Significance of persistence of antibodies against Leishmania infantum in sicilian patients affected by acute visceral leishmaniasis

Mansueto, Pasquale; Pepe, Ilenia; Seidita, Aurelio; Scozzari, Francesca; Vitale, Giustina; Arcoleo, Francesco; Elvira, Inglese; Cillari, Enrìco; Rini, Giovam Battista; Napoli, Nicola; Rosa, Salvatore Di; Mansueto, S; Fede, Gaetana Di

doi:10.1007/s10238-011-0150-9

Cited by 7 publications

(4 citation statements)

References 21 publications

(30 reference statements)

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“…Almost 50% of the initially seropositive individuals retested after 12 months were still seropositive. It is known that after acute VL specific antibodies can be detected for many years, probably mainly owing to persistence of the parasites [17]. A further finding in the present study was that four individuals were PCR positive when followed-up after a year, suggesting that Leishmania spp.…”

Section: Antibody Persistencesupporting

confidence: 61%

Seroprevalence and asymptomatic carriage of Leishmania spp. in Austria, a non-endemic European country

Poeppl

Herkner

Tobudic

et al. 2013

Clinical Microbiology and Infection

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Leishmaniasis is a rare disease in Central Europe and is diagnosed almost exclusively in travellers or migrants coming from tropical or subtropical countries. We conducted an explorative cross-sectional serological study, using a commercial ELISA, in 1048 healthy Austrian individuals to assess the distribution of specific antibodies against Leishmania spp. in humans in Austria. Overall, 47 individuals (4.5%) tested positive, and an additional 32 (3.1%) showed borderline results. After 12 months, sera from 42 of the 79 individuals who had initially tested seropositive/borderline were tested by ELISA a second time: 18 were persistently positive, nine were borderline. Those whose sera were persistently positive/borderline were then screened for potential carrier status using a commercial oligochromatographic PCR test to detect parasite DNA. Four samples were PCR positive and were subjected to a second PCR allowing parasite identification after DNA sequencing: two samples were identified as Leishmania donovani/infantum complex and Leishmania (Viannia) guyanensis, respectively. Epidemiological information was obtained with a questionnaire: no correlation was found for the number of holiday trips within the previous 6 months, but a significant risk of exposure to Leishmania spp. was found for travel to the New World, particularly to the Caribbean. Our data demonstrate that Leishmania spp. seroprevalence in non-endemic countries has been considerably underestimated.

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Section: Antibody Persistencesupporting

confidence: 61%

Seroprevalence and asymptomatic carriage of Leishmania spp. in Austria, a non-endemic European country

Poeppl

Herkner

Tobudic

et al. 2013

Clinical Microbiology and Infection

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“…Antibodies to L(L)infantum might persist for many years and decrease slowly. The persistence of these specific antibodies and an acute increase in their levels might be a sentinel of a VL relapse [33]. ELISA has been used for diagnosis of CL using soluble (SF) and membrane enriched (MF) antigen fractions obtained from Lb.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Immunological Analysis of Cutaneous Leishmaniasis before and after Different Treatments

O'Daly¹,

Spinetti

Gleason³

et al. 2013

Journal of Parasitology Research

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Amastigotes from L. (L.)amazonensis (La), L. (L.)venezuelensis (Lv), L. (V.)brasiliensis (Lb), and L. (L.)chagasi (Lch) were cultured in a free cells liquid culture medium. Patients (n = 87) from a cutaneous leishmaniasis (CL) hyperendemic region receiving different treatments were followed up from January 1994 to August 2000. Time for remission of lesions were spontaneous remission (SR) 7 weeks; Glucantime (Glu) chemotherapy 9 weeks; immunotherapy with La, Lv, Lb, and Lch amastigotes Tosyl-Lysil Chloromethyl-ketone (TLCK) treated and Nonidet P-40(NP-40) extracted (VT) 7 weeks. Delayed type hypersensitivity (DTH) response with leishmanine intradermic reaction (IDR) was higher in CL patients than healthy controls (P < 0.05) and increased in active secondary versus primary infection (P < 0.001) with diagnostic value 1.74 for active infection and 1.81 postclinical remission. Antibodies to amastigotes characterized by Enzyme Linked Immunosorbent Assay (ELISA) decreased in sera postclinical remission versus active infections (P < 0.001), with a diagnostic value from 1.50 to 1.84. Immunoblottings antigenic bands frequency as well as Integral Optical Density (IOD) Area Densitometry decreased with sera from SR, after Glu or VT treatments in CL volunteers. Intracellular parasitism is due to normal antibodies recognizing parasite antigens after inoculation by vector. VT vaccine induced mainly cellular immunity, for remission of lesions and protection from CL infection.

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“…Anam et al (144) also hinted at a possible (diagnostic) role for L. donovani-specific IgG3 antibody isotype detection. While the IgG3 antibody level decreases significantly posttreatment (148,149), the pharmacodynamic value of this marker is probably very low, as the time to normalcy for IgGs is longer than 3 months for both CL and VL patients (150)(151)(152)(153)(154).…”

Section: Identified Biomarkersmentioning

confidence: 99%

Systematic Review of Biomarkers To Monitor Therapeutic Response in Leishmaniasis

Kip

Balasegaram

Beijnen

et al. 2015

Antimicrob Agents Chemother

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e Recently, there has been a renewed interest in the development of new drugs for the treatment of leishmaniasis. This has spurred the need for pharmacodynamic markers to monitor and compare therapies specifically for visceral leishmaniasis, in which the primary recrudescence of parasites is a particularly long-term event that remains difficult to predict. We performed a systematic review of studies evaluating biomarkers in human patients with visceral, cutaneous, and post-kala-azar dermal leishmaniasis, which yielded a total of 170 studies in which 53 potential pharmacodynamic biomarkers were identified. In conclusion, the large majority of these biomarkers constituted universal indirect markers of activation and subsequent waning of cellular immunity and therefore lacked specificity. Macrophage-related markers demonstrate favorable sensitivity and times to normalcy, but more evidence is required to establish a link between these markers and clinical outcome. Most promising are the markers directly related to the parasite burden, but future effort should be focused on optimization of molecular or antigenic targets to increase the sensitivity of these markers. In general, future research should focus on the longitudinal evaluation of the pharmacodynamic biomarkers during treatment, with an emphasis on the correlation of studied biomarkers and clinical parameters.

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Significance of persistence of antibodies against Leishmania infantum in sicilian patients affected by acute visceral leishmaniasis

Cited by 7 publications

References 21 publications

Seroprevalence and asymptomatic carriage of Leishmania spp. in Austria, a non-endemic European country

Seroprevalence and asymptomatic carriage of Leishmania spp. in Austria, a non-endemic European country

Clinical and Immunological Analysis of Cutaneous Leishmaniasis before and after Different Treatments

Systematic Review of Biomarkers To Monitor Therapeutic Response in Leishmaniasis

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