Visceral Infection Caused by Leishmania tropica in Veterans of Operation Desert Storm

Magill, Alan J.; Grögl, Max; Gasser, Robert A.; Sun, Wellington; Oster, Charles N.

doi:10.1056/nejm199305133281904

Cited by 323 publications

(165 citation statements)

References 34 publications

(5 reference statements)

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“…L. tropica, which usually causes CL, may occasionally cause VL. [18][19][20] L. infantum is the predominant visceralizing Leishmania species in the Mediterranean region. 4 The identification of L. infantum as the probable cause of VL in the Jenin region is supported by molecular characterization using PCR of leishmanial isolates from the bone marrow of In addition to the presence of a suitable animal reservoir, a survey of the sand fly fauna in the Jenin region (Abdeen and others, unpublished data) indicated that several sand fly species proven or suspected to be vectors of L. infantum in other parts of the Middle East and the Mediterranean are present in the district.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of visceral leishmaniasis in the Jenin District, West Bank: 1989-1998.

Abdeen¹,

Sawalha²,

Eisenberger³

et al. 2002

The American Journal of Tropical Medicine and Hygiene

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Abstract. Fifty patients from rural areas in the Jenin district of the West Bank, Palestinian Authority, were diagnosed with visceral leishmaniasis (VL) between 1989 and 1998. Forty-nine (98%) were younger than 6 years old, the youngest being 9 months. The yearly incident rate of VL in the Jenin district was highest in 1994 (11.8/100,000) and decreased to 1.5/100,000 in 1998; a mortality rate of 4% was recorded. Seventeen (5.5%) of 308 dogs from the Jenin and Ramallah districts of the West Bank were seropositive by enzyme-linked immunosorbent assay in a survey of canine leishmaniasis. Although all the leishmanial strains cultured from humans and dogs were identified as Leishmania infantum by a species-specific polymerase chain reaction, further genetic analysis by restriction fragment length polymorphism of kinetoplast DNA revealed patterns of polymorphism within isolates. The findings indicate that an active focus of potentially fatal VL exits in the Jenin district of the West Bank and that the parasite, vector, and reservoir host are found in this area. The epidemiology of VL in that vicinity follows the pattern of a predominantly infantile disease traditionally found in Middle Eastern countries, without a considerable involvement of immunocompromised adults infected with HIV virus as reported in other regions.

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Section: Discussionmentioning

confidence: 99%

Epidemiology of visceral leishmaniasis in the Jenin District, West Bank: 1989-1998.

Abdeen¹,

Sawalha²,

Eisenberger³

et al. 2002

The American Journal of Tropical Medicine and Hygiene

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“…The potential different roles of A2 proteins may also be associated with the different sizes and abundance of these proteins because A2 proteins are much less abundant in L. mexicana than in L. donovani. 2 It is also noteworthy that there has been reports of visceral Leishmania infections caused by L. tropica, a cutaneous Leishmania species (23,24). Although the host physical and immune status can also play important roles in determining the outcome of Leishmania infection (24), it is not known what caused the pathogenic change of these L. tropica parasites.…”

mentioning

confidence: 99%

Comparison of the A2 Gene Locus in Leishmania donovani and Leishmania major and Its Control over Cutaneous Infection

Zhang

Méndez

Ghosh

et al. 2003

Journal of Biological Chemistry

101

109

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In Old World Leishmania infections, Leishmania donovani is responsible for fatal visceral leishmaniasis, and L. major is responsible for non-fatal cutaneous leishmaniasis in humans. The genetic differences between these species which govern the pathology or site of infection are not known. We have therefore carried out detailed analysis of the A2 loci in L. major and L. donovani because A2 is expressed in L. donovani but not L. major, and A2 is required for survival in visceral organs by L. donovani. We demonstrate that although L. major contains A2 gene regulatory sequences, the multiple repeats that exist in L. donovani A2 protein coding regions are absent in L. major, and the remaining corresponding A2 sequences appear to represent non-expressed pseudogenes. It was possible to restore amastigote-specific A2 expression to L. major, confirming that A2 regulatory sequences remain functional in L. major. Although L. major is a cutaneous parasite in rodents and humans, restoring A2 expression to L. major inhibited its ability to establish a cutaneous infection in susceptible BALB/c or resistant C57BL6 mice, a phenotype typical of L. donovani. There was no detectable cellular immune response against L. major after cutaneous infection with A2-expressing L. major, suggesting that the lack of growth was not attributable to acquired host resistance but to an A2-mediated suppression of parasite survival in skin macrophages. These observations argue that the lack of A2 expression in L. major contributed to its divergence from L. donovani with respect to the pathology of infection.

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“…1985). Phlebotomus sergenti, the known vector for L. tropica transmission, has also been found in A1 Taif (Nadim et al 1979), where our patient worked. The belief that certain clinical profiles are assigned to specific Leishmania species has recently been challenged.…”

Section: Discussionmentioning

confidence: 52%

“…Visceral leishmaniasis caused by L. infantum has been found near Alexandria, in El Agamy (Awadalla et al 1987). Leishmania tropica, another causative species for cutaneous leishmaniasis, is widely distributed over the Middle East, especially in countries bordering the Arabian Gulf (Nadim et al 1979), but not in Egypt. In Saudi Arabia, L. tropica is endemic in the western and south-western part of the Kingdom (Peters et al 1985).…”

Section: Introductionmentioning

confidence: 99%

Leishmania tropica in Egypt: an undesirable import

Mohareb

Mikhail

Youssef

1996

Tropical Med Int Health

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Summary Cutaneous as well as visceral leishmaniasis has been previously reported in Egypt. The former clinical manifestation is attributed to Leishmania major, the latter to L. infantum. In this study, L. tropica was isolated from an Egyptian labourer returning from Saudi Arabia. Amastigotes were detected by both Giemsa staining and indirect immunofluorescence using rabbit anti‐gp63. Promastigotes from Schneider's medium were typed isoenzymatically as L. tropica. In view of the emerging threat of visceralization of L. tropica, the potential risk for its transmission in Egypt is discussed.

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Visceral Infection Caused by Leishmania tropica in Veterans of Operation Desert Storm

Abstract: _T.-AENY SEONL Oiv bitk). 4411itI A11

Cited by 323 publications

References 34 publications

Epidemiology of visceral leishmaniasis in the Jenin District, West Bank: 1989-1998.

Epidemiology of visceral leishmaniasis in the Jenin District, West Bank: 1989-1998.

Comparison of the A2 Gene Locus in Leishmania donovani and Leishmania major and Its Control over Cutaneous Infection

Leishmania tropica in Egypt: an undesirable import

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