Cross-reactivity using chimeric Trypanosoma cruzi antigens: diagnostic performance in settings where Chagas disease and american cutaneous or visceral leishmaniasis are coendemic

Daltro, Ramona Tavares, Leony, L Leonardo Maia, Maron Freitas, Natália Erdens, Oliveira Silva, Ângelo Antônio, Santos, Emily Ferreira, Del-Rei, Rodrigo Pimenta, Felinto Brito, Maria Edileuza, Brandão-Filho, Sinval Pinto, Gomes, Yara de Miranda, MS Silva, Donato, Silvia Tavares, Bezerra Jerônimo, Selma Maria, de Góis Monteiro, Gloria Regina Gloria Regina, Carvalho, Lucas Pedreira de, Magalhães, Andréa Santos, Nilson Ivo Tonin Zanchin, Fiorani Celedon, Paola Alejandra, Santos, Fred Luciano Neves

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5 Citations (Scopus)

Abstract

Chimeric T. cruzi antigens have been proposed as a diagnostic tool for chronic Chagas disease (CD) in both settings where Chagas disease is endemic and those where it is not endemic. Antibody response varies in accordance to each T. cruzi strain, presenting challenges to the use of antigens lacking demonstrated cross-reactivity with Leishmania spp. Our group expressed four chimeric proteins (IBMP-8.1, IBMP-8.2, IBMP-8.3, and IBMP-8.4) and previously assessed their diagnostic performance to determine cross-reactivity with Leishmania spp. Here, we validated our findings using serum samples from different Brazilian geographic areas reporting endemic Chagas disease, endemic visceral or American cutaneous leishmaniasis (ACL), or both. Overall, 829 serum samples were evaluated using commercial and IBMP enzyme-linked immunosorbent assays. Due to the absence of a reference assay to diagnosis CD, latent class analysis (LCA) was performed through the use of a statistical model. The incidence of cross-reactivity for ACL-positive samples varied from 0.35% (IBMP-8.3) to 0.70% (IBMP-8.1 and IBMP-8.2). Regarding visceral leishmaniasis (VL)-positive samples, the IBMP-8.2 and IBMP-8.3 antigens cross-reacted with six (3.49%) and with only one sample (0.58%), respectively. No cross-reactivity with either ACL or VL was observed for the IBMP-8.4 antigen. Similarly, no cross-reactions were found when VL-positive samples were assayed with IBMP-8.1. The agreement among the results obtained using IBMP antigens ranged from 97.3% for IBMP-8.2 and 99% for IBMP-8.1 and IBMP-8.3 to 100% for IBMP-8.4, demonstrating almost perfect agreement with LCA. Accordingly, in light of the negligible cross-reactivity with both ACL and VL, we suggest the use of IBMP antigens in regions where T. cruzi and Leishmania spp. are coendemic.
Original languageEnglish
Article numbere00762-19
Pages (from-to)e00762-19-e00772-19
Number of pages10
JournalJournal Of Clinical Microbiology
VolumeVol. 57
Issue numbern.º 8
DOIs
Publication statusPublished - 26 Jul 2019

Keywords

  • American cutaneous leishmaniasis
  • Chagas disease
  • Cross-reactivity
  • Recombinant chimeric antigens
  • Visceral leishmaniasis

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