LEISHMANIA

Genomic Insight of Leishmania Parasite: In-Depth Review of Drug Resistance Mechanisms and Genetic Mutations

Leishmaniasis, which is caused by a parasitic protozoan of the genus Leishmania, is still a major threat to global health, impacting millions of individuals worldwide in endemic areas. Chemotherapy has been the principal method for managing leishmaniasis; nevertheless, the evolution of drug resistance offers a significant obstacle to therapeutic success. Drug-resistant behavior in these parasites is a complex phenomenon including both innate and acquired mechanisms. Resistance is frequently related to changes in drug transportation, drug target alterations, and enhanced efflux of the drug from the pathogen. This review has revealed specific genetic mutations in Leishmania parasites that are associated with resistance to commonly used antileishmanial drugs such as pentavalent antimonials, miltefosine, amphotericin B, and paromomycin, resulting in changes in gene expression along with the functioning of various proteins involved in drug uptake, metabolism, and efflux. Understanding the genetic changes linked to drug resistance in Leishmania parasites is essential for creating approaches for tackling and avoiding the spread of drug-resistant variants. Based on which specific treatments focus on mutations and pathways could potentially improve treatment efficacy and help long-term leishmaniasis control. More study is needed to uncover the complete range of genetic changes generating medication resistance and to develop new therapies based on available information.

Triethyl phosphine decorated cerium oxide nanoparticles exhibit selective killing of the unicellular protozoan parasite Leishmania donovani

Globally, Leishmaniasis affects underprivileged communities of the nations and chemotherapy remains one of the preferred treatment options. However, the cytotoxicity, side effects, and cost of the present chemotherapies limit their utilization. Auranofin [an organogold compound having significant structural similarity with triethyl-phosphine (TEP)] has been reported as an effective therapy for Leishmaniasis treatment. Considering the high cost of gold and the strong affinity of cerium oxide nanoparticles (CeNPs) to phosphine ligands, we designed TEP-decorated CeNPs (CeNPs-TEP) and used them as a novel antileishmanial agent. The hydrodynamic size of synthesized CeNPs and CeNPs-TEP was observed to be 22.2 ± 3.7 nm and 92.11 ± 6.2 nm, respectively. CeNPs-TEP provided aqueous stability to TEP as TEP alone is extremely unstable in water. Exposure of CeNPs-TEP showed ~ 60 and ~ 82% cell death in Leishmania donovani Ag83 promastigotes after 24 and 48 h, respectively. The same concentration of CeNPs-TEP did not affect the cellular viability of RAW 264.7 macrophage cells significantly. The oxidative stress and depolarization of the mitochondrial membrane were also observed after the treatment of CeNPs-TEP. Exposure of CeNPs-TEP induced a ~ 2.2-fold increase in ROS generation inside Leishmania donovani Ag83 cells. Dual staining with ethidium bromide and acridine orange reveals that these processes ultimately result in cell death. The results conclude that a combination of CeNPs and TEP could open the door for developing novel antileishmanial therapeutics in the future.

Supplementary Information

The online version contains supplementary material available at 10.1007/s13205-023-03813-7.

An innovative genosensor for the monitoring of Leishmania spp sequence using binding of pDNA to cDNA based on Cit-AgNPs

Leishmaniasis considered as the most crucial epidemic-prone diseases according to the World Health Organization. Early diagnoses and therapy of Leishmania infection is a great challenge since, it has no symptom and is resistance to drugs. Therefore, there is an urgent need for sensitive and precise detection of this pathogen. In this study, a new method was developed for optical biosensing of Leishmania spp sequence based on hybridization of Citrate capped Ag nanoparticles bonded to specific single stranded DNA probe of Leishmania spp. Aggregation of the Citrate capped Ag nanoparticles in the existence or lack of a cDNA sequence of Leishmania, cause eye catching and considerable significant alter in the UV-vis. The obtained low limit of quantification (LLOQ) of was achieved as 1ZM. Based on experimental results in optimum conditions, quick bioanalysis of Leishmania spp sequence was performed (2 min). So, this probe can be used for the clinical diagnosis of this pathogen and infection disease.

LB broth-lyophilized Rabbit serum (LLR) as a new and suitable culture medium for cultivation of promastigotes of Leishmania major

Fetal calf serum is the major part and the most expensive ingredient of the Leishmania culture media. Here, the efficacy of the LB broth-lyophilized Rabbit serum medium (LLR) was evaluated in cultivation of Leishmaniamajor. Conventional Luria-Bertani (LB) broth medium was prepared and autoclaved for 15 min at 121 °C and then lyophilized Rabbit serum was added at the 1, 2.5, 5 and 10 % final concentrations. The efficacy of medium was evaluated by assessing the growth ability and replication pattern of the promastigotes of L. major. According to our finding, the LLR medium with 5-10 % lyophilized Rabbit serum supported the growth of the parasites and can be used for cultivation of Leishmanian parasites with acceptable In vivo infectivity for research purpose. The ability of the parasites to survive and proliferating in the presence of lyophilized Rabbit serum indicating that this serum is a good nutritional source. This study opens a new way to make low-cost medium that could be used in cultivation of Leishmanian parasites.

