Faculty of Medicine, Department of Parasitology, University of Colombo, Colombo, Sri Lanka.
Faculty of Medicine, Department of Parasitology, University of Kelaniya, Ragama, Sri Lanka.
Parasitol Res. 2023 Dec 29;123(1):77. doi: 10.1007/s00436-023-08103-y.
Cutaneous leishmaniasis (CL) in Sri Lanka is caused by Leishmania donovani, a parasite widely known to cause visceral leishmaniasis. Despite the fact that CL is not generally believed to elicit serological immune responses, recent studies show the presence of antibody responses against this atypical form of CL. This study assesses the potential of using recombinant K39 (rK39), KMP11, and crude parasite antigen-based indirect ELISAs as serological diagnostic tools and measures of exposure for CL in Sri Lanka. The study used serum samples from confirmed CL patients (n = 266) and apparently healthy individuals from endemic settings (n = 411). Serum samples from individuals residing in non-endemic areas were used as negative controls. In-house indirect ELISAs were optimized and validated for recombinant antigens. Previously validated crude parasite extract-based indirect ELISA was performed for comparison. The statistical analyses were performed using SPSS v26.0. The rK39 (sensitivity = 71.2%, specificity = 64%) and KMP11 (sensitivity = 79.2%, specificity = 71.4%) based indirect ELISA were shown to be less suitable for the diagnosis of CL, while crude parasite extract-based indirect ELISA (sensitivity = 82.4%, specificity = 85.7%) might be a better method of diagnosis. All 03 ELISAs seemed to be good methods as measures of exposure since correlations were observed between the seropositivity of all 03 ELISAs (rK39: p = 0.037, KMP11: p = 0.007, CrudeAg: p = 0.000) with provincial case incidences. The findings will be important in identifying the disease hotspots in order to design the control measures for CL induced by L. donovani in Sri Lanka.
斯里兰卡的皮肤利什曼病(CL)是由利什曼原虫引起的,这种寄生虫广泛引起内脏利什曼病。尽管一般认为 CL 不会引起血清免疫反应,但最近的研究表明存在针对这种非典型 CL 的抗体反应。本研究评估了使用重组 K39(rK39)、KMP11 和粗寄生虫抗原的间接 ELISA 作为 CL 的血清学诊断工具和暴露测量的潜力。本研究使用了来自确诊 CL 患者(n=266)和来自流行地区的健康个体(n=411)的血清样本。来自非流行地区的个体的血清样本用作阴性对照。使用内部间接 ELISA 对重组抗原进行了优化和验证。并进行了先前验证的基于粗寄生虫提取物的间接 ELISA 进行了比较。使用 SPSS v26.0 进行统计分析。rK39(敏感性=71.2%,特异性=64%)和 KMP11(敏感性=79.2%,特异性=71.4%)的间接 ELISA 表明不太适合 CL 的诊断,而基于粗寄生虫提取物的间接 ELISA(敏感性=82.4%,特异性=85.7%)可能是一种更好的诊断方法。所有 03 种 ELISA 似乎都是暴露的良好测量方法,因为所有 03 种 ELISA 的血清阳性率之间都存在相关性(rK39:p=0.037,KMP11:p=0.007,CrudeAg:p=0.000)与省级病例发生率。这些发现对于确定疾病热点非常重要,以便为斯里兰卡的利什曼原虫引起的 CL 设计控制措施。
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