Serodiagnosis of strongyloidiasis. The application and significance

Sato, Yoshiya; Kobayashi, Jun; Shiroma, Yoshiyuki

doi:10.1590/S0036-46651995000100006

Abstracts

Parasitological diagnosis based on the faecal examination is frequently difficult in cases of chronic, low-level S. stercoralis infection. Even when a newly developed sensitive method (an agar plate culture) is applied, it is essential to examine faecal samples repeatedly to achieve a correct diagnosis. Additionally, it is important to note that a negative result does not necessarily indicate the unequivocal absence of the infection. On the other hand, several serological tests which have recently been developed for strongyloidiasis have proven reliable when used to complement parasitological examination. We have developed two serological tests, ELISA and GPAT, to demonstrate Strongyloides infection and possible applications of the serological tests for diagnosis, mass-screening, epidemiological study and postchemotherapy evaluation of strongyloidiasis were reviewed based on our recent studies.

Strongyloidiasis; Strongyloides stercoralis; Serodiagnosis; ELISA; gelatin particle agglutination test (GPAT)

O diagnóstico parasitológico baseado no exame de fezes é muitas vezes difícil, principalmente nos casos de infecções crônicas ou leves pelo S. stercoralis. Mesmo utilizando o mais novo e sensível método (cultura em placas de ágar) é essencial examinar repetidamente as amostras fecais, para um diagnóstico correto. É importante ressaltar também que o resultado negativo não indica de modo inequívoco a ausência da infecção. Por outro lado, vários testes sorológicos recentemente desenvolvidos para estrongiloidíase tem provado a sua eficácia quando usados para complementar exames parasitológicos. Para demonstrar infecção por Strongyloides desenvolvemos dois tipos de testes sorológicos - ELISA e GPAT - e, com base em nossos recentes estudos, apresentamos uma opinião sobre sua possível aplicação para screening em massa, estudos epidemiológicos e avaliação pós-tratamento de estrongiloidíases.

SEROLOGY

Serodiagnosis of strongyloidiasis. The application and significance(^¹ (1 ) Presented at the 3rd Brazil-Japan Seminar of Gastroenterology - Gastrocentro/UNICAMP, held at Campinas, SP, Brazil, September 23-24, 1993. )

Aplicação e significado do diagnóstico sorológico na estrongiloidíase

Yoshiya Sato^I,II; Jun Kobayashi^I,III; Yoshiyuki Shiroma^IV

^IDepartment of Parasitology

^IIResearch Center of Comprehensive Medicine, School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-01, Japan

^IIILaboratório de Imuno-Parasitologia, Gastrocentro, Universidade Estadual de Campinas, SP, Brasil

^IVIzumizaki Hospital, Naha, Okinawa 901, Japan

^{Correspondence to} Correspondence to: Dr. Yoshiya Sato Departament of Parasitology, School of Medicine, Univerrsity of the Ryukyus 207 Nishihara Okinawa 903-01, Japan

SUMMARY

Parasitological diagnosis based on the faecal examination is frequently difficult in cases of chronic, low-level S. stercoralis infection. Even when a newly developed sensitive method (an agar plate culture) is applied, it is essential to examine faecal samples repeatedly to achieve a correct diagnosis. Additionally, it is important to note that a negative result does not necessarily indicate the unequivocal absence of the infection.

On the other hand, several serological tests which have recently been developed for strongyloidiasis have proven reliable when used to complement parasitological examination. We have developed two serological tests, ELISA and GPAT, to demonstrate Strongyloides infection and possible applications of the serological tests for diagnosis, mass-screening, epidemiological study and postchemotherapy evaluation of strongyloidiasis were reviewed based on our recent studies.

Keywords: Strongyloidiasis; Strongyloides stercoralis; Serodiagnosis; ELISA; gelatin particle agglutination test (GPAT).

RESUMO

O diagnóstico parasitológico baseado no exame de fezes é muitas vezes difícil, principalmente nos casos de infecções crônicas ou leves pelo S. stercoralis. Mesmo utilizando o mais novo e sensível método (cultura em placas de ágar) é essencial examinar repetidamente as amostras fecais, para um diagnóstico correto. É importante ressaltar também que o resultado negativo não indica de modo inequívoco a ausência da infecção.

