Zeyrek Fadile Yildiz, Korkmaz Metin, Ozbel Yusuf
Ege University, Medical School, Department of Parasitology, Izmir, Turkey.
Clin Vaccine Immunol. 2007 Nov;14(11):1409-15. doi: 10.1128/CVI.00133-07. Epub 2007 Aug 29.
In this study, we aimed to evaluate the validity of the conventional enzyme-linked immunosorbent assay (ELISA) and the Western blotting test for the diagnosis of anthroponotic cutaneous leishmaniasis (ACL) using serum samples obtained from 51 patients with parasitologically proven nontreated CL (NonT-CL patients) and 62 patients under treatment for CL (UT-CL patients). Additionally, 29 serum samples obtained from patients with parasitologically and serologically proven visceral leishmaniasis (VL) were also used as positive controls, and serum samples from 43 blood donors were used as negative controls. All sera were diluted to the same dilution (1/100). Leishmania infantum MON-1 was used as the antigen in the conventional ELISA. The sera of 27 (93.1%) of 29 VL patients were seropositive by ELISA, while the sera of 40 (78.4%) of 51 NonT-CL patients and 43 (69.3%) of 62 UT-CL patients were seropositive by the conventional ELISA. The absorbance values of the CL patients' sera were significantly lower than the absorbance values of the VL patients' sera. Bands between 15 and 118 kDa were detected in two groups of CL patients. Among all bands, the 63-kDa band was found to be more sensitive (88.5%). When we evaluated the Western blotting results for the presence of at least one of the diagnostic antigenic bands, the sensitivity was calculated to be 99.1%. By using serological tests, a measurable antibody response was detected in most of the CL patients in Sanliurfa, Turkey. It is also noted that this response can be changed according to the sizes, types, and numbers of lesions that the patient has. The Western blot test was found to be more sensitive and valid than the conventional ELISA for the serodiagnosis of ACL. In some instances, when it is very difficult to demonstrate the presence of parasites in the smears, immunodiagnosis can be a valuable alternative for the diagnosis of ACL.
在本研究中,我们旨在评估传统酶联免疫吸附测定(ELISA)和蛋白质印迹试验对诊断人源性皮肤利什曼病(ACL)的有效性,使用的血清样本来自51例经寄生虫学证实的未经治疗的皮肤利什曼病患者(未治疗的CL患者)和62例正在接受CL治疗的患者(正在治疗的CL患者)。此外,29例经寄生虫学和血清学证实的内脏利什曼病(VL)患者的血清样本也用作阳性对照,43名献血者的血清样本用作阴性对照。所有血清均稀释至相同稀释度(1/100)。婴儿利什曼原虫MON-1用作传统ELISA中的抗原。29例VL患者中有27例(93.1%)的血清通过ELISA呈血清阳性,而51例未治疗的CL患者中有40例(78.4%)和62例正在治疗的CL患者中有43例(69.3%)的血清通过传统ELISA呈血清阳性。CL患者血清的吸光度值显著低于VL患者血清的吸光度值。在两组CL患者中检测到15至118 kDa之间的条带。在所有条带中,发现63 kDa条带更敏感(88.5%)。当我们评估蛋白质印迹结果中是否存在至少一条诊断性抗原条带时,计算出的敏感性为99.1%。通过血清学检测,在土耳其桑尼乌法的大多数CL患者中检测到了可测量的抗体反应。还注意到,这种反应可能会根据患者病变的大小、类型和数量而变化。发现蛋白质印迹试验在ACL的血清诊断方面比传统ELISA更敏感和有效。在某些情况下,当很难在涂片上证明寄生虫的存在时,免疫诊断可能是诊断ACL的一种有价值的替代方法。