ABSTRACT
ABSTRACT Localized cutaneous leishmaniasis (LCL) is an endemic disease in several Mexican States with the main endemic areas located in the South-Southeast region of the country, where 90% of Leishmania (Leishmania) mexicana cases are registered. The Southeast region is located in the Yucatan Peninsula, including Campeche, Quintana Roo and Yucatan States. Campeche and Quintana Roo register more than 60% of the cases in the country each year, while in Yucatan the reports are of imported cases due to residents traveling to endemic areas. However, since 2015, autochthonous cases have been diagnosed by health authorities in municipalities with no previous transmission records. We aimed to identify Leishmania parasite species involved in autochthonous cases by means of the PCR technique. The present study included 13 autochthonous cases of LCL with clinical and parasitological diagnoses during 2018 and 2019 by health authorities, without specific identification of the causal agent. Tissue samples were taken by scraping the margins of active lesions and then they were spotted onto an FTATM Elute Microcard. Next, DNA was eluted and used for PCR amplification of specific Leishmania genus and L. (L.) mexicana species-specific fragments. Molecular analysis showed evidence that L. (L.) mexicana was the causal agent of LCL in 12 of the 13 patients; in one patient, PCR was not performed due to the patient's refusal to participate in the study. Identifying Leishmania species that cause LCL is necessary to define efficient treatment schemes and control strategies for the disease in vulnerable and susceptible areas of the Yucatan State's municipalities.
ABSTRACT
En la leishmaniosis experimental, la función de los anticuerpos no está completamente clara, ya que algunos autores consideran que dichas proteínas no participan en la protección contra la infección; sin embargo, estudios histopatológicos en lesiones con leishmaniosis humana y experimental, muestran infiltrados de células plasmáticas positivas para IgA y secreción de IgM, IgG e IgA que podrían mediar la formación de complejos inmunológicos con antígenos parasitarios o propios, favoreciendo la necrosis lo que conlleva a la eliminación del parásito. En este trabajo se determinó si la IgA sérica en el modelo murino posee reactividad específica contra antígenos de Leishmania (Leishmania) mexicana de utilidad diagnóstica. Para ello, se utilizaron ratones susceptibles y resistentes a leishmaniosis cutánea, demostrándose mediante ELISA indirecta que la IgA sérica de ratones susceptibles es elevada en comparación con la producida por ratones resistentes. Aunque otros estudios en modelos murinos demuestran que la IgG sérica de ratones infectados con L. (L) mexicana presenta reactividad cruzada con antígenos parasitarios no relacionados obtenidos de Trypanosoma cruzi, al analizar la especificidad de IgA por antígenos de L. (L) mexicana y T. cruzi, mediante Western Blot, se demostró que la IgA sérica de ratones infectados con T. cruzi también reaccionan con antígenos de L. (L) mexicana, estos hallazgos sugieren que la IgA puede ser útil para el manejo clínico y pronóstico de la enfermedad.
In experimental leishmaniasis, the role of antibodies is not entirely clear, as some authors consider that these proteins are not involved in protection against infection. However, histopathological studies in human and experimental leishmaniasis lesions, show plasma cell infiltrates positive for IgA and secretion of IgM, IgG and IgA could mediate the formation of immune complexes with parasite antigens or self components, favoring necrosis leading to the elimination of the parasite. In this study, we determined if the serum IgA in the murine model has specific reactivity against antigens of Leishmania (Leishmania) mexicana of diagnostic utility. To do this, we used mice either susceptible or resistant to cutaneous leishmaniasis, and demonstrated by indirect ELISA that serum IgA is elevated in susceptible mice compared with that produced by resistant mice. Although other studies in murine models show that the serum IgG from mice infected with L. (L) mexicana present cross reactivity with unrelated parasite antigens derived from Trypanosoma cruzi, the analysis of the specificity of IgA by antigens of L. (L) mexicana and T. cruzi, by Western Blot, showed that the IgA serum of mice infected with T. cruzi reacts too with antigens of L. (L) mexicana. These findings suggest that IgA may be useful for the clinical management and prognosis of the disease.
Subject(s)
Animals , Female , Mice , Antibodies, Protozoan/blood , Antigens, Protozoan/immunology , Immunoglobulin A/blood , Leishmania mexicana/immunology , Leishmaniasis, Cutaneous/immunology , Antibody Specificity , Antibodies, Protozoan/immunology , Antigens, Protozoan/isolation & purification , Cross Reactions , Disease Resistance , Disease Susceptibility , Electrophoresis, Polyacrylamide Gel , Enzyme-Linked Immunosorbent Assay , Immunoglobulin A/immunology , Leishmania mexicana/growth & development , Leishmaniasis, Cutaneous/blood , Mice, Inbred BALB C , Molecular Weight , Trypanosoma cruzi/immunologyABSTRACT
In the Yucatan Peninsula of Mexico, 95% of the human cases of Cutaneous Leishmaniasis are caused by Leishmania (Leishmania) mexicana with an incidence rate of 5.08 per 100,000 inhabitants. Transmission is limited to the winter months (November to March). One study on wild rodents has incriminated Ototylomys phyllotis and Peromyscus yucatanicus as primary reservoirs of L. (L.) mexicana in the focus of La Libertad, Campeche. In the present study, the prevalence of both infection and disease caused by L. (L.) mexicana in small terrestrial mammals were documented during five transmission seasons (1994-2004) in five foci of Leishmaniasis in the state of Campeche. Foci separated by only 100 km, with similar relative abundances of small mammals, were found to differ significantly in their prevalence of both symptoms and infection. Transmission rates and reservoir species seemed to change in space as well as in time which limited the implementation of effective control measures of the disease even in a small endemic area such as the south of the Yucatan Peninsula.
En la Península de Yucatán, México, la Leishmaniosis Cutánea es causada por Leishmania (L.) mexicana en 95% de los casos humanos, con una incidencia de 5.08% por cada 100,000 habitantes. El ciclo de transmisión se limita a la estación de invierno (noviembre- marzo). Un estudio de mamíferos silvestres incrimina a Ototylomys phyllotis y Peromyscus yucatanicus como reservorios primarios de L. (L.) mexicana en el foco de infección de La Libertad, Campeche. En el presente estudio, se documenta la prevalencia de infección/enfermedad causada por L. (L.) mexicana en pequeños mamíferos, durante cinco estaciones de transmisión (1994-2004) en cinco focos de CL del estado de Campeche. Los focos separados por solamente 100 km. de distancia, aún cuando tienen abundancias relativas de pequeños roedores similares, fueron significativamente diferentes en relación a la prevalencia de síntomas así como de infección. Las tasas de transmisión y las especies de reservorios parecen estar cambiando tanto en el tiempo como en el espacio, lo cual impide el establecimiento de adecuadas medidas de control de la enfermedad aún en un área endémica tan pequeña como lo es el sur de la Península de Yucatán.