LEISHMANIA-(VIANNIA)-PANAMENSIS-SPECIFIC IGE AND IGA ANTIBODIES IN RELATION TO EXPRESSION OF HUMAN TEGUMENTARY LEISHMANIASIS

Leishmania (Viannia) panamensis-specific IgE and IgA antibodies were q uantified in patients with parasitologically confirmed American tegume ntary leishmaniasis using a radioallergosorbent test (RAST) and an enz yme-linked immunosorbent assay (ELISA), respectively. The RAST values, presented as the mean +/- SEM percentage of total isotope added, were significantly elevated in patients having disease evolution greater t han 12 months (3.14 +/- 0.91), as compared with those with an evolutio n time of 12 or fewer months (1.66 +/- 0.15) (P = 0.017). A separate g roup of patients, those with eosinophils in the biopsy specimen of the ir lesion, also had elevated mean RAST values (2.55 +/- 0.58) when com pared with patients who did not demonstrate these cells in their biops y specimens (1.32 +/- 0.24) (P = 0.038). Leishmania-specific IgA level s, presented as the mean +/- SEM optical density, were significantly h igher for patients with mucocutaneous disease (0.40 +/- 0.03) than for patients with cutaneous disease (0.28 +/- 0.023) (P = 0.0063). Inhibi tion testing with homologous and heterologous antigens confirmed the s pecificity of these assays, and were used to assess cross-reactivity a mong L. (Viannia) subspecies and other kineto-plastid hemoparasites. R esults demonstrate that patients with more severe forms of American te gumentary leishmaniasis, defined either as increased duration of disea se or invasion of the mucosa, have elevated levels of Leishmania-speci fic IgE and IgA antibodies, respectively.