Center for Medical Parasitology, Institute for Medical Microbiology and Immunology, University of Copenhagen, Department of Infectious Diseases and Department of Clinical Microbiology, Copenhagen University Hospital (Rigshospitalet), Institute of Tropical Medicine and Institute of Endemic Diseases, University of Khartoum, Copenhagen, Denmark
An enzyme-linked immunosorbent assay (ELISA) using a 28 amino acid sequence of the repetitive element of gene B protein (GBP) from Leishmania major was developed for serodiagnosis of cutaneous leishmaniasis (CL). The assay was compared to ELISAs using crude amastigote and promastigote antigens from L. donovani and the major surface glycoprotein (Gp63) from either L. donovani or L. major as a solid-phase ligand. The sensitivity of the assays was tested in 33 patients suffering from CL caused by L. major. The sensitivity of the GBP peptide (GBPP) ELISA was 82%. This was higher than in the assays using crude amastigote (67%) or promastigote (67%) antigens, but the difference was not statistically significant. The sensitivity in the assays using Gp63 from L. donovani (52%) or L. major (39%) was significantly lower than in the assay using GBPP (P = 0.019 and P < 0.001, respectively). Plasma samples from healthy Sudanese individuals living in an area endemic for malaria but free of leishmaniasis were negative in all the assays. Significantly higher levels of antibodies were found in the patients who had suffered from the disease for more than eight weeks than in patients with a shorter clinical history (GBPP ELISA; P = 0.038; amastigote ELISA; P = 0.004; and promastigote ELISA; P = 0.017). In the former group, the sensitivities of the five ELISAs were 100% (GBPP), 87% (amastigote), 93% (promastigote), 67% (L. donovani), and 53% (L. major), respectively.