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The Maze Pathway of Coevolution: A Critical Review over the Leishmania and Its Endosymbiotic History. Genes (Basel) 2021; 12:genes12050657. [PMID: 33925663 PMCID: PMC8146029 DOI: 10.3390/genes12050657] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/01/2021] [Accepted: 04/05/2021] [Indexed: 01/10/2023] Open
Abstract
The description of the genus Leishmania as the causative agent of leishmaniasis occurred in the modern age. However, evolutionary studies suggest that the origin of Leishmania can be traced back to the Mesozoic era. Subsequently, during its evolutionary process, it achieved worldwide dispersion predating the breakup of the Gondwana supercontinent. It is assumed that this parasite evolved from monoxenic Trypanosomatidae. Phylogenetic studies locate dixenous Leishmania in a well-supported clade, in the recently named subfamily Leishmaniinae, which also includes monoxenous trypanosomatids. Virus-like particles have been reported in many species of this family. To date, several Leishmania species have been reported to be infected by Leishmania RNA virus (LRV) and Leishbunyavirus (LBV). Since the first descriptions of LRVs decades ago, differences in their genomic structures have been highlighted, leading to the designation of LRV1 in L. (Viannia) species and LRV2 in L. (Leishmania) species. There are strong indications that viruses that infect Leishmania spp. have the ability to enhance parasitic survival in humans as well as in experimental infections, through highly complex and specialized mechanisms. Phylogenetic analyses of these viruses have shown that their genomic differences correlate with the parasite species infected, suggesting a coevolutionary process. Herein, we will explore what has been described in the literature regarding the relationship between Leishmania and endosymbiotic Leishmania viruses and what is known about this association that could contribute to discussions about the worldwide dispersion of Leishmania.
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Gonçalves LP, Santos TVD, Campos MB, Lima LVDR, Ishikawa EAY, Silveira FT, Ramos PKS. Further insights into the eco-epidemiology of American cutaneous leishmaniasis in the Belem metropolitan region, Pará State, Brazil. Rev Soc Bras Med Trop 2020; 53:e20200255. [PMID: 33331607 PMCID: PMC7747830 DOI: 10.1590/0037-8682-0255-2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 10/19/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION: In the Belém Metropolitan Region (BMR), Pará State, Brazil, American
cutaneous leishmaniasis (ACL) is endemic; however, very little is known
regarding its causative agents. Therefore, we used our standard diagnostic
approach combined with an RNA polymerase II largest subunit
(RNAPOIILS)-polymerase chain reaction (PCR) followed by analysis of
restriction fragment length polymorphism (PCR-RFLP) to identify
Leishmania spp. ACL agents in this region. METHODS: Thirty-two Leishmania spp. isolates from patients with ACL
in the BMR during 1995-2018 were analyzed. Leishmania spp.
DNA samples were amplified using the primers RPOR2/RPOF2, and the 615-bp PCR
products were subjected to enzymatic digestion using TspRI
and HgaI endonucleases. RESULTS: ACL etiological agents in the BMR comprised Leishmania (Viannia)
lindenbergi (43.7%) followed by Leishmania (Viannia)
lainsoni (34.4%), Leishmania (Leishmania)
amazonensis (12.5%), and Leishmania (Viannia)
braziliensis (9.4%). CONCLUSIONS: To our knowledge, the results of the study revealed for the first time that
L. (V.) lindenbergi and L. (V.)
lainsoni are the main ACL agents in BMR.
