The Efficacy of L. (L.) chagasi Excreted-Secreted Antigens (ESAs) for Visceral Leishmaniasis Diagnosis Is Due To Low Levels of Cross-Reactivity

Viviana Pinedo-Cancino Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, Brazil; Departamento de Microbiologia, Immunologia e Parasitologia, Universidade Federal de São Paulo, Brazil; Instituto Emilio Ribas de São Paulo, Brazil

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Norival Kesper Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, Brazil; Departamento de Microbiologia, Immunologia e Parasitologia, Universidade Federal de São Paulo, Brazil; Instituto Emilio Ribas de São Paulo, Brazil

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Clara Lúcia Barbiéri Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, Brazil; Departamento de Microbiologia, Immunologia e Parasitologia, Universidade Federal de São Paulo, Brazil; Instituto Emilio Ribas de São Paulo, Brazil

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José Angelo Lauletta Lindoso Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, Brazil; Departamento de Microbiologia, Immunologia e Parasitologia, Universidade Federal de São Paulo, Brazil; Instituto Emilio Ribas de São Paulo, Brazil

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Eufrosina Setsu Umezawa Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, Brazil; Departamento de Microbiologia, Immunologia e Parasitologia, Universidade Federal de São Paulo, Brazil; Instituto Emilio Ribas de São Paulo, Brazil

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The analysis of promastigote excreted–secreted antigen (ESA) reactivity with 53 visceral leishmaniasis (VL) cases showed that each sample reacted regardless of the antigen or the Leishmania species used in enzyme-linked immunosorbent assay (ELISA) displayed 100% positivity with the L. (L.) chagasi ESA-blot recognizing bands of molecular weight ranging from 26.5 to 31.5 kDa. The analysis of 160 non-visceral cases showed that 5% of the samples cross-reacted with the L. (L.) chagasi ESA-ELISA and 9.4% reacted with the ESA isolated from L. (L.) amazonensis and L. (V.) braziliensis, whereas a high cross-reaction ranging from 24.4% to 25% was observed with total crude promastigote antigens (PRO-ELISA). The ESA-blot of L. (L.) chagasi tested with non-visceral sera samples showed a cross-reaction with 8.8% of cases; most of these cases represented tegumentary leishmaniasis and only one acute chagasic case. These data lead us to recommend the use of ESA as an alternative antigen in VL diagnosis.

Author Notes

* Address correspondence to Eufrosina Setsu Umezawa, Departamento de Medicina Preventiva-FMUSP, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 470, CEP 05403 000, São Paulo, SP, Brazil. E-mail: eumezawa@usp.br

Financial support: This work represents a portion of the Master's thesis produced by V. Pinedo-Cancino, who is a recipient of a fellowship from CNPq/Brazil. Partial funding was provided by LIM49-FMUSP. The authors thank S. Uliana for encouraging this study and for providing the Leishmania spp. parasites and M. P. Leal for the technical assistance.

Authors' addresses: Viviana Pinedo-Cancino, Norival Kesper, and Eufrosina Setsu Umezawa, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, Brazil, E-mails: vivicancino@usp.br, nkesper@usp.br, and eumezawa@usp.br. Clara Lúcia Barbiéri, Departamento de Microbiologia, Immunologia e Parasitologia, Universidade Federal de São Paulo, Brazil, E-mail: barbieri.clara@unifesp.br. José Angelo Lauletta Lindoso, Instituto Emilio Ribas de São Paulo, Brazil, E-mail: jlindoso@usp.br.

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