Abstract

BackgroundVisceral leishmaniasis (VL), is a parasitic disease that causes serious medical consequences if treatment is delayed. Despite a decline in the number of VL cases in the Indian subcontinent, the commencement of the disease in newer areas continues to be a major concern. Although serological diagnosis mainly by immunochromatographic tests has been found to be effective, a test of cure in different phases of treatment is still desired. Even though a good prophylactic response has been obtained in murine models by a number of vaccine candidates, few have been proposed for human use.MethodsIn this study, nine antigenic components (31, 34, 36, 45, 51, 63, 72, 91 and 97 kDa) of Leishmania promastigote membrane antigens (LAg), were electroeluted and evaluated through ELISA to diagnose and distinguish active VL from one month cured and six months post-treatment patients. Further, to investigate the immunogenicity of electroeluted proteins, human PBMCs of cured VL patients were stimulated with 31, 34, 51, 63, 72 and 91 kDa proteins.ResultsWe found that 34 and 51 kDa proteins show 100% sensitivity and specificity with healthy controls and other diseases. After six months post-treatment, antibodies to 72 and 91 kDa antigens show a significant decline to almost normal levels. This suggests that 34 and 51 kDa proteins are efficient in diagnosis, whereas 72 and 91 kDa proteins may be used to monitor treatment outcome. In another assay, 51 and 63 kDa proteins demonstrated maximum ability to upregulate IFN-γ and IL-12 with minimum induction of IL-10 and TGF-β. The results indicating that 51 and 63 kDa proteins could be strong candidates for human immunization against VL. In contrast, 34 and 91 kDa proteins demonstrated a reverse profile and may not be a good vaccine candidate.ConclusionsThe preliminary data obtained in this study proposes the potential of some of the antigens in Leishmania diagnosis and for test of cure. Additionally, some antigens demonstrated good immunoprophylactic cytokine production through T cell-mediated immune response, suggesting future vaccine candidates for VL. However, further studies are necessary to explore these antigens in diagnosis and to access the long-term immune response.

Highlights

  • Visceral leishmaniasis (VL), is a parasitic disease that causes serious medical consequences if treatment is delayed

  • We have reported the diagnostic value of Leishmania promastigote membrane antigens (LAg) through various immunological techniques such as enzyme-linked immunosorbent assay (ELISA), immunoblot and dipstick test [5, 10, 11]

  • In the follow-up group, sera after six months of treatment showed a remarkable decrease in the antibody titer with no positive reactivity against LAg and the mean was below the cut-off line

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Summary

Introduction

Visceral leishmaniasis (VL), is a parasitic disease that causes serious medical consequences if treatment is delayed. Despite a decline in the number of VL cases in the Indian subcontinent, the commencement of the disease in newer areas continues to be a major concern. Despite a reduction in the number of visceral leishmaniasis (VL) cases in previously endemic areas, many regions still show the presence of disease burden and spread into newer areas has been reported. Since a single antigen is not effective for all endemic areas, newer antigens have been screened and evaluated for the serodiagnosis of VL. Recombinant leishmanial antigens such as rKLO8, rKE16 and rK28 are few of them [6,7,8,9]. Anti-leishmanial antibodies in the sera of active and cured VL patients have shown variable reactivity against several proteins of LAg in the immunoblot assay [12]

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