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Oyeyemi OT, Ogundahunsi O, Schunk M, Fatem RG, Shollenberger LM. Neglected tropical disease (NTD) diagnostics: current development and operations to advance control. Pathog Glob Health 2024; 118:1-24. [PMID: 37872790 PMCID: PMC10769148 DOI: 10.1080/20477724.2023.2272095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023] Open
Abstract
Neglected tropical diseases (NTDs) have become important public health threats that require multi-faceted control interventions. As late treatment and management of NTDs contribute significantly to the associated burdens, early diagnosis becomes an important component for surveillance and planning effective interventions. This review identifies common NTDs and highlights the progress in the development of diagnostics for these NTDs. Leveraging existing technologies to improve NTD diagnosis and improving current operational approaches for deployment of developed diagnostics are crucial to achieving the 2030 NTD elimination target. Point-of-care NTD (POC-NTD) diagnostic tools are recommended preferred diagnostic options in resource-constrained areas for mapping risk zones and monitoring treatment efficacy. However, few are currently available commercially. Technical training of remote health care workers on the use of POC-NTD diagnostics, and training of health workers on the psychosocial consequences of these diagnostics are critical in harnessing POC-NTD diagnostic potential. While the COVID-19 pandemic has challenged the possibility of achieving NTD elimination in 2030 due to the disruption of healthcare services and dwindling financial support for NTDs, the possible contribution of NTDs in exacerbating COVID-19 pandemic should motivate NTD health system strengthening.
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Affiliation(s)
- Oyetunde T. Oyeyemi
- Department of Biosciences and Biotechnology, University of Medical Sciences, Ondo, Nigeria
- Department of Biological Sciences, Old Dominion University, Virginia, USA
| | - Olumide Ogundahunsi
- The Central Office for Research and Development (CORD), University of Medical Sciences, Ondo, Nigeria
| | - Mirjam Schunk
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU) institution, Munich, Germany
| | - Ramzy G. Fatem
- Schistosome Biological Supply Center, Theodor Bilharz Research Institute, Giza, Egypt
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Ivănescu L, Andronic BL, Grigore-Hristodorescu S, Martinescu GV, Mîndru R, Miron L. The immune response in canine and human leishmaniasis and how this influences the diagnosis- a review and assessment of recent research. Front Cell Infect Microbiol 2023; 13:1326521. [PMID: 38149009 PMCID: PMC10749942 DOI: 10.3389/fcimb.2023.1326521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 11/22/2023] [Indexed: 12/28/2023] Open
Abstract
Leishmaniasis is a widespread but still underdiagnosed parasitic disease that affects both humans and animals. There are at least 20 pathogenic species of Leishmania, most of them being zoonotic. The diagnosis of leishmaniasis remains a major challenge, with an important role being played by the species of parasites involved, the genetic background, the immunocompetence of the host. This paper brings to the fore the sensitivity of the balance in canine and human leishmaniasis and addresses the importance of the host's immune response in establishing a correct diagnosis, especially in certain cases of asymptomatic leishmaniasis, or in the situation the host is immunosuppressed or acquired leishmaniasis through vertical transmission. The methods considered as a reference in the diagnosis of leishmaniasis no longer present certainty, the diagnosis being influenced mostly by the immune response of the host, which differs according to the presence of other associated diseases or even according to the breed in dogs. Consequently, the diagnosis and surveillance of leishmaniasis cases remains an open topic, requiring new diagnostic methods adapted to the immunological state of the host.
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Affiliation(s)
- Larisa Ivănescu
- Clinics Department, Faculty of Veterinary Medicine, Iasi University of Life Sciences, Iaşi, Romania
| | - Bianca Lavinia Andronic
- Clinics Department, Faculty of Veterinary Medicine, Iasi University of Life Sciences, Iaşi, Romania
| | | | | | - Raluca Mîndru
- Clinics Department, Faculty of Veterinary Medicine, Iasi University of Life Sciences, Iaşi, Romania
| | - Liviu Miron
- Clinics Department, Faculty of Veterinary Medicine, Iasi University of Life Sciences, Iaşi, Romania
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de Araújo Paz LF, da Silva A, da Silva HRF, Cavalcanti MP, de Lima VMF, da Cunha Beltrão MRO, Silva MBA, de Melo Neto OP, Medeiros ZM, dos Santos WJT. Diagnostic Potential for the Detection of Canine Visceral Leishmaniasis of an ELISA Assay Based on the Q5 Recombinant Protein: A Large-Scale and Comparative Evaluation Using Canine Sera with a Positive Diagnosis from the Dual-Path-Platform (DPP) Test. Vet Sci 2023; 10:608. [PMID: 37888560 PMCID: PMC10610690 DOI: 10.3390/vetsci10100608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/08/2023] [Accepted: 09/20/2023] [Indexed: 10/28/2023] Open
Abstract
Dogs are considered the major domestic reservoir for human visceral leishmaniasis, a serious disease caused by the Leishmania infantum parasite. Diagnosis of canine visceral leishmaniasis (CVL) is critical for disease control, with several methods currently available. Among the serological tests, the DPP rapid test and the EIE-LVC, more commonly used in Brazil, are associated with variable sensitivity and specificity. Research with novel recombinant proteins such as the ELISA with the recombinant chimeric protein Q5 may therefore improve the CVL diagnosis. This study aimed to evaluate the true diagnostic potential of Q5 in an ELISA assay using a large number of CVL-suspected sera (406) with a previous positive diagnosis based on the rapid DPP test. Sera from the DPP-positive dogs, also assessed with the EIE-LVC test, were compared with sera from healthy dogs (n = 46) and used for ELISA tests using the recombinant Q5. The resulting data as well as the correlation with the clinical signs and the environmental characteristics of the animals were analyzed using Medal and GraphPad Prism 8.0. Overall, similar levels of lower sensitivity (67-68%) were seen for both the commercial EIE-LVC test and the Q5 ELISA when all assessed sera were considered, but a much greater sensitivity (92%) was seen for those samples from symptomatic dogs only. In contrast, many negative results were observed for the DPP-positive sera from asymptomatic dogs or those with no clinical information available. A selection of those sera were tested yet again in new ELISA assays using a second batch of the recombinant Q5, purified under milder denaturing conditions, as well as using another recombinant protein (Lci13). The results reveal a higher-than-expected incidence of likely false-positive results for DPP, reinforcing the need for other recombinant proteins, such as the chimeric Q5, to be investigated as possible alternatives to the currently used CVL diagnostic methods.
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Affiliation(s)
| | | | | | | | - Valeria Marçal Felix de Lima
- Department of Clinic, Surgery and Animal Reproduction, College of Veterinary Medicine, São Paulo State University, Aracatuba 16050-680, Brazil
| | | | | | | | - Zulma Maria Medeiros
- Postgraduate Program in Health Sciences, University of Pernambuco, Recife 50100-010, Brazil
- Aggeu Magalhães Institute—Fiocruz, Recife 50740-465, Brazil
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Ghosh P, Chowdhury R, Rahat MA, Hossain F, Arpha NE, Kristan M, Higgins M, El Wahed AA, Goto Y, Islam MMT, Campino S, Cameron M, Duthie MS, Haque R, Mondal D. Dried Blood Spots (DBS): A suitable alternative to using whole blood samples for diagnostic testing of visceral leishmaniasis in the post-elimination era. PLoS Negl Trop Dis 2023; 17:e0011680. [PMID: 37862287 PMCID: PMC10588855 DOI: 10.1371/journal.pntd.0011680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 09/25/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Serum or whole blood collection, processing, transport and storage still present significant challenges in low resource settings where mass surveillance is required to sustain disease elimination. Therefore, in this study, we explored the diagnostic efficacy of dried blood spots (DBS) as a minimally invasive and potentially cost-effective alternative sampling technique to whole blood sampling procedures for subsequent detection of Leishmania donovani antibodies or DNA. METHODOLOGY AND PRINCIPAL FINDINGS Archived serum, DNA samples from whole blood of visceral leishmaniasis (VL) cases and healthy controls, and DBS from corresponding cases and controls, were used. Both molecular and serological assays were optimized to detect L. donovani antibodies or DNA in DBS elute and results were compared against those obtained with whole blood. Serological assays (both rK28 ELISA and rK39 ELISA) of DBS samples showed sensitivity and specificity of 100% and had excellent agreement with results from whole blood samples (kappa value ranged from 0.98-1). Bland-Altman analysis of OD values from rK28-ELISA with DBS elute and patients' serum showed an excellent agreement (ICC = 0.9) whereas a good agreement (ICC = 0.8) was observed in the case of rK39-ELISA. However, qPCR and RPA of DBS samples had a diminished sensitivity of 76% and 68%, respectively, and poor agreement was observed with the whole blood samples. CONCLUSION Our results demonstrate that DBS offer excellent diagnostic efficiency for serological assays and represent a viable alternative to whole blood sampling procedures.
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Affiliation(s)
- Prakash Ghosh
- Nutirition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Banladesh, Dhaka, Bangladesh
| | - Rajashree Chowdhury
- Nutirition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Banladesh, Dhaka, Bangladesh
| | - Md. Abu Rahat
- Nutirition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Banladesh, Dhaka, Bangladesh
| | - Faria Hossain
- Nutirition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Banladesh, Dhaka, Bangladesh
| | - Nur E Arpha
- Genetic Engineering and Biotechnology, BRAC University, Dhaka, Bangladesh
| | - Mojca Kristan
- London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
| | - Matthew Higgins
- London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
| | - Ahmed Abd El Wahed
- Institute of Animal Hygiene and Veterinary Public Health, University of Leipzig, Leipzig, Germany
| | - Yasuyuki Goto
- Laboratory of Molecular Immunology, Department of Animal Resource Sciences, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - M. M. Towhidul Islam
- Department of Biochemistry and Molecular Biology, University of Dhaka, Dhaka, Bangladesh
| | - Susana Campino
- London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
| | - Mary Cameron
- London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
| | | | - Rashidul Haque
- Emerging Infections and Parasitology Laboratory, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Dinesh Mondal
- Nutirition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Banladesh, Dhaka, Bangladesh
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Siqueira WF, Cardoso MS, Fraga VG, Ottino J, Ribeiro VM, Gondim CN, de Paiva Barçante JM, Amado Gomes AC, Galdino AS, Eersels K, van Grinsven B, Bartholomeu DC, Bueno LL, Cleij T, Fujiwara RT. Immunogenic mapping of rDyn-1 and rKDDR-plus proteins and selection of oligopeptides by immunoblotting for the diagnosis of Leishmania infantum-infected dogs. PLoS Negl Trop Dis 2023; 17:e0011535. [PMID: 37540724 PMCID: PMC10442149 DOI: 10.1371/journal.pntd.0011535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 08/21/2023] [Accepted: 07/15/2023] [Indexed: 08/06/2023] Open
Abstract
Endemic in Brazil, visceral leishmaniasis (VL) is a zoonotic infection that is among the most important parasitic diseases transmitted by vectors. Dogs are the main reservoirs of canine leishmaniasis (CanL) and their identification is used in some countries as part of disease prevention and control measures in the canine and human population. In this context, serological tests are necessary, composed of antigens capable of correctly identifying infected dogs, minimizing the number of false-negative cases. This study aimed to identify more immunoreactive peptides derived from two previously described whole proteins (rDyn-1 and rKDDR-plus) and compare their performance to the control antigens rK39 and the crude extract for the detection of dogs infected with L. infantum, especially the asymptomatic ones. The three selected peptides and a mixture of them, along with the rDyn-1, rKDDR-plus, rK39, and crude extract antigens were evaluated using indirect ELISA with sera samples from 186 dogs with CanL, being asymptomatic (n = 50), symptomatic (n = 50), co-infected (n = 19), infected with Babesia sp. (n = 7), Ehrlichia sp. (n = 6), T. cruzi (n = 20) and uninfected (n = 34). The results showed that the rDyn-1 protein and the peptide mixture had the highest sensitivity (100% and 98.32%, respectively) and specificity (97.01 and 98.51, respectively). A high degree of kappa agreement was found for rDyn-1 protein (0.977), mixed peptides (0.965), rKDDR-plus protein (0.953), K-plus peptide 1 (0.930) and Dyn-1 peptide (0.893). The mixture of peptides showed the highest likelihood (65.87). The ELISA using the mixture of peptides and the rDyn-1 protein showed high performance for CanL serodiagnosis. More mix combinations of the peptides and additional extended field tests with a larger sample size are recommended.
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Affiliation(s)
- Williane Fernanda Siqueira
- Department of Parasitology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Faculty of Science and Engineering of Maastricht University, Maastricht, Limburg, Netherlands
| | - Mariana Santos Cardoso
- Department of Parasitology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Vanessa Gomes Fraga
- Department of Parasitology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Jennifer Ottino
- Department of Parasitology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Vitor Márcio Ribeiro
- Veterinary School, Pontificial Catholic University of Minas Gerais, Betim, Brazil
| | | | | | | | - Alexsandro Sobreira Galdino
- Laboratory of Microbial Biotechnology, Universidade Federal de São João Del-Rei, Divinópolis, Minas Gerais, Brazil
| | - Kasper Eersels
- Faculty of Science and Engineering of Maastricht University, Maastricht, Limburg, Netherlands
| | - Bart van Grinsven
- Faculty of Science and Engineering of Maastricht University, Maastricht, Limburg, Netherlands
| | | | - Lilian Lacerda Bueno
- Department of Parasitology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Thomas Cleij
- Faculty of Science and Engineering of Maastricht University, Maastricht, Limburg, Netherlands
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Mahdavi R, Shams-Eldin H, Witt S, Latz A, Heinz D, Fresco-Taboada A, Aira C, Hübner MP, Sukyte D, Visekruna A, Teixeira HC, Abass E, Steinhoff U. Development of a Novel Enzyme-Linked Immunosorbent Assay and Lateral Flow Test System for Improved Serodiagnosis of Visceral Leishmaniasis in Different Areas of Endemicity. Microbiol Spectr 2023; 11:e0433822. [PMID: 37074181 PMCID: PMC10269724 DOI: 10.1128/spectrum.04338-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 03/29/2023] [Indexed: 04/20/2023] Open
Abstract
Visceral leishmaniasis (VL) is caused by protozoan parasites of the Leishmania donovani complex and is one of the most prominent vector-borne infectious diseases with epidemic and mortality potential if not correctly diagnosed and treated. East African countries suffer from a very high incidence of VL, and although several diagnostic tests are available for VL, diagnosis continues to represent a big challenge in these countries due to the lack of sensitivity and specificity of current serological tools. Based on bioinformatic analysis, a new recombinant kinesin antigen from Leishmania infantum (rKLi8.3) was developed. The diagnostic performance of rKLi8.3 was evaluated by enzyme-linked immunosorbent assay (ELISA) and lateral flow test (LFT) on a panel of sera from Sudanese, Indian, and South American patients diagnosed with VL or other diseases, including tuberculosis, malaria, and trypanosomiasis. The diagnostic accuracy of rKLi8.3 was compared with rK39 and rKLO8 antigens. The VL-specific sensitivity of rK39, rKLO8, and rKLi8.3 ranged from 91.2% over 92.4% to 97.1% and specificity ranged from 93.6% over 97.6% to 99.2%, respectively. In India, all tests showed a comparable specificity of 90.9%, while the sensitivity ranged from 94.7% to 100% (rKLi8.3). In contrast to commercial serodiagnostic tests, rKLi8.3-based ELISA and LFT showed improved sensitivity and no cross-reactivity with other parasitic diseases. Thus, rKLi8.3-based ELISA and LFT offer improved VL serodiagnostic efficiency in East Africa and other areas of endemicity. IMPORTANCE Reliable and field suitable serodiagnosis of visceral leishmaniasis (VL) in East Africa has until now been a big challenge due to low sensitivity and cross-reactivity with other pathogens. To improve VL serodiagnosis, a new recombinant kinesin antigen from Leishmania infantum (rKLi8.3) was developed and tested with a panel of sera from Sudanese, Indian, and South American patients diagnosed with VL or other infectious diseases. Both prototype rKLi8.3-based enzyme-linked immunosorbent assay (ELISA) and lateral flow test (LFT) showed improved sensitivity and no cross-reactivity with other parasitic diseases. Thus, rKLi8.3-based ELISA and LFT offer substantially increased diagnostic efficiency for VL in East Africa and other areas of endemicity, compared to currently commercially available serodiagnostic tests.
