Leishmaniasis tanısında rK39 antijeninin yeri; Hasta serumlarında anti-rK39 antikorlarının gösterilmesi

Abstract

ÖZET Leishmaniasisin başarılı tedavisi, Leishmania türünün hızlı ve doğru tanısına bağlıdır. Ancak hızlı ve güvenilir bir diagnostik teknik mevcut değildir. Son yıllarda parazitin doğam antijenik yapılarıyla ilgili serolojik çalışmalar artmıştır. Üzerinde çalışılan antijenlerden biri olan `K39` çoğu Leishmania türünde varlığı tespit edilmiş, Leishmania spp'larının kinezin benzeri genlerinde eksprese edilen ve tekrarlayan 39 aminoasit dizilerinden oluşan bir proteindir. Bu çalışmamızda rekombinant K39 (rK39) antijenine karşı, anti-rK39 antikor düzeyleri Enzyme Linked Immunosorbent Assay (ELISA) testi ile çalışılarak testin kutanöz leishmaniasis (CL) ve visseral leishmaniasisli (VL) hastaların tanısındaki yeri araştırılmıştır. Bu amaçla leishmaniasisin endemik olduğu Şanlıurfa bölgesinden alınan 74 CL'h ve Ç.Ü.Tıp Fakültesi Balcalı Hastanesinde takip edilen 20 VL'lı hasta serumlarında, ELISA ile anti-rK39 antikorları araştırıldı. 74 CL ve 20 VL'li hasta serumlarında antikor titresi, kontrol grubundakinden istatistiksel olarak anlamlı şekilde yüksek bulundu (p<0.05). Ayrıca VL'lı hastaların antikor titresi, CL'h hastalarınkinden de yüksek idi (p<0.05). öte yandan CL'lılarda; antikor titresi ile lezyon sayısı arasında doğru orantılı bir ilişki tespit edilirken (p<0.05), lezyon süresi, yaş ve cinsiyet ile ilişki bulunamadı (p>0.05). VL'li hastalarda da; antikor titresinin yaş, cinsiyet ve hastalık süresi ile ilişkisi yoktu (p>0.05). Anahtar Kelimeler: Leishmaniasis, K39 Antijeni, Serolojik tanı, ELISA. IVABSTRACT Successful treatment of leishmaniasis depends on its rapid and correct diagnosis. Unfortunately a rapid and reliable diagnostic method is not available. In recent years number of studies about the natural antigenic structure of the parasite increase `K39` is a protein made of a 39 aminoacid chain and known to exist in most of the Leishmania species. It is expressed on kinesine-like genes of leishmania species. In our study, anti-K39 antibody levels against recombinant K39 antigen are determined by enzyme linked immunosorbent assay. We aimed to evaluate the value of this test on diagnosis of cutaneous leishmaniasis and visceral leishmaniasis. Seventy four patients with CL from Şanlıurfa and 20 patients with VL who are followed up in Ç.Ü.T.F. Balcali Hospital were included in the study. Their sera were analysed by ELISA for anti-K39 antibodies: Antibody titer of 74 CL and 20 VL patients were found to be high when compared with the control group. This finding is statistically meaningful (p<0.05). Antibody titer of VL patients were higher than those of CL patients (p<0.05). In the CL patients, a positive correlation exist between the antibody titer and the number of lesions (p<0.05). But no relation with the period of existence of lesions, age and sex of the patient is found to exist (p>0.05). There was also no relation between antibody titer and age, sex, period of illness in VL patient (p>0.05). Key Words: Leishmaniasis, K39 antigen, serological diagnosis, ELISA.

ABSTRACT Successful treatment of leishmaniasis depends on its rapid and correct diagnosis. Unfortunately a rapid and reliable diagnostic method is not available. In recent years number of studies about the natural antigenic structure of the parasite increase `K39` is a protein made of a 39 aminoacid chain and known to exist in most of the Leishmania species. It is expressed on kinesine-like genes of leishmania species. In our study, anti-K39 antibody levels against recombinant K39 antigen are determined by enzyme linked immunosorbent assay. We aimed to evaluate the value of this test on diagnosis of cutaneous leishmaniasis and visceral leishmaniasis. Seventy four patients with CL from Şanlıurfa and 20 patients with VL who are followed up in Ç.Ü.T.F. Balcali Hospital were included in the study. Their sera were analysed by ELISA for anti-K39 antibodies: Antibody titer of 74 CL and 20 VL patients were found to be high when compared with the control group. This finding is statistically meaningful (p<0.05). Antibody titer of VL patients were higher than those of CL patients (p<0.05). In the CL patients, a positive correlation exist between the antibody titer and the number of lesions (p<0.05). But no relation with the period of existence of lesions, age and sex of the patient is found to exist (p>0.05). There was also no relation between antibody titer and age, sex, period of illness in VL patient (p>0.05). Key Words: Leishmaniasis, K39 antigen, serological diagnosis, ELISA.