Quantitative Kinetoplast DNA Assessment During Treatment of Mucosal Leishmaniasis as a Potential Biomarker of Outcome: A Pilot Study

Adaui, Vanessa; Lau, Rachel; Arévalo Zelada, Jorge Luis; Llanos Cuentas, Elmer Alejandro; Alba, Milena; Valencia, B. M.; Boggild, Andrea K.; Jara, Marlene

dc.contributor.author	Jara, Marlene
dc.contributor.author	Valencia, B. M.
dc.contributor.author	Adaui, Vanessa
dc.contributor.author	Alba, Milena
dc.contributor.author	Lau, Rachel
dc.contributor.author	Arévalo Zelada, Jorge Luis
dc.contributor.author	Llanos Cuentas, Elmer Alejandro
dc.contributor.author	Boggild, Andrea K.
dc.date.accessioned	2019-02-06T14:57:38Z
dc.date.available	2019-02-06T14:57:38Z
dc.date.issued	2016
dc.identifier.uri	https://hdl.handle.net/20.500.12866/5465
dc.description.abstract	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/mug 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) braziliensis 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.	en_US
dc.language.iso	eng
dc.publisher	American Society of Tropical Medicine and Hygiene
dc.relation.ispartofseries	American Journal of Tropical Medicine and Hygiene (ASTMH Journal)
dc.rights	info:eu-repo/semantics/restrictedAccess
dc.subject	Adolescent	en_US
dc.subject	Adult	en_US
dc.subject	Female	en_US
dc.subject	Humans	en_US
dc.subject	Male	en_US
dc.subject	Young Adult	en_US
dc.subject	Child	en_US
dc.subject	Aged	en_US
dc.subject	Aged, 80 and over	en_US
dc.subject	Middle Aged	en_US
dc.subject	Treatment Outcome	en_US
dc.subject	Biomarkers	en_US
dc.subject	Pilot Projects	en_US
dc.subject	Real-Time Polymerase Chain Reaction	en_US
dc.subject	Amphotericin B/administration & dosage/therapeutic use	en_US
dc.subject	Antimony Sodium Gluconate/administration & dosage/therapeutic use	en_US
dc.subject	DNA, Kinetoplast/genetics	en_US
dc.subject	DNA, Protozoan/genetics/isolation & purification	en_US
dc.subject	Leishmaniasis, Mucocutaneous/parasitology	en_US
dc.title	Quantitative Kinetoplast DNA Assessment During Treatment of Mucosal Leishmaniasis as a Potential Biomarker of Outcome: A Pilot Study	en_US
dc.type	info:eu-repo/semantics/article
dc.identifier.doi	https://doi.org/10.4269/ajtmh.15-0514
dc.subject.ocde	https://purl.org/pe-repo/ocde/ford#3.03.06
dc.relation.issn	1476-1645