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Affiliation(s)
- Rouzbeh Mahdavi
- Institute of Medical Microbiology and Hospital Hygiene, Philipps University Marburg, Marburg, Germany
| | - Hosam Shams-Eldin
- Institute of Medical Microbiology and Hospital Hygiene, Philipps University Marburg, Marburg, Germany
| | - Sandra Witt
- Institute of Medical Microbiology and Hospital Hygiene, Philipps University Marburg, Marburg, Germany
| | - Andreas Latz
- Novatec Immundiagnostica GmbH, part of Gold Standard Diagnostics Europe, Dietzenbach, Germany
| | - Daniela Heinz
- Novatec Immundiagnostica GmbH, part of Gold Standard Diagnostics Europe, Dietzenbach, Germany
| | - Alba Fresco-Taboada
- Eurofins-Immunologia y Genética Aplicada S.A. (Eurofins Ingenasa S.A.), Madrid, Spain
| | - Cristina Aira
- Eurofins-Immunologia y Genética Aplicada S.A. (Eurofins Ingenasa S.A.), Madrid, Spain
| | - Marc P. Hübner
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Bonn, Germany
| | - Dalia Sukyte
- Institute of Medical Microbiology and Hospital Hygiene, Philipps University Marburg, Marburg, Germany
| | - Alexander Visekruna
- Institute of Medical Microbiology and Hospital Hygiene, Philipps University Marburg, Marburg, Germany
| | - Henrique C. Teixeira
- Department of Parasitology, Microbiology and Immunology, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
| | - Elfadil Abass
- Department of Clinical Laboratory Science, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ulrich Steinhoff
- Institute of Medical Microbiology and Hospital Hygiene, Philipps University Marburg, Marburg, Germany
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Pagniez J, Petitdidier E, Parra-Zuleta O, Pissarra J, Bras-Gonçalves R. A systematic review of peptide-based serological tests for the diagnosis of leishmaniasis. Parasite 2023; 30:10. [PMID: 37010451 PMCID: PMC10069404 DOI: 10.1051/parasite/2023011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 03/06/2023] [Indexed: 04/04/2023] Open
Abstract
Serological methods should meet the needs of leishmaniasis diagnosis due to their high sensitivity and specificity, economical and adaptable rapid diagnostic test format, and ease of use. Currently, the performances of serological diagnostic tests, despite improvements with recombinant proteins, vary greatly depending on the clinical form of leishmaniasis and the endemic area. Peptide-based serological tests are promising as they could compensate for antigenic variability and improve performance, independently of Leishmania species and subspecies circulating in the endemic areas. The objective of this systematic review was to inventory all studies published from 2002 to 2022 that evaluate synthetic peptides for serological diagnosis of human leishmaniases and also to highlight the performance (e.g., sensitivity and specificity) of each peptide reported in these studies. All clinical forms of leishmaniasis, visceral and tegumentary, and all Leishmania species responsible for these diseases were considered. Following PRISMA statement recommendations, 1,405 studies were identified but only 22 articles met the selection criteria and were included in this systematic review. These original research articles described 77 different peptides, of which several have promising performance for visceral or tegumentary leishmaniasis diagnosis. This review highlights the importance of and growing interest in synthetic peptides used for serological diagnosis of leishmaniases, and their performances compared to some widely used tests with recombinant proteins.
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Affiliation(s)
- Julie Pagniez
- UMR177 INTERTRYP 911 avenue Agropolis B.P. 64501 34394 Montpellier France
| | - Elodie Petitdidier
- UMR177 INTERTRYP 911 avenue Agropolis B.P. 64501 34394 Montpellier France
| | | | - Joana Pissarra
- UMR177 INTERTRYP 911 avenue Agropolis B.P. 64501 34394 Montpellier France
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8
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Fujimori M, Valencia-Portillo RT, Lindoso JAL, Celeste BJ, de Almeida RP, Costa CHN, da Cruz AM, Druzian AF, Duthie MS, Fortaleza CMCB, de Oliveira ALL, Paniago AMM, Queiroz IT, Reed S, Vallur AC, Goto H, Sanchez MCA. Recombinant protein KR95 as an alternative for serological diagnosis of human visceral leishmaniasis in the Americas. PLoS One 2023; 18:e0282483. [PMID: 36862710 PMCID: PMC9980733 DOI: 10.1371/journal.pone.0282483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 02/15/2023] [Indexed: 03/03/2023] Open
Abstract
In the Americas, visceral leishmaniasis (VL) is caused by the protozoan Leishmania infantum, leading to death if not promptly diagnosed and treated. In Brazil, the disease reaches all regions, and in 2020, 1,933 VL cases were reported with 9.5% lethality. Thus, an accurate diagnosis is essential to provide the appropriate treatment. Serological VL diagnosis is based mainly on immunochromatographic tests, but their performance may vary by location, and evaluation of diagnostic alternatives is necessary. In this study, we aimed to evaluate the performance of ELISA with the scantily studied recombinant antigens, K18 and KR95, comparing their performance with the already known rK28 and rK39. Sera from parasitologically confirmed symptomatic VL patients (n = 90) and healthy endemic controls (n = 90) were submitted to ELISA with rK18 and rKR95. Sensitivity (95% CI) was, respectively, 83.3% (74.2-89.7) and 95.6% (88.8-98.6), and specificity (95% CI) was 93.3% (85.9-97.2) and 97.8% (91.8-99.9). For validation of ELISA with the recombinant antigens, we included samples from 122 VL patients and 83 healthy controls collected in three regions in Brazil (Northeast, Southeast, and Midwest). When comparing the results obtained with the VL patients' samples, significantly lower sensitivity was obtained by rK18-ELISA (88.5%, 95% CI: 81.5-93.2) compared with rK28-ELISA (95.9%, 95% CI: 90.5-98.5), but the sensitivity was similar comparing rKR95-ELISA (95.1%, 95% CI: 89.5-98.0), rK28-ELISA (95.9%, 95% CI: 90.5-98.5), and rK39-ELISA (94.3%, 95% CI: 88.4-97.4). Analyzing the specificity, it was lowest with rK18-ELISA (62.7%, 95% CI: 51.9-72.3) with 83 healthy control samples. Conversely, higher and similar specificity was obtained by rKR95-ELISA (96.4%, 95% CI: 89.5-99.2), rK28-ELISA (95.2%, 95% CI: 87.9-98.5), and rK39-ELISA (95.2%, 95% CI: 87.9-98.5). There was no difference in sensitivity and specificity across localities. Cross-reactivity assessment, performed with sera of patients diagnosed with inflammatory disorders and other infectious diseases, was 34.2% with rK18-ELISA and 3.1% with rKR95-ELISA. Based on these data, we suggest using recombinant antigen KR95 in serological assays for VL diagnosis.
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Affiliation(s)
- Mahyumi Fujimori
- Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | | | - José Angelo Lauletta Lindoso
- Departamento de Doenças Infecciosas e Parasitárias, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil
- Instituto de Infectologia Emílio Ribas, Secretaria de Estado da Saúde, São Paulo, São Paulo, Brazil
| | - Beatriz Julieta Celeste
- Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Roque Pacheco de Almeida
- Departamento de Medicina Interna e Patologia, Hospital Universitário/EBSERH, Universidade Federal de Sergipe, Aracaju, Sergipe, Brazil
| | | | - Alda Maria da Cruz
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz/FIOCRUZ, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Angelita Fernandes Druzian
- Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | | | | | | | | | - Igor Thiago Queiroz
- Hospital Giselda Trigueiro, Secretaria Estadual da Saúde Pública, Natal, Rio Grande do Norte, Brazil
| | - Steve Reed
- HDT Bio, Seattle, Washington, United States of America
| | - Aarthy C. Vallur
- InBios International Inc, Seattle, Washington, United States of America
| | - Hiro Goto
- Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Maria Carmen Arroyo Sanchez
- Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil
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9
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Freire ML, Gonçalves MCDO, Silva ACMD, Cota G, Rabello A, Assis TSMD. Serology for visceral leishmaniasis: How trusty is the accuracy reported by the manufacturers? Rev Soc Bras Med Trop 2023; 56:e0358. [PMID: 36820658 PMCID: PMC9957126 DOI: 10.1590/0037-8682-0358-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 01/06/2023] [Indexed: 02/22/2023] Open
Abstract
Timely and accurate diagnosis is one of the strategies for managing visceral leishmaniasis (VL). Given the specificities of this infection, which affects different vulnerable populations, the local assessment of the accuracy of the available diagnostic test is a requirement for the good use of resources. In Brazil, performance data are required for test registration with the National Regulatory Agency (ANVISA), but there are no minimum requirements established for performance evaluation. Here, we compared the accuracy reported in the manufacturer's instructions of commercially available VL-diagnostic tests in Brazil, and the accuracies reported in the scientific literature which were obtained after test commercialization. The tests were identified via the electronic database of ANVISA, and their accuracy was obtained from the manufacturer's instructions. A literature search for test accuracy was performed using two databases. A total of 28 VL diagnostic tests were identified through the ANVISA database. However, only 13 presented performance data in the manufacturer's instructions, with five immunoenzymatic tests, three indirect immunofluorescence tests, one chemiluminescence test, and four rapid tests. For most tests, the manufacturers did not provide the relevant information, such as sample size, reference standards, and study site. The literature review identified accuracy data for only 61.5% of diagnostic tests registered in Brazil. These observations confirmed that there are significant flaws in the process of registering health technologies and highlighted one of the reasons for the insufficient control of policies, namely, the use of potentially inaccurate and inappropriate diagnostic tools for a given scenario.
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Affiliation(s)
- Mariana Lourenço Freire
- Fundação Oswaldo Cruz, Instituto René Rachou, Pesquisa Clínica e Políticas Públicas em Doenças Infecciosas e Parasitárias, Belo Horizonte, MG, Brasil
| | | | | | - Gláucia Cota
- Fundação Oswaldo Cruz, Instituto René Rachou, Pesquisa Clínica e Políticas Públicas em Doenças Infecciosas e Parasitárias, Belo Horizonte, MG, Brasil
| | - Ana Rabello
- Fundação Oswaldo Cruz, Instituto René Rachou, Pesquisa Clínica e Políticas Públicas em Doenças Infecciosas e Parasitárias, Belo Horizonte, MG, Brasil
| | - Tália Santana Machado de Assis
- Fundação Oswaldo Cruz, Instituto René Rachou, Pesquisa Clínica e Políticas Públicas em Doenças Infecciosas e Parasitárias, Belo Horizonte, MG, Brasil.,Centro Federal de Educação Tecnológica de Minas Gerais, Contagem, MG, Brasil
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10
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Simonson P, Bhattacharyya T, El-Safi S, Miles MA. Linear and conformational determinants of visceral leishmaniasis diagnostic antigens rK28 and rK39. Parasit Vectors 2022; 15:387. [PMID: 36273150 PMCID: PMC9587664 DOI: 10.1186/s13071-022-05495-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 09/14/2022] [Indexed: 11/10/2022] Open
Abstract
Background Recombinant antigens rK39 (based on kinesin sequence) and rK28 (comprising kinesin and HASPB sequences) are a mainstay of serological diagnosis for visceral leishmaniasis (VL). However, their key epitopes and the significance of their structural conformation are not clearly defined, particularly in relation to reported cross-reactivity with sera from patients with malaria, schistosomiasis, and tuberculosis. Methods To assess the effect of conformation on antigenicity with Sudanese VL sera, antigens rK39 and rK28 were heat-denatured at 95 °C for 10 min and then assayed by enzyme-linked immunosorbent assay (ELISA). Amino acid sequences of rK39 and rK28 were submitted to NCBI BLASTp to assess homology with Plasmodium, Schistosoma, and Mycobacterium. Results Heat denaturation significantly diminished the antigenicity of rK39 compared to non-denatured antigen (P = 0.001), but not for rK28 (P = 0.275). In BLASTp searches, HASPB sequences from rK28 had similarities with sequences from Plasmodium, encompassing software-predicted B-cell epitopes. Conclusions The antigenicity of rK39 appears to be dependent on structural conformation, whereas that of rK28 depends on linear sequence. HASPB sequence homology with Plasmodium may be responsible for the reported cross-reactivity of rK28 with malaria sera. Further work is warranted to refine the specificity of these antigens. Graphical Abstract ![]()
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Affiliation(s)
- Poppy Simonson
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
| | - Tapan Bhattacharyya
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Sayda El-Safi
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Michael A Miles
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
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11
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Siqueira WF, Viana AG, Reis Cunha JL, Rosa LM, Bueno LL, Bartholomeu DC, Cardoso MS, Fujiwara RT. The increased presence of repetitive motifs in the KDDR-plus recombinant protein, a kinesin-derived antigen from Leishmania infantum, improves the diagnostic performance of serological tests for human and canine visceral leishmaniasis. PLoS Negl Trop Dis 2021; 15:e0009759. [PMID: 34534217 PMCID: PMC8480608 DOI: 10.1371/journal.pntd.0009759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 09/29/2021] [Accepted: 08/24/2021] [Indexed: 02/07/2023] Open
Abstract
Visceral leishmaniasis (VL) is caused by protozoa belonging to the Leishmania donovani complex and is considered the most serious and fatal form among the different types of leishmaniasis, if not early diagnosed and treated. Among the measures of disease control stand out the management of infected dogs and the early diagnosis and appropriate treatment of human cases. Several antigens have been characterized for use in the VL diagnosis, among them are the recombinant kinesin-derived antigens from L. infantum, as rK39 and rKDDR. The main difference between these antigens is the size of the non-repetitive kinesin region and the number of repetitions of the 39 amino acid degenerate motif (6.5 and 8.5 repeats in rK39 and rKDDR, respectively). This repetitive region has a high antigenicity score. To evaluate the effect of increasing the number of repeats on diagnostic performance, we designed the rKDDR-plus antigen, containing 15.3 repeats of the 39 amino acid degenerate motif, besides the absence of the non-repetitive portion from L. infantum kinesin. Its performance was evaluated by enzyme-linked immunosorbent assay (ELISA) and rapid immunochromatographic test (ICT), and compared with the kinesin-derived antigens (rKDDR and rK39). In ELISA with human sera, all recombinant antigens had a sensitivity of 98%, whereas the specificity for rKDDR-plus, rKDDR and rK39 was 100%, 96% and 71%, respectively. When evaluated canine sera, the ELISA sensitivity was 97% for all antigens, and the specificity for rKDDR-plus, rKDDR and rK39 was 98%, 91% and 83%, respectively. Evaluation of the ICT/rKDDR-plus, using human sera, showed greater diagnostic sensitivity (90%) and specificity (100%), when compared to the IT LEISH (79% and 98%, respectively), which is based on the rK39 antigen. These results suggest that the increased presence of repetitive motifs in the rKDDR-plus protein improves the diagnostic performance of serological tests by increasing the specificity and accuracy of the diagnosis.
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Affiliation(s)
- Williane Fernanda Siqueira
- Programa de Pós-graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Agostinho Gonçalves Viana
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - João Luís Reis Cunha
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Leticia Mansur Rosa
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Lilian Lacerda Bueno
- Programa de Pós-graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Daniella Castanheira Bartholomeu
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Mariana Santos Cardoso
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ricardo Toshio Fujiwara
- Programa de Pós-graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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12
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Dos Santos NS, de Pinho FA, Hlavac NRC, Nunes TL, Almeida NR, Solcà MS, Varjão BM, Portela RW, Rugani JN, Rêgo FD, Barrouin-Melo SM, Soares RP. Feline Leishmaniasis Caused by Leishmania infantum: Parasite Sequencing, Seropositivity, and Clinical Characterization in an Endemic Area From Brazil. Front Vet Sci 2021; 8:734916. [PMID: 34513979 PMCID: PMC8424124 DOI: 10.3389/fvets.2021.734916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 08/02/2021] [Indexed: 11/13/2022] Open
Abstract
Zoonotic leishmaniasis caused by Leishmania infantum is a disease of One Health concern since human and animal cases and environmental damage are interconnected. L. infantum has a complex epidemiological cycle with multiple hosts, including mammals-humans, domestic, and wild animals-and arthropod vectors. Knowledge on mammal infections in endemic areas is crucial for developing control strategies. This work aimed to detect and characterize L. infantum infection in domestic cats from areas where human and canine leishmaniasis cases occur. No cases of feline leishmaniasis (FeL) had been previously reported in those areas. Five municipalities from Bahia state were chosen, comprising 2,480.8 km2 with 1,103,866 inhabitants. Ninety domiciliated and/or sheltered cats underwent clinical examination and serology by a rapid reference test recommended by the Brazilian government. Cytology, PCR, and parasite DNA sequencing were performed in bone marrow samples. Rapid tests detected antibodies in 5.6% (5/90) of the cats. Leishmania infantum infection was confirmed in 7.8% (7/90) of the cats by PCR, sequencing, and parasite isolation. Three out of the five municipalities (60%) had infected cats, and PCR positivity varied from 6.9 to 29%. One cat was categorized as harboring active L. infantum infection with amastigote forms in bone marrow smears. No clinical signs were detected at the first clinical exam, but 1 month later the cat developed severe FeL. The cat isolate was grown in culture, typed and its DNA sequence was homologous to the L. infantum reference strain (PP75). In conclusion, cats are potential hosts and may acquire L. infantum in endemic areas where canine and human cases occur. For cats, the need for surveillance, differential diagnosis and clinical care is highly recommended since a fast clinical progression of FeL developed in a subclinical animal. An accurate standardized immunodiagnostic assay for FeL is warranted.
