<html xmlns:v="urn:schemas-microsoft-com:vml" xmlns:o="urn:schemas-microsoft-com:office:office" xmlns:w="urn:schemas-microsoft-com:office:word" xmlns:st1="urn:schemas-microsoft-com:office:smarttags" xmlns="http://www.w3.org/TR/REC-html40">
<head>
<meta http-equiv=Content-Type content="text/html; charset=iso-8859-1">
<meta name=Generator content="Microsoft Word 11 (filtered medium)">
<!--[if !mso]>
<style>
v\:* {behavior:url(#default#VML);}
o\:* {behavior:url(#default#VML);}
w\:* {behavior:url(#default#VML);}
.shape {behavior:url(#default#VML);}
</style>
<![endif]--><o:SmartTagType
namespaceuri="urn:schemas-microsoft-com:office:smarttags" name="City"/>
<o:SmartTagType namespaceuri="urn:schemas-microsoft-com:office:smarttags"
name="PlaceName"/>
<o:SmartTagType namespaceuri="urn:schemas-microsoft-com:office:smarttags"
name="PlaceType"/>
<o:SmartTagType namespaceuri="urn:schemas-microsoft-com:office:smarttags"
name="country-region"/>
<o:SmartTagType namespaceuri="urn:schemas-microsoft-com:office:smarttags"
name="place"/>
<!--[if !mso]>
<style>
st1\:*{behavior:url(#default#ieooui) }
</style>
<![endif]-->
<style>
<!--a:link
{mso-style-priority:99;}
span.MSOHYPERLINK
{mso-style-priority:99;}
a:visited
{mso-style-priority:99;}
span.MSOHYPERLINKFOLLOWED
{mso-style-priority:99;}
p
{mso-style-priority:99;}
/* Font Definitions */
@font-face
{font-family:Tahoma;
panose-1:2 11 6 4 3 5 4 4 2 4;}
@font-face
{font-family:Calibri;
panose-1:2 15 5 2 2 2 4 3 2 4;}
/* Style Definitions */
p.MsoNormal, li.MsoNormal, div.MsoNormal
{margin:0in;
margin-bottom:.0001pt;
font-size:12.0pt;
font-family:"Times New Roman";}
a:link, span.MsoHyperlink
{color:blue;
text-decoration:underline;}
a:visited, span.MsoHyperlinkFollowed
{color:purple;
text-decoration:underline;}
p
{mso-margin-top-alt:auto;
margin-right:0in;
mso-margin-bottom-alt:auto;
margin-left:0in;
font-size:12.0pt;
font-family:"Times New Roman";}
span.EmailStyle18
{mso-style-type:personal;
font-family:Calibri;
color:#1F497D;}
span.EmailStyle19
{mso-style-type:personal;
font-family:Arial;
color:navy;}
span.EmailStyle20
{mso-style-type:personal;
font-family:Calibri;
color:#1F497D;}
span.EmailStyle21
{mso-style-type:personal;
font-family:Arial;
color:navy;}
span.EmailStyle23
{mso-style-type:personal-reply;
font-family:Arial;
color:navy;}
@page Section1
{size:8.5in 11.0in;
margin:1.0in 1.0in 1.0in 1.0in;}
div.Section1
{page:Section1;}
/* List Definitions */
@list l0
{mso-list-id:122844795;
mso-list-type:hybrid;
mso-list-template-ids:1950523954 67698703 67698713 67698715 67698703 67698713 67698715 67698703 67698713 67698715;}
@list l0:level1
{mso-level-tab-stop:.5in;
mso-level-number-position:left;
text-indent:-.25in;}
@list l1
{mso-list-id:136997033;
mso-list-template-ids:-964259926;}
@list l2
{mso-list-id:199368084;
mso-list-template-ids:-701072380;}
@list l2:level1
{mso-level-start-at:3;
mso-level-tab-stop:.5in;
mso-level-number-position:left;
text-indent:-.25in;}
@list l3
{mso-list-id:203715620;
mso-list-type:hybrid;
mso-list-template-ids:927635716 67698703 67698713 67698715 67698703 67698713 67698715 67698703 67698713 67698715;}
@list l3:level1
{mso-level-tab-stop:.5in;
mso-level-number-position:left;
text-indent:-.25in;}
@list l3:level2
{mso-level-tab-stop:1.0in;
mso-level-number-position:left;
text-indent:-.25in;}
@list l3:level3
{mso-level-tab-stop:1.5in;
mso-level-number-position:left;
text-indent:-.25in;}
@list l3:level4
{mso-level-tab-stop:2.0in;
mso-level-number-position:left;
text-indent:-.25in;}
@list l3:level5
{mso-level-tab-stop:2.5in;
mso-level-number-position:left;
text-indent:-.25in;}
@list l3:level6
{mso-level-tab-stop:3.0in;
mso-level-number-position:left;
text-indent:-.25in;}
@list l3:level7
{mso-level-tab-stop:3.5in;
mso-level-number-position:left;
text-indent:-.25in;}
@list l3:level8
{mso-level-tab-stop:4.0in;
mso-level-number-position:left;
text-indent:-.25in;}
@list l3:level9
{mso-level-tab-stop:4.5in;
mso-level-number-position:left;
text-indent:-.25in;}
@list l4
{mso-list-id:500897440;
mso-list-template-ids:1242229252;}
@list l4:level1
{mso-level-start-at:2;
mso-level-tab-stop:.5in;
mso-level-number-position:left;
text-indent:-.25in;}
@list l5
{mso-list-id:574625700;
mso-list-template-ids:1362415660;}
@list l5:level1
{mso-level-start-at:4;
mso-level-tab-stop:.5in;
mso-level-number-position:left;
text-indent:-.25in;}
ol
{margin-bottom:0in;}
ul
{margin-bottom:0in;}
-->
</style>
</head>
<body lang=EN-US link=blue vlink=purple style='word-wrap: break-word;
-webkit-nbsp-mode: space;-webkit-line-break: after-white-space'>
<div class=Section1>
<div>
<ol style='margin-top:0in' start=1 type=1>
<li class=MsoNormal style='color:navy;mso-list:l0 level1 lfo7'><font size=2
color=navy face=Arial><span style='font-size:10.0pt;font-family:Arial'>Good
suggestion. It has been done to isolate non-cultivable Leishmania by a
number of our colleagues with success in the past. Our Chinese colleagues,
for example, were about to grow two isolates of L infantum variants from CL
lesion aspirates by ip inoculation into Chinese hamsters, although it took
up to six months to get a very modest LD burden in the spleen and liver. Inoculation
of splenic amastigotes into 3N resulted in the appearance of promatigotes,
which can be passaged continuously, although the peak cell density is low.
