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Guha SK, Sardar AA, Misra AK, Saha P, Samanta A, Maji D, Mandal A, Saha P, Halder S, Ali KA, Karmakar S, Sharma D, Maji AK. Active Community-Based Case Finding of Endemic Leishmaniasis in West Bengal, India. J Epidemiol Glob Health 2024:10.1007/s44197-024-00260-2. [PMID: 38884694 DOI: 10.1007/s44197-024-00260-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 06/03/2024] [Indexed: 06/18/2024] Open
Abstract
INTRODUCTION The ongoing visceral leishmaniasis (VL) elimination programme in India is targeting the elimination of the disease VL but not the pathogen. The persistence of hidden parasite pool may initiate a resurgence in suitable conditions. This study dealt with a novel approach to unearth such pathogen pool and their proper management to prevent the resurgence of VL. MATERIALS AND METHODS We deployed a new approach for detection of pathogen pool by following up the VL and post kala-azar dermal leishmaniasis patients treated during the last 10 years along with mass sero-surveillance within a radius of 500 m of recently treated individuals. RESULTS We followed up 72.6% (3026/4168) previously treated VL and post kala-azar dermal leishmaniasis patients and diagnosed 42 (1.4%) new and 38 (1.3%) recurrent post kala-azar dermal leishmaniasis. We detected 93 asymptomatic leishmanial infection, 8 VL and 1 post kala-azar dermal leishmaniasis by mass sero-surveillance. CONCLUSION Our three-step process including mapping and follow-up of previously treated cases, mass surveillance within 500 m of radius of known cases, and 6 monthly follow-on clinical and serological screening of asymptomatic cases, enabled detection of previously undetected cases of post kala-azar dermal leishmaniasis and VL. Recurrent post kala-azar dermal leishmaniasis deserves special attention regarding their treatment guideline. Early diagnosis and effective treatment of all leishmaniasis cases will hasten pathogen elimination and prevent resurgence of VL. This may help the policymakers to develop appropriate strategy for elimination of pathogen to prevent resurgence of VL.
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Affiliation(s)
- Subhasish Kamal Guha
- Calcutta School of Tropical Medicine, 108, C. R. Avenue, Kolkata, West Bengal, India.
| | - Ashif Ali Sardar
- Department of Microbiology, Calcutta School of Tropical Medicine, 108, C. R. Avenue, Kolkata, West Bengal, India
| | - Amartya Kumar Misra
- Department of Tropical Medicine, Calcutta School of Tropical Medicine, 108, C. R. Avenue, Kolkata, West Bengal, India
| | - Pabitra Saha
- Department of Microbiology, Calcutta School of Tropical Medicine, 108, C. R. Avenue, Kolkata, West Bengal, India
- Department of Zoology, P. R. Thakur Government College, Thakurnagar, North 24 Parganas, West Bengal, India
| | - Anwesha Samanta
- Department of Microbiology, Calcutta School of Tropical Medicine, 108, C. R. Avenue, Kolkata, West Bengal, India
| | - Dipankar Maji
- Department of Health and Family Welfare, Government of West Bengal, Swasthya Bhavan, Salt Lake City, Kolkata, West Bengal, India
| | - Amitabha Mandal
- Office of the Chief Medical Officer of Health, Public Health Wing, Malda Medical College Campus, Malda, West Bengal, India
| | - Punita Saha
- R. N. Ray Rural Hospital, Bulbulchandi, Habibpur, Malda, West Bengal, India
| | - Supriya Halder
- Department of Microbiology, Calcutta School of Tropical Medicine, 108, C. R. Avenue, Kolkata, West Bengal, India
| | - Kabiul Akhter Ali
- Office of the Chief Medical Officer of Health, Public Health Wing, Malda Medical College Campus, Malda, West Bengal, India
| | - Sibajyoti Karmakar
- Office of the Chief Medical Officer of Health, Public Health Wing, Raiganj, Uttar Dinajpur, West Bengal, India
| | - Dipendra Sharma
- Office of the Chief Medical Officer of Health, Public Health Wing, Siliguri, Darjeeling, West Bengal, India
| | - Ardhendu Kumar Maji
- Department of Microbiology, Calcutta School of Tropical Medicine, 108, C. R. Avenue, Kolkata, West Bengal, India
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Rock KS, Chapman LAC, Dobson AP, Adams ER, Hollingsworth TD. The Hidden Hand of Asymptomatic Infection Hinders Control of Neglected Tropical Diseases: A Modeling Analysis. Clin Infect Dis 2024; 78:S175-S182. [PMID: 38662705 PMCID: PMC11045017 DOI: 10.1093/cid/ciae096] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Neglected tropical diseases are responsible for considerable morbidity and mortality in low-income populations. International efforts have reduced their global burden, but transmission is persistent and case-finding-based interventions rarely target asymptomatic individuals. METHODS We develop a generic mathematical modeling framework for analyzing the dynamics of visceral leishmaniasis in the Indian sub-continent (VL), gambiense sleeping sickness (gHAT), and Chagas disease and use it to assess the possible contribution of asymptomatics who later develop disease (pre-symptomatics) and those who do not (non-symptomatics) to the maintenance of infection. Plausible interventions, including active screening, vector control, and reduced time to detection, are simulated for the three diseases. RESULTS We found that the high asymptomatic contribution to transmission for Chagas and gHAT and the apparently high basic reproductive number of VL may undermine long-term control. However, the ability to treat some asymptomatics for Chagas and gHAT should make them more controllable, albeit over relatively long time periods due to the slow dynamics of these diseases. For VL, the toxicity of available therapeutics means the asymptomatic population cannot currently be treated, but combining treatment of symptomatics and vector control could yield a quick reduction in transmission. CONCLUSIONS Despite the uncertainty in natural history, it appears there is already a relatively good toolbox of interventions to eliminate gHAT, and it is likely that Chagas will need improvements to diagnostics and their use to better target pre-symptomatics. The situation for VL is less clear, and model predictions could be improved by additional empirical data. However, interventions may have to improve to successfully eliminate this disease.
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Affiliation(s)
- Kat S Rock
- Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research (SBIDER), University of Warwick, Coventry, United Kingdom
- Mathematics Institute, University of Warwick, Coventry, United Kingdom
| | - Lloyd A C Chapman
- Department of Mathematics and Statistics, Lancaster University, Lancaster, United Kingdom
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Andrew P Dobson
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey, USA
- Santa Fe Institute, Santa Fe, New Mexico, USA
| | - Emily R Adams
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - T Déirdre Hollingsworth
- Nuffield Department of Medicine, Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, United Kingdom
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Maia C. Sand fly-borne diseases in Europe: epidemiological overview and potential triggers for their emergence and re-emergence. J Comp Pathol 2024; 209:6-12. [PMID: 38320331 DOI: 10.1016/j.jcpa.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 11/27/2023] [Accepted: 01/03/2024] [Indexed: 02/08/2024]
Abstract
Phlebotomine sand flies (Diptera: Phlebotominae) are vectors of human and animal pathogens, including Leishmania species protozoan parasites and viruses of the genus Phlebovirus. In Europe, visceral zoonotic leishmaniasis caused by Leishmania infantum, a deadly disease when left untreated, is endemic in southern countries, and dogs are the main reservoir hosts for human infection. Most phleboviruses cause asymptomatic infections or flu-like syndromes in humans, but Toscana phlebovirus can cause meningitis and encephalitis. These diseases are likely to re-emerge, posing a growing threat to public and animal health. Potential triggers include the movement of humans and dogs, increasing numbers of immunosuppressive conditions, climate change and other human-mediated environmental changes. An overview of the main epidemiological characteristics of the pathogens transmitted by sand flies in Europe and the potential triggers involved in their emergence and re-emergence are reviewed here. There is a need to implement mandatory notification of human and canine leishmaniases and human phleboviruses and coordinated epidemiological surveillance programmes at a European level, and to raise awareness among healthcare professionals and citizens about sand fly-borne diseases, following a One Health approach.
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Affiliation(s)
- Carla Maia
- Global Health and Tropical Medicine, Associate Laboratory in Translation and Innovation Towards Global Health, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Rua da Junqueira, 100, 1348-009, Lisboa, Portugal.
