The Long Road to the Immunodiagnosis of Neurocysticercosis: Controversies and Confusions

Abstract

To date, even widely studied, there is not a standard diagnostic method to detect neurocysticercotic patients. The later due to the complex nature of cysticercosis disease and the simplicity of common immunological assumptions involved in explaining the low scores and reproducibility of immunotests in the diagnosis of neurocysticercosis. To begin with, the few studies dealing with the immune response during neurocysticercosis are not conclusive, which of course it is crucial to develop an immunodiagnostic test. Their full recognition should clear confusion and reduce controversy as well as provide avenues of research and technological design. In here, logical arguments add that even under common immunological assumptions, serology of neurocysticercosis will always include false negative and positive results. Thus, serology is no strong support for medical diagnosis of neurocysticercosis (NC). In contrast, immunotests performed in the cerebrospinal fluid (CSF) of neurological patients should have fewer false positive and fewer false negatives than in serum. To conclude, it is argued that high scores in serology for NC will not yield to usual approaches and that success needs of a concerted worldwide effort. A more punctilious strategy based on the design of panels of confirmed positive and negative sera needs to be construed, shared and tested by all interested groups to obtain comparable results. The identification of a set of specific and representative antigens of Taenia solium (T. solium) and a thorough compilation of the many forms of antibody response of humans to the many forms of T. solium disease are also to be considered as one of the most importants factors to the disease.