Bull Vet Inst Pulawy 49, 407-410, 2005

USEFULNESS OF TOUCH-DOWN PCR ASSAY FOR THE DIAGNOSIS OF ATYPICAL CASES OF CANIS CANIS INFECTIONS IN

AGNIESZKA S. SOBCZYK1,2, GRZEGORZ KOTOMSKI1, PAWEŁ GÓRSKI1 AND HALINA WĘDRYCHOWICZ1,3

1Department of Parasitology, Faculty of Veterinary Medicine, Warsaw Agricultural University, 02-786 Warszawa, Poland 2 Department of General Biology and Parasitology, Medical University of Warsaw, 02-004 Warszawa, Poland 3 Witold Stefański Institute of Parasitology, Polish Academy of Sciences, 00-818 Warszawa, Poland e-mail:[email protected]

Received for publication May 11, 2005.

Abstract canis have been identified using RFLP (restriction fragment length polymorphism) analysis of PCR The aim of the present study was to evaluate (polymerase chain reaction) when DNA coding for small usefulness of PCR assay for the diagnosis of atypical subunit ribosomal RNA (ssrRNA) was amplified. These cases of the Babesia canis infections. Primers designed subspecies have been named Babesia canis canis, B. based on the 18 S RNA gene sequence of B. canis. The canis vogeli, and B. canis rossi (8). B. canis canis may location of the primers was targeted to evolutionary be transmitted by tick , B. canis conserved region. Blood samples from dogs suspected vogeli is transmitted by and for were analysed microscopically and then B. canis rossi is transmitted by Haemophysalis leachi by PCR. The PCR assay showed higher efficacy and (12, 18, 22). specificity of the parasite detection. It is concluded that In recognition of the disease a proper diagnosis is the sensitivity of the touch-down PCR makes it very essential because in per-acute form of the disease it particularly appropriate for diagnostics of atypical and develops in 1-2 d. Young dogs and puppies are highly chronic cases of babesiosis. The sequencing analysis of susceptible, with death occurring in the absence of the studied isolates revealed that canine babesiosis in treatment, and transplacental transmission has been Warsaw area is caused by Babesia canis canis. suggested since high parasitaemia has been observed in neonates (5, 9, 15). Moreover, the clinical Key words: , Babesia, PCR. manifestations of infections caused by the three subspecies were found to differ significantly. B. canis rossi is highly virulent and causes either a haemolytic Canine babesiosis has recently been recognized as disease (possibly immune-mediated) or an acute and an emerging infectious disease of dogs in Poland (11). overwhelming inflammatory response (17) infection by Babesia canis and Babesia gibsoni are the major species B. canis canis results in transient parasitaemia, usually which may cause babesiosis in dogs. Parasites from below 1% and clinical disease associated with these two species can be distinguished in Giemsa stained congestion of internal organs (19), while infection by B. blood smears as they differ in size. Babesia gibsoni is canis vogeli leads to a relatively mild disease, often twice smaller (1.9 µm x 1.2 µm) than Babesia canis that without evident clinical signs. Therefore, on the basis of is classified as a large piroplasm (2.5 µm x 5.0 µm). clinical symptoms it is difficult to put a proper diagnosis Babesia canis is found worldwide, being the most (2) and confirmation by a sensitive diagnostic test is widespread and also pathogenic Babesia species in dogs. required. A typical intraerythrocytic piroplasma is pear-shaped Babesiosis has been classically diagnosed by and often occurs in pairs (13). In acute infection an demonstrating intraerythrocytic trophozoites on Giemsa- erythrocyte may contain parasites in number from 4 to Romanowsky stained blood smears. B. canis generally 16. In chronic infection amoeboid and ring forms can be appears as a paired, piriform figure measuring 5 x 2-3 observed. micrometers (Fig. 1). This is an insensitive procedure, Developments in genetic technology have particularly for animals in the carrier state. Babesia contributed to the delineation between species and canis infections can also be determined using serological subspecies of Babesia organisms. Three subspecies of B. methods such as the indirect fluorescent antibody test (IFAT) (22, 23) or ELISA (12). 408

