Detection of Ascaris lumbricoides infection by ABA-1 coproantigen ELISA

PLoS Negl Trop Dis. 2020 Oct 15;14(10):e0008807. doi: 10.1371/journal.pntd.0008807. eCollection 2020 Oct.

Abstract

Intestinal worms, or soil-transmitted helminths (STHs), affect hundreds of millions of people in all tropical and subtropical regions of the world. The most prevalent STH is Ascaris lumbricoides. Through large-scale deworming programs, World Health Organization aims to reduce morbidity, caused by moderate-to-heavy intensity infections, below 2%. In order to monitor these control programs, stool samples are examined microscopically for the presence of worm eggs. This procedure requires well-trained personnel and is known to show variability between different operators interpreting the slides. We have investigated whether ABA-1, one of the excretory-secretory products of A. lumbricoides can be used as a coproantigen marker for infection with this parasite. Polyclonal antibodies were generated and a coproantigen ELISA was developed. Using this ELISA, it was found that ABA-1 in stool detected Ascaris infection with a sensitivity of 91.5% and a specificity of 95.3%. Our results also demonstrate that there is a correlation between ABA-1 levels in stool and A. lumbricoides DNA detected in stool. Using a threshold of 18.2 ng/g stool the ABA-1 ELISA correctly assigned 68.4% of infected individuals to the moderate-to-heavy intensity infection group, with a specificity of 97.1%. Furthermore, the levels of ABA-1 in stool were shown to rapidly and strongly decrease upon administration of a standard anthelminthic treatment (single oral dose of 400 mg albendazole). In an Ascaris suum infection model in pigs, it was found that ABA-1 remained undetectable until day 28 and was detected at day 42 or 56, concurrent with the appearance of worm eggs in the stool. This report demonstrates that ABA-1 can be considered an Ascaris -specific coproantigen marker that can be used to monitor infection intensity. It also opens the path for development of point-of-care immunoassay-based tests to determine A. lumbricoides infection in stool at the sample collection site.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Ascariasis / diagnosis*
  • Ascariasis / parasitology
  • Ascariasis / veterinary*
  • Ascaris lumbricoides / genetics
  • Ascaris lumbricoides / isolation & purification*
  • Ascaris lumbricoides / metabolism
  • Enzyme-Linked Immunosorbent Assay / methods*
  • Feces / chemistry
  • Feces / parasitology
  • Female
  • Helminth Proteins / analysis*
  • Helminth Proteins / genetics
  • Helminth Proteins / metabolism
  • Humans
  • Male
  • Swine
  • Swine Diseases / diagnosis*
  • Swine Diseases / parasitology

Substances

  • Helminth Proteins

Grants and funding

OL, AV, KVH and LJS were funded by the Bill and Melinda Gates Foundation (Grant # OPP1192231, https://www.gatesfoundation.org/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.