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Rapid diagnosis of human paragonimiasis using recombinant Paragonimus westermani cysteine protease 6 antigen-based
Patcharaporn Boonroumkaew1, Lakkhana Sadaow1, Nongnapas Kanchanangkul2
1Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Mekong Health Science Research Institute, Khon Kaen University, Khon Kaen, Thailand.
Objectives:
Cysteine proteases, the major components of excretory-secretory substances excreted from adult Paragonimus worms, are known to be useful diagnostic antigens for human paragonimiasis. In this study, we developed immunochromatography-based kits to detect specific immunoglobulin G (IgG) and immunoglobulin G4 (IgG4) antibodies against recombinant cysteine protease-6 (rCP-6) and evaluated their diagnostic performance.
Methods:
The rCP-6 was expressed in Escherichia coli, affinity-purified, and evaluated for immunoreactivity. The rCP-6-based immunochromatographic kits were evaluated for the detection of IgG and IgG4 using simulated whole-blood and serum samples from paragonimiasis patients, healthy individuals, and patients with other infectious diseases. The diagnostic performance was evaluated.
Results:
The IgG detection kit exhibited sensitivity of 76.7%, specificity of 90.5%, and accuracy of 87.3% for both simulated whole-blood and serum samples. In comparison, the IgG4 detection kit demonstrated higher performance, with 85.0% sensitivity, 100% specificity, and 96.5% accuracy across both sample types.
Conclusion:
Both IgG and IgG4 detection kits were useful for diagnosing paragonimiasis. The IgG4 detection kit showed superior diagnostic performance. These immunochromatographic tools may be applicable in clinical laboratories for diagnosing outpatients with paragonimiasis caused by different Paragonimus species (P. heterotremus, P. westermani, and P. skrjabini miyazakii).