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Affiliation(s)
- Lucas Pantoja Gonçalves
- Instituto Evandro Chagas, Laboratório de Leishmanioses 'Prof. Dr. Ralph Lainson', Seção de Parasitologia, Ananindeua, PA, Brasil
| | - Thiago Vasconcelos Dos Santos
- Instituto Evandro Chagas, Laboratório de Leishmanioses 'Prof. Dr. Ralph Lainson', Seção de Parasitologia, Ananindeua, PA, Brasil
| | - Marliane Batista Campos
- Instituto Evandro Chagas, Laboratório de Leishmanioses 'Prof. Dr. Ralph Lainson', Seção de Parasitologia, Ananindeua, PA, Brasil
| | - Luciana Vieira do Rêgo Lima
- Instituto Evandro Chagas, Laboratório de Leishmanioses 'Prof. Dr. Ralph Lainson', Seção de Parasitologia, Ananindeua, PA, Brasil
| | | | - Fernando Tobias Silveira
- Instituto Evandro Chagas, Laboratório de Leishmanioses 'Prof. Dr. Ralph Lainson', Seção de Parasitologia, Ananindeua, PA, Brasil.,Universidade Federal do Pará, Núcleo de Medicina Tropical, Belém, PA, Brasil
| | - Patrícia Karla Santos Ramos
- Instituto Evandro Chagas, Laboratório de Leishmanioses 'Prof. Dr. Ralph Lainson', Seção de Parasitologia, Ananindeua, PA, Brasil
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Cantanhêde LM, Fernandes FG, Ferreira GEM, Porrozzi R, Ferreira RDGM, Cupolillo E. New insights into the genetic diversity of Leishmania RNA Virus 1 and its species-specific relationship with Leishmania parasites. PLoS One 2018; 13:e0198727. [PMID: 29912912 PMCID: PMC6005476 DOI: 10.1371/journal.pone.0198727] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 05/23/2018] [Indexed: 12/16/2022] Open
Abstract
Cutaneous leishmaniasis is a neglected parasitic disease that manifests in infected individuals under different phenotypes, with a range of factors contributing to its broad clinical spectrum. One factor, Leishmania RNA Virus 1 (LRV1), has been described as an endosymbiont present in different species of Leishmania. LRV1 significantly worsens the lesion, exacerbating the immune response in both experimentally infected animals and infected individuals. Little is known about the composition and genetic diversity of these viruses. Here, we investigated the relationship between the genetic composition of LRV1 detected in strains of Leishmania (Viannia) braziliensis and L. (V.) guyanensis and the interaction between the endosymbiont and the parasitic species, analyzing an approximately 850 base pair region of the viral genome. We also included one LRV1 sequence detected in L. (V.) shawi, representing the first report of LRV1 in a species other than L. braziliensis and L. guyanensis. The results illustrate the genetic diversity of the LRV1 strains analyzed here, with smaller divergences detected among viral sequences from the same parasite species. Phylogenetic analyses showed that the LRV1 sequences are grouped according to the parasite species and possibly according to the population of the parasite in which the virus was detected, corroborating the hypothesis of joint evolution of the viruses with the speciation of Leishmania parasites.
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Affiliation(s)
- Lilian Motta Cantanhêde
- Laboratório de Epidemiologia Genética, Fundação Oswaldo Cruz, Unidade Rondônia, Porto Velho, Rondônia, Brazil
| | - Flavia Gonçalves Fernandes
- Laboratório de Epidemiologia Genética, Fundação Oswaldo Cruz, Unidade Rondônia, Porto Velho, Rondônia, Brazil
| | | | - Renato Porrozzi
- Laboratório de Pesquisa em Leishmaniose, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Elisa Cupolillo
- Laboratório de Pesquisa em Leishmaniose, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
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Fagundes-Silva GA, Romero GAS, Cupolillo E, Yamashita EPG, Gomes-Silva A, Guerra JADO, Da-Cruz AM. Leishmania (Viannia) naiffi: rare enough to be neglected? Mem Inst Oswaldo Cruz 2016; 110:797-800. [PMID: 26517660 PMCID: PMC4667584 DOI: 10.1590/0074-02760150128] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 07/14/2015] [Indexed: 11/25/2022] Open
Abstract
In the Brazilian Amazon, American tegumentary leishmaniasis (ATL) is endemic and
presents a wide spectrum of clinical manifestations due, in part, to the circulation
of at least seven Leishmania species. Few reports of
Leishmania (Viannia) naiffi infection suggest that its occurrence
is uncommon and the reported cases present a benign clinical course and a good
response to treatment. This study aimed to strengthen the clinical and
epidemiological importance of L. (V.) naiffi in the Amazon Region
(Manaus, state of Amazonas) and to report therapeutic failure in patients infected
with this species. Thirty Leishmania spp samples isolated from
cutaneous lesions were characterised by multilocus enzyme electrophoresis. As
expected, the most common species was Leishmania (V.) guyanensis (20
cases). However, a relevant number ofL. (V.) naiffi patients (8
cases) was observed, thus demonstrating that this species is not uncommon in the
region. No patient infected withL. (V.) naiffi evolved to
spontaneous cure until the start of treatment, which indicated that this species may
not have a self-limiting nature. In addition, two of the patients experienced a poor
response to antimonial or pentamidine therapy. Thus, either ATL cases due to
L. (V.) naiffi cannot be as uncommon as previously thought or
this species is currently expanding in this region.