A Historical Overview of the Classification, Evolution, and Dispersion of Leishmania Parasites and Sandflies

BACKGROUND

The aim of this study is to describe the major evolutionary historical events among Leishmania, sandflies, and the associated animal reservoirs in detail, in accordance with the geographical evolution of the Earth, which has not been previously discussed on a large scale.

METHODOLOGY AND PRINCIPAL FINDINGS

Leishmania and sandfly classification has always been a controversial matter, and the increasing number of species currently described further complicates this issue. Despite several hypotheses on the origin, evolution, and distribution of Leishmania and sandflies in the Old and New World, no consistent agreement exists regarding dissemination of the actors that play roles in leishmaniasis. For this purpose, we present here three centuries of research on sandflies and Leishmania descriptions, as well as a complete description of Leishmania and sandfly fossils and the emergence date of each Leishmania and sandfly group during different geographical periods, from 550 million years ago until now. We discuss critically the different approaches that were used for Leishmana and sandfly classification and their synonymies, proposing an updated classification for each species of Leishmania and sandfly. We update information on the current distribution and dispersion of different species of Leishmania (53), sandflies (more than 800 at genus or subgenus level), and animal reservoirs in each of the following geographical ecozones: Palearctic, Nearctic, Neotropic, Afrotropical, Oriental, Malagasy, and Australian. We propose an updated list of the potential and proven sandfly vectors for each Leishmania species in the Old and New World. Finally, we address a classical question about digenetic Leishmania evolution: which was the first host, a vertebrate or an invertebrate?

CONCLUSIONS AND SIGNIFICANCE

We propose an updated view of events that have played important roles in the geographical dispersion of sandflies, in relation to both the Leishmania species they transmit and the animal reservoirs of the parasites.

The effect of avian blood on Leishmania development in Phlebotomus duboscqi

Background

The development of pathogens transmitted by haematophagous invertebrate vectors is closely connected with the digestion of bloodmeals and is thus affected by midgut enzymatic activity. Some studies have demonstrated that avian blood inhibits Leishmania major infection in the Old World vector Phlebotomus papatasi; however, this effect has never been observed in the New World vectors of the genus Lutzomyia infected by other Leishmania species. Therefore, our study was focused on the effect of chicken blood on bloodmeal digestion and the development of Leishmania major in its natural vector Phlebotomus duboscqi, i.e. in a vector-parasite combination where the effect of blood is assumed. In addition, we tested the effect of avian blood on midgut trypsin activity and the influence of repeated feedings on the susceptibility of sand flies to Leishmania infection.

Methods

Phlebotomus duboscqi females were infected by rabbit blood containing L. major and either before or after the infection fed on chickens or mice. The individual guts were checked microscopically for presence and localization of Leishmania, parasite numbers were detected by Q-PCR. In addition, midgut trypsin activity was studied.

Results

Sand fly females fed on chicken blood had significantly lower midgut trypsin activity and delayed egg development compared to those fed on rabbits. On the other hand, there was no effect detected of avian blood on parasite development within the sand fly gut: similar infection rates and parasite loads were observed in P. duboscqi females infected by L. major and fed on chickens or mouse one or six days later. Similarly, previous blood feeding of sand flies on chickens or mice did not show any differences in subsequent Leishmania infections, and there was equal susceptibility of P. duboscqi to L. major infection during the first and second bloodmeals.

Conclusion

In spite of the fact that avian blood affects trypsin activity and the oocyte development of sand flies, no effect of chicken blood was observed on the development of L. major in P. duboscqi. Our study unambiguously shows that sand fly feeding on avian hosts is not harmful to Leishmania parasites within the sand fly midgut.

Effects of sheep and mouse urine on the growth pattern of Leishmania major promastigotes

The protozoan parasites of the genus Leishmania are the causative agents of different clinical diseases. Fetal calf serum (FCS) is the main part and the most expensive ingredient of the Leishmania culture media. Here, the efficacies of different concentrations (1%, 2.5%, 5%, and 10%) of the filtered and autoclaved sheep and mouse urine were evaluated as a growth stimulator in Leishmania culture procedure. The results indicated that culture media enriched with the filtered sheep and mouse urine supported the growth of the parasites and can be used for cultivation of Leishmania parasites. In conclusion, this study has demonstrated an alternative low-cost medium that could be used in cultivation process of Leishmania major promastigotes.

Cloning, Expression and Purification of L. Donovani Specific Antigen for Serodiagnosis of Visceral Leishmaniasis

BACKGROUND

Rapid diagnostic test using rk39 antigen is widely used for visceral leishmaniasis. However it detects anti-rk39 antibodies in 20-32% of endemic healthy individuals. In search for a better biomarker of infection, we identified a protein of molecular weight 70 kDa (BHUP1), specifically recognized by sera of visceral leishmaniasis (VL) patients.

METHODS

The protein was cloned as His-tagged fusion protein and purified. We evaluated the sensitivity and specificity of this protein in an enzyme linked immunosorbant assay (ELISA) format in comparison to the rk39 antigen using sera collected from various groups of individuals.

