What Is Leishmaniasis

Visceral leishmaniasis (VL) is a vector-borne chronic infectious disease caused by the protozoan parasite Leishmania donovani or Leishmania infantum. VL is a serious public health problem, causing high morbidity and mortality in the developing world with an estimated 0.2–0.4 million new cases each year. In the absence of a vaccine, chemotherapy remains the favored option for disease control, but is limited by a narrow therapeutic index, significant toxicities, and frequently acquired resistance. Improved understanding of VL pathogenesis offers the development and deployment of immune based treatment options either alone or in combination with chemotherapy. Modulations of host immune response include the inhibition of molecular pathways that are crucial for parasite growth and maintenance; and stimulation of host effectors immune responses that restore the impaired effector functions. In this review, we highlight the challenges in treatment of VL with a particular emphasis on immunotherapy and targeted therapies to improve clinical outcomes.

Leishmaniasis Symptoms

The first sign of the localized cutaneous form is the appearance of an erythematous spot at the site of a mosquito bite, after an incubation period ranging from 2 weeks to 3 months. This spot evolves into a papule, that progressively ulcerates over a period of 2 weeks to 6 months .The typical lesion is a round or oval painless ulcer, located on exposed skin areas Although the ulcerated form comprises the vast majority of ATL cases, the disease can evolve with indeterminate clinical features.

ELISA For Leishmaniasis

Serological assays have been extensively evaluated for diagnosis of visceral leishmaniasis (VL) and considered as a routine method for diagnosis of VL while these methods are not properly evaluated for diagnosis of cutaneous leishmaniasis (CL). This study aimed to assess the performance of indirect immunofluorescent-antibody test (IFA) and enzyme-linked immunosorbent assay (ELISA) for serodiagnosis of cutaneous leishmaniasis in Iran. Sixty-one sera samples from parasitologically confirmed CL patients and 50 sera from healthy controls along with 50 sera from non-CL patients were collected. Antigen was prepared from promastigotes and amastigotes of Leishmania major. IFA was used to detect anti-Leishmania IgG while ELISA was used to detect anti-Leishmania IgM, total IgG, or IgG subclasses (IgG1 and 4). ELISA, for detection of total IgG and IgM, showed sensitivity of 83.6% and 84.7% and specificity of 62.7% and 54.6%, respectively. Sensitivity and specificity of ELISA for detecting IgG1 and IgG4 were 64%, 75% and 85%, 49%, respectively. Sensitivity and specificity of IFA were 91.6% and 81%. Conclusion. Findings of this study demonstrated that serological test, especially IFA, can be used for proper diagnosis of CL.

Leishmaniasis Diagnosis

The term ATL covers a wide clinical spectrum of manifestations, according to several characteristics of the host and the causative agent. Clinical examination, despite not giving a definite diagnosis, is a useful tool to every dermatologist, especially in defining which diagnostic tests should be required. Considering which area of skin is affected, ATL can be classified as cutaneous, mucosal or mucocutaneous. Additional criteria, such as medical history, time of evolution, distribution, extent of lesions and host immunity,will be addressed in the following classifications regarding the utility of various diagnostic tests.

ELISA For Leishmaniasis Related Studies

1.Singh OP, Sundar S.(2014)Immunotherapy and targeted therapies in treatment of visceral leishmaniasis: current status and future prospects.Front Immunol. 5:296.

2.Ciro Martins Gomes et al.(2014).Complementary exams in the diagnosis of american tegumentary leishmaniasis.An Bras Dermatol.89(5):701-9.

3.Sarkari B et al.(2014).Performance of an ELISA and indirect immunofluorescence assay in serological diagnosis of zoonotic cutaneous leishmaniasis in iran.Interdisciplinary Perspectives on Infectious Diseases Volume 2014 , Article ID 505134, 4 pages.