Effect of extraction pH on amino acids, nutritional, in-vitro protein digestibility, intermolecular interactions, and functional properties of guar germ proteins

The chemical compositions, intermolecular interactions, and functional properties of guar germ proteins (GGP) were investigated at different extraction pH (7 to 11). The protein efficiency ratio, essential amino acid index (46.53), predicted biological value (39.02), nutritional index (42.67), and protein purity (91.69 %) were found to be highest at pH 9. The in-vitro protein digestibility of GGP sample was highest at pH 11. From SDS-PAGE, the band intensity (<10 kDa) became thinner with an increase in extraction pH from 7 to 9 and then thicker. Meanwhile, smallest particle size and weaker ionic and hydrogen bonds were found at pH 11. The β-sheet content was more dominating in GGP samples. Moreover, higher denaturation temperatures of GGP samples indicated that protein molecules had a compact tertiary structure. Furthermore, the GGP extracted at pH 7 showed better functional properties. The principal component analysis suggested that pH 9 was more suitable for isolating GGP.

Microwave irradiation of guar seed flour: Effect on anti-nutritional factors, phytochemicals, in vitro protein digestibility, thermo-pasting, structural, and functional attributes

Guar seed flour (GSF) has a high amount of carbohydrates, proteins, phytochemicals, and anti-nutritional factors (ANFs), which limits its use. To address this issue, the current study was undertaken to understand the effect of microwave (MW) irradiation on ANFs, phytochemicals, in vitro protein digestibility (IVPD), and functional attributes of GSF at varying power density (Pd: 1-3 W/g) and duration (3-9 min). The ANFs were determined using a colorimetric assay and a Fourier transform infrared spectrum. At 3 Pd-9 min, the maximum reduction in ANFs (tannin, phytic acid, saponin, and trypsin inhibitor activity) was observed. Higher Pd and treatment duration increased antioxidant activity and total phenolic content, except for total flavonoid content. Furthermore, compared to the control sample (78.38%), the IVPD of the GSF samples increased to 3.28% (3 Pd-9 min). An increase in Pd and duration of MW treatment improved the thermal and pasting properties of GSF samples up to 2 Pd-9 min. Due to inter- and intramolecular hydrogen bonding degradation, the relative crystallinity of the 3 Pd-9 min treated GSF sample was 30.58%, which was lower than that of the control (40.08%). In MW-treated samples, SEM images revealed smaller clusters with rough and porous structures. However, no noticeable color (ΔE) changes were observed in MW-treated samples. Aside from water absorption capacity and water solubility index, MW treatment reduced oil absorption capacity, foaming capacity, and emulsifying capacity. As demonstrated by principal component analysis, MW irradiation with moderate Pd (2-3) was more effective in reducing ANFs, retaining nutritional contents, and improving the digestible properties of GSF, which could be a potential ingredient for developing gluten-free products.

Impact of moisture content on microstructural, thermal, and techno-functional characteristics of extruded whole-grain-based breakfast cereal enriched with Indian horse chestnut flour

The use of non-conventional seed flour is of interest in obtaining healthy breakfast cereals. The research aimed to study the physico-functional, bioactive, microstructure, and thermal characteristics of breakfast cereals using scanning electron microscopy, X-ray diffractometry, and differential scanning calorimeter. The increase in feed moisture content (16 %) enhanced the bulk density (5.24 g/mL), water absorption index (7.76 g/g), total phenolic content (9.03 mg GAE/g), and antioxidant activity (30.36 %) having desirable expansion rate (2.84 mm), water solubility index (48 %), and color attributes. The microstructure showed dense inner structures with closed air cells in extruded flours. Extrusion treatment rearranged the crystalline structure from A-type to V-type by disrupting the granular structure of starch, reducing its crystallinity, and promoting the formation of an amylose-lipid complex network. Increasing conditioning moisture enhanced the degree of gelatinization (%), peak gelatinization temperature (Tp), and starch crystallinity (%) and reduced the gelatinization enthalpy (ΔHG) and gelatinization temperature ranges. The results reported in this study will help industries to develop innovative and novel food products containing functional ingredients.

