Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 20.428
Filtrar
1.
PLoS One ; 16(2): e0246864, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33577615

RESUMEN

BACKGROUND: The presence of neutralizing antibodies (NAbs) is an indicator of protective immunity for most viral infections. A newly developed surrogate viral neutralization assay (sVNT) offers the ability to detect total receptor binding domain-targeting NAbs in an isotype-independent manner, increasing the test sensitivity. Thus, specimens with low IgM/ IgG antibody levels showed strong neutralization activity in sVNT. METHODS: This study aimed to measure the %inhibition of NAbs measured by sVNT in PCR-confirmed COVID-19 patients. The sensitivity of sVNT for the diagnosis of SARS-CoV-2 infection and its kinetics were determined. RESULTS: Ninety-seven patients with PCR-confirmed SARS-CoV-2 infection were included in this study. Majority of the patients were 21-40 years old (67%) and 63% had mild symptoms. The sensitivity of sVNT for the diagnosis of SARS-CoV-2 infection was 99% (95% confidence interval (CI) 94.4-100%) and the specificity was 100% (95% CI 98.3-100%). The negative predictive value of sVNT from the samples collected before and after 7 days of symptom onset was 99.5% (95% CI 97.4-100%) and 100% (95% CI 93.8-100%), respectively. The level of inhibition at days 8-14 were significantly higher than days 0-7 (p<0.001). The median %inhibition values by severity of COVID-19 symptoms were 79.9% (interquartile range (IQR) 49.7-91.8%); 89.0% (IQR 71.2-92.4%); and 86.6% (IQR 69.5-92.8%), for mild, moderate and severe/critical symptoms respectively. The median level of sVNT %inhibition of severe was significantly higher than the mild group (p = 0.05). CONCLUSION: The sVNT is a practical and robust serological test for SARS-CoV-2 infection and does not require specialized biosafety containment. It can be used clinically to aid diagnosis in both early and late infection especially in cases when the real-time RT-PCR results in weakly negative or weakly positive, and to determine the protective immune response from SARS-CoV-2 infection in patients.


Asunto(s)
Anticuerpos Neutralizantes/aislamiento & purificación , /diagnóstico , Pruebas de Neutralización/métodos , /fisiología , Adulto , Anticuerpos Neutralizantes/análisis , Anticuerpos Antivirales/aislamiento & purificación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sensibilidad y Especificidad , Pruebas Serológicas , Glicoproteína de la Espiga del Coronavirus/química , Tailandia , Adulto Joven
2.
J Infect Dis ; 223(2): 192-196, 2021 02 03.
Artículo en Inglés | MEDLINE | ID: mdl-33535238

RESUMEN

At the start of the UK coronavirus disease 2019 epidemic, this rare point prevalence study revealed that one-third of patients (15 of 45) in a London inpatient rehabilitation unit were found to be infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) but asymptomatic. We report on 8 patients in detail, including their clinical stability, the evolution of their nasopharyngeal viral reverse-transcription polymerase chain reaction (RT-PCR) burden, and their antibody levels over time, revealing the infection dynamics by RT-PCR and serology during the acute phase. Notably, a novel serological test for antibodies against the receptor binding domain of SARS-CoV-2 showed that 100% of our asymptomatic cohort remained seropositive 3-6 weeks after diagnosis.


Asunto(s)
/diagnóstico , Nasofaringe/virología , Centros de Rehabilitación/estadística & datos numéricos , /aislamiento & purificación , Anticuerpos Antivirales/sangre , Formación de Anticuerpos , Infecciones Asintomáticas/epidemiología , /virología , Estudios de Cohortes , Femenino , Humanos , Londres/epidemiología , Masculino , Persona de Mediana Edad , Pruebas Serológicas
4.
Ann Intern Med ; 174(2): 287-288, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33587882
5.
Ann Intern Med ; 174(2): 287, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33587883
6.
Biochem Med (Zagreb) ; 31(1): 010708, 2021 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-33594297

