A new Leishmania infantum enzymatic variant, agent of an urban visceral case unresponsive to drugs.
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Biomedical subjects
Publications and source records attributed to L Gradoni.
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One out of 213 Phlebotomus perfiliewi caught from an endemic cutaneous leishmaniasis focus in Abruzzi region (Italy) was naturally infected with promastigotes. The parasites were grown in culture medium and in a hamster, typed by the examination of 11 isoenzymes, and found to be indistinguishable from Leishmania infantum s.st. (Montpellier zymodeme 1). The probable role of P. perfiliewi in the transmission of cutaneous leishmaniasis due to L. infantum s.l. in the focus is discussed.
Dogs naturally infected with Leishmania infantum Nicolle were treated with three courses of meglumine antimoniate. Changes were observed in the dogs' clinical signs, antibody titres and in infection rates of Phlebotomus perniciosus Newstead fed on the dogs. A large reduction in the sandfly infection rate was observed for 4-5 months after the first treatment. The use of antimonial drugs is advocated for the control of canine leishmaniasis and to reduce risks of L.infantum transmission.
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Two promastigote-infected specimens of Phlebotomus perniciosus Newstead, 1911, were found in the province of Cagliari, Italy. The parasites from one specimen were successfully cultured in a hamster. The isolate was typed on 11 enzymes and shown to be identical with the reference strain of Leishmania infantum s.st. This is the first typing of a leishmanial organism from naturally infected P. perniciosus.
The recent occurrence of infantile cases of visceral leishmaniasis in the Isle of Elba, Italy, has stimulated research on the prevalence of Leishmania infection in dogs. Out of 3,000 dogs present in the island 914 were examined through immunofluorescent antibody test (IFAT) and 175 of them (19.1%) were found positive. 100% parasitological confirmation through isolation of parasite was obtained in a sample of 38 IFAT-positive dogs. The distribution of positive dogs in the island showed to be non-uniform, the frequencies of infection ranging from 2.5% to 39.6% according to communes. The causes of this distribution and its relationship with the human visceral leishmaniasis cases are discussed.
The role of the sandfly species Phlebotomus perniciosus Parrot in laboratory transmission of Leishmania infantum was investigated. One of the wild reservoirs of the disease, the black rat (Rattus rattus), was used as vertebrate host. The parasite was transmitted by the bite of experimentally infected P. perniciosus to the black rat which, six months later, was infective to the same sandfly species. These experimental data confirm the role of P. perniciosus in the transmission of L. infantum, as suggested by earlier studies based on epidemiological data.
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Canine leishmaniasis has first been recorded in Italy by Basile (1910). Since then, many cases have been reported. In order to have a general picture of canine leishmaniasis distribution in Italy, from 1910 up to present times, we have collected all records of leishmaniotic dogs which have appeared in the literature, integrated by personal data. A map has been drawn, according to the origin of cases, showing: the present distribution of canine leishmaniasis in central and southern Italy and its islands; the persistence of canine leishmaniasis in some foci for the last 70 years or more; the increasing trend of new foci reports from the pre-war to present times. As opposed to the high diffusion of canine leishmaniasis there has been, in Italy, a marked reduction of human cases of visceral and cutaneous leishmaniasis, a phenomenon which has been observed in other Mediterranean countries as well. Recent data on the epizoology of canine leishmaniasis are discussed.
Seventy-four Leishmania isolates collected in Italy from six different Regions where leishmaniases are endemic, have been typed. Parasites have been isolated from: man (VL and CL), dog, black rat (Rattus rattus), fox (Vulpes vulpes) and geckoes (Tarentola mauritanica and Cyrtodactylus kotschyi). The isolates have been characterized by starch-gel electrophoresis for 9-16 enzymes whose mobility was compared with that of international reference strains for L. infantum, L. tropica, L. major, L. donovani, L. aethiopica and L. tarentolae. The results obtained have shown that the genus Leishmania in Italy is represented by five zymodemes which may be grouped into two taxa: L. infantum s.l. (L. infantum s.st., L. infantum NH130 variant, L. infantum NH140 variant and L. infantum GOT, MDH, NH variant), agent of mammalian leishmaniases (including human leishmaniases), and L. tarentolae, parasite of geckoes. At the moment, the absence of L. tropica in Italy as agent of CL has been revealed. Through the analysis of epidemiological data obtained from the foci where Leishmania parasites were isolated two zymodemes only, L. infantum s.st. and L. infantum NH140 variant, show to be widely distributed. However, L. infantum s.st. appears to be prevalent in Thyrrenean foci which are characterized by VL cases and by high density of Phlebotomus perniciosus, and L. infantum NH140 variant is present in Adriatic areas where CL is diffuse and P. perfiliewi is the probable vector.
