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Detection of high levels of anti-α-galactosyl antibodies in sera of patients with Old World cutaneous leishmaniasis: a possible tool for diagnosis and biomarker for cure in an elimination setting

Published online by Cambridge University Press:  09 October 2014

WALEED S. AL-SALEM
Affiliation:
Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK Saudi Ministry of Health, Riyadh, Kingdom of Saudi Arabia
DANIELA M. FERREIRA
Affiliation:
Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
NAOMI A. DYER
Affiliation:
Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
ESSAM J. ALYAMANI
Affiliation:
National Center for Biotechnology, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
SALAH M. BALGHONAIM
Affiliation:
Saudi Ministry of Health, Riyadh, Kingdom of Saudi Arabia
AHMED Y. AL-MEHNA
Affiliation:
Saudi Ministry of Health, Riyadh, Kingdom of Saudi Arabia
SALEEM AL-ZUBIANY
Affiliation:
Saudi Ministry of Health, Riyadh, Kingdom of Saudi Arabia
EL-KEIR IBRAHIM
Affiliation:
Saudi Ministry of Health, Riyadh, Kingdom of Saudi Arabia
ALI M. AL SHAHRANI
Affiliation:
Saudi Ministry of Health, Riyadh, Kingdom of Saudi Arabia
HAMED ALKHUAILED
Affiliation:
Saudi Ministry of Health, Riyadh, Kingdom of Saudi Arabia
MOHAMMED A. ALDAHAN
Affiliation:
Saudi Ministry of Health, Riyadh, Kingdom of Saudi Arabia
ABDULAZIZ M. AL JARALLH
Affiliation:
Saudi Ministry of Health, Riyadh, Kingdom of Saudi Arabia
SAMER S. ABDELHADY
Affiliation:
Saudi Ministry of Health, Riyadh, Kingdom of Saudi Arabia
MOHAMMED H. AL-ZAHRANI
Affiliation:
Saudi Ministry of Health, Riyadh, Kingdom of Saudi Arabia
IGOR C. ALMEIDA
Affiliation:
Department of Biological Sciences, The Border Biomedical Research Center, University of Texas, El Paso, Texas 79968, USA
ALVARO ACOSTA-SERRANO*
Affiliation:
Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK Department of Vector Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
*
*Corresponding author: Department of Parasitology and Department of Vector Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK. E-mail: alvaro.acosta-serrano@lstmed.ac.uk

Summary

In the Kingdom of Saudi Arabia (KSA), Old World cutaneous leishmaniasis (CL) is mainly caused by Leishmania major and Leishmania tropica parasites. Diagnosis of CL is predominately made by clinicians, who at times fail to detect the disease and are unable to identify parasite species. Here, we report the development of a chemiluminescent enzyme-linked immunosorbent assay (CL-ELISA) to measure the levels of anti-α-galactosyl antibodies in human sera. Using this assay, we have found that individuals infected with either Leishmania spp. had significantly elevated levels (up to 9-fold higher) of anti-α-Gal IgG compared to healthy control individuals. The assay sensitivity was 96% for L. major (95% CI; 94–98%) and 91% for L. tropica (95% CI; 86–98%) infections and therefore equivalent to restriction fragment length polymorphism-polymerase chain reaction analysis of parasite ITS1 gene. In addition, the assay had higher sensitivity than microscopy analysis, which only detected 68 and 45% of the L. major and L. tropica infections, respectively. Interestingly, up to 2 years following confirmed CL cure individuals had 28-fold higher levels of anti-α-Gal IgG compared to healthy volunteers. Monitoring levels of anti-α-Gal antibodies can be exploited as both a diagnostic tool and as a biomarker of cure of Old World CL in disease elimination settings.

Type
Special Issue Article
Copyright
Copyright © Cambridge University Press 2014 

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