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Affiliation(s)
- Nara Santos Dos Santos
- Laboratory of Veterinary Infectious Diseases, Teaching Hospital of Veterinary Medicine, Federal University of Bahia (UFBA), Salvador, Brazil
| | - Flaviane Alves de Pinho
- Laboratory of Veterinary Infectious Diseases, Teaching Hospital of Veterinary Medicine, Federal University of Bahia (UFBA), Salvador, Brazil.,Department of Veterinary Anatomy, Pathology and Clinics of the School of Veterinary Medicine and Zootechny, Federal University of Bahia, Salvador, Brazil
| | - Nicole Regina Capacchi Hlavac
- Department of Veterinary Anatomy, Pathology and Clinics of the School of Veterinary Medicine and Zootechny, Federal University of Bahia, Salvador, Brazil
| | - Talyta Lins Nunes
- Department of Veterinary Anatomy, Pathology and Clinics of the School of Veterinary Medicine and Zootechny, Federal University of Bahia, Salvador, Brazil
| | - Nádia Rossi Almeida
- Department of Veterinary Preventive Medicine and Animal Production of the School of Veterinary Medicine and Zootechny, Federal University of Bahia, Salvador, Brazil
| | - Manuela Silva Solcà
- Department of Veterinary Preventive Medicine and Animal Production of the School of Veterinary Medicine and Zootechny, Federal University of Bahia, Salvador, Brazil
| | - Bruno Milen Varjão
- Laboratory of Veterinary Infectious Diseases, Teaching Hospital of Veterinary Medicine, Federal University of Bahia (UFBA), Salvador, Brazil
| | - Ricardo Wagner Portela
- Laboratory of Immunology and Molecular Biology, Institute of Health Sciences, Federal University of Bahia, Salvador, BA, Brazil
| | | | - Felipe Dutra Rêgo
- Instituto Rene Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brazil
| | - Stella Maria Barrouin-Melo
- Laboratory of Veterinary Infectious Diseases, Teaching Hospital of Veterinary Medicine, Federal University of Bahia (UFBA), Salvador, Brazil.,Department of Veterinary Anatomy, Pathology and Clinics of the School of Veterinary Medicine and Zootechny, Federal University of Bahia, Salvador, Brazil
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13
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Patino LH, Castillo-Castañeda A, Muñoz M, Muskus C, Rivero-Rodríguez M, Pérez-Doria A, Bejarano EE, Ramírez JD. Revisiting the heterogeneous global genomic population structure of Leishmania infantum. Microb Genom 2021; 7. [PMID: 34491157 PMCID: PMC8715437 DOI: 10.1099/mgen.0.000640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Leishmania infantum is the main causative agent responsible for visceral leishmaniasis (VL), a disease with global distribution. The genomic structure and genetic variation of this species have been widely studied in different parts of the world. However, in some countries, this information is still yet unknown, as is the genomic behaviour of the main antigens used in VL diagnosis (rK39 and rK28), which have demonstrated variable sensitivity and specificity in a manner dependent on the geographic region analysed. The objective of this study was to explore the genomic architecture and diversity of four Colombian L. infantum isolates obtained in this study and to compare these results with the genetic analysis of 183 L. infantum isolates from across the world (obtained from public databases), as well as to analyse the whole rK39 and rK28 antigen sequences in our dataset. The results showed that, at the global level, L. infantum has high genetic homogeneity and extensive aneuploidy. Furthermore, we demonstrated that there are distinct populations of L. infantum circulating in various countries throughout the globe and that populations of distant countries have close genomic relationships. Additionally, this study demonstrated the high genetic variability of the rK28 antigen worldwide. In conclusion, our study allowed us to (i) expand our knowledge of the genomic structure of global L. infantum; (ii) describe the intra-specific genomic variability of this species; and (iii) understand the genomic characteristics of the main antigens used in the diagnosis of VL. Additionally, this is the first study to report whole-genome sequences of Colombian L. infantum isolates.
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Affiliation(s)
- Luz H Patino
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Adriana Castillo-Castañeda
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Marina Muñoz
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Carlos Muskus
- Programa de Estudios y Control de Enfermedades Tropicales (PECET), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Matilde Rivero-Rodríguez
- Grupo de Investigaciones Biomédicas, Universidad de Sucre, Sincelejo, Colombia.,Candidata a doctor en Medicina Tropical, Universidad de Cartagena-SUE Caribe, Colombia
| | - Alveiro Pérez-Doria
- Grupo de Investigaciones Biomédicas, Universidad de Sucre, Sincelejo, Colombia
| | - Eduar E Bejarano
- Grupo de Investigaciones Biomédicas, Universidad de Sucre, Sincelejo, Colombia
| | - Juan David Ramírez
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
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14
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Ejazi SA, Choudhury ST, Bhattacharyya A, Kamran M, Pandey K, Das VNR, Das P, da Silva FO, Costa DL, Costa CHN, Rahaman M, Goswami RP, Ali N. Development and Clinical Evaluation of Serum and Urine-Based Lateral Flow Tests for Diagnosis of Human Visceral Leishmaniasis. Microorganisms 2021; 9:microorganisms9071369. [PMID: 34201902 PMCID: PMC8305891 DOI: 10.3390/microorganisms9071369] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/10/2021] [Accepted: 05/20/2021] [Indexed: 11/16/2022] Open
Abstract
Visceral leishmaniasis (VL), a fatal parasitic infection, is categorized as being neglected among tropical diseases. The use of conventional tissue aspiration for diagnosis is not possible in every setting. The immunochromatography-based lateral flow assay (LFA) has attracted attention for a long time due to its ability to give results within a few minutes, mainly in resource-poor settings. In the present study, we optimized and developed the LFA to detect anti-Leishmania antibodies for VL diagnosis. The performance of the developed test was evaluated with serum and urine samples of Indian VL patients and Brazilian sera. The new test exploits well-studied and highly-sensitive purified antigens, LAg isolated from Leishmania donovani promastigotes and protein G conjugated colloidal-gold as a signal reporter. The intensity of the bands depicting the antigen-antibody complex was optimized under different experimental conditions and quantitatively analyzed by the ImageJ software. For the diagnosis of human VL in India, LFA was found to be 96.49% sensitive and 95% specific with serum, and 95.12% sensitive and 96.36% specific with urine samples, respectively. The sensitivity and specificity of LFA were 88.57% and 94.73%, respectively, for the diagnosis of Brazilian VL using patients' sera infected with Leishmania infantum. LFA is rapid and simple to apply, suitable for field usage where results can be interpreted visually and particularly sensitive and specific in the diagnosis of human VL. Serum and urine LFA may improve diagnostic outcomes and could be an alternative for VL diagnosis in settings where tissue aspiration is difficult to perform.
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Affiliation(s)
- Sarfaraz Ahmad Ejazi
- CSIR-Indian Institute of Chemical Biology, Kolkata 700032, India; (S.A.E.); (S.T.C.); (A.B.); (M.K.)
| | | | - Anirban Bhattacharyya
- CSIR-Indian Institute of Chemical Biology, Kolkata 700032, India; (S.A.E.); (S.T.C.); (A.B.); (M.K.)
| | - Mohd Kamran
- CSIR-Indian Institute of Chemical Biology, Kolkata 700032, India; (S.A.E.); (S.T.C.); (A.B.); (M.K.)
| | - Krishna Pandey
- Rajendra Memorial Research Institute of Medical Sciences, Patna 800007, India; (K.P.); (V.N.R.D.); (P.D.)
| | - Vidya Nand Ravi Das
- Rajendra Memorial Research Institute of Medical Sciences, Patna 800007, India; (K.P.); (V.N.R.D.); (P.D.)
| | - Pradeep Das
- Rajendra Memorial Research Institute of Medical Sciences, Patna 800007, India; (K.P.); (V.N.R.D.); (P.D.)
| | - Fernando Oliveira da Silva
- Department of Community Medicine, Universidade Federal do Piaui, Teresina 64001-450, Brazil; (F.O.d.S.); (D.L.C.); (C.H.N.C.)
| | - Dorcas Lamounier Costa
- Department of Community Medicine, Universidade Federal do Piaui, Teresina 64001-450, Brazil; (F.O.d.S.); (D.L.C.); (C.H.N.C.)
| | - Carlos Henrique Nery Costa
- Department of Community Medicine, Universidade Federal do Piaui, Teresina 64001-450, Brazil; (F.O.d.S.); (D.L.C.); (C.H.N.C.)
| | - Mehebubar Rahaman
- School of Tropical Medicine, Kolkata 700073, India; (M.R.); (R.P.G.)
| | | | - Nahid Ali
- CSIR-Indian Institute of Chemical Biology, Kolkata 700032, India; (S.A.E.); (S.T.C.); (A.B.); (M.K.)
- Correspondence: ; Tel.: +91-33-2499-5757
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15
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Improved Performance of ELISA and Immunochromatographic Tests Using a New Chimeric A2-Based Protein for Human Visceral Leishmaniasis Diagnosis. J Immunol Res 2021; 2021:5568077. [PMID: 34007852 PMCID: PMC8102099 DOI: 10.1155/2021/5568077] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/22/2021] [Accepted: 03/30/2021] [Indexed: 01/24/2023] Open
Abstract
Methods A total of 1028 sera samples were used for the development and validation of ELISA (321 samples from L. infantum-infected patients, 62 samples from VL/AIDS coinfected patients, 236 samples from patients infected with other diseases, and 409 samples from healthy donors). A total of 520 sera samples were used to develop and validate ICT (249 samples from L. infantum-infected patients, 46 samples from VL/AIDS coinfected patients, 40 samples from patients infected with other diseases, and 185 samples from healthy donors). Findings. Using the validation sera panels, DTL-4-based ELISA displayed an overall sensitivity of 94.61% (95% CI: 89.94-97.28), a specificity of 99.41% (95% CI: 96.39-99.99), and an accuracy of 97.02% (95% CI: 94.61-98.38), while for ICT, sensitivity, specificity, and accuracy values corresponded to 91.98% (95% CI: 86.65-95.39), 100.00% (95% CI: 96.30-100.00), and 95.14% (95% CI: 91.62-97.15), respectively. When testing sera samples from VL/AIDS coinfected patients, DTL-4-ELISA displayed a sensitivity of 77.42% (95% CI: 65.48-86.16), a specificity of 99.41% (95% CI: 96.39-99.99), and an accuracy of 93.51% (95% CI: 89.49%-96.10%), while for DTL-4-ICT, sensitivity was 73.91% (95% CI: 59.74-84.40), specificity was 90.63% (95% CI: 81.02-95.63), and accuracy was 82.00% (95% CI: 73.63-90.91). Conclusion DTL-4 is a promising candidate antigen for serodiagnosis of VL patients, including those with VL/AIDS coinfection, when incorporated into ELISA or ICT test formats.
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16
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Fujimori M, de Almeida ADBPF, Barrouin-Melo SM, Cortez LRPDB, Duthie MS, Hiramoto RM, de Pinho FA, Reed SG, Sousa VRF, Souza NF, Soares RM, Tolezano JE, Sanchez MCA, Goto H. Validation of ELISA with recombinant antigens in serological diagnosis of canine Leishmania infantum infection. Mem Inst Oswaldo Cruz 2021; 116:e200428. [PMID: 33729396 PMCID: PMC7968437 DOI: 10.1590/0074-02760200428] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 02/09/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Dogs are the main peridomiciliary reservoir of Leishmania infantum thus the correct diagnosis of infection is essential for the control of the transmission and treatment as well. However, the diagnosis is based on serological assays that are not fully effective. OBJECTIVE We aimed to establish an effective serological assay for the diagnosis of L. infantum infected dogs using Leishmania-derived recombinant antigens. METHODS Leishmania derived rK39-, rK28-, rKR95-based enzyme-linked immunosorbent assay (ELISA) was standardized using symptomatic and asymptomatic L. infantum-infected dogs. Then 2,530 samples from inquiry in endemic areas for VL were evaluated and the results compared with recommended assays by the Brazilian Ministry of Health (MH algorithm). Further samples from a cohort of 30 dogs were searched. FINDINGS For rK39-, rK28- and rKR95-ELISA the sensitivity was around 97% and specificity 100%. The positivity of these three ELISA in the inquiry samples was 27-28%, around 10% higher than the assays currently in use. When cohort samples were searched, we observed likely false-negative results (> 65%) with supposedly negative samples that turned positive six months later with the assays in use (MH algorithm). MAIN CONCLUSIONS For the diagnosis of L. infantum-infected dogs, rK39-based ELISA showed better diagnostic performance than other assays in use in Brazil and worldwide.
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Affiliation(s)
- Mahyumi Fujimori
- Instituto de Medicina Tropical da Faculdade de Medicina da Universidade de São Paulo, Laboratório de Soroepidemiologia e Imunobiologia, São Paulo, SP, Brasil
| | | | - Stella Maria Barrouin-Melo
- Universidade Federal da Bahia, Hospital-Escola de Medicina Veterinária, Laboratório de Infectologia Veterinária, Salvador, BA, Brasil
| | | | | | - Roberto Mitsuyoshi Hiramoto
- Instituto Adolfo Lutz, Centro de Parasitologia e Micologia, Núcleo de Parasitoses Sistêmicas, São Paulo, SP, Brasil
| | - Flaviane Alves de Pinho
- Universidade Federal da Bahia, Hospital-Escola de Medicina Veterinária, Laboratório de Infectologia Veterinária, Salvador, BA, Brasil
| | | | - Valéria Régia Franco Sousa
- Universidade Federal de Mato Grosso, Faculdade de Medicina Veterinária, Departamento de Clínica Médica Veterinária, Cuiabá, MT, Brasil
| | - Nazaré Fonseca Souza
- Universidade Federal Rural da Amazônia, Instituto da Saúde e Produção Animal, Belém, Pará, Brasil
| | - Rodrigo Martins Soares
- Universidade de São Paulo, Faculdade de Medicina Veterinária e Zootecnia, Departamento de Medicina Veterinária Preventiva e Saúde Animal, Laboratório de Doenças Parasitárias, São Paulo, SP, Brasil
| | - José Eduardo Tolezano
- Instituto Adolfo Lutz, Centro de Parasitologia e Micologia, Núcleo de Parasitoses Sistêmicas, São Paulo, SP, Brasil
| | - Maria Carmen Arroyo Sanchez
- Instituto de Medicina Tropical da Faculdade de Medicina da Universidade de São Paulo, Laboratório de Soroepidemiologia e Imunobiologia, São Paulo, SP, Brasil
| | - Hiro Goto
- Instituto de Medicina Tropical da Faculdade de Medicina da Universidade de São Paulo, Laboratório de Soroepidemiologia e Imunobiologia, São Paulo, SP, Brasil
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Medicina Preventiva, São Paulo, SP, Brasil
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17
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Pereira JC, Dos Santos Sousa P, De Souza LMB, Pasquali AKS, Bates M, Bates P, Thomaz Soccol V. The efficacy of recombinant protein lbk39 for the diagnosis of leishmaniosis in dogs. Parasitology 2021; 148:302-310. [PMID: 33070782 PMCID: PMC11010170 DOI: 10.1017/s0031182020001997] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 09/21/2020] [Accepted: 10/12/2020] [Indexed: 11/06/2022]
Abstract
Visceral leishmaniosis is one of the most important zoonotic diseases on the planet and dogs are the main reservoir of canine visceral leishmaniosis (CVL) in endemic areas. They play an important role in human infection because in dogs the disease appears long time after infection, and they can move uncontrollably, contributing to disperse the parasite. To take the decision to treat the animals or for euthanasia, in an elimination programme, in order to reduce the parasitic load, it is necessary to diagnose correctly, having more effective tools. Our group has developed a new recombinant antigen-based kinesin-related gene of Leishmania braziliensis (Lbk39), which shows 59% amino acid identity to the L. infantum homologue. The Lbk39 gene was synthesized, inserted into the pLEXSY-sat2 vector and transfected into L. tarentolae cells by electroporation. The recombinant protein was secreted in the culture with a C-terminal histidine marker, purified, generating a product at 337.68 μg mL-1. A total of 152 sera from dog's endemic and non-endemic areas were used, being 78 positives and 75 negatives. The antigen Lbk39 showed 100% sensitivity and 96.1% specificity. We compared this antigen with other antigens such as total extract of the parasite, TRDPP, and our data indicate that Lbk39 has potential application in the diagnosis of CVL through antibody detection.
