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Schäfer I, Schmidt A, Gräßer F, Schieszler A, Aupperle-Lellbach H, Loesenbeck G, Gentil M, Müller E, Naucke TJ. Feline leishmaniosis with focus on ocular manifestation: a case report. Parasit Vectors 2023; 16:161. [PMID: 37173777 PMCID: PMC10176290 DOI: 10.1186/s13071-023-05741-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 03/15/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND In Europe, feline leishmaniosis is commonly caused by Leishmania infantum. There is little knowledge regarding pathogenesis, ocular manifestations and long-term follow-ups in cats with leishmaniosis. FINDINGS A 6-year-old female, spayed European Shorthair cat was imported from Spain to Germany 2 years prior to its first clinical presentation. The cat showed lethargy, weight loss, ulcerative lesions on the front limbs and high-grade chronic uveitis. The diagnosis of L. infantum infection was based on the cytological finding of amastigotes in skin lesions, positive qPCR of EDTA-blood and positive PCR of a cyto-brush sample from the conjunctiva. Supportive findings included positive serology by IFAT, serum protein capillary electrophoresis with peaks in alpha2- and gamma-globulin sections and marked elevation of SAA. Enucleation had to be performed on day 288 on both eyes because of blindness, glaucoma and high-grade uveitis. Histologically, high numbers of Leishmania spp. amastigotes were found in histiocytes. IFAT and PCR were positive in the aqueous humor in both eyes, respectively. Feline leukemia virus antigen and feline immunodeficiency virus antibody testings were positive. Hematological and biochemical results revealed mild leukocytosis with lymphocytosis, monocytosis and eosinopenia as well as marked elevation of SAA and hyperglobulinemia. The cat was treated with allopurinol, responded well and was still alive at follow-up on day 288 after first presentation. However, enucleation was necessary because of refractory glaucoma and uveitis. CONCLUSION: For the first time, ocular evidence of Leishmania IgG antibodies was demonstrated in the aqueous humor of both eyes in cats. There is limited knowledge about the pathogenesis, treatment options and outcomes in cats infected with L. infantum. This case report supports the hypothesis that immunosuppression increases the risk of clinical signs of leishmaniasis in cats. Alpha2- and gamma-globulin peaks in serum protein capillary electrophoresis are supportive criteria for the diagnosis of L. infantum infection. SAA is valuable for monitoring. Regarding ophthalmology, uveitis and glaucoma may have a poor prognosis.
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Affiliation(s)
- Ingo Schäfer
- LABOKLIN GmbH and Co. KG, Bad Kissingen, Germany.
| | - Albert Schmidt
- Small Animal Practice Dr. Fritz Gräßer, Großostheim, Germany
| | - Fritz Gräßer
- Small Animal Practice Dr. Fritz Gräßer, Großostheim, Germany
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Feeding on a Bartonella henselae Infected Host Triggers Temporary Changes in the Ctenocephalides felis Microbiome. Pathogens 2023; 12:pathogens12030366. [PMID: 36986288 PMCID: PMC10056022 DOI: 10.3390/pathogens12030366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/31/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023] Open
Abstract
The effect of Bartonella henselae on the microbiome of its vector, Ctenocephalides felis (the cat flea) is largely unknown, as the majority of C. felis microbiome studies have utilized wild-caught pooled fleas. We surveyed the microbiome of laboratory-origin C. felis fed on B. henselae-infected cats for 24 h or 9 days to identify changes to microbiome diversity and microbe prevalence compared to unfed fleas, and fleas fed on uninfected cats. Utilizing Next Generation Sequencing (NGS) on the Illumina platform, we documented an increase in microbial diversity in C. felis fed on Bartonella-infected cats for 24 h. These changes returned to baseline (unfed fleas or fleas fed on uninfected cats) after 9 days on the host. Increased diversity in the C. felis microbiome when fed on B. henselae-infected cats may be related to the mammalian, flea, or endosymbiont response. Poor B. henselae acquisition was documented with only one of four infected flea pools having B. henselae detected by NGS. We hypothesize this is due to the use of adult fleas, flea genetic variation, or lack of co-feeding with B. henselae-infected fleas. Future studies are necessary to fully characterize the effect of endosymbionts and C. felis diversity on B. henselae acquisition.
