Direct microscopic examination, using a normal saline (0·9% NaCl) and iodine wet smear, was performed for each stool sample. At least two slides were prepared from each stool sample, and more than 30 fields were examined per slide. Lyophilized S. stercoralis filariform larvae were resuspended p38 protein kinase in 1 mL of 0·01 m phosphate-buffered saline (PBS), pH 7·2 that contained a cocktail of protease inhibitors (Roche Diagnostics, Mannheim, Germany), followed by incubation on ice for 10 min. The mixture was then frozen and thawed repeatedly by transfer between a liquid nitrogen tank and a 37°C water bath, respectively, followed by the addition of lysozyme at a final

concentration of 0·5 mg/mL and subsequent incubation on ice for 10 min. The larvae were further disrupted

using a sonicator, for five cycles at 30 s/cycle and a power of 1·5 Hz. The suspension was centrifuged at 10,000 × g for 10 min at 4°C, and the supernatant was analysed for protein content using an RCDC assay (Bio-Rad, Hercules, CA, USA) and then stored at −80°C. The leftover pellet was stirred in PBS overnight at 4°C to further extract the antigen and centrifuged at 10,000 × g for 10 min, and the protein content of the supernatant was determined as described above. Recombinant BmR1 antigen was previously produced in our laboratory according to a previously published method [14, 15]. Preliminary experiments

were performed to determine the optimal conditions for ELISA, particularly antigen concentrations and dilutions of serum and secondary antibody conjugates. High-binding microtitre click here plates (Nunc MaxiSorp; Nalge Nunc International, Rochester, NY) were coated with 5 μg/mL of S. stercoralis antigen in 0·06 M carbonate buffer (pH 9·6) for IgG-ELISA, or 10 μg/ml of antigen for IgG4 and IgE-ELISA, and were incubated overnight at 4°C. After five washes with 0·05% Tween-20 in PBS, the wells were blocked with 3% (w/v) bovine serum albumin (Sigma Aldrich Co, St. Louis, MO, USA) in PBS for 1 h at 37°C. Subsequent steps were carried out using PBS as the diluent, and washes with PBS-T were performed on a plate shaker (500 rpm) between the incubation Tangeritin steps. Serum samples were diluted at 1 : 100 for IgG4- and IgE-ELISAs, and 1 : 200 for IgG-ELISAs. After incubating the serum samples for 2 h at 37°C on a microplate shaker (300 rpm), the plates were washed as described above. The secondary antibody conjugates were added for 30 min at 37°C (1 : 4500 for IgG4-HRP, 1 : 2000 for IgE-HRP and 1 : 8000 for IgG-HRP), followed by an incubation with ABTS substrate solution (Roche Diagnostics). The absorbance readings of the reactions were read at 405 nm, using 490 nm readings as a reference, on a Thermo Multiskan Spectrum Reader (Multiskan Spectrum, Thermo Scientific, Rockford, IL, USA).