Cytokine Release Assays as Tests for Exposure to Leishmania, and for Confirming Cure from Leishmaniasis, in Solid Organ Transplant Recipients.
Spain has one of the world's largest pools of organ donors and is a global leader in terms of the number of transplants it performs. The current outbreak of leishmaniasis in Fuenlabrada (in the southwest of the region of Madrid, Spain) has involved 600 clinical cases since late 2009 (prevalence 0.2%). It may therefore be wise to monitor the town's transplanted population for Leishmania infantum; its members are immunosuppressed and at greater risk of infection and relapse following treatment. The present work examines the use of cytokine release assays to determine the prevalence of Leishmania infection in this population, and to confirm recovery following treatment for visceral leishmaniasis (VL). The humoral and cellular immune responses to L. infantum were characterized in 63 solid organ transplant (SOT) recipients from Fuenlabrada, 57 of whom reported no previous episode of VL (NVL subjects), and six of whom had been cured of VL (CVL subjects). Seventeen subjects (12 NVL and 5 CVL) showed a patent lymphoproliferative response to soluble Leishmania antigen (SLA). Stimulation of peripheral blood mononuclear cell cultures and of whole blood with SLA led to the production of different combinations of cytokines that might serve to confirm Leishmania infection or recovery from VL and help prevent cured patients from relapsing into this serious condition.
WHO Collaborating Centre for Leishmaniasis, Centro Nacional de Microbiologia, Instituto de Salud Carlos III, Madrid, Spain.
Eugenia
E
Carrillo
Unidad de Enfermedades Infecciosas, Hospital Universitario 12 de Octubre, Universidad Complutense, Madrid, Spain.
Nerea
N
Carrasco-Antón
Unidad de Enfermedades Infecciosas, Hospital Universitario 12 de Octubre, Universidad Complutense, Madrid, Spain.
Francisco
F
López-Medrano
Servicio de Microbiología, Hospital Universitario 12 de Octubre, Universidad Complutense, Madrid, Spain.
Efrén
E
Salto
WHO Collaborating Centre for Leishmaniasis, Centro Nacional de Microbiologia, Instituto de Salud Carlos III, Madrid, Spain.
Laura
L
Fernández
Servicio de Medicina Interna, Hospital de Fuenlabrada, Madrid, Spain.
Juan Víctor
JV
San Martín
Head of Visceral Leishmaniasis Program, Drugs for Neglected Diseases initiative (DNDi), Geneva, Switzerland.
Jorge
J
Alvar
Unidad de Enfermedades Infecciosas, Hospital Universitario 12 de Octubre, Universidad Complutense, Madrid, Spain.
Jose María
JM
Aguado
WHO Collaborating Centre for Leishmaniasis, Centro Nacional de Microbiologia, Instituto de Salud Carlos III, Madrid, Spain.
Javier
J
Moreno
D000913:Antibodies, Protozoan / Q000097:blood; D049109:Cell Proliferation; D019411:Clinical Laboratory Techniques / Q000379:methods*; D016207:Cytokines / Q000378:metabolism*; D016903:Drug Monitoring / Q000379:methods*; D006801:Humans; D016867:Immunocompromised Host; D018314:Leishmania infantum / Q000276:immunology*; D007896:Leishmaniasis / Q000175:diagnosis* / Q000453:epidemiology; D007963:Leukocytes, Mononuclear / Q000276:immunology*; D013030:Spain / Q000453:epidemiology; D066027:Transplant Recipients; D019737:Transplants
D000913:Antibodies, Protozoan; D016207:Cytokines