Atmospheric cold plasma induced nutritional & anti-nutritional, molecular modifications and in-vitro protein digestibility of guar seed (Cyamopsis tetragonoloba L.) flour

The present study was carried out to investigate the effect of atmospheric cold plasma treatment on the nutritional, anti-nutritional, functional, morphological, and digestibility of guar seed (Cyamopsis tetragonoloba L.) flour. Here, guar seed flour was kept inside the plasma reactor for 5 to 20 min at different power levels (10 & 20 kV). The cold plasma treatment (CPT) significantly (p < 0.05) reduced the carbohydrate (46.87 - 36.81 %), protein (27.15 - 25.88 %), and increased the WAC (1.89 - 2.91 g/g), OAC (1.18 - 2.17 g/g), FC (113 - 186.17 %), and pasting properties of guar seed flour. High-intensity plasma-treated samples (20 kV-20 min) contained lesser tannin, phytic acid, and saponin with reduced the nutritional value. The FTIR spectrum suggested that functional group formation or destruction might have occurred in the plasma-treated samples. Additionally, the crystallinity is reduced with increasing applied voltage or duration. The SEM analysis reveals that CPT resulted in the formation of rough surfaces with highly porous structures. On the other hand, CPT significantly reduced the trypsin inhibitor activity and had a minor impact on in-vitro protein digestibility except for the 20 kV-20 min treated sample. In PCA analysis, 10 kV-15 min treated samples exhibited better nutritional value, functional, and pasting properties with maximum impact of anti-nutritional factors. From the results, it can be concluded that treatment duration rather than the applied voltage plays a significant role in preserving the nutritional content.

Development of Protein Rich Pregelatinized Whole Grain Cereal Bar Enriched With Nontraditional Ingredient: Nutritional, Phytochemical, Textural, and Sensory Characterization

This study was aimed to use extrusion cooking as a pretreatment for non-conventional seeds (Indian horse chestnut flour) to blend them with whole grain flours (whole wheat flour, whole barley flour, and whole corn flour) for the development of a pregelatinized cereal bar (PCB). In this study, date paste (7.5-17.5%) and walnut grits (2.5-12.5%) were incorporated at varying levels to prepare PCB. The PCB was evaluated for its nutritional, color, textural (both three-point bending test and TPA), antioxidant activity, and sensory attributes. The flexural modulus, rupture stress, and fracture strain of PCB increased with the incorporation of a higher proportion of date paste. The protein and fiber content in PCB increased from 7.74 to 9.13% and 4.81 to 5.59% with the incorporation of walnut grits and date paste, respectively. The DPPH, total phenolic content, and water activity of PCB were determined, which progressively enhanced with increased levels of walnut grits and date paste. The correlation between sensory attributes and instrumental texture on PCB was also investigated. The correlation results showed a significant (p < 0.05) positive correlation between texture analysis and sensory hardness, springiness, adhesiveness, and negatively correlated to instrumental and sensory cohesiveness. For sensorial attributes, all PCB samples presented average scores of 7/10 and 4/5 for buying intention. Therefore, whole grain extrudates, date paste, and walnut grits can be efficiently used to develop PCB with improved nutritional, nutraceutical, and economic values.

Prolamin-based complexes: Structure design and food-related applications

Prolamins are a group of safe food additives that are biocompatible, biodegradable, and sustainable. Zein, gliadin, kafirin, and hordein are common prolamins that have been extensively studied, particularly as these form colloidal particles because of their amphiphilic properties. Prolamin-based binary/ternary complexes, which have stable physicochemical properties and superior functionality, are formed by combining prolamins with polysaccharides, polyphenols, water-soluble proteins, and surfactants. Although the combination of prolamins with other components has received attention, the relationship between the structural design of prolamin-based complexes and their functionalities remains uncertain. This review discusses the production methods of prolamin-based complexes, the factors influencing their structural characteristics, and their applications in the food industry. Further studies are needed to elucidate the structure-function relationships between prolamins and other biopolymers, as well as the toxicological effects of these complexes in food.

