日本血吸虫不同发育阶段抗原检测IgG及IgG_4的疗效考核价值

目的 :建立具有疗效考核价值的抗原 -抗体检测系统。方法 :用日本血吸虫不同发育阶段抗原 (AWA、AMA、AESA、SEA、SIEA)检测治疗前及治疗后不同时间慢性血吸虫病人血清中特异性IgG及IgG4 并测定肺吸虫病人、肝吸虫病人和健康人血清的交叉反应性。结果 :不同发育阶段抗原 -IgG检测系统间对慢性血吸虫病人、肺吸虫病人、肝吸虫病人和健康人血清测试的阳性率无显著性差异 (P >0 .0 5 ) ,慢性血吸虫病人治疗后 12个月IgG的阴转率以SIEA最高 (90 .0 % ) ,其次为AMA(77.5 % ) ,最低为AESA(2 0 .0 % ) ;检测慢性血吸虫病人治疗前的特异性IgG4 的阳性率AWA最高 (85 .0 % ) ,其次为AMA(80 .0 % ) ,最低的为SIEA(37.5 % ) ,治疗后 12个月的IgG4 阴转率SIEA最高 (97.5 % ) ,其次为AMA(95 .0 % )和AWA(85 .0 % ) ,最低的为SEA(6 2 .5 % )。结论 :AMA -IgG、SIEA -IgG、AWA -IgG4 和AMA -IgG4 检测系统具有较好的疗效考核价值 ,且以SIEA -IgG和AMA -IgG4 两个检测系统最好。

SCHISTOSOMIASIS JAPONICA: EVALUATION OF THERAPEUTIC EFFICACY BY DETECTION OF SPECIFIC IgG4 WITH ANTIGENS OF ADULT AND EGG STAGES

Objective: To establish antigen-antibody detection systems which can be used to diagnose schistosomiasis japonica and evaluate the therapeutic efficacy of the disease. Methods: Antigens derived from adult and egg stages including soluble adult worm antigen (AWA), adult worm membrane antigen (AMA), adult worm excretory and secretory antigen (AESA), soluble egg antigen (SEA) and soluble immature egg antigen (SIEA) were used to measure the specific IgG and IgG4 in sera of patients with schistosomiasis japonica before treatment and at 6 months and 12 months after treatment by ELISA. These antigens were also used to detect cross reactive antibody in sera of patients with other parasitic diseases and healthy individuals by ELISA. Results: There was no statistical difference in sensitivity and specificity among these antigens used to detect specific IgG in sera with chronic schistosomiasis japonica and cross reactive IgG in sera of patients with other parasitic diseases and of healthy individuals. The highest negative reversion rate of specific IgG in sera of patients at 12 months after treatment was 90.0% with SIEA, the second was 77.5% with AMA, the lowest was 20.0% with AESA. The highest sensitivity in detecting specific IgG4 in sera of the patients with schistosomiasis before treatment is 85.0% with AWA, the second is 80.0% with AMA, the lowest was 37.5% with SIEA while the highest negative reversion rate of specific IgG4 in sera of patients with schistosomiasis at 12 months after treatment is 97.5% with SIEA, the next were 95.0% with AMA and 85.0% with AWA, the lowest was 62.5% with SEA. Conclusions: Ama-IgG, SIEA-IgG, AWA-IgG4 and AMA-IgG4 detection systems have good property for immunodiagnosis and evaluation of therapeutic efficacy of schistosomiasis japonica.