assay (ELISA), Fluorescent Antibody Technique (IFAT), Hemagglutination Test (HmT), Polymerase Chain Reaction (PCR), and Real-Time Polymerase Chain Reaction (qPCR) diagnosis methods, the sensitivity had a median of 99.0%, 78.0%, 75.0%, 76.0%, and 94.0%, respectively; while specificity presented a median of 99.0%, 99.0%, 99.0%, 98.0%, and 98.0%, respectively. This meta-analysis showed that ELISA and qPCR techniques had a higher performance compared to other methods of diagnosing CD in the chronic and acute phases, respectively. It was concluded utilizing the Area Under the Curve restricted to the false positive rates (AUCFPR), that the ELISA diagnostic test presents the highest performance in diagnosing acute and chronic CD, compared to serological and molecular tests. Future studies focusing on new CD diagnostics approaches should be targeted.
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Affiliation(s)
- Mayron Antonio Candia-Puma
- Computational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Arequipa 04000, Peru
- Facultad de Ciencias Farmacéuticas, Bioquímicas y Biotecnológicas, Universidad Católica de Santa María, Arequipa 04000, Peru
| | - Laura Yesenia Machaca-Luque
- Computational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Arequipa 04000, Peru
- Facultad de Ciencias Farmacéuticas, Bioquímicas y Biotecnológicas, Universidad Católica de Santa María, Arequipa 04000, Peru
| | - Brychs Milagros Roque-Pumahuanca
- Computational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Arequipa 04000, Peru
- Facultad de Ciencias Farmacéuticas, Bioquímicas y Biotecnológicas, Universidad Católica de Santa María, Arequipa 04000, Peru
| | - Alexsandro Sobreira Galdino
- Laboratório de Biotecnologia de Microrganismos, Universidade Federal São João Del-Rei, Divinópolis 35501-296, MG, Brazil
| | - Rodolfo Cordeiro Giunchetti
- Laboratório de Biologia das Interações Celulares, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais, INCT-DT, Salvador 40015-970, BA, Brazil
| | - 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 31270-901, MG, Brazil
- Departamento de Patologia Clínica, COLTEC, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Miguel Angel Chávez-Fumagalli
- Computational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Arequipa 04000, Peru
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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.
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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
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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.
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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.
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Ameku WA, Provance DW, Morel CM, De-Simone SG. Rapid Detection of Anti-SARS-CoV-2 Antibodies with a Screen-Printed Electrode Modified with a Spike Glycoprotein Epitope. BIOSENSORS 2022; 12:272. [PMID: 35624573 PMCID: PMC9139057 DOI: 10.3390/bios12050272] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 05/12/2023]
Abstract
BACKGROUND The coronavirus disease of 2019 (COVID-19) is caused by an infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was recognized in late 2019 and has since spread worldwide, leading to a pandemic with unprecedented health and financial consequences. There remains an enormous demand for new diagnostic methods that can deliver fast, low-cost, and easy-to-use confirmation of a SARS-CoV-2 infection. We have developed an affordable electrochemical biosensor for the rapid detection of serological immunoglobulin G (IgG) antibody in sera against the spike protein. MATERIALS AND METHODS A previously identified linear B-cell epitope (EP) specific to the SARS-CoV-2 spike glycoprotein and recognized by IgG in patient sera was selected for the target molecule. After synthesis, the EP was immobilized onto the surface of the working electrode of a commercially available screen-printed electrode (SPE). The capture of SARS-CoV-2-specific IgGs allowed the formation of an immunocomplex that was measured by square-wave voltammetry from its generation of hydroquinone (HQ). RESULTS An evaluation of the performance of the EP-based biosensor presented a selectivity and specificity for COVID-19 of 93% and 100%, respectively. No cross-reaction was observed to antibodies against other diseases that included Chagas disease, Chikungunya, Leishmaniosis, and Dengue. Differentiation of infected and non-infected individuals was possible even at a high dilution factor that decreased the required sample volumes to a few microliters. CONCLUSION The final device proved suitable for diagnosing COVID-19 by assaying actual serum samples, and the results displayed good agreement with the molecular biology diagnoses. The flexibility to conjugate other EPs to SPEs suggests that this technology could be rapidly adapted to diagnose new variants of SARS-CoV-2 or other pathogens.
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Affiliation(s)
- Wilson A. Ameku
- Oswaldo Cruz Foundation (FIOCRUZ), Center for Technological Development in Health (CDTS)/National Institute of Science and Technology for Innovation in Neglected Populations Diseases (INCT-IDPN), Rio de Janeiro 21040-900, RJ, Brazil; (W.A.A.); (D.W.P.); (C.M.M.)