Recent advances in the structure, synthesis, and applications of natural polymeric hydrogels

Hydrogels, polymeric network materials, are capable of swelling and holding the bulk of water in their three-dimensional structures upon swelling. In recent years, hydrogels have witnessed increased attention in food and biomedical applications. In this paper, the available literature related to the design concepts, types, functionalities, and applications of hydrogels with special emphasis on food applications was reviewed. Hydrogels from natural polymers are preferred over synthetic hydrogels. They are predominantly used in diverse food applications for example in encapsulation, drug delivery, packaging, and more recently for the fabrication of structured foods. Natural polymeric hydrogels offer immense benefits due to their extraordinary biocompatible nature. Hydrogels based on natural/edible polymers, for example, those from polysaccharides and proteins, can serve as prospective alternatives to synthetic polymer-based hydrogels. The utilization of hydrogels has so far been limited, despite their prospects to address various issues in the food industries. More research is needed to develop biomimetic hydrogels, which can imitate the biological characteristics in addition to the physicochemical properties of natural materials for different food applications.

Physical, Textural, Rheological, and Sensory Characteristics of Amaranth-Based Wheat Flour Bread

In this study, the chemical composition, colour analysis, and antioxidant properties of flour and bread were analysed. We also examined the rheological properties of dough and proximate, colour, textural, and organoleptic properties of amaranth wheat bread. Wheat flour was replaced by amaranth flour (AF) at 0-15% levels (100 : 0, 95 : 5, 90 : 10, and 85 : 15, respectively). AF supplementation increased the moisture (31.06 to 33.24%), ash (0.92 to 1.51%), protein (12.17 to 13.11%), fat (2.16 to 2.77%), and crude fibre content (1.11 to 1.72%) of the bread while the nitrogen-free extract and alkali water retention capacity decreased from 52.58 to 47.65% and 136.00 to 112.02%, respectively. The antioxidant activity evaluated by DPPH, FRAP, and total phenolic content was reduced with increased levels of AF. A significant impact on the physical properties like the weight of bread (increased from 474.00 to 489.30 g), height (went down from 80.00 to 74.33 cm), loaf volume (decreased from 1580.00 to 1518.30 cm3), and specific volume (reduced from 3.32 to 3.10 cm3 g-1) was observed with the replacement of wheat flour. Textural measurement depicted that hardness, chewiness, gumminess, springiness, and cohesiveness increased with the substitution of amaranth flour. Rheological parameters like complex viscosity, loss modulus, and storage modulus were also observed in all dough samples. Bread samples with 5%, 10%, and 15% of AF showed lower yellowness (b∗) and higher lightness (L∗) and redness (a∗) values for crust colour while lower L∗ and higher a∗ and b∗ values for crumb colour. The bread prepared by replacing 5% and 10% of AF is nutritionally as well as sensorially acceptable.

The anticancer potential of the dietary polyphenol rutin: Current status, challenges, and perspectives

Rutin is one of the most common dietary polyphenols found in vegetables, fruits, and other plants. It is metabolized by the mammalian gut microbiota and absorbed from the intestines, and becomes bioavailable in the form of conjugated metabolites. Rutin exhibits a plethora of bioactive properties, making it an extremely promising phytochemical. Numerous studies demonstrate that rutin can act as a chemotherapeutic and chemopreventive agent, and its anticancer effects can be mediated through the suppression of cell proliferation, the induction of apoptosis or autophagy, and the hindering of angiogenesis and metastasis. Rutin has been found to modulate multiple molecular targets involved in carcinogenesis, such as cell cycle mediators, cellular kinases, inflammatory cytokines, transcription factors, drug transporters, and reactive oxygen species. This review summarizes the natural sources of rutin, its bioavailability, and in particular its potential use as an anticancer agent, with highlighting its anticancer mechanisms as well as molecular targets. Additionally, this review updates the anticancer potential of its analogs, nanoformulations, and metabolites, and discusses relevant safety issues. Overall, rutin is a promising natural dietary compound with promising anticancer potential and can be widely used in functional foods, dietary supplements, and pharmaceuticals for the prevention and management of cancer.

