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DEVELOPMENT AND EVALUATION OF A LOOP-MEDIATED ISOTHERMAL
AMPLIFICATION ASSAY FOR RAPID DETECTION OF LEISHMANIA INFANTUM
Introduction
Leishmaniasis constitute a group of parasitic diseases caused by protozoan parasites of the genus Leishmania. We have developed a
species-specific L. infantum LAMP assay for the diagnosis of clinical canine leishmaniasis using the cysteine protease B (cpb) multi-
copy gene as target. This technique was compared to serological, PCR and parasitological diagnostics.
Materials and Methods
- The LAMP primer sets were designed using Primer Explorer Ver.4.
- The L. infantum specific LAMP reaction was standardized for optimal temperature and time.
- Seventy-five DNAs extracted from Blood of suspicious Leishmania infected dogs from different zones in and around Tunis.
- The dogs were examined for occurrences of visible clinical signs of the disease.
- The samples were tested by : Microscopy (Gold standard), Serology (IFAT), PCR and LAMP.
- Statistical Analysis.
Results
1. Sensitivity and Specificity of the L. infantum specific LAMP
A set of oligonucleotide primers targeting L. infantum cpb genes
sequences were designed for LAMP reaction. Serially diluted
samples were assessed for the presence of the L. infantum strain
(MHOM/TN/80/IPT1) promastigote DNA used as reference. LAMP
was able to detect up to 50 fg of DNA against up to 100 pg
detected by conventional cpb PCR (Chaouch et al., 2013).
To evaluate the specificity of the LAMP reaction, DNA samples from
other Leishmania and Trypanosoma species (L. major, L. tropica,
L. turanica, L. gerbilii, L. tarentolea and T.cruzi) were examined. No
amplification product was detected even when using up to 50 ng
of DNA showing that the LAMP cpb was specific for L. infantum
detection (data not shown).
Conclusion
MELEK CHAOUCH1, MOEZ MHADHBI2, GERARD J SCHOONE3, SASSI LIMAM2, EMILY R ADAMS3, MOHAMED-AZIZ
DARGHOUTH2, IKRAM GUIZANI1, SOUHA BEN ABDERRAZAK1
Acknowledgments : This study received financial support from the International Atomic Energy Agency (IAEA Contract
n°15137 - Contract n°15111) and from Ministère de l’Enseignement et de la Recherche Scientifique, Tunisia
LR00SP04).
1 INSTITUT PASTEUR DE TUNIS, TUNIS – TUNISIA
2 ECOLE NATIONALE DE MÉDECINE VÉTÉRINAIRE, SIDI-THABET– TUNISIA
3 ROYAL TROPICAL INSTITUTE, AMSTERDAM - NETHERLANDS
2. Hydroxy Naphthol Blue Staining
Fig. 3 : Flow-diagram of the results recorded by the diagnostics techniques applied to clinical samples.
A simpler colorimetric assay using a metal ion indicator, namely,
hydroxy naphthol blue (HNB) was used for the detection of the LAMP
reaction. This HNB staining is superior to the existing colorimetric
assays for LAMP (such as SYBR Green, agarose gel….). It also
presents reduced contamination risks and is helpful in high-
throughput DNA and RNA detection.
Fig 2: Visual examination of LAMP products by HB. A positive reaction is indicated by a color change
from violet to sky blue
3. Microscopy, IFAT, PCR and LAMP reactions
Parasitological examination of the 75 dogs’ samples by
microscopy shows that 35 animals were infected with Leishmania.
The remaining 40 dogs were considered as microscopically
negative. All these animals were tested by IFAT and the detection
of Leishmania DNA was run on the 75 dogs’ biological samples
using the PCR and LAMP assays described previously. The results
obtained from the different diagnostic techniques are presented in
the Flow diagram
Fig 1: Sensitivity of cpb LAMP. Total DNA of L. infantum reference strain (MHOM/TN/80/IPT1) was serially
diluted from 5 ng down to 5 fg (Lanes 1 to 7) - negative control (Lane 8).
4. Statistical analysis
To our knowledge this is the first study that evaluates the L.
infantum specific LAMP alongside other diagnostics tools for CanL.
The relative stability of the reagents indicates that LAMP may be a
good alternative to a conventional PCR, especially under field
conditions. Being able to detect and differentiate Leishmania
species with a technique that combines the reliability of molecular
techniques together with the low cost and technicality, opens
horizons for production of high precision LAMP-based devices.
IFAT PCR cpb LAMP cpb
Sensitivity (%) 88.57 37.14 54.29
Specificity (%) 52.5 82.5 80
Positive predictive value (%) 62 65 70.37
Negative predictive value (%) 84 60 66.67
X ² 14.17 3.86 9.52
The IFAT gave the best sensitivity (88.57%). However, this test
produce a high number of false-positive (22 animals), resulting in a
much lower specificity (52.5%).The PCR assay targeting the cpb
gene, gave the lower sensitivity (37.14%) and specificity around
82.5%.The practical evaluation of the LAMP gave more suitable
sensitivity and specificity.