The culture is unstable and requires extra attention to keep it going. After
going through all these efforts, one would like to take these
promastigotes as representative of the Leishmania in the original lesions.
That may well be the case, although injection of these promastigotes into
Chinese hamsters produce no lesion – a common finding for most, if
not all in vitro cultured promastigotes of L donovani/infantum. <o:p></o:p></span></font></li>
</ol>
<p class=MsoNormal style='margin-left:.25in'><font size=2 color=navy
face=Arial><span style='font-size:10.0pt;font-family:Arial;color:navy'><o:p> </o:p></span></font></p>
<ol style='margin-top:0in' start=2 type=1>
<li class=MsoNormal style='color:navy;mso-list:l0 level1 lfo7'><font size=2
color=navy face=Arial><span style='font-size:10.0pt;font-family:Arial'>Leishmania
comparative genomic, transcriptomic and proteomic analyses are going on
and expected to be informative. VL-specific markers are already available,
e. g. K39, A2, etc. In addition, there is a need to elucidate the genetic
mechanism of Leishmania in relation to Darwinian theory and Mendelian
inheritance in order to understand their evolutionary phylogeny and
speciation into different disease-causing parasites. <o:p></o:p></span></font></li>
</ol>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>KP<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'><o:p> </o:p></span></font></p>
<div class=MsoNormal align=center style='text-align:center'><font size=3
face="Times New Roman"><span style='font-size:12.0pt'>
<hr size=2 width="100%" align=center tabindex=-1>
</span></font></div>
<p class=MsoNormal><b><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma;font-weight:bold'>From:</span></font></b><font size=2
face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'> Farrokh Modabber
[mailto:fmodabber@dndi.org] <br>
<b><span style='font-weight:bold'>Sent:</span></b> Sunday, June 05, 2011 1:44
PM<br>
<b><span style='font-weight:bold'>To:</span></b> Chang, Kwang-Poo<br>
<b><span style='font-weight:bold'>Cc:</span></b> mmukhtar@tropmedicine.org;
Sharman; Petr Volf; Hiro Goto; elfadil abass; vishwamohan_katoch@yahoo.co.in;
lalit Kant ICMR; leish-l@lineu.icb.usp.br<br>
<b><span style='font-weight:bold'>Subject:</span></b> Re: [Leish-l] inquiry</span></font><o:p></o:p></p>
</div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'>Dear All,<o:p></o:p></span></font></p>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'>1- Try taking a few Balb/c mice to the field and inject your specimens,
depending on the suspected organism, to different sites i.e. ear, i.v., id or
sc. Harvest a week or several weeks later from the site of injection,
draining lymph node or spleen. Usually, contaminant will not survive.<o:p></o:p></span></font></p>
</div>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'>2- Patrick Bastien mentioned an important point and said he does not
want to start a discussion - what a pity! The point is that neither
isoenzyme nor the genetic markers that have been used for identification of <i><span
style='font-style:italic'>Leishmania</span></i> are biological markers. They
have been very useful tools to study evolution and inter-relations of different
species, but not defining necessarily the disease they produce (their biology).
All the variants of an isoenzyme have the same enzymatic activity only
somewhere else in the molecule a change occurred that makes it migrate
differently, but does not grossly change its enzymatic activity.
Molecular markers used so far are not biological markers either. Of
course if parasites are closely related they would tend to share many biological
markers as well. This fact has caused a confusion and many take
non-biological markers to define the biology of a parasite: <i><span
style='font-style:italic'>L. donovani</span></i> that causes CL, or <i><span
style='font-style:italic'>L. tropic</span></i> that grows and produces a lesion
in mice! The biological markers to differentiate between species are
few and ancient and no one is too keen to use them, rightly because they are
somewhat inaccurate and cumbersome. They were based on epidemiology
(anthroponotic vs zoonotic), the general form of disease they produced, predominant
vector and reservoir, etc. <i><span style='font-style:italic'>L. tropic</span></i>
is defined by being anthoponotic, transmitted primarily by <i><span
style='font-style:italic'>P.</span></i> <i><span style='font-style:italic'>sergenti</span></i>,
would not produce CL in mice, and the CL it produces in humans tend to be the
dry type (not in all cases), and takes a longer time to self cure (over a year
in general). As opposed to <i><span style='font-style:italic'>L. major</span></i>,
that would produce CL (and or VL) in mice i.e. Balb/c, is zoonotic, transmitted
generally by <i><span style='font-style:italic'>P. papatasi</span></i> or a few
others but not <i><span style='font-style:italic'>sergenti</span></i> lesions
are generally the wet type (not all), and tend to heal in a few months. <o:p></o:p></span></font></p>
</div>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'>I hope we would have some efforts towards using genomics and other
modern tools for identifying biological markers.<o:p></o:p></span></font></p>
</div>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'>Thanks,<o:p></o:p></span></font></p>
</div>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'>Farrokh Modabber <o:p></o:p></span></font></p>
</div>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><o:p> </o:p></span></font></p>
</div>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><o:p> </o:p></span></font></p>
</div>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> <o:p></o:p></span></font></p>
<div>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'>On Jun 2, 2011, at 8:33 PM, Chang, Kwang-Poo wrote:<o:p></o:p></span></font></p>
</div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><br>
<br>
<o:p></o:p></span></font></p>