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Pawłowska M, Mila-Kierzenkowska C, Szczegielniak J, Woźniak A. Oxidative Stress in Parasitic Diseases-Reactive Oxygen Species as Mediators of Interactions between the Host and the Parasites. Antioxidants (Basel) 2023; 13:38. [PMID: 38247462 PMCID: PMC10812656 DOI: 10.3390/antiox13010038] [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: 11/29/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 01/23/2024] Open
Abstract
Oxidative stress plays a significant role in the development and course of parasitic infections, both in the attacked host organism and the parasite organism struggling to survive. The host uses large amounts of reactive oxygen species (ROS), mainly superoxide anion (O2•-) and hydrogen peroxide (H2O2), to fight the developing parasitic disease. On the other hand, the parasite develops the most effective defense mechanisms and resistance to the effects of ROS and strives to survive in the host organism it has colonized, using the resources and living environment available for its development and causing the host's weakening. The paper reviews the literature on the role of oxidative stress in parasitic diseases, which are the most critical epidemiological problem worldwide. The most common parasitosis in the world is malaria, with 300-500 million new cases and about 1 million deaths reported annually. In Europe and Poland, the essential problem is intestinal parasites. Due to a parasitic infection, the concentration of antioxidants in the host decreases, and the concentration of products of cellular components oxidation increases. In response to the increased number of reactive oxygen species attacking it, the parasites have developed effective defense mechanisms, including primarily the action of antioxidant enzymes, especially superoxide dismutase and nicotinamide adenine dinucleotide phosphate hydrogen (NADPH)-dependent complexes glutathione and thioredoxin.
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Affiliation(s)
- Marta Pawłowska
- Department of Medical Biology and Biochemistry, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland; (C.M.-K.); (A.W.)
| | - Celestyna Mila-Kierzenkowska
- Department of Medical Biology and Biochemistry, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland; (C.M.-K.); (A.W.)
| | - Jan Szczegielniak
- Physiotherapy Department, Faculty of Physical Education and Physiotherapy, Opole University of Technology, 45-758 Opole, Poland;
- Ministry of Internal Affairs and Administration’s Specialist Hospital of St. John Paul II, 48-340 Glucholazy, Poland
| | - Alina Woźniak
- Department of Medical Biology and Biochemistry, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-092 Bydgoszcz, Poland; (C.M.-K.); (A.W.)
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Machado CV, Mentz MB, Hartke S, Zancan DM. Occurrence of Cruzia tentaculata Larvae in the Land Snail Megalobulimus abbreviatus-Influence of Natural Parasite Load on Snail Physiology. Zoolog Sci 2023; 40:475-485. [PMID: 38064375 DOI: 10.2108/zs230047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 07/30/2023] [Indexed: 12/18/2023]
Abstract
The nematode Cruzia tentaculata is reported here for the first time in the land snail Megalobulimus abbreviatus in southern Brazil. The snails were infected with a high prevalence of larvae up to the L3 stage (68.6%). Cysts were located mainly in the mantle (pulmonary cavity) and the nerve ring. No other helminths were identified in the collected snails. Some physiological aspects were compared between snails infected with L3 larvae and non-infected snails and among infected animals with different parasite loads. No differences were found in hemolymph protein, glucose, or urea content between L3-infected and non-infected snails, nor among animals with different parasite loads. Discontinuous lesions in the rectum associated with the presence of encapsulated larvae were visible in animals with high parasite loads and were more frequent in adult animals. All analyses were carried out during the breeding season; however, the albumen glands of mature snails had a smaller volume in those with higher parasite loads. Ovotestis weight was also significantly negatively correlated with parasite load. Snail reproductive capacity could, therefore, be partially impaired but only for individuals with higher parasite loads. Considering only the measured parameters, natural infection by C. tentaculata does not appear to affect intermediary metabolism of M. abbreviatus. A greater number of larvae and greater severity of tissue injuries are more frequently observed in older snails.
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Affiliation(s)
- Clivia Valle Machado
- Programa de Pós-Graduação em Neurociências, Instituto de Ciências Básicas da Saúde (ICBS), Universidade Federal do Rio Grande do Sul (UFRGS), Brazil
| | - Marcia B Mentz
- Departamento de Microbiologia, Parasitologia e Imunologia, ICBS, UFRGS, Brazil
| | - Sara Hartke
- Departamento de Fisiologia, ICBS, UFRGS, Brazil
| | - Denise M Zancan
- Programa de Pós-Graduação em Neurociências, Instituto de Ciências Básicas da Saúde (ICBS), Universidade Federal do Rio Grande do Sul (UFRGS), Brazil,
- Departamento de Fisiologia, ICBS, UFRGS, Brazil
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Ajayi OM, Wynne NE, Chen SC, Vinauger C, Benoit JB. Sleep: An Essential and Understudied Process in the Biology of Blood-Feeding Arthropods. Integr Comp Biol 2023; 63:530-547. [PMID: 37429615 PMCID: PMC10503478 DOI: 10.1093/icb/icad097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/01/2023] [Accepted: 07/03/2023] [Indexed: 07/12/2023] Open
Abstract
Understanding the biology of blood-feeding arthropods is critical to managing them as vectors of etiological agents. Circadian rhythms act in the regulation of behavioral and physiological aspects such as blood feeding, immunity, and reproduction. However, the impact of sleep on these processes has been largely ignored in blood-feeding arthropods, but recent studies in mosquitoes show that sleep-like states directly impact host landing and blood feeding. Our focus in this review is on discussing the relationship between sleep and circadian rhythms in blood-feeding arthropods along with how unique aspects such as blood gluttony and dormancy can impact sleep-like states. We highlight that sleep-like states are likely to have profound impacts on vector-host interactions but will vary between lineages even though few direct studies have been conducted. A myriad of factors, such as artificial light, could directly impact the time and levels of sleep in blood-feeding arthropods and their roles as vectors. Lastly, we discuss underlying factors that make sleep studies in blood-feeding arthropods difficult and how these can be bypassed. As sleep is a critical factor in the fitness of animal systems, a lack of focus on sleep in blood-feeding arthropods represents a significant oversight in understanding their behavior and its role in pathogen transmission.
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Affiliation(s)
- Oluwaseun M Ajayi
- Department of Biological Sciences, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Nicole E Wynne
- Department of Biochemistry, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA
| | - Shyh-Chi Chen
- Department of Biological Sciences, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Clément Vinauger
- Department of Biochemistry, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA
| | - Joshua B Benoit
- Department of Biological Sciences, University of Cincinnati, Cincinnati, OH 45221, USA
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7
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Tarannum A, Rodríguez-Almonacid CC, Salazar-Bravo J, Karamysheva ZN. Molecular Mechanisms of Persistence in Protozoan Parasites. Microorganisms 2023; 11:2248. [PMID: 37764092 PMCID: PMC10534552 DOI: 10.3390/microorganisms11092248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/31/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
Protozoan parasites are known for their remarkable capacity to persist within the bodies of vertebrate hosts, which frequently results in prolonged infections and the recurrence of diseases. Understanding the molecular mechanisms that underlie the event of persistence is of paramount significance to develop innovative therapeutic approaches, given that these pathways still need to be thoroughly elucidated. The present article provides a comprehensive overview of the latest developments in the investigation of protozoan persistence in vertebrate hosts. The focus is primarily on the function of persisters, their formation within the host, and the specific molecular interactions between host and parasite while they persist. Additionally, we examine the metabolomic, transcriptional, and translational changes that protozoan parasites undergo during persistence within vertebrate hosts, focusing on major parasites such as Plasmodium spp., Trypanosoma spp., Leishmania spp., and Toxoplasma spp. Key findings of our study suggest that protozoan parasites deploy several molecular and physiological strategies to evade the host immune surveillance and sustain their persistence. Furthermore, some parasites undergo stage differentiation, enabling them to acclimate to varying host environments and immune challenges. More often, stressors such as drug exposure were demonstrated to impact the formation of protozoan persisters significantly. Understanding the molecular mechanisms regulating the persistence of protozoan parasites in vertebrate hosts can reinvigorate our current insights into host-parasite interactions and facilitate the development of more efficacious disease therapeutics.
