The use of synthetic antigens for diagnosis of infectious diseases : report of a WHO scientific group, meeting held in Geneva from 30 November to 4 December 1987

1. Introduction -- 2. General aspects -- 3. synthetic antigens in the diagnosis of viral infections -- 4. Synthetic antigens in diagnosis of human immunodeficiency virus (HIV) infection -- 5. Synthetic antigens in the diagnosis of bacterial and parasitic diseases -- 6. General conclusions and recommendations -- References

A state-of-the-art review of basic and applied research focused on the potential of synthetic antigens to yield more rapid and accurate diagnostic tests for infectious diseases. Addressed to researchers, the book evaluates more than 200 recent studies in an effort to define which lines of investigation are most likely to produce significant diagnostic gains. Applications in viral, bacterial, and parasitic diseases are considered together with prospects for the development of improved diagnostic tests for the detection and monitoring of infection with the human immunodeficiency virus (‎HIV)‎. Throughout, an effort is made to pinpoint specific applications where the use of synthetic antigens offers distinct advantages over natural epitopes. Guidelines for the use of existing synthetic peptides are also provided. The report opens with a review of the remarkable progress achieved in chemical peptide synthesis and in the use of recombinant DNA technology for the production of antigens. An introduction to procedures for the identification of antigenic determinants is followed by a review of progress in the development of diagnostic assays at the B cell and T cell levels. Readers are then given a detailed assessment of the potential usefulness of synthetic antigens in the diagnosis of viral infections, including those caused by influenza virus, paramyxoviruses, arenaviruses, hepatitis B virus, poliovirus, hepatitis A virus, and herpesviruses. Applications in the diagnosis of HIV infection are assessed against the drawbacks of current diagnostic tests, particularly concerning the need for expensive confirmatory tests and the serious problems caused by false-negative responses. Readers learn how the ability to produce synthetic antigens has opened exciting prospects for the design of new screening reagents and the development of urgently needed assays for monitoring the progress of infection and therapy, for routinely following up asymptomatic carriers, and for establishing a prognosis for carriers and patients at various stages of disease severity. The final section reviews the potential of synthetic antigens to improve the diagnosis of bacterial and parasitic diseases. Examples explored include mycobacteria, streptococci, malaria, and schistosomiasis