利什曼原虫抗原对草原兔尾鼠感染婴儿利什曼原虫的免疫保护作用

目的： 测定利什曼原虫主要表面分子抗原对内脏利什曼病的免疫保护作用。方法： 用重组利什曼原虫表面糖蛋白ｒ Ｇ Ｐ６３ 和脂磷酸聚糖（ Ｌ Ｐ Ｇ） 为抗原, 以短棒状杆菌菌苗（ Ｃ Ｐ） 为佐剂免疫草原兔尾鼠后, 用婴儿利什曼原虫强毒株攻击, 观察免疫保护效果。结果： ｒ Ｇ Ｐ６３ 加 Ｌ Ｐ Ｇ 加 Ｃ Ｐ 抗原组合免疫后用２ ×１０７ 前鞭毛体攻击, 免疫动物的肝印片上 Ｌ Ｄ 数量明显降低, 减虫率为８９８ ％ 。 Ｌ Ｐ Ｇ 加 Ｃ Ｐ 免疫组减虫率为６０６ ％ 。ｒ Ｇ Ｐ６３ 包涵体加 Ｃ Ｐ 免疫组减虫率为４２４ ％ , 而纯化ｒ Ｇ Ｐ６３ 加 Ｃ Ｐ 免疫组未显示保护作用。以ｒ Ｇ Ｐ６３ 加 Ｌ Ｐ Ｇ 加 Ｃ Ｐ 免疫后用１ ×１０６ , ５ ×１０６ 和１ ×１０７ 前鞭毛体攻击时, 感染率亦有明显降低。结论： 利什曼原虫主要表面分子抗原 Ｇ Ｐ６３和 Ｌ Ｐ Ｇ 在以 Ｃ Ｐ 为佐剂的条件下, 对草原兔尾鼠婴儿利什曼原虫有明显的免疫保护效果。     

几种利什曼抗原对草原兔尾鼠婴儿利什曼原虫实验感染的保护作用

本项研究旨在确定几种利什曼表现分子抗原对婴儿利什曼原虫实验感染的免疫保护作用。用重组的利什曼原虫细胞表现糖蛋白ＧＰ６３和脂磷酸聚糖（ＬＰＧ）以短小棒状杆菌菌苗为佐剂免疫草原兔尾鼠。用婴儿利什曼原母亲朱前鞭毛体攻击感染,测定其免疫保护作用。经ｒＧＰ６３＋ＬＰＧ＋ＣＰ免疫的动物,在用２×１０＾２前鞭毛体攻击时,其肝脏的利什曼原虫数比对照动物降低８９．７９％。ＬＰＧ＋ＣＰ免疫组降低６０．６％,ｒＧＰ６３     

Leishmaniasis in Turkey: molecular characterization of Leishmania from human and canine clinical samples

Human leishmaniasis, both visceral and cutaneous, and canine leishmaniasis have been reported in Turkey for centuries. However, the advent of new diagnostic tools during the last 30 years has led to the recognition that leishmaniasis is an important public health problem throughout the country. In most disease foci both canine and human leishmaniases exist together and identification of parasite species causing these diseases is a pre-requisite for understanding disease epidemiology. A total of 109 samples obtained from human and canine leishmaniasis cases were examined using internal transcribed spacer 1 PCR followed by restriction fragment length polymorphism analysis. Our results indicate that two species, Leishmania tropica and Leishmania infantum, are primarily responsible for cutaneous and visceral leishmaniasis, respectively, in Turkey. However, a new focus of human cutaneous leishmaniasis caused by L. infantum in Hatay region is described. This finding further stresses the importance of Leishmania species molecular characterization in prescribing appropriate therapy and understanding the disease's transmission in different endemic foci.     

Humoral and in vivo cellular immunity against the raw insect-derived recombinant Leishmania infantum antigens KMPII, TRYP, LACK, and papLe22 in dogs from an endemic area

Leishmania infantum causes visceral leishmaniasis, a severe zoonotic and systemic disease that is fatal if left untreated. Identification of the antigens involved in Leishmania-specific protective immune response is a research priority for the development of effective control measures. For this purpose, we evaluated, in 27 dogs from an enzootic zone, specific humoral and cellular immune response by delayed-type hypersensitivity (DTH) skin test both against total L. infantum antigen and the raw Trichoplusia ni insect-derived kinetoplastid membrane protein-11 (rKMPII), tryparedoxin peroxidase (rTRYP), Leishmania homologue of receptors for activated C kinase (rLACK), and 22-kDa potentially aggravating protein of Leishmania (rpapLe22) antigens from this parasite. rTRYP induced the highest number of positive DTH responses (55% of leishmanin skin test [LST]-positive dogs), showing that TRYP antigen is an important T cell immunogen, and it could be a promising vaccine candidate against this disease. When TRYP-DTH and KMPII-DTH tests were evaluated in parallel, 82% of LST-positive dogs were detected, suggesting that both antigens could be considered as components of a standardized DTH immunodiagnostic tool for dogs.     