- Laboratory of Epidemiology and Molecualr Systematics (LESM), Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro 21040-900, RJ, Brazil
| | - David W. Provance
- Oswaldo Cruz Foundation (FIOCRUZ), Center for Technological Development in Health (CDTS)/National Institute of Science and Technology for Innovation in Neglected Populations Diseases (INCT-IDPN), Rio de Janeiro 21040-900, RJ, Brazil; (W.A.A.); (D.W.P.); (C.M.M.)
- Laboratory of Epidemiology and Molecualr Systematics (LESM), Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro 21040-900, RJ, Brazil
| | - Carlos M. Morel
- Oswaldo Cruz Foundation (FIOCRUZ), Center for Technological Development in Health (CDTS)/National Institute of Science and Technology for Innovation in Neglected Populations Diseases (INCT-IDPN), Rio de Janeiro 21040-900, RJ, Brazil; (W.A.A.); (D.W.P.); (C.M.M.)
| | - Salvatore G. De-Simone
- Oswaldo Cruz Foundation (FIOCRUZ), Center for Technological Development in Health (CDTS)/National Institute of Science and Technology for Innovation in Neglected Populations Diseases (INCT-IDPN), Rio de Janeiro 21040-900, RJ, Brazil; (W.A.A.); (D.W.P.); (C.M.M.)
- Laboratory of Epidemiology and Molecualr Systematics (LESM), Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro 21040-900, RJ, Brazil
- Cellular and Molecular Department, Biology Institute, Federal Fluminense University, Niterói 24020-141, RJ, Brazil
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Dos Santos EF, Silva ÂAO, Freitas NEM, Leony LM, Daltro RT, Santos CADST, de Almeida MDCC, de Araújo FLV, Celedon PAF, Krieger MA, Zanchin NIT, Dos Reis MG, Santos FLN. Performance of Chimeric Trypanosoma cruzi Antigens in Serological Screening for Chagas Disease in Blood Banks. Front Med (Lausanne) 2022; 9:852864. [PMID: 35330587 PMCID: PMC8940225 DOI: 10.3389/fmed.2022.852864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/02/2022] [Indexed: 01/22/2023] Open
Abstract
Chagas disease (CD) is among the top 10 causes of inability to blood donation. Blood donation centers screen for anti-Trypanosoma cruzi antibodies using highly sensitive immunoenzymatic (ELISA) or chemiluminescent methods, which can lead to false positive results. Since positive samples cannot be used, to avoid the loss of valuable blood donations, it is necessary to improve specificity without reducing the sensitivity of the tests used for blood screening. For this purpose, our group has developed four chimeric proteins (IBMP-8.1, IBMP-8.2, IBMP-8.3, and IBMP-8.4) that have been evaluated in phase I and II studies with high performance and low cross-reactivity rates. The study included a panel of 5,014 serum samples collected from volunteer blood donors at the Hematology and Hemotherapy Foundation of the State of Bahia (Brazil). They were subjected to the detection of anti-T. cruzi antibodies, using all four IBMP antigens individually and latent class analysis (LCA) as a reference test, since there is no gold standard test for this purpose. Considering the sample size analyzed, LCA classified 4,993 (99.6%) samples as T. cruzi-negative and 21 (0.42%) as T. cruzi-positive. Sensitivity values ranged from 85.71% for IBMP-8.1 and 90.48% for IBMP-8.2–95.24% for IBMP-8.3 and 100% for IBMP-8.4, while specificity ranged from 99.98% for IBMP-8.3 and IBMP-8.4–100% for IBMP-8.1 and IBMP-8.2. Accuracy values ranged from 99.4 to 99.98%. The pretest probability for the molecules was 0.42, whereas the positive posttest probability ranged from 95.24 to 99.95% and the negative posttest probability ranged from 0.00001 to 0.0006% for all antigens. The higher odds ratio diagnosis was found for IBMP-8.4, which has been shown to be a safe single antigen for serological screening of CD in blood samples. The use of chimeric IBMP antigens is an alternative to reduce the number of bags discarded due to false-positive results. These molecules have high diagnostic performance and were shown to be suitable for use in screening CD in blood banks, isolated (IBMP-8.4) or in combination; and their use in blood banks could significantly reduce unnecessary disposal of blood bags or the risk of T. cruzi transmission.
