Eroglu Fadime, Koltas Ismail S, Alabaz Derya, Uzun Soner, Karakas Mehmet
Department of Medical Microbiology, Faculty of Emine-Bahaeddin Nakıboglu Medicine, University of Zirve, Şahinbey, Gaziantep 27260, Turkey.
Department of Parasitology, Faculty of Medicine, University of Cukurova, Balcali, Saricam, Adana 01330, Turkey.
Exp Parasitol. 2015 Jul;154:67-74. doi: 10.1016/j.exppara.2015.04.014. Epub 2015 Apr 22.
L. infantum was isolated from cutaneous leishmaniasis (CL) skin lesions in patients having no signs and symptoms of visceral leishmaniasis (VL). Similarly, L. tropica had previously been isolated from patients with VL in the absence of cutaneous lesions. It was not certain how visceralization occurred. Smears (207) and bone marrow samples (135) were taken from CL and VL-suspected patients, respectively. Microscopic examination, ITS1-PCR, RFLP and DNA sequencing for all samples were analyzed. The microscopic examination of smears was found to be 61.3% (127/207) in CL-suspected cases and bone marrow samples were found to be positive 8.8% (12/135) in VL-suspected cases. L. tropica 48.6% (72/148), L. infantum 35.8% (53/148), L. major 15.6% (23/148) in CL, and L. infantum 56.3% (18/32), L. donovani 31.2% (10/32), L. tropica 12.5% (4/32) in VL were found with PCR-RFLP. In addition, the DNA sequencing revealed a genetic variation in L. infantum (variants 1-3) and L. tropica (variants 1-5). We assume that the increased disease occurrence may have resulted from geographical expansion of disease, changing patterns of international travel, population migrations, non-immune people into endemic regions of infected people into non-endemic regions. In this study, L. infantum (variant 3) only in CL-patients and L. tropica (variant 2) only in VL-patients were identified. We hypothesize that genetic variation might play a role in the causation of CL and VL in southern Turkey and the genetic variants may differ according to the geographical location among Leishmania strains.
婴儿利什曼原虫是从没有内脏利什曼病（VL）体征和症状的皮肤利什曼病（CL）患者的皮肤病变中分离出来的。同样，热带利什曼原虫此前也曾从没有皮肤病变的VL患者中分离出来。内脏化是如何发生的尚不确定。分别从CL和疑似VL患者中采集涂片（207份）和骨髓样本（135份）。对所有样本进行显微镜检查、ITS1-PCR、RFLP和DNA测序分析。在疑似CL病例中，涂片的显微镜检查阳性率为61.3%（127/207），在疑似VL病例中，骨髓样本的阳性率为8.8%（12/135）。通过PCR-RFLP在CL中发现热带利什曼原虫占48.6%（72/148），婴儿利什曼原虫占35.8%（53/148），硕大利什曼原虫占15.6%（23/148），在VL中发现婴儿利什曼原虫占56.3%（18/32），杜氏利什曼原虫占31.2%（10/32），热带利什曼原虫占12.5%（4/32）。此外，DNA测序揭示了婴儿利什曼原虫（变体1-3）和热带利什曼原虫（变体1-5）的基因变异。我们认为疾病发生率的增加可能是由于疾病的地理扩张、国际旅行模式的变化、人口迁移、非免疫人群进入流行地区以及感染人群进入非流行地区所致。在本研究中，仅在CL患者中鉴定出婴儿利什曼原虫（变体3），仅在VL患者中鉴定出热带利什曼原虫（变体2）。我们假设基因变异可能在土耳其南部CL和VL的病因中起作用，并且基因变体可能因利什曼原虫菌株的地理位置而异。