1162

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DEVELOPMENT AND EVALUATION OF A LOOP-MEDIATED ISOTHERMAL AMPLIFICATION ASSAY FOR RAPID DETECTION OF LEISHMANIA INFANTUM

  • 1. DEVELOPMENT AND EVALUATION OF A LOOP-MEDIATED ISOTHERMAL AMPLIFICATION ASSAY FOR RAPID DETECTION OF LEISHMANIA INFANTUM Introduction Leishmaniasis constitute a group of parasitic diseases caused by protozoan parasites of the genus Leishmania. We have developed a species-specific L. infantum LAMP assay for the diagnosis of clinical canine leishmaniasis using the cysteine protease B (cpb) multi- copy gene as target. This technique was compared to serological, PCR and parasitological diagnostics. Materials and Methods - The LAMP primer sets were designed using Primer Explorer Ver.4. - The L. infantum specific LAMP reaction was standardized for optimal temperature and time. - Seventy-five DNAs extracted from Blood of suspicious Leishmania infected dogs from different zones in and around Tunis. - The dogs were examined for occurrences of visible clinical signs of the disease. - The samples were tested by : Microscopy (Gold standard), Serology (IFAT), PCR and LAMP. - Statistical Analysis. Results 1. Sensitivity and Specificity of the L. infantum specific LAMP A set of oligonucleotide primers targeting L. infantum cpb genes sequences were designed for LAMP reaction. Serially diluted samples were assessed for the presence of the L. infantum strain (MHOM/TN/80/IPT1) promastigote DNA used as reference. LAMP was able to detect up to 50 fg of DNA against up to 100 pg detected by conventional cpb PCR (Chaouch et al., 2013). To evaluate the specificity of the LAMP reaction, DNA samples from other Leishmania and Trypanosoma species (L. major, L. tropica, L. turanica, L. gerbilii, L. tarentolea and T.cruzi) were examined. No amplification product was detected even when using up to 50 ng of DNA showing that the LAMP cpb was specific for L. infantum detection (data not shown). Conclusion MELEK CHAOUCH1, MOEZ MHADHBI2, GERARD J SCHOONE3, SASSI LIMAM2, EMILY R ADAMS3, MOHAMED-AZIZ DARGHOUTH2, IKRAM GUIZANI1, SOUHA BEN ABDERRAZAK1 Acknowledgments : This study received financial support from the International Atomic Energy Agency (IAEA Contract n°15137 - Contract n°15111) and from Ministère de l’Enseignement et de la Recherche Scientifique, Tunisia LR00SP04). 1 INSTITUT PASTEUR DE TUNIS, TUNIS – TUNISIA 2 ECOLE NATIONALE DE MÉDECINE VÉTÉRINAIRE, SIDI-THABET– TUNISIA 3 ROYAL TROPICAL INSTITUTE, AMSTERDAM - NETHERLANDS 2. Hydroxy Naphthol Blue Staining Fig. 3 : Flow-diagram of the results recorded by the diagnostics techniques applied to clinical samples. A simpler colorimetric assay using a metal ion indicator, namely, hydroxy naphthol blue (HNB) was used for the detection of the LAMP reaction. This HNB staining is superior to the existing colorimetric assays for LAMP (such as SYBR Green, agarose gel….). It also presents reduced contamination risks and is helpful in high- throughput DNA and RNA detection. Fig 2: Visual examination of LAMP products by HB. A positive reaction is indicated by a color change from violet to sky blue 3. Microscopy, IFAT, PCR and LAMP reactions Parasitological examination of the 75 dogs’ samples by microscopy shows that 35 animals were infected with Leishmania. The remaining 40 dogs were considered as microscopically negative. All these animals were tested by IFAT and the detection of Leishmania DNA was run on the 75 dogs’ biological samples using the PCR and LAMP assays described previously. The results obtained from the different diagnostic techniques are presented in the Flow diagram Fig 1: Sensitivity of cpb LAMP. Total DNA of L. infantum reference strain (MHOM/TN/80/IPT1) was serially diluted from 5 ng down to 5 fg (Lanes 1 to 7) - negative control (Lane 8). 4. Statistical analysis To our knowledge this is the first study that evaluates the L. infantum specific LAMP alongside other diagnostics tools for CanL. The relative stability of the reagents indicates that LAMP may be a good alternative to a conventional PCR, especially under field conditions. Being able to detect and differentiate Leishmania species with a technique that combines the reliability of molecular techniques together with the low cost and technicality, opens horizons for production of high precision LAMP-based devices. IFAT PCR cpb LAMP cpb Sensitivity (%) 88.57 37.14 54.29 Specificity (%) 52.5 82.5 80 Positive predictive value (%) 62 65 70.37 Negative predictive value (%) 84 60 66.67 X ² 14.17 3.86 9.52 The IFAT gave the best sensitivity (88.57%). However, this test produce a high number of false-positive (22 animals), resulting in a much lower specificity (52.5%).The PCR assay targeting the cpb gene, gave the lower sensitivity (37.14%) and specificity around 82.5%.The practical evaluation of the LAMP gave more suitable sensitivity and specificity. 1162