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Affiliation(s)
- Joyce Carvalho Pereira
- Federal University of Paraná, Post-graduate Course in Bioprocess Engineering and Biotechnology, Polytechnic Centre, Jardim das Américas, CEP 81530-980, Curitiba, Paraná, Brazil
| | - Pedro Dos Santos Sousa
- Federal University of Paraná, Post-graduate Course in Bioprocess Engineering and Biotechnology, Polytechnic Centre, Jardim das Américas, CEP 81530-980, Curitiba, Paraná, Brazil
| | - Ligia Moraes Barizon De Souza
- Federal University of Paraná, Post-graduate Course in Bioprocess Engineering and Biotechnology, Polytechnic Centre, Jardim das Américas, CEP 81530-980, Curitiba, Paraná, Brazil
| | - Aline Kuhn Sbruzzi Pasquali
- Federal University of Paraná, Post-graduate Course in Bioprocess Engineering and Biotechnology, Polytechnic Centre, Jardim das Américas, CEP 81530-980, Curitiba, Paraná, Brazil
| | - Michelle Bates
- Division of Biomedical and Life Sciences, Faculty of Health and Medicine, Lancaster University, Lancaster, LA1 4YQ, UK
| | - Paul Bates
- Division of Biomedical and Life Sciences, Faculty of Health and Medicine, Lancaster University, Lancaster, LA1 4YQ, UK
| | - Vanete Thomaz Soccol
- Federal University of Paraná, Post-graduate Course in Bioprocess Engineering and Biotechnology, Polytechnic Centre, Jardim das Américas, CEP 81530-980, Curitiba, Paraná, Brazil
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Kassa M, Abdellati S, Cnops L, Bremer Hinckel BC, Yeshanew A, Hailemichael W, Vogt F, Adriaensen W, Mertens P, Diro E, van Griensven J, Van den Bossche D. Diagnostic accuracy of direct agglutination test, rK39 ELISA and six rapid diagnostic tests among visceral leishmaniasis patients with and without HIV coinfection in Ethiopia. PLoS Negl Trop Dis 2020; 14:e0008963. [PMID: 33382690 PMCID: PMC7774845 DOI: 10.1371/journal.pntd.0008963] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/09/2020] [Indexed: 01/26/2023] Open
Abstract
Diagnosis of a first-time visceral leishmaniasis (VL) infection in Ethiopia is established by use of a rapid diagnostic test (RDT) detecting antibodies against rK39, direct agglutination test (DAT) and microscopy according to the national algorithm. The performance of individual tests and algorithm is variable and depends on several factors, one being HIV status. Limited data are available on the performance of tests in VL-HIV coinfected patients. Assessment of the performance of DAT (ITM-A), rK39 ELISA (Serion) and six RDT (Onsite Leishmania Ab CTK, Antigen ICT Xinjier, IT Leish Biorad, Kalazar Detect Inbios, rK39 IgG1 Coris, rk28 IgG1 Coris) for the diagnosis of VL was done on a panel of 91 stored serum and plasma samples of 'first-episode' suspected VL patients, with HIV coinfection (n = 51) and without (n = 40). A combined reference standard was used: either positive microscopy on tissue aspirates, or in case of negative microscopy, positive PCR results on the aspirate slide. Additionally, endemic healthy controls (n = 20), non-endemic controls (n = 10) and patients with confirmed malaria infection (n = 10) were tested for specificity evaluation. Sensitivities ranged from 69.2% for DAT (applied cut-off ≥ 1/3200) to 92.2% for the Onsite RDT, whereas specificities ranged from 20.0% for Kalazar Antigen ICT to 100% for IT Leish and rK39 IgG1. Sensitivities from all assays decreased upon stratification according to HIV status but was only significantly different for rK39 Serion ELISA (p-value 0.0084) and the Onsite RDT (p-value 0.0159). In conclusion, performance of commercially available assays for VL on samples from Northern-Ethiopian patients varied widely with a substantial decrease in sensitivity in the VL-HIV coinfected group. Clear guidelines on minimal performance criteria of individual tests and algorithms are needed, as well as which reference standard should be used to determine the performance.
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Affiliation(s)
- Mekibib Kassa
- Leishmaniasis Research and Treatment Centre, University of Gondar, Gondar, Ethiopia
| | - Saïd Abdellati
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Lieselotte Cnops
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | | | - Arega Yeshanew
- Leishmaniasis Research and Treatment Centre, University of Gondar, Gondar, Ethiopia
| | - Wasihun Hailemichael
- Department of Immunology and Molecular Biology, Biomedical Sciences, University of Gondar, Ethiopia
| | - Florian Vogt
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Wim Adriaensen
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | | | - Ermias Diro
- Leishmaniasis Research and Treatment Centre, University of Gondar, Gondar, Ethiopia
| | - Johan van Griensven
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Dorien Van den Bossche
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- * E-mail:
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Visceral Dissemination of Mucocutaneous Leishmaniasis in a Kidney Transplant Recipient. Pathogens 2020; 10:pathogens10010018. [PMID: 33396614 PMCID: PMC7824171 DOI: 10.3390/pathogens10010018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/20/2020] [Accepted: 12/26/2020] [Indexed: 11/17/2022] Open
Abstract
Intracellular protozoan of the genus Leishmania, endemic in the Mediterranean basin, are the cause of cutaneous (CL), mucocutaneous (MCL), and visceral leishmaniasis (VL). A 75-year-old woman was admitted nine years after a second kidney transplant (KT), due to persistent pancytopenia and fever. She presented edema and erythema of the nose in the last two years and an exophytic nodular lesion located on the left arm, with areas of peripheral necrosis and central ulceration in the last 18 months. A bone marrow biopsy revealed features compatible with Leishmania amastigotes, and polymerase chain reaction test (PCR) for Leishmania infantum was positive. Moreover, biopsy and PCR for L. infantum of the cutaneous lesion on the patient's left arm and nose and PCR from peripheral blood were positive. Thus, a diagnosis of CL, MCL, and VL was made, and liposomal amphotericin B was initiated, but the patient had an unfavorable outcome and died. This is the first report of a KT recipient presenting with the entire spectrum of leishmaniasis. In Portugal, this infection is rare-so a high degree of clinical suspicion is required for its diagnosis, especially in endemic regions, as visceral leishmaniasis is a potentially life-threatening infection.
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Mohebali M, Keshavarz H, Shirmohammad S, Akhoundi B, Borjian A, Hassanpour G, Mamishi S, Mahmoudi S. The diagnostic accuracy of direct agglutination test for serodiagnosis of human visceral leishmaniasis: a systematic review with meta-analysis. BMC Infect Dis 2020; 20:946. [PMID: 33308170 PMCID: PMC7729288 DOI: 10.1186/s12879-020-05558-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 10/30/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Direct agglutination test (DAT) as a simple, accurate and reliable method, has been widely used for serodiagnosis of visceral leishmaniasis (VL) during the last three decades. The present study is a systematic review and meta-analysis to evaluate the diagnostic accuracy of DAT for serodiagnosis of human VL. METHODS Electronic databases, including MEDLINE (via PubMed), SCOPUS, Web of Science, SID and Mag Iran (two Persian scientific search engines) were searched from December 2004 to April 2019. We determined the pooled sensitivity and specificity rates of DAT for the diagnosis of human VL, calculated positive and negative likelihood ratios (LR+ and LR-), and constructed summary receiver operating characteristic (ROC) curves parameters across the eligible studies. RESULTS Of the 2928 records identified in the mentioned electronic databases and after examining reference lists of articles, 24 articles met inclusion criteria and were enrolled in the systematic review and out of them 20 records qualified for meta-analysis. The pooled sensitivity and specificity rates of DAT was 96% [95% CI, 92-98] and 95% [CI95% 86-99], respectively. The likelihood ratio of a positive test (LR+) was found to be 21 [CI95%, 6.6-66.5] and the likelihood ratio of a negative test (LR-) was found to be 0.04 [(CI95%, 0.02-0.08]. The combined estimate of the diagnostic odds ratio for DAT was high [467 (CI95%, 114-1912]). We found that the summary receiver operating characteristic curve (SROC) is positioned near the upper left corner of the curve and the area under curve (AUC) was 0.98 (95% CI, 0.97 to 0.99). CONCLUSION Referring to our analysis, we determined that DAT can be considered as a valuable tool for the serodiagnosis of human VL with high sensitivity and specificity. As DAT is a simple, accurate and efficient serological test, it can be recommended for serodiagnosis of human VL particularly in endemic areas.
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Affiliation(s)
- Mehdi Mohebali
- Department of Medical Parasitology and Mycology, Tehran University of Medical Sciences, School of Public Health, Tehran, Iran.,Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Keshavarz
- Department of Medical Parasitology and Mycology, Tehran University of Medical Sciences, School of Public Health, Tehran, Iran.,Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran
| | - Sedigheh Shirmohammad
- Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran
| | - Behnaz Akhoundi
- Department of Medical Parasitology and Mycology, Tehran University of Medical Sciences, School of Public Health, Tehran, Iran
| | - Alireza Borjian
- Department of Medical Parasitology and Mycology, Tehran University of Medical Sciences, School of Public Health, Tehran, Iran
| | - Gholamreza Hassanpour
- Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran
| | - Setareh Mamishi
- Pediatric Infectious Diseases Research Center, Tehran University of Medical Sciences, No. 62, Dr. Gharib St., Tehran, Iran
| | - Shima Mahmoudi
- Pediatric Infectious Diseases Research Center, Tehran University of Medical Sciences, No. 62, Dr. Gharib St., Tehran, Iran.
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Salam MA, Huda MM, Khan MGM, Shomik MS, Mondal D. Evidence-based diagnostic algorithm for visceral leishmaniasis in Bangladesh. Parasitol Int 2020; 80:102230. [PMID: 33147502 DOI: 10.1016/j.parint.2020.102230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 09/17/2020] [Accepted: 10/02/2020] [Indexed: 10/23/2022]
Abstract
Evidence-based diagnostic algorithm is highly recommended for the visceral leishmaniasis (VL). This cross-sectional study was performed in Bangladesh to evaluate VL diagnostic tools including serology, buffy coat smear microscopy for LD body and various DNA-based techniques using buffy coat in 100 confirmed VL cases and 100 controls. The performance of tools against spleen smear (gold standard) was evaluated using kappa coefficient. Diagnostic precision and other inherent indicators were considered for index scoring (IS) of performance of tools using factor analysis. A diagnostic algorithm was formulated based on the IS and availability of the tools at different health care facilities of Bangladesh. A high level of agreement (kappa ≥ 0.80) was observed for all the diagnostic tools. The highest kappa coefficients were found for rK39 RDT and rK39 ELISA (0.95), followed by ssuRNA-PCR (0.94), Buffy coat smear (0.93), rK28 ELISA (0.92), rK28 RDT (0.89), LAMP (0.89), Mini-exon PCR (0.86), ITS1 (0.85), and ITS2 PCR (0.80). rK39 RDT was found to be the best diagnostic test (IS: 1.7) followed by rK28 RDT (IS: 1.5), buffy coat smear microscopy (IS: 0.5), rK39 & rK28 ELISA (IS: 0.3), ssuRNA-PCR (IS: -0.7) and LAMP, Mini-exon, ITS1, & ITS2 PCR (IS: -0.9). rK39 RDT has been proposed as the best option for primary health care facilities, while buffy coat smear microscopy was found to be a good adjunct for confirmation of serology-positive cases and proposed for secondary and tertiary facilities. ssuRNA-PCR or LAMP can be an alternate confirmation tool only applicable to the tertiary facilities.
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Affiliation(s)
- Md Abdus Salam
- Department of Microbiology, Rajshahi Medical College, Rajshahi 6000, Bangladesh.
| | - M Mamun Huda
- Associate Scientist, Nutrition and Infection, Nutrition and Clinical Services Division, icddr,b, Mohakhali, Dhaka 1212, Bangladesh.
| | - Md Gulam Musawwir Khan
- Doctoral Student (3rd cycle), Immunology Division, Department of Anatomy and Cell Biology, Faculty of Medicine and Health Sciences, University of Sherbrooke, QC, Canada.
| | - Mohammad Sohel Shomik
- Deputy Project Coordinator, Nutrition and Clinical Services Division, icddr,b, Mohakhali, Dhaka 1212, Bangladesh.
| | - Dinesh Mondal
- Senior Scientist, Nutrition and Clinical Services Division, icddr,b, Mohakhali, Dhaka 1212, Bangladesh.
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Reimão JQ, Coser EM, Lee MR, Coelho AC. Laboratory Diagnosis of Cutaneous and Visceral Leishmaniasis: Current and Future Methods. Microorganisms 2020; 8:E1632. [PMID: 33105784 PMCID: PMC7690623 DOI: 10.3390/microorganisms8111632] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 02/03/2023] Open
Abstract
Leishmaniasis is a neglected tropical disease with two main clinical forms: cutaneous and visceral leishmaniasis. Diagnosis of leishmaniasis is still a challenge, concerning the detection and correct identification of the species of the parasite, mainly in endemic areas where the absence of appropriate resources is still a problem. Most accessible methods for diagnosis, particularly in these areas, do not include the identification of each one of more than 20 species responsible for the disease. Here, we summarize the main methods used for the detection and identification of leishmaniasis that can be performed by demonstration of the parasite in biological samples from the patient through microscopic examination, by in vitro culture or animal inoculation; by molecular methods through the detection of parasite DNA; or by immunological methods through the detection of parasite antigens that may be present in urine or through the detection of specific antibodies against the parasite. Potential new methods that can be applied for laboratory diagnosis of leishmaniasis are also discussed.
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Affiliation(s)
- Juliana Quero Reimão
- Departamento de Morfologia e Patologia Básica, Faculdade de Medicina de Jundiaí, Jundiaí 13202-550, Brazil; (J.Q.R.); (M.R.L.)
| | - Elizabeth Magiolo Coser
- Departamento de Biologia Animal, Instituto de Biologia, Universidade Estadual de Campinas (UNICAMP), Campinas 13083-862, Brazil;
| | - Monica Ran Lee
- Departamento de Morfologia e Patologia Básica, Faculdade de Medicina de Jundiaí, Jundiaí 13202-550, Brazil; (J.Q.R.); (M.R.L.)
| | - Adriano Cappellazzo Coelho
- Departamento de Biologia Animal, Instituto de Biologia, Universidade Estadual de Campinas (UNICAMP), Campinas 13083-862, Brazil;
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Evaluation of Cysteine Protease C of Leishmania donovani in Comparison with Glycoprotein 63 and Elongation Factor 1α for Diagnosis of Human Visceral Leishmaniasis and for Posttreatment Follow-Up Response. J Clin Microbiol 2020; 58:JCM.00213-20. [PMID: 32848039 DOI: 10.1128/jcm.00213-20] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 07/30/2020] [Indexed: 12/21/2022] Open
Abstract
Visceral leishmaniasis (VL) is a threat in many developing countries. Much effort has been put to eliminating this disease, for which serodiagnosis remains the mainstay for VL control programs. New and improved antigens as diagnostic candidates are required, though, as the available antigens fail to demonstrate equal optimum performance in all areas of endemicity. Moreover, these diagnoses are dependent on invasive serum sampling. In the current study, we cloned and expressed Leishmania donovani cysteine protease C (CPC) and evaluated its diagnostic and test-of-cure possibilities by detecting the antibody levels in human serum and urine through ELISA and immunoblot assays. Two immunodominant antigens, recombinant glycoprotein 63 (GP63) and elongation factor 1α (EF1α), identified earlier by our group, were also assessed by employing human serum and urine samples. Of these three antigens in ELISAs, CPC demonstrated the highest sensitivities of 98.15% and 96% positive testing in serum and urine of VL patients, respectively. Moreover, CPC yielded 100% specificity with serum and urine of nonendemic healthy controls compared to GP63 and EF1α. Urine samples were found to be more specific than serum for distinguishing endemic healthy controls and other diseases by means of all three antigens. In all cases, CPC gave the most promising results. Unlike serum, urine tests demonstrated a significant decrease in antibody levels for CPC, GP63, and EF1α after 6 months of treatment. The diagnostic and test-of-cure performances of CPC in the immunoblot assay were found to be better than those of GP63 and EF1α. In conclusion, CPC, followed by GP63 and EF1α, may be utilized as candidates for diagnosis of VL and to assess treatment response.
