[Leish-l] Articles found by RefScout 2006/07/14

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  REQUEST: [ leishmania ]
(48 articles match this request)

PMID:
16751973<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=16751973>
TITLE: [Epidemiological aspects of American tegumentary leishmaniasis in
Varzelândia, Minas Gerais,
Brazil]<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=16751973>
AUTHORS: Adriana Guimarães Nunes, Edvá Vieira de Paula, Roberto Teodoro,
Aluízio Prata, Mario León Silva-Vergara
AFFILIATION: Universidade Federal do Triângulo Mineiro, Uberaba, Brazil.
REFERENCE: Cad Saude Publica 2006 Jun 22(6):1343-7
To characterize an area of endemic leishmaniasis, aiming to test a candidate
*leishmania* vaccine, a prospective epidemiological survey was implemented
in 1999 in a rural area of Varzelândia, Minas Gerais, Brazil. From a total
of 1,253 persons in 246 households, 1,170 were included, of whom 593 (50.6%)
were males and 662 (56.5%) were under 21 years of age. A Montenegro
intradermal test performed in 1,120 individuals and evaluated in 1,020 was
reactive in 282 (27.6%). Serological testing through indirect
immunofluorescence and ELISA was performed in 970 individuals (82.9%).
Antibodies to *Leishmania* sp. were detected in 117 (13.1%) and 170 (17.5%),
respectively, by the two tests . Cutaneous scars similar to those seen in
American tegumentary leishmaniasis were found in 297 individuals (25.4%),
282 of whom were submitted to the intradermal test, while only 168 (59.6)
were reactive. Initial leishmaniasis prevalence of 5.8% was recorded, and an
annual leishmaniasis incidence rate of 4.6% was observed after one year of
follow-up. The epidemiological characteristics observed in this location are
suggestive of an endemic area with old colonization.


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PMID:
16760512<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=16760512>
TITLE: Responses to *leishmania* donovani in mice deficient in both
phagocyte oxidase and inducible nitric oxide
synthase.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=16760512>
AUTHORS: Henry W Murray, Zhaoying Xiang, Xiaojing Ma
AFFILIATION: Departments of Medicine and Microbiology and Immunology, Weill
Medical College of Cornell University, New York, New York.
REFERENCE: Am J Trop Med Hyg 2006 Jun 74(6):1013-5
Mice deficient in phagocyte oxidase (phox) and inducible nitric oxide
synthase (iNOS), which are primary macrophage killing mechanisms, generated
tissue granulomas but showed unrestrained *Leishmania* donovani visceral
replication and suboptimal initial responsiveness to antimony treatment.
Nevertheless, visceral infection was controlled post- treatment and did not
recur. A phox/iNOS-independent macrophage mechanism, which was not triggered
by L. donovani, emerges after chemotherapy.


PMID:
16722639<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=16722639>
TITLE: 2H-benzimidazole 1,3-dioxide derivatives: a new family of
water-soluble anti-trypanosomatid
agents.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=16722639>
AUTHORS: Mariana Boiani, Lucía Boiani, Ana Denicola, Susana Torres de
Ortiz, Elva Serna, Ninfa Vera de Bilbao, Luis Sanabria, Gloria Yaluff,
HÃ(c)ctor Nakayama, Antonieta Rojas de Arias, Celeste Vega, Miriam Rolan,
Alicia Gómez-Barrio, Hugo Cerecetto, Mercedes Gonzalez
AFFILIATION: Departamento de Química Organica, Facultad de
Ciencias-Facultad de Química, Universidad de la República, Uruguay.
REFERENCE: J Med Chem 2006 Jun 49(11):3215-24
Three series of benzimidazole N-oxide derivatives were developed and were
examined for their activity against trypanosomatid parasites ( Trypanosoma
cruzi and *Leishmania* spp.). 2H-benzimidazole 1,3-dioxides displayed
remarkable in vitro activities against both parasites, with derivatives 28,
29, and 32 being the most potent (IC50 < 5 microM) against the epimastigote
form of T. cruzi and 28, 33, and 35 the most potent against the promastigote
form of *Leishmania* spp. Unspecific cytotoxicity was evaluated using murine
macrophages, and derivative 33 was not toxic at a concentration 30 times
that of its IC50 against T. cruzi that was completely toxic for
*Leishmania*spp., implying that the series of 2H-benzimidazole
1,3-dioxides is selective
toward both trypanosomatid parasites. Derivatives 33 and 35 were submitted
to an in vivo assay using an acute model of Chagas' disease and a short-term
treatment (30 mg/kg/day orally administrated as aqueous solution, during 10
days). While in the control (untreated) and Benznidazole (50 mg/kg/ day)
groups survival fraction was 60.0% and 87.5%, respectively, none of the
animals treated with derivatives 33 and 35 died. From the preliminary
structure-activity relationship studies reduction potential and
electrophilicity were found relevant to anti-T. cruzi activity. Active
compounds are better electrophiles and more easily reduced than inactive
ones.


PMID:
16741336<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=16741336>
TITLE: Hemophagocytic syndrome associated with visceral
leishmaniasis.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=16741336>
AUTHORS: Shilpi Agarwal, Shashi Narayan, Sunita Sharma, Eram Kahkashan, A K
Patwari
AFFILIATION: Department of Pathology, Lady Hardinge Medical College and
Kalawati Saran Children's Hospital, Connought Place, New Delhi, India.
REFERENCE: Indian J Pediatr 2006 May 73(5):445-6
The present paper reports a case of 6-year-old male child, suffering from
pallor, fever and hepatosplenomegaly. A clinical diagnosis of enteric fever
with a second possibility of malaria was considered. Laboratory findings
included bicytopenia, hyperbilirubinemia and raised liver enzymes. Bone
marrow examination revealed active hemophagocytosis . On extensive search
few amastigote forms of *Leishmania* donovani were seen. Patient was
negative for other viral, bacterial and malaria infections. The final
diagnosis of hemophagocytic syndrome associated with visceral leishmaniasis
was made. There was response of anti- Leishmanial treatment with improvement
in clinical condition.


PMID:
16605301<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=16605301>
TITLE: Unresponsiveness to Glucantime treatment in Iranian cutaneous
leishmaniasis due to drug-resistant *leishmania* tropica
parasites.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=16605301>
AUTHORS: Ramtin Hadighi, Mehdi Mohebali, Patrick Boucher, Homa Hajjaran, Ali
Khamesipour, Marc Ouellette
AFFILIATION: School of Public Health and Institute of Public Health
Research, Tehran University of Medical Sciences, Tehran, Iran.
REFERENCE: PLoS Med 2006 May 3(5):e162
BACKGROUND: Recent circumstantial evidence suggests that an increasing
number of Iranian patients with cutaneous leishmaniasis are unresponsive to
meglumine antimoniate (Glucantime), the first line of treatment in Iran.
This study was designed to determine whether the clinical responses
(healing, or non-healing) were correlated with the susceptibility of *
Leishmania* parasites to Glucantime. METHODS AND FINDINGS: In vitro
susceptibility testing was first performed on 185 isolated parasites in the
intracellular mouse peritoneal macrophage model. A strong correlation
between the clinical outcome and the in vitro effective concentration 50%
(EC50) values was observed. Parasites derived from patients with non-healing
lesions had EC50 values at least 4-fold higher than parasites derived from
lesions of healing patients. A selection of these strains was typed at the
molecular level by pulsed- field gels and by sequencing the pteridine
reductase 1 (PTR1) gene. These techniques indicated that 28 out of 31
selected strains were *Leishmania* tropica and that three were
*Leishmania*major. The L. major isolates were part of a distinct
pulsed-field group, and
the L. tropica isolates could be classified in three related additional
pulsed-field groups. For each pulsed-field karyotype, we selected sensitive
and resistant parasites in which we transfected the firefly luciferase
marker to assess further the in vitro susceptibility of field isolates in
the monocyte cell line THP1. These determinations confirmed unequivocally
that patients with non-healing lesions were infected with L. tropica
parasites resistant to Glucantime. Additional characterization of the
resistant isolates showed that resistance is stable and can be reversed by
buthionine sulfoximine, an inhibitor of glutathione biosynthesis.
CONCLUSIONS: To the authors' knowledge, this is the first report of proven
resistant parasites contributing to treatment failure for cutaneous
leishmaniasis and shows that primary Glucantime-resistant L. tropica field
isolates are now frequent in Iran.


PMID:
16446034<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=16446034>
TITLE: Canine visceral leishmaniosis: a comparative analysis of the
EIE-leishmaniose-visceral-canina-Bio-Manguinhos and the
IFI-leishmaniose-visceral-canina-Bio-Manguinhos
kits.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=16446034>
AUTHORS: R A Lira, M Paiva Cavalcanti, M Nakazawa, A G P Ferreira, E D
Silva, F G C Abath, L C Alves, W V Souza, Y M Gomes
AFFILIATION: Departamento de Imunologia, Centro de Pesquisas Aggeu
Magalhães/CPqAM, Fundação Oswaldo Cruz/FIOCRUZ, Av. Moraes Rego s/n,
Cidade Universitária, 50670-420, Recife-PE, Brazil.
REFERENCE: Vet Parasitol 2006 Apr 137(1-2):11-6
This study evaluated the performance of the EIE-leishmaniose-visceral-
canina-Bio-Manguinhos (EIE-LVC) kit and to compare it with that of the
IFI-leishmaniose-visceral-canina-Bio-Manguinhos (IFI-LVC) kit. Four groups
of dogs were studied: group 1 (G1), dogs with clinical signs indicative of
CVL and testing positive for the parasite (n = 25); group 2 (G2), dogs with
only a presumed diagnosis of CVL (n = 62); group 3 (G3 ), dogs that had
never lived in an area where CVL is endemic and never received a blood
transfusion (n = 16); group 4 (G4), dogs carrying other parasites: such as
babesiosis (n = 4), ehrlichiosis (n = 6) and demodicosis (n = 1). G1 and G3
were used for the calculation of sensitivity and specificity, respectively.
The EIE-LVC showed a sensitivity of 72% (IC 95%: 50.4-87.1%) and a
specificity of 87.5% (IC 95%: 60.4-97.8%). The value of the kappa index was
0.975 (CI 95%: 0.926- 1.024), which represents an excellent fit. For
IFI-LVC, the sensitivity was 68.0% (CI 95%: 46.4-84.3%) and the specificity
87.5% (CI 95%: 60.4- 97.8%). When the tests were conducted in parallel,
sensitivity was 92.0 % (CI 95%: 72.5-98.6%) and specificity 75.0% (CI 95%:
47.4-91.7%). However, when conducted consecutively, the tests showed a
sensitivity of 48.0% (CI 95%: 28.3-68.2%) and a specificity of 100.0% (CI
95%: 75.9-99 .4%). The analysis of clinically suspected dogs using IFI-LVC
and EIE- LVC kits in parallel, revealed that 26/62 animals were positive.
Cross- reaction was observed in a dog with demodicosis. These results lead
to the following conclusions: (1) the performance of the EIE-LVC kit is not
statistically different from the IFI-LVC and (2) the kits must be used in
parallel if higher sensitivity is required, reducing the number of
false-negative results.


