印度比卡内尔热带利什曼原虫引起的皮肤利什曼病:使用分子和免疫学工具进行寄生虫鉴定和特征分析

Cutaneous leishmaniasis caused by Leishmania tropica in Bikaner, India: parasite identification and characterization using molecular and immunologic tools.

作者信息

Kumar Rajesh, Bumb Ram Avtar, Ansari Nasim A, Mehta Rajesh D, Salotra Poonam

机构信息

Institute of Pathology (ICMR), Safdarjung Hospital Campus, New Delhi, India.

出版信息

Am J Trop Med Hyg. 2007 May;76(5):896-901.

DOI:
Abstract

Identification of new foci of cutaneous leishmaniasis (CL), along with reports of Leishmania donovani causing the disease, is an issue of concern. Clinico-epidemiologic analysis of 98 cases in the endemic regions of Rajasthan state, India, suggested the preponderance of infection in men (62.24%) compared with women (37.75%). Species characterization by internal transcribed spacer 1 (ITS1) polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP), kDNA-PCR, and immunofluorescence assay established L. tropica as the causative organism. When applied directly to 32 clinical samples, kDNA PCR had a sensitivity of 96.6%, whereas ITS1 PCR had a sensitivity of 82.75%, thus facilitating diagnosis and species identification. Either parasite culture or direct microscopy alone detected 48.2% and 65.5% of the positive samples, respectively, whereas culture and microscopy together improved overall sensitivity to 89.3% (25/28). Except for the kDNA PCR, all other assays were 100% specific. This study provides the first comprehensive molecular and immunologic studies of CL in India.

摘要

发现皮肤利什曼病(CL)新病灶以及杜氏利什曼原虫引发该病的报告令人担忧。对印度拉贾斯坦邦流行地区的98例病例进行临床流行病学分析表明,男性感染率(62.24%)高于女性(37.75%)。通过内转录间隔区1(ITS1)聚合酶链反应(PCR)-限制性片段长度多态性(RFLP)、kDNA-PCR和免疫荧光试验进行的物种鉴定确定热带利什曼原虫为病原体。直接应用于32份临床样本时,kDNA PCR的灵敏度为96.6%,而ITS1 PCR的灵敏度为82.75%,从而有助于诊断和物种鉴定。单独的寄生虫培养或直接显微镜检查分别检测出48.2%和65.5%的阳性样本,而培养和显微镜检查相结合将总体灵敏度提高到89.3%(25/28)。除kDNA PCR外,所有其他检测方法的特异性均为100%。本研究首次对印度的CL进行了全面的分子和免疫学研究。

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