title: Leishmania isoenzyme polymorphisms in Ecuador: relationships with geographic distribution and clinical presentation.
abstract: BACKGROUND
  Determinants of the clinical presentation of the leishmaniases are poorly understood but Leishmania species and strain differences are important. To examine the relationship between clinical presentation, species and isoenzyme polymorphisms, 56 Leishmania isolates from distinct presentations of American tegumentary leishmaniasis (ATL) from Ecuador were analyzed.
  
  
  METHODS
  Isolates were characterized by multilocus enzyme electrophoresis for polymorphisms of 11 isoenzymes. Patients were infected in four different ecologic regions: highland and lowland jungle of the Pacific coast, Amazonian lowlands and Andean highlands.
  
  
  RESULTS
  Six Leishmania species constituting 21 zymodemes were identified: L. (Viannia) panamensis (21 isolates, 7 zymodemes), L. (V.) guyanensis (7 isolates, 4 zymodemes), L. (V.) braziliensis (5 isolates, 3 zymodemes), L. (Leishmania) mexicana (11 isolates, 4 zymodemes), L. (L.) amazonensis (10 isolates, 2 zymodemes) and L. (L.) major (2 isolates, 1 zymodeme). L. panamensis was the species most frequently identified in the Pacific region and was associated with several clinical variants of cutaneous disease (CL); eight cases of leishmaniasis recidiva cutis (LRC) found in the Pacific highlands were associated with 3 zymodemes of this species. Mucocutaneous leishmaniasis found only in the Amazonian focus was associated with 3 zymodemes of L. braziliensis. The papular variant of CL, Uta, found in the Andean highlands was related predominantly with a single zymodeme of L. mexicana.
  
  
  CONCLUSIONS
  Our data show a high degree of phenotypic variation within species, and some evidence for associations between specific variants of ATL (i.e. Uta and LRC) and specific Leishmania zymodemes. This study further defines the geographic distribution of Leishmania species and clinical variants of ATL in Ecuador.
authors.affiliation: Department of Parasitology, Kochi Medical School, Kochi University, Kochi 783-8505, Japan. mcalvopina@hotmail.com
authors.forename: Manuel
authors.initials: M
authors.lastname: Calvopina
authors.forename: Rodrigo X
authors.initials: RX
authors.lastname: Armijos
authors.forename: Jorge D
authors.initials: JD
authors.lastname: Marco
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Uezato
authors.forename: Hirotomo
authors.initials: H
authors.lastname: Kato
authors.forename: Eduardo A
authors.initials: EA
authors.lastname: Gomez
authors.forename: Masataka
authors.initials: M
authors.lastname: Korenaga
authors.forename: Paola A
authors.initials: PA
authors.lastname: Barroso
authors.forename: Tatsuyuki
authors.initials: T
authors.lastname: Mimori
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Cooper
authors.forename: Shigeo
authors.initials: S
authors.lastname: Nonaka
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Hashiguchi
mesh_terms: D000328:Adult; D000818:Animals; D002648:Child; D002675:Child, Preschool; D004484:Ecuador; D005260:Female; D006801:Humans; D007527:Isoenzymes / Q000235:genetics*; D007891:Leishmania / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification; D016773:Leishmaniasis, Cutaneous / Q000469:parasitology*; D008297:Male; D011110:Polymorphism, Genetic
chemical_list: D007527:Isoenzymes