Ann Clin Microbiol.  2024 Jun;27(2):81-91. 10.5145/ACM.2024.27.2.5.

Serological diagnosis of tissue-invading parasites in Korea

Affiliations
  • 1Department of Parasitology and Tropical Medicine, Institute of Endemic Diseases, Seoul National University College of Medicine, Seoul, Korea

Abstract

Although intestinal parasites are no longer considered a significant public health concern in Korea, tissue-invading parasites continue to pose clinical challenges. The diagnosis of tissue helminthiasis by recovering worms or larvae from tissues is invasive; therefore, serodiagnosis is widely used to diagnose infections caused by tissue-invading parasites. Among the serological tests, the enzyme-linked immunosorbent assay (ELISA) is the most commonly used, and various antigens, including crude antigens, excretory-secretory antigens of helminths, and cystic fluid of larval tapeworms, are used to detect specific IgGs against parasite antigens in the sera or cerebrospinal fluid of patients. A multi-antigen ELISA was used to diagnose four major tissue parasitic infections: clonorchiasis, paragonimiasis, cysticercosis, and sparganosis. In addition to these four parasitic infections, ELISA remains a valuable diagnostic method for toxocariasis, trichinellosis, fascioliasis, echinococcosis, and other diseases. A comprehensive history of the mode of transmission of the suspected parasites and the patient’s residence in or travel to an endemic area may help in making a definitive diagnosis. For the management of patients with eosinophilia in Korea, it is essential to perform ELISA for the differential diagnosis of toxocariasis. Serological tests have the disadvantage of being unable to differentiate between past and current infections, and the possibility of cross-reactivity requires careful interpretation. It is important to note that the results of serological tests are not necessarily conclusive and should be interpreted in the context of other symptoms, as well as clinical and imaging findings.

