Qasim Sharhan Al-Mayah1, Ahmed Sadoon Obeid2
and Fatima Abood Chalob3

1Medical Research Unit/ College of Medicine/ Al-Nahrain University/Iraq.
2Al-Rasheed University College/ Medical Laboratory Techniques/Iraq.
3Technical Institute of Al-Dewanyia/Iraq.

Abstract

Cystic echinococcosis (CE) is a cosmopolitan disease especially endemic in temperate areas. Human acts as an intermediate host, and there is no implementable non-invasive technique for definitive diagnosis of this disease. This study aimed to evaluate the diagnostic value of serum concentration of three cytokines: interleukin-4 (IL-4), interleukn-10 (IL-10) and interleukin-12 (IL-12) for detection of CE. A total of 42 patients with hepatic CE and other 30 age- and sex-matched apparently healthy subjects were recruited for this case/control study. Sera were obtained for each subjects, and anti-echinococcal IgG antibodies and serum concentration of IL-4, IL-10 and IL-12 were measured by enzyme linked immunosorbent assay (ELISA). Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of these cytokines. All cases as well as two control subjects were positive for anti-echinococcal IgG antibodies. Serum concentration of IL-4 and IL-10 were higher in cases than controls with significant differences, while there was no such difference in IL-12 concentration. Discrete ROC analysis revealed a moderate diagnostic value for each of IL-4 and IL-10. However, the combined ROC analysis for these two cytokines resulted in a very good discriminative value in which the area under the curve (AUC) was 0.803, 95%CI=0.702-0.905, P<0.001. The sensitivity and specificity of the test at 7.45 pg/mL and 764.5 pg/ml cut-off values (for IL-4 and IL-10 respectively) were 0.70 and 0.71 respectively, Serum concentrations of IL-4 and IL-10 but not IL-12 could be utilized as an additional diagnostic tool for definitive diagnosis of suspected CE. More studies on other Th2-related cytokines or chemokines in CE patients are required to further develop this diagnostic assay.

Keywords: Cystic echinococcus, Th1 interleukins, receiver operating characteristic curve.