Por outro lado, vários testes sorológicos recentemente desenvolvidos para estrongiloidíase tem provado a sua eficácia quando usados para complementar exames parasitológicos. Para demonstrar infecção por Strongyloides desenvolvemos dois tipos de testes sorológicos - ELISA e GPAT - e, com base em nossos recentes estudos, apresentamos uma opinião sobre sua possível aplicação para screening em massa, estudos epidemiológicos e avaliação pós-tratamento de estrongiloidíases.

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Recebido para publicação em 02/12/1993.

Aceito para publicação em 25/03/1994.

1. ARAKAKI, T.; HASEGAWA, H.; ASATO, R. et al. - A new method to detect Strongyloides stercoralis from human stool. J. trop. Med. Hyg., 16: 11-17, 1988.
2. BADARÓ, R.; CARVALHO, E.M.; SANTOS, R.B.; GAM, A.A. & GENTA, R.M. - Parasite-specific humoral immune responses in different clinical forms of strongyloidiasis. Trans. roy. Soc. trop. Med. Hyg., 81: 149-150, 1987.
3. BRANNON, M.C.J. & FAUST, E.C. - Preparation and testing of a specific antigen for diagnosis of human strongyloidiasis. Amer. J. trop. Med. Hyg., 29: 229-239, 1949.
4. CARROLL, S.M.; KARTHIGASU, K.T. & GROVE, D.I. - Serodiagnosis of human strongyloidiasis by an enzyme-linked immunosorbent assay. Trans. roy. Soc. trop. Med. Hyg., 75: 706-709, 1981.
5. COUDERT, J.; AMBROISE-THOMAS, P.; KIEN, T.T. & PATHIER, M.A. - Diagnostic sérologique de 1' anguillulose humaine par immunofluorescence (résultats préliminaires). Bull. Soc. Path. exot., 61: 74-80, 1969.
6. DAFALLA, A.A. - The indirect fluorescent antibody test for the serodiagnosis of strongyloidiasis. J. trop. Med. Hyg., 75: 109-111, 1972.
7. DAFALLA, A.A.; SATTI, M.H. & NUR, A.O. - Cutaneous larva migrans in Northern Kordofan, Sudan: a preliminary report. J. trop. Med. Hyg., 80: 63-67, 1977.
8. GAM, A.A.; NEVA, F.A. & KROTOSKI, W.A. - Comparative sensitivity and specificity of ELISA and 1HA for serodiagnosis of strongyloidiasis with larval antigens. Amer. J. trop. Med. Hyg., 37: 157-161, 1987.
9. GENTA, R.M. & WEIL, G.J. - Antibodies to Strongyloides stercoralis larval surface antigens in chronic strongyloidiasis. Lab. Invest., 47: 78-90, 1983.
10. GENTA, R.M. - Predictive value of an enzyme-linked immunosorbent assay (ELISA) for the serodiagnosis of strongyloidiasis. Amer. J. clin. Path., 89: 391-394, 1988.
11. GROVE, D.I. - Strongyloidiasis in allied exprisoners of war in Southeast Asia. Brit. med. J., 280: 598-601, 1980.
12. GROVE, D.I. & BLAIR, A.J. - Diagnosis of human strongyloidiasis by immunofluorescence using Strongyloides ratti and S. stercoralis larvae. Amer. J. trop. Med. Hyg., 30: 344-349, 1981.
13. GROVE, D.I. - Treatment of strongyloidiasis with thiabendazole: an analysis of toxicity and effectiveness. Trans. roy. Soc. trop. Med. Hyg., 76: 114-118, 1982.
14. JONES, C.A. & ABADIE, S.H. - Studies in human strongyloidiasis. II. A comparison of the efficiency of diagnosis by examination of feces and duodenal fluid. Amer. J. clin. Path., 24: 1154-1158, 1954.