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Affiliation(s)
- Emily Ferreira Dos Santos
- Advanced Health Public Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation - Bahia (FIOCRUZ-BA), Salvador, Brazil
| | - Ângelo Antônio Oliveira Silva
- Advanced Health Public Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation - Bahia (FIOCRUZ-BA), Salvador, Brazil
| | - Natália Erdens Maron Freitas
- Advanced Health Public Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation - Bahia (FIOCRUZ-BA), Salvador, Brazil
| | - Leonardo Maia Leony
- Advanced Health Public Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation - Bahia (FIOCRUZ-BA), Salvador, Brazil
| | - Ramona Tavares Daltro
- Advanced Health Public Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation - Bahia (FIOCRUZ-BA), Salvador, Brazil
| | - Carlos Antônio de Souza Teles Santos
- Center for Integration of Data and Health Knowledge (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation - Bahia (FIOCRUZ-BA), Salvador, Brazil
| | | | | | - Paola Alejandra Fiorani Celedon
- Laboratory of Molecular Biology of Trypanosomatids, Carlos Chagas Institute, Oswaldo Cruz Foundation - Paraná (FIOCRUZ-PR), Curitiba, Brazil
| | - Marco Aurélio Krieger
- Laboratory for Applied Science and Technology in Health, Carlos Chagas Institute, Oswaldo Cruz Foundation - Paraná (FIOCRUZ-PR), Curitiba, Brazil.,Integrated Translational Program in Chagas Disease From Fiocruz (Fio-Chagas), Oswaldo Cruz Foundation - Rio de Janeiro (FIOCRUZ-RJ), Rio de Janeiro, Brazil
| | - Nilson Ivo Tonin Zanchin
- Structural Biology and Protein Engineering, Carlos Chagas Institute, Oswaldo Cruz Foundation - Paraná (FIOCRUZ-PR), Curitiba, Brazil
| | - Mitermayer Galvão Dos Reis
- Integrated Translational Program in Chagas Disease From Fiocruz (Fio-Chagas), Oswaldo Cruz Foundation - Rio de Janeiro (FIOCRUZ-RJ), Rio de Janeiro, Brazil.,Pathology and Molecular Biology Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation - Bahia (FIOCRUZ-BA), Salvador, Brazil.,Faculty of Medicine of Bahia, Federal University of Bahia, Salvador, Brazil.,Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, United States
| | - Fred Luciano Neves Santos
- Advanced Health Public Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation - Bahia (FIOCRUZ-BA), Salvador, Brazil.,Integrated Translational Program in Chagas Disease From Fiocruz (Fio-Chagas), Oswaldo Cruz Foundation - Rio de Janeiro (FIOCRUZ-RJ), Rio de Janeiro, Brazil
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Double-antigen sandwich ELISA based on chimeric antigens for detection of antibodies to Trypanosoma cruzi in human sera. PLoS Negl Trop Dis 2022; 16:e0010290. [PMID: 35275913 PMCID: PMC8942226 DOI: 10.1371/journal.pntd.0010290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 03/23/2022] [Accepted: 02/28/2022] [Indexed: 02/07/2023] Open
Abstract
Background Enzyme-linked immunosorbent assays (ELISA) are generally the chosen test for Chagas disease (CD) diagnosis; however, its performance depends on the antigen preparation adsorbed to the solid phase, which may lead to false-positive results and cross-reactions. The use of chimeric recombinant antigens can overcome this limitation. Four chimeric antigens from Trypanosoma cruzi (IBMP-8.1, IBMP-8.2, IBMP-8.3 and IBMP-8.4) were developed and evaluated in phase I, II and III studies using indirect ELISA as diagnostic platform. However, peroxidase-labeled secondary anti-human IgG antibody, which is employed in indirect ELISAs, limits its use for the detection of species-specific and class-specific antibodies. To overcome this limitation, peroxidase-labeled antigens can be utilized, diagnosing both acute or chronic infection, in a species and immunoglobulin class-independent manner, through the use of a double-antigen sandwich ELISA (DAgS-ELISA). We aimed to evaluate and validate the diagnostic performance of the chimeric antigens IBMP-8.1, IBMP-8.2, IBMP-8.3 and IBMP-8.4 in the DAgS-ELISA platform. Methodology/Principal findings DAgS-ELISA was optimized by checkerboard titration. In phase I study, 207 positive and 205 negative samples were evaluated. Cross-reactivity to other infections was also assessed using 68 samples. The selected conditions for the tests utilized 25 ng of antigen per well and the conjugate diluted at 1:2,000 for all molecules. In the phase I study, the areas under the curve of IBMP-8.1, IBMP-8.2, IBMP-8.3 and IBMP-8.4 were 98.7%, 99.5%, 98.6% and 98.8%, respectively. Among the positive samples, IBMP-8.1 antigen classified 53 (25.6%) as false negative, IBMP-8.2, 27 (13%), IBMP-8.3, 24 (11.6%) and IBMP-8.4, 43 (20.8%), giving sensitivities of 74.4%, 87%, 88.4% and 79.2%, respectively. The only antigen that did not reach 100% specificity was IBMP-8.3, with 96.6%. IBMP-8.3 