Recently, the development of PCR-based denaturation at 94oC, 1 min of annealing at 51oC, 1 min detection assays for some Babesia species have been of extension at 72oC. PCR 0.5 kb products were isolated described (1, 2, 10, 14, 24). The studies have shown from the agarose gel using Gel-Out kit (A&A these assays to be more sensitive than, and equally BIOTECHNOLOGY), purified using DNA Clean-Up specific for the detection of acute cases as smear kit (A&A BIOTECHNOLOGY), digested with EcoRI evaluation. and PstI enzymes and ligated into plasmid vector The aim of the present study was to develop the pBluescript II SK(-) (Stratagene) and used to transform diagnostic test based on PCR assay allowing a proper XL1-Blue Escherichia coli cells by electroporation. diagnosis in cases when blood smear analysis is negative Transformants were checked by the digestion of or dubious as well as to establish which of Babesia canis plasmid DNA with EcoRI i PstI enzymes. subspecies occurs in Central Poland. Sequencing reactions were analysed on the ABI 3100 automatic DNA sequencer (Applied Biosystems).

Material and Methods Results Material. Blood samples were collected from dogs of Warsaw area, showing clinical signs of The majority of samples showed typical babesiosis: depression, lethargy, (40-41oC), trophozoites of Babesia canis (Fig. 1), but anaemia, accelerated respiration and tachycardia, approximately 1.5% of blood smears from dogs showing vomiting, haematuria, and icterus. The dogs were of symptoms of babesiosis contained abnormal various breeds and of different age (from less than 6 trophozoites (neither piriform nor ringform). These months to more than three years). samples were subjected to DNA analysis by touch-down Microscopical examination. Thin blood smears PCR method. of peripheral blood samples were fixed for 3 min with methanol then stained with Giemsa solution for 25 min, washed and observed under microscope. Two hundred oil immersion fields were examined. DNA preparation. Genomic DNA were extracted from the blood of individual dogs using blood DNA Prep Plus (A&A BIOTECHNOLOGY). The DNA samples were stored at -20 oC. Polymerase chain reaction (PCR). PCR was performed using oligonucleotide primers (BcW-A: 5’- CATCTAAGGAAGGCAGCAGG; BcW-B: 5’- TTAATGGAAACGTCCTTGGC) complementary to the region of 18 S ribosomal subunit DNA of Babesia canis submitted to the GenBank under accession No. L19079. The reactions were carried out in 25 µl of mixture containing about 0.5 µg of template DNA, 1.25 U Taq polymerase (Madena Pherma Terpol Group), 1x buffer (100 mM Tris-HCl pH 8.3, 500 mM KCl, 15 mM Fig. 1. Giemsa stained blood smear from B. canis canis MgCl2), 200 µM of dNTPs, 25 pmol of each primer. Negative control reactions were carried out without infected dog showing a typical trophozoite. DNA. To obtain better specificity of the amplicons, touch-down PCR were performed. Reaction consisted of To evaluate a usefulness of the touch-down an initial 2 min denaturation step at 94oC, annealing at PCR assay for definitive diagnosis of B. canis 60oC for 30 s, extension at 72oC for 30 s. In the next 2 infections, we analysed 57 samples and among them 6 cycles temperature of annealing was lowered about 2 containing abnormal trophozoites. Following the PCR degrees; for the next 15 cycles annealing was carried out amplicons of 509 bp appeared in 4 samples with at 54oC and in next 15 cycles at 52oC (denaturation at abnormal trophozoites (Fig. 2). Out of remaining 51 94oC for 1 min; extension at 72oC for 30 s). Final samples tested, in 9 PCR amplicons showing the extension was done at 72oC for 10 min. presence of B. canis DNA were obtained while Amplification products were subjected to simultaneous microscopical analysis did not reveal any electrophoresis and visualized on ethidium bromide- trophozoites. In five cases there was no PCR product stained 1% agarose gel (Sigma-Aldrich). although microscopic examination was positive. In such DNA cloning and sequencing. For facilitation of cases of incompatibility of these two diagnostic subsequent cloning, EcoRI and PstI restriction enzymes methods, PCR reaction was repeated and confirmation sides were incorporated into the 5’ ends of the BCW-1 of earlier obtained results was achieved. and BWC-2 primers. Amplification was performed with three-step cycling program, as follows: 1 min of 409