Tentatives of culturing in vivo and in vitro the etiological agent of cutaneous leishmaniasis in Italy have in the past been carried out by several authors without, however, obtaining stable culture. The use of LHC inbred hamsters, treated with cortisone acetate, gives the possibility of isolating the parasite from human cutaneous lesions. The parasite is localized in the internal organs (spleen, liver and bone marrow) of the host, regardless of the site of inoculation. The infection is similar to that caused by Leishmania infantum from human, canine and murine visceral leishmaniasis. In the subsequent passage in vivo the parasite infects LHC inbred hamsters and outbred hamsters without cortisone acetate. Intrinsic and extrinsic characters of the agent of cutaneous leishmaniasis in Italy are discussed.
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Man-bait catches of Phlebotomus perniciosus were carried out in a human and canine leishmaniasis focus in Central Italy (Monte Argentario, Grosseto) to evaluate the man-sandfly contact of this vector. P. perniciosus females were collected biting on man outside, during the first hours of the night, when the local people are at risk. The results of these captures are discussed and the man-sandfly contact is considered in relation to the epidemiological aspects of the disease in the area under study.
Isoenzyme analysis, carried out on some hundreds of Leishmania isolates from the Mediterranean basin by specialized identification Centres, has provided new data on the taxonomy of this parasite in the area. Three complexes of zymodemes have been identified: L. infantum s.l., L. tropica s.l. and L. major s.l. L. infantum is the agent of human and canine visceral leishmaniasis and it is distributed throughout the Mediterranean area. Furthermore, this parasite is the only responsible for human cutaneous leishmaniasis in Central-Western Europe, including Italy. The distribution of L. tropica, agent of urban, or anthroponotic, cutaneous leishmaniasis, appears to be very limited, being restricted to Middle East, Tunisia and Greece. On the other hand, L. major, which causes rural, or zoonotic, cutaneous leishmaniasis, is widespread throughout North Africa and Middle East. In some countries, such as Tunisia and Israel, leishmaniases are caused by all the three complexes.
The recent finding that four Leishmania isolates from Rattus rattus are enzymologically identical to L. infantum, aetiological agent of human and canine visceral leishmaniasis in the Mediterranean area, has stimulated further research on the role of R. rattus in the epidemiology of visceral leishmaniasis in Tuscany, Italy. The present work has led to the following results: (a) R. rattus experimentally infected with L. infantum displayed a general resistance to the parasite, even though it appeared that a very low number of amastigotes persisted in the animal for a long period; (b) Phlebotomus perniciosus and P. perfiliewi induced to feed on rats, with either a massive visceral infection or a subpatent immunodepressed infection, became infected, though in different proportions; (c) P. perniciosus and P. perfiliewi were readily attracted to, and fed on, the black rat in nature. These findings, together with those obtained earlier, strongly suggest that the black rat may be one of the wild reservoirs of L. infantum in the areas under study.
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A skin test survey carried out in the towns of Porto St. Stefano and Porto Ercole showed a total positivity rate of 15.3%. The progressive increase of positivity according to age was not uniform but similar for the two towns since the values concerning the last two age groups did not follow the general trend of the graph but were lower than expected. The possible causes of this phenomenon have been discussed. The absence of overt visceral leishmaniasis cases in recent years and the concomitant high prevalence of canine leishmaniasis have been considered in the light of the occurrence of infectious diseases and the increase of the nutritional levels in the local human population.