Serum Proteomics for Visceral Leishmaniasis: Promise of Postgenomics Diagnostics for Public Health in Developing Countries

Lokesh   A.   Rukmangadachar; Jitender      Kataria; Alagiri      Srinivasan

Abstract

Visceral leishmaniasis is a vector borne parasitic infection caused by Leishmania donovani or Leishmania infantum, mostly in poorer sections of the population in endemic areas. More than 90% of the cases occur in just six countries, namely, Bangladesh, Brazil, Ethiopia, India, Nepal and Sudan. In the Indian subcontinent where the disease is caused by infection with L. donovani, man is the only host. Hence, the key to eradication of this disease is the proper treatment of the cases and the prevention of spread. Moreover, untreated visceral leishmaniasis is always fatal. The diagnosis of the infection involves invasive procedures. Adverse drug reactions for existing drugs are severe and drug resistance is an increasing problem. There is an urgent need for an early diagnosis of this infection. Equally important is the discovery of effective treatment methods with less or no side effects. The advent of genomics and proteomics has bestowed us with powerful theoretical and experimental tools. These have opened us vistas, which we previously thought as practically impossible to explore. We know now that there are many host alleles, which can attenuate the severity of the disease. Patients carrying these alleles must have different treatment mode than the other patients. Identification of these patients is within the realms of proteomics. Serum immune proteomics have identified many antigens, which can serve as future vaccination candidates. Proteomics reveals the differential protein expression in the infected serum. Genomics differentiates the host and pathogen genes. Both of these “Omics” approaches are complementary. Their strength is that these tools identify the global differential expression enabling disease markers as well as the individual variations enabling personalized medicine. Genomics and proteomics, therefore, have much to offer for advancement of the juxtaposed goals in therapeutics and diagnostics (i.e., theranostics) for visceral leishmaniasis, and neglected diseases of importance for global public health.

Keywords: Development studies and proteomics, global personalized medicine, neglected diseases, postgenomics diagnostics, proteomics, public health proteomics, visceral leishmaniasis.

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