RESUMEN

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serological tests have been suggested as an additional diagnostic tool in highly suspected cases with a negative molecular test and determination of seroprevalence in population. We compared the diagnostic performance of eight commercial serological assays for IgA, IgM, and IgG antibodies to the SARS-CoV-2 virus. Materials and methods: The comparison study was performed on a total of 76 serum samples: 30 SARS-CoV-2 polymerase chain reaction (PCR)-negative and 46 SARS-CoV-2 PCR-positive patients with asymptomatic to severe disease and symptoms duration from 3-30 days. The study included: three rapid lateral flow immunochromatographic assays (LFIC), two enzyme-linked immunosorbent assays (ELISA), and three chemiluminescence immunoassays (CLIA). Results: Agreement between IgM assays were minimal to moderate (kappa 0.26 to 0.63) and for IgG moderate to excellent (kappa 0.72 to 0.92). Sensitivities improved with > 10 days of symptoms and were: 30% to 89% for IgM; 89% to 100% for IgG; 96% for IgA; 100% for IgA/IgM combination; 96% for total antibodies. Overall specificities were: 90% to 100% for IgM; 85% to 100% for IgG; 90% for IgA; 70% for IgA/IgM combination; 100% for total antibodies. Diagnostic accuracy for IgG ELISA and CIA assays were excellent (AUC ≥ 0.90), without significant difference. IgA showed significantly better diagnostic accuracy than IgM (P < 0.001). Conclusion: There is high variability between IgM assays independently of the assay format, while IgG assays showed moderate to perfect agreement. The appropriate time for testing is crucial for the proper immunity investigation.


Asunto(s)
/métodos , /diagnóstico , /virología , Humanos , Sensibilidad y Especificidad , Pruebas Serológicas/métodos
8.
Viruses ; 13(1)2021 Jan 18.
Artículo en Inglés | MEDLINE | ID: mdl-33477472

RESUMEN

Influenza A Viruses (IAV) in domestic swine (IAV-S) are associated with sporadic zoonotic transmission at the human-animal interface. Previous pandemic IAVs originated from animals, which emphasizes the importance of characterizing human immunity against the increasingly diverse IAV-S. We analyzed serum samples from healthy human donors (n = 153) using hemagglutination-inhibition (HAI) assay to assess existing serologic protection against a panel of contemporary IAV-S isolated from swine in the United States (n = 11). Age-specific seroprotection rates (SPR), which are the proportion of individuals with HAI ≥ 1:40, corresponded with lower or moderate pandemic risk classifications for the multiple IAV-S examined (one H1-δ1, one H1-δ2, three H3-IVA, one H3-IVB, one H3-IVF). Individuals born between 2004 and 2013 had SPRs of 0% for the five classified H3 subtype IAV-S, indicating youth may be particularly predisposed to infection with these viruses. Expansion of existing immunologic gaps over time could increase likelihood of future IAV-S spillover to humans and facilitate subsequent sustained human-to-human transmission resulting in disease outbreaks with pandemic potential.


Asunto(s)
Virus de la Influenza A/inmunología , Gripe Humana/epidemiología , Gripe Humana/transmisión , Infecciones por Orthomyxoviridae/veterinaria , Enfermedades de los Porcinos/epidemiología , Enfermedades de los Porcinos/inmunología , Adulto , Anciano , Animales , Femenino , Humanos , Virus de la Influenza A/clasificación , Gripe Humana/virología , Masculino , Persona de Mediana Edad , Estaciones del Año , Pruebas Serológicas , Porcinos , Enfermedades de los Porcinos/virología , Estados Unidos/epidemiología
9.
Exp Parasitol ; 222: 108065, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33428893

