Universidade de Pernambuco (UPE), Programa de Pós-Graduação em Ciências da Saúde, Recife, PE, Brazil; Fundação Oswaldo Cruz (FIOCRUZ), Instituto Aggeu Magalhães (IAM), Departamento de Parasitologia, Recife, PE, Brazil.
Fundação Oswaldo Cruz (FIOCRUZ), Instituto Aggeu Magalhães (IAM), Departamento de Parasitologia, Recife, PE, Brazil.
Braz J Infect Dis. 2019 Mar-Apr;23(2):111-120. doi: 10.1016/j.bjid.2019.04.001. Epub 2019 May 1.
Visceral leishmaniasis is a serious and debilitating infection with high fatality rate in tropical and subtropical countries. As clinical symptoms of visceral leishmaniasis are not so specific, confirmatory diagnostic methods with high sensitivity and specificity are needed. Noninvasive methods have been developed using urine as a clinical sample for visceral leishmaniasis diagnosis. In fact, there is a clear correlation between kidney impairment and Leishmania DNA in urine. However, it has been proved that Leishmania nucleic acid may also be isolated from patients without any sign of renal involvement. Even though urine has become a promissing biological sample, it is still not widely used due to several issues, such as (i) incomprehension of the whole renal pathophysiology process in visceral leishmaniasis, (ii) presence of many amplification inhibitors in urine, and (iii) lack of an efficient urinary DNA extraction method. In this article, we performed a literature review to bring a new perspective for Leishmania DNA isolation in urine.
内脏利什曼病是一种严重且使人虚弱的感染，在热带和亚热带国家的死亡率很高。由于内脏利什曼病的临床症状并不那么特异，因此需要具有高灵敏度和特异性的确认诊断方法。已经开发了使用尿液作为临床样本的非侵入性方法来诊断内脏利什曼病。事实上，肾脏损伤与尿液中的利什曼原虫 DNA 之间存在明确的相关性。然而，已经证明，即使没有任何肾脏受累的迹象，也可以从患者中分离出利什曼核酸。尽管尿液已成为一种很有前途的生物样本，但由于以下几个问题，它仍未得到广泛应用：（i）对内脏利什曼病整个肾脏病理生理学过程的理解不足；（ii）尿液中存在许多扩增抑制剂；以及（iii）缺乏有效的尿液 DNA 提取方法。在本文中，我们进行了文献回顾，为尿液中利什曼原虫 DNA 的分离带来了新的视角。
