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Clinical and Diagnostic Laboratory Immunology, March 2004, p. 411-416, Vol. 11, No. 2
1071-412X/04/$08.00+0 DOI: 10.1128/CDLI.11.2.411-416.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
Department of Parasitology, Gifu University School of Medicine, Gifu, 500-8705 Japan,1 Institute of Anti-parasitic Diseases of Guangdong Province, Guangzhou, 510300 China2
Received 14 October 2003/ Returned for modification 17 November 2003/ Accepted 5 December 2003
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In conventional serological diagnosis of clonorchiasis, the adult worm crude antigens of C. sinensis are used. However, the crude antigens reduce the specificity of the serological test due to cross-reactivity with parasites sharing similar antigens (8). Cathepsin L, one of the cysteine proteinases, has been found in many species of parasites (7, 15, 21, 22). Cathepsin L is secreted by all stages of the developing parasites and is highly antigenic in infected animals. Reportedly, the purified or recombinant cysteine proteinase antigens have been used for diagnosis of human paragonimiasis (9), fascioliasis (1, 4, 5), and schistosomiasis (2, 11).
In this study, we cloned and expressed a C. sinensis cysteine proteinase and first evaluated the specificity and sensitivity of the recombinant protein in an enzyme-linked immunosorbent assay (ELISA) by comparing it with adult worm crude antigen.
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Sera. A total of 76 human serum samples of parasitologically and clinically proven cases were used. Serum samples referred to herein as clonorchiasis sera (n = 50) or schistosomiasis sera (n = 5) were collected from the patients infected with C. sinensis or Schistosoma japonicum, respectively, in the areas where these parasites are endemic in China. The sera from patients infected with other parasites, including Paragonimus westermani (n = 2), Fasciola hepatica (n = 3), Taenia solium (n = 2), Gnathostoma spinigerum (n = 3), Dirofilara immitis (n = 3), Diphyllobothrium latum (n = 3), Trichuris trichiura (n = 2), Anisakis simplex (n = 2), and Entamoeba histolytica (n = 1), were collected from patients in Japan. Serum samples from 48 healthy Japanese subjects without parasitological infections were used as negative controls.
Preparation of C. sinensis cDNA. Total RNA was isolated from adult worms using TRIZOL (Invitrogen, Carlsbad, Calif.) according to the manufacturer's instructions and treated with DNase (Promega, Madison, Wis.). Reverse transcription was performed using Ready-To-Go You-Prime First-Strand beads (Amersham Biosciences Co., Piscataway, N.J.) according to the manufacturer's instructions. Briefly, 3 µg of the total RNA and 1 µg of oligo12-18 (dT) (0.5 µg/µl; Amersham Biosciences Co.) were added to the Ready-To-Go tube, and this was followed by the addition of RNase-free water to produce a final volume of 33 µl. The tube was incubated at 37°C for 60 min and then at 90°C for 5 min.
Sequencing of cysteine proteinase of C. sinensis. The gene encoding full-length cysteine proteinase of C. sinensis was amplified by PCR from C. sinensis cDNA using oligonucleotide primers with BamHI and EcoRI restriction enzyme sites added (underlined). The primers were designed from the reported nucleotide sequences of C. sinensis cysteine proteinase (GenBank accession number AF093242) as follows: 5'-CGG GAT CCC GAT GCG ACT TTT CGT GTG TTG-3' and 5'-CGG AAT TCC GCT ATT TGA TAA TCG CTG TAG TA-3'. The PCR mixture (total volume of 100 µl) consisted of 10 µl of 100 ng of C. sinensis cDNA, 10 µl of 10x PCR buffer, 4 µl of each deoxynucleoside triphosphate (2.5 mM), 1.5 U of Taq polymerase (Takara Shuzo Co., Kyoto, Japan), and 10 µl of 10 µM concentrations of each primer. DNA was amplified for 35 cycles (each cycle consisted of 30 s of denaturation at 94°C, 30 s of annealing at 52°C, and 60 s of extension at 72°C). The purified PCR products were digested with BamHI and EcoRI (New England BioLabs, Beverly, Mass.), and the resulting fragments were cloned into pGEM-3Zf (+) vector (Promega). The nucleotide sequences were determined using Dye Primer Cycle Sequencing kits (Applied Biosystems, Foster City, Calif.) and an ABI DNA automatic sequencer (model 373S). The DNA sequences were assembled and analyzed using the DNASIS software (Hitachi Software Engineering, Tokyo, Japan). The BLAST network service was used to search the DNA and protein database at the National Center for Biotechnology Information.
