{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:27:41Z","timestamp":1792808861793,"version":"4.5.0"},"reference-count":48,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T00:00:00Z","timestamp":1664409600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Science, Research and Innovation Fund, Thailand"},{"name":"Khon Kaen University, Research and Graduate Studies Affairs","id":[{"id":"https:\/\/ror.org\/03cq4gr50","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Faculty of Medicine, Khon Kaen University","award":["RG63301"],"award-info":[{"award-number":["RG63301"]}],"id":[{"id":"https:\/\/ror.org\/03cq4gr50","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Amebic liver abscess (ALA) caused by\n                      <jats:italic>Entamoeba histolytica<\/jats:italic>\n                      is usually diagnosed based on its clinical symptoms, medical imaging abnormalities of the liver, and serological tests, the most common being the enzyme-linked immunosorbent assay (ELISA). For more than three decades, no investigation has evaluated the diagnostic performance of immunoglobulin G (IgG) subclasses in the serodiagnosis of ALA. Herein, we assessed the efficiencies of anti-amebic IgG and IgG subclasses for diagnosing ALA.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A serological ELISA-based test was performed to assess its diagnostic performance using a total of 330 serum samples from ALA patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a014), healthy individuals (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a040), and patients with other diseases (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0276).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      ELISA targeting the total IgG antibody to\n                      <jats:italic>E. histolytica<\/jats:italic>\n                      antigen exhibited 100% sensitivity 95% CI [76.8\u2013100.0] and 97.8% specificity 95% CI [95.5\u201399.1], whereas the assay targeting IgG1 showed the same sensitivity (100% 95% CI [76.8\u2013100.0]) and a slightly higher specificity (99.1% 95% CI [97.3\u201399.8]). The other IgG subclasses (IgG2, IgG3, and IgG4) displayed a lower sensitivity and specificity. The sensitivity and specificity did not significantly differ between tests measuring total IgG and IgG1 (Exact McNemar\u2019s test;\n                      <jats:italic>p<\/jats:italic>\n                      &gt; 0.05), with a concordance of 98.2%, represented by a Cohen\u2019s kappa of 0.83 (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), indicating almost perfect agreement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ELISA targeting IgG1 can provide valuable information to clinicians in differentiating ALA from other parasitic diseases, cancers, cirrhosis, and viral hepatitis. However, enzyme-conjugated anti-human total IgG is cheaper than anti-human IgG subclasses. Therefore, we suggest that total IgG-based ELISA is sufficient for the routine serodiagnosis of human ALA and possibly other clinical manifestations of invasive amebiasis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.7717\/peerj.14085","type":"journal-article","created":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T04:07:21Z","timestamp":1664424441000},"page":"e14085","source":"Crossref","is-referenced-by-count":8,"title":["Evaluation of total immunoglobulin G and subclass antibodies in an enzyme-linked immunosorbent assay for serodiagnosis of human amebic liver abscess"],"prefix":"10.7717","volume":"10","author":[{"given":"Penchom","family":"Janwan","sequence":"first","affiliation":[{"name":"Department of Medical Technology, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand"},{"name":"Hematology and Transfusion Science Research Center, Walailak University, Nakhon Si Thammarat, 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