RESULTS

The sensitivity of rBHUP1 was 96.5% compared to 98.8% with rk39. For healthy controls from non endemic and endemic regions, the specificity of rBHUP1 was 100% and 95.6% compared to 100% and 84.9% for rk39, respectively. For other infectious diseases such as malaria, tuberculosis, viral fever, etc., specificity of rBHUP1 was as low as 74.5% when compared to 94% of rk39. At six month and one year follow-up, 74% and 22.5% patients tested positive with rBHUP1, respectively, compared to 97% and 77.4% with rk39 antigen.

CONCLUSION

Though the high sensitivity and specificity of rBHUP1 antigen for VL and healthy controls would have made it a good diagnostic biomarkers, however, its non-specific reaction with other infectious diseases limit its utility.

Chicken blood provides a suitable meal for the sand fly Lutzomyia longipalpis and does not inhibit Leishmania development in the gut

Background

The aim of this study was to address the role of chickens as bloodmeal sources for female Lutzomyia longipalpis and to test whether chicken blood is harmful to Leishmania parasite development within the sand flies. Bloodmeal ingestion, excretion of urate, reproduction, fecundity, as well as Leishmania infection and development were compared in sand flies fed on blood from chickens and different mammalian sources.

Results

Large differences in haemoglobin and protein concentrations in whole blood (dog>human>rabbit> chicken) did not correlate with differences in bloodmeal protein concentrations (dog = chicken>human>rabbit). This indicated that Lu. longipalpis were able to concentrate bloodmeals taken from different hosts using prediuresis and this was confirmed by direct observation. Sand flies fed on chickens or dogs produced significantly more eggs than those fed on human blood. Female Lu. longipalpis retained significantly more urate inside their bodies when fed on chicken blood compared to those fed on rabbit blood. However, when the amounts of urate excreted after feeding were measured, sand flies fed on rabbit blood excreted significantly more than those fed on chicken blood. There was no difference in female longevity after feeding on avian or mammalian blood.

Sand flies infected via chicken blood produced Leishmania mexicana infections with a similar developmental pattern but higher overall parasite populations than sand flies infected via rabbit blood.

Conclusions

The results of this study help to define the role that chickens play in the epidemiology of leishmaniasis. The present study using a Lu. longipalpis/L. mexicana model indicates that chickens are suitable hosts to support a Lu. longipalpis population and that chicken blood is likely to support the development of transmissible Leishmania infections in Lu. longipalpis.

Host and parasite factors influencing the expression of cutaneous leishmaniasis

Host and parasite factors influencing the expression of cutaneous leishmaniasis were investigated in two murine models of different leishmanial diseases. The role of B lymphocytes in the uncontrolled disease manifested by BALB/c mice infected with cutaneous leishmaniasis was investigated in animals of this inbred strain depleted of B cells by neonatal administration of anti-mouse mu-chain antisera. Whereas non-depleted control mice developed chronic metastatic infections with both Leishmania tropica and Leishmania mexicana and showed depressed delayed-type hypersensitivity when skin-tested with leishmanial antigens, the mu-suppressed mice controlled their initial lesions while displaying strong antigen-specific delayed-type hypersensitivity. These findings reveal an inverse relationship between humoral and cell-mediated immunity in the expression of chronic leishmaniasis and suggest that B lymphocytes or their products regulate the delayed-type hypersensitivity response to leishmanial infection. In a separate study, healing and chronic strains of Leishmania were compared for their susceptibility to killing by lymphokine-activated mouse peritoneal macrophages. Whereas amastigotes of the healing strains were readily destroyed by these macrophages, amastigotes of two Leishmania strains, previously shown to produce chronic infections in mice, were resistant to killing by the same cells. These findings suggest that the ability of certain leishmanial strains to induce chronic disease may result from their capacity to evade intracellular destruction by activated macrophages.

Cloning and characterisation of a cysteine proteinase gene expressed in amastigotes of Leishmania (L.) amazonensis

The present study describes the cloning and characterisation of a gene encoding a cysteine proteinase isoform, Llacys1, expressed in amastigote forms of Leishmania (L.) amazonensis. Recombinant clones containing the Llacys1 gene were isolated from genomic DNA by PCR amplification and screening of an amastigote cDNA library. Sequence analysis of the Llacys1 gene showed a high identity to sequence of Leishmania (L.) pifanoi Lpcys1, Leishmania (L.) major cpa, Leishmania (L.) mexicana LCPa, and Leishmania (L.) chagasi Ldccys2. The Llacys1 gene is present in a single copy per L. (L.) amazonensis haploid genome and was mapped on a chromosome of approximately 700 kb. Two transcripts of the Llacys1 gene were identified, one of 2.4 kb transcribed in both forms of L. (L.) amazonensis, and another of 1.6 kb weakly expressed in amastigotes. Related forms of Llacys1 gene exist in other species of Leishmania genus, including L. (L.) major, L. (L.) mexicana, L. (L.) chagasi and Leishmania (V.) braziliensis. The Llacys1 expression in Escherichia coli was obtained when the nucleotide sequence corresponding to the signal sequence was deleted, suggesting that this signal sequence was recognised by Escherichia coli and cleaved, generating a truncated protein.

