Immunohistochemical diagnosis of human infectious diseases: a review

Hamadou Oumarou Hama,Hubert Lepidi,Rémi Barbieri,Gérard Aboudharam,Michel Drancourt

doi:10.1186/s13000-022-01197-5

Abstract

BackgroundImmunohistochemistry (IHC) using monoclonal and polyclonal antibodies is a useful diagnostic method for detecting pathogen antigens in fixed tissues, complementing the direct diagnosis of infectious diseases by PCR and culture on fresh tissues. It was first implemented in a seminal publication by Albert Coons in 1941.Main bodyOf 14,198 publications retrieved from the PubMed, Google, Google Scholar and Science Direct databases up to December 2021, 230 were selected for a review of IHC techniques, protocols and results. The methodological evolutions of IHC and its application to the diagnosis of infectious diseases, more specifically lice-borne diseases, sexually transmitted diseases and skin infections, were critically examined. A total of 59 different pathogens have been detected once in 22 different tissues and organs; and yet non-cultured, fastidious and intracellular pathogens accounted for the vast majority of pathogens detected by IHC. Auto-IHC, incorporating patient serum as the primary antibody, applied to diseased heart valves surgically collected from blood culture-negative endocarditis patients, detected unidentified Gram-positive cocci and microorganisms which were subsequently identified as Coxiella burnetii, Bartonella quintana, Bartonella henselae and Tropheryma whipplei. The application of IHC to ancient tissues dated between the ends of the Ptolemaic period to over 70 years ago, have also contributed to paleomicrobiology diagnoses.ConclusionIHC plays an important role in diagnostic of infectious diseases in tissue samples. Paleo-auto-IHC derived from auto-IHC, is under development for detecting non-identified pathogens from ancient specimens.

Highlights

Diagnosis of infectious diseases is fundamentally based on the isolation by culture of the causative pathogen and isolation by culture of pathogens remains the gold standard method for the laboratory diagnosis of infectious diseases [1]
As the antigens had been recovered from ancient paraffin blocks and mummified bodies, the preservation of antigenic epitopes dating back at least a century has been demonstrated by immunohistochemical staining, despite the degradation of certain antigenic determinants in ancient tissues [6, 10]
We review immunohistochemistry techniques and protocols as applied to the diagnosis of infectious diseases, including past infections in the context of paleomicrobiology

Summary

Introduction

Diagnosis of infectious diseases is fundamentally based on the isolation by culture of the causative pathogen and isolation by culture of pathogens remains the gold standard method for the laboratory diagnosis of infectious diseases [1]. The application of monoclonal or polyclonal antibodies to viral, bacterial or fungal antigens in order to characterise infectious agents in immunohistochemistry is routinely used in the diagnosis of many infectious diseases [4–6].

Results

Conclusion