Inbar Ehud, Lawyer Philip, Sacks David, Podini Daniele
Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America.
The Department of Forensic Sciences, Columbian College of Arts & Sciences, George Washington University, Washington, D.C., United States of America.
PLoS Negl Trop Dis. 2016 May 18;10(5):e0004706. doi: 10.1371/journal.pntd.0004706. eCollection 2016 May.
BACKGROUND: In the Indian sub-continent, visceral leishmaniasis (VL), also known as kala azar, is a fatal form of leishmaniasis caused by the kinetoplastid parasite Leishmania donovani and transmitted by the sand fly Phlebotomus argentipes. VL is prevalent in northeast India where it is believed to have an exclusive anthroponotic transmission cycle. There are four distinct cohorts of L. donovani exposed individuals who can potentially serve as infection reservoirs: patients with active disease, cured VL cases, patients with post kala azar dermal leishmaniasis (PKDL), and asymptomatic individuals. The relative contribution of each group to sustaining the transmission cycle of VL is not known. METHODOLOGY/PRINCIPAL FINDINGS: To answer this critical epidemiological question, we have addressed the feasibility of an approach that would use forensic DNA methods to recover human DNA profiles from the blood meals of infected sand flies that would then be matched to reference DNA sampled from individuals living or working in the vicinity of the sand fly collections. We found that the ability to obtain readable human DNA fingerprints from sand flies depended entirely on the size of the blood meal and the kinetics of its digestion. Useable profiles were obtained from most flies within the first 24 hours post blood meal (PBM), with a sharp decline at 48 hours and no readable profiles at 72 hours. This early time frame necessitated development of a sensitive, nested-PCR method compatible with detecting L. donovani within a fresh, 24 hours blood meal in flies fed on infected hamsters. CONCLUSION/SIGNIFICANCE: Our findings establish the feasibility of the forensic DNA method to directly trace the human source of an infected blood meal, with constraints imposed by the requirement that the flies be recovered for analysis within 24 hours of their infective feed.
背景:在印度次大陆,内脏利什曼病(VL),也称为黑热病,是由动质体寄生虫杜氏利什曼原虫引起的一种致命性利什曼病,由白蛉传播。VL在印度东北部流行,据信其具有独特的人传人传播周期。有四类不同的杜氏利什曼原虫暴露个体可能作为感染源:活动性疾病患者、已治愈的VL病例、黑热病后皮肤利什曼病(PKDL)患者和无症状个体。每组对维持VL传播周期的相对贡献尚不清楚。 方法/主要发现:为回答这个关键的流行病学问题,我们探讨了一种方法的可行性,即使用法医DNA方法从感染白蛉的血餐中提取人类DNA图谱,然后将其与从白蛉采集地附近生活或工作的个体采集的参考DNA进行匹配。我们发现,从白蛉中获得可读人类DNA指纹的能力完全取决于血餐的大小及其消化动力学。在血餐后(PBM)的头24小时内,大多数白蛉都能获得可用的图谱,48小时时急剧下降,72小时时没有可读图谱。这个早期时间框架需要开发一种灵敏的巢式PCR方法,该方法要能在以感染仓鼠为食的白蛉新鲜24小时血餐中检测到杜氏利什曼原虫。 结论/意义:我们的研究结果确定了法医DNA方法直接追踪感染血餐人类来源的可行性,但存在限制,即要求在感染性进食后24小时内回收白蛉进行分析。
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