Role of the domestic chicken (Gallus gallus) in the epidemiology of urban visceral leishmaniasis in Brazil

Zoonotic visceral leishmaniasis (ZVL) is a serious public health problem in several Brazilian cities. Although the proximity of chicken houses is often cited as a risk factor in studies of urban ZVL, the role chickens play in the epidemiology of the disease has not been defined. Chickens attract both male and female sand flies (Lutzomyia longipalpis) but are unable to sustain Leishmania infections, and their presence may exert a zooprophylactic effect. We discuss environmental, physiologic, socioeconomic, and cultural factors related to chicken raising that could influence Le. infantum transmission in Brazilian cities and evaluate whether this practice significantly affects the risk of acquiring ZVL.

Identification of a 30 kDa antigen from leishmania (L.) chagasi amastigotes implicated in protective cellular reponses in a murine model

An antigen of apparent molecular mass of 30 kDa, termed p30, was purified from Leishmania (L.) chagasi amastigotes after separation of parasite extracts by sodium dodecyl sulfate-polyacrylamide gel eletroctrophoresis followed by electroelution. The use of the purified antigen in lymphocyte cultures from BALB/c mice previously immunised with L. (L.) chagasi amastigotes led to high levels of proliferation. Animal immunisation with p30 plus complete Freund's adjuvant either by subcutaneous or intraperitoneal route led to comparable antigenic stimulation. Similar stimulation indices induced by p30 were also obtained when animals were immunised with Corynebacterium parvum as adjuvant by the intraperitoneal route. Detection of IL-2 and IFN-gamma in the supernatants from lymphocytes stimulated by p30 and inhibition of the production of these lymphokines in the presence of anti-CD4 strongly indicated the involvement of the Th1 subset in the responses elicited by p30 antigen. Immunisation of BALB/c mice with p30 provided partial protection against challenge with L. (L.) chagasi amastigotes, indicating a protective role for p30 and that Th1 can be related to accquired resistance to visceral leishmaniasis in a murine model. Further characterisation studies were performed by the use of a monoclonal antibody directed to a cysteine proteinase of 30 kDa from L. (L.) amazonensis amastigotes. Despite the cross-reactivity presented by p30 from both Leishmania species, the p30 from L. (L.) chagasi amastigotes lacks proteolytic activity.

Sugars in the gut of the sandfly Phlebotomus orientalis from Dinder National Park, Eastern Sudan

The sandfly Phlebotomus orientalis Parrot (Diptera: Psychodidae) is the vector of visceral leishmaniasis in eastern and Upper Nile regions of Sudan, where vector infection rates of over 7% have been reported. Sugars are known to be important for development of the parasite and for increasing the survival and oviposition rates of several species of sandflies. In the present study we have analysed the sugars present in the guts of individuals and groups of male and female P. orientalis and compared these with sugars from several potential local plant sources: Acacia seyal, Balanites aegyptiaca and Combretum kordofanum. The distribution of these trees in Sudan is closely correlated with that of P. orientalis. Only 20% of individually analysed female sandflies had significant amounts of sugars present suggesting that P. orientalis either digest their sugar meal quickly or do not require regular sugar meals. Interestingly, the sugars present in the males were significantly different to those found in the females, indicating that they had fed on different sugar sources. There was evidence that fruit sugars from Balanites aegyptiaca, Combretum kordofanum and aphid or coccid honeydew are utilized by male and female P. orientalis. There was evidence to indicate that female P. orientalis feeds directly on honeydew. There was no evidence to indicate that direct feeding on leaves is a typical source for the sugar meal. There was no melizitose and only a very small amount of turanose present in the male, suggesting that honeydew was not an important sugar source for males.

Cell biology of Leishmania

Leishmania are digenetic protozoa which inhabit two highly specific hosts, the sandfly, where they grow as motile flagellated promastigotes in the gut, and the mammalian macrophage, where they survive and grow intracellularly as non-flagellated amastigotes in the phagolysosome. Leishmaniasis is the outcome of an evolutionary 'arms race' between the host's immune system and the parasite's evasion mechanisms, which ensure survival and transmission in the population. The diverse spectrum of patterns and severity of disease reflect the varying contributions of parasite virulence factors and host responses, some of which act in a host protective manner while others exacerbate disease. This chapter describes the interaction of the Leishmania with their hosts, with emphasis on the molecules and mechanisms evolved by the parasites to avoid, subvert or exploit the environments in the sandfly and the macrophage, and to move from one to the other.

Visceral leishmaniasis from Bal'a, Palestine, caused by Leishmania donovani s.1. identified through polymerase chain reaction and restriction fragment length polymorphism analysis

A 5-year old female from Bal'a, Tulkarm area, Palestine, was admitted with an 8 month history of fever, excessive night sweating, abdominal distension and enlargement, weight loss and sever anorexia. She was investigated elsewhere without reaching specific diagnosis. On admission, the history and symptoms were compatible with visceral leishmaniasis and bone marrow aspirate was positive for Leishmania amastigotes. The serum titer, using IFAT, was 1:640 for L. infantum and 1:320 for L. major promastigotes. When bone marrow material was also subjected to PCR followed by RFLP enzyme analysis, three fragments of the PCR product of the parasite present were obtained: two fragments of 260 bp and one fragment of 80 bp, identical with the pattern obtained with L. donovani. The patient received sodium stibogluconate, 200 mg IM for 30 days. Six months after treatment, the spleen was 2 cm below the costal margin, the liver was not palpable and she gained 1 kg. This case alerts general practitioners, pediatricians and health authorities to the presence of visceral leishmaniasis in Palestine and to the possibility of the disease being encountered in Jordan.

