组合单克隆抗体多表位检测日本血吸虫循环抗原的研究

目的探讨抗肠相关抗原单克隆抗体（单抗）JPG5和抗虫卵可溶性抗原单抗JPS6、JPG5＋JPG1组合和JPS6＋JPG1组合对血吸虫循环抗原（CAg）的诊断效能。方法采用双抗体夹心酶联免疫吸附试验（ELISA）对慢性血吸虫病、急性血吸虫病、晚期血吸虫病、卫氏并殖吸虫病、华支睾吸虫病、乙型肝炎患者血清,以及治疗前、治疗后半年、治疗后1年的慢性血吸虫病疗效考核血清进行CAg单位点和多位点检测。结果JPG5检测慢性血吸虫病患者的敏感性和特异性分别为74.3%和96.8%,JPS6分别为78.7%和95.3%;两株单抗与卫氏并殖吸虫病、华支睾吸虫病及乙型肝炎患者血清的交叉反应率分别为15.2%、15.6%、3.2%和21.5%、15.6%、16.0%。JPG5检测治疗后1年的慢性血吸虫病患者血清CAg阴转率高于JPS6。JPG5＋JPG1组合检测慢性血吸虫病患者的敏感性和特异性分别为80.1%和93.7%,JPS6＋JPG1组合分别为73.5%和96.1%;两种组合与卫氏并殖吸虫病、华支睾吸虫病及乙型肝炎患者血清交叉反应率分别为21.5%、15.6%、18.0%和22.8%、15.6%、16.0%。两种组合多位点检测治疗后1年的慢性血吸虫病患者血清CAg阴转率分别为66．7％和45．5％。结论JPG5、JPS6可用作CAg检测的备选探针。JPG5＋JPG1组合与JPS6＋JPG1组合对CAg的诊断效能相近；较之单位点检测，多位点检测敏感性无明显提高。

Multiple-epitopes detection of circulating antigen of Schistosoma japonicum by using combined monoclonal antibodies

Objective To study the diagnostic efficiency of anti-GAA monoclonal antibody （McAb） JPG5 and anti-SEA McAb JPS6, and the homogeneous combination of JPG5 ＋ JPG1, heterogeneous combination of JPS6 ＋ JPG1 in detection of circulating antigen of Schistosnma japonicum. Methods Single and multiple epitopes of CAg in sera from patients with chronic schistosomiasis, paragonimiasis westermani and clonorchiasis sinensis, and the sera for evaluation of chemotherapeutil efficiency of chronic schistosomiasis were detected by using the method of Sandwich ELISA. Results The sensitivity and specificity of McAb JPG5 to the sera of chronic schistosomiasis were 74.3% and 96.8% , respectively. The sensitivity and specificity of McAb JPS6 were 78.7% and 95.3%, respectively. The cross-reaction rates of them with paragonimiasis westermani, clonorchiasis sinensis and hepatitis B were 15.2% , 15.6%, 3.2% and 21.5%, 15.6% , 16.0% , respectively. The rate of CAg negative conversion detected by JPG5 was higher than that detected by JPS6 in sera of chronic schistosomiasis one year after treatment. The sensitivity and specificity of JPS6 ＋JPG1 were 80. 1% and 93.7% , respectively, and that of JPS6 ＋ JPG1 were 73.5% and 96.1% , respectively. The cross-reaction rates of them with paragonimiasis westermani, clonorchiasis sinensis and hepatitis B were 21.5%, 15.6%, 18.0% and 22.8%, 15.6%, 16.0%, respectively. One year after treatment, the negative conversion rates of the two combinations were 66.7% and 45.5% , respectively. Conclusions McAb JPG5 and JPS6 can be used as alternative probes for CAg detection of schistosomiasis. The diagnostic efficiencies on CAg detection of JPG5 ＋ JPG1 and JPS6 ＋ JPG1 are similar. Comparing to single epitope CAg detection, the multiple epitopes detection shows no significant improvement in sensitivity.