Diagnosing Cutaneous leishmaniasis using Fluorescencein SituHybridization: the Sri Lankan Perspective

Abstract

Cutaneous leishmaniasis (CL) caused by Leishmania donovani MON-37 is becoming a major public health problem in Sri Lanka, with 100 new cases per month being reported in endemic regions. Diagnosis of CL is challenging for several reasons. Due to relative specificity and rapidity we propose Fluorescence in Situ Hybridization as a diagnostic tool for CL.The objective was to evaluate the potential of Fluorescence in Situ Hybridization as a diagnostic method for Cutaneous leishmaniasis in Sri Lanka.Literature on current laboratory tests used to diagnose Cutaneous leishmaniasis in Sri Lanka and globally was reviewed. Sri Lankan data were reviewed systematically following the PRISMA guidelines. A narrative of the results is presented.There is currently no gold standard diagnostic method for Cutaneous leishmaniasis. Fluorescence in Situ Hybridization has been previously applied to detect dermal pathologies including those involving infectious agents, and its use to detect the Leishmania parasite in human cutaneous lesions reported in small number of studies, generally with limited numbers of subjects. Advantages of FISH has been specificity, cost and ease-of-use compared to the alternatives.Based on the available literature and our current work, FISH has potential for diagnosing CL and should now be evaluated in larger cohorts in endemic regions. FISH for CL diagnosis could find application in countries such as Sri Lanka, where laboratory facilities may be limited in rural areas where the disease burden is highest.

Comparación de la sensibilidad y especificidad de las técnicas de laboratorio para el diagnóstico de Leishmaniasis

“…Sin embargo, (Allende et al, 2018) y (Zanetti et al, 2019) concuerdan que la qPCR es una técnica muy útil en el diagnóstico de LC cuando otros métodos dan resultados negativos. Es su investigación (Jayasena Kaluarachchi et al, 2019) y (Owen, Hossain, et al, 2021)describen que para LV se aplican las pruebas serológicas como ELISA, aglutinación directa y las pruebas inmunocromatográficas rK39. Por otro lado, (Silveira et al, 2021) mencionan que la PCR cuantitativa es un método aplicable para la LC y LV, es un método muy sensible, pero se lo utiliza más en las investigaciones de laboratorio.…”

Is There Any Difference in the In Situ Immune Response in Active Localized Cutaneous Leishmaniasis That Respond Well or Poorly to Meglumine Antimoniate Treatment or Spontaneously Heal?

“…The use of in situ skin inflammatory reaction tools is important to identify the structure and organization of the in situ inflammatory process in TL and other diseases. Such information allows the identification of the infectious agent and the type of cells, cytokines, and functional markers involved during the inflammatory response [ 23 , 45 , 46 , 47 , 48 ]. Studies with these tools have demonstrated that interleukin (IL)-17 is involved in lesion chronicity [ 42 ].…”

Immunogenic properties of empty pcDNA3 plasmid against zoonotic cutaneous leishmaniasis in mice

“…Leishmaniasis is a neglected tropical infectious disease caused by a vector-borne intracellular protozoan parasite that belongs to the Leishmania (L) genus. The disease manifests various clinical features, including cutaneous leishmaniasis (CL), mucocutaneous leishmaniasis (MCL), and visceral leishmaniasis (VL) [ 1 – 3 ]. It is one of the leading endemic protozoan infections in 98 countries, where approximately 350 million people are at risk of infection and cause significant mortality and morbidity [ 4 – 6 ].…”