Abstract

BackgroundMany cases of cutaneous leishmaniasis (CL) have been recorded in the Jenin District based on their clinical appearance. Here, their parasites have been characterized in depth.MethodsLeishmanial parasites isolated from 12 human cases of CL from the Jenin District were cultured as promastigotes, whose DNA was extracted. The ITS1 sequence and the 7SL RNA gene were analysed as was the kinetoplast minicircle DNA (kDNA) sequence. Excreted factor (EF) serotyping and multilocus enzyme electrophoresis (MLEE) were also applied.ResultsThis extensive characterization identified the strains as Leishmania tropica of two very distinct sub-types that parallel the two sub-groups discerned by multilocus microsatellite typing (MLMT) done previously. A high degree of congruity was displayed among the results generated by the different analytical methods that had examined various cellular components and exposed intra-specific heterogeneity among the 12 strains.Three of the ten strains subjected to MLEE constituted a new zymodeme, zymodeme MON-307, and seven belonged to the known zymodeme MON-137. Ten of the 15 enzymes in the profile of zymodeme MON-307 displayed different electrophoretic mobilities compared with the enzyme profile of the zymodeme MON-137. The closest profile to that of zymodeme MON-307 was that of the zymodeme MON-76 known from Syria.Strains of the zymodeme MON-307 were EF sub-serotype A2 and those of the zymodeme MON-137 were either A9 or A9B4. The sub-serotype B4 component appears, so far, to be unique to some strains of L. tropica of zymodeme MON-137. Strains of the zymodeme MON-137 displayed a distinctive fragment of 417 bp that was absent in those of zymodeme MON-307 when their kDNA was digested with the endonuclease RsaI. kDNA-RFLP after digestion with the endonuclease MboI facilitated a further level of differentiation that partially coincided with the geographical distribution of the human cases from which the strains came.ConclusionsThe Palestinian strains that were assigned to different genetic groups differed in their MLEE profiles and their EF types. A new zymodeme, zymodeme MON-307 was discovered that seems to be unique to the northern part of the Palestinian West Bank. What seemed to be a straight forward classical situation of L. tropica causing anthroponotic CL in the Jenin District might be a more complex situation, owing to the presence of two separate sub-types of L. tropica that, possibly, indicates two separate transmission cycles involving two separate types of phlebotomine sand fly vector.

Highlights

  • Many cases of cutaneous leishmaniasis (CL) have been recorded in the Jenin District based on their clinical appearance

  • restriction fragment length polymorphism (RFLP) analysis of all fourteen PCR products from the strains of L. tropica after their digestion with RsaI did produce different kinetoplast minicircle DNA (kDNA) RFLP profiles that consisted of seven to nine bands ranging in size from 800 bp to 150 bp but of two basic kinds: Ltro-kD1 and Ltro-kD2, that differed mainly by the presence of a 417 bp component in only the LtrokD2 profiles (Figure 3b)

  • Digestion of the PCR products from the strains of L. tropica with MboI produced different kDNA RFLP profiles, consisting of three to nine bands that were of two basic kinds and congruent with the separation seen for digestion with RsaI

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Summary

Introduction

Many cases of cutaneous leishmaniasis (CL) have been recorded in the Jenin District based on their clinical appearance. Cases caused by L. tropica seem to occur mainly in the northern regions [2,3] and those caused by L. major mainly in the lower Jordan Valley in the vicinity of Jericho [4,5,6] (Figure 1a). Often they exist in close proximity despite differences in their specific biotopes and general epidemiology. A broader characterization incorporating several different methods is more useful in achieving this and exposing variation among the infectious agents This might be significant in prognosis and the need of specific treatment of cases.

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