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Antigenuria in infants with acute and congenital Chagas' disease
Insights
This study shows that detecting Trypanosoma cruzi soluble antigens (SAg) and circulating antigens (CAg) in urine and serum is highly effective for diagnosing pediatric Chagas
Area of Science:
- Parasitology
- Immunology
- Pediatric Infectious Diseases
Background:
- Chagas' disease, caused by Trypanosoma cruzi, poses diagnostic challenges, especially in pediatric acute and congenital cases.
- Traditional diagnostic methods like serology and parasitologic tests have limitations in accuracy and timeliness for early detection.
Purpose of the Study:
- To evaluate the efficacy of detecting Trypanosoma cruzi soluble antigens (SAg) and circulating antigens (CAg) in pediatric patients.
- To compare antigen detection with classical diagnostic techniques for acute and congenital Chagas' disease.
Main Methods:
- Enzyme-linked immunosorbent assay (ELISA) was used to detect SAg in urine and CAg in serum from pediatric patients.
- Samples were collected from 10 patients with acute and 10 with congenital Chagas' disease before treatment.
- Antigenic glycoproteins were partially characterized using iodination, affinity chromatography, immunoprecipitation, and 2D gel electrophoresis.
Main Results:
- 100% of acute and 100% of congenital Chagas' disease patients were positive for SAg.
- 90% of congenital and 100% of acute cases were positive for CAg.
- ELISA for SAg detection demonstrated superior effectiveness for early and precise diagnosis compared to traditional methods.
Conclusions:
- Detection of Trypanosoma cruzi SAg and CAg via ELISA is a highly sensitive and specific method for diagnosing pediatric Chagas' disease.
- This antigen-based assay offers a more effective diagnostic approach than conventional methods, particularly for early detection in acute and congenital infections.
Abstract:
Detection and partial characterization of Trypanosoma cruzi soluble antigens (SAg) in urine, as well as demonstration of parasite circulating antigens (CAg) in serum from pediatric patients with acute (10 patients) and congenital (10 patients) Chagas' disease, are reported. Classical techniques for parasite detection and antibody serology were also conducted in both groups. Samples collected before the onset of parasiticidal drug treatment were tested by an enzyme-linked immunosorbent assay for SAg and CAg demonstration. The control population consisted of 6 children with acute toxoplasmosis, 6 with cutaneous leishmaniasis, and 20 healthy individuals. Patients with acute cases were 100% positive for both SAg and CAg, whereas patients with congenital disease were 80% CAg positive and 100% SAg positive. Controls yielded negative results in all cases. Partial characterization of SAg from two patients with acute disease was performed by iodination, affinity chromatography, immunoprecipitation, and two-dimensional gel electrophoresis. Two different antigenic glycoproteins (80 kilodaltons, pI 6 to 6.5 and 55 kilodaltons, pI 6.5 to 7) were identified by these methods. Traditional serology and classical parasitologic tests failed, each in a different way, to provide an accurate diagnosis in the total of our patients. The enzyme-linked immunosorbent assay for SAg detection proved to be the most effective procedure for achieving early and precise proof of infection in acute and congenital cases of Chagas' disease.