Urine-Based Antigen (Protein) Detection Test for the Diagnosis of Visceral Leishmaniasis
Abstract
:1. Introduction
2. Overall Rationale
- Urine contains much less host proteins than plasma or serum, therefore small amounts of molecules from foreign organisms present in this excretion are much more likely to be identified by mass spectrometry than they would in blood.
- Urine is one of the easiest and least invasive samples that can be collected from a patient. This is particularly important for VL and for example tuberculosis (TB) in children. Gold standard diagnosis of VL requires invasive biopsy of organs like liver, spleen or bone marrow. In TB, because children in general do not spit sputum, invasive gastric lavage is the sample that is used to investigate the presence of Mycobacterium tuberculosis in this group of patients.
- Antigenemia and subsequent antigenuria occurs as a natural consequence of most infectious processes.
- The presence of pathogen’s antigens excreted in the urine may be detectable sooner than the detection of the pathogen itself in target organs of the disease.
- Antigen detection in urine is an attractive possibility to facilitate the diagnosis of VL in HIV-co-infected patients because these patients have in general reduced antibody response to L. infantum/L. donovani antigens.
- Antigens found in urine, theoretically, are likely to be highly stable because they have to resist the proteolytic enzymes present in both, target organs of infection and serum. Therefore, this stability makes them attractive candidates for a diagnostic assay.
- Urine collection is independent of medical facilities, does not require sterile conditions, medical equipment/personnel, and involves minimal sample preparation.
- Urine is a readily available sample for point-of-care diagnostic tests.
3. Approach
4. Markers Discovery and Polyclonal Antibody-Based Test
4.1. L. infantum Markers
4.2. L. donovani Markers
5. Monoclonal Antibody-Based Test
5.1. Recombinant Single Domain Antibodies or VHH
5.2. Conventional mAbs
6. Overall Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Protein | Abbreviature | MW (kDa) | NCBI Accession |
---|---|---|---|
Iron superoxide dismutase | Li-isd1 | 21.53 | XP_001467866.1 |
Tryparedoxin | Li-txn1 | 16.7 | XP_001466642.1 |
Nuclear transport factor 2 | Li-ntf2 | 13.89 | XP_001463738.1 |
MaoC family dehydratase | Ld-mao1 | 16.97 | XP_003858460.1 |
Peptidyl-prolyl cis-trans isomerase | Ld-ppi1 | 12.62 | XP_003858557.1 |
Malate dehydrogenase | Ld-mad1 | 33.28 | XP_003864180.1 |
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Campos-Neto, A.; Abeijon, C. Urine-Based Antigen (Protein) Detection Test for the Diagnosis of Visceral Leishmaniasis. Microorganisms 2020, 8, 1676. https://doi.org/10.3390/microorganisms8111676
Campos-Neto A, Abeijon C. Urine-Based Antigen (Protein) Detection Test for the Diagnosis of Visceral Leishmaniasis. Microorganisms. 2020; 8(11):1676. https://doi.org/10.3390/microorganisms8111676
Chicago/Turabian StyleCampos-Neto, Antonio, and Claudia Abeijon. 2020. "Urine-Based Antigen (Protein) Detection Test for the Diagnosis of Visceral Leishmaniasis" Microorganisms 8, no. 11: 1676. https://doi.org/10.3390/microorganisms8111676