Leishmaniasis in Turkey: first clinical isolation of Leishmania major from 18 autochthonous cases of cutaneous leishmaniasis in four geographical regions. Issue 6 (28th April 2016)

• Record Type: Journal Article
• Authors: Özbilgin, Ahmet; Çulha, Gülnaz; Uzun, Soner; Harman, Mehmet; Topal, Suhan Günaştı; Okudan, Fulya; Zeyrek, Fadile; Gündüz, Cumhur; Östan, İpek; Karakuş, Mehmet; Töz, Seray; Kurt, Özgür; Akyar, Işın; Erat, Ayşegül; Güngör, Dilek; Kayabaşı, Çağla; Çavuş, İbrahim; Bastien, Patrick; Pratlong, Francine; Kocagöz, Tanıl; Özbel, Yusuf
• Is Part Of: Tropical medicine & international health. Volume 21:Issue 6(2016)
• Page Start: 783
• Page End: 791
• Publication Date: 2016-04-28
• Subjects: leishmaniasis -- Leishmania major -- ITS1 RT‐PCR -- enriched NNN medium -- mouse model -- Turkey; Leishmaniose -- Leishmania major -- ITS1 RT‐PCR -- milieu NNN enrichi -- modèle murin -- Turquie; Leishmaniasis -- Leishmania major -- RT‐PCR -- ITS1 -- medio NNN enriquecido -- modelo murino -- Turquía; Tropical medicine -- Periodicals; Public health -- Periodicals; 616.988
• DOI: 10.1111/tmi.12698
• Languages: English
• ISSNs: 1360-2276

Abstract

Abstract: Objective: To report isolation of Leishmania major strains obtained from 18 Turkish autochthonous cutaneous leishmaniasis (CL) patients infected with L. major between 2011 and 2014. Methods: Initial diagnosis relied on microscopy and culture in enriched medium, prepared by adding specific amounts of liver extract, protein and lipid sources to NNN medium. Promastigotes were then transferred to RPMI medium including 10% of foetal calf serum for mass culture. Species‐specific real‐time PCR targeting ITS1 region of Leishmania spp. was performed using both lesion aspiration samples and cultured promastigotes. Two of 18 isolates were identified by isoenzyme analysis in the Leishmaniasis Reference Center in Montpellier, France. Each isolate was inoculated into the footpads of six mice to observe the pathogenicity of L. major . Developing lesions were observed, and the thickening of footpads was measured weekly. Results: Melting curve analyses of 18 isolates showed a peak concordant with L. major, and two of them were confirmed by isoenzyme analyses as L. major zymodeme MON103. In the mouse model, acute lesions seen on day 21 were accepted as an indication of heavy infection. Severe impairments were observed on all mouse footpads over 3 weeks, which even progressed to extremity amputation. Conclusion: Cutaneous leishmaniasis‐causing L. major was recently identified in Adana province in southern Turkey, with PCR. Our study shows that such CL cases are not limited to Adana but currently present from western to Southeastern Anatolia, and along the Mediterranean coast. The role of small mammals, the main reservoirs of L. major in Anatolia, needs to be elucidated, as do the underlying factors that cause severe clinical manifestations in L. major infections in Turkey, contrary to the infections in neighbouring countries.