Expression and purification of recombinant protein.
The gene encoding pro-cysteine proteinase of C. sinensis was amplified by PCR from C. sinensis cDNA using oligonucleotide primers with BamHI and EcoRI restriction enzyme sites added (underlined). The primers were designed from the nucleotide sequences which were determined in "Sequencing of cysteine proteinase of C. sinensis" as follows: 5'-CGG GAT CCC GGC TTT GGC CAG AAC TAC T-3' and 5'-CGG AAT TCC GCT ATT TGA TAA TCG CTG TAG TA-3'. The conditions for PCR were the same as those in "Sequencing of cysteine proteinase of C. sinensis." The purified PCR products were digested with BamHI and EcoRI and were cloned into the pTrcHis expression vector (Invitrogen). The recombinant plasmid was transformed into an Escherichia coli DH5
strain, and the expression of polyhistidine-containing recombinant proteins was induced by adding isopropyl-ß-D-thiogalactopyranaside (IPTG) at a final concentration of 1 mM at 37°C for 3 h. The induced cells were harvested and disrupted by sonication in 20 mM Tris-HCl buffer (pH 8.0). The recombinant protein expressed as inclusion bodies was solubilized completely with 6 M urea in 20 mM Tris-HCl buffer (pH 8.0) and then subjected to a His Trap kit (Amersham Biosciences Co.) for affinity purification of histidine-tagged proteins according to the manufacturer's instructions. Urea was removed from the sample protein solution by stepwise dilution of urea with 20 mM Tris-HCl buffer (pH 8.0) in a His Trap chelating column according to the method of Colangeli et al. (3). The recombinant protein was eluted with 500 mM imidazole, and then the imidazole was removed from samples with a PD-10 column (Amersham Biosciences Co.) and analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) (11% gel) and stained with Coomassie brilliant blue to assess their purity.
Preparation of antiserum. Antiserum against the recombinant protein was collected from BALB/c mice that received intradermal injections with approximately 100 µg of recombinant protein mixed with complete Freund's adjuvant followed by four booster injections of 50 µg of protein mixed with incomplete Freund's adjuvant at 2-week intervals.
Western blotting analysis. Test samples included crude extracts from adult worms and the recombinant protein. Aliquots of crude extracts (20 µg) or recombinant protein (0.4 µg) were subjected to SDS-PAGE (11% gel), electrotransferred to nitrocellulose sheets, and immunostained with sera from patients infected with C. sinensis, sera from patients infected with S. japonicum, sera from healthy adults, or sera from mice immunized against recombinant protein (1:100 dilution). Goat anti-human or mouse immunoglobulin G (Fab specific) alkaline phosphatase conjugate (Sigma Chemical Co., St. Louis, Mo.) was used as the second antibody, and the alkaline phosphatase was developed in 5-bromo-4-chloro-3-indolyl-p-toluidine salt and nitroblue tetrazolium.
Immunocytolocalization. C. sinensis adult worms were processed for light microscopic observation according to the established method (10% formalin fixation and hematoxylin and eosin staining). For immunohistochemical staining, formalin-fixed sections 4 µm thick were incubated with the sera from mice immunized against recombinant protein or normal mouse serum (1:100 dilution) for 1 h, washed, and further processed using the HistoStain SP kit (ZYMED Laboratories, South San Francisco, Calif.) according to the manufacturer's instructions.