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Flatau R, Segoli M, Khokhlova I, Hawlena H. Wolbachia's role in mediating its flea's reproductive success differs according to flea origin. FEMS Microbiol Ecol 2019; 94:5068685. [PMID: 30107579 DOI: 10.1093/femsec/fiy157] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 08/08/2018] [Indexed: 12/19/2022] Open
Abstract
Endosymbionts-microbes that live within and engage in prolonged and intimate associations with their hosts-are gaining recognition for their direct impact on plant and animal reproduction. Here we used the overlooked Wolbachia-flea system to explore the possibility that endosymbionts may also play a role as mediators in shaping the reproductive success of their hosts. We simultaneously quantified the Wolbachia density in field- and laboratory-originated fleas that fed and mated on rodents for either 5 or 10 days and assessed their body size and current reproductive success. By combining multigroup analysis and model selection approaches, we teased apart the contribution of the direct effects of the flea's physiological age and body size and the mediation effect of its Wolbachia endosymbionts on flea reproductive success, and we showed that the latter was stronger than the former. However, interestingly, the mediation effect was manifested only in laboratory-originated fleas, for which the increase in Wolbachia with age translated into lower reproductive success. These results suggest that some well-supported phenomena, such as aging effects, may be driven by endosymbionts and show once again that the role of endosymbionts in shaping the reproductive success of their host depends on their selective environment.
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Affiliation(s)
- Ron Flatau
- Mitrani Department of Desert Ecology, Jacob Blaustein Institutes for Desert Research, Ben-Gurion University of the Negev, Sede-Boqer campus, 84990, Midreshet Ben-Gurion, Israel
| | - Michal Segoli
- Mitrani Department of Desert Ecology, Jacob Blaustein Institutes for Desert Research, Ben-Gurion University of the Negev, Sede-Boqer campus, 84990, Midreshet Ben-Gurion, Israel
| | - Irina Khokhlova
- Wyler Department of Dryland Agriculture, French Associates Institute for Agriculture and Biotechnology of Drylands, Jacob Blaustein Institutes for Desert Research, Ben-Gurion University of the Negev, Sede-Boqer campus, 84990, Midreshet Ben-Gurion, Israel
| | - Hadas Hawlena
- Mitrani Department of Desert Ecology, Jacob Blaustein Institutes for Desert Research, Ben-Gurion University of the Negev, Sede-Boqer campus, 84990, Midreshet Ben-Gurion, Israel
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Duplan F, Davies S, Filler S, Abdullah S, Keyte S, Newbury H, Helps CR, Wall R, Tasker S. Anaplasma phagocytophilum, Bartonella spp., haemoplasma species and Hepatozoon spp. in ticks infesting cats: a large-scale survey. Parasit Vectors 2018; 11:201. [PMID: 29558992 PMCID: PMC5861659 DOI: 10.1186/s13071-018-2789-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 03/07/2018] [Indexed: 12/17/2022] Open
Abstract
Background Ticks derived from cats have rarely been evaluated for the presence of pathogens. The aim of this study was to determine the prevalence of Anaplasma phagocytophilum, Bartonella spp., haemoplasma species and Hepatozoon spp. in ticks collected from cats in the UK. Methods Five hundred and forty DNA samples extracted from 540 ticks collected from cats presenting to veterinarians in UK practices were used. Samples underwent a conventional generic PCR assay for detection of Hepatozoon spp. and real-time quantitative PCR assays for detection of Anaplasma phagocytophilum and three feline haemoplasma species and a generic qPCR for detection of Bartonella spp. Feline 28S rDNA served as an endogenous internal PCR control and was assessed within the haemoplasma qPCR assays. Samples positive on the conventional and quantitative generic PCRs were submitted for DNA sequencing for species identification. Results Feline 28S rDNA was amplified from 475 of the 540 (88.0%) ticks. No evidence of PCR inhibition was found using an internal amplification control. Of 540 ticks, 19 (3.5%) contained DNA from one of the tick-borne pathogens evaluated. Pathogens detected were: A. phagocytophilum (n = 5; 0.9%), Bartonella spp. (n = 7; 1.3%) [including Bartonella henselae (n = 3; 0.6%) and Bartonella clarridgeiae (n = 1; 0.2%)], haemoplasma species (n = 5; 0.9%), “Candidatus Mycoplasma haemominutum” (n = 3; 0.6%), Mycoplasma haemofelis (n = 1; 0.2%), “Candidatus Mycoplasma turicensis” (n = 1; 0.2%), Hepatozoon spp. (n = 2; 0.4%), Hepatozoon felis (n = 1; 0.2%) and Hepatozoon silvestris (n = 1; 0.2%). Conclusion These data provide important information on the prevalence of tick-borne pathogens in ticks infesting cats, with the identification of haemoplasma species, A. phagocytophilum, H. felis and Bartonella spp. (including B. henselae and B. clarridgeiae). This study also documents the first report of H. silvestris in ticks collected from domestic cats.
