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Alveolar echinococcosis (AE) is one of the most lethal zoonotic parasitic infections. The diagnosis is based on the combination of the abdominal imaging including CT, MRI and PET, and serology. To develop a new diagnostic tool for AE with urine as samples, mouse-Echinococcus multilocularis (Em) model and then human cases were studied. The antibody levels of urine and serum samples from the infected mice and AE cases were well correlated with each other. The sensitivity and specificity of the method with urine were 91% and 98%, respectively, when IgG4 to crude Em was examined. Comparing with serum samples, the collection of urine is easier and safer and the urine diagnostic tool makes surveys of this silent disease easier., (© 2013.)

The performance of a rapid and simple immunochromatographic test (ICT) with recombinant Em18 (rEm18) antigen for serological follow-up of Echinococcus multilocularis infection was evaluated by comparison with that of an enzyme-linked immunosorbent assay (ELISA) with rEm18, using serum samples from patients who underwent surgery and/or received antiparasitic chemotherapy. The degree of Em18-band intensity on the ICT correlated highly with the absorbance value obtained by the ELISA. The kinetics of antibody levels obtained by the ICT paralleled those of the ELISA. These data suggest that the ICT has high potential as an easy-to-handle, fast, and reliable follow-up tool to monitor the status of alveolar echinococcosis in different stages.

We compared four enzyme-linked immunosorbent assays (ELISAs) with 172 serum samples from 28 patients with alveolar echinococcosis in different clinical stages according to the World Health Organization-PNM (P = parasitic mass in the liver, N = involvement of neighboring organs, M = metastasis) staging system. The sequential antibody responses against Em (2plus), Em10, and Em18 antigens, and a crude antigen extract were measured in cohorts with resected and unresected lesions. Antibody levels in all assays correlated with the PNM stage before treatment, and the highest correlation was shown for the Em18 assay. The PNM stage did not influence the antibody kinetics, but changes in antibody levels depended on the treatment. In patients after curative surgery, seroreversion in the Em (2plus) ELISA indicated successful resection of lesions in more patients than any other assay, irrespective of the clinical stage. There were no significant differences in the time before assays that use recombinant or purified antigens became unreactive. Antibodies directed against crude antigens were detectable longer than other antibodies in all patient cohorts and stages.