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

BACKGROUND: 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 i...

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Autores principales: Petrone, Linda, Tamarozzi, Francesca, Vola, Ambra, Gomez Morales, Maria Angeles, Ludovisi, Alessandra, Najafi Fard, Saeid, Mariconti, Mara, Brunetti, Enrico, Goletti, Delia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8378729/
https://www.ncbi.nlm.nih.gov/pubmed/34415898
http://dx.doi.org/10.1371/journal.pntd.0009648
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author Petrone, Linda
Tamarozzi, Francesca
Vola, Ambra
Gomez Morales, Maria Angeles
Ludovisi, Alessandra
Najafi Fard, Saeid
Mariconti, Mara
Brunetti, Enrico
Goletti, Delia
author_facet Petrone, Linda
Tamarozzi, Francesca
Vola, Ambra
Gomez Morales, Maria Angeles
Ludovisi, Alessandra
Najafi Fard, Saeid
Mariconti, Mara
Brunetti, Enrico
Goletti, Delia
author_sort Petrone, Linda
collection PubMed
description BACKGROUND: 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. METHODOLOGY/PRINCIPAL FINDINGS: 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). CONCLUSIONS/SIGNIFICANCE: 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.
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spelling pubmed-83787292021-08-21 Accuracy of an experimental whole-blood test for detecting reactivation of echinococcal cysts Petrone, Linda Tamarozzi, Francesca Vola, Ambra Gomez Morales, Maria Angeles Ludovisi, Alessandra Najafi Fard, Saeid Mariconti, Mara Brunetti, Enrico Goletti, Delia PLoS Negl Trop Dis Research Article BACKGROUND: 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. METHODOLOGY/PRINCIPAL FINDINGS: 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). CONCLUSIONS/SIGNIFICANCE: 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. Public Library of Science 2021-08-20 /pmc/articles/PMC8378729/ /pubmed/34415898 http://dx.doi.org/10.1371/journal.pntd.0009648 Text en © 2021 Petrone et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Petrone, Linda
Tamarozzi, Francesca
Vola, Ambra
Gomez Morales, Maria Angeles
Ludovisi, Alessandra
Najafi Fard, Saeid
Mariconti, Mara
Brunetti, Enrico
Goletti, Delia
Accuracy of an experimental whole-blood test for detecting reactivation of echinococcal cysts
title 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_short 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
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8378729/
https://www.ncbi.nlm.nih.gov/pubmed/34415898
http://dx.doi.org/10.1371/journal.pntd.0009648
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