15. KOBAYASHI, J.; SATO, Y.; TOMA, H.; TAKARA, M. & SHIROMA, Y. - Application of enzyme immunoassay for post-chemotherapy evaluation of human strongyloidiasis. Diagn. Microbiol. infect. Dis., 18: 1994. (in press).
16. MANGALI, A.; CHAICUMPA, W.; NONTASUT, P. et al. - Enzyme-linked immunosorbent assay for diagnosis of human strongyloidiasis. Southeast Asian J. trop. Med. publ. Hlth., 22: 88-92, 1991.
17. NEVA, F.A.; GAM, A.A. & BURKE, J. - Comparison of larval antigens in an enzyme-linked immunosorbent assay for strongyloidiasis in humans. J. infect. Dis., 144: 427-432, 1981.
18. RIFAAT, M.A.; SALEM, S.A.; ABDEL-AAR, T.M. & ATTIA, M.M. - Effect of temperature on the serological activity of the antigen of Strongyloides stercoralis. J. Egypt. Parasit., 9: 81-87, 1979.
19. SATO, Y.; TAKAI, A.; MAESHIRO, J.; OTSURU, M. & SHIROMA, Y. - Studies on the preparation of antigen and application of enzyme-linked immunosorbent assay (ELISA) to immunodiagnosis of strongyloidiasis. Ryukyu med. J., 6: 35-49, 1983.
20. SATO, Y.; TAKARA, M. & OTSURU, M. - Detection of antibodies in strongyloidiasis by enzyme-linked immunosorbent assay (ELISA). Trans. roy. Soc. trop. Med. Hyg., 79: 51-55, 1985.
21. SATO, Y.; OTSURU, M.; TAKARA, M. & SHIROMA, Y. - Intradermal reactions in strongyloidiasis. Int. J. Parasit., 16: 87-91, 1986.
22. SATO, Y.; INOUE, F.; KIYUNA, S. & SHIROMA, Y. - Immunoblot analysis of three antigen preparations from Strongyloides stercoralis larvae in human strongyloidiasis. Jap. J. Parasit., 39: 258-266, 1990.
23. SATO, Y.; INOUE, F.; MATSUYAMA, R. & SHIROMA, Y. - Immunoblot analysis of antibodies in human strongyloidiasis. Trans. roy. Soc. trop. Med. Hyg., 84: 403-406, 1990.
24. SATO, Y. & RYUMON, I. - Gelatin particle indirect agglutination test for serodiagnosis of human strongyloidiasis. Jap. J. Parasit., 39: 213-219, 1990.
25. SATO, Y.; TOMA, H.; TAKARA, M. & SHIROMA, Y. - Application of enzyme-linked immunosorbent assay for mass examination of strongyloidiasis in Okinawa, Japan. Int. J. Parasit., 20: 1025-1029, 1990.
26. SATO, Y.; TOMA, H.; KIYUNA, S. & SHIROMA, Y. - Gelatin particle indirect agglutination test for mass examination for strongyloidiasis. Trans. roy. Soc. trop. med. Hyg., 85: 515-518, 1991.
27. SCOWDEN, E.B.; SCHAFFNER, W. & STONE, W.J. - Overwhelming strongyloidiasis: an unappreciated opportunistic infection. Medicine (Baltimore), 57: 527-544, 1978.
28. TAKARA, M.; TOMA, H.; KOBAYASHI, J. & SATO, Y. - Effect of concurrent HTLV-I infection on the efficacy of pyrvinium pamoate treatment of strongyloidiasis. Jap. J. Parasit., 41: 202-212, 1992.
29. TRIBOULEY-DURET, J.; TRIBOULEY, J. & PAUTR1ZEL, R. - Intéręt des tests d'allergie cutanée pour le diagnostic de la strongyloidose. Bull. Soc. Path. exot., 69: 360-367, 1976.
30. TRIBOULEY-DURET, J.; TRIBOULEY, J.; APPRIOU, M. & MEGRAUD, R.N. - Application de test E.L.I.S.A. au diagnostic de la strongyloidose. Ann. Parasit. hum. comp., 53: 641-648, 1978.

