The Intracutaneous Test in Cutaneous Leishmaniasis

Dostrovsky, A.; Sagher, F.

doi:10.1080/00034983.1946.11685285

Cited by 32 publications

(5 citation statements)

References 3 publications

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“…The magnitude of the skin response was assessed 48–72 h after intradermal injection of 0.1 ml of the antigen in the anterior of the right forearm [14], [15]. The diameter of the induration was measured in millimeters by outlining the indurated border, with MST considered positive if it measured ≥5 mm [16].…”

Section: Methodsmentioning

confidence: 99%

American Tegumentary Leishmaniasis: Effectiveness of an Immunohistochemical Protocol for the Detection of Leishmania in Skin

et al. 2013

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BackgroundAmerican tegumentary leishmaniasis (ATL) is endemic in Latin America, where Brazil has over 27 thousand cases per year. The aim of the present study was to develop an immunohistochemical method (IHC) for ATL diagnosis. For this purpose, we used serum from a dog naturally infected with Leishmania (L) infantum (canine hyperimmune serum) as the primary antibody, followed by a detection system with a secondary biotinylated antibody.MethodologySkin samples were obtained from 73 patients in an endemic area of Caratinga, Minas Gerais (MG) State, Brazil all testing positive for ATL with the Montenegro skin test, microscopy, and PCR. Canine hyperimmune serum of a dog naturally infected with Leishmania (L.) infantum was employed as a primary antibody in an immunohistochemical diagnostic method using streptavidin-biotin peroxidase. To assess the specificity of this reaction, IHC assays employing two monoclonal antibodies were carried out. As the polymer-based technology is less time-consuming and labor intensive than the IHC labeled streptavidin-biotin peroxidase method, we compared the two methods for all samples.ResultsThe IHC method detected ATL in 67 of the 73 cases (91.8%). Immunolabeled parasites were primarily detected inside macrophages either in the superficial or the deep dermis. Detection was facilitated by the high contrast staining of amastigotes (dark brown) against the light blue background. A lower detection rate (71.2%) was observed with the both of the monoclonal Leishmania antibodies compared to the canine hyperimmune serum. This may have been due to a non-specific background staining observed in all histological samples rendering positive detection more difficult. The higher efficacy of the canine hyperimmune serum in the IHC method was confirmed by the method using streptavidin-biotin peroxidase as well as that with the polymer-based technology (biotin-avidin-free system).ConclusionsThe data are encouraging with regard to validating IHC as a standard alternative method for ATL diagnosis.

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Section: Methodsmentioning

confidence: 99%

American Tegumentary Leishmaniasis: Effectiveness of an Immunohistochemical Protocol for the Detection of Leishmania in Skin

et al. 2013

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“…L. tropica produces a limited cutaneous ulcer {oriental sore) which is self-healing and is followed by permanent immunity to reinfection. The main immunological characteristic of this condition is the presence of strong delayed hypersensitivity reaction (DH) to leishmania antigen (Dostrowsky & Sagher 1945); antibodies may be present, although in low levels (Bray & Lainson 1967). In similarity with leprosy, leishmaniasis has been considered as a spectral disease (Turk & Bryceson 1971) with two polar forms: the diffuse cutaneous leishmaniasis (DCL) of South-America and Ethiopia, and leishmaniasis recidiva.…”

Section: Evidence For Cell-mediated and Humoral Responsesmentioning

confidence: 99%

Cell‐Mediated and Humoral Immunity to Protozoan Infections

Mauël

Behin

1974

Immunological Reviews

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“…This result was then reproduced in humans by João Montenegro, for whom the test is named, who showed that the reaction is positive in patients with active CL in a sensitive and specific manner [13]. It was soon demonstrated that the LST can detect cellular immunity even in cases in which parasites are too scarce to be found by microscopy in biological samples; thus, the LST became the preferred diagnostic tool for CL [14]. In 1966, it was observed that the LST is often positive in individuals lacking scars to indicate previous infection and who do not recall ever having had symptoms, and it was suggested that these individuals had asymptomatic infections [15].…”

Section: Development Of the Leishmanin Skin Testmentioning

confidence: 93%

A review of the leishmanin skin test: A neglected test for a neglected disease

et al. 2021

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The leishmanin skin test (LST) has been used for decades to detect exposure and immunity to the parasite Leishmania, the causative agent of the neglected tropical disease leishmaniasis. In the LST, Leishmania antigen (leishmanin) is intradermally injected into the forearm. In an individual who has been previously infected, a delayed-type hypersensitivity (DTH) reaction results in a measurable induration at the site of the injection, indicating that previous exposure to Leishmania has resulted in the development of cell-mediated immunity. LST positivity is associated with long-lasting protective immunity against reinfection, most notably as reported for visceral leishmaniasis (VL). Despite efforts over the past few decades, leishmanin antigen is no longer produced under good manufacturing practice (GMP) conditions anywhere in the world. Consequently, the use of the LST in epidemiological studies has declined in favor of serological and molecular tests. In this review, we provide a historical overview of the LST and justification for the reintroduction of leishmanin. A GMP-grade leishmanin can be used to detect immunity in vivo by the LST and can be investigated for use in an interferon-γ release assay (IGRA), which may serve as an in vitro version of the LST. The LST will be a valuable tool for surveillance and epidemiological studies in support of the VL elimination programs and as a surrogate marker of immunity in vaccine clinical trials. Methods A review of the literature was conducted using PubMed as the primary database, with MeSH terms “leishmanin skin test” OR “Montenegro test” OR “Montenegro skin test.” Articles written in English that describe the history or standardization of leishmanin, the use of leishmanin in an IGRA, or the use of the LST in epidemiological studies or vaccine trials were prioritized in our appraisal of the literature.

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The Intracutaneous Test in Cutaneous Leishmaniasis

Cited by 32 publications

References 3 publications

American Tegumentary Leishmaniasis: Effectiveness of an Immunohistochemical Protocol for the Detection of Leishmania in Skin

American Tegumentary Leishmaniasis: Effectiveness of an Immunohistochemical Protocol for the Detection of Leishmania in Skin

Cell‐Mediated and Humoral Immunity to Protozoan Infections

A review of the leishmanin skin test: A neglected test for a neglected disease

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