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Affiliation(s)
| | | | | | - Zemfira N. Karamysheva
- Department of Biological Sciences, Texas Tech University, Lubbock, TX 79409, USA; (A.T.); (C.C.R.-A.); (J.S.-B.)
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8
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Agustina KK, Wirawan IMA, Sudarmaja IM, Subrata IM, Dharmawan NS. Ascaris suum - A zoonosis in Bali, Indonesia. Trop Parasitol 2023; 13:100-106. [PMID: 37860613 PMCID: PMC10583779 DOI: 10.4103/tp.tp_24_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/28/2023] [Accepted: 07/27/2023] [Indexed: 10/21/2023] Open
Abstract
Background Ascariasis is a common disease in humans and pigs. In previous reports, it has been known that ascariasis in humans is not only caused by Ascaris lumbricoides but also by Ascaris suum which is known to originate from pigs. Aims and Objectives This research aims to identify the species of Ascaris that infect traditional pig farmers in Bali, Indonesia. Materials and Methods To achieve this, an observational study was conducted, in which 239 feces samples were collected from traditional pig farmers. The collected samples were then divided into two parts, with one part stored in a pot containing 10% formalin for microscopic testing, and the other part stored in 70% ethanol for molecular testing. In cases where Ascaris infection was observed during the microscopic examination, a further test was conducted using the polymerase chain reaction (PCR) method for molecular examination. The DNA derived from the PCR was then subjected to DNA sequencing. Results The result was compared to A. suum gene data previously published in the Gene Bank. The results of the microscopic examination showed that 22 farmers were infected with Ascaris. However, PCR testing and DNA sequencing indicated that three infections were caused by A. suum. Conclusion Therefore, it can be concluded that A. suum is a zoonosis in Bali. Thus, efforts to control ascariasis must pay attention to the presence of pigs around it. Handling of ascariasis is not only carried out in humans but also in pigs and the environment.
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Affiliation(s)
- Kadek Karang Agustina
- Department of Veterinary Public Health, Faculty of Veterinary Medicine, Udayana University, Denpasar, Bali, Indonesia
- Department of Doctoral Program in Biomedical Sciences, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
| | - I Made Ady Wirawan
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
| | - I Made Sudarmaja
- Department of Parasitology, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
| | - I Made Subrata
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
| | - Nyoman Sadra Dharmawan
- Department of Veterinary Clinical Pathology, Faculty of Veterinary Medicine, Udayana University, Denpasar, Bali, Indonesia
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Ridwan Y, Sudarnika E, Dewi TIT, Budiono NG. Gastrointestinal helminth parasites of pets: Retrospective study at the veterinary teaching hospital, IPB University, Bogor, Indonesia. Vet World 2023; 16:1043-1051. [PMID: 37576768 PMCID: PMC10420713 DOI: 10.14202/vetworld.2023.1043-1051] [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: 02/01/2023] [Accepted: 04/10/2023] [Indexed: 08/15/2023] Open
Abstract
Background and Aim Dogs and cats are popular pets that play integral roles in human societies worldwide. Unfortunately, they can carry potential zoonotic helminths that can be transmitted to humans. However, data on the gastrointestinal helminths affecting dogs and cats in Bogor, Indonesia, are currently lacking. This study aimed to investigate the occurrence of gastrointestinal helminth parasites in pets from this area using a retrospective analysis. Materials and Methods A retrospective study was conducted at the Veterinary Teaching Hospital of IPB University, Bogor. Cat and dog patients from January 2014 to April 2019 were tested for helminth infections and the results as well as their age, sex, and breed data were analyzed using the Chi-square test. Results Among the dogs and cats examined for internal parasites, 61.11% (33/51) of the dogs and 53.80% (92/171) of the cats were infected by helminths. Among the dogs, hookworm (37.04%) and Toxocara spp. (24.07%) were detected, while in the cats, hookworm (11.11%), Toxocara spp. (38.01%), and Dipylidium caninum (4.68%) were detected. The prevalence of hookworm and D. caninum was higher in older pets, while Toxocara spp. infected younger cats and dogs (<1 year) more frequently. The prevalence of Toxocara spp. in the Indonesian local dog breed was higher when than other breeds. Sex did not significantly affect the prevalence of parasites in dogs or cats. Conclusion The discovery of zoonotic helminth parasites in the cat and dog pets from Bogor raises concerns for the inhabitants. Initiatives will be required to inform pet owners about prevention strategies for these parasitic diseases.
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Affiliation(s)
- Yusuf Ridwan
- Division of Parasitology and Medical Entomology, School of Veterinary Medicine and Biomedical Sciences, IPB University, Bogor, Indonesia
| | - Etih Sudarnika
- Division of Veterinary Public Health and Epidemiology, School of Veterinary Medicine and Biomedical Sciences, IPB University, Bogor, Indonesia
| | - Tri Isyani Tungga Dewi
- Veterinary Teaching Hospital, School of Veterinary Medicine and Biomedical Sciences, IPB University, Bogor, Indonesia
| | - Novericko Ginger Budiono
- Veterinary Teaching Hospital, School of Veterinary Medicine and Biomedical Sciences, IPB University, Bogor, Indonesia
- Division of Medical Microbiology, School of Veterinary Medicine and Biomedical Sciences, IPB University, Bogor, Indonesia
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Pereira LQ, Tanaka SCSV, Ferreira-Silva MM, Gomes FVBAF, Santana MP, Aguiar PR, de Araújo Pereira G, Gómez-Hernández C, Junior VR, De Vito FB, Moraes-Souza H. Leukoreduction as a control measure in transfusion transmission of visceral leishmaniasis. Transfusion 2023; 63:1044-1049. [PMID: 36929836 DOI: 10.1111/trf.17308] [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: 01/19/2022] [Revised: 01/18/2023] [Accepted: 01/30/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Asymptomatic visceral leishmaniasis (VL) infection is a risk for transfusion safety. Leukoreduction has been an alternative for the prevention of some blood-borne diseases, including VL. This study aimed to evaluate the role of leukoreduction of cellular blood components as a control measure for transfusional VL transmission. RESEARCH DESIGN AND METHODS A total of 161 polytransfused patients with non-leukoreduced blood components (HNL), 95 polytransfused with leukoreduced blood components (LH), and 202 non-transfused (NT) from endemic regions for VL and with a similar epidemiological profile. The detection of antibodies against VL was performed by ELISA and the presence of the parasite was investigated by real-time PCR. Statistical significance was defined as p < .05. RESULTS When comparing three groups, ELISA results were statistically significant (p = .0065). The residual analysis of ELISA showed statistically significant for the HNL group compared to the general group (p = .002; OR: 5.6; CI: 1.7-25.8), demonstrating that individuals who received non-leukoreduced transfusions are five times more likely to acquire Leishmania infantum infection than the general. DISCUSSION Higher prevalence in the group with HNL and low prevalence in those who received LH, similar to NT patients, highlight the risk of transfusional VL transmission and reinforce the role of leukoreduction in its prevention.
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Affiliation(s)
- Loren Queli Pereira
- Laboratory of Hematological Research, Triângulo Mineiro Federal University, Uberaba, Brazil
| | | | | | | | - Melissa Palis Santana
- Government of Piauí, Hemopi - Hematology and Hemotherapy Center of the State of Piauí, Teresina, Brazil
| | - Paulo Roberto Aguiar
- Hemominas Foundation, Regional Blood Center of Montes Claros (Minas Gerais), Montes Claros, Brazil
| | - Gilberto de Araújo Pereira
- Department of Nursing in Education and Community Health, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | | | | | | | - Helio Moraes-Souza
- Laboratory of Hematological Research, Triângulo Mineiro Federal University, Uberaba, Brazil
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Vanillin allied 1,2,3- triazole as a selective sensor for detection of Al3+ ions: A potent inhibitor against Entamoeba histolytica. J Mol Struct 2023. [DOI: 10.1016/j.molstruc.2022.134325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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12
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Abstract
Leishmaniasis (visceral and cutaneous), Chagas disease and human African trypanosomiasis cause substantial death and morbidity, particularly in low- and middle-income countries. Although the situation has improved for human African trypanosomiasis, there remains an urgent need for new medicines to treat leishmaniasis and Chagas disease; the clinical development pipeline is particularly sparse for Chagas disease. In this Review, we describe recent advances in our understanding of the biology of the causative pathogens, particularly from the drug discovery perspective, and we explore the progress that has been made in the development of new drug candidates and the identification of promising molecular targets. We also explore the challenges in developing new clinical candidates and discuss potential solutions to overcome such hurdles.
