Banaras Hindu University, Varanasi, India.
PLoS Negl Trop Dis. 2011 Apr 19;5(4):e1042. doi: 10.1371/journal.pntd.0001042.
BACKGROUND: In areas endemic for visceral leishmaniasis (VL), a large number of infected individuals mount a protective cellular immune response and remain asymptomatic carriers. We propose an interferon-gamma release assay (IFN-γRA) as a novel marker for latent L. donovani infection. METHODS AND FINDINGS: We modified a commercial kit (QuantiFERON) evaluating five different leishmania-specific antigens; H2B, H2B-PSA2, H2B-Lepp12, crude soluble antigen (CSA) and soluble leishmania antigen (SLA) from L. donovani with the aim to detect the cell-mediated immune response in VL. We evaluated the assay on venous blood samples of active VL patients (n = 13), cured VL patients (n = 15), non-endemic healthy controls (n = 11) and healthy endemic controls (n = 19). The assay based on SLA had a sensitivity of 80% (95% CI = 54.81-92.95) and specificity of 100% (95% CI = 74.12-100). CONCLUSION: Our findings suggest that a whole-blood SLA-based QuantiFERON assay can be used to measure the cell-mediated immune response in L. donovani infection. The positive IFN-γ response to stimulation with leishmania antigen in patients with active VL was contradictory to the conventional finding of a non-proliferative antigen-specific response of peripheral blood mononuclear cells and needs further research.
背景:在内脏利什曼病(VL)流行地区,大量感染个体产生保护性细胞免疫反应,成为无症状携带者。我们提出了一种干扰素-γ释放检测(IFN-γRA)作为潜在利什曼原虫感染的新型标志物。
方法和发现:我们修改了一种商用试剂盒(QuantiFERON),评估了来自利什曼原虫的五种不同的利什曼原虫特异性抗原;H2B、H2B-PSA2、H2B-Lepp12、粗可溶性抗原(CSA)和可溶性利什曼抗原(SLA),目的是检测 VL 中的细胞介导免疫反应。我们在活动性 VL 患者(n=13)、已治愈的 VL 患者(n=15)、非流行地区健康对照者(n=11)和流行地区健康对照者(n=19)的静脉血样本中评估了该检测方法。基于 SLA 的检测方法具有 80%的灵敏度(95%CI=54.81-92.95)和 100%的特异性(95%CI=74.12-100)。
结论:我们的研究结果表明,基于全血 SLA 的 QuantiFERON 检测方法可用于测量利什曼原虫感染中的细胞介导免疫反应。活动性 VL 患者对利什曼原虫抗原刺激的阳性 IFN-γ反应与外周血单核细胞非增殖性抗原特异性反应的传统发现相矛盾,需要进一步研究。
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