Rapid, novel, specific, high-throughput assay for diagnosis of Loa loa infection

J Clin Microbiol. 2008 Jul;46(7):2298-304. doi: 10.1128/JCM.00490-08. Epub 2008 May 28.

Abstract

The ability to diagnose Loa loa infection readily and accurately remains a demanding task. Among the available diagnostic methods, many are impractical for point-of-care field testing. To investigate whether luciferase immunoprecipitation systems (LIPS) can be used for rapid and specific diagnosis of L. loa infection, a LIPS assay was developed based on immunoglobulin G (IgG) and IgG4 subclass antibodies to a recombinant L. loa SXP-1 (designated LlSXP-1) antigen and tested with sera from healthy controls or patients with proven infection with L. loa, Mansonella perstans, Onchocerca volvulus, Strongyloides stercoralis, or Wuchereria bancrofti. A LIPS test measuring IgG antibody against LlSXP-1 readily differentiated L. loa-infected from uninfected patients and demonstrated markedly improved sensitivity and specificity compared with an LlSXP-1 IgG4-based enzyme-linked immunosorbent assay (67% sensitivity and 99% specificity). No significant immunoreactivity was observed with S. stercoralis-infected sera, but a small number of patients infected with O. volvulus, M. perstans, or W. bancrofti showed positive immunoreactivity. Measuring anti-IgG4-specific antibodies to LlSXP-1 showed a significant correlation (r approximately 0.85; P < 0.00001) with the anti-IgG results but showed no advantage over measuring the total IgG response alone. In contrast, a rapid LIPS format (called QLIPS) in which the tests are performed in less than 15 minutes under nonequilibrium conditions significantly improved the specificity for cross-reactive O. volvulus patient sera (100% sensitivity and 100% specificity). These results suggest that LIPS (and the even more rapid test QLIPS) represents a major advance in the ability to diagnose L. loa infection and may have future applications for point-of-care diagnostics.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, N.I.H., Intramural

MeSH terms

  • Amino Acid Sequence
  • Animals
  • Antibodies, Helminth / blood*
  • Antigens, Helminth*
  • Enzyme-Linked Immunosorbent Assay
  • False Positive Reactions
  • Humans
  • Immunoglobulin G / blood
  • Immunoprecipitation / methods*
  • Loa / genetics
  • Loa / isolation & purification*
  • Loiasis / diagnosis*
  • Mansonella / immunology
  • Onchocerca volvulus / immunology
  • Point-of-Care Systems
  • Sensitivity and Specificity
  • Sequence Alignment
  • Wuchereria bancrofti / immunology

Substances

  • Antibodies, Helminth
  • Antigens, Helminth
  • Immunoglobulin G