RESUMEN

Visceral leishmaniasis (VL) is a protozoan disease caused by Leishmania infantum in the Mediterranean region including Iran. In 95% of cases, the disease can be fatal if not rapidly diagnosed and left untreated. We aimed to identify immunoreactive proteins of L. infantum (Iranian strain), and to design and evaluate a recombinant multi-epitope antigen for serodiagnosis of human VL. To detect the immunoreactive proteins of L. infantum promastigotes, 2DE immunoblotting technique was performed using different pooled sera of VL patients. The candidate immunoreactive proteins were identified using MALDI-TOF/TOF mass spectrophotometry. Among 125 immunoreactive spots detected in 2-DE gels, glucose-regulated protein 78 (GRP78), ubiquitin-conjugating enzyme E2, calreticulin, mitochondrial heat shock 70-related protein 1 (mtHSP70), heat shock protein 70-related protein, i/6 autoantigen-like protein, ATPase beta subunit, and proteasome alpha subunit 5 were identified. The potent epitopes from candidate immunodominant proteins including GRP78, mtHSP70 and ubiquitin-conjugating enzyme E2 were then selected to design a recombinant antigenic protein (GRP-UBI-HSP). The recombinant antigen was evaluated by ELISA and compared to direct agglutination test for detection of anti L. infantum human antibodies. We screened 34 sera of VL patients from endemic areas and 107 sera of individuals without L. infantum infection from non-endemic area of VL. The recombinant protein-based ELISA provided a sensitivity of 70.6% and a specificity of 84.1%. These results showed that GRP78, ubiquitin-conjugating enzyme E2, and mtHSP70 proteins are potential immunodominant targets of the host immune system in response to the parasite and they can be considered as potential candidate markers for diagnosis purposes.


Asunto(s)
Epítopos Inmunodominantes/aislamiento & purificación , Leishmania infantum/inmunología , Leishmaniasis Visceral/diagnóstico , Proteómica/métodos , Secuencia de Aminoácidos , Antígenos de Protozoos/aislamiento & purificación , Western Blotting , Biología Computacional/métodos , Electroforesis en Gel Bidimensional , Ensayo de Inmunoadsorción Enzimática , Epítopos/inmunología , Epítopos/aislamiento & purificación , Humanos , Immunoblotting , Leishmaniasis Visceral/inmunología , Conformación Molecular , Estructura Secundaria de Proteína , Proteómica/normas , Proteínas Protozoarias/aislamiento & purificación , Proteínas Recombinantes/química , Proteínas Recombinantes/inmunología , Pruebas Serológicas/métodos , Pruebas Serológicas/normas , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción
10.
Int Immunopharmacol ; 92: 107330, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33412393

RESUMEN

In addition to molecular testing, there is evolving interest for anti-SARS-CoV-2 antibodies serologic assays. Majority of them focus on IgM/IgG despite IgA important role in mucosal immunity. A simultaneous anti-SARS-CoV-2 IgA/IgG/IgM immunoassay, performed on an automated instrument by ELISA kit coated with native inactivated SARS-CoV-2, was detected on two control groups (negative swab healthcare workers; pre-pandemic healthy or with other viral infections individuals) and on two COVID-19 patient groups (early and late infection). Specificities were 100% in all groups, indicating no cross-reactivity with other infectious or pre-pandemic sera. Sensitivities were 94% in early infection group and 97% in total positive patient group, reaching 100% in late infection group. To our knowledge, this is the first technique based on native SARS-CoV-2. It is able to identify more positive samples than kits using recombinant antigens, therefore virus native epitopes as well as simultaneous anti-SARS-CoV-2 IgA/IgM/IgG detection could help to contain COVID-19 spreading.


Asunto(s)
Anticuerpos Antivirales/sangre , Inmunoglobulina A/sangre , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Anticuerpos Antivirales/inmunología , Especificidad de Anticuerpos , /virología , Humanos , Inmunoensayo/métodos , Sensibilidad y Especificidad , Pruebas Serológicas/métodos
11.
Int Immunopharmacol ; 92: 107360, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33508702

RESUMEN

OBJECTIVES: The objective of this study was to investigate the differences between the results of two serology assays for detection of COVID-19 among medical staff, who are at higher risks of infection. METHODS: The immunochromatography (ICG) rapid test kit and the chemiluminescence immunoassay (CLIA) quantitative antibody test were performed. The differences in IgM and IgG antibody prevalence in different serological assays were descriptively analyzed. RESULTS: A total of 637 participants were included in this research. Two staff were IgM positive in the CLIA quantitative antibody test (cutoff value: 10 AU/ml) of 51 staff who were IgM positive in the rapid test kit. Six staff were IgG positive in the CLIA quantitative antibody test of 56 staff who were IgG positive in the rapid test kit. The proportion of antibody positive staff differed greatly between the rapid test kit and the CLIA quantitative antibody test. CONCLUSIONS: There was a vast difference in the proportions of IgG and IgM antibody positive staff in the rapid test kit and the CLIA quantitative antibody test results. The results from the only rapid test kit might have to be interpreted with caution. Further studies to evaluate antibody testing accuracy are required to promote the understanding of each assay's characteristics and determine their purposes in each community.