Keyword

Helminths; Serological tests; ELISA; Korea

Reference

1. WHO. Neglected tropical diseases. https://www.who.int/health-topics/neglected-tropicaldiseases#tab=tab_1 [Online] (last visited on 3 April 2024). .
2. Choi MH, Yu JR, Hong ST. Who neglects Neglected Tropical Diseases? - Korean perspective. J Korean Med Sci 2015;30:S122-30. .
3. Hong ST, Chai JY, Choi MH, Huh S, Rim HJ, Lee SH. A successful experience of soiltransmitted helminth control in the Republic of Korea. Korean J Parasitol 2006;44:177-85. .
4. Lee MK, Hong SJ, Kim HR. Seroprevalence of tissue invading parasitic infections diagnosed by ELISA in Korea. J Korean Med Sci 2010;25:1272-6. .
5. Jin Y, Kim EM, Choi MH, Oh MD, Hong ST. Significance of serology by multi-antigen ELISA for tissue helminthiases in Korea. J Korean Med Sci 2017;32:1118-23. .
6. Kim JY, Yi MH, Yong TS. Parasitic infections and medical expenses according to health insurance review assessment claims data in South Korea, 2011-2018. PLoS One 2019;14:e0225508. .
7. Jeong YI, Shin HE, Lee SE, Cheun HI, Ju JW, Kim JY, et al. Prevalence of Clonorchis sinensis infection among residents along 5 major rivers in the Republic of Korea. Korean J Parasitol 2016;54:215-9. .
8. Choi MH, Park IC, Li S, Hong ST. Excretory-secretory antigen is better than crude antigen for the serodiagnosis of clonorchiasis by ELISA. Korean J Parasitol 2003;41:35-9. .
9. Kim JG, Ahn CS, Sripa B, Eom KS, Kang I, Sohn WM, et al. Clonorchis sinensis omegaclass glutathione transferases are reliable biomarkers for serodiagnosis of clonorchiasis and opisthorchiasis. Clin Microbiol Infect 2019;25:109.e1-.e6. .
10. Na BK, Lee HJ, Cho SH, Lee HW, Cho JH, Kho WG, et al. Expression of cysteine proteinase of Clonorchis sinensis and its use in serodiagnosis of clonorchiasis. J Parasitol 2002;88:10006. .
11. Zhao QP, Moon SU, Lee HW, Na BK, Cho SY, Kong Y, et al. Evaluation of Clonorchis sinensis recombinant 7-kilodalton antigen for serodiagnosis of clonorchiasis. Clin Diagn Lab Immunol 2004;11:814-7. .
12. Shen C, Lee JA, Allam SRA, Bae YM, Han ET, Takeo S, et al. Serodiagnostic applicability of recombinant antigens of Clonorchis sinensis expressed by wheat germ cell-free protein synthesis system. Diagn Microbiol Infect Dis 2009;64:334-9. .
13. Ahn CS, Shin JW, Kim JG, Lee WY, Kang I, Im JG, et al. Spectrum of pleuropulmonary paragonimiasis: an analysis of 685 cases diagnosed over 22 years. J Infect 2021;82:150-8. .
14. Blair D. Paragonimiasis. In: Toledo R and Fried B, eds. Digenetic trematodes. New York; Springer New York, 2014:115-52. .
15. Cho SY, Hong ST, Rho YH, Choi SY, Han YC. Application of micro-ELISA in serodiagnosis of human paragonimiasis. Korean J Parasitol 1981;19:151-6. .
16. Kim JG, Ahn CS, Kang I, Shin JW, Jeong HB, Nawa Y, et al. Cerebral paragonimiasis: clinicoradiological features and serodiagnosis using recombinant yolk ferritin. PLoS Negl Trop Dis 2022;16:e0010240. .
17. Kong Y, Cho SY, Cho MS, Kwon OS, Kang WS. Seroepidemiological observation of Taenia solium cysticercosis in epileptic patients in Korea. J Korean Med Sci 1993;8:145-52. .
18. Cho SY, Kim SI, Kang SY, Choi DY, Suk JS, Choi KS, et al. Evaluation of enzyme-linked immunosorbent assay in serological diagnosis of human neurocysticercosis using paired samples of serum and cerebrospinal fluid. Korean J Parasitol 1986;24:25-41. .
19. Cho SY, Kim SI, Kang SY. Serologic follow-up study in neurocysticercosis patients by ELISA after praziquantel treatment. Korean J Parasitol 1986;24:159-70. .
20. Ahn CS, Kim JG, Huh S, Kang I, Kong Y. Advances in serological diagnosis of Taenia solium neurocysticercosis in Korea. Genomics Inform 2019;17:e7. .
21. Bae YA, Jeong YT, Chung JY, Kim SH, Mahanta J, Feng Z, et al. A recombinant chimeric antigen toward a standardized serodiagnosis of Taenia solium neurocysticercosis. Proteomics Clin Appl 2008;2:1596-610. .
22. Kim JG, Ahn CS, Sohn WM, Nawa Y, Kong Y. Human sparganosis in Korea. J Korean Med Sci 2018;33:e273. .
23. Kong Y, Cho SY, Kang WS. Sparganum infections in normal adult population and epileptic patients in Korea: a seroepidemiologic observation. Korean J Parasitol 1994;32:85-92. .
24. Lee KJ, Bae YT, Kim DH, Deung YK, Ryang YS. A seroepidemiologic survey for human sparganosis in Gangweon-do. Korean J Parasitol 2002;40:177-80. .
25. Lee MR, Ju JW, Yang HW, Kim TS, Park MY, Cho SH. Seropositivity and identification of paramyosin for sparganosis in the Kangwon and Incheon provinces of the Republic of Korea. J Helminthol 2017;91:642-6. .
26. Glickman LT. The epidemiology of human toxocariasis. In: Lewis JW and Maizels RM, eds. Toxocara and toxocariasis: clinical, epidemiological and molecular perspectives. London; Birbeck & Sons, 1993:3-10. .
27. Song HB, Lee D, Jin Y, Kang J, Cho SH, Park MS, et al. Prevalence of toxocariasis and its risk factors in patients with eosinophilia in Korea. Korean J Parasitol 2020;58:413-9. .