was also the only molecule to show cross-reactivity with HTLV. Conclusions/Significance DAgS-ELISA is a promising tool for immunodiagnosis, and despite the high AUC values, the performance of this assay was different from the values obtained by our group when using these antigens in the indirect ELISA, for this reason, improvements are being considered to increase the sensitivity of the DAgS-ELISA. Indirect immunoassays are the recommended method for chronic Chagas disease diagnosis and its performance relies on the employed antigen preparation. Chimeric antigens have been successfully utilized for chronic CD in vitro diagnosis and efficiently addresses commonly encountered hurdles arising from the use of recombinant and native antigens. Thus, our group developed four Trypanosoma cruzi chimeric antigens and evaluated their diagnostic potential in an indirect Enzyme-linked immunosorbent assays (ELISA) design; however, this design restricts detection to a single antibody class and for a single species. To overcome this, we utilized conjugated antigens in a double-antigen sandwich ELISA (DAgS-ELISA) design, which is able to detect both acute and chronic infections, in a species and immunoglobulin class-independent manner. Despite their high discrimination levels, as illustrated through elevated AUC values, our results were different from those obtained previously, especially regarding sensitivity. Specificity values remained elevated, reaching 100% for 3 out of 4 antigens. As such, improvements are being considered to increase the sensitivity of the DAgS-ELISA.
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Rodrigues ES, Santos GQ, da Silva MV, Barros JHS, Bernardo AR, Diniz RL, Rubim NM, Roque ALR, Jansen AM, Silva ED, Xavier SCC. Chagas Immunochromatographic Rapid Test in the Serological Diagnosis of Trypanosoma cruzi Infection in Wild and Domestic Canids. Front Cell Infect Microbiol 2022; 12:835383. [PMID: 35273924 PMCID: PMC8902141 DOI: 10.3389/fcimb.2022.835383] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/02/2022] [Indexed: 12/13/2022] Open
Abstract
Canis lupus familiaris (domestic dog) represents a reliable sentinel for the occurrence of a well-established transmission cycle of Trypanosoma cruzi among wild mammals in the surroundings and, consequently, where the risk of human infection exists. Serological diagnosis is the chosen method to identify T. cruzi infection in dogs that, in Brazil, rarely present positive parasitological tests. The use of recombinant chimeric parasitic antigens results in a sensitive and specific serological diagnostic test in contrast to the use of crude T. cruzi antigens. Our objective was to evaluate the Chagas/Bio-Manguinhos Lateral Flow Immunochromatographic Rapid Test (Chagas-LFRT) for the diagnosis of T. cruzi infection in domestic dogs and the potential of application of this diagnostic platform to wild canid species. Two recombinant proteins (IBMP-8.1 and IBMP-8.4) that displayed the best performance in the enzyme immunoassay (ELISA) in previous studies were tested in a platform with two diagnostic bands. A panel of 281 dog serum samples was evaluated: 133 positive for T. cruzi by serological diagnosis, including 20 samples with positive blood cultures belonging to different discrete typing units (DTUs); 129 negative samples; and 19 samples from dogs infected by other trypanosomatids: Leishmania infantum, Trypanosoma rangeli, Trypanosoma caninum and Crithidia mellificae, in addition to samples infected by Anaplasma platys, Dirofilaria immitis and Erlichia sp. that were employed to evaluate eventual cross-reactions. We also evaluated the Chagas-LFRT to detect T. cruzi infection in 9 serum samples from six wild canid species. We observed that the intensity pattern of the bands was directly proportional to the serological titer observed in IFAT. The sensitivity was 94%, the specificity was 91% according to the ROC curve, and the defined cutoff was an optical density of 4.8. The agreement obtained was considered substantial by the kappa analysis (84%). From T. cruzi positive hemoculture samples, 88.9% were positive by Chagas-LFRT. The test was efficient in recognizing infections by five of the six T. cruzi DTUs. Cross-reactions were not observed in infections by L. infantum, T. rangeli, T. caninum and D. immitis; however, they were observed in sera of dogs infected by Crithidia mellificae, Anaplasma sp. and Erlichia sp. A strong reaction was observed when serum samples from wild canids were submitted to the Protein A affinity test, confirming its applicability for these species. This test will allow rapid preventive actions in areas with high risk to the emergence of Chagas disease in a safer, reliable, low-cost and immediate manner, without the need for more complex laboratory tests.