PMID:
16243558<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=16243558>
TITLE: Hemophagocytic syndrome associated with visceral
leishmaniasis.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=16243558>
AUTHORS: Badreddine Kilani, Lamia Ammari, Fakher Kanoun, Taoufik Ben
Chaabane, Sami Abdellatif, Emna Chaker
REFERENCE: Int J Infect Dis 2006 Jan 10(1):85-6


PMID:
16757380<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=16757380>
TITLE: DNA topoisomerase I from parasitic protozoa: A potential target for
chemotherapy.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=16757380>
AUTHORS: R M Reguera, C M Redondo, R Gutierrez de Prado, Y PÃ(c)rez-Pertejo, R
Balaña-Fouce
AFFILIATION: Dpto. Farmacología y Toxicología (INTOXCAL), Universidad de
León, Campus de Vegazana s/n, 24071 León, Spain.
REFERENCE: Biochim Biophys Acta 2006 Mar-Apr 1759(3-4):117-31
The growing occurrence of drug resistant strains of unicellular prokaryotic
parasites, along with insecticide-resistant vectors, are the factors
contributing to the increased prevalence of tropical diseases in
underdeveloped and developing countries, where they are endemic. Malaria,
cryptosporidiosis, African and American trypanosomiasis and leishmaniasis
threaten human beings, both for the high mortality rates involved and the
economic loss resulting from morbidity. Due to the fact that effective
immunoprophylaxis is not available at present; preventive sanitary measures
and pharmacological approaches are the only sources to control the
undesirable effects of such diseases. Current anti-parasitic chemotherapy is
expensive, has undesirable side effects or, in many patients, is only
marginally effective. Under this point of view molecular biology techniques
and drug discovery must walk together in order to find new targets for
chemotherapy intervention. The identification of DNA topoisomerases as a
promising drug target is based on the clinical success of camptothecin
derivatives as anticancer agents. The recent detection of substantial
differences between trypanosome and *leishmania* DNA topoisomerase IB with
respect to their homologues in mammals has provided a new lead in the study
of the structural determinants that can be effectively targeted. The present
report is an up to date review of the new findings on type IB DNA
topoisomerase in unicellular parasites and the role of these enzymes as
targets for therapeutic agents.


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PMID:
16407349<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=16407349>
TITLE: Evaluation of a new recombinant K39 rapid diagnostic test for
Sudanese visceral
leishmaniasis.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=16407349>
AUTHORS: Koert Ritmeijer, Yoseph Melaku, Marius Mueller, Sammy Kipngetich,
Caroline O'keeffe, Robert N Davidson
AFFILIATION: MÃ(c)decins sans Frontières-Holland, Amsterdam, The Netherlands.
koert.ritmeijer at amsterdam.msf.org
REFERENCE: Am J Trop Med Hyg 2006 Jan 74(1):76-80
A new rK39 rapid diagnostic dipstick test (DiaMed-IT-Leish) was compared
with aspiration and a direct agglutination test (DAT) for diagnosis of
visceral leishmaniasis (VL) in 201 parasitologically confirmed cases, 133
endemic controls, and in 356 clinical suspects in disease-endemic and
-epidemic areas in Sudan. The sensitivity of the rK39 test in
parasitologically confirmed VL cases was 90%, whereas the specificity in
disease-endemic controls was 99%. The sensitivity of the DAT was 98%. In
clinically suspected cases, the sensitivity of the rK39 test was 81% and the
specificity was 97%. When compared with the diagnostic protocol based on the
DAT and aspiration used by MÃ(c)decins sans Frontières in epidemic
situations, the positive predictive value was 98%, and the negative
predictive value was 71%. This rK39 rapid diagnostic test is suitable for
screening as well as diagnosis of VL. Further diagnostic work-up of
dipstick-negative patients with clinically suspected VL is important. The
ease and convenience of the dipstick test will allow decentralization and
improved access to care in disease-endemic areas in Sudan.


PMID:
16390983<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=16390983>
TITLE: Rapid, noninvasive diagnosis of visceral leishmaniasis in India:
comparison of two immunochromatographic strip tests for detection of
anti-K39
antibody.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=16390983>
AUTHORS: Shyam Sundar, Radheshyam Maurya, Rakesh K Singh, K Bharti, Jaya
Chakravarty, Ashish Parekh, Madhukar Rai, Kailash Kumar, Henry W Murray
AFFILIATION: Kala-Azar Medical Research Center, Department of Medicine,
Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
shyam_vns at sify.com
REFERENCE: J Clin Microbiol 2006 Jan 44(1):251-3
Used with blood or serum, a new anti-K39 antibody immunochromatographic
strip test (IT-Leish; DiaMed AG) proved sensitive (range, 99 to 100%) and
specific (range, 95 to 100%) for the noninvasive serodiagnosis of visceral
leishmaniasis in India. Used with serum, the IT-Leish test and the existing
Kalazar Detect test (InBios International, Inc.) yielded comparable results
for symptomatic infection and identified apparent subclinical infection in
15 to 32% of healthy residents in a region where visceral leishmaniasis is
highly endemic.


PMID:
16517998<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=16517998>
TITLE: Evaluation of a rapid immunochromatographic test for diagnosis of
kala-azar & post kala-azar dermal leishmaniasis at a tertiary care centre of
north
India.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=16517998>
AUTHORS: Purva Mathur, Jyotish Samantaray, Neeraj Kumar Chauhan
AFFILIATION: Department of Microbiology, All India Institute of Medical
Sciences, New Delhi, India.
REFERENCE: Indian J Med Res 2005 Dec 122(6):485-90
BACKGROUND & OBJECTIVE: Definitive diagnosis of kala-azar requires
demonstration of parasites by diagnostic protocols based on invasive organ
aspirations. We evaluated in the present study the diagnostic utility of an
immunochromatographic test (ICT) for detection of anti- rK -39 antibodies
for the non-invasive diagnosis of kala-azar and post kala -azar dermal
leishmaniasis (PKDL) at a tertiary care centre of north India. METHODS: The
study was conducted in the Department of Microbiology, All India Institute
of Medical Sciences, New Delhi, from July 2003 to October 2004. Of the 120
samples tested, 57 were found to be positive by ICT; of which, 51 were
diagnosed as kala-azar and 6 as PKDL. The controls included individuals from
endemic (50) and non endemic (19) areas with malignancies, haemolytic
disorders, chronic liver diseases, hypersplenism, portal hypertension,
metabolic disorders and sarcoidosis. In addition, 47 sera from confirmed
cases of tuberculosis, malaria, typhoid, filariasis, leptospirosis,
histoplasmosis, toxoplasmosis, invasive aspergillosis, amoebic liver
abscess, AIDS, leprosy, cryptococcosis, strongyloidiasis, cyclosporosis ,
patients having collagen vascular diseases and hypergammaglobulinaemia were
also tested to check the specificity of the test. RESULTS: Of the 51 cases
with kala-azar 43 were males, children accounted for 25 per cent of these
cases. All had fever of duration ranging from <1 month to 1.5 yr
(median 4.5months). All PKDL patients (n=6, 4 males) gave a history of
having suffered
from kala-azar in the past, and their slit skin test smears were
microscopically positive for Leishman-Donovan (LD ) bodies. The strip test
was positive in all the cases of kala-azar and PKDL (estimated sensitivity
100%), all control sera were negative by the ICT (specificity 100%).
INTERPRETATION & CONCLUSION: The rK-39 ICT is a highly sensitive and
specific test, and may be suitable for a rapid , cost-effective and reliable
field diagnosis of kala-azar and PKDL.


PMID:
16339064<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=16339064>
TITLE: Application of an improved method for the recombinant k 39
enzyme-linked immunosorbent assay to detect visceral leishmaniasis disease
and infection in
Bangladesh.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=16339064>
AUTHORS: K M Kurkjian, L E Vaz, R Haque, C Cetre-Sossah, S Akhter, S Roy, F
Steurer, J Amann, M Ali, R Chowdhury, Y Wagatsuma, J Williamson, S Crawford,
R F Breiman, J H Maguire, C Bern, W E Secor
AFFILIATION: Centers for Disease Control and Prevention, Division of
Parasitic Diseases, Mailstop F-13, 4770 Buford Highway NE, Atlanta, GA
30341, USA.
REFERENCE: Clin Diagn Lab Immunol 2005 Dec 12(12):1410-5
Several serology-based immunoassays are used to diagnose visceral
leishmaniasis (VL), a chronic protozoan parasitic disease caused by the *
Leishmania* donovani complex. These tests are primarily designed to diagnose
the most severe clinical form of VL, known as kala-azar. However,
leishmanial infection is frequently asymptomatic and may manifest only as a
positive serologic response or positive leishmanin skin test. We modified a
previously described enzyme-linked immunosorbent assay (ELISA) that detects
patient antibodies reactive with the recombinant *Leishmania* protein K39
(rK39) to confirm suspected kala-azar and to detect asymptomatic infection
in a community study in Bangladesh. With the inclusion of a standard curve
on each ELISA plate, the rK39 ELISA was more repeatable (kappa coefficient
of agreement=0.970 ) and more reliable compared to the original method
(kappa=0.587, P<0 .001). The cutoff point for a positive antibody response
was chosen based on the 99th percentile of the ELISA distribution for the
negative- control sera. However, we found that sera from all patients with
active kala-azar yielded values more than twice the magnitude of this
cutoff. Using receiver-operator characteristic curves, we determined a
second cutoff value predictive of kala-azar. Using these criteria, the
sensitivity and specificity of the modified ELISA for kala-azar were 97. 0%
and 98.9%, respectively, for sera from our study population. We hypothesize
that individuals with antibody levels greater than the 99th percentile of
the negative controls but less than the cutoff point for kala-azar have
asymptomatic leishmanial infections.