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De Pascali AM, Todeschini R, Baiocchi S, Ortalli M, Attard L, Ibarra-Meneses AV, Carrillo E, Varani S. Test combination to detect latent Leishmania infection: A prevalence study in a newly endemic area for L. infantum, northeastern Italy. PLoS Negl Trop Dis 2022; 16:e0010676. [PMID: 35969605 PMCID: PMC9410555 DOI: 10.1371/journal.pntd.0010676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 08/25/2022] [Accepted: 07/19/2022] [Indexed: 11/23/2022] Open
Abstract
Background Most people infected with Leishmania remain asymptomatic, which is a common element that may promote the resurgence of clinically evident leishmaniasis in individuals with impaired cell-mediated immune responses. Unfortunately, there is no universally accepted assay to identify asymptomatic infection. This cross-sectional study focuses on the employment of three methods targeting different features of the parasitic infection to be used in combination for the screening of latent leishmaniasis in a newly endemic area of northeastern Italy. Methodology/principal findings The selected methods included highly sensitive Real-Time PCR for detection of parasitic kinetoplast (k)DNA in peripheral blood, Western Blot (WB) for detection of specific IgG, and Whole Blood stimulation Assay (WBA) to evaluate the anti-leishmanial T-cell response by quantifying the production of IL-2 after stimulation of patients’ blood with Leishmania specific antigens. Among 145 individuals living in a municipality of the Bologna province, northeastern Italy, recruited and screened for Leishmania infection, 23 subjects tested positive (15.9%) to one or more tests. Positive serology was the most common marker of latent leishmaniasis (15/145, 10%), followed by the detection of specific cell-mediated response (12/145, 8%), while only few individuals (6/145, 4%) harbored parasitic DNA in the blood. Conclusions/significance Combining different tests substantially increased the yield of positivity in detecting latent Leishmania infection. The test combination that we employed in this study appears to be effective to accurately identify latent leishmaniasis in an endemic area. After infection with Leishmania infantum cutaneous or visceral leishmaniasis can develop, but in most cases the host becomes an asymptomatic carrier of the parasite. This key population of individuals with latent leishmaniasis can undergo reactivation of the infection with severe outcome in case of immunosuppression and can contribute to disease transmission. The public health impact of leishmaniasis is currently underestimated in Europe, despite Leishmania infection is endemic in the Mediterranean countries and outbreaks of human leishmaniasis have been reported in the last decades, including northeastern Italy. One of the causes contributing to this neglect is that the available diagnostic tests exhibit scarce sensitivity in identification of latent leishmaniasis. In this study, we identified latent Leishmania infection in a newly endemic area of northeastern Italy by using three different diagnostic methods; serological, molecular and immunological tests. Sixteen percent of individuals residing in the selected area were shown to be positive to at least one of the three tests, which indicates a previous contact with the parasite. This study highlights the importance of test combination to enhance the ability to identify latent Leishmania infection.
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Affiliation(s)
- Alessandra Mistral De Pascali
- Section of Microbiology, Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Renato Todeschini
- Unit of Hygiene and Public Health, Department of Public Health, AUSL Bologna, Bologna, Italy
| | - Simone Baiocchi
- Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Margherita Ortalli
- Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Luciano Attard
- Infectious Diseases Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Ana Victoria Ibarra-Meneses
- WHO Collaborating Centre for Leishmaniasis, National Centre for Microbiology, Instituto de Salud Carlos III, Majadahonda (Madrid), Spain, CIBERINFEC
- Département de pathologie et microbiologie, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Quebec, Canada
- The Research Group on Infectious Diseases in Production Animals (GREMIP), Faculty of Veterinary Medicine, Université de Montréal, Montreal, Canada
| | - Eugenia Carrillo
- WHO Collaborating Centre for Leishmaniasis, National Centre for Microbiology, Instituto de Salud Carlos III, Majadahonda (Madrid), Spain, CIBERINFEC
- * E-mail: (EC); (SV)
| | - Stefania Varani
- Section of Microbiology, Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy
- Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- * E-mail: (EC); (SV)
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14
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Humoral and Cellular Immune Response in Asymptomatic Dogs with Visceral Leishmaniasis: A Review. Vaccines (Basel) 2022; 10:vaccines10060947. [PMID: 35746555 PMCID: PMC9229064 DOI: 10.3390/vaccines10060947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/09/2022] [Accepted: 06/10/2022] [Indexed: 02/05/2023] Open
Abstract
Visceral leishmaniasis is one of the deadliest parasitic diseases in the world and affects both humans and dogs. The host immune response to Leishmania infection plays a critical role in the evolution of canine visceral leishmaniasis (CVL) and consequently in the manifestation of clinical signs. The asymptomatic form of the disease is a major concern in the diagnosis of CVL and in the transmission control of Leishmania infection. Asymptomatic dogs are found in large proportions in endemic areas and are an unquantifiable source of infection. The present review analyzes the possible relationship between the activation of the antigen-specific immune response of the host and resistance or susceptibility to CVL. The review focuses on works that address the characterization of the humoral and cellular immune response profile, at both the functional and phenotypic levels, in infected dogs. Most studies relate the absence of clinical symptomatology to an increased proliferative response and a Th1 cytokine profile. Despite the numerous findings pointing to a differential immune response in asymptomatic dogs, the contradictory results reported in this review highlight the importance of establishing a precise clinical classification of the disease, performing more longitudinal studies, and including a higher number of animals in trials.
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15
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Kratz JM, Gonçalves KR, Romera LM, Moraes CB, Bittencourt-Cunha P, Schenkman S, Chatelain E, Sosa-Estani S. The translational challenge in Chagas disease drug development. Mem Inst Oswaldo Cruz 2022; 117:e200501. [PMID: 35613156 PMCID: PMC9128742 DOI: 10.1590/0074-02760200501] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 01/13/2021] [Indexed: 12/20/2022] Open
Abstract
Chagas disease is a neglected tropical disease caused by the protozoan parasite Trypanosoma cruzi. There is an urgent need for safe, effective, and accessible new treatments since the currently approved drugs have serious limitations. Drug development for Chagas disease has historically been hampered by the complexity of the disease, critical knowledge gaps, and lack of coordinated R&D efforts. This review covers some of the translational challenges associated with the progression of new chemical entities from preclinical to clinical phases of development, and discusses how recent technological advances might allow the research community to answer key questions relevant to the disease and to overcome hurdles in R&D for Chagas disease.