The Leishmania hertigi (Kinetoplastida; Trypanosomatidae) complex and the lizard Leishmania: their classification and evidence for a neotropical origin of the Leishmania-Endotrypanum clade

The relationships of the Leishmania hertigi complex and the lizard Leishmania species to the main groups of mammalian Leishmania and Endotrypanum parasites were examined. Restriction fragment length polymorphisms and sequences of small subunit ribosomal RNA genes and hybridization studies of kinetoplast DNA indicated that the L. hertigi complex was more closely related to the genus Endotrypanum than to the genus Leishmania. The lizard Leishmania species were found to be at the crown of the Leishmania tree. The data provides strong evidence for a Neotropical origin of the Endotrypanum/Leishmania clade since the parasites closest to the root of the tree are all found exclusively in the Neotropics. The evolution of the Leishmania/Endotrypanum clade in relation to the evolution of the known hosts of these parasites is discussed.

Lack of serological specificity of recombinant heat shock protein of Leishmania donovani

In order to identify a specific recombinant antigen of Leishmania donovani with potential use for diagnosis, a cDNA library was constructed in lambda ZAP II expression vector. On screening the cDNA library using pooled sera from Indian patients with kala azar, 20 antibody reactive clones were identified. These were subcloned into pBluescript phagemid by an in vivo excision procedure. The molecular weights of the expressed recombinant proteins varied from 15 to 70 kDa and the cDNA insert sizes varied from 0.5 kb to the largest size of approximately 2.0 kb which was designated as the E2b clone. The nucleotide sequencing revealed that 50% of the clones had sequence homology to the heat shock protein gene of L. donovani. The serological studies conducted with the kala azar positive sera and sera from healthy laboratory workers using the recombinant protein from the E2b clone and having sequence homology to Ldhsp 70, indicated that although all the kala azar sera was positive, 12 of 20 healthy individuals also showed antibodies against the recombinant hsp70, indicating that this antigen is not suitable for serological diagnosis of kala azar.

Leishmania donovani flagellum-specific epitopes mediating host-parasite interactions

Monoclonal antibodies were developed against flagellar components of promastigotes of Leishmania donovani. The monoclonal antibody produced by clone A11 (mAb A11) recognised epitopes in the polypeptides with molecular weights of 86, 66 and weakly 53 kDa. These epitopes were found to be distributed along the flagellum and at the anterior end of promastigotes. The mAb A11 of IgG1 isotype strongly agglutinated the promastigotes of L. donovani. The prior treatment of promastigotes of L. donovani with mAb A11 resulted in a significant (P < 0.001) reduction in the attachment of promastigotes to cultured mouse peritoneal macrophages of line J774G8. The affinity-purified epitopes identified by mAb A11 were recognised by human sera of cases of visceral leishmaniasis. The present study suggest that flagellar-specific epitopes mediate host-parasite interactions and, therefore, the role of these epitopes in the disease process is speculated.

Niche breadth in parasites: an evolutionarily stable strategy model, with special reference to the protozoan parasite Leishmania

A parasite's host range essentially defines its niche breadth, which, as foraging theory predicts, is influenced by resource availability. For parasites, the interaction of infection and transmission characteristics with host population dynamics determines host availability. An epidemiological model, involving two host types and describing competition between a "generalist" parasite strain and a related "specialist" strain, is used to examine the interplay among host range, relative host availabilities, and adaptational compromises engendered by increased host range. Results show that the generalist can predominate even when it cannot maintain itself in either host alone, but that the specialist can persist if its reproductive rate attains some threshold relative to either of the generalist's respective rates in its two hosts. The model is in rough, qualitative agreement with observed dynamics of two Leishmania parasite-host systems, and overall results suggest that infection of two species with a common parasite can lead to complex, indirect coevolutionary dynamics.

Detection of leishmania antigen in kala azar patients using monoclonal antibodies

Twenty-one monoclonal antibodies were produced against promastigote antigens of Leishmania donovani. Five monoclonal antibodies (Hyb.17, 6, 5, 4 and 2) identifying molecules associated with various L. donovani antigenic determinants ranging from 42-116 kDa were selected as 'capture antibodies' and compared with specific anti-leishmania antisera for detection of circulating leishmania antigens in kala azar patients' sera in a competitive-enzyme-linked immunosorbent assay system (ELISA). The anti-leishmania antisera could detect circulating antigen in 30% of kala azar cases while out of the five monoclonals, Hyb.17 could effectively detect circulating leishmania antigen in 85.4%. The efficacy of Hyb.6 was however low (31.7%). The antigens recognized by these monoclonal antibodies in the western blot assay could possibly represent the ones circulating in sera of patients suffering from kala azar. A cocktail of these monoclonal antibodies may be more useful than the conventional polyclonal antisera in detection of circulating antigen for clinical diagnosis of kala azar.