Immunity to a salivary protein of a sand fly vector protects against the fatal outcome of visceral leishmaniasis in a hamster model

Visceral leishmaniasis (VL) is a fatal disease for humans, and no vaccine is currently available. Sand fly salivary proteins have been associated with protection against cutaneous leishmaniasis. To test whether vector salivary proteins can protect against VL, a hamster model was developed involving intradermal inoculation in the ears of 100,000 Leishmania infantum chagasi parasites together with Lutzomyia longipalpis saliva to mimic natural transmission by sand flies. Hamsters developed classical signs of VL rapidly, culminating in a fatal outcome 5-6 months postinfection. Saliva had no effect on the course of infection in this model. Immunization with 16 DNA plasmids coding for salivary proteins of Lu. longipalpis resulted in the identification of LJM19, a novel 11-kDa protein, that protected hamsters against the fatal outcome of VL. LJM19-immunized hamsters maintained a low parasite load that correlated with an overall high IFN-gamma/TGF-beta ratio and inducible NOS expression in the spleen and liver up to 5 months postinfection. Importantly, a delayed-type hypersensitivity response with high expression of IFN-gamma was also noted in the skin of LJM19-immunized hamsters 48 h after exposure to uninfected sand fly bites. Induction of IFN-gamma at the site of bite could partly explain the protection observed in the viscera of LJM19-immunized hamsters through direct parasite killing and/or priming of anti-Leishmania immunity. We have shown that immunity to a defined salivary protein (LJM19) confers powerful protection against the fatal outcome of a parasitic disease, which reinforces the concept of using components of arthropod saliva in vaccine strategies against vector-borne diseases.     

Leucine rich repeats are the main epitopes in Leishmania infantum PSA during canine and human visceral leishmaniasis

The PSA protein is one of the major antigens of the surface of the Leishmania infantum parasite membrane. We describe the immune humoral response against the PSA in dogs and human patients with visceral leishmaniasis caused by L. infantum. The immunodominant region of the PSA was determined by subcloning, expression and purification of three fragments covering the complete protein. The analysis revealed that the antibodies are mostly directed against the central region, which is formed exclusively by leucine rich repeats. This region is recognized by 100% of the sera from the infected dogs and 40% of the human sera. These percentages are significantly higher than those observed when the complete protein was used as antigen. The analysis of the isotype of the G immunoglobulins raised against the immunodominant determinants of the PSA indicates that both IgG1 and IgG2 classes are produced during natural infections but that the IgG2 predominates over that of the IgG1.     

Relapses versus reinfections in patients coinfected with Leishmania infantum and human immunodeficiency virus type 1

In the Mediterranean basin, Leishmania infantum is a major opportunistic parasite in people with acquired immunodeficiency syndrome (AIDS), and up to 9% of the patients with AIDS suffer from newly acquired or reactivated visceral leishmaniasis. Distinguishing between reinfections and relapses in these patients is important because some apparent treatment failures occur in patients with new rather than reactivated infections. Isoenzyme characterization is limited for use in determining relapsed versus newly acquired leishmaniasis in human immunodeficiency virus (HIV)-infected patients because of the variability of L. infantum and the predominance of the MON-1 zymodeme in people coinfected with HIV. A seminested polymerase chain reaction (PCR) was used to amplify L. infantum minicircle kinetoplast DNA, and, after digestion, the restriction fragment-length polymorphism (RFLP) profiles showed that 3 (7.5%) of 40 patients coinfected with L. infantum and HIV had a new infection, whereas isoenzyme characterization indicated that all 40 patients had infection relapses. These results suggest the utility of this PCR-RFLP analysis in detecting leishmaniasis reinfection in HIV-positive patients.     

