Evidence map›Paper›PMID 39969576›Full record

ArticleMedical microbiology and immunology2025

Production of recombinant electron transfer flavoprotein beta subunit protein and its application in a lateral flow assay for early diagnosis of leptospirosis.

Uraiwan Kositanont, Charin Thawornkuno, Athisri Sitthipunya, Worawan Dachavichitlead, Chanwit Tribuddharat, Suppalak Brameld, Galayanee Doungchawee, Benchaporn Lertanantawong, Chatchawan Srisawat

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Article in Medical microbiology and immunology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Uraiwan KositanontFaculty of Public Health, Thammasat University, Pathum Thani, 12121, Thailand. uraiwan.kos@mahidol.ac.th.
Charin ThawornkunoDepartment of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand.
Athisri SitthipunyaDepartment of Pathobiology, Faculty of Science, Mahidol University, Bangkok, 10400, Thailand.
Worawan DachavichitleadFaculty of Science, Mahidol University, Bangkok, 10400, Thailand.
Chanwit TribuddharatDepartment of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand.
Suppalak BrameldDepartment of Medical Sciences, Ministry of Public Health, National Institute of Health, Nonthaburi, 11000, Thailand.
Galayanee DoungchaweeDepartment of Pathobiology, Faculty of Science, Mahidol University, Bangkok, 10400, Thailand.
Benchaporn LertanantawongDepartment of Biomedical Engineering, Faculty of Engineering, Mahidol University, Phutthamonthon 4 Road, Salaya, Nakhon Pathom, 73170, Thailand.
Chatchawan SrisawatDepartment of Biochemistry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Leptospirosis is a major cause of acute febrile illness, often presenting with non-specific symptoms that can lead to misdiagnosis. Early laboratory diagnosis is essential for confirmation to avoid misdiagnosis and ensure appropriate management. This study aimed to identify and produce a recombinant protein, approximately 25 kDa, with high antigenicity for diagnostic applications. The 25 kDa protein from Leptospira interrogans was identified as electron transfer flavoprotein beta subunits (Etfβ) and exhibited 98% nucleotide and 99% amino acid homology to the reference strain. Lateral flow assays (LFAs) using recombinant Etfβ (rEtfβ) as antigens were developed to detect specific antibodies, namely rEtfβ-IgM and rEtfβ-IgG, and evaluated their performance against the standard microscopic agglutination test (MAT). Testing 33 paired serum samples from confirmed leptospirosis cases and 24 controls revealed sensitivities of 69.7% for IgM and 57.6% for IgG. However, the combined assays yielded enhanced diagnostic accuracy, achieving a sensitivity of 94.0%, specificity of 95.8%, positive predictive value of 96.9%, negative predictive value of 92.0%, and percent agreement of 94.7% (kappa value of 0.89). Also, the combined LFAs demonstrated 66.7% in initial serum samples whose MAT results were negative, enhancing the capacity for early diagnosis. In conclusion, the developed rapid tests demonstrated strong diagnostic capability, particularly in early-phase leptospirosis, distinguishing between initial and recurrent infections. Importantly, rEtfβ-IgG identified a subset of patients lacking detectable IgM. Thus, integrating rEtfβ-IgM and rEtfβ-IgG is recommended to improve sensitivity and accuracy in endemic populations. The rEtfβ is a promising target for future antigen-based diagnostic strategies for leptospirosis. The rEtfβ antigen shows promise as a target for future development of antigen-based diagnostic strategies for leptospirosis.

Indexed as

Antigens, BacterialElectron-Transferring FlavoproteinsLeptospira interrogansLeptospirosisAntibodies, BacterialEarly DiagnosisFemaleHumansImmunoglobulin GImmunoglobulin MRecombinant ProteinsSensitivity and SpecificityAntibodies, BacterialAntigens, BacterialElectron-Transferring FlavoproteinsImmunoglobulin GImmunoglobulin MRecombinant ProteinsAntibody detectionEarly diagnosisElectron transfer flavoprotein beta subunitLeptospirosisRecombinant protein

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.