Leishmania donovani: antagonistic effect of S-adenosyl methionine on ultrastructural changes and growth inhibition induced by sinefungin

Sinefungin, an antifungal and antiparasitic nucleoside antibiotic, is a very potent antileishmanial agent in vitro and in vivo (Bachrach et al. 1980, FEBS Letters 121, 287-291; Neal et al. 1985, Transactions of the Royal Society of Tropical Medicine and Hygiene 79, 85-122). It was previously shown that this molecule is a competitive inhibitor of AdoMet for transmethylases (Paolantonacci et al. 1986, Molecular and Biochemical Parasitology 21, 47-54; Avila et al. 1987, Molecular and Biochemical Parasitology 26, 69-76) and that it induces shape changes of Leishmania donovani promastigotes as observed by light microscopy (Lawrence and Robert-Gero 1990; Bulletin de la Societé Française de Parasitologie 8, 13-18). In the present work the effect of the antibiotic on the ultrastructure was analyzed by electron microscopy. The main changes induced at sublethal concentrations (0.26 microM sinefungin for 16 hr) were progressive rounding, decreased motility, enlargement of the flagellar pocket, and shortening and loss of the external part of the flagellum. The comparison with control cells showed shorter Golgi saccules and fragmentation of the trans-Golgi network into vesicles, indicating a stimulated Golgi apparatus activity. This result, associated with the enlarged flagellar pocket, suggests an unbalanced cytoplasmic exchange between exocytosis and endocytosis. These effects are quite different from those induced by tunicamycin (Dagger et al. 1984, Biology of the Cell 50; 173-180) or paromomycin. In addition, other nucleoside and nonnucleoside growth inhibitors failed to induce similar changes. AdoMet antagonized the sinefungin-induced shape changes and ultrastructural modifications but had no effect with respect to other growth inhibitors. This suggests that the sinefungin activity at the cellular level is specifically related to competition with AdoMet. A comparative study of N-methylation and carboxylmethylation of proteins in sinefungin-treated promastigotes showed that the antibiotic preferentially inhibits the latter, catalyzed by protein-O-methyltransferases. These enzymes are known to regulate the function of various proteins involved in secretion. Overall the results suggest that one of the main targets of sinefungin in exponentially growing cells is the protein carboxylmethylation involved in membrane transport.

Entomopathogens of phlebotomine sand flies: laboratory experiments and natural infections

The susceptibility of different geographical strains of Phlebotomus papatasi to a cytoplasmic polyhedrosis virus (CPV) was determined experimentally by feeding polyhedra to larvae. Of the Indian P. papatasi, 15.6% became infected, whereas Egyptian P. papatasi were mostly refractory. Infection rates were not augmented in colony flies from the Jordan Valley, 23.8% of which were naturally infected with CPV. The infectivity of Serratia marcescens and Beauvaria bassiana to P. papatasi were determined experimentally. A suspension of B. bassiana spores or S. marcescens bacteria, ingested by P. papatasi in sucrose solution, did not significantly augment mortality rates or reduce the number of eggs oviposited. However, B. bassiana spores smeared on a filter paper constituting 1 or 5% of the surface area available to flies induced 100% mortality of P. papatasi on days 5 and 4, respectively. Mortality in Lutzomyia longipalpis reached 100% on day 4. There were markedly lower mortality rates in the control groups and more eggs were produced by these females (P. papatasi: control = 48.5; experimental = 0.9-1.6 eggs/female; L. longipalpis; control = 17.1; experimental = 0 eggs/female). From wild-caught Colombian Lutzomyia spp., a nonfluorescent pseudomonas, an Entomophthorales fungus, and a Trypanosomatid protozoon (probably Leptomonas) were isolated in culture media. Gregarines (Ascogregarina saraviae) and nematodes (Tylenchida and Spirurida) were also recorded. In laboratory-reared flies, an ectoparasitic fungus was associated with high mortality rates of first instar Lutzomyia spp. larvae. Opportunistic ectoparasitic aggregates of bacteria, yeast, and fungi on the tarsi of colonized L. longipalpis and P. papatasi hindered their mobility and were associated with reduced colony vigor. Aspergillus flavus, B. bassiana, and S. marcescens were isolated from laboratory-bred P. papatasi adults.

Extracellular amastigote-like forms of Leishmania panamensis and L. braziliensis. II. Stage- and species-specific monoclonal antibodies

Immunochemical evidence, employing monoclonal antibodies, shows that the forms of L. braziliensis complex axenically grown at elevated temperature are amastigote-like. The monoclonal antibodies were raised against membrane proteins of amastigote-like forms, strains of both L. panamensis (WR442) and L. braziliensis (M5052), which were grown axenically. The specificities of these antibodies were examined by indirect radioimmune binding assay, indirect immunofluorescent assay and Western blot analyses. Two distinct groups of monoclonal antibodies were obtained and their specificities were consistent with the 3 methods used. Four antibodies are specific for the species L. panamensis and react with both developmental stages. Six antibodies specifically recognize amastigote-like forms grown at elevated temperature and intracellular amastigotes of both L. panamensis (WR442) and L. braziliensis (M5052). These monoclonal antibodies do not bind to promastigotes of these species, nor to promastigotes of any other species of Leishmania. Therefore these antibodies are specific for amastigotes of L. panamensis (WR442) and L. braziliensis (M5052), and suggest that immunochemically both amastigote forms (culture and macrophage) are developmentally very close, if not identical. The molecules associated with the amastigote-specific antigenic determinants consist of a Mr 12-kD component and a heterogeneous component (Mr from 50 kD to greater than 200 kD); these molecules appear to be identical for both amastigote-like forms and amastigotes isolated from macrophages.