The health benefits, functional properties, modifications, and applications of pea (Pisum sativum L.) protein: Current status, challenges, and perspectives

In recent years, the development and application of plant proteins have drawn increasing scientific and industrial interests. Pea (Pisum sativum L.) is an important source of high-quality vegetable protein in the human diet. Its protein components are generally considered hypoallergenic, and many studies have highlighted the health benefits associated with the consumption of pea protein. Pea protein and its hydrolysates (pea protein hydrolysates [PPH]) possess health benefits such as antioxidant, antihypertensive, and modulating intestinal bacteria activities, as well as various functional properties, including solubility, water- and oil-holding capacities, and emulsifying, foaming, and gelling properties. However, the application of pea protein in the food system is limited due to its poor functional performances. Several frequently applied modification methods, including physical, chemical, enzymatic, and combined treatments, have been used for pea protein to improve its functional properties and expand its food applications. To date, different applications of pea protein in the food system have been extensively studied, for example, encapsulation for bioactive ingredients, edible films, extruded products and substitution for cereal flours, fats, and animal proteins. This article reviews the current status of the knowledge regarding pea protein, focusing on its health benefits, functional properties, and structural modifications, and comprehensively summarizes its potential applications in the food industry.

Thermal and functional characteristics of defatted bovine heart using supercritical CO2 and organic solvent

BACKGROUND

Consumer demand for low-fat foods has been increasing as a result of attempts to reduce obesity and chronic diseases. Bovine heart was defatted using supercritical CO₂ (SC-CO₂ ) at different pressures together with solvent extraction to produce a protein-based functional ingredient for low-fat food products. Thermal and functional characteristics of control and defatted samples were compared.

RESULTS

Supercritical CO₂ treatment at high pressure results in more removal of fat, producing a protein-rich defatted bovine heart (DBH). The differential scanning calorimeter (DSC) thermograms and SDS-PAGE bands for SC-CO₂ -treated DBHs were similar to those of the control sample, indicating high protein stability and better functionality. Hexane-treated DBH showed no major thermal peaks and very diffuse bands in SDS-PAGE, indicating denaturation of proteins during solvent extraction. No denaturation of proteins in SC-CO₂ -treated DBHs resulted in significantly higher water/oil absorption capacities (3320.00 and 2630.00 g kg^-1 , respectively), total soluble solids (822.20 and 208.71 g kg^-1 at pH 3.5 and 6.5, respectively), foaming capacities (149.37%), and emulsion activity (66.89%) than the hexane-treated DBH.

CONCLUSION

Supercritical CO₂ treatment of DBH led to higher thermal stability and functional properties than the control and hexane-treated DBH. Defatted bovine heart using SC-CO₂ can be a functional ingredient for various low-fat and high-protein food products for health-conscious consumers. © 2018 Society of Chemical Industry.

Giant pubertal prolactinoma: Complete resolution following short term carbegoline treatment

Prolactinomas are the most common pituitary tumors but rarely seen in adolescent males. There is no indication for surgery both in micro- and macro-adenomas unless an urgent treatment is necessary. First line treatment is always medical with dopamine agonists. In this report, we presented a patient with pubertal arrest and giant prolactinoma that disappeared in a short time with cabergoline treatment.

