Neurol India Home 
 

LETTERS TO EDITOR
Year : 2019  |  Volume : 67  |  Issue : 2  |  Page : 574--575

Intrathecal synthesis of immunoglobulin G antibodies to Taenia solium scolex antigens in neurocysticercosis

Lisandra A Suzuki, Cláudio L Rossi 
 Department of Clinical Pathology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil

Correspondence Address:
Dr. Cláudio L Rossi
Department of Clinical Pathology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Rua Tessália Vieira de Camargo 126, Cidade Universitária Zeferino Vaz, 13083-887, Campinas, SP
Brazil




How to cite this article:
Suzuki LA, Rossi CL. Intrathecal synthesis of immunoglobulin G antibodies to Taenia solium scolex antigens in neurocysticercosis.Neurol India 2019;67:574-575


How to cite this URL:
Suzuki LA, Rossi CL. Intrathecal synthesis of immunoglobulin G antibodies to Taenia solium scolex antigens in neurocysticercosis. Neurol India [serial online] 2019 [cited 2019 Jun 17 ];67:574-575
Available from: http://www.neurologyindia.com/text.asp?2019/67/2/574/257988


Full Text



Sir,

The heterogeneity of the clinical manifestations associated with neurocysticercosis makes the diagnosis of this disease very difficult when not combined with neuroimaging studies and epidemiological and laboratory data.[1] Detection of specific antibodies in the cerebrospinal fluid (CSF) samples against different Taenia solium cysticercal antigenic preparations using reliable immunologic tests has been considered a useful tool for diagnosing neurocysticercosis, especially when neuroimaging techniques are unavailable. The presence of specific antibodies in serum must be evaluated critically because extraneural cysticercosis may result in specific antibody development.[2] On the contrary, the detection of antibodies in the CSF may reflect the diffusion of proteins from the blood after blood–brain barrier dysfunction.[3] In this context, the demonstration of intrathecal antibody production to cysticercal antigens may be a useful tool in establishing the involvement of the central nervous system in cysticercosis.[4]

The demonstration of the parasite scolex in neuroimaging procedures has been considered an absolute criterion for the diagnosis of neurocysticercosis.[1],[2],[5] In the present study, the intrathecal synthesis of specific immunoglobulin G (IgG) antibodies to a scolex antigen preparation from T. solium cysticerci was investigated in 16 patients with a confirmed diagnosis of neurocysticercosis (eight female, eight male, mean age = 51 years), five of them with neuroimaging studies showing the parasite scolex. The patients were attended at the University Hospital of the State University of Campinas (UNICAMP, Campinas, SP, Brazil) and the study was approved by the Ethics Committee of the Faculty of Medical Sciences, UNICAMP, in accordance with the resolutions of the Brazilian National Ethics Committee.

The antigen preparation from scolex was obtained as previously described.[6] Serum and CSF samples were collected concurrently from patients and the intrathecal synthesis of cysticercus-specific antibodies was determined as previously described.[4] A cysticercus-specific IgG antibody index (AIIgG) ≥1.5 was considered to be indicative of intrathecal antibody production.[3],[4]

Intrathecal production of IgG antibodies to scolex antigens was detected in 11 (68.75%) of the 16 patients with neurocysticercosis. In the 11 patients where intrathecal synthesis was observed, the AIIgG ranged from 7.2 to 17.5 (mean index = 10.5). Of the five patients with neurocysticercosis who had no intrathecal antibody production, two had neuroimaging data showing the parasite scolex.

The usefulness of detection of specific anti-T.solium scolex antibodies for the immunodiagnosis of neurocysticercosis is controversial. Some authors have suggested that the detection of these antibodies could help in the immunodiagnosis of neurocysticercosis,[6],[7],[8] whereas others investigators have considered the finding of these antibodies to be of little importance for the diagnosis of infection.[9] Our results confirm that the detection of antibodies to scolex antigens from T. solium cysticerci is not a reliable marker for the diagnosis of neurocysticercosis.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Del Brutto OH. Neurocisticercosis: Actualización en diagnóstico y tratamiento. Neurologia 2005;20:412-8.
2Del Brutto OH, Rajshekhar V, White AC Jr, Tsang VC, Nash TE, Takayanagui OM, et al. Proposed diagnostic criteria for neurocysticercosis. Neurology 2001;57:177-83.
3Reiber H, Peter JB. Cerebrospinal fluid analysis: Disease-related data patterns and evaluation programs. J Neurol Sci 2001;184:101-22.
4Arruda GC, Quagliato EM, Rossi CL. Intrathecal synthesis of specific immunoglobulin G antibodies in neurocysticercosis: Evaluation of antibody concentrations by enzyme-linked immunosorbent assay using a whole cysticercal extract and cyst vesicular fluid as antigen. Diagn Microbiol Infect Dis 2006;54:45-9.
5Del Brutto OH, Nash TE, White Jr. AC, Rajshekhar V, Wilkins PP, Singh G, et al. Revised diagnostic criteria for neurocysticercosis. J Neurol Sci 2017;372:202-10.
6Nascimento E, Tavares CA, Lopes JD. Immunodiagnosis of human cysticercosis (Taenia solium) with antigens purified by monoclonal antibodies. J Clin Microbiol 1987;25:1181-5.
7Ev LV, Maria AAM, Pianetti G, Nascimento E. Immunological evaluation of a 26-kDa antigen from Taenia solium larvae for specific immunodiagnosis of human neurocysticercosis. Parasitol Res 1999;85:98-102.
8Iudici Neto F, Pianetti-Filho G, Araujo RA, Nascimento E. Immunodiagnosis of human neurocysticercosis by using semi-purified scolex antigens from Taenia solium cysticerci. Rev Soc Bras Med Trop 2007;40:163-9.
9Arruda GC, da Silva AD, Quagliato EM, Maretti MA, Rossi CL. Evaluation of Taenia solium and Taenia crassiceps cysticercal antigens for the serodiagnosis of neurocysticercosis. Trop Med Int Health 2005;10:1005-12.