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Diagnostic performance of Strongyloides-specific IgG4 detection in urine for diagnosis of human strongyloidiasis

BACKGROUND: Detection of parasite-specific IgG in urine is a sensitive method for diagnosis of strongyloidiasis and gives similar accuracy to serum IgG. However, there are no data concerning detection of IgG subclass in urine. To further explore the utility of diagnosis from urine samples, we evalua...

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Autores principales: Wongphutorn, Phattharaphon, Worasith, Chanika, Kopolrat, Kulthida Y., Homwong, Chutima, Sithithaworn, Jiraporn, Eamudomkarn, Chatanun, Techasen, Anchalee, Tippayawat, Patcharaporn, Pitaksakurat, Opal, Hongsrichan, Nuttanan, Crellen, Thomas, Sithithaworn, Paiboon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10464225/
https://www.ncbi.nlm.nih.gov/pubmed/37641157
http://dx.doi.org/10.1186/s13071-023-05935-6
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author Wongphutorn, Phattharaphon
Worasith, Chanika
Kopolrat, Kulthida Y.
Homwong, Chutima
Sithithaworn, Jiraporn
Eamudomkarn, Chatanun
Techasen, Anchalee
Tippayawat, Patcharaporn
Pitaksakurat, Opal
Hongsrichan, Nuttanan
Crellen, Thomas
Sithithaworn, Paiboon
author_facet Wongphutorn, Phattharaphon
Worasith, Chanika
Kopolrat, Kulthida Y.
Homwong, Chutima
Sithithaworn, Jiraporn
Eamudomkarn, Chatanun
Techasen, Anchalee
Tippayawat, Patcharaporn
Pitaksakurat, Opal
Hongsrichan, Nuttanan
Crellen, Thomas
Sithithaworn, Paiboon
author_sort Wongphutorn, Phattharaphon
collection PubMed
description BACKGROUND: Detection of parasite-specific IgG in urine is a sensitive method for diagnosis of strongyloidiasis and gives similar accuracy to serum IgG. However, there are no data concerning detection of IgG subclass in urine. To further explore the utility of diagnosis from urine samples, we evaluated the diagnostic performance of IgG4 in urine compared with parasitological and other immunological methods. METHODS: The urine and sera included proven strongyloidiasis (group 1, n = 93), other parasitic infections (group 2, n = 40) and parasite negatives (group 3, n = 93). The performance of Strongyloides-specific IgG4 in urine for diagnosis of strongyloidiasis using fecal examinations as the reference standard was assessed. RESULTS: With fecal examination as a gold standard, Strongyloides-specific IgG4 in urine had 91.4% sensitivity and 93.2% specificity while serum IgG4 had 93.6% sensitivity and 91.0% specificity. IgG4 in both urine and serum had almost perfect diagnostic agreements with fecal examination (Cohen's kappa coefficient was > 0.8). Cross-reactivity to Opisthorchis viverrini and Taenia spp. of IgG4 in urine were 7.5% and 12.5% in serum. Concurrent analyses of total IgG in urine and serum showed that the sensitivities (97.9–100%) and specificities (88.7–91.0%) were similar (P > 0.05). The sensitivity for parasitological examination by the formalin-ethyl acetate concentration technique (FECT) was 49.5% and that for agar plate culture technique (APC) it was 92.6%. CONCLUSION: Our findings showed that specific IgG4 detection in urine yielded similar diagnostic performance to the same biomarkers in serum. This suggests that accurate diagnosis of strongyloidiasis can be performed using urine samples and IgG4 is a valid choice of diagnostic marker. Further assessment is required to assess the utility of urine IgG4 for measuring the response treatment in strongyloidiasis. GRAPHICAL ABSTRACT: [Image: see text] SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13071-023-05935-6.
