Reed S G, Badaró R, Masur H, Carvalho E M, Lorenco R, Lisboa A, Teixeira R, Johnson W D, Jones T C
Am J Trop Med Hyg. 1986 Jan;35(1):79-85. doi: 10.4269/ajtmh.1986.35.79.
Studies were designed to examine skin test responses to leishmanial antigens in American visceral leishmaniasis (AVL) in Brazil. We found that after recovery from AVL, patients had positive delayed hypersensitivity reactions to Leishmania. Different amounts of a soluble extract obtained from Leishmania donovani chagasi promastigotes were compared with whole L. d. chagasi promastigotes in persons with past AVL. The most effective soluble preparations tested contained 25 and 50 micrograms leishmanial protein. These produced positive responses in 95%-100% of the individuals with past AVL. The 25 micrograms protein dose was used in further studies. This preparation produced no positive responses in either normal controls, tuberculosis patients, or schistosomiasis patients, and less than 5% positive responses in persons with Chagas' disease. The same amount of soluble extract prepared from L. mexicana amazonensis produced 82% positive skin test responses in persons with past AVL. When persons living in an area endemic for AVL were skin tested with the 25 micrograms preparation of L. d. chagasi extract, 34.1% yielded positive tests with a low number of positive responses in young children and 48% positive in adults. Only 3.1% of the population studied had a history of AVL. We have found that positive delayed hypersensitivity response to a soluble Leishmania extract is a sensitive and specific indicator of previous infection with AVL.
研究旨在检测巴西美洲内脏利什曼病（AVL）患者对利什曼原虫抗原的皮肤试验反应。我们发现，从AVL康复后，患者对利什曼原虫有阳性迟发型超敏反应。将从杜氏利什曼原虫恰加斯前鞭毛体获得的不同量的可溶性提取物与完整的杜氏利什曼原虫恰加斯前鞭毛体在既往感染AVL的人群中进行比较。测试的最有效的可溶性制剂含有25和50微克利什曼原虫蛋白。这些制剂在95%-100%的既往感染AVL的个体中产生了阳性反应。25微克蛋白剂量用于进一步研究。该制剂在正常对照、结核病患者或血吸虫病患者中均未产生阳性反应，在恰加斯病患者中的阳性反应少于5%。从亚马逊利什曼原虫制备的相同量的可溶性提取物在既往感染AVL的个体中产生了82%的阳性皮肤试验反应。当用25微克杜氏利什曼原虫恰加斯提取物制剂对生活在AVL流行地区的人群进行皮肤试验时，34.1%的人呈阳性反应，其中幼儿阳性反应数量较少，成人阳性反应率为48%。所研究的人群中只有3.1%有AVL病史。我们发现，对可溶性利什曼原虫提取物的阳性迟发型超敏反应是既往感染AVL的敏感和特异性指标。