Importance of cats in zoonotic leishmaniasis in Portugal

Leishmaniasis, caused by Leishmania infantum, is an endemic zoonosis in the Mediterranean basin. Dogs are considered the major host for these parasites, as well as the main reservoir for human visceral infection. In recent years, asymptomatic infection or clinical disease caused by L. infantum in cats has been reported in several countries where zoonotic leishmaniasis is present. The aim of the present study was to perform a leishmaniasis survey in cats from an endemic focus. Twenty-three adult stray cats were surveyed by clinical examination, and peripheral blood samples for serological and molecular analysis were collected. In 7 of the 23 cats (30.4%) Leishmania DNA was detected in blood. A low level of fluorescent antibodies was detected in four serum samples. All the animals were asymptomatic. Taking into account the high rate of asymptomatic feline leishmaniasis in this survey, it can be suggested that cats may act as a habitual reservoir host of L. infantum infection in endemic areas. Furthermore, it will be important in the future to add this parasitosis to the differential diagnosis of feline infections from leishmaniasis foci in cats. Feline leishmaniasis diagnosis should be accessed by molecular tools.     

Importance of worldwide asymptomatic carriers of Leishmania infantum (L. chagasi) in human

Leishmaniasis due to Leishmania infantum (syn. L. chagasi) infection is a zoonotic disease present mainly in Mediterranean basin, central Asia and Brazil. Besides a limited number of human cases of clinical visceral leishmaniasis, a great number of infections remains asymptomatic. In this review, the prevalence of asymptomatic carriers of L. infantum was evaluated worldwide using parasitological methods or indirect testing such as a skin test or serology. The consequences of the presence of asymptomatic carriers on parasite transmission by blood donation or the development of clinical visceral leishmaniasis in immunocompromised individuals and its possible role as reservoir are discussed.     

Expression of Recombinant Heat-Shock Protein 70 of MCAN/IR/96/LON-49, a Tool for Diagnosis and Future Vaccine Research

Background: Heat shock protein 70 (HSP70) is present in all organisms studied so far, and is a major immunogen in infections caused by pathogens including Leishmania spp. Objective: The aim of this study was to clone and express HSP70 from L. infantum strain MCAN/IR/96/LON-49 and evaluate antibody response against HSP70 in visceral leishmaniasis (VL). Methods: The L. infantum HSP70 gene segment was amplified by specific primers. It was cloned into pTZ57R vector and subcloned into pET32a (+) expression vector. The new construct was transformed in the E.coli Rosetta strain, and HSP70 protein was expressed in the presence of 1 mM IPTG and purified using a HiTrap chelating column. Antibody responses against HSP70 were determined by ELISA in 37 patients with visceral leishmaniasis and 63 healthy controls. Results: Expression of HSP70 protein was confirmed using SDS-PAGE electrophoresis and dot blot with an anti-His tag antibody. There was no difference between the sequence of nucleotides of the HSP70 gene in the present study and other reported sequences. The ELISA results indicated that the sera of 81.1% (30/37) of the patients and 6.3% (5/63) of controls reacted to L. infantum HSP70. Conclusion: The conservative nature of the HSP70 molecule is an advantage in vaccine studies, because of minor differences (6%) between the nucleotide sequences and consequently the similarity in amino acid sequences in various strains of L. infantum. It could therefore be used in vaccine research against leishmaniasis and also as a tool for serodiagnosis.     

Synthetic glycovaccine protects against the bite of leishmania-infected sand flies

Leishmaniasis is a vectorborne disease transmitted to human and other mammalian hosts by sand fly bite. In the present study, we show that immunization with Leishmania mexicana promastigote secretory gel (PSG) or with a chemically defined synthetic glycovaccine containing the glycans found in L. mexicana PSG can provide significant protection against challenge by the bite of infected sand flies. Only the glycan from L. mexicana was protective; those from other species did not protect against L. mexicana infection. Furthermore, neither PSG nor the glycovaccine protected against artificial needle challenge, which is traditionally used in antileishmanial vaccine development. Conversely, an antigen preparation that was effective against needle challenge offered no protection against sand fly bite. These findings provide a new target for Leishmania vaccine development and demonstrate the critical role that the vector plays in the evaluation of candidate vaccines for leishmaniasis and other vectorborne diseases.     

Evidence of subjects sensitized to Leishmania infantum on the French Mediterranean coast: differences in gamma interferon production between this population and visceral leishmaniasis patients

The Marseilles region is an endemic area for visceral mediterranean leishmaniasis, but although the number of dog cases, the parasite's main host, is very high, only a few people develop the disease. We looked for sensitized healthy subjects among 25 healthy individuals living in this area by studying their in vitro lymphoproliferative response to Leishmania infantum antigens and gamma interferon synthesis. We found that 65% of tested subjects were sensitized against L. infantum. We compared their cell mediated immunity to that of 13 active Kala-Azar patients and 13 controls from non-endemic areas. In patients, results showed a specific cellular immuno-deficiency in the lymphocyte response to L. infantum antigens and a global deficiency of gamma interferon production. Interestingly, the healthy individuals from the endemic area who responded to L. infantum antigens were found to produce high gamma interferon levels after L. infantum antigen stimulation. After healing, the cell mediated-immunity of the 3 patients we followed up was similar to that of the sensitized tested healthy subjects, but the former were still producing antibodies at the time of study.     