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PMID:
16209934<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=16209934>
TITLE: Serological screening for *Leishmania* infantum in asymptomatic blood
donors living in an endemic area (Sicily,
Italy).<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=16209934>
AUTHORS: Claudia Colomba, Laura Saporito, Valentina Frasca Polara, Teresa
Barone, Antonino Corrao, Lucina Titone
AFFILIATION: Istituto di Patologia Infettiva e Virologia, Università di
Palermo, piazza Montalto 8, 90134 Palermo, Italy. claudia.colomba at libero.it
REFERENCE: Transfus Apher Sci 2005 Nov 33(3):311-4
The purpose of our study was to assess whether *Leishmania* infantum
parasitemia occurs in asymptomatic *Leishmania*-seropositive subjects.
Samples from 500 blood donors were tested using an enzyme-linked
immunosorbent assay (ELISA). Anti-*Leishmania* antibodies were not found in
any sample. Our findings suggest that the risk of L. infantum transmission
by blood transfusion in Sicily is very low.


PMID:
15879027<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=15879027>
TITLE: Development of recombinant chimeric antigen expressing immunodominant
B epitopes of *Leishmania* infantum for serodiagnosis of visceral
leishmaniasis.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=15879027>
AUTHORS: A Boarino, A Scalone, L Gradoni, E Ferroglio, F Vitale, R Zanatta,
M G Giuffrida, S Rosati
AFFILIATION: Dipartimento di Produzioni Animali, Epidemiologia ed Ecologia,
Facoltà di Medicina Veterinaria, Via Leonardo da Vinci 44, 10095 Grugliasco
(TO) Italy. sergio.rosati at unito.it
REFERENCE: Clin Diagn Lab Immunol 2005 May 12(5):647-53
Wild canids and domestic dogs are the main reservoir of zoonotic visceral
leishmaniasis (VL) caused by *Leishmania* infantum (syn.:
*Leishmania*chagasi). Serological diagnosis of VL is therefore
important in both human
and dog leishmaniasis from a clinical and epidemiological point of view.
Routine diagnosis of VL is traditionally carried out by immunofluorescent
antibody test (IFAT), which is laborious and difficult to standardize and to
interpret. In the last decade, however, several specific antigens of *
Leishmania* infantum have been characterized, allowing the development of a
recombinant-based immunoassay. Among them , the whole open reading frame
encoding K9 antigen, the gene fragment encoding the repetitive sequence of
K26, and the 3'-terminal gene fragment of the kinesin-related protein
(K39sub) were previously evaluated as diagnostic markers for canine
leishmaniasis and proved to be independent in their antibody reactivity.
Since sensitivity of serological test is usually higher in multiple-epitope
format, in this study the relevant epitopes of K9, K26, and K39 antigens
were joined by PCR strategy to produce the chimeric recombinant protein. The
resulting mosaic antigen was found highly expressed in Escherichia coli and
efficiently purified by affinity chromatography. Antigenic properties of
this recombinant antigen were evaluated by indirect enzyme-linked
immunosorbent assay (ELISA) using a panel of human and dog sera previously
characterized by parasitological and/or serological techniques. Chimeric
ELISA showed 99% specificity in both human (n = 180 ) and canine (n = 343)
control groups, while sensitivity was higher in canine VL (96%, n = 213)
than in human VL (82%, n = 185). Accordingly, concordance between IFAT and
canine chimeric ELISA (k = 0.95, 95% confidence interval = 0.93 to 0.98) was
higher than between IFAT and human chimeric ELISA (k = 0.81, 95% confidence
interval = 0.76 to 0.87 ). Results suggest the potential use of this new
antigen for routine serodiagnosis of VL in both human and canine hosts.


PMID:
15725545<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=15725545>
TITLE: Participation of Rhipicephalus sanguineus (Acari: Ixodidae) in the
epidemiology of canine visceral
leishmaniasis.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=15725545>
AUTHORS: Maria Teresa Zanatta Coutinho, Lilian Lacerda Bueno, Annelise
Sterzik, Ricardo Toshio Fujiwara, Jose Ramiro Botelho, Mario De Maria, Odair
Genaro, Pedro Marcos Linardi
AFFILIATION: Departamento de Parasitologia, Instituto de Ciências
Biológicas, Universidade Federal de Minas Gerais, Caixa Postal 486, Avenida
Antônio Carlos, 6627, Campus UFMG, Belo Horizonte, Minas Gerais, CEP
31270-901, Brazil.
REFERENCE: Vet Parasitol 2005 Mar 128(1-2):149-55
The vectorial competence of the tick Rhipicephalus sanguineus is discussed
in relation to the epidemiology of canine visceral leishmaniasis, taking
into account its strict association with dogs and the low indices of natural
infection presented by its known vector, the phlebotomine sand fly Lutzomyia
longipalpis. In order to evaluate natural infection by *Leishmania* chagasi
and the infectivity of these parasites in the tick, 39 specimens (6 females,
11 males and 22 nymphs) of R. sanguineus were removed from 21 dogs showing
diverse symptoms of zoonotic visceral leishmaniasis (ZVL). Six ticks (15.4%)
gave positive results for the genus *Leishmania* using the PCR technique. To
determine the infectivity of the parasites, 36 hamsters were inoculated
orally and peritoneally with macerates of ticks removed from nine dogs
symptomatic for visceral leishmaniasis. After 6 months the hamsters were
sacrificed and necropsied. Serum was removed for IFAT, as well as spleen and
liver fragments to make imprint smears and for PCR. Eight (88.9%) of these
dogs presented ticks that were infective for 14 hamsters (41.2%), 12 (85
.7%) of them infected peritoneally and two (14.3%) orally. PCR revealed 27
smears (40.9%) to be positive, 20 (62.5%) of them infected peritoneally and
seven (20.6%) orally. IFAT showed 14 positive animals ( 41.2%). Based on
these findings, we suggest that the vectorial capacity of R. sanguineus for
L. chagasi should be evaluated further, opening new perspectives in the
epidemiology of ZVL.


PMID:
15788098<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=15788098>
TITLE: Heterologous expression of the filarial nematode alt gene products
reveals their potential to inhibit immune
function.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=15788098>
AUTHORS: Natalia Gomez-Escobar, Clare Bennett, Lidia Prieto-Lafuente, Toni
Aebischer, Clare C Blackburn, Rick M Maizels
AFFILIATION: Institute of Immunology and Infection Research, University of
Edinburgh, UK. n.gomez at ed.ac.uk
REFERENCE: BMC Biol 2005 3():8
BACKGROUND: Parasites exploit sophisticated strategies to evade host
immunity that require both adaptation of existing genes and evolution of new
gene families. We have addressed this question by testing the immunological
function of novel genes from helminth parasites, in which conventional
transgenesis is not yet possible. We investigated two such novel genes from
Brugia malayi termed abundant larval transcript (alt), expression of which
reaches ~5% of total transcript at the time parasites enter the human host.
RESULTS: To test the hypothesis that ALT proteins modulate host immunity, we
adopted an alternative transfection strategy to express these products in
the protozoan parasite *Leishmania* mexicana. We then followed the course of
infection in vitro in macrophages and in vivo in mice. Expression of ALT
proteins, but not a truncated mutant, conferred greater infectivity of
macrophages in vitro , reaching 3-fold higher parasite densities.
alt-transfected parasites also caused accelerated disease in vivo, and fewer
mice were able to clear infection of organisms expressing ALT.
alt-transfected parasites were more resistant to IFN-gamma-induced killing
by macrophages. Expression profiling of macrophages infected with transgenic
L. mexicana revealed consistently higher levels of GATA-3 and SOCS-1
transcripts, both associated with the Th2-type response observed in in vivo
filarial infection. CONCLUSION: *Leishmania* transfection is a tractable and
informative approach to determining immunological functions of single genes
from heterologous organisms. In the case of the filarial ALT proteins, our
data suggest that they may participate in the Th2 bias observed in the
response to parasite infection by modulating cytokine- induced signalling
within immune system cells.


