Detection of potentially diagnostic antigens with western blot analysis of Sera from patients with cutaneous and visceral leishmaniases. [4.6C78.0]). This IB may be helpful to exclude the diagnosis of CL, prompting physicians to look for another diagnosis in the case of a negative IB. INTRODUCTION New World cutaneous leishmaniasis (CL) is a vector-borne disease caused by many species. This neglected tropical IKK1 disease1 represents a significant public health burden in South America. According to the WHO leishmaniasis working group, the annual incidence of CL between 2004 and 2008 was estimated at 650 to 1 1,100 cases per year in French Guiana but is probably underestimated.2 This French overseas territory located in South America has an equatorial climate that is tempered by trade winds,3 enabling the development of vectors and reservoir hosts. Five species involved in human infection are sympatric in this area: causes about 85% of CL cases,6 chiefly localized and rarely disseminated leishmaniasis,7 but the incidence of infection, the possible causative agent of mucosal leishmaniasis, has also increased Trans-Tranilast in recent Trans-Tranilast years. 8 Cutaneous leishmaniasis is difficult to diagnose because of its broad and heterogeneous clinical presentation.9 Conventional diagnosis of CL is based on the direct microscopic examination of Giemsa-stained smears, histopathological examination of fixed biopsies, or culture from lesion samples.10 However, these microscopy-based techniques display poor sensitivity because of a relatively low density and heterogeneous distribution of the parasites within clinical samples, and do not make it possible to identify the species involved. Several diagnostic tools, mainly PCR-based methods, have been developed, which both increased the diagnosis sensitivity and enabled species identification.11 Serological diagnosis is considered to be of limited importance for CL diagnosis. Recently, ELISAs have been developed and appear to be promising.12 Serology has also recently demonstrated its usefulness in the diagnosis of (Old-World CL).13C15 Immunoblot (IB) techniques providing a detailed pattern of the patients antibody response against various leishmanial antigens16 are Trans-Tranilast considered to be more sensitive and specific than ELISA, particularly in cases of asymptomatic visceral leishmaniasis (VL) and Old-World CL,15 despite the fact that the two clinical forms are very distinct. However, data on the serological diagnosis of New-World CL by IB remain scarce. Pomares et al.15 and Seyyedtabaei et al.13 demonstrated that CL could be diagnosed using IB performed with the most specific antigens 14 and 16 kDa. Thus, these antigens seem to have an interspecies specificity for and therefore tare of potential interest for the complex. This study aimed to evaluate the effectiveness of immunoblotting, targeting 14 Trans-Tranilast and 16 Trans-Tranilast kDa antigens, for the diagnosis of New-World CL in French Guiana. METHODS Ethical aspect. The study was performed in accordance with the Declaration of Helsinki and used only healthcare data that are routinely used for clinical purposes in patients with all pathogens mentioned in this article. Patients. Patients were included in the study if 1) at least one serum sample had been collected from them and sent to the laboratory for the diagnosis of leishmaniasis, and has been kept in the biological collection of the Cayenne Hospital laboratory (French Guiana); and 2) they complied with the case definition of the following four groups. Group I. This group included patients with a CL diagnosis that was confirmed by direct microscopical examination of lesions, positive PCR, and/or culture. Species identification was made via polymerase chain reaction-restriction fragment length polymorphism4 and/or matrix assisted laser desorption ionization – time of flight.17 For each patient, demographic data; duration of symptoms; the number, distribution, and description of the skin or mucosal lesions; and the identification of the species involved were recorded. Group II. This group included patients in whom a diagnosis of CL was refuted, presenting with an acute infection caused by various tropical endemic pathogens, including toxoplasmosis (with specific IgG and IgM), intestinal nematodes (and hookworms), extraintestinal amoebiasis, malaria, Chagas disease due to or infections, dengue, and chronic histoplasmosis. Group III. This group included patients in whom a diagnosis of CL was refuted, presenting with proven autoimmune diseases. Group IV. This control group included.