Health Benefits of Anthocyanins and Their Encapsulation for Potential Use in Food Systems: A Review

Anthocyanins are one of the six subgroups of large and widespread group of plant constituents known as flavonoids. These are responsible for the bright and attractive orange, red, purple, and blue colors of most fruits, vegetables, flowers and some cereal grains. More than 600 structurally distinct anthocyanins have been identified in nature. Earlier, anthocyanins were only known for their coloring properties but now interest in anthocyanin pigments has intensified because of their possible health benefits as dietary antioxidants, which help to prevent neuronal diseases, cardiovascular illnesses, cancer, diabetes, inflammation, and many such others diseases. Ability of anthocyanins to counter oxidants makes them atherosclerosis fighters. Therefore, anthocyanin-rich foods may help to boost overall health by offering an array of nutrients. However, the incorporation of anthocyanins into food and medical products is a challenging task due to their low stability toward environmental conditions during processing and storage. Encapsulation seems to be an efficient way to introduce such compounds into these products. Encapsulating agents act as a protector coat against ambient adverse conditions such as light, humidity, and oxygen. Encapsulated bioactive compounds are easier to handle and offer improved stability. The main objective of this review is to explore health benefits of anthocyanins and their extraction, characterization, encapsulation, and delivery.

Seroprevalence of serum HBsAg positivity and hepatitis delta virus infection among blood donors in Southeastern Turkey

AIMS

HBV and HDV infection is still a serious health problem in Southeastern Turkey. In this study, we aim to investigate the prevalence serum HBsAg along with HDV infection among volunteer blood donors.

MATERIALS AND METHODS

This single centre and prospective study was performed in 6200 consecutive volunteer blood donors admitted to the Central Blood Bank of Dicle University Hospital. All adult blood donors included males and females were screened for HBsAg positivity. The positive serum samples for HBsAg were assessed for total anti-delta antibodies using the micro-ELISA method. Serum samples of anti-delta antibody positive cases were then examined for the presence of serum HDV RNA by real time, reverse transcription PCR method.

RESULTS

Six thousand two hundred adult volunteer blood donors were enrolled to the study. Of all analyzed blood donors, 6004 (96.8%) were men and 196 (3.2%) were women. Serum HBsAg positivity was found in 3% (186/6200) of 6200 blood donors. The mean age and female/male ratio of HBsAg positive cases (n=186) were 32.85±10.04 years and 12/174, respectively. Serum anti-delta antibodies were detected in 6.98% (13/186) of HBsAg positive cases. The mean age of anti-delta antibody positive cases (n=13) was 44.5±13.61 years and female/male ratio was 1/12. Moreover, 2 cases, (15.39%, 2/13) that were positive for anti-delta antibody, had serum HDV RNA positivity.

CONCLUSIONS

It would be appropriate for HBsAg positive volunteer blood donors to be assessed regarding concurrent HDV infection as well. The magnitude of the contribution and benefit that this screening would provide to our region, which is endemic for HDV infection, is the early diagnosis and management of this devastating disease. The real viremia in these cases can be best shown by using sensitive real time PCR method for the presence of serum HDV RNA.

Thyroid carcinoma risk in patients with hyperthyroidism and role of preoperative cytology in diagnosis

AIM

The aim of this study was to determine the frequency of thyroid carcinoma in patients with hyperthyroidism and evaluate the role of preoperative ultrasonography (US) guided thyroid fine needle aspiration biopsy (FNAB) in diagnosis of thyroid carcinoma in these patients.

METHODS

Three hundred twenty-five hyperthyroid patients--119 with toxic multinodular goiter (TMNG), 47 with autonomous functioning toxic nodule (AFTN) and 159 with Graves Disease (GD)--were included in this study. All patients were evaluated with US and in all patients with nodules, US guided FNAB was carried out.