Critical role for phosphoinositide 3-kinase gamma in parasite invasion and disease progression of cutaneous leishmaniasis

Obligate intracellular pathogens such as Leishmania specifically target host phagocytes for survival and replication. Phosphoinositide 3-kinase γ (PI3Kγ), a member of the class I PI3Ks that is highly expressed by leukocytes, controls cell migration by initiating actin polymerization and cytoskeletal reorganization, which are processes also critical for phagocytosis. In this study, we demonstrate that class IB PI3K, PI3Kγ, plays a critical role in pathogenesis of chronic cutaneous leishmaniasis caused by L. mexicana. Using the isoform-selective PI3Kγ inhibitor, AS-605240 and PI3Kγ gene-deficient mice, we show that selective blockade or deficiency of PI3Kγ significantly enhances resistance against L. mexicana that is associated with a significant suppression of parasite entry into phagocytes and reduction in recruitment of host phagocytes as well as regulatory T cells to the site of infection. Furthermore, we demonstrate that AS-605240 is as effective as the standard antileishmanial drug sodium stibogluconate in treatment of cutaneous leishmaniasis caused by L. mexicana. These findings reveal a unique role for PI3Kγ in Leishmania invasion and establishment of chronic infection, and demonstrate that therapeutic targeting of host pathways involved in establishment of infection may be a viable strategy for treating infections caused by obligate intracellular pathogens such as Leishmania.     

PCR检测婴儿利什曼原虫无症状感染的研究

目的 建立适合检测我国婴儿利什曼原虫无症状感染的PCR方法。 方法 选择6种常用于诊断内脏利什曼病的PCR引物（RV1-RV2、K13A-K13B、MC1-MC2、174-798、Pia3-Pia4和DBY-Ajs31），以培养的甘肃人株利什曼原虫前鞭毛体种植人抗凝全血抽提的DNA为模板，确定了这6种PCR引物检测我国婴儿利什曼原虫的最适条件，并比较其检测的敏感性和特异性。选用两种敏感性和特异度均佳的引物对采自利什曼病疫区100份无利什曼病症状居民的静脉血进行检测。 结果 6种PCR引物检测的特异性均达到100%，而检测的敏感性各异，检测到的原虫数目从0.1~1000条原虫/ml，其中引物RV1-RV2（0.1个原虫/ml血）和K13A-K13B（1个原虫/ml血）敏感性较高。这两对引物对100份无症状居民血的阳性检出率分别为33%（33/100）和30%（30/100）。 结论 引物RV1-RV2和K13A-K13B适于检测我国婴儿利什曼原虫无症状感染。在我国甘肃动物源性利什曼病疫区，人群利什曼原虫无症状感染率颇高。     

Influence of the inoculation route in BALB/c mice infected by Leishmania infantum

Mice of the BALB/c strain are frequently used, due to their high susceptibility to Leishmania infection. Most of the studies in visceral leishmaniasis use the endovenous or the intraperitoneal routes to inoculate the parasites. In this study, the development of experimental visceral leishmaniasis infection was evaluated in BALB/c mice inoculated with Leishmania infantum parasites by endovenous (EV group) or intraperitoneal (IP group) routes. The results shows that both inoculation routes were able to produce progressive infection in mice. However, a higher dispersion of the values of parasite density was detected among the animals of the EV group than the IP group. Our results indicate that the intraperitoneal inoculation results in a higher homogeneity of infections, so we suggest that this route should be preferentially used in experimental infections in the mice model, particularly when pools of samples are required for immune cellular studies.     

The immunobiology of leishmaniasis

Members of the genus Leishmania are important intracellular pathogens that produce either cutaneous, mucocutaneous, or visceral disease in many areas of the world. In humans as well as in other mammals, the parasite is inoculated through the skin as a flagellated, extracellular promastigote by its arthropod vector, the sandfly. Once in its mammalian host, the promastigote converts to its amastigote stage, which lacks an exteriorized flagellum and is found solely within mononuclear phagocytes during established infection. In vitro, human monocyte-derived macrophages and peritoneal macrophages from several species of rodents can ingest both promastigotes and amastigotes, and they can permit intracellular multiplication of amastigotes only. Although serum factors may play a role in the pathogenesis of the disease and in protection against reinfection, the resolution of leishmaniasis is dependent primarily on cell-mediated immune responses. There appears to be a complicated interplay between cell-mediated helper and suppressor activities. The outcome of infection in each type of leishmaniasis depends on the complex and intriguing interaction of virulence factors inherent in the parasite and genetically determined host defense mechanisms.     

