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- Title
Severity of Old World Cutaneous Leishmaniasis Is Influenced by Previous Exposure to Sandfly Bites in Saudi Arabia.
- Authors
Mondragon-Shem, Karina; Al-Salem, Waleed S.; Kelly-Hope, Louise; Abdeladhim, Maha; Al-Zahrani, Mohammed H.; Valenzuela, Jesus G.; Acosta-Serrano, Alvaro
- Abstract
Background: The sandfly Phlebotomus papatasi is the vector of Leishmania major, the main causative agent of Old World cutaneous leishmaniasis (CL) in Saudi Arabia. Sandflies inject saliva while feeding and the salivary protein PpSP32 was previously shown to be a biomarker for bite exposure. Here we used recombinant PpSP32 to evaluate human exposure to Ph. papatasi bites, and study the association between antibody response to saliva and CL in endemic areas in Saudi Arabia. Methodology/Principal Findings: In this observational study, anti-PpSP32 antibodies, as indicators of exposure to sandfly bites, were measured in sera from healthy individuals and patients from endemic regions in Saudi Arabia with active and cured CL. Ph. papatasi was identified as the primary CL vector in the study area. Anti-PpSP32 antibody levels were significantly higher in CL patients presenting active infections from all geographical regions compared to CL cured and healthy individuals. Furthermore, higher anti-PpSP32 antibody levels correlated with the prevalence and type of CL lesions (nodular vs. papular) observed in patients, especially non-local construction workers. Conclusions: Our findings suggest a possible correlation between the type of immunity generated by the exposure to sandfly bites and disease outcome. Author Summary: Leishmania is transmitted by the bite of infected female sandflies. When a sandfly bites a vertebrate host, it injects a cocktail of salivary proteins meant to facilitate blood feeding. The constant exposure to sandfly bites in endemic areas triggers a humoral response against the major antigenic components in the saliva. These antibodies can be then exploited to measure exposure to vector sandflies, which is useful for surveillance in leishmaniasis control programmes. In Saudi Arabia, cutaneous leishmaniasis (CL) is mainly transmitted by the Phlebotomus papatasi sandfly. Here we study the recognition of the main antigenic salivary protein from Ph. papatasi, PpSP32, in leishmaniasis patients and healthy individuals from three CL endemic areas in Saudi Arabia. Anti-PpSP32 antibody levels were significantly higher in CL patients presenting active infections from all geographical regions compared to the CL-cured and healthy individuals. Furthermore, higher anti-PpSP32 antibody levels correlated with the prevalence and type of CL lesions observed in patients. Our results suggest that previous long-term exposure to sandfly saliva can have a role in modulating the severity of leishmaniasis infection, resulting in a milder form of the disease.
- Subjects
SAUDI Arabia; CUTANEOUS leishmaniasis; SALIVARY proteins; ANTIBODY formation; PHLEBOTOMUS; LEISHMANIA major
- Publication
PLoS Neglected Tropical Diseases, 2015, Vol 9, Issue 2, p1
- ISSN
1935-2727
- Publication type
Article
- DOI
10.1371/journal.pntd.0003449