ELISA. The antigens were assayed at several concentrations to determine the sensitivity of the ELISA, and the optimal concentration of the antigens was determined to be 5 µg/ml (data not shown). ELISA was performed as reported by Matsuda et al. (12) with slight modifications. Briefly, 96-well microtiter plates (MaxiSorp; Nalge Nunc International, Tokyo, Japan) were sensitized with either recombinant protein or adult worm extracts at a concentration of 5 µg/ml in 0.05 M bicarbonate buffer, pH 9.6 (100 µl/well), for 3 h at 37°C and overnight at 4°C. After the microplates were washed three times with 0.15 M phosphate-buffered saline (PBS)-0.05% Tween 20, they were blocked with 150 µl of PBS containing 2% bovine serum albumin for 1 h at 37°C. After washing as described above, the microplates were probed with a 1:200-diluted human serum sample (100 µl/well), in PBS containing 1% bovine serum albumin for 1 h at 37°C. After washing, 100 µl of 1:10,000-diluted goat anti-human immunoglobulin G (Fab specific) peroxidase conjugate (Sigma Chemical Co.) was incubated for 45 min at 37°C. For color development, 2-2'-azino-bis(3-ethylbenzthiazoline-6-sulfonic acid) (Sigma Chemical Co.) was added to each well as substrate (0.3 mg/ml; 100 µl/well), and the reaction was terminated after 60 min by adding 50 µl of 1.25% sodium fluoride per well. Absorbance at 414 nm was monitored with a Multiskan JX plate reader (Labsystems, Helsinki, Finland). All samples were carried out in duplicate. The cutoff point was set at three times the mean values of the A414 for the negative samples from 48 healthy persons.
Nucleotide sequence accession number. Nucleotide sequence data reported in this article are available in the GenBank, EMBL, and DDBJ databases under accession number AY273802.
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FIG. 1. Alignment of the deduced amino acid sequence of C. sinensis cysteine proteinase (Cs-cp) open reading frame, with that of P. westermani cathepsin L (Pw) (GenBank accession number AAB93494), S. japonicum cathepsin L (Sj) (GenBank accession number AAM44058), and F. hepatica cathepsin L (Fh) (GenBank accession number BAA23743). The putative signal peptide of Cs-cp is shaded. Amino acid residues conserved in all four sequences are indicated by asterisks. The identities with Cs-cp are represented along the margins. Gaps are represented by dashed lines. Amino acid positions are shown to the left of the sequences.
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FIG. 2. SDS-PAGE (11% gel) analysis of the Cs-cp recombinant protein. Lane 1, molecular mass standards (masses shown on the left side); lane 2, lysate of E. coli with Cs-cp before induction; lane 3, lysate of E. coli with Cs-cp after induction; lane 4, supernatants of lysate of E. coli with Cs-cp after induction; lane 5, precipitants of lysate of E. coli with Cs-cp after induction; lane 6, Cs-cp recombinant proteins purified by the affinity purification method.
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FIG. 3. (A) Western blotting analysis of C. sinensis adult worm crude extracts (lanes 2 and 6) and Cs-cp recombinant protein (lanes 4 and 8) stained with the pooled sera from patients infected with C. sinensis (lanes 2 and 4) and with the pooled sera from patients infected with S. japonicum (lanes 6 and 8). Lanes 1, 3, 5, and 7, molecular mass standards (masses shown on the left side). (B) Western blotting analysis of reactivity of sera from mice immunized against the Cs-cp recombinant protein with C. sinensis adult worm crude extracts (lane 2) and Cs-cp recombinant protein (lane 4). Lanes 1 and 3, molecular mass standards (masses shown on the left side).
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Cytolocalization of Cs-cp protein in C. sinensis adult worms. Intense staining with the sera from mice immunized against the Cs-cp recombinant protein was found within the intestinal epithelial cells of the adult parasite and in the intrauterine eggs (Fig. 4). The tegumental surface and parenchymal tissues had no reaction. Normal mouse sera did not result in any positive reaction (data not shown).