Enzymatic polymorphism during Leishmania/HIV co-infection: a study of 381 Leishmania strains received between 1986 and 2000 at the international cryobank in Montpellier, France

Between 1986 and 2000, 381 Leishmania strains isolated from 288 HIV-positive patients were studied at the international cryobank in Montpellier, France. Most (95.1%) of the strains came from cases of visceral leishmaniasis but 4.9% were from HIV-positives with cutaneous leishmaniasis. The majority of the strains came from patients infected in the Mediterranean region, with a few originating in sub-Saharan Africa and South America. Isoenzymatic characterization revealed 28 zymodemes in four different species: L. infantum (which was predominant), L. donovani, L. major and L. guyanensis. The strains belonging to the L. infantum complex included 20 zymodemes, some of which have so far only been found in cases of Leishmania/HIV co-infection.     

A species-specific approach to the use of non-antimony treatments for cutaneous leishmaniasis

We used a species-specific approach to treat 10 patients with cutaneous leishmaniasis diagnosed using polymerase chain reaction. Non-antimony treatments (oral miltefosine, ketoconazole, and liposomal amphotericin B) were chosen as an alternative to pentavalent antimony drugs based on likely or proven drug efficacy against the infecting species. Leishmania Viannia panamensis was diagnosed in three patients and treated successfully with oral ketoconazole. Miltefosine treatment cured two patients with L. infantum chagasi. A wide variety of Leishmania responded to liposomal amphotericin B administered for 5-7 days. Three patients with L. V. braziliensis, one patient with L. tropica, and two patients with L. infantum chagasi were treated successfully. One person with L. V. braziliensis healed slowly because of a resistant bacterial superinfection, and a second patient with L. infantum chagasi relapsed and was retreated with miltefosine. These drugs were reasonably well-tolerated. In this limited case series, alternative non-antimony-based regimens were convenient, safe, and effective.     

Evidence for direct interaction between mast cells and Leishmania parasites

When stimulated through IgE- (or IgG-) immune complexes with parasite antigens, mast cells can release several cytokines, including IL-4, IL-6, IL-10, IL-12, Interferon-γ (IFN-γ) and tumour necrosis factor-α (TNF-α) that may influence the host response to Leishmania major in modulating lesion size and persistence during experimental infection in the mouse. Moreover, recent data demonstrated that mast cells are able to be antibody-independently activated by direct contact with bacteria, making them important elements in innate immunity. Given these data, we asked whether cell-parasite contact could directly induce mast cell mediator release and whether mast cells could be infected by L. major or L. infantum parasites.    In this study, we showed that a pure homogeneous population of mouse bone marrow derived mast cells (BMMC) in contact with living L. major or L. infantum promastigotes, but not with attenuated parasites or soluble parasite antigens, released preformed mediators such as β-hexosaminidase and the preformed pool of TNF-α within minutes. Furthermore, direct cell-parasite contact induced TNF-α synthesis by mast cells within hours. Moreover, we demonstrated by in vitro co-culture experiments that metacyclic L. major or L. infantum promastigotes are directly infective for a significant proportion of BMMC and are transformed into intracellular amastigotes. Taken together, these data suggest that mast cell can participate in the first line of defence, i.e. innate immunity, during local cutaneous infection with Leishmania parasites.     

Geographical distribution and epidemiological features of Old World cutaneous leishmaniasis foci, based on the isoenzyme analysis of 1048 strains

A series of 1048 Leishmania strains from Old World cutaneous leishmaniasis foci, isolated between 1981 and 2005, were studied by isoenzyme analysis. The strains were obtained from humans, rodents, dogs and sandflies from 33 countries. The four typically dermotropic species, Leishmania major , L. tropica , L. aethiopica and L. killicki , were found. The viscerotropic species L. donovani and L. infantum, which can occasionally be responsible for cutaneous leishmaniasis, are not considered in this paper. Leishmania major was the least polymorphic species (12 zymodemes, 638 strains). Leishmania tropica was characterized by a complex polymorphism varying according to focus (35 zymodemes, 329 strains). Leishmania aethiopica , a species restricted to East Africa, showed a high polymorphism, in spite of a limited number of strains (23 zymodemes, 40 strains). Leishmania killicki , mainly restricted to Tunisia had a single zymodeme for 39 strains. Recently a parasite close to L. killicki (one zymodeme, two strains) was isolated in Algeria, which lead us to revise the taxonomic status of this taxon.