ChimLeish, a new recombinant chimeric protein evaluated as a diagnostic and prognostic marker for visceral leishmaniasis and human immunodeficiency virus coinfection

• Published in: Parasitology research (1987) Vol. 120; no. 12; pp. 4037 - 4047
• Main Authors: Galvani, Nathalia C., Machado, Amanda S., Lage, Daniela P., Freitas, Camila S., Vale, Danniele L., de Oliveira, Daysiane, Ludolf, Fernanda, Ramos, Fernanda F., Fernandes, Bruna B., Luiz, Gabriel P., Mendonça, Débora V. C., Oliveira-da-Silva, João A., Reis, Thiago A. R., Tavares, Grasiele S. V., Chaves, Ana T., Guimarães, Nathalia S., Tupinambás, Unaí, Cota, Gláucia F., Humbert, Maria V., Martins, Vívian T., Christodoulides, Myron, Coelho, Eduardo A. F., Machado-de-Ávila, Ricardo A.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-12-2021; Springer; Springer Nature B.V
• Subjects: Antigenic determinants; Antigens; Antigens, Protozoan - genetics; Biomedical and Life Sciences; Biomedicine; Chagas disease; Coinfection - diagnosis; Comorbidity; Cross-reactivity; Development and progression; Diagnosis; Epitopes; HIV; HIV - genetics; HIV Infections - complications; Human immunodeficiency virus; Humans; Immune system; Immunology; Kala-azar; Leishmania infantum; Leishmaniasis, Visceral - diagnosis; Lymphocytes B; Malaria; Medical Microbiology; Microbiology; Parasitic diseases; Patients; Peptides; Prognosis; Protozoology - Original Paper; Recombinant Fusion Proteins; Serology; Synthetic peptides; Tropical diseases; Tuberculosis; Visceral leishmaniasis; Brazil; Recombinant chimera; Synthetic peptides; Prognosis; Diagnosis; Visceral leishmaniasis; ELISA
• ISSN: 0932-0113; 1432-1955
• DOI: 10.1007/s00436-021-07342-1

Visceral leishmaniasis (VL) is a neglected tropical disease of global importance caused by parasites of the genus
Leishmania
, and coinfection with human immunodeficiency virus (HIV) is common in countries where both diseases are endemic. In particular, widely used immunological tests for VL diagnosis have impaired sensitivity (Se) and specificity (Sp) in VL/HIV coinfected patients and there is also cross-reactivity with other endemic diseases, e.g., Chagas disease, malaria, and tuberculosis. To develop new antigens to improve the diagnosis of VL and VL/HIV coinfection, we predicted eight specific B-cell epitopes of four
Leishmania infantum
antigens and constructed a recombinant polypeptide chimera antigen called ChimLeish. A serological panel of 195 serum samples was used to compare the diagnostic capabilities of ChimLeish alongside the individual synthetic peptides. ChimLeish reacted with sera from all VL and VL/HIV coinfected patients [Se = 100%; Sp = 100%; area under the curve (AUC) = 1.0]. Peptides showed lower reactivities (Se = 76.8 to 99.2%; Sp = 67.1 to 95.7%; AUC between 0.87 and 0.98) as did a
L. infantum
antigenic preparation used as an antigen control (Se = 56.8%; Sp = 69.5%: AUC = 0.45). Notably, ChimLeish demonstrated a significant reduction (
p
< 0.05) of anti-ChimLeish antibodies after treatment and cure of a small number of patients. Although only a limited serological panel was tested, preliminary data suggest that ChimLeish should be evaluated in larger sample studies for the diagnosis of VL and VL/HIV coinfection.