Extracellular cultivation and morphological characterization of amastigote-like forms of Leishmania panamensis and L. braziliensis

Two strains of the Leishmania braziliensis complex have been adapted to grow extracellularly at elevated temperature as amastigote-like forms in a cell-free medium. These parasites can be serially cultivated and maintained at 32 degrees C for L. panamensis (WR442; L. braziliensis panamensis) and at 28 degrees C for L. braziliensis (M5052; L. braziliensis braziliensis). Several observations are presented that the forms adapted at elevated temperature are amastigote-like. Morphologically, the amastigote-like organisms appear rounded to ovoid and are immotile and smaller than promastigotes; the flagellum of the amastigote-like forms does not extend beyond the flagellar pocket. In comparison, the promastigotes are very elongated, with a nucleus at mid-cell length and a very long flagellum. By electron microscopy, the short flagellum of the amastigote-like form is within a distended flagellar pocket; the 9 + 2 axonemal configuration is present but the paraxial rod is not observed. By contrast, the flagellum of the promastigote has a paraxial rod which extends from the axosome level. In addition, these amastigote-like forms of Leishmania are able to infect, to survive and to divide within the macrophage cell line J774.

Development of metacyclic Leishmania promastigotes is associated with the increasing expression of GP65, the major surface antigen

Using immunofluorescence techniques and flow microfluorometry analysis, we have demonstrated that the binding of a monoclonal antibody (VD5/25) produced against GP65, the major surface antigen of Leishmania braziliensis, increased on the surface of stationary-phase promastigotes from all the New World Leishmania species causing mucocutaneous or cutaneous disease as compared with the log-phase parasites. In addition, a sequential development of Leishmania amazonensis promastigotes from a non-infective to an infective stage was demonstrated. Indeed, promastigotes in the stationary phase (days 6-7) were found to be far more infective than those in the logarithmic phase of growth (day 3) both in vitro for mouse peritoneal macrophages and in vivo for BALB/c mice. The intracellular survival and multiplication of L. amazonensis were significantly inhibited when infective promastigotes were treated with the VD5/25 monoclonal antibody. The increasing expression of GP65 on the promastigote surface may thus contribute to Leishmania infectivity. This seems to represent a characteristic mechanism applicable to all New World Leishmania species studied.

Leishmania amazonensis: acidic organelles in amastigotes

Leishmania amastigotes are intracellular protozoan parasites which exclusively invade cells of the macrophage series and multiply within phagolysosomes. Recent studies showed that intracellular and isolated amastigotes of L. amazonesis are killed by amino acid esters which appear to be trapped within as yet unidentified, possibly acidified, "lysosome-like" parasite compartments and cleaved by hydrolytic enzyme(s) (M. Rabinovitch, V. Zilberfarb, and C. Ramazeilles, 1986, Journal of Experimental Medicine 163, 520-535). In the present study, we have localized acidic compartments of Leishmania amastigotes using as a probe the weak base 3-(2,4 dinitroanilino)-3'-amino-N-methyldipropylamine (DAMP). This indicator, which can be detected within cells by light and electron microscopy using immunocytochemical immunocytochemical methods, mainly accumulates within megasomes and in dense inclusion vacuoles. With the help of quantitative assays to titrate cell-associated DAMP, it was found that (a) its uptake is temperature dependent and thus probably requires an energy supply, (b) the proton ionophore monensin partially inhibits the trapping of DAMP, and (c) monensin greatly increases its efflux from cells. These results, as well as those obtained by quantitative ultrastructural immunocytochemistry of cells incubated with DAMP in the absence or presence of monensin, show that megasomes and inclusion vacuoles have a low pH probably maintained by an active process. Furthermore, confirming the report of H. F. Hassan and G. H. Coombs (1987, Molecular and Biochemical Parasitology 23, 285-296) megasomes were found to display acid phosphatase activity at both light and electron microscope levels. This, together with the demonstration that megasomes are acidified, suggests that these organelles may be targets for amino acid derivatives.

Canine visceral leishmaniasis at Wadi Hamam, in Israel

A preliminary survey of canine leishmaniasis was made in Israel by serodiagnosis, using a direct and competitive enzyme-linked immunosorbent assay. Three (4%) of the 75 dogs surveyed were seropositive. The infected dogs came from Wadi Hamam near Tiberias in northern Israel. Parasites isolated from one dog by needle aspiration were identified as Leishmania donovani sensu lato by their excreted factor.

Immunosuppressive medication associated with leishmanial antibodies in adults residing in an endemic focus of infantile visceral leishmaniasis--a case/control study

In a focus of infantile visceral leishmaniasis in Al Agamy (Alexandria), Egypt, adults were found by radioimmune assay to have leishmanial antibodies. This finding was unexpected, and an explanation was sought. Seropositive adults and age- and sex-matched seronegative controls were interviewed to ascertain possible predisposing risk factors. Ten of 16 seropositive individuals were taking corticosteroids compared to one of 22 seronegative individuals (P = 0.0002). Two seropositive individuals (one woman and one man) were taking phenylbutazone, and two women were taking female sex hormones. The association between immunosuppressive medication and leishmanial seropositivity suggests that acquired changes in host population immunocompetence may significantly alter age-specific seroprevalence of leishmanial antibodies.

