Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Basic Science in Infectious Diseases, Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Trop Med Int Health. 2019 Jan;24(1):116-126. doi: 10.1111/tmi.13042. Epub 2018 Dec 10.
Leishmania major has been considered as the main aetiological agent of cutaneous leishmaniasis in Iran. However, there are recent reports about the existence of Crithidia spp in cutaneous lesions in southern Iran. Therefore, this study was designed to decipher some morphological, biological and molecular aspects of this phenomenon.
Clinical isolates were obtained from 167 patients with cutaneous ulcers. A set of specific primers based on GAPDH (Glyceraldehyde-3-Phosphate Dehydrogenase) gene were used to distinguish between Crithidia and Leishmania genera. For molecular analysis, Pulsed Field Gel Electrophoresis and Mi-Seq Illumina platform were applied. Then, morphological analysis and some biological features (including potential growth at 37 °C and the ability of infecting mammalian macrophages) were studied.
In 92.8% of clinical cases, L. major was the only causative microorganism isolated; in 5.4% of cases, co-infection of L. major and Crithidia spp. was identified; and in 1.8% of lesions, only Crithidia spp. were found.
We isolated Crithidia spp. from clinical samples of patients suspected of cutaneous leishmaniasis in Iran, indicating that Crithidia spp. are capable of surviving at human body temperature and infecting macrophage cells. This raises questions on the influence of this phenomenon on pathogenicity, therapeutic outcome and disease control strategies.
利什曼原虫被认为是伊朗皮肤利什曼病的主要病原体。然而，最近有报道称在伊朗南部的皮肤损伤中存在锥体虫属。因此，本研究旨在阐明这一现象的一些形态学、生物学和分子学方面。
从 167 例皮肤溃疡患者中获得临床分离株。使用基于甘油醛-3-磷酸脱氢酶（GAPDH）基因的一组特异性引物来区分锥体虫属和利什曼原虫属。进行分子分析时，应用了脉冲场凝胶电泳和 Mi-Seq Illumina 平台。然后，进行形态学分析和一些生物学特征（包括在 37°C 下的潜在生长能力和感染哺乳动物巨噬细胞的能力）研究。
在 92.8%的临床病例中，仅分离出利什曼原虫这一致病微生物；在 5.4%的病例中，鉴定出利什曼原虫和锥体虫属的混合感染；在 1.8%的病变中，仅发现锥体虫属。
我们从伊朗疑似皮肤利什曼病患者的临床样本中分离出锥体虫属，表明锥体虫属能够在人体温度下存活并感染巨噬细胞。这引发了对这种现象对致病性、治疗效果和疾病控制策略影响的疑问。