PMID:
15690948<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=15690948>
TITLE: Recombinant K39 dipstick immunochromatographic test: a new tool for
the serodiagnosis of canine
leishmaniasis.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=15690948>
AUTHORS: Domenico Otranto, Paola Paradies, Mariateresa Sasanelli, Nicola
Leone, Donato de Caprariis, Jan Chirico, Rosa Spinelli, Gioia Capelli, Olga
Brandonisio
AFFILIATION: Department of Animal Health and Welfare, Faculty of Veterinary
Medicine of Bari, Valenzano, Bari, Italy. d.otranto at veterinaria.uniba.it
REFERENCE: J Vet Diagn Invest 2005 Jan 17(1):32-7
The spread of human leishmaniasis has prompted the scientific community to
study dogs as reservoirs for *Leishmania* infantum. Canine leishmaniasis
(CanL) is widespread in the Mediterranean area with a prevalence of up to
50%. The first step toward controlling the disease is to monitor its
distribution, mainly in stray dogs. The validity of a recombinant K39 (rK39)
dipstick test, commercially available for the serodiagnosis of human
leishmaniasis, was evaluated using sera from 165 dogs selected on the basis
of positive or negative lymph node smears at parasitological examination.
The results were compared with the indirect fluorescent antibody test (IFAT)
(cutoff 1:80). Sera from a group of dogs with other diagnosed diseases but
negative for leishmaniasis were also tested to evaluate any
cross-reactivity. Various procedures were used for testing whole blood
samples. The relative specificity of the rK39 dipstick and IFAT was 100% (97
of 97) and 98.97% (96 of 97), whereas the relative sensitivity was
97.06%(66 of 68) and
98.53% (67 of 68), respectively. The results of the dipstick and IFAT
corresponded except for 2 sera (k = 0.987). This data confirm the usefulness
of rK39 antigen for diagnosing CanL both in symptomatic and asymptomatic
dogs. The rK39 dipstick proved to be a rapid, sensitive, and specific test
that may be very useful in the field for large-scale screening and also in
veterinary practice, requiring minimal equipment and operator expertise.


PMID:
14651132<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=14651132>
TITLE: Diagnosis of kala-azar--an important
stride.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=14651132>
AUTHORS: Shyam Sundar
REFERENCE: J Assoc Physicians India 2003 Aug 51():753-5


PMID:
14651134<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=14651134>
TITLE: K39 strip test--easy, reliable and cost-effective field diagnosis for
visceral leishmaniasis in
India.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=14651134>
AUTHORS: R P Goswami, B Bairagi, P K Kundu
AFFILIATION: Department of Tropical Medicine, School of Tropical Medicine,
Kolkata 700 073, India.
REFERENCE: J Assoc Physicians India 2003 Aug 51():759-61
OBJECTIVE: A firm diagnosis of visceral leishmaniasis (VL) requires
demonstration of the parasite in splenic or bone marrow aspirate. The aim of
this prospective study was to assess the usefulness of K39 strip test as a
noninvasive method of diagnosing visceral leishmaniasis under field
conditions by testing serum antibody to the leishmanial antigen K39.
MATERIAL AND METHODS: One drop of serum/blood was applied to the sample
application pad on the test strip, which was diluted with 2 drops of chase
buffer solution. The development of two visible red lines indicates the
presence of IgG anti-K39. In the first phase of the study (2001), a total of
200 patients (Active VL-70, ex-VL-30, healthy endemic control-20 and
patients with other tropical diseases-80) were tested with the K39 strip
test at the School of Tropical Medicine, Kolkata. In the second phase of the
study (2002), the test was applied in a remote tribal area of West Bengal
where an epidemic of VL had occurred. Thirty-two patients were identified in
207 villagers of the affected area; all of them were tested with the K39
strip test. RESULTS : In the first phase, all VL and ex-VL cases gave
positive results (100 %). Ten percent of the healthy endemic controls were
positive. The test results were negative in all other prevalent tropical
diseases (100%). The estimated sensitivity of the test was 100% and the
specificity was 98.18%. In the second phase of the study, all 32 patients of
the epidemic were shown to be positive. All patients were treated with
sodium stibogluconate injections and they recovered uneventfully.
CONCLUSIONS: K39 strip test is ideal for rapid reliable field diagnosis of
visceral leishmaniasis. The test has high sensitivity and specificity but it
remains positive long after treatment (up to 3 years).


PMID:
15748082<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=15748082>
TITLE: Visceral leishmaniasis in the Syrian Arab Republic: early detection
using
rK39.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=15748082>
AUTHORS: S Al-Nahhas, M Shabaan, L Hammoud, A Al-Taweel, S Al-Jorf
AFFILIATION: Department of Biology, Faculty of Science, University of
Damascus, Damascus, Syrian Arab Republic.
REFERENCE: East Mediterr Health J 2003 Jul 9(4):856-62
Leishmaniasis causes significant morbidity and mortality in areas where it
is endemic. A seroprevalence survey was conducted in 2 endemic villages in
Daraa, Syrian Arab Republic, where 80 out of 345 children ( 23.2%) tested
positive for visceral leishmaniasis (VL) using rK39 dipstick test. Only 10
cases were symptomatic (12.5%), and 27.5% were positive by ELISA test. All
the sera (N = 138) obtained from the control village were negative. Of the
rK39 initially positive cases, 52 had seroconverted to negative 9 months
later, 55 remained ELISA negative, and none developed the full-blown
disease. Being faster and less expensive than other diagnostic tests, rK39
is a rapid, sensitive and specific diagnostic tool for symptomatic cases of
VL in remote areas with poor accessibility to health services.


PMID:
12685638<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=12685638>
TITLE: Performance of recombinant K39 antigen in the diagnosis of Brazilian
visceral
leishmaniasis.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=12685638>
AUTHORS: Silvio F Guimarães Carvalho, Elenice Moreira Lemos, Ralph Corey,
Reynaldo Dietze
AFFILIATION: Universidade Estadual de Montes Claros, Montes Claros, Minas
Gerais, Brazil.
REFERENCE: Am J Trop Med Hyg 2003 Mar 68(3):321-4
This study evaluated the performance of recombinant K39 (rK39) antigen in a
immunochromatographic format (strip test) and a crude antigen enzyme-linked
immunosorbent assay in the diagnosis of Brazilian visceral leishmaniasis
(VL) in 128 consecutive patients with parasitologically proven infections
(by microscopy and/or culture). For each patient, a medical history was
obtained and a complete physical examination was performed. Controls
included 10 healthy volunteers and 50 patients with other diseases: malaria
(10), leprosy (9), Chagas' disease (10), tuberculosis (10), and cutaneous
leishmaniasis (11). The sensitivities of the rK39 antigen strip test and the
ELISA were 90% and 89%, respectively, while the specificities were 100% and
98%, respectively. Our study confirms the accuracy of the rK39 antigen strip
test in the diagnosis of VL in a high prevalence population.


PMID:
12631320<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=12631320>
TITLE: Prospective evaluation and comparison of the direct agglutination
test and an rK39-antigen-based dipstick test for the diagnosis of suspected
kala-azar in
Nepal.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=12631320>
AUTHORS: F Chappuis, S Rijal, R Singh, P Acharya, B M S Karki, M L Das, P A
Bovier, P Desjeux, D Le Ray, S Koirala, L Loutan
AFFILIATION: Department of Community Medicine, Geneva University Hospital,
Geneva, Switzerland. francois.chappuis at hcuge.ch
REFERENCE: Trop Med Int Health 2003 Mar 8(3):277-85
The diagnosis of visceral leishmaniasis (kala-azar) remains difficult in
rural endemic areas and practical and reliable tests are badly needed. Two
serological tests, the Direct Agglutination Test (DAT) and an rK39-
antigen-based dipstick test, were compared to parasitological diagnosis in a
group of 184 patients presenting at a tertiary care centre in south -eastern
Nepal with a history of fever > or = 14 days and splenomegaly; 139 patients
had a parasitologically proven kala-azar and 45 patients had a negative
parasitological work-up. The rK39 dipstick showed a sensitivity of 97% and a
specificity of 71%. The DAT was up to 99% sensitive with a low cut-off titre
(1:400) but its specificity did not exceed 82% even with a high cut-off
titre (1:51 200). Both tests could be used for screening suspect patients in
endemic areas. However, their use as confirmatory tests should be restricted
to situations where the proportion of kala-azar among clinical suspect
patients is high. The rK39 dipstick is cheaper and easier to use than the
DAT and could be used widely provided that both its performance and
production remain stable.


PMID:
15719773<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=15719773>
TITLE: [Evaluation of a rapid test using recombinant k39 antigen in the
diagnosis of visceral leishmaniasis in Brazil
]<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=15719773>
AUTHORS: Elenice Moreira Lemos, Silvio F Guimarães Carvalho, Ralph Corey,
Reynaldo Dietze
AFFILIATION: Núcleo de Doenças Infecciosas, Universidade Federal do
Espírito Santo, Vitória, Espírito Santo, Brazil.
REFERENCE: Rev Soc Bras Med Trop 2003 36 Suppl 2():36-8


PMID:
16117962<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=16117962>
TITLE: Standardization of a rapid immunochromatographic test with the
recombinant antigens K39 and K26 for the diagnosis of canine visceral
leishmaniasis.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=16117962>
AUTHORS: Roberto Teodoro da Costa, João Carlos França, Wilson Mayrink,
Evaldo Nascimento, Odair Genaro, Antonio Campos-Neto
AFFILIATION: Laboratory of Leishmaniasis and Vaccines, Department of
Parasitology, Institute of Biological Sciences, UFMG, Belo Horizonte, Minas
Gerais, Brazil.
REFERENCE: Trans R Soc Trop Med Hyg 2003 Nov-Dec 97(6):678-82
The serological diagnosis of canine visceral leishmaniasis (CVL) remains
problematic because there areno reliable commercially available tests. Most
laboratories use domestically prepared tests such as the enzyme- linked
immunosorbent assay (ELISA) or the indirect immunofluorescent antibody test
(IFAT). We evaluated rapid immunochromatographic (RICH) test kits for the
diagnosis of CVL. The tests were assembled with either *Leishmania* chagasi
recombinant antigens K39 or K26 and with either gold -labelled
Staphylococcus aureus protein A or Streptococcus pyogenes protein G. Fifty
sera from dogs with CVL, 14 sera from dogs with Chagas disease, and 50 sera
from normal healthy dogs were tested. The results show that the RICH test
using recombinant antigen K39 has a sensitivity of 96% and 100% specificity
for the diagnosis of CVL. No significant differences were observed in the
tests assembled with either protein A or protein G. The RICH tests using
recombinant antigen K26 were equally specific but less sensitive than those
using K39. However, the 2 antigens complemented each other and increased the
overall sensitivity of the test. Because of its simplicity and performance
the RICH test is a quick and reliable alternative for the diagnosis of CVL
either in conventional laboratories or for remote areas where laboratories
are not readily accessible for conventional assays.