<u1:smarttagtype namespaceuri="urn:schemas-microsoft-com:office:smarttags" name="City"><u1:smarttagtype namespaceuri="urn:schemas-microsoft-com:office:smarttags" name="PlaceType"><u1:smarttagtype namespaceuri="urn:schemas-microsoft-com:office:smarttags" name="PlaceName"><u1:smarttagtype namespaceuri="urn:schemas-microsoft-com:office:smarttags" name="country-region"><u1:smarttagtype namespaceuri="urn:schemas-microsoft-com:office:smarttags" name="place"><u1:smarttagtype namespaceuri="urn:schemas-microsoft-com:office:smarttags" name="PersonName"><!--[if gte mso 9]><xml>
<u1:shapedefaults u2:ext="edit" spidmax="1026"/>
</xml><![endif]--><!--[if gte mso 9]><xml>
<u1:shapelayout u3:ext="edit">
<u1:idmap u3:ext="edit" data="1"/>
</u1:shapelayout>
</xml><![endif]-->
<div bgcolor=white link=blue vlink=purple name="Compose message area"
id=MailContainerBody>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>Dear Maowia,<u1:p></u1:p></span></font><o:p></o:p></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'><u1:p> </u1:p></span></font><o:p></o:p></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>Thanks again for the info.<u1:p></u1:p></span></font><o:p></o:p></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'><u1:p> </u1:p></span></font><o:p></o:p></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>Are there any record available for the
number of successful isolations versus the total number attempted for a given
endemic site ?<u1:p></u1:p></span></font><o:p></o:p></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'><u1:p> </u1:p></span></font><o:p></o:p></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>KP<u1:p></u1:p></span></font><o:p></o:p></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'><u1:p> </u1:p></span></font><o:p></o:p></p>
<div>
<div class=MsoNormal align=center style='text-align:center'><font size=3
face="Times New Roman"><span style='font-size:12.0pt'>
<hr size=2 width="100%" align=center tabindex=-1>
</span></font></div>
<p class=MsoNormal><b><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma;font-weight:bold'>From:</span></font></b><font size=2
face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'> Maowia Mukhtar
[mailto:<st1:personname u4:st="on"><a href="mailto:mmukhtar@tropmedicine.org">mmukhtar@tropmedicine.org</a></st1:personname>]
<br>
<b><span style='font-weight:bold'>Sent:</span></b> Wednesday, June 01, 2011
10:41 PM<br>
<b><span style='font-weight:bold'>To:</span></b> Chang, Kwang-Poo; 'Sharman';
'Petr Volf'; 'Hiro Goto'; 'elfadil abass'; <a
href="mailto:vishwamohan_katoch@yahoo.co.in">vishwamohan_katoch@yahoo.co.in</a>;
'lalit Kant ICMR'<br>
<b><span style='font-weight:bold'>Cc:</span></b> <a
href="mailto:leish-l@lineu.icb.usp.br">leish-l@lineu.icb.usp.br</a><br>
<b><span style='font-weight:bold'>Subject:</span></b> RE: [Leish-l] inquiry</span></font><u1:p></u1:p><o:p></o:p></p>
</div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><u1:p> </u1:p><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'>Dear KP,<u1:p></u1:p></span></font><o:p></o:p></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'>Thanks for your
comments and valuable notes. We have a high success rate inc culturing
Leishmania from clinical aspirates. We have even succeeded in culturing
Leishmania directly from PKDL lesions without using hamsters although the
parasite is known to be scarce in these lesions. We have noticed that the
rate of success of cultures varies between endemic regions in <st1:country-region u4:st="on"><st1:place u4:st="on"><st1:country-region
w:st="on"><st1:place w:st="on">Sudan</st1:place></st1:country-region></st1:place></st1:country-region>
as well as between the clinical forms. Sudanese Leishmania donovani is
known to be different from the Indian donovani even in their response to
antileishmania drugs and in their reaction using different diagnostic serology
tests. <u1:p></u1:p></span></font><o:p></o:p></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'>Best regards<u1:p></u1:p></span></font><o:p></o:p></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'>Maowia<u1:p></u1:p></span></font><o:p></o:p></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'><u1:p> </u1:p></span></font><o:p></o:p></p>
<div>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'><u1:p> </u1:p></span></font><o:p></o:p></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'><u1:p> </u1:p></span></font><o:p></o:p></p>
<p class=MsoNormal><b><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D;font-weight:bold'>Professor
Maowia M. Mukhtar<u1:p></u1:p></span></font></b><o:p></o:p></p>
<p class=MsoNormal><st1:place u4:st="on"><st1:placetype u4:st="on"><st1:place
w:st="on"><st1:PlaceType w:st="on"><b><font size=2 color="#1f497d"
face=Calibri><span style='font-size:11.0pt;font-family:Calibri;color:#1F497D;
font-weight:bold'>Institute</span></font></b></st1:PlaceType><b><font size=2
color="#1f497d" face=Calibri><span style='font-size:11.0pt;font-family:Calibri;
color:#1F497D;font-weight:bold'></st1:placetype> of <st1:placename u4:st="on"><st1:PlaceName
w:st="on">Endemic</st1:placename></st1:PlaceName></span></font></b></st1:place></st1:place><b><font
size=2 color="#1f497d" face=Calibri><span style='font-size:11.0pt;font-family:
Calibri;color:#1F497D;font-weight:bold'> Diseases<u1:p></u1:p></span></font></b><o:p></o:p></p>
<p class=MsoNormal><st1:place u4:st="on"><st1:placetype u4:st="on"><st1:place
w:st="on"><st1:PlaceType w:st="on"><b><font size=2 color="#1f497d"
face=Calibri><span style='font-size:11.0pt;font-family:Calibri;color:#1F497D;
font-weight:bold'>University</span></font></b></st1:PlaceType><b><font
size=2 color="#1f497d" face=Calibri><span style='font-size:11.0pt;font-family:
Calibri;color:#1F497D;font-weight:bold'></st1:placetype> of <st1:placename u4:st="on"><st1:PlaceName
w:st="on">Khartoum</st1:placename></st1:PlaceName></span></font></b></st1:place></st1:place><o:p></o:p></p>
<u1:p></u1:p>
<p class=MsoNormal><b><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D;font-weight:bold'>P.O.
Box 11463, khartoum, Sudan<u1:p></u1:p></span></font></b><o:p></o:p></p>
<p class=MsoNormal><st1:city u4:st="on"><st1:place u4:st="on"><st1:City w:st="on"><st1:place
w:st="on"><b><font size=2 color="#1f497d" face=Calibri><span style='font-size:
11.0pt;font-family:Calibri;color:#1F497D;font-weight:bold'>Mobile</span></font></b></st1:place></st1:City></st1:place></st1:city><b><font
size=2 color="#1f497d" face=Calibri><span style='font-size:11.0pt;font-family:
Calibri;color:#1F497D;font-weight:bold'>; +249912234268<u1:p></u1:p></span></font></b><o:p></o:p></p>
<p class=MsoNormal><b><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D;font-weight:bold'>Fax:
+249183779712<u1:p></u1:p></span></font></b><o:p></o:p></p>
</div>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'><u1:p> </u1:p></span></font><o:p></o:p></p>
<div>
<div style='border:none;border-top:solid #B5C4DF 1.0pt;padding:3.0pt 0in 0in 0in'>
<p class=MsoNormal><b><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma;font-weight:bold'>From:</span></font></b><font size=2
face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'> Chang, Kwang-Poo
[mailto:KwangPoo.Chang@rosalindfranklin.edu] <br>
<b><span style='font-weight:bold'>Sent:</span></b> 02 June 2011 01:42<br>
<b><span style='font-weight:bold'>To:</span></b> mmukhtar; Sharman; Petr Volf;
Hiro Goto; elfadil abass; <a href="mailto:vishwamohan_katoch@yahoo.co.in">vishwamohan_katoch@yahoo.co.in</a>;
lalit Kant ICMR<br>
<b><span style='font-weight:bold'>Cc:</span></b> <a
href="mailto:leish-l@lineu.icb.usp.br">leish-l@lineu.icb.usp.br</a>; Chang,
Kwang-Poo<br>
<b><span style='font-weight:bold'>Subject:</span></b> RE: [Leish-l] inquiry<u1:p></u1:p></span></font><o:p></o:p></p>
</div>
</div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><u1:p> </u1:p><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>Dear Maowia,<u1:p></u1:p></span></font><o:p></o:p></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'><u1:p> </u1:p></span></font><o:p></o:p></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>Gald to hear from you with your
work-in-progress. May I ask you some questions and share with you some info
from my very limited experience with Sudanese L donovani ? Please correct my
statements, if inccorrect.<u1:p></u1:p></span></font><o:p></o:p></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'><u1:p> </u1:p></span></font><o:p></o:p></p>
<ol style='margin-top:0in' start=1 type=1>
<li class=MsoNormal style='color:navy;mso-list:l3 level1 lfo3'><font size=2
color=navy face=Arial><span style='font-size:10.0pt;font-family:Arial'>“difficult
to maintain” means that the promastigotes emerge after incubation of
lesion aspirates/punctures in appropriate media and replicate during
successive passages, but are low in cell density and easily lost during
repetitive passages for continuous cultivation ?<u1:p></u1:p></span></font><o:p></o:p></li>
</ol>
<p class=MsoNormal style='margin-left:.25in'><font size=2 color=navy
face=Arial><span style='font-size:10.0pt;font-family:Arial;color:navy'><u1:p> </u1:p></span></font><o:p></o:p></p>
<ol style='margin-top:0in' start=2 type=1>
<li class=MsoNormal style='color:navy;mso-list:l3 level1 lfo3'><font size=2
color=navy face=Arial><span style='font-size:10.0pt;font-family:Arial'>“difficult
to grow” means that the promastigotes never emerge or emerge after
incubation of lesion aspirates/punctures in appropriate media, but
subsequently fail to replicate or replicate to a limited extent on
subculture ?<u1:p></u1:p></span></font><o:p></o:p></li>
</ol>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'><u1:p> </u1:p></span></font><o:p></o:p></p>
<ol style='margin-top:0in' start=3 type=1>
<li class=MsoNormal style='color:navy;mso-list:l3 level1 lfo3'><font size=2
color=navy face=Arial><span style='font-size:10.0pt;font-family:Arial'>What
is the rate of success in your attempts to isolate parasites in culture
from clinical samples in each endemic site over the years ? <u1:p></u1:p></span></font><o:p></o:p></li>
</ol>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'><u1:p> </u1:p></span></font><o:p></o:p></p>
<ol style='margin-top:0in' start=4 type=1>
<li class=MsoNormal style='color:navy;mso-list:l3 level1 lfo3'><font size=2
color=navy face=Arial><span style='font-size:10.0pt;font-family:Arial'>The
Sudanese strain used by many in the <st1:country-region u4:st="on"><st1:place u4:st="on"><st1:country-region
w:st="on"><st1:place w:st="on">USA</st1:place></st1:country-region></st1:place></st1:country-region>
was probably brought over decades ago by Donald Hyneman and established in
Syrian Golden hamsters by Leslie Stauber and his students. In the
70’s, I had the good fortune of working with Dennis Dwyer on his S1
or S2 strains of this origin. As widely reported in the literature, this
is an excellent model of visceral leishmaniasis, producing typical clinical
outcome consistently, including invariable death and splenic LD loads of
up to 10<sup>10</sup> per heavily infected spleen. I recall I had
difficult time to differentiate these splenic amastigotes into
promastigotes. I did see some motile promastigotes. While a small number
remains viable, many died and appeared as ghosts during the subsequent
incubation. This has led me to suspect selection of cultivable clones. In
some, but not all of these cultures, promastigotes eventually became
‘adapted’ to the culture conditions and grew, producing
consistently up to ~40 X 10<sup>6</sup> cells/ml in 4-5 days in successive
passages (starting from ~10<sup>6</sup>/ml = ~ 4-5 generation or
replication cycles). The stationary phase promastigotes of these cultures
no longer produce good infection of hamsters, irrespective of the passage
numbers (Isolation of ‘metacyclics” to produce good infection
has since been reported in the literature, if I remember correctly). These
promastigotes are more similar to the Mediterranean L infantum than to the
Indian L donovani of the <st1:place u4:st="on"><st1:place w:st="on">Bihar</st1:place></st1:place>
region in the sequence of their single-copy protein-coding genes, as
probably already shown by many based on sequencing other genetic sites. <u1:p></u1:p></span></font><o:p></o:p></li>
</ol>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'><u1:p> </u1:p></span></font><o:p></o:p></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>KP<u1:p></u1:p></span></font><o:p></o:p></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'><u1:p> </u1:p></span></font><o:p></o:p></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'><u1:p> </u1:p></span></font><o:p></o:p></p>
<div>
<div class=MsoNormal align=center style='text-align:center'><font size=3
face="Times New Roman"><span style='font-size:12.0pt'>
<hr size=2 width="100%" align=center>
</span></font></div>
<p class=MsoNormal><b><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma;font-weight:bold'>From:</span></font></b><font size=2
face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'> Maowia Mukhtar
[mailto:<st1:personname u4:st="on"><a href="mailto:mmukhtar@tropmedicine.org">mmukhtar@tropmedicine.org</a></st1:personname>]
<br>
<b><span style='font-weight:bold'>Sent:</span></b> Tuesday, May 31, 2011 2:30
PM<br>
<b><span style='font-weight:bold'>To:</span></b> 'Sharman'; 'Petr Volf'; Chang,
Kwang-Poo; 'Hiro Goto'; 'elfadil abass'; <a
href="mailto:vishwamohan_katoch@yahoo.co.in">vishwamohan_katoch@yahoo.co.in</a>;
'lalit Kant ICMR'<br>
<b><span style='font-weight:bold'>Cc:</span></b> <a
href="mailto:leish-l@lineu.icb.usp.br">leish-l@lineu.icb.usp.br</a><br>
<b><span style='font-weight:bold'>Subject:</span></b> RE: [Leish-l] inquiry</span></font><u1:p></u1:p><o:p></o:p></p>
</div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><u1:p> </u1:p><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'>Dear Colleagues,<u1:p></u1:p></span></font><o:p></o:p></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'>We have very
interesting experience with Sudanese L.donovani. This group of parasite although
are genetically homogenous they still cause diverse clinical forms in <st1:country-region u4:st="on"><st1:place u4:st="on"><st1:country-region
w:st="on"><st1:place w:st="on">Sudan</st1:place></st1:country-region></st1:place></st1:country-region>
ranging from VL, PKDL, ML to CL. We have isolated L. donovani MON82 from
classic cutaneous ulcers and typed them using both isoenzyme and molecular
typing techniques. Please check our manuscript (Elamin et al. 2008. </span></font><span
class=jrnl><font size=1 face=Arial><span style='font-size:9.0pt;font-family:
Arial'>Trans R Soc <font color="#1f497d"><span style='color:#1F497D'>Trop Med
Hyg</span></font></span></font></span><font size=1 color="#1f497d" face=Arial><span
style='font-size:9.0pt;font-family:Arial;color:#1F497D'>. 2008
Jan;102(1):54-7.). We have analyzed several virulence genes comparing the
isolates from the diverse clinical forms and they turned to be are highly homologous.
Immunologically they induce different immune responses (TH1/TH2). We know the
vector of L.donovani VL isolates which is P. orientalis, but we still
don’t know the vector of cutaneous L. donovani parasite. We believe the
vector plays an important role in the pathogenesis and the outcome of L.
donovani infection together with the host immune response and may be some of
the parasite virulence factors. We will soon published our data on parasite
typing and host immune responses of the diverse clinical forms. <u1:p></u1:p></span></font><o:p></o:p></p>
<p class=MsoNormal><font size=1 color="#1f497d" face=Arial><span
style='font-size:9.0pt;font-family:Arial;color:#1F497D'>Best regards<u1:p></u1:p></span></font><o:p></o:p></p>
<p class=MsoNormal><font size=1 color="#1f497d" face=Arial><span
style='font-size:9.0pt;font-family:Arial;color:#1F497D'>Maowia</span></font><o:p></o:p></p>
<u1:p></u1:p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'><u1:p> </u1:p></span></font><o:p></o:p></p>
<div>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'><u1:p> </u1:p></span></font><o:p></o:p></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'><u1:p> </u1:p></span></font><o:p></o:p></p>
<p class=MsoNormal><b><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D;font-weight:bold'>Professor
Maowia M. Mukhtar<u1:p></u1:p></span></font></b><o:p></o:p></p>
<p class=MsoNormal><st1:place u4:st="on"><st1:placetype u4:st="on"><st1:place
w:st="on"><st1:PlaceType w:st="on"><b><font size=2 color="#1f497d"
face=Calibri><span style='font-size:11.0pt;font-family:Calibri;color:#1F497D;
font-weight:bold'>Institute</span></font></b></st1:PlaceType><b><font size=2
color="#1f497d" face=Calibri><span style='font-size:11.0pt;font-family:Calibri;
color:#1F497D;font-weight:bold'></st1:placetype> of <st1:placename u4:st="on"><st1:PlaceName
w:st="on">Endemic</st1:placename></st1:PlaceName></span></font></b></st1:place></st1:place><b><font
size=2 color="#1f497d" face=Calibri><span style='font-size:11.0pt;font-family:
Calibri;color:#1F497D;font-weight:bold'> Diseases<u1:p></u1:p></span></font></b><o:p></o:p></p>
<p class=MsoNormal><st1:place u4:st="on"><st1:placetype u4:st="on"><st1:place
w:st="on"><st1:PlaceType w:st="on"><b><font size=2 color="#1f497d"
face=Calibri><span style='font-size:11.0pt;font-family:Calibri;color:#1F497D;
font-weight:bold'>University</span></font></b></st1:PlaceType><b><font
size=2 color="#1f497d" face=Calibri><span style='font-size:11.0pt;font-family:
Calibri;color:#1F497D;font-weight:bold'></st1:placetype> of <st1:placename u4:st="on"><st1:PlaceName
w:st="on">Khartoum</st1:placename></st1:PlaceName></span></font></b></st1:place></st1:place><o:p></o:p></p>
<u1:p></u1:p>
<p class=MsoNormal><b><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D;font-weight:bold'>P.O.
Box 11463, khartoum, Sudan<u1:p></u1:p></span></font></b><o:p></o:p></p>
<p class=MsoNormal><st1:city u4:st="on"><st1:place u4:st="on"><st1:City w:st="on"><st1:place
w:st="on"><b><font size=2 color="#1f497d" face=Calibri><span style='font-size:
11.0pt;font-family:Calibri;color:#1F497D;font-weight:bold'>Mobile</span></font></b></st1:place></st1:City></st1:place></st1:city><b><font
size=2 color="#1f497d" face=Calibri><span style='font-size:11.0pt;font-family:
Calibri;color:#1F497D;font-weight:bold'>; +249912234268<u1:p></u1:p></span></font></b><o:p></o:p></p>
<p class=MsoNormal><b><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D;font-weight:bold'>Fax:
+249183779712<u1:p></u1:p></span></font></b><o:p></o:p></p>
</div>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'><u1:p> </u1:p></span></font><o:p></o:p></p>
<div>
<div style='border:none;border-top:solid #B5C4DF 1.0pt;padding:3.0pt 0in 0in 0in'>
<p class=MsoNormal><b><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma;font-weight:bold'>From:</span></font></b><font size=2
face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'> <a
href="mailto:leish-l-bounces@lineu.icb.usp.br">leish-l-bounces@lineu.icb.usp.br</a>
[mailto:leish-l-bounces@lineu.icb.usp.br] <b><span style='font-weight:bold'>On
Behalf Of </span></b>Sharman<br>
<b><span style='font-weight:bold'>Sent:</span></b> 31 May 2011 18:13<br>
<b><span style='font-weight:bold'>To:</span></b> Petr Volf; Chang, Kwang-Poo;
Hiro Goto; elfadil abass; <a href="mailto:vishwamohan_katoch@yahoo.co.in">vishwamohan_katoch@yahoo.co.in</a>;
lalit Kant ICMR<br>
<b><span style='font-weight:bold'>Cc:</span></b> <a
href="mailto:leish-l@lineu.icb.usp.br">leish-l@lineu.icb.usp.br</a><br>
<b><span style='font-weight:bold'>Subject:</span></b> Re: [Leish-l] inquiry<u1:p></u1:p></span></font><o:p></o:p></p>
</div>
</div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><u1:p> </u1:p><o:p></o:p></span></font></p>
<div>
<p class=MsoNormal><font size=3 face=Calibri><span style='font-size:12.0pt;
font-family:Calibri'>Hi Petr,</span></font><u1:p></u1:p><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=3 face=Calibri><span style='font-size:12.0pt;
font-family:Calibri'>Thanks for enclosing the pdf. In fact the strain which we are
dealing with is not very difficult to grow but difficult to maintain, It is rK
39 positive and as I mentioned in the conversation below that even the serous
exudate from the ulcer is also positive for rK 39 dipstick. In between because
of my relocation to a different institute I was little away from this work but
I intend to resume this work in couple of months. Although in past we tried to
isolate the parasite from sand flies but did not succeed. We will surely
attempt again with the techniques described by you and others. Contamination is
the problem.</span></font><u1:p></u1:p><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=3 face=Calibri><span style='font-size:12.0pt;
font-family:Calibri'>This particular focus seems to be a complex one.</span></font><u1:p></u1:p><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=3 face=Calibri><span style='font-size:12.0pt;
font-family:Calibri'>NL Sharma</span></font> <u1:p></u1:p><o:p></o:p></p>
</div>
<div>
<div>
<p class=MsoNormal><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma'><u1:p> </u1:p></span></font><o:p></o:p></p>
</div>
<div>
<div>
<p class=MsoNormal style='background:whitesmoke'><b><font size=2 face=Tahoma><span
style='font-size:10.0pt;font-family:Tahoma;font-weight:bold'>From:</span></font></b><font
size=2 face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'> <a
href="mailto:volf@cesnet.cz" title="volf@cesnet.cz">Petr Volf</a> <u1:p></u1:p></span></font><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal style='background:whitesmoke'><b><font size=2 face=Tahoma><span
style='font-size:10.0pt;font-family:Tahoma;font-weight:bold'>Sent:</span></font></b><font
size=2 face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'> Tuesday,
May 31, 2011 12:36 PM<u1:p></u1:p></span></font><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal style='background:whitesmoke'><b><font size=2 face=Tahoma><span
style='font-size:10.0pt;font-family:Tahoma;font-weight:bold'>To:</span></font></b><font
size=2 face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'> <a
href="mailto:KwangPoo.Chang@rosalindfranklin.edu"
title="KwangPoo.Chang@rosalindfranklin.edu">Chang, Kwang-Poo</a> ; <a
href="mailto:nandlals@hotmail.com"
title="mailto:nandlals@hotmail.com CTRL + Click to follow link">Sharman</a>
; <a href="mailto:hgoto@usp.br"
title="mailto:hgoto@usp.br CTRL + Click to follow link">Hiro Goto</a>
; <a href="mailto:elfadil_abass@yahoo.com"
title="mailto:elfadil_abass@yahoo.com CTRL + Click to follow link">elfadil
abass</a> <u1:p></u1:p></span></font><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal style='background:whitesmoke'><b><font size=2 face=Tahoma><span
style='font-size:10.0pt;font-family:Tahoma;font-weight:bold'>Cc:</span></font></b><font
size=2 face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'> <a
href="mailto:leish-l@lineu.icb.usp.br" title="leish-l@lineu.icb.usp.br">leish-l@lineu.icb.usp.br</a>
<u1:p></u1:p></span></font><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal style='background:whitesmoke'><b><font size=2 face=Tahoma><span
style='font-size:10.0pt;font-family:Tahoma;font-weight:bold'>Subject:</span></font></b><font
size=2 face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'> Re:
[Leish-l] inquiry<u1:p></u1:p></span></font><o:p></o:p></p>
</div>
</div>
</div>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><u1:p> </u1:p><o:p></o:p></span></font></p>
</div>
<div>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>Hi K.P.,</span></font><u1:p></u1:p><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>in Cukurova region, <st1:country-region u4:st="on"><st1:place u4:st="on"><st1:country-region
w:st="on"><st1:place w:st="on">Turkey</st1:place></st1:country-region></st1:place></st1:country-region>,
cutaneous L. infantum (now it seems that we are dealing with L.donovani/L.
infantum hybrid) grew very poorely if we isolated them from patients. Only 1 of
25 isolations was succesfull. However, the same strain (confirmed by molecular
methods) grew repeatedly and very well if we isolated them from sandflies. It
might be useful for Dr. Sharma try to get isolates from sand flies. It is very
laborious but very useful, in Cukurova we got about dozen of isolates by this
method (all identical).</span></font><u1:p></u1:p><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>Patients are rK39 negative, see attached paper.</span></font><u1:p></u1:p><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>Best wishes</span></font><u1:p></u1:p><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>Petr</span></font><u1:p></u1:p><o:p></o:p></p>
</div>
<blockquote style='border:none;border-left:solid black 1.5pt;padding:0in 0in 0in 4.0pt;
margin-left:3.75pt;margin-top:5.0pt;margin-right:0in;margin-bottom:5.0pt'>
<div>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>----- Original Message ----- <u1:p></u1:p></span></font><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal style='background:#E4E4E4'><b><font size=2 face=Arial><span
style='font-size:10.0pt;font-family:Arial;font-weight:bold'>From:</span></font></b><font
size=2 face=Arial><span style='font-size:10.0pt;font-family:Arial'> <a
href="mailto:KwangPoo.Chang@rosalindfranklin.edu"
title="KwangPoo.Chang@rosalindfranklin.edu">Chang, Kwang-Poo</a> <u1:p></u1:p></span></font><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><b><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial;font-weight:bold'>To:</span></font></b><font size=2
face=Arial><span style='font-size:10.0pt;font-family:Arial'> <a
href="mailto:nandlals@hotmail.com" title="nandlals@hotmail.com">Sharman</a> ; <a
href="mailto:hgoto@usp.br" title="hgoto@usp.br">Hiro Goto</a> ; <a
href="mailto:elfadil_abass@yahoo.com" title="elfadil_abass@yahoo.com">elfadil
abass</a> <u1:p></u1:p></span></font><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><b><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial;font-weight:bold'>Cc:</span></font></b><font size=2
face=Arial><span style='font-size:10.0pt;font-family:Arial'> <a
href="mailto:leish-l@lineu.icb.usp.br" title="leish-l@lineu.icb.usp.br">leish-l@lineu.icb.usp.br</a>
<u1:p></u1:p></span></font><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><b><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial;font-weight:bold'>Sent:</span></font></b><font size=2
face=Arial><span style='font-size:10.0pt;font-family:Arial'> Sunday, May 22,
2011 1:39 AM<u1:p></u1:p></span></font><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><b><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial;font-weight:bold'>Subject:</span></font></b><font size=2
face=Arial><span style='font-size:10.0pt;font-family:Arial'> Re: [Leish-l]
inquiry<u1:p></u1:p></span></font><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><u1:p> </u1:p><o:p></o:p></span></font></p>
</div>
<div id=idOWAReplyText41530>
<div>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'>Dr. NL Sharma has been working on an
important CL endemic area along the <st1:placename u4:st="on"><st1:PlaceName
w:st="on">Satluj</st1:placename></st1:PlaceName> <st1:placetype u4:st="on"><st1:PlaceType
w:st="on">River</st1:placetype></st1:PlaceType> valley to the south of
Himalaya in <st1:country-region u4:st="on"><st1:place u4:st="on"><st1:country-region
w:st="on"><st1:place w:st="on">India</st1:place></st1:country-region></st1:place></st1:country-region>
(Please correct me should I be wrong for anything I said here and below). I had
the good fortune of visiting the site several years back courtesy of Dr.