Asunto(s)
/sangre , Personal de Salud , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pruebas Serológicas , Adulto Joven
12.
Anticancer Res ; 41(2): 811-819, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33517286

RESUMEN

BACKGROUND/AIM: The GastroPanel® test (Biohit Oyj) is interpreted by the GastroSoft® application distinguishing eight biomarker profiles, of which five profiles have a morphological equivalent in the Updated Sydney System (USS) classification of gastritis, and 3 others specify functional disorders of the stomach: 1) high acid output, 2) low acid output, and 3) effects of proton pump inhibitor (PPI) medication. This study evaluated the prevalence of these biomarker profiles in dyspeptic patients. PATIENTS AND METHODS: A cross-sectional study was designed to assess the point prevalence of these biomarker profiles in a random sample of 500 subjects derived from our archives of GastroPanel® samples. RESULTS: Reflux symptoms were reported by 35.2% and use of PPI medication by 36.8% of the study subjects. Biomarker profile 2 (high acid output) was the second most common GastroPanel® profile in this cohort; 31.2%, second only (33.6%) to profile 1 (healthy stomach). Hp-infection was detected in 25.0% of the subjects. Profiles related to use of PPI (low acid output, PPI effect) were found in 7.4% of the cases. AG was uncommon, diagnosed in 14 patients only (2.8%). CONCLUSION: These data are derived from the population with the highest frequency of dyspepsia, and the results might have widespread implications in diagnostic and screening practices.


Asunto(s)
Dispepsia/tratamiento farmacológico , Gastritis Atrófica/diagnóstico , Infecciones por Helicobacter/diagnóstico , Inhibidores de la Bomba de Protones/uso terapéutico , Anciano , Estudios Transversales , Dispepsia/etiología , Femenino , Determinación de la Acidez Gástrica , Gastritis Atrófica/epidemiología , Infecciones por Helicobacter/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Juego de Reactivos para Diagnóstico , Pruebas Serológicas
13.
Public Health ; 190: 132-134, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33453689

RESUMEN

OBJECTIVES: The impact of the COVID-19 pandemic in Scotland has been amongst the most severe in Europe. Serological surveillance is critical to determine the overall extent of infection across populations and to inform the public health response. This study aimed to estimate the proportion of people who have antibodies to SARS-CoV-2 ('seroprevalence') in the general population of Scotland and to see if this changes over time. STUDY DESIGN/METHODS: Between International Organization for Standardization (ISO) week 17 (i.e. week commencing 20th April) and ISO week 25 (week commencing 15 June), 4751 residual blood samples were obtained from regional biochemistry laboratories in six participating regional health authority areas covering approximately 75% of the Scottish population. Samples were tested for the presence of anti-SARS-CoV-2 IgG antibodies using the LIAISON®SARS-CoV-2 S1/S2 IgG assay (DiaSorin, Italy). Seroprevalence rates were adjusted for the sensitivity and specificity of the assay using Bayesian methods. RESULTS: The combined adjusted seroprevalence across the study period was 4.3% (95% confidence interval: 4.2%-4.5%). The proportion varied each week between 1.9% and 6.8% with no difference in antibody positivity by age, sex or geographical area. CONCLUSIONS: At the end of the first wave of the COVID-19 pandemic, only a small fraction of the Scottish population had antibodies to SARS-CoV-2. Control of COVID-19 requires the ability to detect asymptomatic and mild infections that would otherwise remain undetected through existing surveillance systems. This is important to determine the true number of infections within the general population which, in turn, can help to understand transmission, inform control measures and provide a denominator for the estimation of severity measures such as the proportion of infected people who have been hospitalised and/or have died.