Correspondence to:

Dr. Yoshiya Sato

Departament of Parasitology, School of Medicine, Univerrsity of the Ryukyus

207 Nishihara

Okinawa 903-01, Japan

(1

) Presented at the 3rd Brazil-Japan Seminar of Gastroenterology - Gastrocentro/UNICAMP, held at Campinas, SP, Brazil, September 23-24, 1993.

Publication Dates

Publication in this collection
22 Feb 2007
Date of issue
Feb 1995

History

Accepted
25 Mar 1994
Received
02 Dec 1993

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ARAKAKI, T.; HASEGAWA, H.; ASATO, R. et al. - A new method to detect Strongyloides stercoralis from human stool. J. trop. Med. Hyg., 16: 11-17, 1988.

[2] 2. BADARÓ, R.; CARVALHO, E.M.; SANTOS, R.B.; GAM, A.A. & GENTA, R.M. - Parasite-specific humoral immune responses in different clinical forms of strongyloidiasis. Trans. roy. Soc. trop. Med. Hyg., 81: 149-150, 1987.

[3] 3. BRANNON, M.C.J. & FAUST, E.C. - Preparation and testing of a specific antigen for diagnosis of human strongyloidiasis. Amer. J. trop. Med. Hyg., 29: 229-239, 1949.

[4] 4. CARROLL, S.M.; KARTHIGASU, K.T. & GROVE, D.I. - Serodiagnosis of human strongyloidiasis by an enzyme-linked immunosorbent assay. Trans. roy. Soc. trop. Med. Hyg., 75: 706-709, 1981.

[5] 5. COUDERT, J.; AMBROISE-THOMAS, P.; KIEN, T.T. & PATHIER, M.A. - Diagnostic sérologique de 1' anguillulose humaine par immunofluorescence (résultats préliminaires). Bull. Soc. Path. exot., 61: 74-80, 1969.

[6] 6. DAFALLA, A.A. - The indirect fluorescent antibody test for the serodiagnosis of strongyloidiasis. J. trop. Med. Hyg., 75: 109-111, 1972.

[7] 7. DAFALLA, A.A.; SATTI, M.H. & NUR, A.O. - Cutaneous larva migrans in Northern Kordofan, Sudan: a preliminary report. J. trop. Med. Hyg., 80: 63-67, 1977.

[8] 8. GAM, A.A.; NEVA, F.A. & KROTOSKI, W.A. - Comparative sensitivity and specificity of ELISA and 1HA for serodiagnosis of strongyloidiasis with larval antigens. Amer. J. trop. Med. Hyg., 37: 157-161, 1987.

[9] 9. GENTA, R.M. & WEIL, G.J. - Antibodies to Strongyloides stercoralis larval surface antigens in chronic strongyloidiasis. Lab. Invest., 47: 78-90, 1983.

[10] 10. GENTA, R.M. - Predictive value of an enzyme-linked immunosorbent assay (ELISA) for the serodiagnosis of strongyloidiasis. Amer. J. clin. Path., 89: 391-394, 1988.

[11] 11. GROVE, D.I. - Strongyloidiasis in allied exprisoners of war in Southeast Asia. Brit. med. J., 280: 598-601, 1980.

[12] 12. GROVE, D.I. & BLAIR, A.J. - Diagnosis of human strongyloidiasis by immunofluorescence using Strongyloides ratti and S. stercoralis larvae. Amer. J. trop. Med. Hyg., 30: 344-349, 1981.

[13] 13. GROVE, D.I. - Treatment of strongyloidiasis with thiabendazole: an analysis of toxicity and effectiveness. Trans. roy. Soc. trop. Med. Hyg., 76: 114-118, 1982.

[14] 14. JONES, C.A. & ABADIE, S.H. - Studies in human strongyloidiasis. II. A comparison of the efficiency of diagnosis by examination of feces and duodenal fluid. Amer. J. clin. Path., 24: 1154-1158, 1954.

[15] 15. KOBAYASHI, J.; SATO, Y.; TOMA, H.; TAKARA, M. & SHIROMA, Y. - Application of enzyme immunoassay for post-chemotherapy evaluation of human strongyloidiasis. Diagn. Microbiol. infect. Dis., 18: 1994. (in press).

