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首页> 外文期刊>The American Journal of Tropical Medicine and Hygiene >Quantitative Kinetoplast DNA Assessment during Treatment of Mucosal Leishmaniasis as a Potential Biomarker of Outcome: A Pilot Study
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Quantitative Kinetoplast DNA Assessment during Treatment of Mucosal Leishmaniasis as a Potential Biomarker of Outcome: A Pilot Study

机译：黏膜利什曼病治疗过程中的定量动子体DNA评估作为结果的潜在生物标志物：一项初步研究。

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Mucosal leishmaniasis (ML) is a disfiguring manifestation of Leishmania (Viannia) infection. We evaluated parasite load (PL) over time as a potential biomarker of treatment outcome in ML. PL was assessed with kinetoplast DNA quantitative real-time polymerase chain reaction (kDNA-qPCR) at enrollment, days 14 and 21-28 of therapy and 3, 6, 12-18, and 18-24 months after treatment of ML and correlated to demographic, clinical, and parasitologic factors. Forty-four patients were enrolled: 30 men and 14 women. Enrollment PL differed significantly by causative species (P < 0.001), and was higher in patients with severe ML (nasal and laryngeal involvement) compared with those with only isolated nasal involvement (median = 1,285 versus 51.5 parasites/mu g tissue DNA; P = 0.005). Two patterns of PL emerged: pattern 1 (N = 23) was characterized by a sequential decline in PL during and after therapy until kDNA was undetectable. Pattern 2 (N = 18) was characterized by clearance of detectable kDNA during treatment, followed by an increased PL thereafter. All patients who failed treatment (N = 4) demonstrated pattern 1. Leishmania (Viannia) brazillensis was overrepresented among those with pattern 2 (P = 0.019). PL can be quantified by cytology brush qPCR during and after treatment in ML. We demonstrate that treatment failure was associated with undetectable PL, and L. (V) braziliensis infection was overrepresented in those with rebounding PL.
机译：粘膜利什曼病（ML）是利什曼原虫（Viannia）感染的毁容性表现。我们评估了随时间推移的寄生虫负荷（PL）作为ML治疗结果的潜在生物标志物。在入组时，治疗的第14天和第21-28天以及在ML治疗后的3、6、12-18和18-24个月，通过运动质体DNA定量实时聚合酶链反应（kDNA-qPCR）评估了PL。人口统计学，临床和寄生虫学因素。入选了44例患者：30名男性和14名女性。 PL的病因种类之间存在显着差异（P <0.001），严重ML（鼻和喉部受累）的患者与仅鼻部受累的患者相比（中位数= 1,285与51.5寄生虫/μg组织DNA; P = 0.005）。出现了两种PL模式：模式1（N = 23）的特征是在治疗期间和之后PL依次下降，直到无法检测到kDNA。模式2（N = 18）的特征是在治疗过程中清除了可检测到的kDNA，随后PL升高。所有治疗失败（N = 4）的患者均显示出模式1。在模式2的患者中，利什曼原虫（Viannia）brazillensis的人数过多（P = 0.019）。 ML可以在ML治疗期间和之后通过细胞学刷qPCR进行定量。我们证明，治疗失败与无法检测到的PL有关，而L.（V）巴西感染在PL反弹患者中代表过多。

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