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rK39试纸条在土耳其人兽共患内脏利什曼病中的诊断价值

Diagnostic value of rK39 dipstick in zoonotic visceral leishmaniasis in Turkey.

作者信息

Toz Seray Ozensoy, Chang Kwang-Poo, Ozbel Yusuf, Alkan M Ziya

机构信息

Department of Parasitology, Ege University Medical School, 35100 Bornova-Izmir, Turkey.

出版信息

J Parasitol. 2004 Dec;90(6):1484-6. doi: 10.1645/GE-339R.

Abstract

K39 is a repetitive immunodominant epitope in a kinesin-related protein expressed predominantly in the amastigotes of visceral Leishmania spp. Enzyme immunoassays of patient's sera with recombinant K39 (rK39) proved to be highly specific and sensitive for diagnosis of active visceral leishmaniasis (VL, kala-azar). The same assays in dipstick format were also found effective for diagnosis of both human VL (HVL) and canine VL (CanVL) in most endemic areas of these diseases. Fifty-eight human patients and 22 dogs, clinically suspected of kala-azar, were screened with rK39 dipstick in comparison with the conventional methods of diagnosis, i.e., microscopic examinations of bone marrow and lymph node aspirates and immunofluorescent antibody tests (IFAT), respectively. Sixteen patients and 12 dogs were found to be rK39 dipstick positive. The results were corroborated with those of parasitological examinations, except 1, rK39-positive but smear-negative, case in each group. IFAT of the 2 discordant cases gave positive results. The rK39 dipstick is thus reliable for diagnosis of both HVL and canVL cases in Turkey.

摘要

K39是一种在主要在内脏利什曼原虫无鞭毛体中表达的驱动蛋白相关蛋白中的重复性免疫显性表位。用重组K39(rK39)对患者血清进行酶免疫测定,结果证明对活动性内脏利什曼病(VL,黑热病)的诊断具有高度特异性和敏感性。在大多数这些疾病的流行地区,同样的试纸条形式的检测方法对人类VL(HVL)和犬类VL(CanVL)的诊断也被发现是有效的。与传统诊断方法(即分别对骨髓和淋巴结穿刺物进行显微镜检查以及免疫荧光抗体试验(IFAT))相比,用rK39试纸条对58例临床疑似黑热病的人类患者和22只犬进行了筛查。发现16例患者和12只犬的rK39试纸条检测呈阳性。除每组各有1例rK39阳性但涂片阴性的病例外,结果与寄生虫学检查结果一致。对这2例不一致的病例进行IFAT检测呈阳性。因此,rK39试纸条在土耳其对HVL和CanVL病例的诊断是可靠的。

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