Aspectos clínicos da neurocisticercose humana e viabilidade de padronização de teste de ELISA para seu imunodiagnóstico

Abstract

The neurocysticercosis (NC), infection caused by the Cysticercus cellulosae, larvae form of the Taenia solium, has high incidence in the countries in development, mainly in Brazil, where its prevalence is higher. Diagnosis its bases on the clinical aspects and, mainly, in the imaging technology, such as computerized tomography (CT) and/or magneticresonance imaging (MRI), techniques that are expensive and frequently inaccessible in endemic areas and to the lacking populations. The diagnosis and practice medicine him of the NC it is complicated due to the polimorfism of the manifestations common to the severalcomorbities. The development and standardization of a simple, effective and serological test for the diagnosis of the disease would be, therefore, of great help in the epidemiological studies, in the prevention and in the therapeutic of the disease. In the present work, besides the clinical aspects of NC, a peptíde (pepNC), identified and selected by the expression of molecules in the covering of filamentous bacteriophages technique (Phage display), was synthesized and used in experiments type ELISA for the sensibility and specificity definition in relation that samples of patients' sera with NC. Two groups were studied; Group Iconstituted of samples from normal patients sera (n=23) for negative control and elaboration of the cut point (cut-off) of the experiment and the Group II constituted from sera of 57 patients and subdivided in two subgroups; patients without neurocysticercosis, NS (n=34) and patients with neurocysticercosis, NC (n=23) confirmed through imaging exams (CT and MRI). Some patient of the subgroups NS and NC presented other comorbities that were striped and included in the study. The obtained results demonstrated that the synthetic peptide was capable found to be recognize samples of patients' sera with NC when compared with the scolex protein antigen from Cysticercus cellulosae (SPACc) in a test type ELISA. The statistical analysis, in this study, evidenced that the sensibility of the test ELISA-peptide was just lightly larger than the sensibility of the test ELISA-SPACc. The specificity of the testELISA-SPACc was larger, however, being taken in consideration that there was not significant difference among the tests, that variation is, possibly, aleatory. Besides, through ROC's curve analysis (receiver operator characteristic) was evidenced that the test ELISApeptide,for that sample specifies, it pretends to be better than the test of ELISA-SPACc, despite no significant difference exist among them. New studies with better samples for the negative control and elaboration of the cut bridge should turn more real the indexes sensibility and specificity of the pepNC.