Epidemiological analysis of L. tropica strains isolated from Turkey using multilocus microsatellite typing (MLMT) method

Turkey has an important geographic location by being the link between Asia and Europe in terms of epidemiology and infectious vector-borne diseases. Leishmaniasis is classified as cutaneous, visceral and mucocutaneous by clinically and it is among the world's six major tropical diseases. The causative agent of leishmaniasis is a protozoon parasite belongs to Leishmania genus. Depending on the type of causative agent, leishmaniasis can be antroponotic and zoonotic. In Turkey, Antroponotic Cutaneous Leishmaniasis (ACL) particularly reported in Southeastern Anatolia and east of the Mediterranean region and the causative agent is Leishmania tropica, which is known as highly heterogeneous in genetical terms. Leishmaniasis agents, especially L. tropica, in Turkey has not been studied enough yet by modern molecular techniques and there are signifficant gaps in the knowledge compared to other countries where the disease is endemic. To reveal changes and the problems encountered in epidemiology of leishmaniasis, Multilocus Microsatellite Typing (MLMT) is an important tool to monitor the parasite differentiation. Therefore 33 strains isolated from different parts of Turkey and 5 imported strains from Syrian refugees were studied using 12 highly specific microsatellite markers to reveal the genetical structure of Leishmania tropica. Specific peak signals of these strains were used to identify intra and inter population diversity by using short tandem repeats. With the identification of different genetical populations, significant differences between Aegean and Southeastern strains were demonstrated. Four main population structure were revealed in this study and Syrian strains were found highly similar (99%) to those isolated from Şanlıurfa while they totally differs from Aydın strains. Aydın strains were failed to amplify the LIST7010 region and that makes these strains differs from others in minor level. One of strains that isolated from visceral leishmaniasis patient from Manisa does not show any differences compared to Aydın strains that isolated from cutaneous leishmaniasis patients. The data obtained from this study will help to demonstrate the genetical structure of the disease and to improve the treatment methods. Determining the gene flow and differences among strains will provide important data to the geographical distribution of the disease.