PMID:
12563469<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=12563469>
TITLE: Epidemiological and immunological aspects of human visceral
leishmaniasis on Margarita Island,
Venezuela.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=12563469>
AUTHORS: Olga Zerpa, Marian Ulrich, Margarita Benitez, Concepción Avila,
Vestalia Rodríguez, Marta Centeno, Doris Belizario, Steven G Reed, Jacinto
Convit
AFFILIATION: Instituto de Biomedicina, Universidad Central de Venezuela,
Caracas, Venezuela. ozerpa at telcel.net.ve
REFERENCE: Mem Inst Oswaldo Cruz 2002 Dec 97(8):1079-83
Sixty-five patients were diagnosed with visceral leishmaniasis (VL) on
Margarita Island in the decade from 1990 to1999; 86.2% were <= 3 years old.
All were leishmanin-negative at diagnosis. Evaluation of 23 cured patients
in 1999 revealed that 22/23 had converted to leishmanin- positive; five had
persisting antibodies to rK39 antigen, with no clinical evidence of disease.
Leishmanin tests were positive in 20.2% of 1,643 healthy individuals from
417 households in endemic areas. Of the positive reactors, 39.8% were
identified in 35 (8.4%) of the households , 15 of which had an antecedent
case of VL, a serologically positive dog or both. Weak serological activity
to rK39 antigen was detected in 3 of 488 human sera from the endemic areas.
The presence of micro-foci of intense peri-urban transmission and the
apparent absence of other Trypanosomatidae causing human disease offer a
unique opportunity for the study of reservoirs, alternative vectors and
evaluation of control measures on the Island.


[image: Shop at Amazon.com]

PMID:
12471430<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=12471430>
TITLE: Evaluation of the direct agglutination test and the rK39 dipstick
test for the sero-diagnosis of visceral
leishmaniasis.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=12471430>
AUTHORS: Henk D F H Schallig, Marilene Canto-Cavalheiro, Eduardo S da Silva
AFFILIATION: Koninklijk Instituut voor de Tropen, Biomedical Research,
Amsterdam, The Netherlands. H.Schallig at kit.nl
REFERENCE: Mem Inst Oswaldo Cruz 2002 Oct 97(7):1015-8
The direct agglutination test (DAT) based on a freeze-dried antigen and the
rK39 dipstick test were evaluated for the sero-diagnosis of visceral
leishmaniasis (VL). The sensitivity and specificity of both tests were
determined using sera from confirmed VL patients (n = 21), healthy controls
(n = 19) and from patients with other confirmed infectious diseases (n =
42). The DAT had a sensitivity and a specificity of 100%. The rK39 had a
sensitivity of 85.7% and a specificity of 82%. Both tests were also used to
screen blood samples of confirmed VL patients (n = 15 ) and serum samples of
VL suspects (n = 61). The DAT found all blood samples of confirmed VL
patients positive and tested 98.4% of the serum samples of the VL suspects
positive. In contrast, rK39 detected in 9/15 blood samples (60%) antibodies
against *Leishmania* chagasi and found 85.3 % of the serum samples of the
suspected patients positive. Although the rK39 dipstick is more rapid and
user friendlier than the DAT, the latter has a superior sensitivity and
specificity. Furthermore, the reagents used for DAT do not require cold
storage, whereas the buffer of the rK39 must be stored at 4oC. Therefore,
the DAT is the most suitable test for the sero-diagnosis of VL under field
conditions.


PMID:
12452487<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=12452487>
TITLE: The sensitivity and specificity of *Leishmania* chagasi recombinant
K39 antigen in the diagnosis of American visceral leishmaniasis and in
differentiating active from subclinical
infection.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=12452487>
AUTHORS: Regina F S Braz, Eliana T Nascimento, Daniella R A Martins, Mary E
Wilson, Richard D Pearson, Steven G Reed, Selma M B Jeronimo
AFFILIATION: Department of Microbiology and Parasitology, Universidade
Federal Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
REFERENCE: Am J Trop Med Hyg 2002 Oct 67(4):344-8
The sensitivity and specificity of a *Leishmania* chagasi recombinant K39
(rK39)-based enzyme-linked immunosorbent assay (ELISA) for visceral
leishmaniasis (VL) was assessed in Natal, Brazil. Anti-rK39 antibodies were
detected in 93.3% of patients with parasitologically confirmed VL ( n = 120)
and in 33 others with clinically diagnosed disease. Anti-rK39 antibodies
decreased significantly following treatment. The presence of antibodies was
inversely correlated with development of a positive leishmanin skin test
result. Anti-rK39 antibodies were detected in only 2.9% of asymptomatic
subjects with a positive skin test result (n = 168 ). They were not detected
in healthy controls (n = 30) or in persons with Chagas' disease (n = 13) or
active tuberculosis (n = 31). Antibodies were found in only one of 13
patients with cutaneous leishmaniasis. In contrast, an ELISA using total L.
chagasi promastigote antigen was sensitive, but not specific. The results
indicate that the rK39-based ELISA is a sensitive and specific diagnostic
test for symptomatic VL and can differentiate progressive from
self-resolving infection.


PMID:
12173133<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=12173133>
TITLE: Noninvasive management of Indian visceral leishmaniasis: clinical
application of diagnosis by K39 antigen strip testing at a kala-azar
referral
unit.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=12173133>
AUTHORS: S Sundar, M Sahu, H Mehta, A Gupta, U Kohli, M Rai, J D Berman, H W
Murray
AFFILIATION: Kala-Azar Medical Research Center, Department of Medicine,
Banaras Hindu University, Institute of Medical Sciences, Varanasi, 211 005,
India. shyam_vns at satyam.net.in
REFERENCE: Clin Infect Dis 2002 Sep 35(5):581-6
Firm diagnosis of visceral leishmaniasis (kala-azar) requires organ
aspiration and microscopic examination of tissue specimens. To determine the
usefulness of noninvasive diagnosis by strip test detection of anti -K39
immunoglobulin (Ig) G antibody in blood specimens obtained by fingerstick,
143 Indian patients with suspected kala-azar (fever, splenomegaly, anemia)
were studied. Of 120 strip test-positive subjects (subjects with presumed
kala-azar [group A]), amphotericin B treatment induced clinical cure in 119.
Of 23 strip test-negative subjects ( subjects presumed to have other
diseases [group B]), 16 had other disorders diagnosed at entry, 4 responded
to empiric antimalarial therapy, 2 were proven to have kala-azar, and 1 died
elsewhere after undergoing splenic aspiration. Six months after treatment
ended, all 120 patients in group A and the 18 assessable patients in group B
were healthy. In a region in India where visceral infection is prevalent,
strip test detection of anti-K39 IgG is a clinically promising diagnostic
guide in persons with suspected kala-azar.


PMID:
12111603<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=12111603>
TITLE: Evaluation of a rapid immunochromatographic test for serodiagnosis of
visceral
leishmaniasis.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=12111603>
AUTHORS: O Brandonisio, L Fumarola, P Maggi, R Cavaliere, R Spinelli, G
Pastore
AFFILIATION: Dipartimento di Clinica Medica, Immunologia e Malattie
Infettive, Sezione di Microbiologia e Immunologia, University of Bari,
Policlinico, Piazza G. Cesare, 70124 Bari, Italy. brandoni at cimedoc.uniba.it
REFERENCE: Eur J Clin Microbiol Infect Dis 2002 Jun 21(6):461-4
The purpose of this study was to compare the performance of a rapid
immunochromatographic dipstick test for the qualitative detection of
circulating antibodies to the leishmanial recombinant antigen K39 with that
of a classical immunofluorescent antibody test for serodiagnosis of visceral
leishmaniasis. Sera from 143 Italian subjects, including 69 patients with
clinically suspected visceral leishmaniasis, 23 patients with
hypergammaglobulinemia and 51 healthy controls, were tested. The
immunochromatographic test was performed according to the manufacturer's
instructions, using antigen-impregnated nitrocellulose paper strips. The
immunofluorescent antibody test was performed according to an established
method, using promastigotes of *Leishmania* infantum zymodeme Montpellier 1
as antigen. In 11 patients, diagnosis of active *Leishmania* infection was
established by microscopic examination of biopsy samples and/or clinical
response to meglumine antimoniate. Results of the two tests correlated for
all but two sera examined. In two patients, one with proven infectious
mononucleosis and one with bacterial pneumonia, the immunofluorescent
antibody test was positive and the dipstick test was negative. In the
restricted sample of patients in whom a definitive diagnosis was
established, the immunochromatographic test was positive in 11 of 11
patients with confirmed *Leishmania* infection and negative in 103 of 103
subjects who either had other documented diseases or were healthy controls,
showing 100% sensitivity and 100% specificity.


PMID:
11986261<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=11986261>
TITLE: Predicting kala-azar disease manifestations in asymptomatic patients
with latent *Leishmania* donovani infection by detection of antibody against
recombinant K39
antigen.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=11986261>
AUTHORS: Sarman Singh, Veena Kumari, Niti Singh
AFFILIATION: Department of Laboratory Medicine, All India Institute of
Medical Sciences, New Delhi-110029, India. ssingh56 at hotmail.com
REFERENCE: Clin Diagn Lab Immunol 2002 May 9(3):568-72
Clinically visceral leishmaniasis is suspected in only a fraction of
infected persons, as the majority of these may not have clinical
manifestations and remain asymptomatic. There is scanty information on
diagnosing latent infections and predicting disease in asymptomatic persons.
We therefore carried out a study on asymptomatic contacts of patients with
visceral leishmaniasis and post-kala-azar dermal leishmaniasis by using
methods for detection of antibody to recombinant K39 (rK39) antigen. A total
of 240 patients with leishmaniasis and 150 asymptomatic contacts were tested
for anti-rK39 immunoglobulin G (IgG) and IgA antibodies. Fifty-five
asymptomatic persons were found to be seropositive. These individuals were
monitored every 3 months for 1 year . On follow-up, 43.9% of the
asymptomatic seropositive contacts developed kala-azar within the first 3
months, and a cumulative total of 69% developed kala-azar within 1 year. The
rest remained asymptomatic and self-healed the infection. The sensitivity
and specificity of rK39 enzyme-linked immunosorbent assay (ELISA) and
dipstick tests were 100%, while an in-house-developed latex agglutination
test had 80% sensitivity . The antibody profile showed that the IgG
anti-rK39 antibodies reached a titer of up to 10(-6) within 6 months of
infection, started declining thereafter, and completely disappeared in 2 to
3 years in successfully treated cases. Significant titers of IgA antibodies
were detectable a little earlier than those of IgG antibodies and were
undetectable after 6 months. The study showed that mass screening of family
members and contacts by using anti-rK39 ELISA could be a highly reliable
tool for early diagnosis and to plan prophylactic treatment of latently
infected asymptomatic carriers to eradicate kala-azar.