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Affiliation(s)
- Florent Duplan
- Small Animal Hospital, Langford Vets, University of Bristol, Langford, United Kingdom
| | - Saran Davies
- Veterinary Parasitology and Ecology Group, School of Biological Sciences, University of Bristol, Bristol, United Kingdom
| | - Serina Filler
- Bristol Veterinary School, University of Bristol, Langford, United Kingdom
| | - Swaid Abdullah
- Veterinary Parasitology and Ecology Group, School of Biological Sciences, University of Bristol, Bristol, United Kingdom
| | - Sophie Keyte
- Small Animal Hospital, Langford Vets, University of Bristol, Langford, United Kingdom
| | - Hannah Newbury
- MSD Animal Health, Walton Manor, Walton, Milton Keynes, United Kingdom
| | - Chris R Helps
- Molecular Diagnostic Unit, Diagnostic Laboratories, Langford Vets, University of Bristol, Langford, United Kingdom
| | - Richard Wall
- Veterinary Parasitology and Ecology Group, School of Biological Sciences, University of Bristol, Bristol, United Kingdom
| | - Séverine Tasker
- Small Animal Hospital, Langford Vets, University of Bristol, Langford, United Kingdom. .,Molecular Diagnostic Unit, Diagnostic Laboratories, Langford Vets, University of Bristol, Langford, United Kingdom.
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Attipa C, Papasouliotis K, Solano-Gallego L, Baneth G, Nachum-Biala Y, Sarvani E, Knowles TG, Mengi S, Morris D, Helps C, Tasker S. Prevalence study and risk factor analysis of selected bacterial, protozoal and viral, including vector-borne, pathogens in cats from Cyprus. Parasit Vectors 2017; 10:130. [PMID: 28285597 PMCID: PMC5346881 DOI: 10.1186/s13071-017-2063-2] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 02/24/2017] [Indexed: 11/10/2022] Open
Abstract
Background Feline infectious agent studies are lacking in Cyprus. The aims of this study were to determine the prevalence and risk factors for various feline infectious agents, including feline vector-borne pathogens (FVBP), in cats from Cyprus. Methods A cross-sectional, descriptive, multicentre study was performed on 174 feline samples [138 owned and 36 shelter-feral, including both healthy (43) and non-healthy (131), cats] from private veterinary clinics from all six districts of Cyprus. Real-time quantitative polymerase chain reaction (qPCR) assays were used to detect Mycoplasma haemofelis (Mhf), “Candidatus Mycoplasma haemominutum” (CMhm) and “Candidatus Mycoplasma turicensis” (CMt). The population was tested for four FVBP including Bartonella henselae and Leishmania spp. using qPCR, while conventional PCR assays were used to detect Ehrlichia/Anaplasma spp. and Hepatozoon spp. Serological assays were performed to detect Leishmania infantum antibodies, feline leukaemia virus (FeLV) antigen and feline immunodeficiency virus (FIV) antibodies. Statistical analysis was performed to test associations and possible risk factors between variables and infectious agents. Results Ninety-six (55.2%) of the 174 cats were PCR-positive for at least one infectious agent. Forty-six cats (26.4%) were haemoplasma positive, including 13 (7.5%) for Mhf, 36 (20.7%) for CMhm and 12 (6.9%) for CMt. Sixty-six cats (37.9%) were positive for Hepatozoon spp., while 19 (10.9%) were positive for B. henselae, four (2.3%) for Leishmania spp. and one (0.6%) for Ehrlichia/Anaplasma spp. Sequencing revealed the presence of Hepatozoon felis, L. infantum and Anaplasma platys. Of the 164 cats that underwent retroviral serology, 10 (6.1%) were FeLV-positive and 31 (18.9%) were FIV-positive, while L. infantum serology was positive in 7 (4.4%) of the 160 cats tested. Multivariable logistic regression revealed significant associations for various infectious agents including L. infantum with each of Hepatozoon spp. and CMt infection. Conclusions A high prevalence of infectious agents was found in cats from Cyprus with Mhf, CMhm, CMt, L. infantum, B. henselae, H. felis, A. platys, FeLV and FIV infections reported for the first time. The significant associations between different pathogens provide a better understanding of similarities in the epidemiology of these pathogens and interactions between them. Electronic supplementary material The online version of this article (doi:10.1186/s13071-017-2063-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Charalampos Attipa
- Molecular Diagnostic Unit, Diagnostic Laboratories, Langford Vets and School of Veterinary Sciences, University of Bristol, Langford, UK. .,Cyvets Veterinary Center, Paphos, Cyprus.