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spelling pubmed-104642252023-08-30 Diagnostic performance of Strongyloides-specific IgG4 detection in urine for diagnosis of human strongyloidiasis Wongphutorn, Phattharaphon Worasith, Chanika Kopolrat, Kulthida Y. Homwong, Chutima Sithithaworn, Jiraporn Eamudomkarn, Chatanun Techasen, Anchalee Tippayawat, Patcharaporn Pitaksakurat, Opal Hongsrichan, Nuttanan Crellen, Thomas Sithithaworn, Paiboon Parasit Vectors Research BACKGROUND: Detection of parasite-specific IgG in urine is a sensitive method for diagnosis of strongyloidiasis and gives similar accuracy to serum IgG. However, there are no data concerning detection of IgG subclass in urine. To further explore the utility of diagnosis from urine samples, we evaluated the diagnostic performance of IgG4 in urine compared with parasitological and other immunological methods. METHODS: The urine and sera included proven strongyloidiasis (group 1, n = 93), other parasitic infections (group 2, n = 40) and parasite negatives (group 3, n = 93). The performance of Strongyloides-specific IgG4 in urine for diagnosis of strongyloidiasis using fecal examinations as the reference standard was assessed. RESULTS: With fecal examination as a gold standard, Strongyloides-specific IgG4 in urine had 91.4% sensitivity and 93.2% specificity while serum IgG4 had 93.6% sensitivity and 91.0% specificity. IgG4 in both urine and serum had almost perfect diagnostic agreements with fecal examination (Cohen's kappa coefficient was > 0.8). Cross-reactivity to Opisthorchis viverrini and Taenia spp. of IgG4 in urine were 7.5% and 12.5% in serum. Concurrent analyses of total IgG in urine and serum showed that the sensitivities (97.9–100%) and specificities (88.7–91.0%) were similar (P > 0.05). The sensitivity for parasitological examination by the formalin-ethyl acetate concentration technique (FECT) was 49.5% and that for agar plate culture technique (APC) it was 92.6%. CONCLUSION: Our findings showed that specific IgG4 detection in urine yielded similar diagnostic performance to the same biomarkers in serum. This suggests that accurate diagnosis of strongyloidiasis can be performed using urine samples and IgG4 is a valid choice of diagnostic marker. Further assessment is required to assess the utility of urine IgG4 for measuring the response treatment in strongyloidiasis. GRAPHICAL ABSTRACT: [Image: see text] SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13071-023-05935-6. BioMed Central 2023-08-28 /pmc/articles/PMC10464225/ /pubmed/37641157 http://dx.doi.org/10.1186/s13071-023-05935-6 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Wongphutorn, Phattharaphon
Worasith, Chanika
Kopolrat, Kulthida Y.
Homwong, Chutima
Sithithaworn, Jiraporn
Eamudomkarn, Chatanun
Techasen, Anchalee
Tippayawat, Patcharaporn
Pitaksakurat, Opal
Hongsrichan, Nuttanan
Crellen, Thomas
Sithithaworn, Paiboon
Diagnostic performance of Strongyloides-specific IgG4 detection in urine for diagnosis of human strongyloidiasis
title Diagnostic performance of Strongyloides-specific IgG4 detection in urine for diagnosis of human strongyloidiasis
title_full Diagnostic performance of Strongyloides-specific IgG4 detection in urine for diagnosis of human strongyloidiasis
title_fullStr Diagnostic performance of Strongyloides-specific IgG4 detection in urine for diagnosis of human strongyloidiasis
title_full_unstemmed Diagnostic performance of Strongyloides-specific IgG4 detection in urine for diagnosis of human strongyloidiasis
title_short Diagnostic performance of Strongyloides-specific IgG4 detection in urine for diagnosis of human strongyloidiasis
title_sort diagnostic performance of strongyloides-specific igg4 detection in urine for diagnosis of human strongyloidiasis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10464225/
https://www.ncbi.nlm.nih.gov/pubmed/37641157
http://dx.doi.org/10.1186/s13071-023-05935-6
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