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Affiliation(s)
- Esthefany S. Rodrigues
- Laboratory of Tripanosomatid Biology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
- Institutional Program for Initiation Scholarships in Technological Development and Innovation, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), National Council for Scientific and Technological Development (CNPq), Rio de Janeiro, Brazil
| | - Gilbert Q. Santos
- Pedagogical Coordination Section, Army Complementary Training School and Salvador Military College, EsFCEx, Salvador, Brazil
| | - Marlon Vicente da Silva
- Laboratory of Tripanosomatid Biology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Juliana H. S. Barros
- Laboratory of Tripanosomatid Biology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Aline R. Bernardo
- Diagnostic Technology Laboratory, Immunobiological Technology Institute (Bio-Manguinhos), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Rafaela L. Diniz
- Diagnostic Technology Laboratory, Immunobiological Technology Institute (Bio-Manguinhos), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Nara M. Rubim
- Diagnostic Technology Laboratory, Immunobiological Technology Institute (Bio-Manguinhos), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - André L. R. Roque
- Laboratory of Tripanosomatid Biology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
- Chagas Disease Translational Research Program, Fio-Chagas, Oswaldo Cruz Foundation, (FIOCRUZ), Rio de Janeiro, Brazil
| | - Ana Maria Jansen
- Laboratory of Tripanosomatid Biology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Edimilson D. Silva
- Diagnostic Technology Laboratory, Immunobiological Technology Institute (Bio-Manguinhos), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Samanta C. C. Xavier
- Laboratory of Tripanosomatid Biology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
- Chagas Disease Translational Research Program, Fio-Chagas, Oswaldo Cruz Foundation, (FIOCRUZ), Rio de Janeiro, Brazil
- *Correspondence: Samanta C. C. Xavier,
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Stability Assessment of Four Chimeric Proteins for Human Chagas Disease Immunodiagnosis. BIOSENSORS-BASEL 2021; 11:bios11080289. [PMID: 34436091 PMCID: PMC8391164 DOI: 10.3390/bios11080289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/25/2021] [Accepted: 07/26/2021] [Indexed: 12/24/2022]
Abstract
The performance of an immunoassay relies on antigen-antibody interaction; hence, antigen chemical stability and structural integrity are paramount for an efficient assay. We conducted a functional, thermostability and long-term stability analysis of different chimeric antigens (IBMP), in order to assess effects of adverse conditions on four antigens employed in ELISA to diagnose Chagas disease. ELISA-based immunoassays have served as a model for biosensors development, as both assess molecular interactions. To evaluate thermostability, samples were heated and cooled to verify heat-induced denaturation reversibility. In relation to storage stability, the antigens were analyzed at 25 °C at different moments. Long-term stability tests were performed using eight sets of microplates sensitized. Antigens were structurally analyzed through circular dichroism (CD), dynamic light scattering, SDS-PAGE, and functionally evaluated by ELISA. Data suggest that IBMP antigens are stable, over adverse conditions and for over a year. Daily analysis revealed minor changes in the molecular structure. Functionally, IBMP-8.2 and IBMP-8.3 antigens showed reactivity towards anti-T. cruzi antibodies, even after 72 h at 25 °C. Long-term stability tests showed that all antigens were comparable to the control group and all antigens demonstrated stability for one year. Data suggest that the antigens maintained their function and structural characteristics even in adverse conditions, making them a sturdy and reliable candidate to be employed in future in vitro diagnostic tests applicable to different models of POC devices, such as modern biosensors in development.
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Santos EF, Leony LM, Silva ÂAO, Daltro RT, Freitas NEM, Vasconcelos LCM, de Araújo FLV, Celedon PAF, Krieger MA, Zanchin NIT, Santos FLN. Assessment of Liaison XL Murex Chagas diagnostic performance in blood screening for Chagas disease using a reference array of chimeric antigens. Transfusion 2021; 61:2701-2709. [PMID: 34240750 PMCID: PMC9292309 DOI: 10.1111/trf.16583] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 06/23/2021] [Accepted: 06/23/2021] [Indexed: 12/12/2022]
Abstract
Background Chagas disease (CD) serological screening at blood banks is usually performed by a single highly sensitive serological assay, with chemiluminescent immunoassays (CLIAs) being the method of choice. CLIAs employ recombinant, fusion peptides and/or chimeric antigens that selectively capture anti‐Trypanosoma cruzi antibodies. However, despite high sensitivity, the ability of these tests to identify CD‐positive cases should be evaluated against T. cruzi strains circulating in specific locales. Herein, we used a latent class analysis (LCA) approach employing an array of four chimeric antigens to assess the diagnostic performance of the Liaison XL Murex Chagas CLIA for the detection of anti‐T. cruzi IgG in serum samples. Study Design and Methods The study included a panel of 5014 serum samples collected from volunteer blood donors at the Hematology and Hemotherapy Foundation of the State of Bahia, submitted to anti‐T. cruzi antibody detection using Liaison Chagas CLIA and LCA as a reference test in the absence of a gold standard. Results LCA classified 4993 samples as negative, while positivity for T. cruzi antibodies was predicted in 21 samples. Compared with LCA, CLIA demonstrated sensitivity and specificity of 76.2% and 99.5%, respectively, providing an overall accuracy of 99.4%. Discussion In blood banks lacking a de facto highly sensitive screening immunoassay, the low sensitivity offered by Liaison Chagas CLIA renders it unsuitable for standalone use in serological screening procedures for CD. Moreover, blood banks are encouraged to carefully assess the ability of diagnostic methods to identify local T. cruzi strains in circulation.
