Molecular and Cell Biology Research Center, Department of Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Toxoplasmosis Research Center, Communicable Diseases Institute, Iranian National Registry Center for Lophomoniasis (INRCL) and Toxoplasmosis (INRCT), Department of Parasitolgy, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Transbound Emerg Dis. 2021 May;68(3):1493-1503. doi: 10.1111/tbed.13818. Epub 2020 Sep 30.
Cutaneous leishmaniasis (CL) is a major health problem in Iran, with a heavy burden on human health and society. There is little knowledge about the molecular epidemiology of the disease, as well as phylogenetic relationship of causative agents in south-eastern Iran. The aim of the present study was to investigate the molecular aspects of CL, especially atypical CL in the Bam district, Kerman province, south-eastern Iran, as an endemic region of CL in Iran. The smears were collected from lesion samples of 353 patients clinically suspected to CL, who attended local health centres in the Bam district during 2016-2017. Direct smears were examined for Leishmania parasites using the Giemsa staining technique. Amplification of kinetoplast DNA (kDNA) and the ribosomal internal transcribed spacer 1(ITS-1) gene were carried out using polymerase chain reaction (PCR). Then, the ITS1-PCR products were sequenced for phylogenetic analysis. Overall, 278 cases were confirmed as CL by microscopic examination of Giemsa-stained slides. Clinical presentation of the lesions was basically of two types: (a) typical lesions and (b) atypical including lupoid ulcers, sporotrichoid, nodular and exudative lesions. The PCR assay on all specimens of skin lesions proved L. tropica as the main pathogenic agent. Phylogenic analysis revealed high similarity among isolates from the Bam district in the south-east with isolates from Birjand in eastern Iran, as well as with isolates from Herat province in western Afghanistan. The study provided valuable information concerning the genetic diversity of the parasite as one of the factors influencing the clinical manifestations in CL in south-eastern Iran, which could be the basis for planning future control strategies.
皮肤利什曼病（CL）是伊朗的一个主要卫生问题，对人类健康和社会造成了沉重负担。人们对该疾病的分子流行病学以及伊朗东南部致病因子的系统发育关系知之甚少。本研究旨在调查 CL 的分子方面，特别是伊朗东南部克尔曼省巴姆地区的非典型 CL，因为该地区是 CL 的流行地区。2016-2017 年，从 353 名临床疑似 CL 的患者的病变样本中采集了涂片，这些患者在巴姆地区的当地卫生中心就诊。使用吉姆萨染色技术直接检查涂片是否有利什曼原虫寄生虫。使用聚合酶链反应（PCR）扩增动基体 DNA（kDNA）和核糖体内部转录间隔区 1（ITS-1）基因。然后，对 ITS1-PCR 产物进行测序进行系统发育分析。总体而言，通过对吉姆萨染色载玻片的微观检查，278 例病例被确认为 CL。病变的临床表现主要有两种类型：（a）典型病变和（b）非典型包括狼疮样溃疡、孢子丝菌样、结节和渗出性病变。对所有皮肤病变标本的 PCR 检测均证实 L. tropica 为主要病原体。系统发育分析显示，来自伊朗东南部巴姆地区的分离株与来自伊朗东部比尔詹德的分离株以及来自阿富汗西部赫拉特省的分离株高度相似。该研究提供了有关寄生虫遗传多样性的有价值信息，这是影响伊朗东南部 CL 临床表现的因素之一，可为制定未来控制策略提供依据。
