Recombinant antigen-based multiplex serology for the differential diagnosis of human cestodiases: toward integrated...

The serological diagnosis of human cestodiases, particularly cystic echinococcosis (CE) and neurocysticercosis (NCC), is frequently constrained by cross-reactivity associated with crude parasite extracts, limiting its utility in differential diagnosis. This review evaluates the potential of recombinant antigen-based multiplex serology to improve the differentiation between CE and NCC. We examine key diagnostic targets, including the chimeric antigens DIPOL and 2B2t for CE, and T24H together with lentil lectin-adherent glycoproteins (LLGP) for NCC. We further discuss bead-based multiplex platforms that allow the simultaneous detection of antibodies against multiple antigens from a single, small-volume sample. Current evidence indicates that these approaches may reduce cross-reactivity and provide a more nuanced characterisation of pathogen-specific immune responses. Multiplex immunoprofiling represents a promising step toward more integrated serological strategies for the differential diagnosis of human cestodiases. However, further standardisation and validation across diverse epidemiological settings are required prior to routine clinical implementation.