Abstract

Many laboratory methods are used to diagnose leishmaniasis because it is characterized by varied symptoms and caused by different Leishmania species. A quantitative real-time PCR method based on a TaqMan probe was developed and modified for accurate identification of human cutaneous leishmaniasis (caused by Leishmania major or Leishmania tropica) from endemic areas of Iran. Two gene regions of amino acid permease 3 (AAP3) and cytochrome oxidase II (COII) were considered. Six new sets of species-specific primers and probes were designed. A total of 123 samples were examined and employed to evaluate and validate real-time PCR. According to parasitic load of the genesig® Leishmania Advanced Standard Kit, a serial dilution of purified plasmid (2–2×107 copies/reaction) was prepared under the same conditions for both genes. Specific primers and probes were able to detect three and six parasite copies in AAP3 and COII genes, respectively, and were able to detect three copies of parasites for L. major and L. tropica. The sensitivities of the reference kit and our method were 98.7 and 98.1%, respectively, and specificity was 100% for detecting parasite genomes in all assays. Designed primers and probes performed well in terms of efficiency and regression coefficient. For AAP3 and COII genes, respectively, the linear log range was 7 and the correlation coefficient (R2) was 0.749 and 0.996 for the reference kit using the standard generated curve and 0.98 and 0.96 with serial dilutions of parasite DNA. This research detected L. major and L. tropica definitely and opens the horizon for the other scientists in the multiplex reactions in designing and optimization of the conditions in silico and in vivo.

Highlights

  • The genus Leishmania belongs to the flagellate protozoan parasites which are transmitted through the bite of infected female phlebotomine sand flies (Ready, 2013; World Health Organization, 2021) Different manifestations of leishmaniasis depend on Leishmania species and genetics and immune status of host and can cause a variety of chronic cutaneous, cutaneousmucosal, and visceral infections (World Health Organization, 2021)

  • DNA of all 123 samples were extracted (112 fixed slides first identified with microscopic assessment applied to DNA extraction) as well as the promastigotes extracted from 11 cultured samples in NNN medium

  • The cytochrome oxidase II (COII) gene was more sensitive than amino acid permease 3 (AAP3), but AAP3 was better in terms of protection and GC percentage for discrimination and separation of Leishmania species (Table 1)

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Summary

Introduction

The genus Leishmania belongs to the flagellate protozoan parasites which are transmitted through the bite of infected female phlebotomine sand flies (Ready, 2013; World Health Organization, 2021) Different manifestations of leishmaniasis depend on Leishmania species and genetics and immune status of host and can cause a variety of chronic cutaneous, cutaneousmucosal, and visceral infections (World Health Organization, 2021). Cutaneous leishmaniasis (CL) is usually caused by L. major, L. tropica, and L. aetiopica in the Eastern Hemisphere (Dowlati, 1996; Schönian et al, 2003; Desjeux, 2004; World Health Organization, 2021). It is estimated that about 90% of CL occurs in about seven countries including Iran (Dowlati, 1996; Desjeux, 2004; World Health Organization, 2021). Wet lesions (rural CL) caused by L. major mainly appear on the lower limbs of the body, which include more than 70% of cases of CL in Iran. Dry lesions (urban CL) caused by L. tropica usually occur around a healed lesion in new papules (Dowlati, 1996; Tashakori et al, 2003; Vazirianzadeh et al, 2014)

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