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Affiliation(s)
- Jadel M Kratz
- Drugs for Neglected Diseases initiative, Geneva, Switzerland
| | - Karolina R Gonçalves
- Universidade de São Paulo, Instituto de Ciências Biomédicas, Departamento de Microbiologia, São Paulo, SP, Brasil
| | - Lavínia Md Romera
- Universidade de São Paulo, Instituto de Ciências Biomédicas, Departamento de Microbiologia, São Paulo, SP, Brasil
| | - Carolina Borsoi Moraes
- Universidade Federal de São Paulo, Departamento de Ciências Farmacêuticas, Diadema, SP, Brasil
| | - Paula Bittencourt-Cunha
- Universidade de São Paulo, Instituto de Ciências Biomédicas, Departamento de Microbiologia, São Paulo, SP, Brasil.,Universidade Federal de São Paulo, Departamento de Microbiologia, Imunologia e Parasitologia, São Paulo, SP, Brasil
| | - Sergio Schenkman
- Universidade Federal de São Paulo, Departamento de Microbiologia, Imunologia e Parasitologia, São Paulo, SP, Brasil
| | - Eric Chatelain
- Drugs for Neglected Diseases initiative, Geneva, Switzerland
| | - Sergio Sosa-Estani
- Drugs for Neglected Diseases initiative, Geneva, Switzerland.,Epidemiology and Public Health Research Centre, CIESP-CONICET, Buenos Aires, Argentina
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16
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Speidel A, Theile M, Pfeiffer L, Herrmann A, Figarella K, Ishikawa H, Schwerk C, Schroten H, Duszenko M, Mogk S. Transmigration of Trypanosoma brucei across an in vitro blood-cerebrospinal fluid barrier. iScience 2022; 25:104014. [PMID: 35313698 PMCID: PMC8933718 DOI: 10.1016/j.isci.2022.104014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 01/24/2022] [Accepted: 02/28/2022] [Indexed: 11/28/2022] Open
Abstract
Trypanosoma brucei is the causative agent of human African trypanosomiasis. The parasite transmigrates from blood vessels across the choroid plexus epithelium to enter the central nervous system, a process that leads to the manifestation of second stage sleeping sickness. Using an in vitro model of the blood-cerebrospinal fluid barrier, we investigated the mechanism of the transmigration process. For this, a monolayer of human choroid plexus papilloma cells was cultivated on a permeable membrane that mimics the basal lamina underlying the choroid plexus epithelial cells. Plexus cells polarize and interconnect forming tight junctions. Deploying different T. brucei brucei strains, we observed that geometry and motility are important for tissue invasion. Using fluorescent microscopy, the parasite’s moving was visualized between plexus epithelial cells. The presented model provides a simple tool to screen trypanosome libraries for their ability to infect cerebrospinal fluid or to test the impact of chemical substances on transmigration. HIBCPP cells on Transwell filters were used as a model of the blood-CSF barrier Transmigration efficiency of Trypanosoma brucei brucei was quantified by qPCR Transmigration seemed independent of major surface metalloprotease B Transmigration might be a mechanical process affected by parasite geometry/motility
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17
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Carrasco-Antón N, Ibarra-Meneses AV, Carrillo E, Fernández-Ruiz M, Hernández-Jiménez P, Aguado JM, Moreno J, López-Medrano F. An exploratory analysis of C-X-C motif chemokine ligand 10 as a new biomarker of asymptomatic Leishmania infantum infection in Solid-Organ Transplant Recipients. J Infect 2022; 84:573-578. [PMID: 35101535 DOI: 10.1016/j.jinf.2022.01.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 01/11/2022] [Accepted: 01/21/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Sensitive and less laborious assays are needed to detect asymptomatic Leishmania among solid organ transplant (SOT) recipients. Using SLA-stimulated plasma from SOT recipients living where an outbreak of Leishmania infantum occurred, we examined potential biomarkers to identify asymptomatic Leishmania infections. METHODS Concentrations of cytokines/chemokines in plasma from whole blood stimulated with specific Leishmania antigen (SLA) were compared against infection status as determined by a currently used cell proliferation assay. RESULTS Twenty-six percent (13/50) of the SOT recipients had a cell proliferation assay (CPA) indicating asymptomatic infection, and showed higher processed plasma C-X-C motif chemokine ligand 10 (CXCL10 or IP-10) concentrations than did non-infected subjects (median 2272.0 pg/ml [IQR-1570-2772] vs. 18.2 pg/ml [IQR 1-150.1]; p<0.0001). CXCL10 showed a sensitivity of 93% and a specificity of 95% compared to CPA. In addition, we demonstrated that the number of asymptomatic infections detected using CXCL10, decreased with distance from a park at the centre of the mentioned outbreak. CONCLUSION CXCL10 in plasma from SLA-stimulated blood could be a robust biomarker of asymptomatic L. infantum infection in solid organ transplant recipients.
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Affiliation(s)
- Nerea Carrasco-Antón
- Unit of Infectious Diseases, University Hospital 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre (imas12), Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain, CIBERINFEC.
| | - Ana Victoria Ibarra-Meneses
- WHO Collaborating Centre for Leishmaniasis, Spanish National Center for Microbiology, Instituto de Salud Carlos III, Majadahonda, Spain, CIBERINFEC.
| | - Eugenia Carrillo
- WHO Collaborating Centre for Leishmaniasis, Spanish National Center for Microbiology, Instituto de Salud Carlos III, Majadahonda, Spain, CIBERINFEC.
| | - Mario Fernández-Ruiz
- Unit of Infectious Diseases, University Hospital 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre (imas12), Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain, CIBERINFEC.
| | - Pilar Hernández-Jiménez
- Unit of Infectious Diseases, University Hospital 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre (imas12), Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain, CIBERINFEC.
| | - José María Aguado
- Unit of Infectious Diseases, University Hospital 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre (imas12), Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain, CIBERINFEC.
| | - Javier Moreno
- WHO Collaborating Centre for Leishmaniasis, Spanish National Center for Microbiology, Instituto de Salud Carlos III, Majadahonda, Spain, CIBERINFEC.
| | - Francisco López-Medrano
- WHO Collaborating Centre for Leishmaniasis, Spanish National Center for Microbiology, Instituto de Salud Carlos III, Majadahonda, Spain, CIBERINFEC.
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18
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Live attenuated vaccines, a favorable strategy to provide long-term immunity against protozoan diseases. Trends Parasitol 2021; 38:316-334. [PMID: 34896016 DOI: 10.1016/j.pt.2021.11.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 11/12/2021] [Accepted: 11/12/2021] [Indexed: 12/25/2022]
Abstract
The control of diseases caused by protozoan parasites is one of the United Nations' Sustainable Development Goals. In recent years much research effort has gone into developing a new generation of live attenuated vaccines (LAVs) against malaria, Chagas disease and leishmaniasis. However, there is a bottleneck related to their biosafety, production, and distribution that slows downs further development. The success of irradiated or genetically attenuated sporozoites against malaria, added to the first LAV against leishmaniasis to be evaluated in clinical trials, is indicative that the drawbacks of LAVs are gradually being overcome. However, whether persistence of LAVs is a prerequisite for sustained long-term immunity remains to be clarified, and the procedures necessary for clinical evaluation of vaccine candidates need to be standardized.
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19
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Risch F, Ritter M, Hoerauf A, Hübner MP. Human filariasis-contributions of the Litomosoides sigmodontis and Acanthocheilonema viteae animal model. Parasitol Res 2021; 120:4125-4143. [PMID: 33547508 PMCID: PMC8599372 DOI: 10.1007/s00436-020-07026-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 12/20/2020] [Indexed: 12/16/2022]
Abstract
Filariae are vector-borne parasitic nematodes that are endemic worldwide, in tropical and subtropical regions. Important human filariae spp. include Onchocerca volvulus, Wuchereria bancrofti and Brugia spp., and Loa loa and Mansonella spp. causing onchocerciasis (river blindness), lymphatic filariasis (lymphedema and hydrocele), loiasis (eye worm), and mansonelliasis, respectively. It is estimated that over 1 billion individuals live in endemic regions where filarial diseases are a public health concern contributing to significant disability adjusted life years (DALYs). Thus, efforts to control and eliminate filarial diseases were already launched by the WHO in the 1970s, especially against lymphatic filariasis and onchocerciasis, and are mainly based on mass drug administration (MDA) of microfilaricidal drugs (ivermectin, diethylcarbamazine, albendazole) to filarial endemic areas accompanied with vector control strategies with the goal to reduce the transmission. With the United Nations Sustainable Development Goals (SDGs), it was decided to eliminate transmission of onchocerciasis and stop lymphatic filariasis as a public health problem by 2030. It was also requested that novel drugs and treatment strategies be developed. Mouse models provide an important platform for anti-filarial drug research in a preclinical setting. This review presents an overview about the Litomosoides sigmodontis and Acanthocheilonema viteae filarial mouse models and their role in immunological research as well as preclinical studies about novel anti-filarial drugs and treatment strategies.
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Affiliation(s)
- Frederic Risch
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, Bonn, Germany
| | - Manuel Ritter
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, Bonn, Germany
| | - Achim Hoerauf
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, Bonn, Germany
- German Center for Infection Research (DZIF), partner site Bonn-Cologne, Bonn, Germany
| | - Marc P Hübner
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, Bonn, Germany.
- German Center for Infection Research (DZIF), partner site Bonn-Cologne, Bonn, Germany.
