Resumen
As técnicas sorológicas convencionais utilizadas no diagnóstico da doença de Chagas são limitadas devido às reações cruzadas com outras doenças parasitárias, à falta de padronização dos reagentes e pela diversidade de procedimentos técnicos. Métodos têm sido desenvolvidos para melhorar a sensibilidade e especificidade do diagnóstico utilizando abordagens moleculares. O kit EIE-Recombinante-Chagas-Biomanguinhos (EIE-Rec) que emprega o ELISA direto e as proteínas recombinantes CRA e FRA de T. cruzi como antígenos, tem se mostrado promissor. Em estudos o EIE-Rec mostrou uma especificidade de 100% e uma sensibilidade de 98.2-100%. A utilização do kit EIE-Rec para monitorar a cura da doença de Chagas humana, cujos resultados concordaram em 90.9% com os métodos clássicos de diagnóstico, abre caminho para o uso do EIE-Rec em ensaios iniciais para avaliar a cura de pacientes chagásicos tratados. A análise comparativa do EIE-Rec com o ELISA convencional e o teste de hemaglutinação indireta mostrou que o uso de dois ELISAs com preparações antigênicas diferentes prove uma combinação de testes eficiente para a triagem da doença de Chagas em bancos de sangue. Algumas vantagens do EIE-Rec são: impede reações falso-positivas; o ELISA direto aumenta a sensibilidade do método; o uso de amostras não diluídas reduz a possibilidade de erro.
Palabras clave
Doença de Chagas, diagnóstico, testes sorológicos, antígenos recombinantes, Trypanosoma cruzi
Clasificación en siicsalud
Artículos originales> Expertos de Iberoamérica>
página www.siicsalud.com/des/des040/04n03023.htm
Especialidades
Principal: Infectología
Relacionadas: Diagnóstico por Laboratorio, Medicina Interna, Cardiología, Bioquímica
Enviar correspondencia a:
Miranda Gomes, Yara,
Patrocinio y reconocimiento
AgradecimentosA John Wiley & Sons Inc pela permissão da reprodução de uma tabela do Journal Clinical Laboratory Analysis 16:132-136, 2002, e a Blackwell Publishing pela permissão do reprodução de duas tabelas do Vox Sanguinis 85:165-170, 2003.
Artículo completo
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USE OF THE EIE-RECOMBINANTE-CHAGAS-BIOMANGUINHOS FOR DIAGNOSIS OF CHRONIC CHAGAS' DISEASE
Abstract
Conventional serological techniques for the diagnosis of Chagas' disease are limited due to cross-reactivity with other parasitic diseases, non-standardization of reagents and the diversity of technical procedures available. Thus, methods are being developed to improve the sensitivity and specificity of the diagnosis using molecular approaches. The EIE-Recombinant-Chagas-Biomanguinhos (EIE-Rec) kit, that uses direct ELISA and the recombinant proteins CRA and FRA of T. cruzi as antigens has given promising results. We have previously showed that the EIE-Rec kit gives a specificity of 100% and a sensitivity of 98.2-100%. The use of the EIE-Rec kit in order to monitor the cure of human Chagas'disease, agreed in 90.9% with classical diagnostic methods. These results encourage further work using the EIE-Rec kit in initial trials to investigate the cure of treated chagasic patients. The comparative analysis of the EIE-Rec with the conventional ELISA and indirect hemmaglutination tests showed that, the combination of both enzyme immunoassays using different antigen preparations generates an efficient diagnostic test for blood bank screening of Chagas' disease. Advantages of the EIE-Rec include the use of specific recombinant parasite antigens avoiding false positive results, the sensitivity of the method is improved by using direct ELISA and the possibility of error is also reduced by using undiluted samples.
Key words
Chagas' disease, diagnosis, serological assays, recombinant antigens, Trypanosoma cruzi
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