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Open Access Research

Recombinant antigen-based antibody assays for the diagnosis and surveillance of lymphatic filariasis – a multicenter trial

Patrick J Lammie1*, Gary Weil2, Rahmah Noordin3, Perumal Kaliraj4, Cathy Steel5, David Goodman1, Vijaya B Lakshmikanthan4 and Eric Ottesen6

Author Affiliations

1 Division of Parasitic Diseases, Centers for Disease Control and Prevention, MS-F13, 4770 Buford Highway, Atlanta, Georgia, 30341, USA

2 Infectious Diseases Division, Campus Box 8051, Washington University School of Medicine, 660 S. Euclid Avenue, St. Louis, MO 63110, USA

3 Institute for Research in Molecular Medicine and School of Medical Sciences, Universiti Sains Malaysia, Malaysia

4 Centre for Biotechnology, Anna University, Chennai – 600 025, India

5 Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, 20892, USA

6 Emory University Lymphatic Filariasis Support Center, 1518 Clifton Road, Atlanta, Georgia, 30322, USA

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Filaria Journal 2004, 3:9  doi:10.1186/1475-2883-3-9

Published: 3 September 2004

Abstract

The development of antifilarial antibody responses is a characteristic feature of infection with filarial parasites. It should be possible to exploit this fact to develop tools to monitor the progress of the global program to eliminate lymphatic filariasis (LF); however, assays based on parasite extracts suffer from a number of limitations, including the paucity of parasite material, the difficulty of assay standardization and problems with assay specificity. In principle, assays based on recombinant filarial antigens should address these limitations and provide useful tools for diagnosis and surveillance of LF. The present multicenter study was designed to compare the performance of antibody assays for filariasis based on recombinant antigens Bm14, WbSXP, and BmR1. Coded serum specimens were distributed to five participating laboratories where assays for each antigen were conducted in parallel. Assays based on Bm14, WbSXP, or BmR1 demonstrated good sensitivity (>90%) for field use and none of the assays demonstrated reactivity with specimens from persons with non-filarial helminth infections. Limitations of the assays are discussed. Well-designed field studies are now needed to assess sampling methodology and the application of antibody testing to the monitoring and surveillance of LF elimination programs.