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20
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Microbiomes of Blood-Feeding Arthropods: Genes Coding for Essential Nutrients and Relation to Vector Fitness and Pathogenic Infections. A Review. Microorganisms 2021; 9:microorganisms9122433. [PMID: 34946034 PMCID: PMC8704530 DOI: 10.3390/microorganisms9122433] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 11/08/2021] [Accepted: 11/20/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Blood-feeding arthropods support a diverse array of symbiotic microbes, some of which facilitate host growth and development whereas others are detrimental to vector-borne pathogens. We found a common core constituency among the microbiota of 16 different arthropod blood-sucking disease vectors, including Bacillaceae, Rickettsiaceae, Anaplasmataceae, Sphingomonadaceae, Enterobacteriaceae, Pseudomonadaceae, Moraxellaceae and Staphylococcaceae. By comparing 21 genomes of common bacterial symbionts in blood-feeding vectors versus non-blooding insects, we found that certain enteric bacteria benefit their hosts by upregulating numerous genes coding for essential nutrients. Bacteria of blood-sucking vectors expressed significantly more genes (p < 0.001) coding for these essential nutrients than those of non-blooding insects. Moreover, compared to endosymbionts, the genomes of enteric bacteria also contained significantly more genes (p < 0.001) that code for the synthesis of essential amino acids and proteins that detoxify reactive oxygen species. In contrast, microbes in non-blood-feeding insects expressed few gene families coding for these nutrient categories. We also discuss specific midgut bacteria essential for the normal development of pathogens (e.g., Leishmania) versus others that were detrimental (e.g., bacterial toxins in mosquitoes lethal to Plasmodium spp.).
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21
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Schuster S, Lisack J, Subota I, Zimmermann H, Reuter C, Mueller T, Morriswood B, Engstler M. Unexpected plasticity in the life cycle of Trypanosoma brucei. eLife 2021; 10:66028. [PMID: 34355698 PMCID: PMC8448533 DOI: 10.7554/elife.66028] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 08/05/2021] [Indexed: 12/22/2022] Open
Abstract
African trypanosomes cause sleeping sickness in humans and nagana in cattle. These unicellular parasites are transmitted by the bloodsucking tsetse fly. In the mammalian host’s circulation, proliferating slender stage cells differentiate into cell cycle-arrested stumpy stage cells when they reach high population densities. This stage transition is thought to fulfil two main functions: first, it auto-regulates the parasite load in the host; second, the stumpy stage is regarded as the only stage capable of successful vector transmission. Here, we show that proliferating slender stage trypanosomes express the mRNA and protein of a known stumpy stage marker, complete the complex life cycle in the fly as successfully as the stumpy stage, and require only a single parasite for productive infection. These findings suggest a reassessment of the traditional view of the trypanosome life cycle. They may also provide a solution to a long-lasting paradox, namely the successful transmission of parasites in chronic infections, despite low parasitemia.
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Affiliation(s)
- Sarah Schuster
- Department of Cell and Developmental Biology, University of Würzburg, Würzburg, Germany
| | - Jaime Lisack
- Department of Cell and Developmental Biology, University of Würzburg, Würzburg, Germany
| | - Ines Subota
- Department of Cell and Developmental Biology, University of Würzburg, Würzburg, Germany
| | - Henriette Zimmermann
- Department of Cell and Developmental Biology, University of Würzburg, Würzburg, Germany
| | - Christian Reuter
- Department of Cell and Developmental Biology, University of Würzburg, Würzburg, Germany
| | | | | | - Markus Engstler
- Department of Cell and Developmental Biology, University of Würzburg, Würzburg, Germany
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22
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Botana L, Ibarra-Meneses AV, Sanchez C, Matia B, San Martin JV, Moreno J, Carrillo E. Leishmaniasis: A new method for confirming cure and detecting asymptomatic infection in patients receiving immunosuppressive treatment for autoimmune disease. PLoS Negl Trop Dis 2021; 15:e0009662. [PMID: 34339445 PMCID: PMC8360552 DOI: 10.1371/journal.pntd.0009662] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 08/12/2021] [Accepted: 07/19/2021] [Indexed: 11/19/2022] Open
Abstract
Visceral leishmaniasis (VL) in patients receiving immunosuppressant drugs for autoimmune disease has been on the rise. It is important—but difficult—to know when cure has been achieved in these patients since the withdrawal of immunosuppressants during antileishmania treatment is commonly required, and there is a risk of relapse when immunosuppression is restored. The prevalence of asymptomatic infection among those immunosuppressed for autoimmune disease is also uncertain. The present work describes how cytokine release assays can be used to confirm the cure of VL, and to determine the prevalence of asymptomatic infection, in such patients. After collection of blood from volunteers (n = 108), SLA-stimulation of peripheral blood mononuclear cell cultures and of whole blood was found to induce the production of different combinations of cytokines that served to confirm recovery from VL, and asymptomatic Leishmania infection. Indeed, cure was confirmed in 14 patients, all of whom showed a specific Th1 immune response against Leishmania, and the prevalence of asymptomatic infection was determined as 21.27%. Cytokine profiles could be used to manage VL in patients with autoimmune disease, and to identify and better protect those with asymptomatic infection who are at risk of developing this disease. Cytokine release assays were used to confirm the cure of visceral leishmaniasis in patients (from an area where Leishmania infantum is endemic) with autoimmune disease. They were also used to determine the prevalence of asymptomatic Leishmania infantum infection in similar patients. Some 21.27% of those with no clinical history of leishmaniasis were shown to have been contact with the parasite.
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Affiliation(s)
- Laura Botana
- WHO Collaborating Centre for Leishmaniasis, National Centre for Microbiology, Instituto de Salud Carlos III, Majadahonda (Madrid), Spain
- Cardiology Department, Universidad Francisco de Vitoria/Hospital Ramón y Cajal Research Unit (IRYCIS), Madrid, Spain
| | - Ana Victoria Ibarra-Meneses
- WHO Collaborating Centre for Leishmaniasis, National Centre for Microbiology, Instituto de Salud Carlos III, Majadahonda (Madrid), Spain
| | - Carmen Sanchez
- WHO Collaborating Centre for Leishmaniasis, National Centre for Microbiology, Instituto de Salud Carlos III, Majadahonda (Madrid), Spain
| | - Belen Matia
- Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
| | | | - Javier Moreno
- WHO Collaborating Centre for Leishmaniasis, National Centre for Microbiology, Instituto de Salud Carlos III, Majadahonda (Madrid), Spain
| | - Eugenia Carrillo
- WHO Collaborating Centre for Leishmaniasis, National Centre for Microbiology, Instituto de Salud Carlos III, Majadahonda (Madrid), Spain
- * E-mail:
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23
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Hatherell HA, Simpson H, Baggaley RF, Hollingsworth TD, Pullan RL. Sustainable Surveillance of Neglected Tropical Diseases for the Post-Elimination Era. Clin Infect Dis 2021; 72:S210-S216. [PMID: 33977302 PMCID: PMC8201586 DOI: 10.1093/cid/ciab211] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
The World Health Organization’s (WHO’s) 2030 road map for neglected tropical diseases (NTDs) emphasizes the importance of strengthened, institutionalized “post-elimination” surveillance. The required shift from disease-siloed, campaign-based programming to routine, integrated surveillance and response activities presents epidemiological, logistical, and financial challenges, yet practical guidance on implementation is lacking. Nationally representative survey programs, such as demographic and health surveys (DHS), may offer a platform for the integration of NTD surveillance within national health systems and health information systems. Here, we describe characteristics of DHS and other surveys conducted within the WHO Africa region in terms of frequency, target populations, and sample types and discuss applicability for post-validation and post-elimination surveillance. Maximizing utility depends not only on the availability of improved diagnostics but also on better understanding of the spatial and temporal dynamics of transmission at low prevalence. To this end, we outline priorities for obtaining additional data to better characterize optimal post-elimination surveillance platforms.
