Recombinant Proteins, Multiepitope Constructs, and Synthetic Peptides for ELISA-Based Diagnosis of Leptospirosis: A...

Leptospirosis, caused by pathogenic species of the gram-negative spirochete called Leptospira spp., is one of the most serious zoonotic diseases in the world. This disease commonly affects impoverished or underdeveloped populations with no proper sanitary conditions and is especially endemic in Latin American and tropical countries. Currently, the standard test for diagnosing leptospirosis, recommended by the World Health Organization (WHO), is the microscopic agglutination test (MAT). However, this test can be considered inefficient due to several technical and logistical constraints. For this reason, enzyme-linked immunosorbent assays (ELISAs) using recombinant or synthetic antigens have emerged as promising alternatives for serodiagnosis. Facing the need to improve the diagnosis of leptospirosis, and with the promising applications of recombinant and synthetic antigens, we performed a comprehensive narrative review of the use of recombinant proteins (RP), recombinant multiepitope proteins (RMP), and synthetic peptides (SP), applied in ELISAs for leptospirosis diagnosis. It was possible to observe some promising results using recombinant and synthetic antigens, which represent powerful means of optimizing the ELISA-based diagnosis of leptospirosis. Among the studies reviewed, RPs, the type of antigen most widely studied, showed outstanding diagnostic performance. Although RMPs and SPs are not studied as widely, all these antigens showed diagnostic potential with great values for sensitivity and specificity. Despite these good results, it remains necessary to improve the studies under development to find quicker, more accurate, and widely accessible diagnostic tools for leptospirosis, which may provide a better prognosis for patients.