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Article

Evaluation of Multi-Target Genotyping (ITS-hsp70-cpb) for Detecting Population Heterogeneity Within Mediterranean Leishmania infantum, with a Focus on Zymodeme MON-24

by
Trentina Di Muccio
1,*,
Daniele Tonanzi
2,
Gert Van der Auwera
3,
Eleonora Fiorentino
1,
Luigi Gradoni
1,
Marina Gramiccia
1,† and
Giuseppe La Rosa
2,†
1
Unit of Vector-Borne Diseases, Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
2
European Union Reference Laboratory for Parasites, Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
3
Institute of Tropical Medicine, 2000 Antwerp, Belgium
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Pathogens 2026, 15(2), 145; https://doi.org/10.3390/pathogens15020145
Submission received: 22 December 2025 / Revised: 23 January 2026 / Accepted: 26 January 2026 / Published: 29 January 2026
(This article belongs to the Section Parasitic Pathogens)

Abstract

L. infantum and L. donovani, distinct species in the L. donovani complex, show high phenotypic and genotypic polymorphism and share molecular traits. Therefore, genotyping by a single molecular target can give uncertain results. This study focuses on genotyping a set of L. donovani complex strains, including 18 zymodemes classified according to Montpellier nomenclature (ZMONs) and different clinical forms, by internal transcribed spacer (ITS), heat shock protein 70 (hsp70), and cysteine proteinase b (cpb) sequencing to evaluate their ability in species discrimination. We found an unexpected L. infantum hsp70 variability, with 8 sequence variants. Cpb-PCR could not distinguish L. donovani complex species, due to a L. infantum intraspecific allelic (cpbEF) polymorphism. By combining ITS-hsp70-cpb sequence variants, we obtained different genotypes. ITS(A)-hsp70inf(2)-cpbE identified 69.9% of L. infantum strains representing 12 ZMONs from Mediterranean visceral and cutaneous cases, ITS(A)-hsp70inf(2)-cpbF identified a non-ZMON-1 cluster. Four genotypes represented ZMON-24: ITS(A, B)-hsp70(Y)-cpbF identified a cutaneous cluster from Italy and North Africa, ITS(A, Lombardi)-hsp70(2)-cpbE identified cutaneous and visceral cases from Mediterranean areas. We believe this study contributes to an overview of L. infantum variant populations, and to the discussion on diagnostic targets, in single or multi -target-based approaches, to identify Leishmania populations in the Mediterranean area.
Keywords: Leishmania infantum; heat shock protein 70; cysteine proteinase B; ITS; molecular diagnosis; sequencing; zymodeme MON-24; Mediterranean area Leishmania infantum; heat shock protein 70; cysteine proteinase B; ITS; molecular diagnosis; sequencing; zymodeme MON-24; Mediterranean area

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MDPI and ACS Style

Di Muccio, T.; Tonanzi, D.; Van der Auwera, G.; Fiorentino, E.; Gradoni, L.; Gramiccia, M.; La Rosa, G. Evaluation of Multi-Target Genotyping (ITS-hsp70-cpb) for Detecting Population Heterogeneity Within Mediterranean Leishmania infantum, with a Focus on Zymodeme MON-24. Pathogens 2026, 15, 145. https://doi.org/10.3390/pathogens15020145

AMA Style

Di Muccio T, Tonanzi D, Van der Auwera G, Fiorentino E, Gradoni L, Gramiccia M, La Rosa G. Evaluation of Multi-Target Genotyping (ITS-hsp70-cpb) for Detecting Population Heterogeneity Within Mediterranean Leishmania infantum, with a Focus on Zymodeme MON-24. Pathogens. 2026; 15(2):145. https://doi.org/10.3390/pathogens15020145

Chicago/Turabian Style

Di Muccio, Trentina, Daniele Tonanzi, Gert Van der Auwera, Eleonora Fiorentino, Luigi Gradoni, Marina Gramiccia, and Giuseppe La Rosa. 2026. "Evaluation of Multi-Target Genotyping (ITS-hsp70-cpb) for Detecting Population Heterogeneity Within Mediterranean Leishmania infantum, with a Focus on Zymodeme MON-24" Pathogens 15, no. 2: 145. https://doi.org/10.3390/pathogens15020145

APA Style

Di Muccio, T., Tonanzi, D., Van der Auwera, G., Fiorentino, E., Gradoni, L., Gramiccia, M., & La Rosa, G. (2026). Evaluation of Multi-Target Genotyping (ITS-hsp70-cpb) for Detecting Population Heterogeneity Within Mediterranean Leishmania infantum, with a Focus on Zymodeme MON-24. Pathogens, 15(2), 145. https://doi.org/10.3390/pathogens15020145

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