American tegumentary leishmaniasis caused by Leishmania (Viannia) braziliensis: assessment of parasite genetic variability at intra- and inter-patient levels

Abstract

BackgroundThe genetic variability of Leishmania (Viannia) braziliensis was assessed at intra and interpatient levels of individuals with different clinical manifestations of American tegumentary leishmaniasis (ATL).MethodsFifty-two samples, of which 13 originated from cutaneous lesions and 39 from mucosal lesions, provided by 35 patients, were examined by low-stringency single-specific-primer PCR (LSSP-PCR) and phenetic analysis. Genetic variability of L. (V.) braziliensis, in kinetoplast DNA (kDNA) signatures, was compared both from different patients and from different lesions of the same patient. Phenetic analysis was performed to evaluate the degree of heterogeneity of the kDNA minicircles. In order to evaluate inter and intrapatient L. (V.) braziliensis genetic variability, the percentage of shared bands and analysis of the coefficients of similarity were analyzed.ResultsDifferent genetic profiles, representing kDNA signatures of the parasite, were obtained by LSSP-PCR analysis of each sample. Phenetic analysis grouped genetic profiles of different levels of differentiation from more similar to most divergent. The percentage of shared bands at the inter and intrapatient levels was 77% and 89%, respectively. Comparison of the average inter and intrapatient coefficients of similarity and their standard deviations were statistically significant (p < 0.001).ConclusionGenetic variability at the intrapatient level was less pronounced than that between different patients. A conceptual model was proposed to better understand the complexity at both levels.

Favorable responses to treatment with 5 mg Sbv/kg/day meglumine antimoniate in patients with American tegumentary leishmaniasis acquired in different Brazilian regions

“…It is uncertain if the genetic variability observed in L. (V.) braziliensis populations is an important factor affecting the therapeutic outcome 48,49 . Results from our study and other studies 30,34,35 indicate that the L. (V.) braziliensis population endemic to the state of Rio de Janeiro presents a homogeneous genetic pattern with low variability, which could explain the favorable therapeutic response to MA observed in patients who were infected in this state. However, therapeutic response to antimonial drugs may vary in states other than Rio de Janeiro, where ATL may be caused by different Leishmania species or by an L. (V.) braziliensis subpopulation with a high genetic variability 6,8,50 .…”

“…Some authors suggested that different ATL clinical forms, including localized or disseminated leishmaniasis, are caused by distinct L. (V.) braziliensis subpopulations distributed among various locations of the state of Bahia 8,31,32 . Previous studies performed in Rio de Janeiro observed no association between Leishmania's genotypic patterns and the clinical manifestations or therapeutic responses 33,34,35 .…”

American Cutaneous Leishmaniasis With Unusual Clinical Presentation and Response to Treatment

“…According to WHO, the CL clinical forms include localized, disseminated, diffuse, and atypical cutaneous and mucocutaneous leishmaniases 12 . Many factors can influence the clinical manifestations and prognosis of leishmaniasis, such as the immune response of the patient and the species of the parasite 1 , 13 . The parasite was identified as L. (V.) braziliensis, a prevalent species in southern Brazil and widely distributed in the country 2 .…”

The case of diagnosis of imported cutaneous leishmaniasis in Zaporozhye

“…Шкірний лейшманіоз, що зумовлений Leishmania mexicana, розглядають як антропоноз або синантропний зооноз, де резервуаром збудника є собаки. Для патологічного процесу, котрий викликаний Leishmania mexicana, характерні по-одинокі виразки, які за умов сприятливого перебігу можуть рубцюватись протягом року [13,14]. Діагноз шкірного лейшманіозу підтверджується клініч-ною симптоматикою і виявленням збудника в уражених ділянках шкіри (мікроскопія і біопсія) [15].…”