title: Severity of old world cutaneous leishmaniasis is influenced by previous exposure to sandfly bites in Saudi Arabia.
abstract: BACKGROUND
  The sandfly Phlebotomus papatasi is the vector of Leishmania major, the main causative agent of Old World cutaneous leishmaniasis (CL) in Saudi Arabia. Sandflies inject saliva while feeding and the salivary protein PpSP32 was previously shown to be a biomarker for bite exposure. Here we used recombinant PpSP32 to evaluate human exposure to Ph. papatasi bites, and study the association between antibody response to saliva and CL in endemic areas in Saudi Arabia.
  
  
  RESULTS
  In this observational study, anti-PpSP32 antibodies, as indicators of exposure to sandfly bites, were measured in sera from healthy individuals and patients from endemic regions in Saudi Arabia with active and cured CL. Ph. papatasi was identified as the primary CL vector in the study area. Anti-PpSP32 antibody levels were significantly higher in CL patients presenting active infections from all geographical regions compared to CL cured and healthy individuals. Furthermore, higher anti-PpSP32 antibody levels correlated with the prevalence and type of CL lesions (nodular vs. papular) observed in patients, especially non-local construction workers.
  
  
  CONCLUSIONS
  Our findings suggest a possible correlation between the type of immunity generated by the exposure to sandfly bites and disease outcome.
authors: Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
authors: Karina
authors: K
authors: Mondragon-Shem
authors: Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Department of Vector Borne Diseases, Saudi Ministry of Health, Riyadh, Kingdom of Saudi Arabia.
authors: Waleed S
authors: WS
authors: Al-Salem
authors: Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Centre for Neglected Tropical Diseases, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
authors: Louise
authors: L
authors: Kelly-Hope
authors: Vector Molecular Biology Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America.
authors: Maha
authors: M
authors: Abdeladhim
authors: Department of Vector Borne Diseases, Saudi Ministry of Health, Riyadh, Kingdom of Saudi Arabia.
authors: Mohammed H
authors: MH
authors: Al-Zahrani
authors: Vector Molecular Biology Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America.
authors: Jesus G
authors: JG
authors: Valenzuela
authors: Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
authors: Alvaro
authors: A
authors: Acosta-Serrano
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D000913:Antibodies, Protozoan / Q000097:blood* / Q000276:immunology; D000917:Antibody Formation / Q000276:immunology; D002460:Cell Line; D005260:Female; D006801:Humans; D007299:Insect Bites and Stings / Q000469:parasitology*; D007303:Insect Vectors / Q000469:parasitology; D018320:Leishmania major / Q000276:immunology*; D016773:Leishmaniasis, Cutaneous / Q000276:immunology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010691:Phlebotomus / Q000469:parasitology*; D011379:Prognosis; D012463:Saliva / Q000276:immunology / Q000378:metabolism; D012471:Salivary Proteins and Peptides / Q000276:immunology*; D012529:Saudi Arabia; D055815:Young Adult
chemical_list: D000913:Antibodies, Protozoan; D012471:Salivary Proteins and Peptides
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