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Karimi Kakh M, Golchin M, Kazemi Arababadi M, Daneshvar H. Application of the Leishmania infantum 21-kDa recombinant protein for the development of an immunochromatographic test. Parasite Immunol 2020; 42:e12770. [PMID: 32592182 DOI: 10.1111/pim.12770] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 06/14/2020] [Accepted: 06/15/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Visceral leishmaniasis (VL), caused by Leishmania infantum, is a systemic parasitic disease and presents a global health problem which can be fatal if not diagnosed and treated. Dogs are the main hosts and provide reservoirs for the transmission of the disease to humans. METHODS In this study, the gene encoding a 21-kDa protein was cloned and expressed as a fusion protein in Escherichia coli strain BL21 (DE3) for developing a rapid immunochromatographic test (ICT) to identify infected dogs. The expression of the recombinant 21-kDa protein (r21) was investigated using SDS-PAGE and Western blot methods. The purified r21-kDa protein was spotted onto ICT strips and tested by sera from experimentally infected, naturally infected and uninfected dogs. RESULTS The SDS-PAGE and Western blot methods showed the successful expression of r21-kDa protein. The ICT strip test revealed that the r21-kDa protein was detected by the sera of experimentally and naturally infected dogs. The specificity tests also confirmed no cross-reactivity with animals infected with Trypanosoma cruzi, Toxoplasma gondii and Ehrlichia canis. CONCLUSIONS Based on these findings, the new r21-kDa protein may be a suitable target for developing a new simple, specific and rapid serological method to detect VL in infected dogs.
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Affiliation(s)
- Mansoureh Karimi Kakh
- Department of Immunology, Faculty of Medicine, Kerman University of Medical Science, Kerman, Iran
| | - Mehdi Golchin
- Department of Pathobiology, Faculty of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Mohammad Kazemi Arababadi
- Immunology of Infectious Diseases Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Hamid Daneshvar
- Department of Immunology, Faculty of Medicine, Kerman University of Medical Science, Kerman, Iran
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Gene design, optimization of protein expression and preliminary evaluation of a new chimeric protein for the serological diagnosis of both human and canine visceral leishmaniasis. PLoS Negl Trop Dis 2020; 14:e0008488. [PMID: 32716931 PMCID: PMC7410341 DOI: 10.1371/journal.pntd.0008488] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 08/06/2020] [Accepted: 06/16/2020] [Indexed: 11/19/2022] Open
Abstract
Background Visceral leishmaniasis (VL) is a major neglected disease, potentially fatal, whose control is still impaired by inefficient and/or expensive treatment and diagnostic methods. The most promising approach for VL diagnosis uses serological assays with recombinant proteins, since they are more efficient and easier to perform. Tests developed for the human form of the disease, however, have not been shown to be efficient for its diagnosis in the canine host, the major reservoir for the American VL. Methodology/Principal findings Here, we describe a systematic approach aimed at the production of a new chimeric protein potentially able to be used for both human and canine VL diagnosis and based both on in silico gene design and experimental data. Starting from the previous identification of Leishmania infantum recombinant antigens efficient for the diagnosis of either human or canine VL, three of the best performing antigens were selected (Lci2, Lci3 and Lci12). After a preliminary evaluation validating the chimeric approach, DNA fragments encoding predicted antigenic regions from each protein, enriched with repeats, were joined in various combinations to generate a total of seventeen chimeric genes optimized for prokaryotic expression. These were assessed for optimal expression and purification yield, with four chimeric proteins being efficiently produced. Their diagnostic potential was then evaluated through ELISA assays with sera from VL afflicted humans and dogs. After two rounds of gene design, the results showed high levels of sensitivity for the best chimeric protein, named Q5, in humans (82%) and dogs (100%) with 100% specificity in comparison with healthy controls. A single non-specific reaction was seen with serum from individuals with tegumentary leishmaniasis. Conclusion The newly described chimeric protein is potentially useful for the detection of both humans and dogs afflicted with VL, with its use in rapid tests necessary for validation as a new diagnostic tool. Visceral leishmaniasis (VL) is a major neglected disease, potentially fatal, caused mainly by Leishmania infantum and L. donovani. Its control is still impaired by inefficient and/or expensive treatment and diagnostic methods. VL diagnosis is mostly dependent on serological assays made with bacterially expressed Leishmania proteins. Tests developed for the human form of the disease, however, are not efficient for its diagnosis in the canine host. Dogs are the major reservoir for the American VL and their infection also needs to be monitored, requiring a distinct diagnostic test. Here, we describe a new chimeric protein potentially able to be used for both human and canine VL diagnosis. Based on a systematic approach using three Leishmania proteins known to be efficient for the diagnosis of either human or canine VL, fragments of each were joined in various combinations. The diagnostic potential of different chimeric proteins was then evaluated with human and canine sera from VL afflicted individuals. The best protein showed high levels of sensitivity in humans and dogs with no relevant false positive results with healthy controls or humans with tegumentary leishmaniasis. It is then potentially useful for the detection of both humans and dogs afflicted with VL in novel diagnostic tests.
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Leishmaniasis immunopathology-impact on design and use of vaccines, diagnostics and drugs. Semin Immunopathol 2020; 42:247-264. [PMID: 32152715 DOI: 10.1007/s00281-020-00788-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 02/03/2020] [Indexed: 12/18/2022]
Abstract
Leishmaniasis is a disease complex caused by 20 species of protozoan parasites belonging to the genus Leishmania. In humans, it has two main clinical forms, visceral leishmaniasis (VL) and cutaneous or tegumentary leishmaniasis (CL), as well as several other cutaneous manifestations in a minority of cases. In the mammalian host Leishmania parasites infect different populations of macrophages where they multiply and survive in the phagolysosomal compartment. The progression of both VL and CL depends on the maintenance of a parasite-specific immunosuppressive state based around this host macrophage infection. The complexity and variation of immune responses and immunopathology in humans and the different host interactions of the different Leishmania species has an impact upon the effectiveness of vaccines, diagnostics and drugs.
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Thakur S, Joshi J, Kaur S. Leishmaniasis diagnosis: an update on the use of parasitological, immunological and molecular methods. J Parasit Dis 2020; 44:253-272. [PMID: 32419743 PMCID: PMC7223249 DOI: 10.1007/s12639-020-01212-w] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 03/07/2020] [Indexed: 12/24/2022] Open
Abstract
Diagnosis of leishmaniasis has always been a major challenge as its clinical features resemble some other commonly occurring diseases such as tuberculosis, typhoid, and malaria. Reliable laboratory methods become important for differential diagnosis. Demonstration of the parasites in stained preparations of bone marrow and splenic aspirates being risky and invasive is still the gold standard for diagnosis. Serological tests utilizing rapid immunochromatographic formats or rK39 in enzyme linked immune sorbent assay, immunoblotting, direct agglutination test have complications related to high proportions of positive asymptomatic individuals and the inability to diagnose a relapse. Among the molecular techniques, polymerase chain reaction is the most commonly used technique that is successfully implied for diagnosis. This review provides updated information on the recent developments in the field of diagnosis in leishmaniasis, various methods utilized with their advantages and limitations.
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Affiliation(s)
- Shivani Thakur
- Parasitology Laboratory, Department of Zoology, Panjab University, Chandigarh, 160014 India
| | - Jyoti Joshi
- Parasitology Laboratory, Department of Zoology, Panjab University, Chandigarh, 160014 India
| | - Sukhbir Kaur
- Parasitology Laboratory, Department of Zoology, Panjab University, Chandigarh, 160014 India
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Ejazi SA, Ghosh S, Bhattacharyya A, Kamran M, Das S, Bhowmick S, Rahaman M, Goswami RP, Ali N. Investigation of the antigenicity and protective efficacy of Leishmania promastigote membrane antigens in search of potential diagnostic and vaccine candidates against visceral leishmaniasis. Parasit Vectors 2020; 13:272. [PMID: 32473634 PMCID: PMC7260476 DOI: 10.1186/s13071-020-04138-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 05/14/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Visceral leishmaniasis (VL), is a parasitic disease that causes serious medical consequences if treatment is delayed. Despite a decline in the number of VL cases in the Indian subcontinent, the commencement of the disease in newer areas continues to be a major concern. Although serological diagnosis mainly by immunochromatographic tests has been found to be effective, a test of cure in different phases of treatment is still desired. Even though a good prophylactic response has been obtained in murine models by a number of vaccine candidates, few have been proposed for human use. METHODS In this study, nine antigenic components (31, 34, 36, 45, 51, 63, 72, 91 and 97 kDa) of Leishmania promastigote membrane antigens (LAg), were electroeluted and evaluated through ELISA to diagnose and distinguish active VL from one month cured and six months post-treatment patients. Further, to investigate the immunogenicity of electroeluted proteins, human PBMCs of cured VL patients were stimulated with 31, 34, 51, 63, 72 and 91 kDa proteins. RESULTS We found that 34 and 51 kDa proteins show 100% sensitivity and specificity with healthy controls and other diseases. After six months post-treatment, antibodies to 72 and 91 kDa antigens show a significant decline to almost normal levels. This suggests that 34 and 51 kDa proteins are efficient in diagnosis, whereas 72 and 91 kDa proteins may be used to monitor treatment outcome. In another assay, 51 and 63 kDa proteins demonstrated maximum ability to upregulate IFN-γ and IL-12 with minimum induction of IL-10 and TGF-β. The results indicating that 51 and 63 kDa proteins could be strong candidates for human immunization against VL. In contrast, 34 and 91 kDa proteins demonstrated a reverse profile and may not be a good vaccine candidate. CONCLUSIONS The preliminary data obtained in this study proposes the potential of some of the antigens in Leishmania diagnosis and for test of cure. Additionally, some antigens demonstrated good immunoprophylactic cytokine production through T cell-mediated immune response, suggesting future vaccine candidates for VL. However, further studies are necessary to explore these antigens in diagnosis and to access the long-term immune response.
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Affiliation(s)
- Sarfaraz Ahmad Ejazi
- Infectious Diseases and Immunology Division, Indian Institute of Chemical Biology, Kolkata, West Bengal, India
| | - Smriti Ghosh
- Infectious Diseases and Immunology Division, Indian Institute of Chemical Biology, Kolkata, West Bengal, India.,Department of Botany, Serampore College, Hooghly, Serampore, West Bengal, India
| | - Anirban Bhattacharyya
- Infectious Diseases and Immunology Division, Indian Institute of Chemical Biology, Kolkata, West Bengal, India
| | - Mohd Kamran
- Infectious Diseases and Immunology Division, Indian Institute of Chemical Biology, Kolkata, West Bengal, India
| | - Sonali Das
- Infectious Diseases and Immunology Division, Indian Institute of Chemical Biology, Kolkata, West Bengal, India
| | - Sudipta Bhowmick
- Infectious Diseases and Immunology Division, Indian Institute of Chemical Biology, Kolkata, West Bengal, India.,Dr. Kanailal Bhattacharyya College, Dharmatala, Ramrajatala, Santragachi, Howrah, West Bengal, India
| | - Mehebubar Rahaman
- Department of Tropical Medicine, School of Tropical Medicine, Kolkata, West Bengal, India
| | - Rama Prosad Goswami
- Department of Tropical Medicine, School of Tropical Medicine, Kolkata, West Bengal, India
| | - Nahid Ali
- Infectious Diseases and Immunology Division, Indian Institute of Chemical Biology, Kolkata, West Bengal, India.
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Abass E. Leishmania donovani infection in Eastern Sudan: Comparing direct agglutination and rK39 rapid test for diagnosis-a retrospective study. ASIAN PAC J TROP MED 2020. [DOI: 10.4103/1995-7645.285831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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30
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Kühne V, Büscher P. The Unknown Nature of the Antigen in the Direct Agglutination Test for Visceral Leishmaniasis Hampers Development of Serodiagnostic Tests. Am J Trop Med Hyg 2019; 100:246-255. [PMID: 30560773 PMCID: PMC6367635 DOI: 10.4269/ajtmh.18-0740] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Current diagnostic tests for visceral leishmaniasis (VL) are either not adapted for use in resource-poor settings or are insufficiently accurate in Eastern Africa. Only the direct agglutination test (DAT), based on whole Leishmania promastigotes, is highly reliable in all endemic regions, but its implementation is hampered by the need for a cold chain, minimal laboratory conditions, and long incubation times. Integrating the DAT antigen(s) in an immunochromatographic rapid diagnostic test (RDT) would overcome these disadvantages. Unfortunately, the identity of the DAT antigen(s) involved in the agglutination reaction is unknown. For this study, we reviewed all publications that might shed some light on this issue. We conclude that the DAT antigen is a mixture of Leishmania-specific epitopes of protein, carbohydrate, and lipid nature. To develop an accurate RDT for VL diagnosis in Eastern Africa, we suggest to complement the classical protein antigen discovery with approaches to identify carbohydrate and lipid epitopes.
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Affiliation(s)
- Vera Kühne
- Institute of Tropical Medicine, Antwerp, Belgium
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31
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Oliveira Dos Santos Maciel M, Soares MF, Costa SF, Bragato JP, Rebech GT, de Freitas JH, Alves GB, de Oliveira TCB, Bresciani KDS, de Lima VMF. Plasmonic rK28 ELISA improves the diagnosis of canine Leishmania infection. Parasite Immunol 2019; 42:e12684. [PMID: 31729767 DOI: 10.1111/pim.12684] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 11/07/2019] [Accepted: 11/12/2019] [Indexed: 01/21/2023]
Abstract
In this study, we evaluated the performance of a new enzyme-linked immunosorbent assay (ELISA) variant known as indirect "plasmonic ELISA" (pELISA) for the detection of Leishmania spp. infection. Serum samples from 170 dogs from an area where canine leishmaniosis (CanL) is endemic and from 26 healthy dogs from a nonendemic area were tested by indirect pELISA, and the results were compared to those of an indirect ELISA (both with recombinant antigen rK28) and those of an immunochromatographic test (dual-path platform, TR-DPP®) using real-time PCR on blood samples or conjunctival swabs as the gold standard. The pELISA, indirect rK28 ELISA and the TR-DPP® immunochromatographic test presented sensitivities of 94.7%, 89.5% and 79.0% and specificities of 100%, 92.7% and 91.5%, respectively. The analysis of the results revealed that the specificity of the indirect pELISA was greater than that of the method recommended by the Ministry of Health in Brazil and may increase the feasibility of diagnosis in resource-constrained countries because it does not require sophisticated instruments to read. Thus, this method can be used as an additional tool for the detection of Leishmania spp. infection in these areas.
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Affiliation(s)
| | | | - Sidnei Ferro Costa
- School of Veterinary Medicine, São Paulo State University (UNESP), Araçatuba, Brazil
| | | | | | | | | | | | - Katia Denise Saraiva Bresciani
- Department of Support, Production and Animal Health, School of Veterinary Medicine, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Valéria Marçal Felix de Lima
- Department of Clinics, Surgery and Animal Reproduction, School of Veterinary Medicine, São Paulo State University (UNESP), Araçatuba, Brazil
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32
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van Griensven J, Diro E. Visceral Leishmaniasis: Recent Advances in Diagnostics and Treatment Regimens. Infect Dis Clin North Am 2019; 33:79-99. [PMID: 30712769 DOI: 10.1016/j.idc.2018.10.005] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Diagnostic advances in visceral leishmaniasis include the development of the rK39 and rK28 rapid diagnostic test. The direct agglutination test is also increasingly used, as well as conventional and real-time polymerase chain reaction, which also performs well on peripheral blood. The choice of treatment for visceral leishmaniasis depends on the geographic region where the infection is acquired. Liposomal amphotericin B is generally found to be safe and effective in most endemic regions of the world; antimonials still remain to be the most effective in eastern Africa despite its high toxicity. Combination therapy is increasingly explored. Immunosuppressed patients require adapted diagnostic and therapeutic strategies.