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Affiliation(s)
| | | | - Elisa Cupolillo
- Laboratório de Pesquisas em Leishmaniose, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | | | - Adriano Gomes-Silva
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | | | - Alda Maria Da-Cruz
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
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Cantanhêde LM, da Silva Júnior CF, Ito MM, Felipin KP, Nicolete R, Salcedo JMV, Porrozzi R, Cupolillo E, Ferreira RDGM. Further Evidence of an Association between the Presence of Leishmania RNA Virus 1 and the Mucosal Manifestations in Tegumentary Leishmaniasis Patients. PLoS Negl Trop Dis 2015; 9:e0004079. [PMID: 26372217 PMCID: PMC4570810 DOI: 10.1371/journal.pntd.0004079] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 08/21/2015] [Indexed: 01/08/2023] Open
Abstract
Tegumentary Leishmaniasis (TL) is endemic in Latin America, and Brazil contributes approximately 20 thousand cases per year. The pathogenesis of TL, however, is still not fully understood. Clinical manifestations vary from cutaneous leishmaniasis (CL) to more severe outcomes, such as disseminated leishmaniasis (DL), mucosal leishmaniasis (ML) and diffuse cutaneous leishmaniasis (DCL). Many factors have been associated with the severity of the disease and the development of lesions. Recent studies have reported that the presence of Leishmania RNA virus 1 infecting Leishmania (Leishmania RNA virus 1, LRV1) is an important factor associated with the severity of ML in experimental animal models. In the present study, 156 patients who attended Rondonia's Hospital of Tropical Medicine with both leishmaniasis clinical diagnoses (109 CL; 38 ML; 5 CL+ML; 3 DL and 1 DCL) and molecular diagnoses were investigated. The clinical diagnosis were confirmed by PCR by targeting hsp70 and kDNA DNA sequences and the species causing the infection were determined by HSP70 PCR-RFPL. The presence of LVR1 was tested by RT-PCR. Five Leishmania species were detected: 121 (77.6%) samples were positive for Leishmania (Viannia) braziliensis, 18 (11.5%) were positive for Leishmania (V.) guyanensis, 3 (1.8%) for Leishmania (V.) lainsoni, 2 (1.3%) for Leishmania (Leishmania) amazonensis and 2 (1.3%) for Leishmania (V.) shawi. Six (3.9%) samples were positive for Leishmania sp. but the species could not be determined, and 4 (2.6%) samples were suggestive of mixed infection by L. (V.) braziliensis and L. (V.) guyanensis. The virus was detected in L. braziliensis (N = 54), L. guyanensis (N = 5), L. amazonensis (N = 2), L. lainsoni (N = 1) and inconclusive samples (N = 6). Patients presenting with CL+ML, DL and DCL were excluded from further analysis. Association between the presence of the virus and the disease outcome were tested among the remaining 147 patients (CL = 109 and ML = 38). Of them, 71.1% (n = 27) mucosal lesions were positive for LRV1, and 28.9% (n = 11) were negative. In cutaneous lesions, 36.7% (n = 40) were positive and 63.3% (n = 69) were negative for LRV1. The ratio P(ML|LRV1+)/P(ML|LRV1-) was 2.93 (CI95% 1.57…5.46; p<0.001), thus corroborating the hypothesis of the association between LRV1 and the occurrence of mucosal leishmaniasis, as previously described in animal models; it also indicates that