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Master's Dissertation
DOI
10.11606/D.99.2017.tde-22112017-105830
Document
Author
Full name
Camila Massae Sato
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2017
Supervisor
Committee
Goto, Hiro (President)
Kesper Junior, Norival
Silva, Marcos Vinicius da
Title in Portuguese
Diagnóstico sorológico da leishmaniose tegumentar americana causada por espécies diferentes de Leishmania
Keywords in Portuguese
Antígenos
Diagnóstico
ELISA
Leishmania
Leishmaniose cutânea
Testes sorológicos
Abstract in Portuguese
A leishmaniose tegumentar americana (LTA) é causada por várias espécies de protozoários do gênero Leishmania e compreende um grupo de doenças que apresentam características clínicas, histopatológicas e imunológicas distintas. O diagnóstico é realizado em base epidemiológica, clínica e patológica, confirmadas por exames parasitológicos positivos e demonstração de hipersensibilidade retardada a antígeno de leishmânia. Os testes sorológicos para o diagnóstico, utilizados até o momento, apresentam várias limitações e por isso é de grande importância identificar proteínas recombinantes de leishmânia, para que sejam testadas como potenciais antígenos para o desenvolvimento de técnicas para o diagnóstico da LTA. Neste estudo, foram utilizadas duas proteínas recombinantes de leishmânia altamente conservadas, Lb8E e Lb6H, derivadas de Leishmania (Viannia) braziliensis (Lb), avaliando a sua capacidade para detectar anticorpos no soro de vários grupos de pacientes por teste imunoenzimático (ELISA). Os antígenos recombinantes reagiram com amostras de 83,3% e 100,0% (Lb6H) dos pacientes com LTA e 95,4% (Lb8E) e 89,4% (Lb6H) dos soros de pacientes de leishmaniose visceral (LV). Em amostras de indivíduos saudáveis, as reações com Lb8E e Lb6H foram altamente específicas. Soros de 219 pacientes com LTA infectados com diferentes espécies de leishmânia prevalentes no Brasil (Leishmania (Leishmania) amazonensis, L. (Viannia) braziliensis, L. (V.) guyanensis e L. (V.) shawi) e amostras de pacientes com outras infecções parasitárias foram avaliados para a presença de anticorpos anti-rLb6H, obtendo-se sensibilidade de 100,0% nas 219 amostras de LTA e especificidade geral de 93,9% (considerando 68 indivíduos saudáveis e 213 pacientes com outras doenças infecciosas). Além disso, as amostras de outras doenças infecciosas indicaram provável ausência de reação cruzada, pois apenas uma minoria de amostras de pacientes com doença de Chagas possuía anticorpos contra rLb6H e essas respostas foram baixas. Enfim, os resultados obtidos sugerem que a técnica de ELISA utilizando o antígeno rLb6H pode ser consideradoa para uso na rotina do diagnóstico sorológico da LTA.
Title in English
Serologic diagnosis of American tegumentary leishmaniasis caused by different species of Leishmania
Keywords in English
Antigen
Cutaneous leishmaniasis
Diagnostics
ELISA
Leishmania
Serological tests
Abstract in English
American tegumentary leishmaniasis (ATL) is caused by various species of protozoan of the genus Leishmania and comprises a group of diseases that present distinct clinical, histopathological and immunological characteristics. The diagnosis is performed based on epidemiological, clinical and pathological features, supported by positive parasitological tests and presence of delayed hypersensitivity to Leishmania antigens. The serological tests used to date have several limitations and therefore it is of great importance to identify recombinant proteins from Leishmania so that they can be tested as potential antigens for the development of techniques for the diagnosis of ATL. In this study, two highly conserved Leishmania recombinant proteins, Lb8E and Lb6H, derived from Leishmania (Viannia) braziliensis (Lb), were used, evaluating their ability to detect antibodies in the serum of several groups of patients by enzyme-linked immunosorbent assay (ELISA). Recombinant antigens detected 83.3% (Lb8E) and 100.0% (Lb6H) ATL patients, and 95.4% (Lb8E) and 89.4% (Lb6H) visceral leishmaniasis (VL) patients. These reactions with Lb8E and Lb6H were highly specific in healthy subjects. Sera from ATL patients infected with different species of Leishmania, prevalent in Brazil, (Leishmania (Leishmania) amazonensis, L. (Viannia) braziliensis, L. (V.) guyanensis and L. (V.) shawi) and samples from patients with other parasitic infections were evaluated for the presence of anti-rLb6H antibodies. In 219 ATL, the sensitivity was 100.0% e the general specificity, considering 68 healthy subjects and 213 patients with other infectious diseases. In addition, samples from other infectious diseases indicated a probable lack of cross-reactivity, as only a minority of samples from patients with Chagas disease had antibodies against rLb6H and all of these responses were low. Finally, the results suggest that the ELISA using rLb6H antigen may be considered for routine use for serological diagnosis of ATL.
 
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Publishing Date
2017-11-22
 
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