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J. Venom. Anim. Toxins incl. Trop. Dis.

V.20, 2014.

Original paper - ISSN 1678-9199.

 

Tracking false-negative results in molecular diagnosis: proposal of a triplex-PCR based method for leishmaniasis diagnosis

 
Suênia da Cunha Gonçalves-de-Albuquerque, Rômulo Pessoa e Silva, Rayana Carla Silva de Morais, Lays Adrianne Mendonça Trajano-Silva, Carlos Gustavo Régis-da-Silva, Sinval Pinto Brandão Filho, Milena de Paiva-Cavalcanti

 

Departamento de Imunologia, Centro de Pesquisas Aggeu Magalhães (CPqAM), Av. Prof. Moraes Rego, s/n, Recife, Pernambuco CEP 50670-420, Brasil

 

ABSTRACT

Background

Molecular biological methods have become increasingly relevant to the diagnosis and control of infectious diseases, such as leishmaniasis. Since various factors may affect the sensitivity of PCR assays, including DNA yield and purity, an optimal extraction method is pivotal. Losses of a parasite’s DNA during extraction may significantly impair its detection by PCR and lead to false-negative results. This study proposes a triplex PCR assay targeting the parasite’s DNA, an external control (pUC18) and an internal control (G3PD) for accurate diagnosis of leishmaniasis.

 

Results

Two primer pairs were designed to detect the plasmid pUC18 and a triplex PCR assay targeting the Leishmania braziliensis kinetoplast DNA, the external control and the internal control was standardized. The triplex PCR assay was assessed for its ability to detect the three target DNA fragments simultaneously. PCR products from pUC18 DNA resulted in bands of 368 (P1) and 316 (P2) base pairs (bp). The triplex PCR optimized with the chosen external control system (P1) allowed the simultaneous detection of the internal control (G3PD – 567 bp) as well as of small quantities (10 pg) of the target parasite’s DNA, detected by amplification of a 138 bp product.

 

Conclusions

The new tool standardized herein enables a more reliable interpretation of PCR results, mainly by contributing to quality assurance of leishmaniasis diagnosis. Furthermore, after simple standardization steps, this protocol could be applied to the diagnosis of other infectious diseases in reference laboratories. This triplex PCR enables the assessment of small losses during the DNA extraction process, problems concerning DNA degradation (sample quality) and the detection of L. braziliensis kDNA.

 

Key words: Extraction control; Multiplex PCR; pUC18; Leishmaniasis; Diagnosis; False-negative result

 

Ethics committee approval

The present study was approved by the Ethics Committee for Animal Use (CEUA- FIOCRUZ/RJ, LW-41/10 and LW-1/11) of Oswaldo Cruz Foundation.

 

Consent

Informed consent was obtained from the dogs’ owners and the person included in the study. Moreover, all procedures were approved by the Research Ethics Committee of Oswaldo Cruz Foundation (CEP-FIOCRUZ/PE, 42/2010).

 

Received: October 17, 2013; Revised: April 7, 2014; Accepted: April 22, 2014

 

Corresponding author: Milena de Paiva-Cavalcantimp@cpqam.fiocruz.br

 

Competing interests

The authors declare that they have no competing interests.

 

Authors’ contributions

MPC is the lead researcher of this study. MPC, SCGA and RPS designed the study. MPC and CGRS designed primers and gave intellectual support for this work. RPS, RCSM, LAMTS and SCGA performed experiments and their analysis. SCGA carried out the molecular genetic studies, analyzed amplicon sequencing and drafted the manuscript. SPBF and all authors read and approved the final version of this manuscript.