Accuracy of an experimental whole-blood test for detecting reactivation of echinococcal cysts.

<h4>Background</h4>Cystic echinococcosis (CE) is a complex disease for which clear understanding of clinical manifestations is needed to avoid misdiagnosis, inappropriate treatment, and severe complications. We evaluated the accuracy of a whole-blood stimulation test based on Interleukin...

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Autores principales:	Linda Petrone, Francesca Tamarozzi, Ambra Vola, Maria Angeles Gomez Morales, Alessandra Ludovisi, Saeid Najafi Fard, Mara Mariconti, Enrico Brunetti, Delia Goletti
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/087fbe7e5b1447d2aa6439396095cda3
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spelling	oai:doaj.org-article:087fbe7e5b1447d2aa6439396095cda32021-12-02T20:23:37ZAccuracy of an experimental whole-blood test for detecting reactivation of echinococcal cysts.1935-27271935-273510.1371/journal.pntd.0009648https://doaj.org/article/087fbe7e5b1447d2aa6439396095cda32021-08-01T00:00:00Zhttps://doi.org/10.1371/journal.pntd.0009648https://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735<h4>Background</h4>Cystic echinococcosis (CE) is a complex disease for which clear understanding of clinical manifestations is needed to avoid misdiagnosis, inappropriate treatment, and severe complications. We evaluated the accuracy of a whole-blood stimulation test based on Interleukin (IL)-4 detection in response to Antigen B (AgB) of Echinococcus granulosus sensu lato to discriminate cyst viability and detect cyst reactivation in patients with hepatic CE.<h4>Methodology/principal findings</h4>Thirty patients with CE3b cysts and 37 patients with spontaneously-inactivated CE4-CE5 cysts were recruited (T0). After enrollment, 5 patients with CE3b cysts received albendazole, resulting in cyst solidification (CE4) in 4/5. Within a two-year follow-up, the whole-blood test was repeated at two time-points, in ≥14 (T1) and in ≥4 (T2) patients per group. IL-4 and a panel of other soluble factors were measured in the stimulated plasma. Baseline IL-4 levels were significantly higher in patients with CE3b compared to those with CE4 cysts (p = 0.006). Test accuracy for CE3b diagnosis had a sensitivity of 33-60% and a specificity of 76-95%, depending on the cut-off applied. Overall, IL-4 levels did not change significantly over time in either group; however, patients within the CE3b group showed a significant decrease of IL-1ra, IL-6, IL-8, G-CSF, IFN-γ, IP-10, MCP-1, MIP-1α, FGF at T1 compared to T0 (p≤0.042).<h4>Conclusions/significance</h4>Whole-blood IL-4-response to AgB is significantly higher in patients with active compared to inactive CE but apparently not modulated over time after treatment. On the contrary, the levels of IL-1ra, IL-6, IL-8, G-CSF, IFN-γ, IP-10, MCP-1, MIP-1α, FGF significantly decreased in active CE during follow-up. Additional studies are needed to understand whether these findings might have a clinical significance for patients' follow-up.Linda PetroneFrancesca TamarozziAmbra VolaMaria Angeles Gomez MoralesAlessandra LudovisiSaeid Najafi FardMara MaricontiEnrico BrunettiDelia GolettiPublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 15, Iss 8, p e0009648 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
spellingShingle	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Linda Petrone Francesca Tamarozzi Ambra Vola Maria Angeles Gomez Morales Alessandra Ludovisi Saeid Najafi Fard Mara Mariconti Enrico Brunetti Delia Goletti Accuracy of an experimental whole-blood test for detecting reactivation of echinococcal cysts.
description	<h4>Background</h4>Cystic echinococcosis (CE) is a complex disease for which clear understanding of clinical manifestations is needed to avoid misdiagnosis, inappropriate treatment, and severe complications. We evaluated the accuracy of a whole-blood stimulation test based on Interleukin (IL)-4 detection in response to Antigen B (AgB) of Echinococcus granulosus sensu lato to discriminate cyst viability and detect cyst reactivation in patients with hepatic CE.<h4>Methodology/principal findings</h4>Thirty patients with CE3b cysts and 37 patients with spontaneously-inactivated CE4-CE5 cysts were recruited (T0). After enrollment, 5 patients with CE3b cysts received albendazole, resulting in cyst solidification (CE4) in 4/5. Within a two-year follow-up, the whole-blood test was repeated at two time-points, in ≥14 (T1) and in ≥4 (T2) patients per group. IL-4 and a panel of other soluble factors were measured in the stimulated plasma. Baseline IL-4 levels were significantly higher in patients with CE3b compared to those with CE4 cysts (p = 0.006). Test accuracy for CE3b diagnosis had a sensitivity of 33-60% and a specificity of 76-95%, depending on the cut-off applied. Overall, IL-4 levels did not change significantly over time in either group; however, patients within the CE3b group showed a significant decrease of IL-1ra, IL-6, IL-8, G-CSF, IFN-γ, IP-10, MCP-1, MIP-1α, FGF at T1 compared to T0 (p≤0.042).<h4>Conclusions/significance</h4>Whole-blood IL-4-response to AgB is significantly higher in patients with active compared to inactive CE but apparently not modulated over time after treatment. On the contrary, the levels of IL-1ra, IL-6, IL-8, G-CSF, IFN-γ, IP-10, MCP-1, MIP-1α, FGF significantly decreased in active CE during follow-up. Additional studies are needed to understand whether these findings might have a clinical significance for patients' follow-up.
format	article
author	Linda Petrone Francesca Tamarozzi Ambra Vola Maria Angeles Gomez Morales Alessandra Ludovisi Saeid Najafi Fard Mara Mariconti Enrico Brunetti Delia Goletti
author_facet	Linda Petrone Francesca Tamarozzi Ambra Vola Maria Angeles Gomez Morales Alessandra Ludovisi Saeid Najafi Fard Mara Mariconti Enrico Brunetti Delia Goletti
author_sort	Linda Petrone
title	Accuracy of an experimental whole-blood test for detecting reactivation of echinococcal cysts.
title_short	Accuracy of an experimental whole-blood test for detecting reactivation of echinococcal cysts.
title_full	Accuracy of an experimental whole-blood test for detecting reactivation of echinococcal cysts.
title_fullStr	Accuracy of an experimental whole-blood test for detecting reactivation of echinococcal cysts.
title_full_unstemmed	Accuracy of an experimental whole-blood test for detecting reactivation of echinococcal cysts.
title_sort	accuracy of an experimental whole-blood test for detecting reactivation of echinococcal cysts.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/087fbe7e5b1447d2aa6439396095cda3
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Accuracy of an experimental whole-blood test for detecting reactivation of echinococcal cysts.

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