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Affiliation(s)
- Johan van Griensven
- Department of Clinical Sciences, Institute of Tropical Medicine, Nationalestraat 155, Antwerp 2000, Belgium.
| | - Ermias Diro
- Department of Internal Medicine, University of Gondar, Post Office Box 196, Gondar, Ethiopia
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Lima C, Santarém N, Nieto J, Moreno J, Carrillo E, Bartholomeu DC, Bueno LL, Fujiwara R, Amorim C, Cordeiro-da-Silva A. The Use of Specific Serological Biomarkers to Detect CaniLeish Vaccination in Dogs. Front Vet Sci 2019; 6:373. [PMID: 31709270 PMCID: PMC6821643 DOI: 10.3389/fvets.2019.00373] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 10/08/2019] [Indexed: 01/06/2023] Open
Abstract
Canine leishmaniosis (CanL) prevention in the Mediterranean basin is considered essential to stop human zoonotic visceral leishmaniasis. In this context, vaccination of dogs is expected to have a significant impact in disease control. CaniLeish® (Virbac Animal Health) is one of a few CanL vaccines that are at this moment licensed in Europe. This vaccine contains purified excreted-secreted proteins of Leishmania having several antigens/immunogens with potential to influence serological response. Therefore, it is important to know if CaniLeish vaccination increased the diagnostic challenges associated with conventional serology, limiting the value of some antigens. To address this 20 dogs from a cohort of 35 healthy dogs that were vaccinated, maintained indoor for 1 month and then returned to their natural domiciles for 2 years. After this period, they were re-called to evaluate their clinical/parasitological condition and assess the evolution of seroreactivity against different antigens: soluble promastigote Leishmania antigens (SPLA), recombinant protein Leishmania infantum cytosolic peroxiredoxin, recombinant protein K39 (rK39), recombinant protein K28 and recombinant kinesin degenerated derived repeat using ELISA. Two years after vaccination all vaccinated non-infected animals were seropositive for SPLA. For the other antigens the serological profile was indistinguishable from non-infected animals. Moreover, vaccinated animals presented a characteristic relative serological profile, with higher normalized serological response to SPLA than rK39. This fact enabled to distinguish with sensitivity 92.3% and specificity 95.4%, vaccinated non-infected dogs from infected and non-infected dogs. Ultimately, relative serological profile enabled the detection of healthy vaccinated animals enabling more accurate serological surveys.
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Affiliation(s)
- Carla Lima
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,IBMC - Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, Portugal.,Faculdade de Farmácia da Universidade do Porto, Departamento de Ciências Biológicas, Porto, Portugal
| | - Nuno Santarém
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,IBMC - Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, Portugal
| | - Javier Nieto
- WHO Collaborating Centre for Leishmaniasis, National Centre for Microbiology, Instituto de Salud Carlos III, Majadahonda, Spain
| | - Javier Moreno
- WHO Collaborating Centre for Leishmaniasis, National Centre for Microbiology, Instituto de Salud Carlos III, Majadahonda, Spain
| | - Eugenia Carrillo
- WHO Collaborating Centre for Leishmaniasis, National Centre for Microbiology, Instituto de Salud Carlos III, Majadahonda, Spain
| | - Daniella Castanheira Bartholomeu
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Lilian Lacerda Bueno
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Ricardo Fujiwara
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Célia Amorim
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,IBMC - Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, Portugal
| | - Anabela Cordeiro-da-Silva
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,IBMC - Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, Portugal.,Faculdade de Farmácia da Universidade do Porto, Departamento de Ciências Biológicas, Porto, Portugal
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Maciel MODS, Soares MF, Costa SF, Bragato JP, de Freitas JH, Venturin GL, Melo LM, Rebech GT, Reed S, Lima VMFD. Development of plasmonic ELISA for the detection of anti-Leishmania sp. IgG antibodies. J Immunol Methods 2019; 474:112664. [PMID: 31521674 DOI: 10.1016/j.jim.2019.112664] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 07/31/2019] [Accepted: 09/11/2019] [Indexed: 11/27/2022]
Abstract
Recently, a novel Enzyme-Linked Immunosorbent Assay (ELISA) strategy has emerged, known as "plasmonic ELISA" (pELISA), which enables the detection of disease biomarkers at low concentrations with the naked eye. For the first time, this research has developed a signal-generation mechanism for the detection of anti-Leishmania sp. IgG antibodies with the naked eye using pELISA. The immunoassay incorporates an indirect ELISA with successive growth of gold nanoparticles to obtain blue or red-colored solutions in the presence or absence of anti-Leishmania sp. IgG antibodies in canine serum, respectively. The technique we developed was successfully tested in canine serum positive and negative for canine leishmaniasis (CanL), and was shown to be an effective method that could be used as an additional tool for CanL diagnosis. It will be particularly useful in resource-constrained countries, because it does not require sophisticated instruments to read the results, increasing the practicality of CanL detection in these areas.
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Affiliation(s)
| | - Matheus Fujimura Soares
- Department of Clinic, Surgery and Animal Reproduction, School of Veterinary Medicine, São Paulo State University, Araçatuba, SP, Brazil
| | - Sidnei Ferro Costa
- Department of Clinic, Surgery and Animal Reproduction, School of Veterinary Medicine, São Paulo State University, Araçatuba, SP, Brazil
| | - Jaqueline Poleto Bragato
- Department of Clinic, Surgery and Animal Reproduction, School of Veterinary Medicine, São Paulo State University, Araçatuba, SP, Brazil
| | - Jéssica Henrique de Freitas
- Department of Clinic, Surgery and Animal Reproduction, School of Veterinary Medicine, São Paulo State University, Araçatuba, SP, Brazil
| | - Gabriela Lovizutto Venturin
- Department of Clinic, Surgery and Animal Reproduction, School of Veterinary Medicine, São Paulo State University, Araçatuba, SP, Brazil
| | - Larissa Martins Melo
- Department of Clinic, Surgery and Animal Reproduction, School of Veterinary Medicine, São Paulo State University, Araçatuba, SP, Brazil
| | - Gabriela Torres Rebech
- Department of Clinic, Surgery and Animal Reproduction, School of Veterinary Medicine, São Paulo State University, Araçatuba, SP, Brazil
| | - Steve Reed
- Infectious Disease Research Institute, Seattle, WA, USA
| | - Valéria Marçal Felix de Lima
- Department of Clinic, Surgery and Animal Reproduction, School of Veterinary Medicine, São Paulo State University, Araçatuba, SP, Brazil.
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Herrera G, Castillo A, Ayala MS, Flórez C, Cantillo-Barraza O, Ramirez JD. Evaluation of four rapid diagnostic tests for canine and human visceral Leishmaniasis in Colombia. BMC Infect Dis 2019; 19:747. [PMID: 31455227 PMCID: PMC6712844 DOI: 10.1186/s12879-019-4353-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 08/02/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Leishmaniasis caused by different species of Leishmania affect 98 countries worldwide. Visceral Leishmaniasis (VL) is the mortal clinical presentation of the disease that causes the dead to more than 90% of the patients who suffer it. The diagnosis of VL is made by the direct observation of the parasite in bone marrow, spleen and/or liver aspirates that requires complex proceedings. Therefore, serum samples are submitted to Indirect Immunofluorescence to identify the presence of anti-Leishmania antibodies. Despite the variability in the diagnostic performance of the Immunochromatographic Tests (ICTs), there are many evidences that suggest that ICTs can be used for epidemiological screening. However, in Colombia there are not any evidence about the performance of the ICTs for VL diagnosis, both for human and canine serum samples. Therefore, this study evaluated the diagnostic performance of 4 ICTs for VL (2 ICTs in human sera and 2 ICTs in canine sera) in samples from endemic areas of Colombia. METHODS We selected a total of 156 human serum samples (82 positive and 74 negative for VL) and 126 canine serum samples (71 positive and 54 negative) diagnosed by in house Indirect Immunofluorescence (IIF). The samples were submitted to the ICTs following the manufacturers' instructions. Statistical analysis was performed to evaluate the diagnostic performance of each ICT in comparison with the IIF. PCR for HSP70 gene and sanger sequencing was performed in samples with negative results for both ICTs. RESULTS The sensitivity (S) of both ICTs for human samples (Ad-bio Leishmania IgG/IgM Combo Rapid Test and Kalazar Detect™) was 91.5% and specificity (E) were 93.2 and 89.2% respectively, while for the ICTs tested on canine samples (Kalazar Detect™ Rapid Test, Canine and DPP® CVL rapid test) we found S values between 82.9 and 85.7% and E values between 79.6 and 92.6%. We found L. infantum by PCR and sequencing in 2 human samples, and L. braziliensis and L. amazonensis in canine serum samples that were negative by both ICTs. CONCLUSIONS We conclude that both tests evaluated on human samples have a similar diagnostic performance, while the Kalazar Detect™ Rapid Test, Canine showed a better diagnostic performance than the DPP® CVL rapid test evaluated on canine samples. Also, we suggest that it is necessary to design tests with antigens of the circulating strains to increase its diagnostic utility.
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Affiliation(s)
- Giovanny Herrera
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Departamento de Biología, Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Bogotá, Colombia
| | - Adriana Castillo
- Grupo de Parasitología, Instituto Nacional de Salud, Bogotá, Colombia
| | - Martha S. Ayala
- Grupo de Parasitología, Instituto Nacional de Salud, Bogotá, Colombia
| | - Carolina Flórez
- Grupo de Parasitología, Instituto Nacional de Salud, Bogotá, Colombia
| | - Omar Cantillo-Barraza
- Grupo Biología y Control de Enfermedades Infecciosas (BCEI), Sede de Investigación Universitaria, Universidad de Antioquia, Medellín, Colombia
| | - Juan David Ramirez
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Departamento de Biología, Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Bogotá, Colombia
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Kühne V, Rezaei Z, Pitzinger P, Büscher P. Systematic review on antigens for serodiagnosis of visceral leishmaniasis, with a focus on East Africa. PLoS Negl Trop Dis 2019; 13:e0007658. [PMID: 31415564 PMCID: PMC6711545 DOI: 10.1371/journal.pntd.0007658] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 08/27/2019] [Accepted: 07/24/2019] [Indexed: 11/26/2022] Open
Abstract
Background Accurate and accessible diagnosis is key for the control of visceral leishmaniasis (VL). Yet, current diagnostic tests for VL have severe limitations: they are invasive or not suitable as point of care (POC) test or their performance is suboptimal in East Africa. We analysed the antigens in the VL serodiagnostics development pipeline to identify shortcomings and to propose strategies in the development of an alternative POC test for VL in East Africa. Objectives The objective of this study was to identify and to analyse all antigens for VL serodiagnosis that have been published before 2018 in order to identify candidates and gaps in the pipeline for a new POC test in East Africa. Methods A systematic literature search was performed on PubMed for original research articles on Leishmania-specific antigens for antibody detection of VL in humans. From each article, the following information was extracted: the antigen name, test format and characteristics, its reported sensitivity and specificity and study cohort specifications. Results One hundred and seven articles containing information about 96 tests based on 89 different antigens were included in this study. Eighty six of these tests, comprising 80 antigens, were evaluated in phase I and II studies only. Only 20 antigens, all of which are native, contain a carbohydrate and/or lipid moiety. Twenty-four antigens, of which 7 are non-native, are composed of antigen mixtures. Nineteen tests, comprising 18 antigens, have been evaluated on East African specimens, of which only 2 (rK28 based immunochromatographic test and intact promastigote based indirect fluorescent antibody technique) consistently showed sensitivities above 94 and specificities above 97% in a phase III study and one in a phase II study (dot blot with SLA). Only rK28 is a non-native mixture of antigens which we consider suitable for further evaluation and implementation. Conclusions The development pipeline for an alternative serodiagnostic test for VL is almost empty. Most antigens are not sufficiently evaluated. Non-protein antigens and antigen mixtures are being neglected. We propose to expand the evaluation of existing antigen candidates and to investigate the diagnostic potential of defined non-native carbohydrate and lipid antigens for VL serodiagnosis in East Africa. Visceral leishmaniasis is a potentially fatal disease that affects more than 20 000 people every year. Its diagnosis is difficult since the clinical symptoms are not specific and the existing diagnostic tests are not useful in limited resource countries or they a not accurate enough in East Africa. In this review we performed a systematic search of the published literature to analyse the potential candidate antigens in the pipeline for a new antibody detection test in East Africa. We found 96 tests based on 89 antigens. Eighty six of these tests were evaluated in a study design that is insufficient (phase I and II) to make conclusions on their performance in clinical practice. We found that the candidate antigens either lacked carbohydrate or lipid structures or are based on single antigens as opposed to mixtures or are extracted from the causative parasite itself, making them expensive and prone to variations. Considering that the most widely used diagnostic test does not detect all cases of visceral leishmaniasis in East Africa, we analysed how many of the candidate antigens were tested on East African specimens: We found that only 2 tests (rK28 based immunochromatographic test and the intact promastigote based indirect fluorescent antibody technique) that were tested in a phase III study and only one (dot blot with SLA) that was tested in a phase II study performed well according to our criteria. Due to the antigen characteristics we consider only the rK28 based test as suitable for further evaluation and implementation.
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Affiliation(s)
- Vera Kühne
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- * E-mail:
| | - Zahra Rezaei
- Professor Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Paul Pitzinger
- Institute of Medical Microbiology, University Medical Center Göttingen, Göttingen, Germany
| | - Philippe Büscher
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
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A multicentric evaluation of dipstick test for serodiagnosis of visceral leishmaniasis in India, Nepal, Sri Lanka, Brazil, Ethiopia and Spain. Sci Rep 2019; 9:9932. [PMID: 31289323 PMCID: PMC6616445 DOI: 10.1038/s41598-019-46283-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 05/30/2019] [Indexed: 12/24/2022] Open
Abstract
Visceral leishmaniasis (VL) is one of the leading infectious diseases affecting developing countries. Colloidal gold-based diagnostic tests are rapid tools to detect blood/serum antibodies for VL diagnosis. Lack of uniformity in the performance of these tests in different endemic regions is a hurdle in early disease diagnosis. This study is designed to validate a serum-based dipstick test in eight centres of six countries, India, Nepal, Sri Lanka, Brazil, Ethiopia and Spain with archived and fresh sera from 1003 subjects. The dipstick detects antibodies against Leishmania donovani membrane antigens (LAg). The overall sensitivity and specificity of the test with 95% confidence intervals were found to be 97.10% and 93.44%, respectively. The test showed good sensitivity and specificity in the Indian subcontinent (>95%). In Brazil, Ethiopia, and Spain the sensitivity and specificity of the dipstick test (83.78–100% and 79.06–100%) were better as compared to the earlier reports of the performance of rK39 rapid test in these regions. Interestingly, less cross-reactivity was found with the cutaneous form of the disease in Spain, Brazil, and Sri Lanka demonstrating 91.58% specificity. This dipstick test can therefore be a useful tool for diagnosing VL from other symptomatically similar diseases and against cutaneous form of leishmaniasis.
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Bremer Hinckel BC, Marlais T, Airs S, Bhattacharyya T, Imamura H, Dujardin JC, El-Safi S, Singh OP, Sundar S, Falconar AK, Andersson B, Litvinov S, Miles MA, Mertens P. Refining wet lab experiments with in silico searches: A rational quest for diagnostic peptides in visceral leishmaniasis. PLoS Negl Trop Dis 2019; 13:e0007353. [PMID: 31059497 PMCID: PMC6522066 DOI: 10.1371/journal.pntd.0007353] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 05/16/2019] [Accepted: 04/01/2019] [Indexed: 11/19/2022] Open
Abstract
Background The search for diagnostic biomarkers has been profiting from a growing number of high quality sequenced genomes and freely available bioinformatic tools. These can be combined with wet lab experiments for a rational search. Improved, point-of-care diagnostic tests for visceral leishmaniasis (VL), early case detection and surveillance are required. Previous investigations demonstrated the potential of IgG1 as a biomarker for monitoring clinical status in rapid diagnostic tests (RDTs), although using a crude lysate antigen (CLA) as capturing antigen. Replacing the CLA by specific antigens would lead to more robust RDTs. Methodology Immunoblots revealed L. donovani protein bands detected by IgG1 from VL patients. Upon confident identification of these antigens by mass spectrometry (MS), we searched for evidence of constitutive protein expression and presence of antigenic domains or high accessibility to B-cells. Selected candidates had their linear epitopes mapped with in silico algorithms. Multiple high-scoring predicted epitopes from the shortlisted proteins were screened in peptide arrays. The most promising candidate was tested in RDT prototypes using VL and nonendemic healthy control (NEHC) patient sera. Results Over 90% of the proteins identified from the immunoblots did not satisfy the selection criteria and were excluded from the downstream epitope mapping. Screening of predicted epitope peptides from the shortlisted proteins identified the most reactive, for which the sensitivity for IgG1 was 84% (95% CI 60—97%) with Sudanese VL sera on RDT prototypes. None of the sera from NEHCs were positive. Conclusion We employed in silico searches to reduce drastically the output of wet lab experiments, focusing on promising candidates containing selected protein features. By predicting epitopes in silico we screened a large number of peptides using arrays, identifying the most promising one, for which IgG1 sensitivity and specificity, with limited sample size, supported this proof of concept strategy for diagnostics discovery, which can be applied to the development of more robust IgG1 RDTs for monitoring clinical status in VL. Visceral leishmaniasis (VL) is a neglected tropical disease caused by protozoan parasites of the Leishmania donovani complex. Without treatment, VL is fatal. Although diagnostic techniques, mainly based on the detection of anti-Leishmania antibodies are available, invasive procedures such as microscopy from spleen or bone marrow aspirates are still required for the diagnosis of seronegative VL suspects, for the detection of recurrent cases and to confirm cure after successful treatment. Previous investigations showed the potential of IgG1 as a biomarker of post-chemotherapeutic relapse for VL in rapid diagnostic tests (RDTs) sensitised with crude lysate antigen (CLA). Here we employed in silico tools to search for desired protein features in a large number of L. donovani antigens detected by human IgG1 in western blots. We then employed prediction algorithms to profile epitopes from the shortlisted proteins. We screened a panel of high-scoring peptides in a high-throughput manner using arrays, with low reagent consumption. The most reactive peptide was adapted to RDTs, showing promising results of both sensitivity and specificity. This peptide has the potential of replacing the CLAs in IgG1 RDTs. Thus we believe that in silico tools can be used to optimise wet lab experiments for a rational search of biomarkers.
