Comparison of urine and serum IgG detection ELISA for tegumentary leishmaniasis diagnosis and prognosis

Immunobiology. 2024 Nov;229(6):152853. doi: 10.1016/j.imbio.2024.152853. Epub 2024 Sep 17.

Abstract

Laboratorial diagnosis of tegumentary leishmaniasis (TL) is hampered by variable sensitivity and/or specificity of the tests, which are still hampered by blood́ invasive collection. In this context, in the present study, we develop a serum- and urine-based ELISA to TL diagnoses. A recombinant protein (rLiHyA), which was previously showed to be antigenic for the disease, as well as a B-cell epitope produced as synthetic peptide and a Leishmania antigenic extract (SLA), were used as antigens. A total of paired 205 urine and serum samples were used, which were comprised by samples from cutaneous (n = 30) and mucosal (n = 30) leishmaniasis patients, as well as from healthy individuals living in endemic region of disease (n = 45), of patients with Chagas disease (n = 30), leprosy (n = 35), malaria (n = 15) or HIV-infected (n = 20). Results showed that serum-based ELISA presented sensitivity of 24.0 %, 100 % and 41.0 %, when SLA, rLiHyA and synthetic peptide were used as antigens, and specificity of 98.4 %, 98.4 % and 98.4 %, respectively. The area under the curve (AUC) was calculated and results were 0.74, 1.0, and 0.71, respectively, when SLA, rLiHyA and synthetic peptide were used as antigens. Performing an urine-based ELISA, sensitivity was 28.0 %, 100 % and 75.0 %, respectively, when SLA, rLiHyA, and synthetic peptide were used, while specificity values were of 98.4 %, 98.4 % and 98.4 %, respectively. In addition, the AUC values were 0.82, 1.0, and 0.94, respectively. A significant drop in specific antibodies levels in both patientś serum and urine samples was found six months after treatment, suggesting a prognostic role of rLiHyA for TL. In conclusion, preliminary data suggest the potential of use patient urine to TL diagnoses.

Keywords: Diagnosis; Enzyme-linked immunosorbent assay; Leishmania braziliensis; Recombinant protein; Tegumentary leishmaniasis; Urine.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antibodies, Protozoan* / blood
  • Antibodies, Protozoan* / immunology
  • Antibodies, Protozoan* / urine
  • Antigens, Protozoan* / immunology
  • Antigens, Protozoan* / urine
  • Chagas Disease / diagnosis
  • Chagas Disease / immunology
  • Chagas Disease / urine
  • Enzyme-Linked Immunosorbent Assay*
  • Epitopes, B-Lymphocyte / immunology
  • Female
  • HIV Infections / diagnosis
  • HIV Infections / immunology
  • HIV Infections / urine
  • Humans
  • Immunoglobulin G* / blood
  • Immunoglobulin G* / immunology
  • Immunoglobulin G* / urine
  • Leishmania / immunology
  • Leishmaniasis, Cutaneous* / blood
  • Leishmaniasis, Cutaneous* / diagnosis
  • Leishmaniasis, Cutaneous* / immunology
  • Leishmaniasis, Cutaneous* / urine
  • Leprosy / blood
  • Leprosy / diagnosis
  • Leprosy / immunology
  • Leprosy / urine
  • Malaria / blood
  • Malaria / diagnosis
  • Malaria / immunology
  • Malaria / urine
  • Male
  • Middle Aged
  • Prognosis
  • Sensitivity and Specificity*
  • Young Adult

Substances

  • Immunoglobulin G
  • Antigens, Protozoan
  • Antibodies, Protozoan
  • Epitopes, B-Lymphocyte