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#9310 Echinococcus multilocularis (Em18)
ELISA kit for alveolar echinococcosis patient follow-up in humans

Parasitology and clinical relevance

Alveolar echinococcosis is caused by an infection with the cestode Echinococcus multilocularis and is a very dangerous disease for humans. Adult worms mature in the intestine of the definitive host (usually fox, occasionally dog or cat) and the eggs are released in the feces. Accidental ingestion of soil, berries or vegetables contaminated with eggs iniate the infection in humans. Oncospheres hatch in the duodenum, penetrate the intestine and are carried via the bloodstream to organs. Although alveolar cysts have been found in other tissues, the most common site of development is the liver. The cysts are not limited by a membrane but penetrate the tissues and may resemble a slow growing carcinoma. Surgical removing is difficult but drugs have been found that stop the development of the metacestode. The Em18-ELISA is suitable for monitoring serologically the treatment efficacy in AE patients. Extensive evaluations revealed that anti-recEm18 serum antibody levels rapidly declined to undetectable concentrations upon complete surgical resection of the parasite lesion, usually within a time span of several months to less than one year. Inactivation of the parasite by drug treatment results in a full calcification of the lesion(s), plus negativation of both Em18-serology and PET-scan (see refs. below).

Test-Kit

96 determinations of IgG antibodies using standard methodologies.

Wells sensitized with recombinant antigen (Em18) from Echinococcus multilocularis.

8-well polystyrene breakable strips : useful and economic format for laboratories with a small workload.

CE registration:  CH-201708-0010

Sensitivity and specificity

Paired pre- and post-surgical serum samples of 12 patients with confirmed alveolar echinococcosis and having had a radical or non-radical surgery were studied. Pre-surgically, 9 patients (75%) had an index >1. Among these patients, 5 had negative post-surgical results. But in all 12 patients, post-surgical Em18 antibody levels dropped and were significantly lower than in pre-surgical samples.

Serum samples of 25 patients with confirmed alveolar echinococcosis without surgery but with stable disease under antiparasitic chemotherapy were studied. 18 (72%) of them had an index >1 (median index 6.3).

Serum samples of 7 patients with confirmed alveolar echinococcosis without surgery but with progressive disease under antiparasitic chemotherapy were studied. 6 (86%) of them had an index >1 (median index 13.8). 

Contents

96 wells coated with Echinococcus multilocularis Em18 antigen.

Dilution buffer (TBS-Tween), 50 ml
Washing solution, 50 ml
Enzyme buffer, 50 ml
Stop solution, 25 ml
Negative control serum (rabbit), 200 l
Cut-off serum (rabbit), 200 l
Positive control serum (rabbit), 200 l
Protein A - AP conjugate, 300 l
Alk. phosphatase substrate, 20 tab.
Multipipette resevoir 25ml, 1x
Frame for ELISA 8-wells holder, 1x
Instructions for use

Ordering information

Echinococcus multilocularis (Em18)
complete kit (96 assays) No. 9310

References

Ammann, R.W., Rebber, E.C., Gottstein, B., Grimm, F. Eckert, J., Renner, E.L. (2004) Immunosurveillance of alveolar echinococcosis by specific humoral and cellular immune tests: long-term analysis of the Swiss chemotherapy trial (1976-2001). (2004)  J. Hepatol. 41 : 551-9.

Tappe, D., Frosch, M., Sako, Y. Itoh, S., Gruner, B., Reuter, S., Nakao, M., Ito, A., Kern, P. (2009) Close relationship between clinical regression and specific serology in the follow-up of patients with alveolar echinococcosis in different clinical stages. (2009) Am. J. Trop. Med. Hyg. 80 : 792-7.

Ishikawa, Y., Sako, Y. Itoh, S., Ohtake, T., Kohgo, Y., Matsuno, T., Ohsaki, Y., Miyokawa, N., Nakao, M., Nakaya, K., Ito, A. (2009) Serological monitoring of progression of alveolar echinococcosis with multiorgan involvement by use of recombinant Em18. J. Clin. Microbiol. 47 : 3191-6.

Tappe, D., Sako, Y., Itoh, S. Frosch, M., Gruner, B., Kern, P., Ito, A. (2010) Immunoglobulin G subclass responses to recombinant Em18 in the follow-up of patients with alveolar echinococcosis in different clinical stage. Clin Vaccine Immunol. 17 : 944-8.

Ammann, R.W., Stumpe, K.D.M., Grimm, F. Deplazes, P., Huber, S., Bertogg, K., et al. (2015) Outcome after discontinuing long-term benzimidazole treatment in 11 patients with non-resectable alveolar echinococcosis with negative FDG-PET/CT and anti-EmII/3-10 serology. PloS Negl Trop Dis. 9.

European directive 98/79/EC registration

Material Safety Data Sheet: Eng - Fra - Deu

Evaluation of  the Bordier Em18 antibody ELISA for the detection of human active Echinococcus multilocularis infection (Freiburg University, Germany) : Report

 

Bordier Affinity Products SA, Chatanerie 2, Btiment Biokema, CH-1023 Crissier, Switzerland
Phone: + 41 21 633 31 67.  Fax: + 41 21 633 31 78. Email: cb(at)bordier.ch

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