| | - Kostas Papasouliotis
- Molecular Diagnostic Unit, Diagnostic Laboratories, Langford Vets and School of Veterinary Sciences, University of Bristol, Langford, UK
| | - Laia Solano-Gallego
- Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Gad Baneth
- Koret School of Veterinary Medicine, Hebrew University, Rehovot, Israel
| | | | - Elpida Sarvani
- Molecular Diagnostic Unit, Diagnostic Laboratories, Langford Vets and School of Veterinary Sciences, University of Bristol, Langford, UK
| | - Toby G Knowles
- School of Veterinary Sciences, University of Bristol, Langford, UK
| | - Sena Mengi
- Petcare Veterinary Clinic, Nicosia, Cyprus
| | - David Morris
- Molecular Diagnostic Unit, Diagnostic Laboratories, Langford Vets and School of Veterinary Sciences, University of Bristol, Langford, UK
| | - Chris Helps
- Molecular Diagnostic Unit, Diagnostic Laboratories, Langford Vets and School of Veterinary Sciences, University of Bristol, Langford, UK
| | - Séverine Tasker
- Molecular Diagnostic Unit, Diagnostic Laboratories, Langford Vets and School of Veterinary Sciences, University of Bristol, Langford, UK.,School of Veterinary Sciences, University of Bristol, Langford, UK
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Canine tick-borne pathogens in Cyprus and a unique canine case of multiple co-infections. Ticks Tick Borne Dis 2016; 8:341-346. [PMID: 28089651 PMCID: PMC5315763 DOI: 10.1016/j.ttbdis.2016.12.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 11/28/2016] [Accepted: 12/14/2016] [Indexed: 11/21/2022]
Abstract
Canine tick-borne pathogens such as Ehrlichia canis and Hepatozoon canis are widespread in the Mediterranean basin but have never been reported or investigated in Cyprus. We describe herein the presence of canine tick-borne pathogens in three dogs with clinical signs compatible with vector-borne diseases from Paphos area of Cyprus. Molecular and phylogenetic analysis revealed the presence of E. canis, Anaplasma platys, H. canis, Babesia vogeli and Mycoplasma haemocanis in Cyprus. One dog co-infected with E. canis, H. canis, B. vogeli and M. haemocanis is, to the best of our knowledge, the first report of this multiple co-infection in dogs. The tick-borne pathogens reported in the current study should be considered in the differential diagnoses in dogs exposed to ticks in Cyprus.
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Parra E, Segura F, Tijero J, Pons I, Nogueras MM. Development of a real-time PCR for Bartonella spp. detection, a current emerging microorganism. Mol Cell Probes 2016; 32:55-59. [PMID: 27746242 DOI: 10.1016/j.mcp.2016.10.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 10/10/2016] [Accepted: 10/11/2016] [Indexed: 10/20/2022]
Abstract
A real-time PCR assay using SYBR Green was optimized to detect those Bartonella that are most frequently described as pathogens. The assay was genus-specific. Sequencing allowed to distinguish species. Assay sensitivity was determined using 10-fold serial dilutions of genomic DNA. Dynamic range was 100 ng-100 fg and sensitivity was 50 copies/reaction.
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Affiliation(s)
- Elena Parra
- Infectious Diseases Department, Corporació Sanitària Parc Taulí, Institut de Investigació I Innovació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, Parc Taulí 1, Sabadell 08208, Barcelona, Spain
| | - Ferran Segura
- Infectious Diseases Department, Corporació Sanitària Parc Taulí, Institut de Investigació I Innovació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, Parc Taulí 1, Sabadell 08208, Barcelona, Spain
| | - Jessica Tijero
- Infectious Diseases Department, Corporació Sanitària Parc Taulí, Institut de Investigació I Innovació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, Parc Taulí 1, Sabadell 08208, Barcelona, Spain
| | - Imma Pons
- Infectious Diseases Department, Corporació Sanitària Parc Taulí, Institut de Investigació I Innovació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, Parc Taulí 1, Sabadell 08208, Barcelona, Spain
| | - Maria-Mercedes Nogueras
- Infectious Diseases Department, Corporació Sanitària Parc Taulí, Institut de Investigació I Innovació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, Parc Taulí 1, Sabadell 08208, Barcelona, Spain.
