Abstract
Post-kala-azar dermal leishmaniasis (PKDL) is a skin manifestation of visceral leishmaniasis (VL) which develops after apparent cure in some patients. PKDL is considered as the potential reservoir for the VL infection. Molecular epidemiological characterization of L. donovani isolates obtained from VL and PKDL isolates is essentially required in order to understand the transmission dynamics of the VL infection. To date, genetic variation among the VL and PKDL L. donovani isolates was not fully elucidated. Therefore, 14 clinical isolates from VL and 4 clinical isolates from PKDL were speciated by hsp70 and rDNA genes. Further characterization of L. donovani by haspB PCR demonstrates two different genotypes. All PKDL isolates have the same genetic structure. kDNA PCR-RFLP assay revealed 18 different genotypes; however, structural analysis showed the two distinct kDNA genotype population (k = 2). The kDNA fingerprint patterns of parasites from hilly districts were clustered separately from low-land districts. Therefore, further study with a large number of samples is urgently required for systematic characterization of the clinical isolates to track the molecular epidemiology of the Leishmania donovani causing VL and the role of PKDL as a reservoir.
Highlights
Post-kala-azar dermal leishmaniasis (PKDL) is a progression of visceral leishmaniasis (VL) that demonstrates lesions or hypopigmented skin rashes in patients even after successful treatment of VL [1]. is cryptic PKDL is characterised by papular, macular, and/or nodular lesions throughout the body, mainly demonstrated on the face, trunk, legs, arms, and genitals
The asymptomatic VL infection is considered as the reservoir for VL transmission that threatens for VL elimination in the Indian subcontinent [8]. e immunological responses are found to be different in patients with VL and PKDL [2]
The molecular epidemiology of L. donovani causing different clinical manifestations is required to understand in order to minimize the risk of VL elimination in the Indian subcontinent. e genetic analysis has shown the significant heterogeneity among the Indian L. donovani isolates that cause different clinical presentations such as VL and PKDL [9, 10]
Summary
Post-kala-azar dermal leishmaniasis (PKDL) is a progression of visceral leishmaniasis (VL) that demonstrates lesions or hypopigmented skin rashes in patients even after successful treatment of VL [1]. is cryptic PKDL is characterised by papular, macular, and/or nodular lesions throughout the body, mainly demonstrated on the face, trunk, legs, arms, and genitals. E PKDL skin lesion has a tendency to become chronic and harbours the parasite, considered as a reservoir, especially challenging the elimination programme of VL from the Indian subcontinent [5, 6]. E genetic analysis has shown the significant heterogeneity among the Indian L. donovani isolates that cause different clinical presentations such as VL and PKDL [9, 10]. The molecular epidemiology of L. donovani causing different clinical manifestations is required to understand in order to minimize the risk of VL elimination in the Indian subcontinent. No such data on genetic characterization of L
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