Open AccessSensitive and Specific Immunohistochemical Diagnosis of Human Alveolar Echinococcosis with the Monoclonal Antibody Em2G11
Author(s) -
Thomas Barth,
Tobias Sebastian Herrmann,
Dennis Tappe,
Lorenz Georg Stark,
Beate Grüner,
Klaus Buttenschoen,
Andreas Hillenbrand,
Markus Juchems,
Doris HenneBruns,
Petra Kern,
H. M. Seitz,
Peter Möller,
Robert L. Rausch,
Peter Kern,
Peter Deplazes
Publication year - 2012
Publication title -
plos neglected tropical diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.99
H-Index - 135
eISSN - 1935-2735
pISSN - 1935-2727
DOI - 10.1371/journal.pntd.0001877
Subject(s) - echinococcus multilocularis , metacestode , pathology , immunohistochemistry , echinococcosis , monoclonal antibody , staining , h&e stain , biology , medicine , antibody , cestoda , immunology , helminths
Background Alveolar echinococcosis (AE) is caused by the metacestode stage of Echinococcus multilocularis . Differential diagnosis with cystic echinococcosis (CE) caused by E. granulosus and AE is challenging. We aimed at improving diagnosis of AE on paraffin sections of infected human tissue by immunohistochemical testing of a specific antibody. Methodology/Principal Findings We have analysed 96 paraffin archived specimens, including 6 cutting needle biopsies and 3 fine needle aspirates, from patients with suspected AE or CE with the monoclonal antibody (mAb) Em2G11 specific for the Em2 antigen of E. multilocularis metacestodes. In human tissue, staining with mAb Em2G11 is highly specific for E. multilocularis metacestodes while no staining is detected in CE lesions. In addition, the antibody detects s mall p articles of E . m ultiloculari s (spems) of less than 1 µm outside the main lesion in necrotic tissue, liver sinusoids and lymphatic tissue most probably caused by shedding of parasitic material. The conventional histological diagnosis based on haematoxylin and eosin and PAS stainings were in accordance with the immunohistological diagnosis using mAb Em2G11 in 90 of 96 samples. In 6 samples conventional subtype diagnosis of echinococcosis had to be adjusted when revised by immunohistology with mAb Em2G11. Conclusions/Significance Immunohistochemistry with the mAb Em2G11 is a new, highly specific and sensitive diagnostic tool for AE. The staining of s mall p articles of E . m ultiloculari s (spems) outside the main lesion including immunocompetent tissue, such as lymph nodes, suggests a systemic effect on the host.