[16] 16. MANGALI, A.; CHAICUMPA, W.; NONTASUT, P. et al. - Enzyme-linked immunosorbent assay for diagnosis of human strongyloidiasis. Southeast Asian J. trop. Med. publ. Hlth., 22: 88-92, 1991.

[17] 17. NEVA, F.A.; GAM, A.A. & BURKE, J. - Comparison of larval antigens in an enzyme-linked immunosorbent assay for strongyloidiasis in humans. J. infect. Dis., 144: 427-432, 1981.

[18] 18. RIFAAT, M.A.; SALEM, S.A.; ABDEL-AAR, T.M. & ATTIA, M.M. - Effect of temperature on the serological activity of the antigen of Strongyloides stercoralis. J. Egypt. Parasit., 9: 81-87, 1979.

[19] 19. SATO, Y.; TAKAI, A.; MAESHIRO, J.; OTSURU, M. & SHIROMA, Y. - Studies on the preparation of antigen and application of enzyme-linked immunosorbent assay (ELISA) to immunodiagnosis of strongyloidiasis. Ryukyu med. J., 6: 35-49, 1983.

[20] 20. SATO, Y.; TAKARA, M. & OTSURU, M. - Detection of antibodies in strongyloidiasis by enzyme-linked immunosorbent assay (ELISA). Trans. roy. Soc. trop. Med. Hyg., 79: 51-55, 1985.

[21] 21. SATO, Y.; OTSURU, M.; TAKARA, M. & SHIROMA, Y. - Intradermal reactions in strongyloidiasis. Int. J. Parasit., 16: 87-91, 1986.

[22] 22. SATO, Y.; INOUE, F.; KIYUNA, S. & SHIROMA, Y. - Immunoblot analysis of three antigen preparations from Strongyloides stercoralis larvae in human strongyloidiasis. Jap. J. Parasit., 39: 258-266, 1990.

[23] 23. SATO, Y.; INOUE, F.; MATSUYAMA, R. & SHIROMA, Y. - Immunoblot analysis of antibodies in human strongyloidiasis. Trans. roy. Soc. trop. Med. Hyg., 84: 403-406, 1990.

[24] 24. SATO, Y. & RYUMON, I. - Gelatin particle indirect agglutination test for serodiagnosis of human strongyloidiasis. Jap. J. Parasit., 39: 213-219, 1990.

[25] 25. SATO, Y.; TOMA, H.; TAKARA, M. & SHIROMA, Y. - Application of enzyme-linked immunosorbent assay for mass examination of strongyloidiasis in Okinawa, Japan. Int. J. Parasit., 20: 1025-1029, 1990.

[26] 26. SATO, Y.; TOMA, H.; KIYUNA, S. & SHIROMA, Y. - Gelatin particle indirect agglutination test for mass examination for strongyloidiasis. Trans. roy. Soc. trop. med. Hyg., 85: 515-518, 1991.

[27] 27. SCOWDEN, E.B.; SCHAFFNER, W. & STONE, W.J. - Overwhelming strongyloidiasis: an unappreciated opportunistic infection. Medicine (Baltimore), 57: 527-544, 1978.

[28] 28. TAKARA, M.; TOMA, H.; KOBAYASHI, J. & SATO, Y. - Effect of concurrent HTLV-I infection on the efficacy of pyrvinium pamoate treatment of strongyloidiasis. Jap. J. Parasit., 41: 202-212, 1992.

[29] 29. TRIBOULEY-DURET, J.; TRIBOULEY, J. & PAUTR1ZEL, R. - Intéręt des tests d'allergie cutanée pour le diagnostic de la strongyloidose. Bull. Soc. Path. exot., 69: 360-367, 1976.

[30] 30. TRIBOULEY-DURET, J.; TRIBOULEY, J.; APPRIOU, M. & MEGRAUD, R.N. - Application de test E.L.I.S.A. au diagnostic de la strongyloidose. Ann. Parasit. hum. comp., 53: 641-648, 1978.