RESULTS

Among 159 patients with GD, 62 were without nodules. Totally, 583 nodules in 263 patients were sampled by FNAB. Cytologic results of nodules were as follows: 87.7% benign, 6.2% inadequate, 4.3% suspicious and 1.9% malignant. Postoperatively, 42 (12.9%) patients were diagnosed as thyroid carcinoma histopathologically. Thyroid carcinoma was detected postoperatively in all patients with malignant cytology, in 47.8% of patients with suspicious cytology and in 44.4% of patients with inadequate cytology. Moreover, in 13 patients with benign cytology and in 3 Graves patients without any nodule ultrasonographically, incidental thyroid carcinoma was found (5.7%). Consequently, thyroid malignancy rates were 16% in TMNG, 6.4% in AFTN and 12.6% in GD.

CONCLUSION

Thyroid carcinoma is common in hyperthyroidism and FNAB is a reliable method in diagnosis of thyroid malignancy in these patients. Additionally, incidental thyroid carcinoma prevalence is also high in patients with hyperthyroidism. We suggest that it is reasonable to evaluate nodules with FNAB in hyperthyroid patients prior to radioactive iodine treatment or surgical intervention.

Assessment of left ventricular functions by tissue Doppler echocardiography in patients with Cushing's disease

OBJECTIVE

To verify whether tissue Doppler imaging (TDI) could contribute to a better understanding of the natural history of cardiomyopathy in active Cushing's disease (CD), through its enhanced sensitivity to diastolic dysfunction, and identifying preliminary regional signs of systolic dysfunction before the appearance of clinical symptoms of cardiac pathologies.

METHODS

Eleven women with newly diagnosed CD and 32 control cases, purposely matched for gender, age, body mass index and co-incidental diseases were enrolled in this study. Echocardiographic examinations were assessed by conventional echocardiography and tissue Doppler imaging. The peak systolic velocity (S'm), early diastolic myocardial peak velocity (E'm), late diastolic myocardial peak velocity (A'm), isovolumic acceleration (IVA), myocardial pre-contraction time (PCT'm), myocardial contraction time (CT'm) and myocardial relaxation time (RT'm) were measured at septal and lateral mitral anulus.

RESULTS

In TDI, E'm and, E'm/A'm ratio were significantly lower, and PCT'm/CT'm ratio was higher, S'm, A'm, peak early diastole/E'm ratio, PCT'm, and isovolumetric myocardial relaxation time values were similar at lateral and septal anulus in patients with CD than controls (p>0.05). Lateral and septal anulus IVA were significantly lower in patients with CD than the control group (p<0.05). Correlation analysis showed that IVA time at lateral anulus correlated positively with S'm at lateral anulus (r=0.58; p=0.002) and IVA time at septal anulus correlated positively with S'm at septal anulus (r=0.51; p=0.008).

CONCLUSION

Our study confirms that patients with CD have impaired diastolic function. More importantly, we also demonstrated an impairment of myocardial systolic function in patients with CD by TDI. We recommend using TDI in addition to conventional echocardiography parameters for the cardiovascular risk assessment of patients with Cushing' syndrome.

Effects of percutaneous laser ablation treatment in benign solitary thyroid nodules on nodule volume, thyroglobulin and anti-thyroglobulin levels, and cytopathology of nodule in 1 yr follow-up

OBJECTIVE

To investigate the effects of ultrasound (US)-guided percutaneous laser ablation (PLA) in the treatment of benign solid hypoactive thyroid nodules on nodule volume, thyroid functions, nodule cytology and patients' complaints.

MATERIAL AND METHOD

Criteria for enrollment in the study were as follows: patients with euthyroid, benign, hypofunctional nodule who had compressive symptoms or cosmetic complaints, but considered inoperable, or who rejected surgical treatment. PLA procedure at 3-5 watts (W) was applied to 15 thyroid nodules of 12 patients (4 male and 8 female; age range 20-78 yr, mean age 47.42+/-17.05 yr), and patients were followed up for 12 months. Thyroid functions and nodule volumes (ultrasonographically) were evaluated. US-guided fine needle aspiration biopsy (FNAB) was performed before and after the procedure, and biopsy specimens were cytologically evaluated.

