Gupta Himanshu, Srivastava Shikha, Chaudhari Sima, Vasudevan Thanvanthri G, Hande Manjunath H, D'souza Sydney C, Umakanth Shashikiran, Satyamoorthy Kapaettu
Department of Biotechnology, School of Life Sciences, Manipal University, Manipal, Karnataka, India.
Department of Medicine, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
Acta Trop. 2016 Aug;160:15-22. doi: 10.1016/j.actatropica.2016.04.013. Epub 2016 Apr 27.
For the effective control of malaria, development of sensitive, accurate and rapid tool to diagnose and manage the disease is essential. In humans subjects, the severe form of malaria is caused by Plasmodium falciparum (Pf) and Plasmodium vivax (Pv) and there is need to identify these parasites in acute, chronic and latent (during and post-infection) stages of the disease. In this study, we report a species specific and sensitive diagnostic method for the detection of Pf and Pv in humans. First, we identified intra and intergenic multiloci short stretch of 152 (PfMLS152) and 110 (PvMLS110) nucleotides which is present up to 44 and 34 times in the genomes of Pf and Pv respectively. We developed the single-step amplification-based method using isolated DNA or from lysed red blood cells for the detection of the two malaria parasites. The limit of detection of real-time polymerase chain reaction based assays were 0.1copyof parasite/μl for PfMLS152 and PvMLS110 target sequences. Next, we have tested 250 clinically suspected cases of malaria to validate the method. Sensitivity and specificity for both targets were 100% compared to the quantitative buffy coat microscopy analysis and real-time PCR (Pf-chloroquine resistance transporter (PfCRT) and Pv-lactate dehydrogenase (PvLDH)) based assays. The sensitivity of microscopy and real-time PCR (PfCRT and PvLDH primers) assays were 80.63%; 95%CI 75.22%-85.31%; p<0.05 and 97.61%; 95%CI 94.50%-99.21%; p<0.05 in detecting malaria infection respectively when compared to PfMLS152 and PvMLS110 targets to identify malaria infection in patients. These improved assays may have potential applications in evaluating malaria in asymptomatic patients, treatment, blood donors and in vaccine studies.
为有效控制疟疾,开发灵敏、准确且快速的疾病诊断和管理工具至关重要。在人类受试者中,严重形式的疟疾由恶性疟原虫(Pf)和间日疟原虫(Pv)引起,需要在疾病的急性、慢性和潜伏(感染期间及感染后)阶段识别这些寄生虫。在本研究中,我们报告了一种用于检测人类体内Pf和Pv的物种特异性灵敏诊断方法。首先,我们鉴定出分别存在于Pf和Pv基因组中多达44次和34次的152个核苷酸(PfMLS152)和110个核苷酸(PvMLS110)的基因内和基因间多位点短片段。我们开发了基于单步扩增的方法,使用分离的DNA或裂解的红细胞来检测这两种疟原虫。基于实时聚合酶链反应的检测方法对PfMLS152和PvMLS110靶序列的检测限为0.1拷贝寄生虫/微升。接下来,我们对250例临床疑似疟疾病例进行了检测以验证该方法。与定量血沉棕黄层显微镜分析以及基于实时PCR(Pf - 氯喹抗性转运蛋白(PfCRT)和Pv - 乳酸脱氢酶(PvLDH))的检测方法相比,两个靶标的灵敏度和特异性均为100%。当与PfMLS152和PvMLS110靶标相比以识别患者的疟疾感染时,显微镜检测和实时PCR(PfCRT和PvLDH引物)检测方法检测疟疾感染的灵敏度分别为80.63%;95%置信区间75.22% - 85.31%;p<0.05和97.61%;95%置信区间94.50% - 99.21%;p<0.05。这些改进的检测方法可能在评估无症状患者的疟疾、治疗、献血者以及疫苗研究中具有潜在应用。