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Affiliation(s)
- Hollie-Ann Hatherell
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Hope Simpson
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Rebecca F Baggaley
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom
| | | | - Rachel L Pullan
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom
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24
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Firdaus ER, Park JH, Muh F, Lee SK, Han JH, Lim CS, Na SH, Park WS, Park JH, Han ET. Performance Evaluation of Biozentech Malaria Scanner in Plasmodium knowlesi and P. falciparum as a New Diagnostic Tool. THE KOREAN JOURNAL OF PARASITOLOGY 2021; 59:113-119. [PMID: 33951766 PMCID: PMC8106981 DOI: 10.3347/kjp.2021.59.2.113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 03/11/2021] [Indexed: 12/21/2022]
Abstract
The computer vision diagnostic approach currently generates several malaria diagnostic tools. It enhances the accessible and straightforward diagnostics that necessary for clinics and health centers in malaria-endemic areas. A new computer malaria diagnostics tool called the malaria scanner was used to investigate living malaria parasites with easy sample preparation, fast and user-friendly. The cultured Plasmodium parasites were used to confirm the sensitivity of this technique then compared to fluorescence-activated cell sorting (FACS) analysis and light microscopic examination. The measured percentage of parasitemia by the malaria scanner revealed higher precision than microscopy and was similar to FACS. The coefficients of variation of this technique were 1.2–6.7% for Plasmodium knowlesi and 0.3–4.8% for P. falciparum. It allowed determining parasitemia levels of 0.1% or higher, with coefficient of variation smaller than 10%. In terms of the precision range of parasitemia, both high and low ranges showed similar precision results. Pearson’s correlation test was used to evaluate the correlation data coming from all methods. A strong correlation of measured parasitemia (r2=0.99, P<0.05) was observed between each method. The parasitemia analysis using this new diagnostic tool needs technical improvement, particularly in the differentiation of malaria species.
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Affiliation(s)
- Egy Rahman Firdaus
- Department of Medical Environmental Biology and Tropical Medicine, School of Medicine, Kangwon National University, Chuncheon 24341, Korea
| | - Ji-Hoon Park
- Department of Medical Environmental Biology and Tropical Medicine, School of Medicine, Kangwon National University, Chuncheon 24341, Korea
| | - Fauzi Muh
- Department of Medical Environmental Biology and Tropical Medicine, School of Medicine, Kangwon National University, Chuncheon 24341, Korea
| | - Seong-Kyun Lee
- Department of Medical Environmental Biology and Tropical Medicine, School of Medicine, Kangwon National University, Chuncheon 24341, Korea
| | - Jin-Hee Han
- Department of Medical Environmental Biology and Tropical Medicine, School of Medicine, Kangwon National University, Chuncheon 24341, Korea
| | - Chae-Seung Lim
- Department of Laboratory Medicine, Korea University College of Medicine, Seoul 08308, Korea
| | - Sung-Hun Na
- Department of Obstetrics and Gynecology, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon 24341, Korea
| | - Won Sun Park
- Department of Physiology, School of Medicine, Kangwon National University, Chuncheon 24341, Korea
| | - Jeong-Hyun Park
- Department of Anatomy and Cell Biology, School of Medicine, Kangwon National University, Chuncheon 24341, Korea
| | - Eun-Taek Han
- Department of Medical Environmental Biology and Tropical Medicine, School of Medicine, Kangwon National University, Chuncheon 24341, Korea
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25
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Arendse LB, Wyllie S, Chibale K, Gilbert IH. Plasmodium Kinases as Potential Drug Targets for Malaria: Challenges and Opportunities. ACS Infect Dis 2021; 7:518-534. [PMID: 33590753 PMCID: PMC7961706 DOI: 10.1021/acsinfecdis.0c00724] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Indexed: 12/30/2022]
Abstract
Protein and phosphoinositide kinases have been successfully exploited as drug targets in various disease areas, principally in oncology. In malaria, several protein kinases are under investigation as potential drug targets, and an inhibitor of Plasmodium phosphatidylinositol 4-kinase type III beta (PI4KIIIβ) is currently in phase 2 clinical studies. In this Perspective, we review the potential of kinases as drug targets for the treatment of malaria. Kinases are known to be readily druggable, and many are essential for parasite survival. A key challenge in the design of Plasmodium kinase inhibitors is obtaining selectivity over the corresponding human orthologue(s) and other human kinases due to the highly conserved nature of the shared ATP binding site. Notwithstanding this, there are some notable differences between the Plasmodium and human kinome that may be exploitable. There is also the potential for designed polypharmacology, where several Plasmodium kinases are inhibited by the same drug. Prior to starting the drug discovery process, it is important to carefully assess potential kinase targets to ensure that the inhibition of the desired kinase will kill the parasites in the required life-cycle stages with a sufficiently fast rate of kill. Here, we highlight key target attributes and experimental approaches to consider and summarize the progress that has been made targeting Plasmodium PI4KIIIβ, cGMP-dependent protein kinase, and cyclin-dependent-like kinase 3.
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Affiliation(s)
- Lauren B. Arendse
- Drug
Discovery and Development Centre (H3D), South African Medical Research
Council Drug Discovery and Development Research Unit, Department of
Chemistry, and Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Rondebosch, Cape Town, Western Cape 7701, South Africa
| | - Susan Wyllie
- Wellcome
Centre for Anti-Infectives Research, Division of Biological Chemistry
and Drug Discovery, University of Dundee, Dundee DD1 5EH, United Kingdom
| | - Kelly Chibale
- Drug
Discovery and Development Centre (H3D), South African Medical Research
Council Drug Discovery and Development Research Unit, Department of
Chemistry, and Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Rondebosch, Cape Town, Western Cape 7701, South Africa
| | - Ian H. Gilbert
- Wellcome
Centre for Anti-Infectives Research, Division of Biological Chemistry
and Drug Discovery, University of Dundee, Dundee DD1 5EH, United Kingdom
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26
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de Freitas E Silva R, von Stebut E. Unraveling the Role of Immune Checkpoints in Leishmaniasis. Front Immunol 2021; 12:620144. [PMID: 33776999 PMCID: PMC7990902 DOI: 10.3389/fimmu.2021.620144] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 01/13/2021] [Indexed: 12/18/2022] Open
Abstract
Leishmaniasis are Neglected Tropical Diseases affecting millions of people every year in at least 98 countries and is one of the major unsolved world health issues. Leishmania is a parasitic protozoa which are transmitted by infected sandflies and in the host they mainly infect macrophages. Immunity elicited against those parasites is complex and immune checkpoints play a key role regulating its function. T cell receptors and their respective ligands, such as PD-1, CTLA-4, CD200, CD40, OX40, HVEM, LIGHT, 2B4 and TIM-3 have been characterized for their role in regulating adaptive immunity against different pathogens. However, the exact role those receptors perform during Leishmania infections remains to be better determined. This article addresses the key role immune checkpoints play during Leishmania infections, the limiting factors and translational implications.
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Affiliation(s)
| | - Esther von Stebut
- Department of Dermatology, Medical Faculty, University of Cologne, Cologne, Germany
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27
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Pereira LQ, Ferreira-Silva MM, Ratkevicius CMA, Gómez-Hérnandez C, De Vito FB, Tanaka SCSV, Rodrigues Júnior V, Moraes-Souza H. Identification of Leishmania infantum in blood donors from endemic regions for visceral leishmaniasis. Parasitology 2021; 148:110-114. [PMID: 33143775 PMCID: PMC11010041 DOI: 10.1017/s0031182020001936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/06/2020] [Accepted: 10/11/2020] [Indexed: 11/05/2022]
Abstract
Visceral leishmaniasis is an endemic protozoonosis observed in over 60 countries, with over 500 000 new cases recorded annually. Although the diagnostic procedure of its symptomatic forms is well established, for asymptomatic patients, who represent about 85% of those infected, there is no consensus on the best method for its identification. Recent studies have presented molecular techniques as viable identification methods, with good sensitivity and specificity indices in asymptomatic individuals. Therefore, we aimed to use molecular methods to assess their effectiveness in identifying the presence of asymptomatic infection by Leishmania infantum (L. infantum) individuals from endemic regions of Brazil. Screening was performed by real-time polymerase chain reaction (qPCR) and confirmed by sequencing the cytochrome B gene. Of the 127 samples [from 608 blood donors who had participated in a previous study, of which 34 were positive by the enzyme-linked immunosorbent assay (ELISA) rK39] tested by qPCR, 31 (24.4%) were positive. In the sequencing of 10 qPCR-positive samples, five were identified as L. infantum. Complimentary samples of the ELISA rK39 and conventional PCR showed only reasonable and low agreement with qPCR, respectively. The qPCR confirmed the presence of infection in five of the 10 sequenced samples, ELISA confirmed three, and the conventional PCR confirmed none.