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Affiliation(s)
- Emily F Santos
- Advanced Public Health Laboratory, Gonçalo Moniz Institute (FIOCRUZ/BA), Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - Leonardo M Leony
- Advanced Public Health Laboratory, Gonçalo Moniz Institute (FIOCRUZ/BA), Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - Ângelo A O Silva
- Advanced Public Health Laboratory, Gonçalo Moniz Institute (FIOCRUZ/BA), Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - Ramona T Daltro
- Advanced Public Health Laboratory, Gonçalo Moniz Institute (FIOCRUZ/BA), Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - Natália E M Freitas
- Advanced Public Health Laboratory, Gonçalo Moniz Institute (FIOCRUZ/BA), Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - Larissa C M Vasconcelos
- Advanced Public Health Laboratory, Gonçalo Moniz Institute (FIOCRUZ/BA), Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - Fernando L V de Araújo
- Hematology and Hemotherapy Foundation of the State of Bahia (HEMOBA), Salvador, Bahia, Brazil
| | - Paola A F Celedon
- Molecular Biology Institute of Paraná (IBMP), Curitiba, Paraná, Brazil
| | - Marco A Krieger
- Molecular Biology Institute of Paraná (IBMP), Curitiba, Paraná, Brazil.,Carlos Chagas Institute (Fiocruz/PR), Oswaldo Cruz Foundation, Curitiba, Paraná, Brazil
| | - Nilson I T Zanchin
- Carlos Chagas Institute (Fiocruz/PR), Oswaldo Cruz Foundation, Curitiba, Paraná, Brazil
| | - Fred L N Santos
- Advanced Public Health Laboratory, Gonçalo Moniz Institute (FIOCRUZ/BA), Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
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16
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Cordeiro TAR, Martins HR, Franco DL, Santos FLN, Celedon PAF, Cantuária VL, de Lana M, Reis AB, Ferreira LF. Impedimetric immunosensor for rapid and simultaneous detection of chagas and visceral leishmaniasis for point of care diagnosis. Biosens Bioelectron 2020; 169:112573. [PMID: 32905944 DOI: 10.1016/j.bios.2020.112573] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/25/2020] [Accepted: 08/28/2020] [Indexed: 02/08/2023]
Abstract
In this work, a dual detection system based on an impedimetric immunosensor was developed for the first time for the simultaneous detection of anti-Trypanosoma cruzi and anti-Leishmania infantum antibodies in human and dog serum samples. The IBMP 8.1 and rLci1A/rLci2B recombinant antigens were immobilized over the surface of dual screen-printed carbon electrodes (W1 and W2) modified with poly (4-hydroxyphenylacetic acid). Under optimized conditions, the immunosensor recognized specific interactions for anti-T. cruzi antibodies up to a dilution of 1:10,240 and for anti-L. infantum up to 1:5120 in canine serum samples. Relative standard deviation (RSD) values of 2.8% for W1 and 3.6% for W2 were obtained for T. cruzi (W1) and L. infantum antigen (W2) samples in three different electrodes for 3 days (n = 9). The immunosensor was stored at 4 °C for 8 weeks, with activity retention of 70.2% in W1 and 78.2% in W2. The results using the recombinant proteins revealed that all antigens discriminated between negative and positive samples (p < 0.0001) in both dog and human groups, as well as no cross-reactivity could be detected among sera with other infections. With this approach, immunosensor-based diagnostic tests achieved 100% accuracy, suggesting that the antigens are eligible to enter Phase-II studies.
