Sakru Nermin, Korkmaz Metin, Ozbel Yusuf, Ertabaklar Hatice, Sengul Mustafa, Toz Seray Ozensoy
Ege University, Medical School Department of Parasitology, Bornova, Izmir, Turkey.
New Microbiol. 2007 Jan;30(1):13-8.
In Turkey, Leishmania infantum is responsible for human visceral leishmaniasis (VL), which is seen mainly in the Aegean, Mediterranean, and Central Anatolia Regions. This study aimed to determine asymptomatic infections in an endemic area of VL in Turkey using the western blot technique. A total of 82 persons including children and adults were chosen randomly in Denizli province which is one of the endemic sites for VL. Serum samples were collected and screened using indirect immunofluorescent test (IFAT), enzyme-linked immunosorbent assay (ELISA) and western blot (WB). One year later, 35 of the 82 persons were sampled and screened serologically for the second time. Seven out of 82 samples were found to be positive by western blot analysis with the presence of 14 and/or 18 kDa bands. Two of these seven sera were also positive by IFAT, but only one of these two was positive by ELISA. Only one person showing seropositivity with all three tests had clinical symptoms and was diagnosed as VL with the presence of amastigotes in bone marrow aspirate. Because six people, including the one found to be seropositive in all two tests, had no clinical symptoms, they were accepted as asymptomatic carriers. The ratio of asymptomatic infection was calculated as 7.41% (6/81) in the region. In the second sampling, the western blot revealed antibodies against the same antigens in all seven subjects. Our findings showed that the presence of antibodies against 14 and 18 kDa antigens are important for the diagnosis of symptomatic and asymptomatic infections. Western blot was found to be effective in the detection of asymptomatic persons in the epidemiological studies in endemic areas.
在土耳其，婴儿利什曼原虫是人类内脏利什曼病（VL）的病原体，该病主要见于爱琴海、地中海和安纳托利亚中部地区。本研究旨在运用蛋白质印迹技术确定土耳其VL流行地区的无症状感染情况。在作为VL流行地点之一的代尼兹利省，随机选取了包括儿童和成人在内的82人。采集血清样本，并采用间接免疫荧光试验（IFAT）、酶联免疫吸附测定（ELISA）和蛋白质印迹法（WB）进行筛查。一年后，对82人中的35人再次进行采样并进行血清学筛查。通过蛋白质印迹分析发现，82份样本中有7份呈阳性，出现了14 kDa和/或18 kDa条带。这7份血清中有2份通过IFAT也呈阳性，但这2份中只有1份通过ELISA呈阳性。在所有三项检测中均显示血清学阳性的只有一人有临床症状，骨髓穿刺液中发现无鞭毛体，被诊断为VL。包括在所有两项检测中均呈血清学阳性的那个人在内，有6人没有临床症状，他们被视为无症状携带者。该地区无症状感染率经计算为7.41%（6/81）。在第二次采样中，蛋白质印迹法显示所有7名受试者体内均存在针对相同抗原的抗体。我们的研究结果表明，针对14 kDa和18 kDa抗原的抗体的存在对于有症状和无症状感染的诊断很重要。蛋白质印迹法被发现对于流行地区流行病学研究中无症状个体的检测有效。