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Affiliation(s)
- Loren Queli Pereira
- Laboratory of Hematological Research of the Triângulo Mineiro Federal University and Uberaba Regional Blood Center – Hemominas Fundation, Uberaba, Minas Gerais, Brazil
| | - Márcia Maria Ferreira-Silva
- Laboratory of Hematological Research of the Triângulo Mineiro Federal University and Uberaba Regional Blood Center – Hemominas Fundation, Uberaba, Minas Gerais, Brazil
| | | | - César Gómez-Hérnandez
- Laboratory of Immunology, Triângulo Mineiro Federal University, Uberaba, Minas Gerais, Brazil
| | - Fernanda Bernadelli De Vito
- Laboratory of Hematological Research of the Triângulo Mineiro Federal University and Uberaba Regional Blood Center – Hemominas Fundation, Uberaba, Minas Gerais, Brazil
| | - Sarah Cristina Sato Vaz Tanaka
- Laboratory of Hematological Research of the Triângulo Mineiro Federal University and Uberaba Regional Blood Center – Hemominas Fundation, Uberaba, Minas Gerais, Brazil
| | | | - Helio Moraes-Souza
- Laboratory of Hematological Research of the Triângulo Mineiro Federal University and Uberaba Regional Blood Center – Hemominas Fundation, Uberaba, Minas Gerais, Brazil
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28
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Tello-Cajiao ME, Agudelo-Rojas OL, Quintero M, Cardenas L, Rosso F. Trends of Seroprevalence of Chagas´s diseases in healthy blood donors, solid organ donors and heart transplant recipients: experience of a single health care center in Colombia. Epidemiol Infect 2020; 148:1-25. [PMID: 33153501 PMCID: PMC7770375 DOI: 10.1017/s0950268820002721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 10/13/2020] [Indexed: 11/07/2022] Open
Abstract
The prevalence of Chagas disease has decreased in the Americas region due to vector control measures. However, non-vectorial transmission through blood transfusions and organ transplantation has gained importance in recent years. Screening among blood and organ donors are essential to reduce Trypanosoma cruzi transmission and could provide information to estimate population prevalence. We conducted a cross-sectional study on the prevalence of immunoglobulin G (IgG) antibodies against T. cruzi in healthy blood donors, solid organ donors and heart transplant recipients from 2012 to 2019. We found a total of 99 357 IgG T. cruzi results during the study period. The cumulative seroprevalence in healthy blood donors was 0.13% (95% confidence interval (CI) 0.10–0.15), in organ donors was 0.53% (95% CI 0.06–1.92) and in heart transplant recipients was 3.03 (95% CI 0.07–15.75). Seroprevalence trend in healthy blood donors showed annual increase between 2012 and 2015, decreasing in the following years. No trend was seen in organ donors neither heart recipients. Adjusted rates did not show difference by sex and age among blood donors. No significant increases in seroprevalence T. cruzi were found during the study period. T. cruzi transmission remains low.
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Affiliation(s)
- María Elena Tello-Cajiao
- Centro de Investigaciones Clínicas (CIC), Fundación Valle del Lili, Cali, Valle del Cauca, Colombia
| | - Olga Lucia Agudelo-Rojas
- Centro de Investigaciones Clínicas (CIC), Fundación Valle del Lili, Cali, Valle del Cauca, Colombia
| | - Marcela Quintero
- Blood Bank, Fundación Valle del Lili, Cali, Valle del Cauca, Colombia
| | - Laura Cardenas
- Blood Bank, Fundación Valle del Lili, Cali, Valle del Cauca, Colombia
| | - Fernando Rosso
- Centro de Investigaciones Clínicas (CIC), Fundación Valle del Lili, Cali, Valle del Cauca, Colombia
- Fundacion Valle del Lili, Internal Medicine Department, Infectious Disease Service, Cali, Valle del Cauca, Colombia
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Abstract
As the global COVID-19 pandemic advances, it increasingly impacts those vulnerable populations who already bear a heavy burden of neglected tropical disease. Chagas disease (CD), a neglected parasitic infection, is of particular concern because of its potential to cause cardiac, gastrointestinal, and other complications which could increase susceptibility to COVID-19. The over one million people worldwide with chronic Chagas cardiomyopathy require special consideration because of COVID-19’s potential impact on the heart, yet the pandemic also affects treatment provision to people with acute or chronic indeterminate CD. In this document, a follow-up to the WHF-IASC Roadmap on CD, we assess the implications of coinfection with SARS-CoV-2 and Trypanosoma cruzi, the etiological agent of CD. Based on the limited evidence available, we provide preliminary guidance for testing, treatment, and management of patients affected by both diseases, while highlighting emerging healthcare access challenges and future research needs.
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30
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Geerts M, Van Reet N, Leyten S, Berghmans R, S Rock K, Ht Coetzer T, E-A Eyssen L, Büscher P. Trypanosoma brucei gambiense-iELISA: a promising new test for the post-elimination monitoring of human African trypanosomiasis. Clin Infect Dis 2020; 73:e2477-e2483. [PMID: 32856049 PMCID: PMC8563279 DOI: 10.1093/cid/ciaa1264] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 08/24/2020] [Indexed: 11/13/2022] Open
Abstract
Background The World Health Organization targeted Trypanosoma brucei gambiense human African trypanosomiasis (gHAT) for elimination as a public health problem and for elimination of transmission. To measure gHAT elimination success with prevalences close to zero, highly specific diagnostics are necessary. Such a test exists in the form of an antibody-mediated complement lysis test, the trypanolysis test, but biosafety issues and technological requirements prevent its large-scale use. We developed an inhibition ELISA with high specificity and sensitivity that is applicable in regional laboratories in gHAT endemic countries. Methods The T. b. gambiense inhibition ELISA (g-iELISA) is based on the principle that binding of monoclonal antibodies to specific epitopes of T. b. gambiense surface glycoproteins can be inhibited by circulating antibodies of gHAT patients directed against the same epitopes. Using trypanolysis as reference test, the diagnostic accuracy of the g-iELISA was evaluated on plasma samples from 739 gHAT patients and 619 endemic controls and on dried blood spots prepared with plasma of 95 gHAT and 37 endemic controls. Results Overall sensitivity and specificity on plasma were, respectively, 98.0% (95% CI 96.7–98.9) and 99.5% (95% CI 98.6–99.9). With dried blood spots, sensitivity was 92.6% (95% CI 85.4–97.0), and specificity was 100% (95% CI 90.5–100.0). The g-iELISA is stable for at least 8 months when stored at 2–8°C. Conclusion The g-iELISA might largely replace trypanolysis for monitoring gHAT elimination and for postelimination surveillance. The g-iELISA kit is available for evaluation in reference laboratories in endemic countries.
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Affiliation(s)
- Manon Geerts
- Department of Biomedical Sciences, Institute of Tropical Medicine Antwerp, Belgium
| | - Nick Van Reet
- Department of Biomedical Sciences, Institute of Tropical Medicine Antwerp, Belgium
| | - Sander Leyten
- Advanced Practical Diagnostics BVBA, Turnhout, Belgium
| | - Raf Berghmans
- Advanced Practical Diagnostics BVBA, Turnhout, Belgium
| | - Kat S Rock
- Mathematics Institute, University of Warwick, Coventry, United Kingdom
| | - Theresa Ht Coetzer
- School of Life Sciences, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - Lauren E-A Eyssen
- School of Life Sciences, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - Philippe Büscher
- Department of Biomedical Sciences, Institute of Tropical Medicine Antwerp, Belgium
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31
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Introduction: immunopathology of unresolved tropical diseases. Semin Immunopathol 2020; 42:229-230. [PMID: 32556442 PMCID: PMC7299133 DOI: 10.1007/s00281-020-00797-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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