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Clinical and Diagnostic Laboratory Immunology, March 1999, p. 231-235, Vol. 6, No. 2
1071-412X/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Immunoglobulin Subclass Distribution and Diagnostic Value of Leishmania donovani Antigen-Specific Immunoglobulin G3 in Indian Kala-Azar Patients

Khairul Anam,1 Farhat Afrin,1 Dwijadas Banerjee,2 Netai Pramanik,2 Subhasis K. Guha,2 Rama P. Goswami,2 Pratap N. Gupta,3 Shiben K. Saha,2 and Nahid Ali1,*

Leishmania Group, Indian Institute of Chemical Biology,1 and Department of Tropical Medicine,2 and Department of Leprosy,3 School of Tropical Medicine, Calcutta 700032, India

Received 22 June 1998/Returned for modification 5 October 1998/Accepted 11 December 1998

Visceral leishmaniasis, or kala-azar, a fatal tropical disease, remains problematic, as early diagnosis is difficult and treatment often results in drug resistance and relapse. We have developed a sensitive enzyme-linked immunosorbent assay (ELISA), using leishmanial membrane antigenic extracts (LAg) to detect specific antibody responses in 25 untreated Indian visceral leishmaniasis patients. To investigate the pathogenetic significance of isotype markers in kala-azar, relative levels of specific immunoglobulin G (IgG), IgM, IgA, IgE, and IgG subclasses were analyzed under clinically established diseased conditions. Since LAg showed higher sensitivity for specific IgG than lysate, the immunoglobulin isotype responses were evaluated, with LAg as antigen. Compared to 60 controls, which included patients with malaria, tuberculosis, leprosy, and typhoid and healthy subjects, visceral leishmaniasis patients showed significantly higher IgG (100% sensitivity, 85% specificity), IgM (48% sensitivity, 100% specificity), and IgE (44% sensitivity, 98.3% specificity) responses. Low levels of IgA in visceral leishmaniasis patients contrasted with a 13-fold-higher reactivity in sera from patients with leprosy. Among IgG subclasses, IgG1, -3, and -4 responses were significantly higher in visceral leishmaniasis patients than in the controls. IgG2 response, however, was significantly higher (twofold) in leprosy than even visceral leishmaniasis patients. The rank orders for sensitivity (IgG = IgG1 = IgG3 = IgG4 > IgG2 > IgM > IgE > IgA) and specificity (IgM = IgG3 > IgE > IgG4 > IgG2 > IgG > IgG1 > IgA) for LAg-specific antibody responses suggest the potentiality of IgG3 as a diagnostic marker for visceral leishmaniasis.


* Corresponding author. Mailing address: Indian Institute of Chemical Biology, 4, Raja S. C. Mullick Rd., Calcutta 700032, India. Phone: 91-33-473-3491/0492/6793. Fax: 91-33-4730284/5197. E-mail: IICHBIO{at}GIASCL01.VSNL.NET.IN.


Clinical and Diagnostic Laboratory Immunology, March 1999, p. 231-235, Vol. 6, No. 2
1071-412X/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.



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