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Diagnosis of gnathostomiasis by skin testing using partially purified specific antigen and total IgE levels.

AbstractBACKGROUND:
A finding of antibodies to Gnathostoma spinigerum 24-kDa antigen by immunoblot analysis is currently used to confirm a diagnosis of gnathostomiasis. A simple skin test for the diagnosis of gnathostomiasis was developed, and the results were evaluated and compared with the standard Western blot (WB) test.
METHODS:
This cross-sectional study was conducted at the Hospital for Tropical Diseases, Bangkok, Thailand, in 2008-2011. All eligible patients were tested with partially purified proteins of mAb-detected fractions pooled and sterilized by 0.2 μm diameter syringe filter, with a phenol saline solution of 1:10 w/v.
RESULTS:
A total of 69 cases, 39 gnathostomiasis cases and 30 controls, were enrolled into the study; the median age (IQR) was 40 (30.5-52.5) years. The most common presenting symptom was edema (56/69, 81%). Gnathostomiasis cases having strong cutaneous reactions to the intradermal test (81%) were also positive by immunoblot. A significant correlation between skin and immunoblot tests was detected (p<0.001). The difference in total IgE levels between cases and controls was not statistically significant (p=0.51). Logistic regression models showed that positive WB and skin-test results were significantly associated with gnathostomiasis (p=0.001 and p=0.007, respectively).
CONCLUSION:
Gnathostoma skin testing, using prepared fractionated antigen solution of Gnathostoma spinigerum, yields good reactivity and significantly correlates with the results of immunoblot testing.
AuthorsWirach Maek-A-Nantawat, Valai Bussaratid, Benjaluck Phonrat, Wallop Pakdee, Supaporn Nuamtanong, Paron Dekumyoy
JournalTransactions of the Royal Society of Tropical Medicine and Hygiene (Trans R Soc Trop Med Hyg) Vol. 108 Issue 2 Pg. 71-6 (Feb 2014) ISSN: 1878-3503 [Electronic] England
PMID24463581 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Antigens, Bacterial
  • Immunoglobulin E
Topics
  • Adult
  • Antibody Specificity
  • Antigens, Bacterial (immunology)
  • Case-Control Studies
  • Cross-Sectional Studies
  • Female
  • Gnathostomiasis (diagnosis, immunology)
  • Humans
  • Immunoglobulin E (analysis)
  • Logistic Models
  • Male
  • Middle Aged
  • Sensitivity and Specificity
  • Skin Tests (methods)
  • Thailand

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