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FIG. 4. (B to D) Immunocytochemical staining of C. sinensis adult worms with sera from mice immunized against the Cs-cp recombinant protein. (A) Hematoxylin and eosin staining of C. sinensis adult worms. Abbreviations: i, intestine; e, intrauterine egg; t, testis.
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FIG. 5. Western blotting analysis of Cs-cp recombinant protein stained with sera from patients infected with C. sinensis (lanes 2 to 11), with sera from patients infected with S. japonicum (lanes 12 to 16), and with sera from healthy persons (lanes 17 to 21). Lane 1, molecular mass standards (masses shown on the left side).
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FIG. 6. Immunoreactivity of the Cs-cp recombinant protein (A) and C. sinensis adult worm extracts (B). Analysis by ELISA of 50 sera from patients infected with C. sinensis and 48 sera from healthy persons. The y axis shows the frequency of absorbance measurements.
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FIG. 7. Comparison of reactivity in enzyme-linked immunosorbent assay of the Cs-cp recombinant protein (A) and C. sinensis adult worm extracts (B) against those of sera from patients infected with C. sinensis (Cs), S. japonicum (Sj), P. westermani (Pw), F. hepatica (Fh), T. solium (Ts), G. spinigerum (Gs), D. immitis (Di), D. latum (Dl), T. trichiura (Tt), A. simplex (As), and E. histolytica (Eh). The cutoff values are indicated by the long horizontal lines. Open circles indicate values below the cutoff, and solid circles indicate values above the cutoff.
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Cysteine proteinases are highly antigenic because parasitic trematodes continually release them into the host. Therefore, cysteine proteinases are possible diagnostic antigens. Reportedly, the acidic extracts of various developmental stages of C. sinensis (metacercariae and adult worms) have cysteine proteinase activity (17). The present experiment showed that a recombinant cysteine proteinase of C. sinensis (Cs-cp) ensured the sensitivity and specificity of ELISA for serological diagnosis of clonorchiasis.
The amino acid sequence of the Cs-cp cysteine proteinase was less similar to the cathepsin L cysteine proteinases from P. westermani, S. japonicum, and F. hepatica. These data suggest that for serological diagnosis, the Cs-cp recombinant protein probably does not cross-react with sera from patients with P. westermani, S. japonicum, and F. hepatica infections. Indeed, in an ELISA, the Cs-cp recombinant protein did not cross-react with sera from patients with S. japonicum infection, and cross-reaction was observed in only one patient with G. spinigerum infection. On the contrary, adult worm extracts did not cross-react with all sera from patients with parasitic infections, but the sensitivity of the test using adult worm extracts was lower than that of Cs-cp antigen.
Cysteine proteinases from some trematodes were reported to localize in the intestine or in cercarial extracts or immature eggs (10, 13, 20), but immnocytochemical analysis of C. sinensis cysteine proteinases has not been reported. In this study, C. sinensis cysteine proteinases are localized in the intestinal epithelial cells of the adult parasite and in the intrauterine eggs. These cysteine proteinases are parts of the excretory-secretory products of C. sinensis and are mainly synthesized in the intestinal epithelia, secreted into the lumen, and have been shown to be highly antigenic in infected animals.
In C. sinensis, two kinds of cysteine proteinases have been reported (14, 15, 18). We preliminarily produced these two kinds of cysteine proteinases in the E. coli expression system and analyzed these recombinant cysteine proteinases by Western blotting. The sera from patients infected with C. sinensis strongly reacted with the Cs-cp recombinant protein but did not react with other kinds of recombinant cysteine proteinase. These data suggested that all of the cysteine proteinases of C. sinensis were not immunodominant and did not induce immunological reaction during infection.
In conclusion, it has been demonstrated that the recombinant cysteine proteinase is useful for immunodiagnosis of clonorchiasis by ELISA and will provide more reliable results not only for routine diagnosis but also for epidemiological surveys of clonorchiasis. Thus, the use of recombinant antigen may provide a new source of diagnostic reagent and more reliable results for diagnosis of clonorchiasis.
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