PMID:
11836028<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=11836028>
TITLE: Evaluation of the *Leishmania* recombinant K39 antigen as a
diagnostic marker for canine leishmaniasis and validation of a standardized
enzyme-linked immunosorbent
assay.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=11836028>
AUTHORS: A Scalone, R De Luna, G Oliva, L Baldi, G Satta, G Vesco, W
Mignone, C Turilli, R R Mondesire, D Simpson, A R Donoghue, G R Frank, L
Gradoni
AFFILIATION: Laboratorio di Parassitologia, Istituto Superiore di Sanità ,
Rome, Italy.
REFERENCE: Vet Parasitol 2002 Apr 104(4):275-85
Canine infections with *Leishmania* infantum are important as a cause of
serious disease in the dog and as a reservoir for human visceral
leishmaniasis (VL). Accurate diagnosis of canine infections is essential to
the veterinary community and for VL surveillance programs. A standardized
ELISA using a purified recombinant antigen (rK39) specific to VL was
compared to the immunofluorescent antibody test (IFAT) as the standard. The
ELISA was developed, optimized and evaluated using sera from 6368 dogs. The
standardized ELISA and IFAT results were highly concordant. The timing and
pattern of ELISA and IFAT seroconversion in dogs followed prospectively
after natural infections were very similar. Antibodies reacting with rK39
were more common in asymptomatic canine infections than reported for
subclinical human VL. The rK39 ELISA is a relatively simple and rapid assay
for assessing the infection status of dogs, and is an alternative to IFAT,
especially when screening large numbers of samples.


PMID:
11874880<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=11874880>
TITLE: Evaluation of enzyme-linked immunosorbent assay for diagnosis of
post-kala-azar dermal leishmaniasis with crude or recombinant k39
antigen.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=11874880>
AUTHORS: P Salotra, G Sreenivas, A A Nasim, B V Subba Raju, V Ramesh
AFFILIATION: Molecular Biology Lab, Institute of Pathology (ICMR),
Safdarjung Hospital, New Delhi 110-029, India. salotra at vsnl.com
REFERENCE: Clin Diagn Lab Immunol 2002 Mar 9(2):370-3
The diagnosis of post-kala-azar dermal leishmaniasis (PKDL), a dermatosis
that provides the only known reservoir for the parasite
*Leishmania*donovani in India, remains a problem. Timely recognition
and treatment of
PKDL would contribute significantly to the control of kala- azar. We
evaluated here the potential of the enzyme-linked immunosorbent assay
(ELISA) as a diagnostic tool for PKDL. Antigen prepared from promastigotes
and axenic amastigotes with parasite isolates that were derived from skin
lesions of a PKDL patient gave sensitivities of 86.36 and 92%, respectively,
in the 88 PKDL cases examined. The specificity of the ELISA test was
examined by testing groups of patients with other skin disorders (leprosy
and vitiligo) or coendemic infections (malaria and tuberculosis), as well as
healthy controls from areas where this disease is endemic or is not endemic.
A false-positive reaction was obtained in 14 of 144 (9.8%) of the controls
with the promastigote antigen and in 14 of 145 (9.7%) of the controls with
the amastigote antigen. Evaluation of the serodiagnostic potential of
recombinant k39 by ELISA revealed a higher sensitivity (94.5%) and
specificity (93.7%) compared to the other two antigens used. The data
demonstrate that ELISA with crude or recombinant antigen k39 provides a
relatively simple and less-invasive test for the reliable diagnosis of PKDL.


PMID:
11825959<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=11825959>
TITLE: Imported visceral leishmaniasis: diagnostic dilemmas and comparative
analysis of three
assays.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=11825959>
AUTHORS: Jamshaid Iqbal, Parsotam R Hira, Grover Saroj, Reeni Philip, Faiza
Al-Ali, Patrick J Madda, Ali Sher
AFFILIATION: Department of Microbiology, Faculty of Medicine, Kuwait
University, Safat, Kuwait. iqbal at hsc.kuniv.edu.kw
REFERENCE: J Clin Microbiol 2002 Feb 40(2):475-9
The present study evaluates the performances of three noninvasive
serological assays for the detection of immunoglobulin G antibodies to *
leishmania* antigen for the diagnosis of imported cases of kala azar (
visceral leishmaniasis [VL]) in a country, Kuwait, where the disease is not
endemic. A total of 323 individuals including 21 patients with documented
cases of VL, 72 individuals with suspected cases of VL, 155 patients with
other parasitic infections, and 75 healthy control individuals were tested
by indirect hemagglutination assay (IHA; Behring Diagnostics GmbH, Marburg,
Germany), indirect fluorescent-antibody assay (IFA; bioMerieux sa, Marcy
l'Etoile, France), and a qualitative membrane-based immunoassay with
recombinant *leishmania* antigen K39 ( strip-test; Intersep Ltd, Berkshire,
United Kingdom). Our data show that IHA is the most sensitive test (100%),
followed by IFA (86.6%) and the strip-test (80.0%). The strip-test was the
most specific (100%) of the three assays, followed by IFA (93.0%) and IHA (
86.0%). However, the strip-test failed to detect at least three confirmed
cases of VL. We conclude that IHA is preferred over IFA and the strip-test
for the screening of individuals with suspected cases of VL, especially in a
country where VL is not endemic and where the number of cases is regular but
limited. The details about some of the patients with VL are presented to
highlight the diversity of clinical presentations and problems encountered
in the diagnosis of VL in a country where VL is not endemic.


PMID:
11989529<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=11989529>
TITLE: Immunochromatographic strip-test detection of anti-K39 antibody in
Indian visceral
leishmaniasis.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=11989529>
AUTHORS: S Sundar, K Pai, M Sahu, V Kumar, H W Murray
AFFILIATION: Kala-Azar Medical Research Center, Banaras Hindu University,
Institute of Medical Sciences, Varanasi, India. shyam_vns at satyam.net.in
REFERENCE: Ann Trop Med Parasitol 2002 Jan 96(1):19-23
Stored sera from 429 Indian subjects were assayed to extend the analysis of
the accuracy of immunochromatographic strip-test detection of anti- K39
antibody in the non-invasive diagnosis of visceral leishmaniasis (VL ). All
225 samples from patients with proven *Leishmania* infection tested positive
[estimated sensitivity = 100%; 95% confidence interval (CI)=98 %-100%]. Sera
from 99 of the 100 symptomatic patients with other diseases were
non-reactive (estimated specificity = 99%; CI = 94%-100 %). However, samples
from 13 of the 104 apparently healthy controls showed positive strip-test
results (estimated specificity = 88%; CI = 79 %-93%), yielding an overall
specificity of 93% (190/204; CI = 88%-96%). If applied in a practical
clinical setting (on symptomatic patients in whom active VL is suspected and
other common infections have been excluded), strip testing of serum for
anti-K39 antibody should be both sensitive and specific for diagnosing VL in
India.


PMID:
11802273<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=11802273>
TITLE: Value of a dipstick based on recombinant RK39 antigen for
differential diagnosis of American visceral leishmaniasis from other
sympatric endemic diseases in
Venezuela.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=11802273>
AUTHORS: O Delgado, M D Feliciangeli, V Coraspe, S Silva, A Perez, J Arias
AFFILIATION: Instituto de Medicina Tropical, UCV, Caracas, Venezuela.
REFERENCE: Parasite 2001 Dec 8(4):355-7
A laboratory trial using recombinant rK39 dipsticks for differential
diagnosis of American visceral leishmaniasis (AVL) from other sympatric
endemic diseases which share similar clinic features (Chagas disease,
malaria, schistosomiasis and toxoplasmosis) was conducted in Venezuela. The
100% specificity of the test previously obtained in other countries was
confirmed. The use of this test at the primary health care level in
Venezuela for a rapid diagnosis of active AVL cases, which may avoid deaths,
is recommended.


PMID:
11687466<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=11687466>
TITLE: Enzyme-linked immunosorbent assay for recombinant K39 antigen in
diagnosis and prognosis of Indian visceral
leishmaniasis.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=11687466>
AUTHORS: R Kumar, K Pai, K Pathak, S Sundar
AFFILIATION: Kala-Azar Medical Research Center, Department of Medicine,
Institute of Medical Sciences, Banaras Hindu University, Varanasi-221005,
India.
REFERENCE: Clin Diagn Lab Immunol 2001 Nov 8(6):1220-4
The recombinant product (rK39) of the 39-amino-acid repeats encoded by a
kinesin-like protein-encoding gene of *Leishmania* chagasi was evaluated by
enzyme-linked immunosorbent assay (ELISA) for diagnostic potential and the
ability to predict the response to therapy in Indian kala-azar or visceral
leishmaniasis (VL); we also compared its performance with that of crude
soluble antigen (CSA). At the diagnosis of VL, the anti- rK39 antibody titer
was 59-fold higher than the anti-CSA antibody titer . With successful
therapy, antibody titers declined steeply at the end of treatment and during
follow-up. In contrast, patients who relapsed showed increased titers of
antibodies to rK39. The extremely high levels of anti-rK39 antibodies in VL
cases suggest the application of rK39 for sensitive and specific
serodiagnosis, and rK39 ELISA is also valuable in monitoring drug therapy
and detecting relapse of the disease.


