Antibody subclass profile against Leishmania braziliensis and Leishmania amazonensis in the diagnosis and follow-up of mucosal leishmaniasis.

Sensitivities and specificities of IgG subclasses-ELISA and IgG-indirect fluorescent antibody test (IFAT) against Leishmania braziliensis (Lb) and L. amazonensis (La) antigens were determined in 17 patients with mucosal (ML) and 19 with muco-cutaneous (MCL) leishmaniasis. Using IFAT-IgG both antigens gave high sensitivities and were statistically similar, being 89.5% with La and 100% with Lb. Using ELISA, the highest sensitivity was achieved with total IgG for ML (94.7% with both antigens) and MCL (100% with both antigens). Cross-reactivity, observed with Chagas disease and malaria sera reduced the specificity of the IgG-based assays, being 50 to 70% with IFAT and 40 to 70% with ELISA. An increase in specificity was obtained with IgG1-ELISA (90% with Lb and 100% with La). Serum levels of anti-Lb-IgG and IgG3 dropped 90 days after treatment. IgG subclasses antibody detection constitute an valuable alternative to increase the efficiency of sorological diagnostics of ML/MCL.