Abstract:
Chagas disease (CD), caused by the protozoan Trypanosoma cruzi, is an important public health problem, occurring mainly in Latin America. The disease has a major social and economical effect, negatively impacting the life of the infected individuals, and bringing great costs to public health. An early and accurate diagnosis is essential for administration of early treatment. In addition, prognostic tests may aid disease management, decreasing hospitalization costs. However, the serological diagnostic scenario for CD still faces several challenges, making the development of new diagnostic kits a pressing matter. Facing this scenario, several researchers have expanded efforts in developing and testing new antigens, such as recombinant proteins and recombinant multiepitope proteins, with promising results. These recombinant antigens offer several advantages, such as improved sensitivity and specificity, in addition to facilitated scaling. Also, it has been possible to observe a rising number of studies using ELISA and point-of-care platforms, employing these antigens in the past few years. Among them, recombinant proteins were the most applied antigens, demonstrating great capacity to discriminate between positive and negative samples. Although fewer in number, recombinant multiepitope proteins also demonstrated an improved diagnostic performance. Indeed, a great number of studies employing these antigens showed sensitivity and specificity values above 90%, greatly impacting diagnostic accuracy. Nevertheless, despite the good results found, it is still possible to observe some bottlenecks in the development of new antigens, such as the scarcity of tests with sera from the acute phase and the variability of results in different geographic areas. In this sense, aiming to contribute to control and health programs, the continuous search for a more accurate serological diagnosis is essential, both for the acute and chronic phases of the disease.
摘要:
恰加斯病(CD),由原生动物克氏锥虫引起的,是一个重要的公共卫生问题,主要发生在拉丁美洲。本病具有主要的社会经济效应,对感染者的生活产生负面影响,给公共卫生带来巨大的代价。早期和准确的诊断对于早期治疗的管理至关重要。此外,预后测试可能有助于疾病管理,降低住院费用。然而,CD的血清学诊断方案仍然面临几个挑战,使开发新的诊断试剂盒成为当务之急。面对这种情况,一些研究人员扩大了开发和测试新抗原的努力,如重组蛋白和重组多表位蛋白,有希望的结果。这些重组抗原提供了几个优点,如提高灵敏度和特异性,除了促进缩放。此外,使用ELISA和即时护理平台观察到越来越多的研究是可能的,在过去几年中使用了这些抗原。其中,重组蛋白是应用最多的抗原,表现出很强的区分阳性和阴性样本的能力。虽然数量较少,重组多表位蛋白也表现出改进的诊断性能。的确,大量使用这些抗原的研究显示灵敏度和特异性值超过90%,极大地影响诊断准确性。然而,尽管发现了良好的结果,仍然有可能观察到新抗原开发的一些瓶颈,例如急性期血清检测的稀缺性以及不同地理区域结果的变异性。在这个意义上,旨在为控制和健康计划做出贡献,不断寻找更准确的血清学诊断至关重要,对于疾病的急性和慢性阶段。