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Affiliation(s)
- Bruno Cesar Bremer Hinckel
- Coris BioConcept, Gembloux, Belgium
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
- * E-mail:
| | - Tegwen Marlais
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Stephanie Airs
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Tapan Bhattacharyya
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Hideo Imamura
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | | | - Sayda El-Safi
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Om Prakash Singh
- Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Shyam Sundar
- Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | | | - Bjorn Andersson
- Department of Cell- and Molecular Biology, Karolinska Institutet, Stockholm, Sweden
| | | | - Michael A. Miles
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Silva ED, Oliveira BC, Oliveira AP, Santos WJT, Diniz GT, de Melo Neto OP, Costa CHN, Silva MRB, Andrade LD, Medeiros ZM, Pereira VRA. Performance evaluation of anti-fixed Leishmania infantum promastigotes immunoglobulin G (IgG) detected by flow cytometry as a diagnostic tool for visceral Leishmaniasis. J Immunol Methods 2019; 469:18-25. [PMID: 30817916 DOI: 10.1016/j.jim.2019.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 02/08/2019] [Accepted: 02/22/2019] [Indexed: 12/30/2022]
Abstract
Visceral Leishmaniasis (VL) is a severe disease, caused by the protozoans Leishmania infantum and L. donovani that is widely diagnosed using serological tools. These, however, have limitations in performance that limit their use for the correct identification of the cases. This study aimed to evaluate the performance of flow cytometry with fixed parasites for VL diagnosis, comparing it with four other serological tests. Samples from two endemic VL regions in Brazil, diagnosed by direct examination (DG1) and by at least two or one standard serological test (DG2 and DG3, respectively), as well as patients with chronic Chagas' disease (CG1) and healthy controls (CG2) were used in this study. The flow cytometry results were expressed as levels of IgG reactivity, based on the percentage of positive fluorescent parasites (PPFP). Using a 1:4096 serum dilution, a ROC curve analysis of the serum titration on flow cytometry has indicated a PPFP of 2% as the cutoff point to segregate positive and negative results. In the present study, flow cytometry had the best performance for DG1 (sensitivity of 96%) while rK39 (imunocromagraphic rapid test) and DAT (Direct agglutination test) were also associated with high sensitivity and specificity. The substantial agreement and kappa indexes observed suggested similar performances between these two tests and flow cytometry. IFAT (Immunofluorescent antibody test) and ELISA (Enzyme-linked immunosorbent assay) had lower performances and the lower values of agreement with flow cytometry. Together, these findings suggest that although adjustments are needed in order to reduce cross reactivity with other trypanosomatids, flow cytometry has the potential to be a safe serological alternative for the diagnosis of VL.
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Affiliation(s)
- Elis D Silva
- Fundação Oswaldo Cruz (Fiocruz-Pernambuco), Instituto Aggeu Magalhães, Recife, Pernambuco, Brazil.
| | - Beatriz C Oliveira
- Fundação Oswaldo Cruz (Fiocruz-Pernambuco), Instituto Aggeu Magalhães, Recife, Pernambuco, Brazil
| | - Andresa P Oliveira
- Fundação Oswaldo Cruz (Fiocruz-Pernambuco), Instituto Aggeu Magalhães, Recife, Pernambuco, Brazil
| | - Wagner J T Santos
- Fundação Oswaldo Cruz (Fiocruz-Pernambuco), Instituto Aggeu Magalhães, Recife, Pernambuco, Brazil
| | - George T Diniz
- Fundação Oswaldo Cruz (Fiocruz-Pernambuco), Instituto Aggeu Magalhães, Recife, Pernambuco, Brazil
| | - Osvaldo P de Melo Neto
- Fundação Oswaldo Cruz (Fiocruz-Pernambuco), Instituto Aggeu Magalhães, Recife, Pernambuco, Brazil
| | - Carlos H N Costa
- Instituto de Doenças Tropicais Natan Portella (IDTNP), Teresina, Piaui, Brazil
| | | | - Luiz D Andrade
- Fundação Oswaldo Cruz (Fiocruz-Pernambuco), Instituto Aggeu Magalhães, Recife, Pernambuco, Brazil
| | - Zulma M Medeiros
- Fundação Oswaldo Cruz (Fiocruz-Pernambuco), Instituto Aggeu Magalhães, Recife, Pernambuco, Brazil; Faculdade de Ciências Médicas, Universidade de Pernambuco, Recife, Brazil
| | - Valéria R A Pereira
- Fundação Oswaldo Cruz (Fiocruz-Pernambuco), Instituto Aggeu Magalhães, Recife, Pernambuco, Brazil
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40
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Santos ARRD, Serufo ÂV, Figueiredo MM, Godoi LC, Vitório JG, Marcelino AP, Avelar DMD, Rodrigues FTG, Machado-Coelho GLL, Medeiros FAC, Jerônimo SMB, Oliveira EJD, Nascimento FC, Teixeira SMR, Gazzinelli RT, Nagem RAP, Fernandes AP. Evaluation of three recombinant proteins for the development of ELISA and immunochromatographic tests for visceral leishmaniasis serodiagnosis. Mem Inst Oswaldo Cruz 2019; 114:e180405. [PMID: 30726344 PMCID: PMC6364332 DOI: 10.1590/0074-02760180405] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 01/04/2019] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Visceral Leishmaniasis (VL) is an infectious disease that is a significant
cause of death among infants aged under 1 year and the elderly in Brazil.
Serodiagnosis is a mainstay of VL elimination programs; however, it has
significant limitations due to low accuracy. OBJECTIVE This study aimed to evaluate three recombinant Leishmania
infantum proteins (rFc, rC9, and rA2) selected from previous
proteomics and genomics analyses to develop enzyme-linked immunosorbent
assay (ELISA) and immunochromatographic tests (ICT) for the serodiagnosis of
human VL (HVL) and canine VL (CVL). METHODS A total of 186 human (70 L. infantum-infected symptomatic,
20 other disease-infected, and 96 healthy) and 185 canine (82 L.
infantum-infected symptomatic, 27 L.
infantum-infected asymptomatic, and 76 healthy) sera samples were
used for antibody detection. FINDINGS Of the three proteins, rA2 (91.5% sensitivity and 87% specificity) and rC9
(95.7% sensitivity and 87.5% specificity) displayed the best performance in
ELISA-HVL and ELISA-CVL, respectively. ICT-rA2 also displayed the best
performance for HVL diagnosis (92.3% sensitivity and 88.0% specificity) and
had high concordance with immunofluorescence antibody tests (IFAT),
ELISA-rK39, IT-LEISH®, and ELISAEXT. ICT-rFc, ICT-rC9,
and ICT-rA2 had sensitivities of 88.6%, 86.5%, and 87.0%, respectively, with
specificity values of 84.0%, 92.0%, and 100%, respectively for CVL
diagnosis. MAIN CONCLUSIONS The three antigens selected by us are promising candidates for VL diagnosis
regardless of the test format, although the antigen combinations and test
parameters may warrant further optimisation.
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Affiliation(s)
| | - Ângela Vieira Serufo
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Belo Horizonte, MG, Brasil
| | - Maria Marta Figueiredo
- Centro de Tecnologia em Vacinas da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Lara Carvalho Godoi
- Centro de Tecnologia em Vacinas da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | | | | | | | | | | | | | | | | | | | - Santuza Maria Ribeiro Teixeira
- Centro de Tecnologia em Vacinas da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.,Universidade Federal de Minas Gerais, Departamento de Bioquímica e Imunologia, Belo Horizonte, MG, Brasil
| | - Ricardo Tostes Gazzinelli
- Fundação Oswaldo Cruz-Fiocruz, Centro de Pesquisas René Rachou, Belo Horizonte, MG, Brasil.,Centro de Tecnologia em Vacinas da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.,Universidade Federal de Minas Gerais, Departamento de Bioquímica e Imunologia, Belo Horizonte, MG, Brasil
| | - Ronaldo Alves Pinto Nagem
- Universidade Federal de Minas Gerais, Departamento de Bioquímica e Imunologia, Belo Horizonte, MG, Brasil
| | - Ana Paula Fernandes
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Belo Horizonte, MG, Brasil.,Centro de Tecnologia em Vacinas da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
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41
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Figueiredo FB, de Vasconcelos TCB, Madeira MDF, Menezes RC, Maia-Elkhoury ANS, Marcelino AP, Werneck GL. Validation of the Dual-path Platform chromatographic immunoassay (DPP® CVL rapid test) for the serodiagnosis of canine visceral leishmaniasis. Mem Inst Oswaldo Cruz 2018; 113:e180260. [PMID: 30379198 PMCID: PMC6216333 DOI: 10.1590/0074-02760180260] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 09/25/2018] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Visceral leishmaniasis is a major public health challenge in South America, and dogs are its main urban reservoir. OBJECTIVE Validation of the canine Dual-path Platform immunoassay for canine visceral leishmaniasis (DPP® CVL) for a sample set composed of 1446 dogs from different Brazilian endemic areas. METHODS A well-defined reference standard by means of parasitological culture, immunohistochemistry, and histopathology was used. Animals were classified as asymptomatic, oligosymptomatic, or symptomatic. Sensitivity and specificity were assessed as a single set and in clinical groups. A reproducibility assessment of the tests was conducted using the Kappa (κ) index at three different laboratories (A, B, and C). FINDINGS Overall, 89% sensitivity and 70% specificity were obtained for the entire sample set. Analysis of the clinical groups showed a gradual decrease in the sensitivity and an increase in the specificity with the reduction of clinical signs in the dogs that were assessed, reaching a sensitivity of 75% (42.8-94.5%) among asymptomatic dogs and lower specificity of 56% (46.2-66.3%) among symptomatic dogs. Inter-laboratory agreement was substantial (κAB= 0.778; κAC= 0.645; κCB= 0.711). MAIN CONCLUSIONS The test performance is somewhat dependent on canine symptomatology, but such influence was less evident than in previous studies. Favourable results for sensitivity and specificity can be obtained even in asymptomatic animals; however, caution is needed in these evaluations, and the results suggest that the immunochromatographic test may be further improved for better investigation in asymptomatic dogs. The results obtained confirm the usefulness of DPP® CVL for application in serological surveys.
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Affiliation(s)
- Fabiano Borges Figueiredo
- Fundação Oswaldo Cruz-Fiocruz, Instituto Carlos Chagas, Laboratório de Biologia Celular, Curitiba, PR, Brasil
| | | | - Maria de Fátima Madeira
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia, Laboratório de Vigilância em Leishmanioses, Rio de Janeiro, RJ, Brasil
| | - Rodrigo Caldas Menezes
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de infectologia, Laboratório de Pesquisa Clínica em Dermatozoonoses em Animais Domésticos, Rio de Janeiro, RJ, Brasil
| | - Ana Nilce Silveira Maia-Elkhoury
- Organização Pan-Americana de Saúde, Doenças Negligenciadas, Tropicais e Transmitidas por Vetores, Doenças Transmissíveis e Determinantes Ambientais de Saúde, Duque de Caxias, RJ, Brasil
| | | | - Guilherme L Werneck
- Universidade do Estado do Rio de Janeiro, Instituto de Medicina Social, Departamento de Epidemiologia, Rio de Janeiro, RJ, Brasil
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42
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Figueiredo FB, de Vasconcelos TCB, Madeira MDF, Menezes RC, Maia-Elkhoury ANS, Marcelino AP, Werneck GL. Validation of the Dual-path Platform chromatographic immunoassay (DPP® CVL rapid test) for the serodiagnosis of canine visceral leishmaniasis. Mem Inst Oswaldo Cruz 2018. [PMID: 30379198 PMCID: PMC6216333 DOI: 10.1590/0074-02760180206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Visceral leishmaniasis is a major public health challenge in South America, and dogs are its main urban reservoir. OBJECTIVE Validation of the canine Dual-path Platform immunoassay for canine visceral leishmaniasis (DPP® CVL) for a sample set composed of 1446 dogs from different Brazilian endemic areas. METHODS A well-defined reference standard by means of parasitological culture, immunohistochemistry, and histopathology was used. Animals were classified as asymptomatic, oligosymptomatic, or symptomatic. Sensitivity and specificity were assessed as a single set and in clinical groups. A reproducibility assessment of the tests was conducted using the Kappa (κ) index at three different laboratories (A, B, and C). FINDINGS Overall, 89% sensitivity and 70% specificity were obtained for the entire sample set. Analysis of the clinical groups showed a gradual decrease in the sensitivity and an increase in the specificity with the reduction of clinical signs in the dogs that were assessed, reaching a sensitivity of 75% (42.8-94.5%) among asymptomatic dogs and lower specificity of 56% (46.2-66.3%) among symptomatic dogs. Inter-laboratory agreement was substantial (κAB= 0.778; κAC= 0.645; κCB= 0.711). MAIN CONCLUSIONS The test performance is somewhat dependent on canine symptomatology, but such influence was less evident than in previous studies. Favourable results for sensitivity and specificity can be obtained even in asymptomatic animals; however, caution is needed in these evaluations, and the results suggest that the immunochromatographic test may be further improved for better investigation in asymptomatic dogs. The results obtained confirm the usefulness of DPP® CVL for application in serological surveys.
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Affiliation(s)
- Fabiano Borges Figueiredo
- Fundação Oswaldo Cruz-Fiocruz, Instituto Carlos Chagas, Laboratório de Biologia Celular, Curitiba, PR, Brasil
| | | | - Maria de Fátima Madeira
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia, Laboratório de Vigilância em Leishmanioses, Rio de Janeiro, RJ, Brasil
| | - Rodrigo Caldas Menezes
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de infectologia, Laboratório de Pesquisa Clínica em Dermatozoonoses em Animais Domésticos, Rio de Janeiro, RJ, Brasil
| | - Ana Nilce Silveira Maia-Elkhoury
- Organização Pan-Americana de Saúde, Doenças Negligenciadas, Tropicais e Transmitidas por Vetores, Doenças Transmissíveis e Determinantes Ambientais de Saúde, Duque de Caxias, RJ, Brasil
| | | | - Guilherme L Werneck
- Universidade do Estado do Rio de Janeiro, Instituto de Medicina Social, Departamento de Epidemiologia, Rio de Janeiro, RJ, Brasil
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43
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Zhang WW, Ghosh AK, Mohamath R, Whittle J, Picone A, Lypaczewski P, Ndao M, Howard RF, Das P, Reed SG, Matlashewski G. Development of a sandwich ELISA to detect Leishmania 40S ribosomal protein S12 antigen from blood samples of visceral leishmaniasis patients. BMC Infect Dis 2018; 18:500. [PMID: 30285653 PMCID: PMC6171325 DOI: 10.1186/s12879-018-3420-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 09/27/2018] [Indexed: 01/12/2023] Open
Abstract
Background Visceral leishmaniasis (VL), caused by Leishmania donovani complex parasites, is a neglected parasitic disease that is generally fatal if untreated. Despite decades of research to develop a sensitive VL diagnostic test, definitive diagnosis of VL still mainly relies on the visualization of the parasite in aspirates from the spleen, liver or bone marrow, an invasive and dangerous process with variable sensitivity. A sensitive assay that can detect Leishmania antigen from blood samples will help confirm cause, cure or recurrence of VL. Methods In this study, rabbit polyclonal antibodies were raised against eight recombinant Leishmania proteins that are highly abundant in Leishmania. The antibodies were purified and labeled with biotin for developing a prototype sandwich enzyme-linked immunosorbent assay (ELISA). Results The ELISA for the Leishmania 40S ribosomal protein S12 detected target antigen with the highest sensitivity and specificity and could detect 1 pg of purified protein or as few as 60 L. donovani parasites. The 40S ribosomal protein S12 sandwich ELISA could detect the target antigen from Peripheral Blood Mononuclear Cell (PBMC) samples in 68% of VL patients and post-kala-azar dermal leishmaniasis (PKDL) patients, providing an estimation of parasitemia ranging from 15 to 80 amastigotes per ml of blood. Conclusion These results indicate that the 40S ribosomal protein S12 sandwich ELISA warrants further tests with more clinical samples of VL patients and other parasitic diseases. It is hopeful that this ELISA could become a useful tool for confirming VL diagnosis, monitoring treatment progress, disease recurrence and possibly detecting asymptomatic Leishmania infections with a high parasite load.