RESULTS

The mean nodule volume before the procedure was 11.97 ml (min-max 0.95-26.30 ml). However, 12 months after the procedure the mean nodule volume was 2.21+/-2.32 ml (min-max 0.10-7.65 ml). The mean reduction in nodule volumes was 82%. Thyroglobulin levels reached peak values at 1 month after the procedure, and anti-thyroglobulin levels at 3 months after the procedure. FNAB performed at 12th month showed neutrophil polymorphs, macrophages, abundant cell debris, colloid, multinucleated giant cells, and small fragments of fibrous stroma which indicated that PLA procedure led to degenerative changes in nodules.

CONCLUSION

US-guided PLA is a new, successful treatment method which is reliable in the long term in benign solid thyroid nodules for selected patients who are inoperable or do not prefer surgery.

Calculations for the excitation functions of 3-26 MeV proton reactions on 66Zn, 67Zn and 68Zn

Calculation of excitation functions of 66Zn(p,n)66Ga, 66Zn(p,n + p)65Zn, 66Zn(p,2n)65Ga, 67Zn(p,2n)66Ga, 68Zn(p,n)68Ga, 68Zn(p,2n)67Ga natZn(p,xn)66Ga and natZn(p,xn)67Ga reactions has been carried out using the statistical and pre-equilibrium nuclear reaction models in the 3-26 MeV energy range. The calculational results are compared with the reported measurements and evaluations.

Calculations for the excitation functions of the 63Cu(p,n)63Zn, 63Cu(p, 2n)62Zn and 65Cu(p,n)65Zn reactions

Calculations for the excitation functions of 63Cu(p, n)63Zn, 63Cu(p, 2n)65Zn and 65Cu(p, n)65Zn reactions have been carried out in 3-30 MeV energy range using statistical and pre-equilibrium nuclear reaction models. The calculations have been compared with reported measurements and discussed.

Serodiagnosis and epidemiology of visceral leishmaniasis in Turkey

Infantile Mediterranean visceral leishmaniasis (IVL) and anthroponotic cutaneous leishmaniasis (ACL) have long been known to exist in the western and southeastern Turkey, respectively. To further study these and other related diseases, a recombinant antigen (rK39) specific to VL was used in an ELISA for serodiagnosis of selected patients and for screening dog reservoir populations in several endemic sites. Among 24 confirmed VL cases from western Turkey, the rK39 ELISA proved to be more sensitive than a combination of cultivation and microscopy of bone marrow aspirates. The specificity of rK39 for leishmaniasis was demonstrated by its lack of cross-reactivity with sera from other human diseases in the same sites. Interestingly, six of the 83 parasitologically proven ACL cases from southeast Turkey were also rK39 positive. The end point titers of the positive VL and CL cases vary from 10(-2) to 10(-5) and from 10(-2) to 10(-3), respectively. The rK39 ELISA was also used to screen 494 apparently healthy dogs from Urfa in southeast Turkey, Manisa/Alasehir near the Aegean Sea, and Karabuk near the Black Sea. Eighteen rK39-positive cases (3.6%), all from the latter two areas, were found to have varying endpoint titers (10(-2)-10(-4)). The high titers predicted increased severity and frequency of the clinical symptoms (i.e., lymphadenopathy, depilation, skin lesion, weight loss and/or death), which were manifested subsequently in 16 of these 18 cases. In addition, more positive canine cases were diagnosed by the rK39 ELISA preclinically than the procedures to detect parasites postsymptomatically in the lymph node aspirates. The use of the rK39 ELISA as a sensitive tool makes it possible to demonstrate coendemicity of canine and human VL, as expected in the case of IVL. The results also point to the possible presence of additional VL types in western Turkey and cutanovisceral type in the southeast part of this country.