Leishmania is an intracellular parasitic flagellate whose main host is vertebrates. There are four species of Leishmania parasites in humans, with sandflies as the main vector. Leishmaniasis is a parasitic infection caused by the protozoa Leishmania. After infection, due to the destruction of macrophages, patients develop clinical symptoms such as fever, anemia, and swollen lymph nodes. In addition, Leishmaniadonovani (L. donovani) can parasitize the internal organs and cause kala-azar. Currently, in vitro diagnosis (IVD) of Leishmania is carried out through immunological examination and molecular biology methods.
Figure 1. The life cycle of Leishmania parasites. (Kaye P, et al., 2011)
Main Steps of IVD for Leishmania
Antibody testing. Enzyme-linked immunosorbent assay (ELISA), indirect hemagglutination test (IHA), convective immunoelectrophoresis (CIE), indirect fluorescence test (IF), direct agglutination test and Dip-stick method were used to detect specific antibodies in the patient's serum.
Serum circulating antigen detection. Monoclonal antibody-antigen spot test (MeAb-AST) has high sensitivity and specificity for diagnosing kala-azar.
Pathogen testing. Smear staining and culture methods. The puncture smear is stained with Gibbs or Wright, and then the puncture is inoculated into the culture medium for observation.
Molecular biology technology. Higher specificity and sensitivity of PCR technology can distinguish various Leishmania genera.
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Reference
Kaye P, Scott P. (2011). Leishmaniasis: complexity at the host–pathogen interface[J]. Nature reviews microbiology. 9(8): 604-615.