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Relationship between the Presence of Bartonella Species and Bacterial Loads in Cats and Cat Fleas (Ctenocephalides felis) under Natural Conditions. Appl Environ Microbiol 2015; 81:5613-21. [PMID: 26070666 DOI: 10.1128/aem.01370-15] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Accepted: 06/05/2015] [Indexed: 11/20/2022] Open
Abstract
Cats are considered the main reservoir of three zoonotic Bartonella species: Bartonella henselae, Bartonella clarridgeiae, and Bartonella koehlerae. Cat fleas (Ctenocephalides felis) have been experimentally demonstrated to be a competent vector of B. henselae and have been proposed as the potential vector of the two other Bartonella species. Previous studies have reported a lack of association between the Bartonella species infection status (infected or uninfected) and/or bacteremia levels of cats and the infection status of the fleas they host. Nevertheless, to date, no study has compared the quantitative distributions of these bacteria in both cats and their fleas under natural conditions. Thus, the present study explored these relationships by identifying and quantifying the different Bartonella species in both cats and their fleas. Therefore, EDTA-blood samples and fleas collected from stray cats were screened for Bartonella bacteria. Bacterial loads were quantified by high-resolution melt real-time quantitative PCR assays. The results indicated a moderate correlation between the Bartonella bacterial loads in the cats and their fleas when both were infected with the same Bartonella species. Moreover, a positive effect of the host infection status on the Bartonella bacterial loads of the fleas was observed. Conversely, the cat bacterial loads were not affected by the infection status of their fleas. Our results suggest that the Bartonella bacterial loads of fleas are positively affected by the presence of the bacteria in their feline host, probably by multiple acquisitions/accumulation and/or multiplication events.
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Assessment of persistence of Bartonella henselae in Ctenocephalides felis. Appl Environ Microbiol 2013; 79:7439-44. [PMID: 24056468 DOI: 10.1128/aem.02598-13] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Bartonella henselae (Rhizobiales: Bartonellaceae) is a Gram-negative fastidious bacterium of veterinary and zoonotic importance. The cat flea Ctenocephalides felis (Siphonaptera: Pulicidae) is the main recognized vector of B. henselae, and transmission among cats and humans occurs mainly through infected flea feces. The present study documents the use of a quantitative molecular approach to follow the daily kinetics of B. henselae within the cat flea and its excreted feces after exposure to infected blood for 48 h in an artificial membrane system. B. henselae DNA was detected in both fleas and feces for the entire life span of the fleas (i.e., 12 days) starting from 24 h after initiation of the blood meal.
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Sint D, Raso L, Traugott M. Advances in multiplex PCR: balancing primer efficiencies and improving detection success. Methods Ecol Evol 2012; 3:898-905. [PMID: 23549328 PMCID: PMC3573865 DOI: 10.1111/j.2041-210x.2012.00215.x] [Citation(s) in RCA: 89] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Accepted: 04/03/2012] [Indexed: 11/29/2022]
Abstract
1. Multiplex PCR is a valuable tool in many biological studies but it is a multifaceted procedure that has to be planned and optimised thoroughly to achieve robust and meaningful results. In particular, primer concentrations have to be adjusted to assure an even amplification of all targeted DNA fragments. Until now, total DNA extracts were used for balancing primer efficiencies; however, the applicability for comparisons between taxa or different multiple-copy genes was limited owing to the unknown number of template molecules present per total DNA. 2. Based on a multiplex system developed to track trophic interactions in high Alpine arthropods, we demonstrate a fast and easy way of generating standardised DNA templates. These were then used to balance the amplification success for the different targets and to subsequently determine the sensitivity of each primer pair in the multiplex PCR. 3. In the current multiplex assay, this approach led to an even amplification success for all seven targeted DNA fragments. Using this balanced multiplex PCR, methodological bias owing to variation in primer efficiency will be avoided when analysing field-derived samples. 4. The approach outlined here allows comparing multiplex PCR sensitivity, independent of the investigated species, genome size or the targeted genes. The application of standardised DNA templates not only makes it possible to optimise primer efficiency within a given multiplex PCR, but it also offers to adjust and/or to compare the sensitivity between different assays. Along with other factors that influence the success of multiplex reactions, and which we discuss here in relation to the presented detection system, the adoption of this approach will allow for direct comparison of multiplex PCR data between systems and studies, enhancing the utility of this assay type.
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Affiliation(s)
- Daniela Sint
- Institute of Ecology, University of Innsbruck Technikerstraße 25, 6020 Innsbruck, Austria
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