Diagnosis of visceral leishmaniasis by enzyme-linked immunosorbent assay using urine samples.
A diagnostic method has been developed to detect anti-Leishmania donovani immunoglobulin G (IgG) in urine by enzyme-linked immunosorbent assay (ELISA). In measuring anti-L. donovani IgG, IgA, and IgM in urine, the method performed best in the detection of IgG. The sensitivity and specificity of the assay were determined with panels of urine samples from 62 visceral leishmaniasis (VL) patients, 59 healthy controls from areas of endemicity, 53 healthy controls from areas of nonendemicity, 59 malaria patients, 13 tuberculosis patients, 23 cutaneous leishmaniasis patients, and 7 patients with other diseases. Using L. donovani promastigote crude antigen, the test had 93.5% sensitivity (58 positives of 62 VL patient samples) and 89.3% specificity (191 negatives of 214 non-VL patient samples). The ELISA with acetone-treated L. donovani promastigote antigen raised the sensitivity and specificity to 95.0 and 95.3%, respectively. Western blot analysis revealed that most of the samples that cross-reacted with crude antigen in ELISA did not recognize any antigenic component of L. donovani crude antigen. We also checked 40 serum samples from the same group of VL patients for anti-L. donovani IgG and got 90.0% sensitivity with both crude and acetone-treated antigens. As collection of urine is much easier than collection of serum, the detection of anti-L. donovani IgG in urine with acetone-treated antigen will be useful in epidemiological studies. It could be an adjunct of laboratory diagnosis.
Islam
Mohammad Zahidul
MZ
Department of Parasitology, Aichi Medical University School of Medicine, Nagakute, Japan. zahid@aichi-med-u.ac.jp
Itoh
Makoto
M
Shamsuzzaman
S M
SM
Mirza
Rusella
R
Matin
Farzana
F
Ahmed
Iftikhar
I
Shamsuzzaman Choudhury
A K M
AK
Hossain
M Akram
MA
Qiu
Xu-Guang
XG
Begam
Nilufar
N
Furuya
Masato
M
Leafasia
Judson L
JL
Hashiguchi
Yoshihisa
Y
Kimura
Eisaku
E
D000096:Acetone; D000293:Adolescent; D000328:Adult; D000368:Aged; D000913:Antibodies, Protozoan / Q000652:urine*; D000953:Antigens, Protozoan; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay / Q000592:standards; D006801:Humans; D007074:Immunoglobulin G / Q000652:urine; D007898:Leishmaniasis, Visceral / Q000175:diagnosis* / Q000652:urine; D008666:Metalloendopeptidases / Q000276:immunology; D008875:Middle Aged; D012680:Sensitivity and Specificity
D000913:Antibodies, Protozoan; D000953:Antigens, Protozoan; D007074:Immunoglobulin G; D000096:Acetone; D008666:Metalloendopeptidases; C055146:glycoprotein gp63, Leishmania