Asunto(s)
Anticuerpos Antivirales/sangre , Infecciones por Coronavirus/virología , Inmunoglobulina G/sangre , Pandemias , Vigilancia de la Población/métodos , /inmunología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Prevalencia , Vigilancia en Salud Pública , Escocia/epidemiología , Estudios Seroepidemiológicos , Pruebas Serológicas/métodos
14.
BMC Infect Dis ; 21(1): 61, 2021 Jan 13.
Artículo en Inglés | MEDLINE | ID: mdl-33435863

RESUMEN

BACKGROUND: To effectively reduce vertical HIV transmission requires a reduction of HIV prevalence and incidence among pregnant women and a full understanding of its epidemiology. The study aimed to determine the prevalence of HIV among women attending antenatal care and further determine spousal support during antenatal care attendance in rural areas in Eastern Cape province, South Africa. METHODS: A Cross-sectional study of women attending antenatal care in four Primary Care facilities was conducted using an interviewer-administered questionnaire which collected information on socio-demographic characteristics and medical history. Binomial logistic regression analyses were used to determine factors associated with HIV and to estimate the prevalence ratio (PR). The 95% confidence interval (95%CI) is used for precision of estimates; p≤0.05 for statistical significance. RESULTS: A total of 343 participants were included in the final analysis. The antenatal HIV prevalence was 38.2% (95%CI: 33.2-43.9). For 75% of the women, the HIV diagnosis was made 141 days before the date of the interview (median=77 days, interquartile range=42-141 days). Participants between the age of 30 to 39 years were 50% more likely to be HIV positive compared to those who were between the age of 20 to 29, these differences were statistically significant (PR=1.5; p-value=0.001). Furthermore, self-employed women were 30% less likely to be HIV positive when compared to unemployed participants, this was also statistically significant (PR=0.7; p-value< 0.0001). CONCLUSION: Despite a 100% antenatal HIV testing rate, the antenatal HIV prevalence remains high in this population, coupled with no spousal attendance in antenatal care. It is important to move beyond awareness about the HIV status to actionable strategies of reducing the HIV incident cases. It is therefore important to remain vigilant and monitor mother-to-child transmission that could be associated with this increased prevalence.


Asunto(s)
Infecciones por VIH/epidemiología , VIH/aislamiento & purificación , Pobreza , Complicaciones Infecciosas del Embarazo/epidemiología , Atención Prenatal , Atención Primaria de Salud , Servicios de Salud Rural , Adolescente , Adulto , Estudios Transversales , Femenino , Infecciones por VIH/virología , Humanos , Incidencia , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Embarazo , Complicaciones Infecciosas del Embarazo/virología , Prevalencia , Pruebas Serológicas , Sudáfrica/epidemiología , Adulto Joven
15.
BMC Infect Dis ; 21(1): 69, 2021 Jan 13.
Artículo en Inglés | MEDLINE | ID: mdl-33441087

RESUMEN

BACKGROUND: Scrub typhus is a mite-borne infectious disease caused by Orientia tsutsugamushi. Few follow-up studies have assessed antibody titers using serologic tests from various commercial laboratories and the Korea Centers for Disease Control and Prevention (KCDC). METHODS: A prospective study to assess the antibody titers in patients with scrub typhus and seroprevalence in individuals undergoing health checkups was conducted using results of immunofluorescence antibody assays (IFAs) and serologic tests, used by the KCDC and commercial laboratories, respectively. The following tests were performed simultaneously: (i) indirect IFA used by the KCDC to detect immunoglobulin (Ig) M and IgG, (ii) IFA used by a commercial laboratory to detect total Ig, and (iii) antibody tests using two commercially available kits. RESULTS: When the IgM and IgG cutoff values (≥1:16 and ≥1:256, respectively) used in the IFA and the total IgG cutoff values (≥1:40) were used in prospective follow-up investigations, the antibody positivity rates of 102 patients with scrub typhus were 44.1, 35.3, and 57.6%, respectively, within 5 days of symptom onset. Among 91 individuals who recovered from scrub typhus, the follow-up IgM, IgG, and total Ig positivity rates for 13 years were 37.4% (34/91), 22.0% (20/91), and 76.9% (70/91), respectively. Among 216 individuals undergoing health checkups, the seroprevalence of IgM was 4.2% (9/216); no seroprevalence of IgG was observed. CONCLUSIONS: IFAs used by the KCDC and the commercial laboratory and rapid commercial kits could not distinguish between patients who had recovered from scrub typhus and those who are currently infected with O. tsutsugamushi. In South Korea and other countries, where low antibody cutoff values are used, upward adjustments of cutoff values may be necessary.