28. Won EJ, Kim J, Shin MG, Shin JH, Suh SP, Ryang DW. Seroepidemiology of toxocariasis and its clinical implications in Gwangju and Jeonnam-province, Korea. Ann Lab Med 2015;35:449-53. .
29. Jacquier P, Gottstein B, Stingelin Y, Eckert J. Immunodiagnosis of toxocarosis in humans: evaluation of a new enzyme-linked immunosorbent assay kit. J Clin Microbiol 1991;29:18315. .
30. Jin Y, Shen C, Huh S, Sohn WM, Choi MH, Hong ST. Serodiagnosis of toxocariasis by ELISA using crude antigen of Toxocara canis larvae. Korean J Parasitol 2013;51:433-9. .
31. Kim HS, Jin Y, Choi MH, Kim JH, Lee YH, Yoon CH, et al. Significance of serum antibody test for toxocariasis in healthy healthcare examinees with eosinophilia in Seoul and Gyeongsangnam-do, Korea. J Korean Med Sci 2014;29:1618-25. .
32. Lee JY, Yang MH, Hwang JH, Kang M, Paeng JW, Yune S, et al. The prevalence of toxocariasis and diagnostic value of serologic tests in asymptomatic Korean adults. Allergy Asthma Immunol Res 2015;7:467-75. .
33. Park HY, Lee SU, Huh S, Kong Y, Magnaval JF. A seroepidemiological survey for toxocariasis in apparently healthy residents in Gangwon-do, Korea. Korean J Parasitol 2002;40:113-7.Jin Y, Shen C, Huh S, Sohn WM, Choi MH, Hong ST. Serodiagnosis of toxocariasis by ELISA using crude antigen of Toxocara canis larvae. Korean J Parasitol 2013;51:433-9. .
34. Kim YH, Huh S, Chung YB. Seroprevalence of toxocariasis among healthy people with eosinophilia. Korean J Parasitol 2008;46:29-32. .
35. Kwon NH, Oh MJ, Lee SP, Lee BJ, Choi DC. The prevalence and diagnostic value of toxocariasis in unknown eosinophilia. Ann Hematol 2006;85:233-8. .
36. Yoon SY, Baek S, Park SY, Shin B, Kwon HS, Cho YS, et al. Clinical course and treatment outcomes of toxocariasis-related eosinophilic disorder. Medicine 2018;97:e12361. .
37. Choi D, Lim JH, Choi DC, Paik SW, Kim SH, Huh S. Toxocariasis and ingestion of raw cow liver in patients with eosinophilia. Korean J Parasitol 2008;46:139-43. .
38. Seo M and Yoon SC. A seroepidemiological survey of toxocariasis among eosinophilia patients in Chungcheongnam-do. Korean J Parasitol 2012;50:249-51. .
39. Sohn WM, Kim HM, Chung DI, Yee ST. The first human case of Trichinella spiralis infection in Korea. Korean J Parasitol 2000;38:111-5. .
40. Jeong JT, Seo M, Hong ST, Kim YK. An outbreak of trichinellosis by consumption of raw soft-shelled turtle meat in Korea. Korean J Parasitol 2015;53:219-22. .
41. Bang SH, Park JB, Chee HK, Kim JS, Ko SM, Kim WS, et al. Cardiac parasitic infection in trichinellosis associated with right ventricle outflow tract obstruction. Korean J Thorac Cardiovasc Surg 2014;47:145-8. .
42. Kim G, Choi MH, Kim JH, Kang YM, Jeon HJ, Jung Y, et al. An outbreak of trichinellosis with detection of Trichinella larvae in leftover wild boar meat. J Korean Med Sci 2011;26:1630-3. .
43. Lee SR, Yoo SH, Kim HS, Lee SH, Seo M. Trichinosis caused by ingestion of raw soft-shelled turtle meat in Korea. Korean J Parasitol 2013;51:219-21. .
44. Rhee JY, Hong ST, Lee HJ, Seo M, Kim SB. The fifth outbreak of trichinosis in Korea. Korean J Parasitol 2011;49:405-8. .
45. Han JK, Choi BI, Cho JM, Chung KB, Han MC, Kim CW. Radiological findings of human fascioliasis. Abdom Imaging 1993;18:261-4. .
46. Cho SY, Seo BS, Kim YI, Won CK, Cho SK. A case of human fascioliasis in Korea. Korean J Parasitol 1976;14:147-52. .
47. Park CI, Kim H, Ro JY, Gutierrez Y. Human ectopic fascioliasis in the cecum. Am J Surg Pathol 1984;8:73-7. .
48. Cho SY, Yang HN, Kong Y, Kim JC, Shin KW, Koo BS. Intraocular fascioliasis: a case report. Am J Trop Med Hyg 1994;50:349-53. .
49. Kim YH, Kang KJ, Kwon JH. [Four cases of hepatic fascioliasis mimicking cholangiocarcinoma]. Korean J Hepatol 2005;11:169-75. .
50. Lee OJ and Kim TH. Indirect evidence of ectopic pancreatic fascioliasis in a human. J Gastroenterol Hepatol 2006;21:1631-3. .
51. Park HJ, Choi GS, Jung M, Lee SU. Fasciola hepatica induced hepatic abscess treated with triclabendazole. Korean J Gastroenterol 2021;77:39-44. .
52. Jeong MJ, Park JK, Yu HS. Phylogenetic characteristics of Fasciola hepatica isolated from a Korean patient. Korean J Parasitol 2022;60:367-70. .
53. Kim SW and Jang BK. Toxocara canis and Fasciola hepatica co-infection leading to hepatic abscess: a case report. J Korean Med Sci 2023;38:e323. .
54. Mirzadeh A, Jafarihaghighi F, Kazemirad E, Sabzevar SS, Tanipour MH, Ardjmand M. Recent developments in recombinant proteins for diagnosis of human fascioliasis. Acta Parasitol 2021;66:13-25. .
55. Kim TY, Lee YS, Yun JH, Kim JJ, Choi WH, Oh IH, et al. A case of probable mixed-infection with Clonorchis sinensis and Fasciola sp.: CT and parasitological findings. Korean J Parasitol 2010;48:157-60. .
56. McManus DP, Gray DJ, Zhang W, Yang Y. Diagnosis, treatment, and management of echinococcosis. BMJ 2012;344:e3866. .
57. Jin Y, Anvarov K, Khajibaev A, Hong S, Hong ST. Serodiagnosis of echinococcosis by ELISA using cystic fluid from Uzbekistan sheep. Korean J Parasitol 2013;51:313-7. .
Full Text Links
  • ACM
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr