Abstract
Cystic echinococcosis (CE) is an important helminthic zoonotic disease caused by the Echinococcus granulosus complex. In humans, CE is a chronic disease driven by the growth of echinococcal cysts in different organs. Prognosis of this disease depends on multiple factors, including location, number, size, and stage of the cysts, making CE a disease of complex management. CE is usually asymptomatic for years and attracts limited attention from funding organizations and health authorities. For this reason, only experts' recommendations are available but no evidence-based conclusions have been drawn for CE clinical management. One of those pitfalls refers to the lack of evidence to support the use of serological tools for the diagnosis and follow-up of CE patients. In this respect, crude antigens are used to detect specific antibodies in patients, giving rise to false positive results. The advent of molecular techniques allowing the production of recombinant proteins has provided a number of candidate antigens that could overcome the problems associated with the use of crude parasite extracts in the serological assays. In this review, we present the last advances in this field, proposing the use of serology to support cyst stage-specific diagnosis and follow-up.
Highlights
Cystic echinococcosis (CE) is a parasitic disease caused by the larval stage of Echinococcus granulosus complex which affects livestock, wildlife, and humans
Specific recombinant antigens have good potential as diagnostic and follow-up tools for CE, but progress in this field is hampered by lack of standardization
A challenge still exists to develop a reliable world standard based on serology for the diagnosis and monitoring of CE patients
Summary
Cystic echinococcosis (CE) is a parasitic disease caused by the larval stage (metacestode) of Echinococcus granulosus complex which affects livestock, wildlife, and humans. There are hints showing that some antigens are differentially expressed in different cyst stages, and antibody levels against these antigens could be associated with cyst activity and posttreatment outcome (i.e., surgery or chemotherapy) and could be applied for diagnosis and follow-up of CE patients [9, 10]. In this context, a better characterization and standardization of each antigen should be performed to clearly define its role within CE serology. We update the findings about the available serological tools from 2006 to date
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