Asunto(s)
Anticuerpos Antibacterianos/sangre , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Orientia tsutsugamushi/inmunología , Tifus por Ácaros/sangre , Tifus por Ácaros/diagnóstico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Técnica del Anticuerpo Fluorescente Indirecta/métodos , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , República de Corea/epidemiología , Tifus por Ácaros/epidemiología , Tifus por Ácaros/microbiología , Estudios Seroepidemiológicos , Pruebas Serológicas/métodos , Adulto Joven
16.
Nat Commun ; 12(1): 324, 2021 01 12.
Artículo en Inglés | MEDLINE | ID: mdl-33436573

RESUMEN

The rapid development of a SARS-CoV-2 vaccine is a global priority. Here, we develop two capsid-like particle (CLP)-based vaccines displaying the receptor-binding domain (RBD) of the SARS-CoV-2 spike protein. RBD antigens are displayed on AP205 CLPs through a split-protein Tag/Catcher, ensuring unidirectional and high-density display of RBD. Both soluble recombinant RBD and RBD displayed on CLPs bind the ACE2 receptor with nanomolar affinity. Mice are vaccinated with soluble RBD or CLP-displayed RBD, formulated in Squalene-Water-Emulsion. The RBD-CLP vaccines induce higher levels of serum anti-spike antibodies than the soluble RBD vaccines. Remarkably, one injection with our lead RBD-CLP vaccine in mice elicits virus neutralization antibody titers comparable to those found in patients that had recovered from COVID-19. Following booster vaccinations, the virus neutralization titers exceed those measured after natural infection, at serum dilutions above 1:10,000. Thus, the RBD-CLP vaccine is a highly promising candidate for preventing COVID-19.


Asunto(s)
Anticuerpos Neutralizantes/inmunología , Cápside/inmunología , Unión Proteica/inmunología , /inmunología , Animales , Anticuerpos Antivirales/inmunología , Femenino , Humanos , Inmunogenicidad Vacunal , Cinética , Ratones , Ratones Endogámicos BALB C , Unión Proteica/genética , Proteínas Recombinantes/genética , Proteínas Recombinantes/inmunología , Pruebas Serológicas , Glicoproteína de la Espiga del Coronavirus/inmunología
17.
Am J Gastroenterol ; 116(1): 17-44, 2021 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-33315591

RESUMEN

Irritable bowel syndrome (IBS) is a highly prevalent, chronic disorder that significantly reduces patients' quality of life. Advances in diagnostic testing and in therapeutic options for patients with IBS led to the development of this first-ever American College of Gastroenterology clinical guideline for the management of IBS using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. Twenty-five clinically important questions were assessed after a comprehensive literature search; 9 questions focused on diagnostic testing; 16 questions focused on therapeutic options. Consensus was obtained using a modified Delphi approach, and based on GRADE methodology, we endorse the following: We suggest that a positive diagnostic strategy as compared to a diagnostic strategy of exclusion be used to improve time to initiating appropriate therapy. We suggest that serologic testing be performed to rule out celiac disease in patients with IBS and diarrhea symptoms. We suggest that fecal calprotectin be checked in patients with suspected IBS and diarrhea symptoms to rule out inflammatory bowel disease. We recommend a limited trial of a low fermentable oligosaccharides, disacchardies, monosaccharides, polyols (FODMAP) diet in patients with IBS to improve global symptoms. We recommend the use of chloride channel activators and guanylate cyclase activators to treat global IBS with constipation symptoms. We recommend the use of rifaximin to treat global IBS with diarrhea symptoms. We suggest that gut-directed psychotherapy be used to treat global IBS symptoms. Additional statements and information regarding diagnostic strategies, specific drugs, doses, and duration of therapy can be found in the guideline.


