Multiparametric analysis of host and parasite elements in new world tegumentary leishmaniasis

Abstract

Tegumentary leishmaniasis is a tropical disease caused by protozoa of the genus Leishmania. Clinically, the disease presents a broad spectrum of symptoms, the mechanisms underlying the development of lesions remaining to be fully elucidated. In the present work, we performed a correlation and multiparametric analysis to evaluate how parasite- and host-related aspects associate with each other, and with the different clinical manifestations of tegumentary leishmaniasis. This cross-sectional study involved 75 individuals from endemic areas of Brazil, grouped according to their symptoms. Leishmania species were determined by DNA sequencing, and parasite load, antibody production, and cytokine profile were evaluated by kDNA qPCR, ELISA, and flow cytometry. Data were analyzed using the Chi-square test, principal component analysis, canonical discriminant analysis, and correlation analysis. Among the recruited patients, 23 (31%) were asymptomatic, 34 (45%) had primary cutaneous leishmaniasis, 10 (13%) presented recurrent cutaneous leishmaniasis, and eight (11%) had mucocutaneous leishmaniasis. Leishmania species identified included L. amazonensis, L. braziliensis, and L. guyanensis. Surprisingly, no Leishmania RNA virus infection was detected in any sample. In summary, our work showed that parasite load, antibody production, and cytokine levels alone are not determinants for tegumentary leishmaniasis symptoms. However, the correlation analysis allowed us to observe how these factors are correlated to each other within the groups, which revealed a unique network for each clinical manifestation. Our work reinforces the complexity of tegumentary leishmaniasis outcomes - which are associated with multiple host and parasite-related elements and provides a holistic model of the disease.

Automated Identification of Cutaneous Leishmaniasis Lesions Using Deep-Learning-Based Artificial Intelligence

“…However, collaborations with other dermatology centers to increase the database of other dermatoses may be a possible solution. It is important to expand the database to include CL lesions and other skin diseases caused by various Leishmania species found in other countries, as our study indicates that the lesions are predominantly caused by L. braziliensis, and in some cases, by L. amazonensis and L. guyanensis [60,61]. It is noteworthy that Old World CL lesions differ from New World lesions, which may progress to hyperkeratotic plaques.…”

Case report: Diagnosis of visceral leishmaniasis using metagenomic next-generation sequencing and bone marrow smear

“…However, the specificity is low, and false-positive results may occur (van Griensven and Diro, 2019;Scarpini et al, 2022). In recent years, some studies have found that qPCR analysis of mitochondrial DNA minicircle network (kDNA) based on the characteristics of Leishmania genus has high sensitivity and specificity, and can thus be useful for quantitative detection of pan-Leishmania (Ceccarelli et al, 2020;de Carvalho et al, 2022;Mota et al, 2022). However, this technique is expensive and has not been used for routine clinical testing.…”

Clinical Profile and Diagnosis of Recurrent Cutaneous Leishmaniasis

“…In an area of L braziliensis transmission in the northeast region of Brazil, RCL was found in 4% of the cases, usually more than 5 years after the treatment and cure of primary CL [ 1 ]. Others have found that although the parasite load was similar in lesions from RCL patients infected with L braziliensis and with primary CL (PCL), it was higher in the blood of RCL patients compared with PCL patients [ 4 ]. In CL caused by Leishmania major , recurrence was associated with female gender, number of lesions, and longer duration of therapy of PCL, but it is not known which factors influence the occurrence of RCL in areas of L braziliensis transmission.…”