hand, false positive results of microscopic method can be caused by artifacts (e.g. dye deposits in erythrocytes). Touch-down PCR used in this study revealed higher specificity than a conventional PCR, six cycles were carried out conditions of higher temperature which gives higher specificity, and the next cycles under standard condition. The sensitivity of the test, determined by serial dilutions of DNA samples extracted from blood of dog with parasitaemia, was 0.15%. Parasitaemia detectable by our modification of the PCR was estimated as 0.00015%. In 2001 Japanese scientists applied nested PCR for the detection of Babesia gibsoni – the most frequent etiological agent of canine babesiosis in Japan. This diagnostic test was designed to amplify a fragment of small ribosomal subunit gene, as in our study. The Fig. 2. Gel electrophoresis of PCR products obtained nested PCR with inner primers was carried out only with DNA isolated from blood of dogs. Lane M – DNA when in the first reaction there was no PCR product length standard; Lanes 1-3 & P – samples from dogs because of small amount of DNA sample. The infected with B. canis canis; Lane N – sample from non- sensitivity of the test was established as 0.000118% infected dog. performing serial dilutions of infected dog blood samples (1). Recently, it has been developed a seminested PCR test which was able to detect and discriminate B. gibsoni (Asian genotype), B. canis To determine the sensivity of the PCR test, DNA subsp. vogeli, B. canis subsp. canis, and B. canis subsp. extracted from the blood of infected dog was diluted, rossi DNA in blood samples from infected dogs (6). then used as the template for the test. On the basis of the Sequencing results obtained in the present study dilution experiments it was found that our PCR test can suggest that in Central Poland only Babesia canis canis detect parasitaemia on the level of 0.00015%. is present. Molecular analysis of full length ssr RNA The PCR amplicons were digested with EcoRI from Italian dog which acquired infection during its stay and PstI, cloned into pBluscript plasmid and sequenced. in Poland confirmed this result (7). The three sequenced amplicons of ssrDNA possessed Amplicons of two out of three sequenced samples 509, 509 and 508 bp and in the BLAST analysis showed had a length of 509 bp and the third one 508 bp. A 100% similarity score with complete ssrRNA sequence BLAST search against GenBank revealed the highest of Babesia canis canis from France (accession No. similarity score (100%) with a partial, 365 bp long AY072926), and 99% with sequence from Great Britain sequence from B. canis canis from France (accession (AY272047). No. AY072926) and Great Britain (99%, accession No. The full Warsaw sequence of B. canis canis AY272047). Two out of three sequences analysed in the ssrDNA fragment was then submitted to GenBank present study were identical in length and one was (accession No. AY321119). shorter. There were also two nucleotide substitutions. The observed differences may represent sequencing errors or minor strain variation. Similar variations in Discussion sequences of B. canis canis were reported by Zahler et al. (25). The presence of B. canis canis in infected dogs Classical diagnosis of canine babesiosis relies from Poland is in agreement with the known distribution mainly on microscopic identification of piroplasms in of the vectors of the subspecies (21). However, because erythrocytes. However, in animals with chronic disease of the expanding international mobility of pet dogs, and the number of parasites is too low to be detected by the presence of competent tick vectors this situation may microscopic observation of Giemsa-stained thin blood change in the future. An increased contact of dogs with smears (3). Effectiveness of this method is also limited the wild environment may expose them to infection with by 10 day period when parasites disappear from new Babesia species (18) and a possible role of dogs as peripheral blood (4). During this period DNA of reservoirs of zoonotic disease can not be excluded. parasites can be detected by PCR (10). The advantage of microscopic method is that it does not demand any specialistic equipment but, on the other hand, it needs a very well trained and skilled microscopist. References Divergence among results observed in the present 1. Ano H., Makimura S., Harasawa R.: Detection of study may be an example of such lower sensitivity of Babesia species from infected dog blood by polymerase microscopic method, which is able to detect the parasite chain reaction. J Vet Med Sci 2001, 63, 111-113. in blood with parasitaemia of 0.001% (15). On the other 2. Bashiruddin J. B., Camma C., Rebelo E.: Molecular detection of Babesia equi and Babesia caballi in horse 410

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