Asunto(s)
Agonistas de los Canales de Cloruro/uso terapéutico , Terapia Cognitivo-Conductual , Estreñimiento/terapia , Diarrea/terapia , Dietoterapia , Fármacos Gastrointestinales/uso terapéutico , Agonistas de la Guanilato Ciclasa C/uso terapéutico , Síndrome del Colon Irritable/terapia , Enfermedad Celíaca/diagnóstico , Enfermedad Celíaca/inmunología , Estreñimiento/fisiopatología , Técnica Delfos , Diagnóstico Diferencial , Diarrea/fisiopatología , Manejo de la Enfermedad , Heces/química , Gastroenterología , Humanos , Hipnosis , Enfermedades Inflamatorias del Intestino/diagnóstico , Síndrome del Colon Irritable/diagnóstico , Síndrome del Colon Irritable/fisiopatología , Complejo de Antígeno L1 de Leucocito/análisis , Rifaximina/uso terapéutico , Pruebas Serológicas , Sociedades Médicas
18.
PLoS Negl Trop Dis ; 14(12): e0008932, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33332357

RESUMEN

BACKGROUND: Chagas disease is a neglected zoonosis of growing concern in the southern US, caused by the parasite Trypanosoma cruzi. We genotyped parasites in a large cohort of PCR positive dogs to shed light on parasite transmission cycles and assess potential relationships between parasite diversity and serological test performance. METHODOLOGY/PRINCIPAL FINDINGS: We used a metabarcoding approach based on deep sequencing of T. cruzi mini-exon marker to assess parasite diversity. Phylogenetic analysis of 178 sequences from 40 dogs confirmed the presence of T. cruzi discrete typing unit (DTU) TcI and TcIV, as well as TcII, TcV and TcVI for the first time in US dogs. Infections with multiple DTUs occurred in 38% of the dogs. These data indicate a greater genetic diversity of T. cruzi than previously detected in the US. Comparison of T. cruzi sequence diversity indicated that highly similar T. cruzi strains from these DTUs circulate in hosts and vectors in Louisiana, indicating that they are involved in a shared T. cruzi parasite transmission cycle. However, TcIV and TcV were sampled more frequently in vectors, while TcII and TcVI were sampled more frequently in dogs. CONCLUSIONS/SIGNIFICANCE: These observations point to ecological host-fitting being a dominant mechanism involved in the diversification of T. cruzi-host associations. Dogs with negative, discordant or confirmed positive T. cruzi serology harbored TcI parasites with different mini-exon sequences, which strongly supports the hypothesis that parasite genetic diversity is a key factor affecting serological test performance. Thus, the identification of conserved parasite antigens should be a high priority for the improvement of current serological tests.


Asunto(s)
Enfermedad de Chagas/veterinaria , Exones/genética , Variación Genética , Trypanosoma cruzi/genética , Animales , Enfermedad de Chagas/epidemiología , Enfermedad de Chagas/parasitología , Enfermedad de Chagas/transmisión , Estudios de Cohortes , Perros , Genotipo , Humanos , Louisiana/epidemiología , Filogenia , Pruebas Serológicas/veterinaria , Trypanosoma cruzi/inmunología , Trypanosoma cruzi/fisiología , Zoonosis
19.
Ann Clin Lab Sci ; 50(6): 852-854, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33334805

RESUMEN

Due to the COVID-19 pandemic, the Food and Drug Administration issued an Emergency Use Authorization to permit developers of certain serological tests to market their product prior to a comprehensive review. Nonetheless, the reliability of these assays is of great importance in order to be useful as a tool in estimating the relative proportions of different populations that have been exposed to SARS-CoV-2. We provide a sampling of 145 individuals from an ambulatory setting simultaneously tested with a qualitative point of care rapid finger prick Lateral Wave® IgM and IgG assay and a sample for the Mayo Clinic enzyme linked immunosorbent assay (ELISA) IgM/IgG antibody assay. Significant discrepancies did exist between the purported antibody responses as demonstrated by each assay.


Asunto(s)
Anticuerpos Antivirales/sangre , Ensayo de Inmunoadsorción Enzimática/métodos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Sistemas de Atención de Punto/normas , /aislamiento & purificación , Bioensayo , /virología , Humanos , Pruebas Serológicas/métodos
20.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 32(6): 605-611, 2020 Nov 24.
Artículo en Chino | MEDLINE | ID: mdl-33325195

