From laboratory to clinical practice: an update of the immunological and molecular tools for neurocysticercosis diagnosis

Abstract

Neurocysticercosis (NCC) is caused by the invasion of Taenia solium larvae in the central nervous system (CNS) and stands as the predominant cause of epilepsy and other neurological disorders in many developing nations. NCC diagnosis is challenging because it relies on brain imaging exams (CT or MRI), which are poorly available in endemic rural or resource-limited areas. Moreover, some NCC cases cannot be easily detected by imaging, leading to inconclusive results. Multiple laboratory assays, principally immunological, have been developed to support the diagnosis and/or monitor the treatment efficacy, but its production can be costly, laborious, and non-globally accessible because they depend on parasite material. Therefore, recent advances have been focused on the implementation of recombinant or synthetic antigens as well as monoclonal antibodies for NCC immunodiagnosis purposes. Similarly, molecular diagnosis has been explored, obtaining promising results. Here we described the recent progress in the development of immunological and molecular diagnostic tools for NCC diagnosis over the past 13 years, discussing their potential application to address important challenges and how to focus future directions to improve NCC diagnosis with emphasis on enhance accessibility and the importance of test validation to provide an adequate support for clinical decisions.

Keywords: Peru; Taenia solium; immunodiagnosis; molecular diagnosis; neurocysticercosis.

Figure 1

(A) Enzyme-linked immunoelectrotransfer blot (EITB) appearance antibody pattern obtained using consecutive serum samples from a pig experimentally infected with cysticercosis. The position of the seven antibody bands and the names are shown. “A” indicates the basal EITB result (0b = 0 bands) before the infection, and “B” to “F” are the EITB results during the time that the pig was followed (5 months after infection). (B) EITB disappearance antibody pattern obtained using consecutive serum samples from a neurocysticercosis patient under antiparasitic treatment. “A” indicates the initial EITB result (7b = 7 bands), and “B” to “H” are the EITB results during the time that the patient was under treatment and the infection was finally resolved.