Persistence of elevated levels of galactosyl-alpha(1-3)galactose antibodies in sera from patients cured of visceral leishmaniasis

Using rabbit erythrocyte-derived neutral glycosphingolipids enriched for a ceramide pentasaccharide as the antigen, we detected elevated anti-galactosyl-alpha(1-3)galactose (anti-G alpha G) antibody levels in 76% of children with active visceral leishmaniasis (kala-azar [KA]) and in 42% of clinically cured patients with KA who had been treated about 5 years previously with meglumine antimonate (30 mg/kg in a series of 15 daily injections). The long-term persistence of elevated G alpha G antibodies was also found in 56% of children living in the same geographic zone who, at the time of the initial clinical examination, had fever and evident splenomegaly with hyperglobulinemia but a negative bone marrow aspirate for leishmanial bodies. Five years after antimonate treatment, these clinically cured children with presumptive KA were studied serologically. Their mean G alpha G antibody values were slightly lower than those in patients with active KA but were still abnormal. Using different biochemical and immunological approaches, we found that elevated G alpha G antibodies present in patients with KA bound specifically to glycoconjugates with an alpha(1-3)-terminal galactose residue. G alpha G antibodies were mainly distributed between immunoglobulin classes G and M in patients with active KA and in antimonate-treated patients with clinically cured KA. The possibility of the existence of remnant living parasites or the persistence of inserted G alpha G epitopes in parasitized macrophages was proposed as a mechanism to explain the long-term persistence of abnormal G alpha G antibodies in patients apparently cured of KA.

Serological activity against galactosyl-alpha(1-3)galactose in sera from patients with several kinetoplastida infections

Using rabbit erythrocyte-derived neutral glycosphingolipids enriched for a defined ceramide pentasaccharide as antigens, we have detected elevated anti-galactosyl-alpha(1-3)galactose (anti-G alpha G) antibody values in patients with American cutaneous leishmaniasis (ACL), chronic Chagas' disease, and Trypanosoma rangeli infections compared with normal subjects or with patients suffering from any of 15 other infectious diseases. The specificity of the G alpha G antibodies was determined by inhibition enzyme-linked immunosorbent assays, which revealed that several alpha-galactosyl- but not beta-galactosyl-bearing sugars blocked absorption of G alpha G antibodies to the specific antigen used. G alpha G antibodies were mainly distributed between immunoglobulin classes G and M in three Kinetoplastida infections studied, with a lower increase in reactivity detected in immunoglobulin A. Absorption of highly reactive G alpha G antibodies with purified murine laminin and nidogen, two basement membrane proteins, almost abolished G alpha G reactivity, suggesting the identity of anti-G alpha G with laminin and nidogen antibodies previously reported as elevated in Kinetoplastida infections. In ACL, G alpha G antibodies were detected in 71% of patients having skin lesions with a clinical evolution time of 0.5 month. This percentage increased with the time of evolution of skin lesions, reaching 93% in lesions older than 3 months, and tended to decrease inversely to the induration diameter in the skin leishmanin test. It is proposed that similar epitopes may exist on kinetoplast protozoa and that the determination of G alpha G antibodies may be a highly sensitive assay for the detection of humoral responses to Kinetoplastida infections.

Natural infection of Phlebotomus perfiliewi with Leishmania infantum in a cutaneous leishmaniasis focus of the Abruzzi region, Italy

One out of 213 Phlebotomus perfiliewi caught from an endemic cutaneous leishmaniasis focus in Abruzzi region (Italy) was naturally infected with promastigotes. The parasites were grown in culture medium and in a hamster, typed by the examination of 11 isoenzymes, and found to be indistinguishable from Leishmania infantum s.st. (Montpellier zymodeme 1). The probable role of P. perfiliewi in the transmission of cutaneous leishmaniasis due to L. infantum s.l. in the focus is discussed.

Leishmania mexicana: comparative fine structure of amastigotes and promastigotes in vitro and in vivo

Amastigotes of Leishmania mexicana pifanoi were cultivated by serial transfers in cell-free medium UM-54 at 33 and 35 C. Electron microscopy was used to analyze the structural relationships among promastigotes, axenically cultured amastigotes, and amastigotes in footpads of infected hamsters. These studies revealed very close structural similarities between culture and hamster derived amastigotes. However, both of these amastigotes differed from the promastigotes in the following aspects. The flagellum of promastigotes contained a paraxial rod originating at the axosome level within the flagellar pocket, whereas the flagellum of amastigotes lacks this structure. The flagellar pocket of promastigotes was usually small whereas amastigotes had a distended reservoir. Subpellicular microtubules of promastigotes terminated at the posterior end, whereas those of amastigotes ended subterminally. Membrane bounded vesicles were present only in amastigotes. These results along with the biologic and antigenic comparisons indicate that amastigotes obtained from axenic cultures are related very closely to amastigotes from infected hamster footpads and that their relationship to promastigotes is far more distant.