title: Detection of high levels of anti-α-galactosyl antibodies in sera of patients with Old World cutaneous leishmaniasis: a possible tool for diagnosis and biomarker for cure in an elimination setting.
abstract: In the Kingdom of Saudi Arabia (KSA), Old World cutaneous leishmaniasis (CL) is mainly caused by Leishmania major and Leishmania tropica parasites. Diagnosis of CL is predominately made by clinicians, who at times fail to detect the disease and are unable to identify parasite species. Here, we report the development of a chemiluminescent enzyme-linked immunosorbent assay (CL-ELISA) to measure the levels of anti-α-galactosyl antibodies in human sera. Using this assay, we have found that individuals infected with either Leishmania spp. had significantly elevated levels (up to 9-fold higher) of anti-α-Gal IgG compared to healthy control individuals. The assay sensitivity was 96% for L. major (95% CI; 94-98%) and 91% for L. tropica (95% CI; 86-98%) infections and therefore equivalent to restriction fragment length polymorphism-polymerase chain reaction analysis of parasite ITS1 gene. In addition, the assay had higher sensitivity than microscopy analysis, which only detected 68 and 45% of the L. major and L. tropica infections, respectively. Interestingly, up to 2 years following confirmed CL cure individuals had 28-fold higher levels of anti-α-Gal IgG compared to healthy volunteers. Monitoring levels of anti-α-Gal antibodies can be exploited as both a diagnostic tool and as a biomarker of cure of Old World CL in disease elimination settings.
authors.affiliation: Department of Parasitology,Liverpool School of Tropical Medicine,Pembroke Place, Liverpool L3 5QA,UK.
authors.forename: Waleed S
authors.initials: WS
authors.lastname: Al-Salem
authors.affiliation: Department of Clinical Sciences,Liverpool School of Tropical Medicine,Pembroke Place, Liverpool L3 5QA,UK.
authors.forename: Daniela M
authors.initials: DM
authors.lastname: Ferreira
authors.affiliation: Department of Parasitology,Liverpool School of Tropical Medicine,Pembroke Place, Liverpool L3 5QA,UK.
authors.forename: Naomi A
authors.initials: NA
authors.lastname: Dyer
authors.affiliation: National Center for Biotechnology, King Abdulaziz City for Science and Technology,Riyadh,Saudi Arabia.
authors.forename: Essam J
authors.initials: EJ
authors.lastname: Alyamani
authors.affiliation: Saudi Ministry of Health,Riyadh,Kingdom of Saudi Arabia.
authors.forename: Salah M
authors.initials: SM
authors.lastname: Balghonaim
authors.affiliation: Saudi Ministry of Health,Riyadh,Kingdom of Saudi Arabia.
authors.forename: Ahmed Y
authors.initials: AY
authors.lastname: Al-Mehna
authors.affiliation: Saudi Ministry of Health,Riyadh,Kingdom of Saudi Arabia.
authors.forename: Saleem
authors.initials: S
authors.lastname: Al-Zubiany
authors.affiliation: Saudi Ministry of Health,Riyadh,Kingdom of Saudi Arabia.
authors.forename: El-Keir
authors.initials: el-K
authors.lastname: Ibrahim
authors.affiliation: Saudi Ministry of Health,Riyadh,Kingdom of Saudi Arabia.
authors.forename: Ali M
authors.initials: AM
authors.lastname: Al Shahrani
authors.affiliation: Saudi Ministry of Health,Riyadh,Kingdom of Saudi Arabia.
authors.forename: Hamed
authors.initials: H
authors.lastname: Alkhuailed
authors.affiliation: Saudi Ministry of Health,Riyadh,Kingdom of Saudi Arabia.
authors.forename: Mohammed A
authors.initials: MA
authors.lastname: Aldahan
authors.affiliation: Saudi Ministry of Health,Riyadh,Kingdom of Saudi Arabia.
authors.forename: Abdulaziz M
authors.initials: AM
authors.lastname: Al Jarallh
authors.affiliation: Saudi Ministry of Health,Riyadh,Kingdom of Saudi Arabia.
authors.forename: Samer S
authors.initials: SS
authors.lastname: Abdelhady
authors.affiliation: Saudi Ministry of Health,Riyadh,Kingdom of Saudi Arabia.
authors.forename: Mohammed H
authors.initials: MH
authors.lastname: Al-Zahrani
authors.affiliation: Department of Biological Sciences,The Border Biomedical Research Center, University of Texas,El Paso, Texas 79968,USA.
authors.forename: Igor C
authors.initials: IC
authors.lastname: Almeida
authors.affiliation: Department of Parasitology,Liverpool School of Tropical Medicine,Pembroke Place, Liverpool L3 5QA,UK.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Acosta-Serrano
mesh_terms: D000293:Adolescent; D000328:Adult; D000888:Antibodies, Anti-Idiotypic / Q000097:blood*; D000913:Antibodies, Protozoan / Q000097:blood*; D015415:Biomarkers / Q000378:metabolism; D060740:Disease Eradication; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods*; D005260:Female; D006801:Humans; D007891:Leishmania / Q000235:genetics / Q000276:immunology* / Q000302:isolation & purification; D018320:Leishmania major / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D007895:Leishmania tropica / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D016773:Leishmaniasis, Cutaneous / Q000175:diagnosis* / Q000469:parasitology / Q000517:prevention & control; D008163:Luminescent Measurements / Q000379:methods; D008297:Male; D008875:Middle Aged; D012529:Saudi Arabia; D012680:Sensitivity and Specificity; D014312:Trisaccharides / Q000276:immunology*; D055815:Young Adult
chemical_list: D000888:Antibodies, Anti-Idiotypic; D000913:Antibodies, Protozoan; D015415:Biomarkers; D014312:Trisaccharides; C076569:alpha-galactosyl epitope; C048844:anti-IgG