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Affiliation(s)
- Taís Aparecida Reis Cordeiro
- Institute of Science and Technology, Laboratory of Electrochemistry and Applied Nanotechnology, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
| | - Helen Rodrigues Martins
- Department of Pharmacy, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
| | - Diego Leoni Franco
- Institute of Chemistry, Group of Electrochemistry Applied to Polymers and Sensors, Laboratory of Electroanalytical Applied to Biotechnology and Food Engineering, Federal University of Uberlândia, Patos de Minas, Minas Gerais, Brazil
| | - Fred Luciano Neves Santos
- Advanced Laboratory of Public Health, Gonçalo Moniz Institute (IGM), FIOCRUZ-BA, Salvador, Bahia, Brazil
| | | | - Vinícius Lopes Cantuária
- Department of Pharmacy, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
| | - Marta de Lana
- Department of Clinical Analysis, School of Pharmacy, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Alexandre Barbosa Reis
- Department of Clinical Analysis, School of Pharmacy, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Lucas Franco Ferreira
- Institute of Science and Technology, Laboratory of Electrochemistry and Applied Nanotechnology, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil.
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Development of a New Lateral Flow Assay Based on IBMP-8.1 and IBMP-8.4 Chimeric Antigens to Diagnose Chagas Disease. BIOMED RESEARCH INTERNATIONAL 2020; 2020:1803515. [PMID: 32908871 PMCID: PMC7450325 DOI: 10.1155/2020/1803515] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/05/2020] [Accepted: 07/21/2020] [Indexed: 12/12/2022]
Abstract
Despite several available methodologies for Chagas disease (CD) serological screening, the main limitation of chronic CD diagnosis is the lack of effective tools for large-scale screening and point-of-care diagnosis to be used in different CD epidemiological scenarios. Taking into account that developing such a diagnostic tool will significantly improve the ability to identify CD carriers, we aimed at performing a proof-of-concept study (phase I study) to assess the use of these proteins in a point-of-care platform using serum samples from different geographical settings of Brazil and distinct clinical presentations. The diagnostic accuracy study was conducted on a panel of two WHO International Standards (IS) and 14 sera from T. cruzi-positive and 16 from T. cruzi-negative individuals. The results obtained with the test strips were converted to digital images, allowing quantitative comparison expressed as a relative band intensity ratio (RBI). The diagnostic potential and performance were also determined. Regardless of the geographical origin or clinical presentation, all sera with T. cruzi antibodies returned positive both for IBMP-8.1 and IBMP-8.4 chimeric antigens. The area under the ROC curve (AUC) values was 100% for both antigens, demonstrating an outstanding overall diagnostic accuracy (100%). Based on the data, we believe that the lateral flow assays based on these antigens are promising methodologies for screening CD.
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Leony LM, Freitas NEM, Del-Rei RP, Carneiro CM, Reis AB, Jansen AM, Xavier SCC, Gomes YM, Silva ED, Reis MG, Fraga DBM, Celedon PAF, Zanchin NIT, Dantas-Torres F, Santos FLN. Performance of recombinant chimeric proteins in the serological diagnosis of Trypanosoma cruzi infection in dogs. PLoS Negl Trop Dis 2019; 13:e0007545. [PMID: 31242195 PMCID: PMC6615644 DOI: 10.1371/journal.pntd.0007545] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 07/09/2019] [Accepted: 06/11/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Dogs are considered sentinels in areas of Trypanosoma cruzi transmission risk to humans. ELISA is generally the method of choice for diagnosing T. cruzi exposure in dogs, but its performance substantially depends on the antigenic matrix employed. In previous studies, our group has developed four chimeric antigens (IBMP-8.1, 8.2, 8.3, and 8.4) and evaluated their potential for diagnosing T. cruzi exposure in humans. For human sera, these chimeric antigens presented superior diagnostic performances as compared to commercial tests available in Brazil, Spain, and Argentina. Therefore, in this study we have evaluated the potential of these antigenic proteins for detection of anti-T. cruzi IgG antibodies in dog sera. METHODOLOGY/PRINCIPAL FINDINGS The IBMP-ELISA assays were optimized by checkerboard titration. Subsequently, the diagnostic potential was validated through analysis of ROC curves and the performance of the tests was determined using double entry tables. Cross-reactivity was also evaluated for babesiosis, ehrlichiosis, dirofilariosis, anaplasmosis, and visceral leishmaniasis. Best performance was shown by IBMP-8.3 and IBMP-8.4, although all four antigens demonstrated a high diagnostic performance with 46 positive and 149 negative samples tested. IBMP-8.3 demonstrated 100% sensitivity, followed by IBMP-8.4 (96.7-100%), IBMP-8.2 (73.3-87.5%), and IBMP-8.1 (50-100%). The highest specificities were achieved with IBMP-8.2 (100%) and IBMP-8.4 (100%), followed by IBMP-8.3 (96.7-97.5%) and IBMP 8.1 (89.1-100%). CONCLUSIONS/SIGNIFICANCE The use of chimeric antigenic matrices in immunoassays for anti-T. cruzi IgG antibody detection in sera of infected dogs was shown to be a promising tool for veterinary diagnosis and epidemiological studies. The chimeric antigens used in this work allowed also to overcome the common hurdles related to serodiagnosis of T. cruzi infection, especially regarding variation of efficiency parameters according to different strains and cross-reactivity with other infectious diseases.
