Ancylostoma duodenale infection: a study of serum immunoglobulin G4 response to the excretory secretory antigen of adult worm
Mahmoud, M.S.E.; Abou Gamra, M.M.M.; Elkhayat, M.M.
Journal of the Egyptian Society of Parasitology 35(1): 1-17
2005
ISSN/ISBN: 1110-0583 PMID: 15880990 Document Number: 593464
The serum anti-A. duodenale immunoglobulin (Ig) G4 antibody response to fraction III of the partially purified excretory secretory antigen of the adult worm (Ad III ESA) was studied in 60 patients with parasitologically confirmed A. duodenale infection, attending the outpatient clinic of the Tropical Medicine Department of Menoufia University in Egypt (group I), 40 patients with parasitologically and/or serologically-confirmed parasitic infections (group II) and 30 healthy subjects (group III) . The serum anti-Ad III ESA IgG and IgG 1-4 subclass antibodies were significantly elevated in patients in group I as compared to group III (P<0.001). Serum specific IgG4 was expressed in 100% of group I patients at a significantly elevated level than IgG1 (P<0.01), IgG2 and IgG3 (P<0.001). Specific IgG1 was expressed in 88.3% of group I patients at a significantly elevated level than IgG2 (31.7%) and IgG3 (38.3%). The levels of serum IgG4 to the partially purified ESA of adult A. duodenale among patients with A. duodenale infection showed a significant positive correlation with the intensity of A. duodenale infection, quantified as egg counts (P<0.001). Diagnosis of A. duodenale infection by detection of serum anti-Ad III ESA antibody recorded a 100% sensitivity that was significantly higher than specific IgG1, IgG2 and IgG3 antibodies (88.3%, 31.7%, and 38.3%, respectively). Serum specific IgG4 recorded a 100% specificity that was significantly higher than IgG, IgG2, IgG3 (P<0.01) and IgG1 (P<0.05).