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PMID:
11703291<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=11703291>
TITLE: A simple and sensitive test for field diagnosis of post kala-azar
dermal
leishmaniasis.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=11703291>
AUTHORS: P Salotra, G Sreenivas, V Ramesh, S Sundar
AFFILIATION: Molecular Biology Laboratory, Institute of Pathology (ICMR),
Safdarjung Hospital Campus, Post Box 4909, New Delhi 110, 029, India.
salotra at vsnl.com
REFERENCE: Br J Dermatol 2001 Oct 145(4):630-2
BACKGROUND: Current methods for diagnosis of post kala-azar dermal
leishmaniasis (PKDL) do not offer adequate sensitivity and specificity.
OBJECTIVES: To develop a simple and sensitive test for field diagnosis of
PKDL. METHODS: Immunochromatographic nitrocellulose strips precoated with
recombinant k39 antigen were evaluated for the detection of circulating
antibodies to leishmanial k39 in PKDL sera. A drop of serum applied to the
strip followed by buffer led to the development of two visible bands
indicating the presence of anti-k39 IgG. RESULTS: The strip test was able to
detect cases of PKDL with 91% sensitivity. The specificity of the test was
evaluated using controls with other skin diseases, other common infections
and healthy persons from endemic and non-endemic regions. Of 125 controls
examined, all were negative on the strip test, indicating 100% specificity
of the test. CONCLUSIONS: The immunochromatographic nitrocellulose strips
provide a non-invasive, rapid and accurate method for diagnosing PKDL.


PMID:
11251906<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=11251906>
TITLE: Diagnosing visceral leishmaniasis with the recombinant K39 strip
test: experience from the
Sudan.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=11251906>
AUTHORS: E E Zijlstra, Y Nur, P Desjeux, E A Khalil, A M El-Hassan, J Groen
AFFILIATION: Institute of Endemic Diseases, University of Khartoum, Sudan.
eezijlstra at malawi.net
REFERENCE: Trop Med Int Health 2001 Feb 6(2):108-13
We compared a strip test employing recombinant K39 (rK39) antigen and
protein A/colloidal gold as read-out agents with the rK39 ELISA for IgM and
IgG antibodies and the direct agglutination test (DAT) using 55 sera from
patients with parasitologically confirmed visceral leishmaniasis ( VL). The
rK39 strip test was positive in 37/55 (67%), the DAT in 50/55 ( 91%) at > or
= 1 : 1600 cut-off value and in 47/55 (85%) at > or = 1 : 6400 cut-off
value. The rK39-ELISA gave positive IgG results for all sera; those who had
a positive strip test had significantly higher IgG levels than those with a
negative strip test (31.1 (SD=3.6) and 17.7 U/ ml (SD=9.8), respectively, P
< 0.0001). A total of 31/55 (56%) sera showed a positive IgM result; of
these 27 (49%) had a positive strip test. We tested 115 apparently cured VL
patients with the strip test during follow-up; 68 were also tested with DAT.
In the strip test, 25-43 % of patients had a positive result at time points
3, 6, 9 and 12 months after treatment; for DAT (cut-off > or = 1 : 1600)
these results were 67-83%. In neither test did a significant decrease in
positivity rates occur over time (P=0.37 for the strip test, P=0.17 for the
DAT). No correlation (P=0.33) was found between a positive strip test and a
positive DAT result (cut-off > or = 1: 1600), indicating that the strip test
and DAT are complementary rather than interchangeable. Of 61 endemic
controls two (3%) had a positive strip test result; both had a positive
leishmanin skin test. The rK39 strip test has the ideal format for use in
the field, but its sensitivity is limited; like DAT, but to a lesser extent,
it remains positive after treatment.


PMID:
11164745<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=11164745>
TITLE: Latex agglutination test for the detection of urinary antigens in
visceral
leishmaniasis.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=11164745>
AUTHORS: Z J Attar, M L Chance, S el-Safi, J Carney, A Azazy, M El-Hadi, C
Dourado, M Hommel
AFFILIATION: Molecular Biology and Immunology Division, Liverpool School of
Tropical Medicine, L3 5QA, Liverpool, UK.
REFERENCE: Acta Trop 2001 Jan 78(1):11-6
This paper describes a new latex agglutination test ('KATEX') for the
detection of leishmanial antigen in the urine of patients with visceral
leishmaniasis. In preliminary laboratory trials, using urine collected from
well-defined cases and controls from Brazil, Yemen and Nepal, the test had
100% specificity and a sensitivity between 68 and 100%. When used in a
time-course experiment in cotton rats infected with *Leishmania* donovani,
the test became positive 1 week after inoculation and antigen levels in
urine declined rapidly after chemotherapy (the test was negative before the
end of the course of treatment). Finally, in an integrated study performed
in Sudan, KATEX was compared to microscopy and four different serological
tests in a group of 73 patients having presented with clinical
manifestations suggestive of visceral leishmaniasis. Compared to microscopy,
KATEX performed better than any single serological test in predicting
positivity and a particularly good result was obtained by combining KATEX
and the direct agglutination test (DAT).


PMID:
11388508<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=11388508>
TITLE: Use of the recombinant K39 dipstick test and the direct agglutination
test in a setting endemic for visceral leishmaniasis in
Nepal.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=11388508>
AUTHORS: C Bern, S N Jha, A B Joshi, G D Thakur, M B Bista
AFFILIATION: Division of Parasitic Diseases, National Center for Infectious
Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
30341, USA.
REFERENCE: Am J Trop Med Hyg 2000 Sep-Oct 63(3-4):153-7
We evaluated the field use of two serologic tests for visceral leishmaniasis
(VL), the direct agglutination test (DAT) and rK39 dipstick test, in the
context of a case-control study. Most VL cases in Nepal are currently
diagnosed on clinical grounds and with relatively non-specific tests such as
the formol-gel test. Among 14 newly diagnosed VL patients with bone-marrow
slides confirmed positive in two independent laboratories, the sensitivity
of both tests was 100%. Among 113 controls with no personal or household
history of VL, the specificity of the rK39 was 100% while that of the DAT
was 93%. The rK39 was less expensive than DAT, and has the advantages of
ease of use and obtaining results within minutes. The wider use of the rK39
dipstick test could improve the specificity of VL diagnosis in Nepal.


PMID:
9729541<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=9729541>
TITLE: rK39 enzyme-linked immunosorbent assay for diagnosis of
*Leishmania*donovani
infection.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=9729541>
AUTHORS: E E Zijlstra, N S Daifalla, P A Kager, E A Khalil, A M El-Hassan, S
G Reed, H W Ghalib
AFFILIATION: Institute of Endemic Diseases, University of Khartoum,
Khartoum, Sudan.
REFERENCE: Clin Diagn Lab Immunol 1998 Sep 5(5):717-20
The rK39 enzyme-linked immunosorbent assay (ELISA) was compared with the
direct agglutination test (DAT) for *Leishmania* donovani infection in the
Sudan. rK39 ELISA proved more sensitive than DAT in diagnosis of kala-azar
(93 and 80%, respectively); both tests may remain positive up to 24 months
after treatment. For patients with post-kala-azar dermal leishmaniasis and
individuals with subclinical infection, rK39 ELISA performed as well as DAT
but could detect infection 6 months earlier in approximately 40% of
patients. Conversion in DAT and rK39 ELISA also occurred in leishmanin skin
test (LST)-positive individuals, suggesting active parasite replication
(rK39 is an amastigote antigen) in these presumably immune individuals. In
contrast to DAT, rK39 ELISA also detected infection in randomly selected
LST-positive individuals (in four of six) and endemicity (LST-negative)
controls (in one of five). rK39 ELISA appears more sensitive than DAT and
may prove an important tool in epidemiological studies.


PMID:
9593022<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=9593022>
TITLE: A cloned antigen (recombinant K39) of *Leishmania* chagasi diagnostic
for visceral leishmaniasis in human immunodeficiency virus type 1 patients
and a prognostic indicator for monitoring patients undergoing drug
therapy.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=9593022>
AUTHORS: R L Houghton, M Petrescu, D R Benson, Y A Skeiky, A Scalone, R
Badaró, S G Reed, L Gradoni
AFFILIATION: Corixa Corp., Seattle, Washington 98104, USA.
houghton at corixa.com
REFERENCE: J Infect Dis 1998 May 177(5):1339-44
Serologic assays using crude antigens for the diagnosis of visceral
leishmaniasis in human immunodeficiency virus type 1 (HIV)-seropositive
patients have been shown to lack sensitivity and specificity, particularly
in AIDS patients. Antibodies to a cloned antigen, recombinant (r) K39, of *
Leishmania* chagasi are specific for members of the *Leishmania* donovani
complex and have been shown to indicate active disease in immunocompetent
persons. This study demonstrated that antibodies to rK39 were also
detectable in HIV-seropositive patients coinfected with
*Leishmania*infantum. Furthermore, the rK39 ELISA was more sensitive
than an IFA for
detecting L. infantum infections in patients with AIDS. In addition,
antibody titers to rK39 in HIV-negative patients infected with L. infantum
or L. chagasi declined during treatment with meglumine antimoniate or
liposomal amphotericin B. In contrast, most patients who clinically relapsed
showed increased antibody titers to rK39. These data demonstrate the
diagnostic and prognostic utility of rK39 in detecting active visceral
leishmaniasis.