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Affiliation(s)
- Wen-Wei Zhang
- Department of Microbiology and Immunology, McGill University, 3775 University Street, Montreal, Quebec, H3A2B4, Canada
| | - Ayan Kumar Ghosh
- Rajendra Memorial Research Institute of Medical Sciences (ICMR), Patna, Bihar, India
| | | | | | | | - Patrick Lypaczewski
- Department of Microbiology and Immunology, McGill University, 3775 University Street, Montreal, Quebec, H3A2B4, Canada
| | - Momar Ndao
- National Reference Center for Parasitology, The Research Institute of the McGill University Health Center, Montreal, Quebec, Canada
| | | | - Pradeep Das
- Rajendra Memorial Research Institute of Medical Sciences (ICMR), Patna, Bihar, India
| | - Steven G Reed
- Infectious Disease Research Institute, Seattle, WA, USA
| | - Greg Matlashewski
- Department of Microbiology and Immunology, McGill University, 3775 University Street, Montreal, Quebec, H3A2B4, Canada.
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Duthie MS, Lison A, Courtenay O. Advances toward Diagnostic Tools for Managing Zoonotic Visceral Leishmaniasis. Trends Parasitol 2018; 34:881-890. [PMID: 30131210 PMCID: PMC6168404 DOI: 10.1016/j.pt.2018.07.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 07/23/2018] [Accepted: 07/24/2018] [Indexed: 11/20/2022]
Abstract
Visceral leishmaniasis (VL) is a life-threatening outcome of Leishmania infantum or Leishmania donovani infection. Dogs are the primary domestic reservoir of L. infantum parasites, and ownership of infected dogs increases the risk of human VL. Controlling infection within dog populations is regarded as critical to VL management in endemic countries, both preventing progression of canine disease and limiting parasite transmission to humans and dogs. Here we discuss various strategies that are used to diagnose canine visceral leishmaniasis (CVL) and the possibilities of adapting these for use within population screening and control programs. In addition, given the variable transmissibility of L. infantum to the sand fly vector, we outline some possibilities for the preferential identification of 'super-spreader' dogs among the overall infected population.
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Affiliation(s)
- Malcolm S Duthie
- Infectious Disease Research Institute, 1616 Eastlake Ave E, Suite 400, Seattle, WA 98102, USA.
| | - Aurore Lison
- School of Life Sciences, University of Warwick, Coventry, UK
| | - Orin Courtenay
- School of Life Sciences, University of Warwick, Coventry, UK
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45
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Immunoproteomic Identification and Characterization of Leishmania Membrane Proteins as Non-Invasive Diagnostic Candidates for Clinical Visceral Leishmaniasis. Sci Rep 2018; 8:12110. [PMID: 30108316 PMCID: PMC6092337 DOI: 10.1038/s41598-018-30546-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 07/27/2018] [Indexed: 11/23/2022] Open
Abstract
Visceral leishmaniasis (VL), a potentially fatal disease is an outcome of infection caused by the parasite Leishmania donovani. The clinical diagnostic tests for this disease are still related to invasive tissue aspiration or serological immunochromatography. Advancements in immunoproteomics such as two-dimensional gel electrophoresis, mass spectrometry, B cell epitope prediction, and peptide synthesis have enabled researchers to discover newer biomarkers for disease diagnosis. In this study, we have screened several urine-reactive leishmanial membrane proteins as potential biomarker candidates. In the immunoblot assay, three proteins 51, 55 and 63 kDa showed 100% reactivity to the urine of 47 VL patients and nonreactive to 18 healthy and other diseases. Mass spectrometry revealed the identity of 51, 55 and 63 kDa proteins as elongation factor 1α (EF1-α), α-tubulin, and glycoprotein 63, respectively. B cell reactive epitopes of these proteins were mapped through bioinformatic tools and one epitope from each protein that had the highest score were synthesized. All the three native electroeluted proteins and their corresponding synthetic peptides were tested through ELISA for reactivity with VL and control urine samples. While all three demonstrated good reactivity, the diagnostic performance of EF1-α was the best. Our findings illustrate the use of urine-based proteomic approach for biomarker discovery in non-invasive clinical diagnosis of VL.
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46
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Lamm R, Alves C, Perrotta G, Murphy M, Messina C, Sanchez JF, Perez E, Rosales LA, Lescano AG, Smith E, Valdivia H, Fuhrer J, Ballard SB. Prevalence of and Factors Associated with Negative Microscopic Diagnosis of Cutaneous Leishmaniasis in Rural Peru. Am J Trop Med Hyg 2018; 99:331-337. [PMID: 29869605 DOI: 10.4269/ajtmh.17-0909] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Cutaneous leishmaniasis is endemic to South America where diagnosis is most commonly conducted via microscopy. Patients with suspected leishmaniasis were referred for enrollment by the Ministry of Health (MoH) in Lima, Iquitos, Puerto Maldonado, and several rural areas of Peru. A 43-question survey requesting age, gender, occupation, characterization of the lesion(s), history of leishmaniasis, and insect-deterrent behaviors was administered. Polymerase chain reaction (PCR) was conducted on lesion materials at the Naval Medical Research Unit No. 6 in Lima, and the results were compared with those obtained by the MoH using microscopy. Factors associated with negative microscopy and positive PCR results were identified using χ2 test, t-test, and multivariate logistic regression analyses. Negative microscopy with positive PCR occurred in 31% (123/403) of the 403 cases. After adjusting for confounders, binary multivariate logistic regression analyses revealed that negative microscopy with positive PCR was associated with patients who were male (adjusted odds ration [OR] = 1.93 [1.06-3.53], P = 0.032), had previous leishmaniasis (adjusted OR = 2.93 [1.65-5.22], P < 0.0001), had larger lesions (adjusted OR = 1.02 [1.003-1.03], P = 0.016), and/or had a longer duration between lesion appearance and PCR testing (adjusted OR = 1.12 [1.02-1.22], P = 0.017). Future research should focus on further exploration of these underlying variables, discovery of other factors that may be associated with negative microscopy diagnosis, and the development and implementation of improved testing in endemic regions.
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Affiliation(s)
- Ryan Lamm
- Stony Brook University School of Medicine, Stony Brook, New York.,Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.,US Naval Medical Research Unit No. 6, Lima, Peru
| | | | - Grace Perrotta
- Stony Brook University School of Medicine, Stony Brook, New York
| | - Meagan Murphy
- Stony Brook University School of Medicine, Stony Brook, New York
| | | | - Juan F Sanchez
- Universidad Peruana Cayetano Heredia, Lima, Peru.,School of Medicine, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru.,US Naval Medical Research Unit No. 6, Lima, Peru
| | - Erika Perez
- US Naval Medical Research Unit No. 6, Lima, Peru
| | | | - Andres G Lescano
- Universidad Peruana Cayetano Heredia, Lima, Peru.,US Naval Medical Research Unit No. 6, Lima, Peru
| | - Edward Smith
- US Naval Medical Research Unit No. 6, Lima, Peru
| | | | - Jack Fuhrer
- Stony Brook University School of Medicine, Stony Brook, New York
| | - Sarah-Blythe Ballard
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,US Naval Medical Research Unit No. 6, Lima, Peru
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Toepp A, Larson M, Grinnage-Pulley T, Bennett C, Anderson M, Parrish M, Fowler H, Wilson G, Gibson-Corely K, Gharpure R, Cotter C, Petersen C. Safety Analysis of Leishmania Vaccine Used in a Randomized Canine Vaccine/Immunotherapy Trial. Am J Trop Med Hyg 2018; 98:1332-1338. [PMID: 29512486 DOI: 10.4269/ajtmh.17-0888] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
In Leishmania infantum-endemic countries, controlling infection within dogs, the domestic reservoir, is critical to public health. There is a need for safe vaccines that prevent canine progression with disease and transmission to others. Protective vaccination against Leishmania requires mounting a strong, inflammatory, Type 1 response. Three commercially available canine vaccines on the global veterinary market use saponin or inflammatory antigen components (Letifend) as a strong pro-inflammatory adjuvant. There is very little information detailing safety of saponin as an adjuvant in field trials. Safety analyses for the use of vaccine as an immunotherapeutic in asymptomatically infected animals are completely lacking. Leishmania infantum, the causative agent of canine leishmaniasis, is enzootic within U.S. hunting hounds. We assessed the safety of LeishTec® after use in dogs from two different clinical states: 1) without clinical signs and tested negative on polymerase chain reaction and serology or 2) without clinical signs and positive for at least one Leishmania diagnostic test. Vaccine safety was assessed after all three vaccinations to quantify the number and severity of adverse events. Vaccinated animals had an adverse event rate of 3.09%, whereas placebo animals had 0.68%. Receiving vaccine was correlated with the occurrence of mild, site-specific, reactions. Occurrence of severe adverse events was not associated with having received vaccine. Infected, asymptomatic animals did not have a higher rate of adverse events. Use of vaccination is, therefore, likely to be safe in infected, asymptomatic animals.
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Affiliation(s)
- Angela Toepp
- Center for Emerging Infectious Diseases, University of Iowa Research Park, Coralville, Iowa.,Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Mandy Larson
- Center for Emerging Infectious Diseases, University of Iowa Research Park, Coralville, Iowa.,Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Tara Grinnage-Pulley
- Center for Emerging Infectious Diseases, University of Iowa Research Park, Coralville, Iowa.,Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Carolyne Bennett
- Center for Emerging Infectious Diseases, University of Iowa Research Park, Coralville, Iowa.,Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Michael Anderson
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Molly Parrish
- Center for Emerging Infectious Diseases, University of Iowa Research Park, Coralville, Iowa.,Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Hailie Fowler
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Geneva Wilson
- Center for Emerging Infectious Diseases, University of Iowa Research Park, Coralville, Iowa.,Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | | | - Radhika Gharpure
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Caitlin Cotter
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Christine Petersen
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa.,Center for Emerging Infectious Diseases, University of Iowa Research Park, Coralville, Iowa
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Travi BL, Cordeiro-da-Silva A, Dantas-Torres F, Miró G. Canine visceral leishmaniasis: Diagnosis and management of the reservoir living among us. PLoS Negl Trop Dis 2018; 12:e0006082. [PMID: 29324838 PMCID: PMC5764232 DOI: 10.1371/journal.pntd.0006082] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
This article reviews essential topics of canine visceral leishmaniasis (CVL) due to Leishmania infantum infection. It focuses on the current serological and molecular diagnostic methods used in epidemiological research and veterinary clinics to diagnose CVL and includes new point-of-care (POC) tests under development. The efficacy of different treatment regimens on the clinical improvement and infectiousness of dogs is also addressed. In the last section, the review provides a critical appraisal of the effectiveness of different control measures that have been implemented to curb disease transmission. Dogs are the principal reservoir hosts of L. infantum and consequently play a critical role in the transmission cycle of urban VL, which also affects humans. This review provides updated information on important topics such as diagnostic tests and dog treatments that improve dog health and decrease their transmission efficacy to insect vectors. A critical review of control measures is also provided.
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Affiliation(s)
- Bruno L. Travi
- Department of Internal Medicine-Division of Infectious Diseases, University of Texas Medical Branch, Galveston, Texas, United States of America
- * E-mail:
| | - Anabela Cordeiro-da-Silva
- Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- Parasite Disease Group, Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, Portugal
- Departamento de Ciências Biológicas, Faculdade de Farmácia da Universidade do Porto, Porto, Portugal
| | - Filipe Dantas-Torres
- Department of Immunology, Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Recife, Pernambuco, Brazil
| | - Guadalupe Miró
- Veterinary Faculty, Animal Health Department, Universidad Complutense de Madrid, Madrid, Spain
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SARKARI B, REZAEI Z, MOHEBALI M. Immunodiagnosis of Visceral Leishmaniasis: Current Status and Challenges: A Review Article. IRANIAN JOURNAL OF PARASITOLOGY 2018; 13:331-341. [PMID: 30483323 PMCID: PMC6243177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
BACKGROUND Diagnosis of Visceral Leishmaniasis (VL) is still challenging. This review highlighted current status and challenges in the serological diagnosis of VL. Furthermore, the drawback of currently available serological tests and the most recent advancement in the designing and application of these assays for the diagnosis of VL are addressed. METHODS All the published literature cited within PubMed, ISI Web of Science, Google Scholar, Scopus, and IranMedex, regarding the immunodiagnosis of VL in human were sought from 2000 till Mar 2017. The search terms were "visceral leishmaniasis", or "kala-azar" subsequently combined with the search terms "diagnosis", "serodiagnosis", "human", "serological", "antigen detection" or "antibody detection". Data were extracted from literature which fulfilled our eligibility criteria. RESULTS Direct agglutination test (DAT) and rk39 dipstick have made a great improvement in the serological diagnosis of VL. Besides, other kinesin-related protein including K26, K28, and KE16 provided promisingly diagnostic accuracy in the diagnosis of VL. The Latex Agglutination Test for the diagnosis of VL (KAtex), with moderate sensitivity but high specificity, made a substantial contribution to the field. Moreover, a range of protein antigens has recently been detected in the urine of VL patients with encouraging diagnostic value. CONCLUSION The suboptimal diagnostic accuracy of the currently available serological assays for the diagnosis of human VL necessitates further research and development in this field. Outcomes of immunodiagnostic tests based on recombinant antigens are favorable. These proteins might be the most appropriate antigens to be further evaluated and utilized for the diagnosis of human VL.
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Affiliation(s)
- Bahador SARKARI
- Dept. of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran, Basic Sciences in Infectious Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,Correspondence
| | - Zahra REZAEI
- Dept. of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehdi MOHEBALI
- Dept. of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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50
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HOSSEINI FARASH BR, MOHEBALI M, KAZEMI B, HAJJARAN H, AKHOUNDI B, RAOOFIAN R, FATA A, MOJARRAD M, SHARIFI-YAZDI MK. Cloning of K26 Hydrophilic Antigen from Iranian Strain of Leishmania infantum. IRANIAN JOURNAL OF PUBLIC HEALTH 2017; 46:1359-1365. [PMID: 29308379 PMCID: PMC5750347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Visceral leishmaniasis (VL) caused by Leishmania infantum is the most severe form of leishmaniasis in Iran, which causes a high mortality rate in the case of inaccurate diagnosis and treatment. This study aimed to clone of K26 gene from Iranian strain of L. infantum and register the sequencing results in Genbank to facilitate the preparation a new K26 antigen for the detection of L. infantum infection. METHODS L. infantum was obtained from an infected domestic dog in Meshkin-Shahr area from northwestern Iran in 2015. Canine visceral leishmaniasis was confirmed by direct agglutination test (DAT), rK39 dipstick and parasitological methods. L. infantum was confirmed by N-acetyl glucosamine -1-phosphate transferase (nagt)-PCR and its sequencing. The band of interest for k26 form Iranian strain of L. infantum was purified by gel extraction kit after PCR amplification and then ligated into pBluescript II SK (+) and pET-32a (+), respectively. The sequences of recombinant plasmids were analyzed and submitted to Genbank. RESULTS The submission of rk26 nucleotide sequence was performed to the GeneBank/NCBI Data Base under accession number KY212883. The related gene was showed a homology about 99% to L. chagasi and L. infantum k26 gene, while the level of homology in comparison with different strains of L. donovani ranged from 84-94%. CONCLUSION The successful rk26 cloning into an expression vector performed in this study could help to produce a new recombinant antigen for serodiagnosis of VL especially in areas where L. infantum is the main causative agent.
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Affiliation(s)
- Bibi Razieh HOSSEINI FARASH
- Dept. of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi MOHEBALI
- Dept. of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,Center for Research of Endemic Parasites of Iran, Tehran University of Medical Sciences, Tehran, Iran,Corresponding Author:
| | - Bahram KAZEMI
- Dept. of Biotechnology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Homa HAJJARAN
- Dept. of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnaz AKHOUNDI
- Dept. of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza RAOOFIAN
- Legal Medicine Research Center, Iranian Legal Medicine Organization, Tehran, Iran
| | - Abdolmajid FATA
- Dept. of Medical Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid MOJARRAD
- Dept. of Medical Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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