RESUMEN

OBJECTIVE: To evaluate the efficiency of three Chinese commercial anti-Echinococcus antibody-based assays for the serodiagnosis of echinococcosis. METHODS: A total of 142 sera from cystic echinococcosis patients, 89 sera from alveolar echinococcosis and 39 sera from healthy controls were sampled, and detected by kits A (ELISA), B (ELISA) and C (colloidal gold immunoassay). The routine blood testing results and biochemical parameters were compared between the cystic and alveolar echinococcosis patients, and the associations of the absorbance (A value) of the serum specific antibody detected by A and B kits with the routine blood testing results and biochemical parameters were examined in echinococcosis patients. In addition, the performance of these three assays for the serodiagnosis of echinococcosis was evaluated. RESULTS: There were no significant differences between the cystic and alveolar echinococcosis patients in terms of the median white blood cell count (WBC), neutrophil count (NEU), monocyte count (MONO), basophil count (BASO), alanine aminotransferase concentration (ALT), aspirate aminotransferase concentration (AST), total bilirubin (TBIL), direct bilirubin (DBIL), indirect bilirubin (IBIL) (all P values > 0.05), and higher median lymphocyte count (LYM) and albumin levels (ALB) were detected in cystic echinococcosis patients than in alveolar echinococcosis patients (both P values < 0.05), while the median eosinophil count (EOS) was greater in the alveolar echinococcosis patients than in the cystic echinococcosis patients (P < 0.01). The A value of the serum specific antibody detected by kit A showed a linear positive correlation with WBC (rs = 0.153, P < 0.05) and EOS (rs = 0.174, P < 0.05), and a linear negative correlation with TBIL (rs = -0.134, P < 0.05) and IBIL (rs = -0.146, P < 0.05), while the A value of the serum specific antibody detected by kit B showed a linear positive correlation with WBC (rs = 0.257, P < 0.01), NEU (rs = 0.203, P < 0.01), MONO (rs = 0.159, P < 0.05), EOS (rs = 0.330, P < 0.01), ALT (rs = 0.171, P < 0.01) and AST (rs = 0.160, P < 0.05), and a linear negative correlation with ALB (rs = -0.168, P < 0.05). The overall coincidence rate, sensitivity, specificity, Youden's index and Kappa value of A, B and C kits were 86.30%, 69.63% and 91.48%; 84.42%, 64.94% and 92.21%; 97.44%, 97.44% and 87.18%; 0.82, 0.62 and 0.79; and 0.600, 0.337 and 0.750 for the diagnosis of echinococcosis, respectively. The overall coincidence rate, sensitivity, specificity and Youden's index of A, B and C kits were 84.54%, 64.64% and 71.82%; 80.99%, 55.63% and 68.31%; 97.44%, 97.44% and 87.18%; and 0.78, 0.53 and 0.56 for the diagnosis of cystic echinococcosis, respectively, while the overall coincidence rate, sensitivity, specificity and Youden's index of A, B and C kits were 92.19%, 85.16% and 85.16%; 89.89%, 79.78% and 84.27%; 97.44%, 97.44% and 87.18%; and 0.87, 0.77 and 0.72 for the diagnosis of alveolar echinococcosis, respectively. The C kit showed cross-reactions in the serodiagnosis of cystic echinococcosis and alveolar echinococcosis. There were no significant difference in the area under the receiver operating characteristic curve (ROC) between A and B kits for the diagnosis of echinococcosis (0.970 vs. 0.948, Z = 1.618, P > 0.05), and there was a high agreement between A and B kits in the diagnosis of echinococcosis (Kappa = 0.585, P < 0.01). CONCLUSIONS: The three commercial anti-Echinococcus antibody-based kits exhibit a higher serodiagnostic efficiency for alveolar echinococcosis than for cystic echinococcosis. The A kit shows a high sensitivity and specificity for the diagnosis of echinococcosis, and has a relatively stable diagnostic performance and fewer influencing factors, which is suitable for the pre-surgical preliminary diagnosis and post-surgical follow-up monitoring of serum anti-Echinococcus antibody, while the C kit shows a high sensitivity and specificity for the diagnosis of echinococcosis, and is easy to perform and high in reporting rate, which is feasible for initial screening of echinococcosis.


Asunto(s)
Anticuerpos Antihelmínticos/análisis , Equinococosis/diagnóstico , Pruebas Serológicas , Animales , Antígenos Helmínticos , Estudios de Casos y Controles , Echinococcus/inmunología , Ensayo de Inmunoadsorción Enzimática , Humanos , Inmunoensayo , Sensibilidad y Especificidad
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA