Anti-Leishmania IgG is a marker of disseminated leishmaniasis caused by Leishmania braziliensis

Abstract

Background: In this study, we determined the accuracy of anti-Leishmania IgG and IgG subclasses to distinguish clinical forms of American tegumentary leishmaniasis (ATL) and and determined the relationship between antibodies levels with cytokine production and severity of ATL. Methods: Participants were 40 patients with cutaneous leishmaniasis (CL), 20 patients with mucosal leishmaniasis (ML), 20 patients with disseminated leishmaniasis (DL), and 20 individuals with subclinical Leishmania braziliensis infection (SC). Diagnosis was performed by DNA of L. braziliensis or IFN-g production in SC. IgG and subclasses of IgG to soluble Leishmania antigen and cytokine levels in supernatants of mononuclear cells were detected by ELISA. Results: IgG was detected in 95%, 95%, and 100% of patients with CL, ML, and DL, respectively. Higher levels of anti-Leishmania IgG and IgG2 were seen in DL compared to CL, ML, and SC. ROC analysis confirmed the ability of IgG to distinguish DL from the other clinical forms. A direct correlation was observed between IgG titers and levels of IFN-g and CXCL10 in CL and DL, and IgG2 antibodies were correlated with the number of lesions in DL. Conclusions: High anti-Leishmania IgG and IgG2 levels are characteristic of DL, and while IgG was correlated with pro-inflammatory cytokines, IgG2 was direct correlated with the number of lesions.

IgG3 and IL10 are effective biomarkers for monitoring therapeutic effectiveness in Post Kala-Azar Dermal Leishmaniasis

“…In patients with VL, increased levels of circulating IFNγ regularly accompany progressive infections as also cure, and was reflected in raised IgG2 and IgG4 at disease presentation and cure [ 17 , 25 , 39 ]. A similar scenario was reported in Disseminated Leishmaniasis wherein high levels of IFNγ were accompanied by an increased IgG2, and importantly, was an effective predictor of disease [ 51 ]. At disease presentation, the raised IFNγ reported in human VL [ 21 , 52 , 53 ], CL [ 54 ], and PKDL [ 21 , 41 ] indicates a mixed Th1/Th2 milieu, the latter being predominant [ 20 – 22 ]).…”

Validation of an In-House ELISA Method in the Diagnosis of Cutaneous Leishmaniasis Caused by Leishmania donovani in Hambantota District, Sri Lanka

“…Seropositivity rates and antibody titers were higher among people with multiple lesions (100.0%) compared to those with single lesions (90.2%; p < 0.05). A similar finding was observed among patients with multiple CL lesions caused by L. tropica (Wright, 1903) [ 37 , 38 ], and anti- Leishmania IgG2 was shown to be directly correlated to the number of lesions in patients with diffuse cutaneous leishmaniasis caused by L. braziliensis (Vianna, 1911) [ 39 , 40 ]. Multiple lesions could be due to multiple inoculating bites by the vector.…”

ELISA‐based evaluation of antibody response to Leishmania in a region endemic for cutaneous leishmaniasis

“…Higher levels of total anti-leishmanial IgG and IgG subclasses have also been associated with active disease 32 as well as severity of disease. 33 Moreover, some studies have demonstrated the presence of IgG antibodies as an indicator of disease progression of CL infection. 26,[34][35][36] A shift to relatively low antibody levels, which happened earlier in the patients under treatment in our study population, suggests that the decrease in antibody levels may be a marker of the therapeutic response.…”

“…Furthermore, the antibody levels remained high for an extended period of time in untreated patients, which is likely to be due to higher parasite antigenic stimulation in this group. Higher levels of total anti‐leishmanial IgG and IgG subclasses have also been associated with active disease 32 as well as severity of disease 33 . Moreover, some studies have demonstrated the presence of IgG antibodies as an indicator of disease progression of CL infection 26,34–36 .…”