Sharma. </span></font><u1:p></u1:p><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> <u1:p></u1:p><o:p></o:p></span></font></p>
</div>
<div>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>I believe Dr. Sharma's finding is important, since the
parasites there are different from the familiar Indian L donovani in <st1:place u4:st="on"><st1:place
w:st="on">Bihar</st1:place></st1:place>. The parasites are refratory to in
vitro cultivation. They do differentiate into promastigotes and may grow a
little, but can't really be subcultured to establish passageable
lines. This is very much reminescent of L infantum in the Mediterranean area. I
recall Dr. Sharma has also found rK39+ dogs, if I remember correctly. If
so, Satluj river valley is endemic to the infantile CL.</span></font><u1:p></u1:p><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> <u1:p></u1:p><o:p></o:p></span></font></p>
</div>
<div>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>Analyses of several batches of basically clinical CL samples
from Dr. Sharma showed evidence of L infantum, but also L tropica as well as a
mixture of the two in one sample. This is the same picture we have noted
for samples from <st1:place u4:st="on"><st1:city u4:st="on"><st1:place w:st="on"><st1:City
w:st="on">Hatay</st1:city></st1:City>, <st1:country-region u4:st="on"><st1:country-region
w:st="on">Turkey</st1:country-region></st1:place></st1:country-region></st1:place>.</span></font><u1:p></u1:p><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> <u1:p></u1:p><o:p></o:p></span></font></p>
</div>
<div>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'>These observations make me wonder a lot about our current
knowledge on the clinico-epidemiology based on data collected previously by
analyses of cultured promastigotes from one or
few 'representative samples'. Nowaday, technology makes it very
doable to work with biological samples for Leish DNAs directly from sand flies,
patients and reservoir animals.</span></font><u1:p></u1:p><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> <u1:p></u1:p><o:p></o:p></span></font></p>
</div>
<div>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>KP</span></font><u1:p></u1:p><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> <u1:p></u1:p><o:p></o:p></span></font></p>
</div>
</div>
<div id=idSignature79278>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> <u1:p></u1:p><o:p></o:p></span></font></p>
</div>
<div>
<div class=MsoNormal align=center style='text-align:center'><font size=3
face="Times New Roman"><span style='font-size:12.0pt'>
<hr size=2 width="100%" align=center>
</span></font></div>
<p class=MsoNormal style='margin-bottom:12.0pt'><b><font size=2 face=Tahoma><span
style='font-size:10.0pt;font-family:Tahoma;font-weight:bold'>From:</span></font></b><font
size=2 face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'> <a
href="mailto:leish-l-bounces@lineu.icb.usp.br">leish-l-bounces@lineu.icb.usp.br</a>
on behalf of Sharman<br>
<b><span style='font-weight:bold'>Sent:</span></b> Fri 5/20/2011 11:31 PM<br>
<b><span style='font-weight:bold'>To:</span></b> Hiro Goto; elfadil abass<br>
<b><span style='font-weight:bold'>Cc:</span></b> <a
href="mailto:leish-l@lineu.icb.usp.br">leish-l@lineu.icb.usp.br</a><br>
<b><span style='font-weight:bold'>Subject:</span></b> Re: [Leish-l] inquiry</span></font><u1:p></u1:p><o:p></o:p></p>
</div>
</div>
<div>
<p><font size=2 face="Times New Roman"><span style='font-size:10.0pt'>Dear all<br>
I agree with Hiro gito, We are working on a focus where the CL is<br>
predominantly caused by L. donovani, and the rK 39 STRIPS GIVE POSITIVE<br>
RESULTS WITH SERA as well as serous exudate from the lesion. The results are<br>
dependent upon species.<br>
NL Sharma<br>
<br>
--------------------------------------------------<br>
From: "Hiro Goto" <<a href="mailto:hgoto@usp.br">hgoto@usp.br</a>><br>
Sent: Wednesday, May 18, 2011 12:09 AM<br>
To: "elfadil abass" <<a href="mailto:elfadil_abass@yahoo.com">elfadil_abass@yahoo.com</a>><br>
Cc: <<a href="mailto:leish-l@lineu.icb.usp.br">leish-l@lineu.icb.usp.br</a>><br>
Subject: Re: [Leish-l] inquiry<br>
<br>
> Dear all,<br>
> In our oppinion, DAT and rK39 for those samples are not indicated
since<br>
> these tests are produced for the diagnosis of visceral
leishmaniasis.<br>
> In case of tegumentary leishmaniasis, it is very appropriate the<br>
> observation of J.J. Shaw appointing species specificity of antibody<br>
> response in these cases. Titers of antibodies are in general low in
these<br>
> cases therefore depending on the species, it may result negative. We
have<br>
> published a review recently in Expert Rev. Anti Infect. Ther. 8(4),<br>
> 419?433 (2010), Current diagnosis and treatment of cutaneous and<br>
> mucocutaneous leishmaniasis, where we raise this point.<br>
> Hiro Goto<br>
><br>
> Citando elfadil abass <<a href="mailto:elfadil_abass@yahoo.com">elfadil_abass@yahoo.com</a>>:<br>
><br>
>> Dear all I would recommend using DAT and rK39 strip test to measure<br>
>> antibody<br>
>> responses and to evaluate the diagnostic efficiency for both
tests in<br>
>> such group<br>
>> of patients.<br>
>><br>
>> Elfadil Abass<br>
>> ________________________________________________________________________________<br>
>> <st1:place u4:st="on"><st1:placetype u4:st="on"><st1:place w:st="on"><st1:PlaceType
w:st="on">Institute</st1:placetype></st1:PlaceType> of <st1:placename u4:st="on"><st1:PlaceName
w:st="on">Medical</st1:placename></st1:place></st1:PlaceName></st1:place>
Microbiology and Hospital Hygiene<br>
>> <st1:placename u4:st="on"><st1:PlaceName w:st="on">Philipps</st1:placename></st1:PlaceName>
<st1:placename u4:st="on"><st1:PlaceName w:st="on">University</st1:placename></st1:PlaceName>