PMID:
9492776<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=9492776>
TITLE: Rapid accurate field diagnosis of Indian visceral
leishmaniasis.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=9492776>
AUTHORS: S Sundar, S G Reed, V P Singh, P C Kumar, H W Murray
AFFILIATION: Kala-Azar Medical Research Center, Banaras Hindu University,
Varanasi, India.
REFERENCE: Lancet 1998 Feb 351(9102):563-5
BACKGROUND: A firm diagnosis of visceral leishmaniasis (kala-azar) requires
demonstration of the parasite in organ aspirates or tissue biopsy samples.
The aim of this prospective study was to assess the diagnostic usefulness of
non-invasive testing for antibody to the leishmanial antigen K39 by means of
antigen-impregnated nitrocellulose paper strips adapted for use under field
conditions. METHODS: One drop of peripheral blood is applied to the
hitrocellulose strip. Three drops of test buffer (phosphate-buffered saline
plus bovine serum albumin) are added to the dried blood. The development of
two visible bands indicates presence of IgG anti-K39. 323 consecutive
patients with suspected kala-azar referred to two specialist units in India,
and 25 healthy controls, provided fingerstick blood samples for the test.
Spleen aspirates were taken from 250 patients. FINDINGS: Kala-azar was
confirmed by microscopy of spleen-aspirate smears in 127 patients. The K39
strip test was positive in all 127; the estimated sensitivity was therefore
100% (95% CI 98-100). Four patients had positive strip tests but negative
aspirate smears; all four responded to treatment for leishmaniasis. 217
individuals, including the 25 healthy controls, 73 patients with malaria or
tuberculosis, and 119 spleen-aspirate-negative patients who had presumed
malaria or cirrhosis (79) or no final diagnosis (40), had negative
strip-test results. None of the 119 aspirate-negative patients developed
evidence of kala-azar during 3-6 months of follow-up. The estimated
specificity of the strip test was 98 % (95-100; 217/221). INTERPRETATION:
Detection of anti-K39 by immunochromatographic strip testing is a rapid and
non-invasive method of diagnosing kala-azar, which has good sensitivity and
specificity and is well suited for use in field conditions.


PMID:
8627048<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=8627048>
TITLE: rK39: a cloned antigen of *Leishmania* chagasi that predicts active
visceral
leishmaniasis.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=8627048>
AUTHORS: R Badaró, D Benson, M C Eulálio, M Freire, S Cunha, E M Netto, D
Pedral-Sampaio, C Madureira, J M Burns, R L Houghton, J R David, S G Reed
AFFILIATION: Federal University of Bahia, Salvador, Brazil.
REFERENCE: J Infect Dis 1996 Mar 173(3):758-61
The diagnosis of visceral leishmaniasis (VL), a serious and often fatal
parasitic disease caused by members of the *Leishmania* donovani complex,
remains problematic. Current methods rely on clinical criteria, parasite
identification in aspirate material, and serology. The latter methods use
crude antigen preparations lacking in specificity. A previously described
cloned antigen, rK39, of *Leishmania* specific for all members of the L.
donovani complex (L. chagasi, L. donovani, L. infantum) was very useful in
the serodiagnosis by ELISA of both human and canine VL. The present study
demonstrated that rK39 seroreactivity correlated with active disease. The
sera from early or self-healing infected subjects reacted with leishmanial
lysate and were generally nonreactive with rK39 . These data demonstrate the
utility of rK39 in the serodiagnosis of VL and as an indicator of active
disease.


PMID:
8544037<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=8544037>
TITLE: Diagnostic and prognostic value of K39 recombinant antigen in Indian
leishmaniasis.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=8544037>
AUTHORS: S Singh, A Gilman-Sachs, K P Chang, S G Reed
AFFILIATION: Department of Microbiology/Immunology, University of Health
Sciences/Chicago Medical School, Illinois 60064, USA.
REFERENCE: J Parasitol 1995 Dec 81(6):1000-3
The recombinant product (rK39) of the 39 amino acid repeats encoded by a
kinesin-like gene of visceral *Leishmania* spp. was further evaluated by
enzyme-linked immunosorbent assay (ELISA) for its diagnostic potential in
Indian kala-azar (VL) and post kala-azar dermal leishmaniasis (PKDL ).
Anti-rK39 antibodies were highly positive in 20 symptomatic cases, including
6 resistant to single or double chemotherapy, but became negligible or
absent in 9 recently cured patients. Endpoint titration of samples from the
20 active cases showed that the anti-rK39 IgG titers fell within a wide
range of 10(-2) to > 10(-6), and that their mean was > 1 order of magnitude
higher than in VL reported previously. The anti- rK39 IgG titers were
correlated with parasite burden found in the patients and remained
undiminished in those refractory to chemotherapy. These results indicate
that: (1) the K39 epitope is conserved in Indian strains of
*Leishmania*donovani, (2) the extremely high levels of K39 antibodies
in both VL and
PKDL suggest the application of rK39 for sensitive and specific
serodiagnosis, and (3) rK39 ELISA is also valuable for prognostic evaluation
of both diseases.


PMID:
7992333<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=7992333>
TITLE: Serodiagnosis of Asian leishmaniasis with a recombinant antigen from
the repetitive domain of a *Leishmania*
kinesin.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=7992333>
AUTHORS: J Q Qu, L Zhong, M Masoom-Yasinzai, M Abdur-Rab, H S Aksu, S G
Reed, K P Chang, A Gilman-Sachs
AFFILIATION: Department of Microbiology/Immunology, University of Health
Sciences/Chicago Medical School, North Chicago, Illinois 60064.
REFERENCE: Trans R Soc Trop Med Hyg 1994 Sep-Oct 88(5):543-5
rK39 is a recombinant product of the 39 amino acid repeats found in a
kinesin-like gene of visceral *Leishmania* spp. This and other antigens were
compared for immunodiagnostic potential by enzyme-linked immunosorbent assay
with sera from confirmed cases of Asian cutaneous and visceral
leishmaniasis. In preliminary trials, rK39 proved superior to 2 purified *
Leishmania* antigens, a cytosolic protein (p36) and a membrane protein
(gp63), for immunodiagnosis of visceral leishmaniasis. Of the 53 visceral
cases from China and Pakistan assayed, 52 were seropositive (98%) at a
10(-1) dilution with 36 ng of rK39. End point titrations of 27 highly
positive samples yielded anti-rK39 antibody titres ranging from c. 10(-3) to
beyond 10(-4). Antigen titrations with one positive serum further revealed
that rK39 was 25-fold more sensitive than *Leishmania* whole cell soluble
lysates. 31 cutaneous leishmaniasis cases from Turkey assayed for anti-rK39
antibody gave reactions ranging from negative or marginally positive to
positive. In Brazil, all cutaneous and mucocutaneous leishmaniasis cases
gave negative results in this assay.


PMID:
7802487<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=7802487>
TITLE: Sensitivity and specificity of a recombinant *Leishmania* chagasi
antigen in the serodiagnosis of visceral
leishmaniasis.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=7802487>
AUTHORS: R Badaro, M C Eulalio, D Benson, M Freire, J C Miranda, D
Pedral-Sampaio, J M Burns, J R David, W D Johnson, S G Reed
AFFILIATION: Federal University of Bahia, Brazil.
REFERENCE: Arch Inst Pasteur Tunis 1993 Jul-Oct 70(3-4):331-2


PMID:
8421715<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=8421715>
TITLE: Molecular characterization of a kinesin-related antigen of *
Leishmania* chagasi that detects specific antibody in African and American
visceral
leishmaniasis.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=8421715>
AUTHORS: J M Burns, W G Shreffler, D R Benson, H W Ghalib, R Badaro, S G
Reed
AFFILIATION: Seattle Biomedical Research Institute, WA 98109.
REFERENCE: Proc Natl Acad Sci U S A 1993 Jan 90(2):775-9
We report the cloning of a *Leishmania* chagasi antigen gene and an
evaluation of leishmaniasis patient antibody responses to the recombinant
protein, rK39. rK39 contains a 39-amino acid repeat that is part of a
230-kDa protein predominant in L. chagasi tissue amastigotes. Sequence
analyses showed this protein, LcKin, to be related to the kinesin
superfamily of motor proteins. Southern blot analyses demonstrated
LcKin-related sequences in seven species of *Leishmania*, with conservation
of the repeat between L. chagasi and *Leishmania* donovani. Serological
evaluation revealed that 98% (56 of 57) of Brazilian and 100% (52 of 52) of
Sudanese visceral leishmaniasis patients have high antibody levels to the
rK39 repeat. Detectable anti- K39 antibody was virtually absent in cutaneous
and mucosal leishmaniasis patients and in individuals infected with
Trypanosoma cruzi. The data show that rK39 may replace crude parasite
antigens as a basis for serological diagnosis of visceral leishmaniasis.


REQUEST: [ sand fly NOT culicoides ]
(1 article matches this request. 1 article matching other requests removed)

REQUEST: [ sandfly NOT culicoides ]
(1 article matches this request)

PMID:
16729709<http://refscout.com/cgi-bin/exportAbstract.pl?base=medline-28-1.xml&id=16729709>
TITLE: Detection of a malaria parasite (Plasmodium mexicanum) in
ectoparasites (mites and ticks), and possible significance for
transmission.<http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=16729709>
AUTHORS: Jos J Schall, Thomas C Smith
AFFILIATION: Department of Biology, University of Vermont, Burlington,
Vermont 05405, USA. jschall at zoo.uvm.edu
REFERENCE: J Parasitol 2006 Apr 92(2):413-5
Two species of sandflies (Lutzomyia) are competent vectors of Plasmodium
mexicanum, a malaria parasite of lizards. The very patchy distribution of
sites with high P. mexicanum prevalence in the lizards, and often low or
even nil *sandfly* density at such sites, provoked an evaluation of 2 common
lizard ectoparasites, the tick Ixodes pacificus and the mite Geckobiella
occidentalis, as potential passive vectors. Plasmodium sp.- specific
polymerase chain primers were used to amplify a long segment of the
mitochondrial cytochrome b gene that is unlikely to survive intact if the
parasite cells are killed within a blood-feeding arthropod. The segment was
strongly amplified from sandflies (the positive control for the method) from
1 to 96 hr postfeeding on an infected lizard. For ticks , the gene fragment
was poorly amplified at 0 hr postfeed, and not amplified after 2 hr. In
contrast, strong amplification of the parasite DNA was observed from mites
from 0 to 20 hr postfeed, and weak amplification even at 96 hr.


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