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Affiliation(s)
- Leonardo M. Leony
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | | | | | - Claudia M. Carneiro
- Immunopathology Laboratory, Nucleus of Research in Biological Sciences, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Alexandre B. Reis
- Immunopathology Laboratory, Nucleus of Research in Biological Sciences, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Ana Maria Jansen
- Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Samanta C. C. Xavier
- Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Yara M. Gomes
- Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Recife, Pernambuco, Brazil
| | - Edmilson D. Silva
- Immunobiological Technology Institute, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mitermayer G. Reis
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
- Department of Pathology and Legal Medicine, Federal University of Bahia, Bahia, Brazil
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, Connecticut, United States of America
| | | | | | | | | | - Fred L. N. Santos
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
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Del-Rei RP, Leony LM, Celedon PAF, Zanchin NIT, dos Reis MG, Gomes YDM, Schijman AG, Longhi SA, Santos FLN. Detection of anti-Trypanosoma cruzi antibodies by chimeric antigens in chronic Chagas disease-individuals from endemic South American countries. PLoS One 2019; 14:e0215623. [PMID: 30998741 PMCID: PMC6472793 DOI: 10.1371/journal.pone.0215623] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 04/04/2019] [Indexed: 12/21/2022] Open
Abstract
Background Laboratory diagnosis of chronic Chagas disease is a troubling factor due to lack of reference tests. The WHO suggests the use of two distinct commercial serological tests in parallel. The performance of commercial immunoassays might fluctuate depending on the antigenic matrices and the local strains of T. cruzi in different geographical settings. The use of antigenic matrices based on chimeric proteins can solve these limitations. Here, we evaluated the diagnostic performance of two chimeric T. cruzi antigens (IBMP-8.1 and -8.4) to diagnose chronic Chagas disease in individuals from endemic South American countries. Methodology/Principal findings IBMP-8.1 and IBMP-8.4 chimeric antigens were expressed as soluble proteins in E. coli and purified using chromatography methods. Reactivity of IBMP-8.1 and IBMP-8.4 was assessed using an in-house ELISA with sera from 122 non-infected and 215 T. cruzi-infected individuals from Argentina, Bolivia, and Paraguay. Cut-off values were based on ROC curves and performance parameters were determined using a dichotomous approach. Area under the curve values were > 99.7% for both IBMP-8.1 and IBMP-8.4 antigens. IgG levels in T. cruzi-positive and negative samples were higher for IBMP-8.4 than IBMP-8.1. Both IBMP-8.1 and -8.4 were 100% specific, while IBMP-8.4 were 100% sensitive compared to IBMP-8.1 (95.3%). Admitting RI values of 1.0 ± 0.10 as the inconclusive interval, 6.2% of the samples tested using IBMP-8.1 and 2.1% using IBMP-8.4 fell inside the grey zone. Based on accuracy and diagnostic odds ratio values, IBMP-8.4 presented the best performance. Differences in sensitivity and IgG levels among the samples from Argentina, Bolivia, and Paraguay were not significant. Conclusions/Significance Our findings showed a notable performance of IBMP-8.1 and -8.4 chimeric antigens in diagnosing chronic Chagas disease in individuals from endemic South American countries, confirming our hypothesis that these antigens could be used in geographical areas where distinct T. cruzi DTUs occur.
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Affiliation(s)
| | | | | | | | - Mitermayer Galvão dos Reis
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
- Department of Pathology and Legal Medicine, Federal University of Bahia, Salvador, Bahia, Brazil
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, Connecticut, United States of America
| | | | - Alejandro Gabriel Schijman
- Laboratory of Molecular Biology of Chagas Disease, Institute for Research on Genetic Engineering and Molecular Biology “Dr Héctor Torres”, Buenos Aires, Argentina
| | - Silvia Andrea Longhi
- Laboratory of Molecular Biology of Chagas Disease, Institute for Research on Genetic Engineering and Molecular Biology “Dr Héctor Torres”, Buenos Aires, Argentina
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