<st1:city u4:st="on"><st1:place u4:st="on"><st1:City w:st="on"><st1:place
w:st="on">Marburg</st1:place></st1:city></st1:place></st1:City><br>
>> BMFZ / Hans-Meerwein Straße 2<br>
>> D-35033 <st1:place u4:st="on"><st1:city u4:st="on"><st1:place w:st="on"><st1:City
w:st="on">Marburg</st1:city></st1:City>, <st1:country-region u4:st="on"><st1:country-region
w:st="on">Germany</st1:country-region></st1:place></st1:country-region></st1:place><br>
>> ________________________________________________________________________________<br>
>><br>
>><br>
>><br>
>><br>
>> ________________________________<br>
>> From: Nuha Nuwayri-Salti <<a href="mailto:racha@aub.edu.lb">racha@aub.edu.lb</a>><br>
>> To: saad saad <<a href="mailto:saad1426@gmail.com">saad1426@gmail.com</a>>;
"<a href="mailto:leish-l@lineu.icb.usp.br">leish-l@lineu.icb.usp.br</a>"<br>
>> <<a href="mailto:leish-l@lineu.icb.usp.br">leish-l@lineu.icb.usp.br</a>><br>
>> Sent: Fri, May 13, 2011 9:39:33 AM<br>
>> Subject: Re: [Leish-l] inquiry<br>
>><br>
>> Dear Saad first precaution to take is to separate your samples into<br>
>> several<br>
>> portions each (at least 5 each being no more than a few
hundred(200-400)<br>
>> microliters). This is a necessary precaution to avoid freezing and<br>
>> thawing<br>
>> several times the same sample which will be the case should you do<br>
>> different<br>
>> studies at different times which is unavoidable.<br>
>><br>
>> What you can do is correlate the type(ulcerated, abscess, furuncle<br>
>> etc.. ) the<br>
>> locale, the number and age of lesions with the levels of antibody
in the<br>
>> sera of<br>
>> these patgients and also monitor cell mediated immunity with
leishmanin<br>
>> skin<br>
>> test!<br>
>> I have just published (in print) an article about having circulating<br>
>> parasites<br>
>> in some of these patients with apparently pure cutaneous disease. It
is<br>
>> the<br>
>> first paper that revealed this fact. It would be interesting to
confirm<br>
>> or<br>
>> de-confirm this fact repeating what we did.<br>
>> Best wishes<br>
>><br>
>> Nuha Nuwayri-Salti MD<br>
>><br>
>><br>
>><br>
>> AOA<br>
>> Medical Honor Society<br>
>><br>
>><br>
>><br>
>><br>
>> -----Original Message-----<br>
>> From: <a href="mailto:leish-l-bounces@lineu.icb.usp.br">leish-l-bounces@lineu.icb.usp.br</a><br>
>> [<a href="mailto:leish-l-bounces@lineu.icb.usp.br">mailto:leish-l-bounces@lineu.icb.usp.br</a>]<br>
>> On Behalf Of saad saad<br>
>> Sent: Friday, April 29, 2011 11:23 PM<br>
>> To: <a href="mailto:leish-l@lineu.icb.usp.br">leish-l@lineu.icb.usp.br</a><br>
>> Subject: [Leish-l] inquiry<br>
>><br>
>> Dear all<br>
>> Hi. i am Saad from <st1:country-region u4:st="on"><st1:place u4:st="on"><st1:country-region
w:st="on"><st1:place w:st="on">Saudi Arabia</st1:place></st1:country-region></st1:place></st1:country-region>.
i have 60 sera from positive case of<br>
>> CL from south west of the country. I would like to have your<br>
>> recommendations to start a good research line in CL using these sera.<br>
>> Thanks in advance for your help<br>
>> _______________________________________________<br>
>> Leish-l mailing list<br>
>> <a href="mailto:Leish-l@lineu.icb.usp.br">Leish-l@lineu.icb.usp.br</a><br>
>> <a href="http://lineu.icb.usp.br/cgi-bin/mailman/listinfo/leish-l">http://lineu.icb.usp.br/cgi-bin/mailman/listinfo/leish-l</a><br>
>> _______________________________________________<br>
>> Leish-l mailing list<br>
>> <a href="mailto:Leish-l@lineu.icb.usp.br">Leish-l@lineu.icb.usp.br</a><br>
>> <a href="http://lineu.icb.usp.br/cgi-bin/mailman/listinfo/leish-l">http://lineu.icb.usp.br/cgi-bin/mailman/listinfo/leish-l</a><br>
>><br>
><br>
><br>
><br>
> Profa. Dra. Hiro Goto<br>
> Laboratório de Soroepidemiologia e Imunobiologia<br>
> Instituto de Medicina Tropical de <st1:city u4:st="on"><st1:place u4:st="on"><st1:City
w:st="on"><st1:place w:st="on">São Paulo</st1:place></st1:city></st1:place></st1:City>,
USP<br>
> Av. Dr. Enéas de Carvalho Aguiar, 470, prédio II, quarto andar<br>
> 05403-000 - <st1:city u4:st="on"><st1:place u4:st="on"><st1:City w:st="on"><st1:place
w:st="on">São Paulo</st1:place></st1:city></st1:place></st1:City>, SP<br>
> Tel. +55-11-3061 7023, 3061 7056 ou 3061 7027<br>
> Fax. +55-11-3061-8270<br>
><br>
> _______________________________________________<br>
> Leish-l mailing list<br>
> <a href="mailto:Leish-l@lineu.icb.usp.br">Leish-l@lineu.icb.usp.br</a><br>
> <a href="http://lineu.icb.usp.br/cgi-bin/mailman/listinfo/leish-l">http://lineu.icb.usp.br/cgi-bin/mailman/listinfo/leish-l</a><br>
><br>
_______________________________________________<br>
Leish-l mailing list<br>
<a href="mailto:Leish-l@lineu.icb.usp.br">Leish-l@lineu.icb.usp.br</a><br>
<a href="http://lineu.icb.usp.br/cgi-bin/mailman/listinfo/leish-l">http://lineu.icb.usp.br/cgi-bin/mailman/listinfo/leish-l</a></span></font><u1:p></u1:p><o:p></o:p></p>
</div>
<div class=MsoNormal align=center style='text-align:center'><font size=3
face="Times New Roman"><span style='font-size:12.0pt'>
<hr size=2 width="100%" align=center>
</span></font></div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'>_______________________________________________<br>
Leish-l mailing list<br>
<a href="mailto:Leish-l@lineu.icb.usp.br">Leish-l@lineu.icb.usp.br</a><br>
<a href="http://lineu.icb.usp.br/cgi-bin/mailman/listinfo/leish-l">http://lineu.icb.usp.br/cgi-bin/mailman/listinfo/leish-l</a><u1:p></u1:p><o:p></o:p></span></font></p>
</blockquote>
</div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><ATT00001..txt><o:p></o:p></span></font></p>
</div>
</u1:smarttagtype></u1:smarttagtype></u1:smarttagtype></u1:smarttagtype></u1:smarttagtype></u1:smarttagtype>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><o:p> </o:p></span></font></p>
</div>
</div>
</body>
</html>