LRV1 is not the only factor contributing to the disease outcome. Leishmaniasis is an infectious disease caused by protozoa of the genus Leishmania. Tegumentary Leishmaniasis (TL) is characterized by a variety of clinical forms, ranging from simple skin lesions to more severe lesions with mucosal destruction. The mechanisms by which some patients develop a severe form of the disease remain unclear. It is already known that the immune statuses of the host and parasite species are key factors influencing the clinical outcome of the disease, but is not known which are the factors that influence the parasite’s tropism to the mucosal regions. Recently, a virus found infecting Leishmania, Leishmania RNA virus 1 (LRV1), has also been reported as one important factor contributing to the disease severity. The present article reports, among 147 investigated patients from the Brazilian Western Amazon, a higher frequency of LRV1 among patients with mucosal lesions compared to patients with cutaneous lesions, statistically demonstrating that the virus is related to the worsening of the disease, increasing the risk of developing mucosal injury by almost 3 times.
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Affiliation(s)
| | | | - Marcos Massayuki Ito
- Secretaria de Saúde, Governo do Estado de Rondonia, Porto Velho, Rondonia, Brazil
| | | | - Roberto Nicolete
- Fundação Oswaldo Cruz, Unidade Rondonia, Porto Velho, Rondonia, Brazil
| | | | - Renato Porrozzi
- Laboratório de Pesquisa em Leishmaniose, Instituto Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Elisa Cupolillo
- Laboratório de Pesquisa em Leishmaniose, Instituto Oswaldo Cruz, Rio de Janeiro, Brazil
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Jennings YL, de Souza AAA, Ishikawa EA, Shaw J, Lainson R, Silveira F. Phenotypic characterization of Leishmania spp. causing cutaneous leishmaniasis in the lower Amazon region, western Pará state, Brazil, reveals a putative hybrid parasite, Leishmania (Viannia) guyanensis × Leishmania (Viannia) shawi shawi. ACTA ACUST UNITED AC 2014; 21:39. [PMID: 25083790 PMCID: PMC4118625 DOI: 10.1051/parasite/2014039] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Accepted: 07/14/2014] [Indexed: 11/14/2022]
Abstract
We phenotypically characterized 43 leishmanial parasites from cutaneous leishmaniasis by isoenzyme electrophoresis and the indirect immunofluorescence antibody test (23 McAbs). Identifications revealed 11 (25.6%) strains of Leishmania (V.) braziliensis, 4 (9.3%) of L. (V.) shawi shawi, 7 (16.3%) of L. (V.) shawi santarensis, 6 (13.9%) of L. (V.) guyanensis and L. (V.) lainsoni, 2 (4.7%) of L. (L.) amazonensis, and 7 (16.3%) of a putative hybrid parasite, L. (V.) guyanensis/L. (V.) shawi shawi. McAbs detected three different serodemes of L. (V.) braziliensis: I-7, II-1, and III-3 strains. Among the strains of L. (V.) shawi we identified two populations: one (7 strains) expressing the B19 epitope that was previously considered to be species-specific for L. (V.) guyanensis. We have given this population sub-specific rank, naming it L. (V.) s. santarensis. The other one (4 strains) did not express the B19 epitope like the L. (V.) shawi reference strain, which we now designate as L. (V.) s. shawi. For the first time in the eastern Brazilian Amazon we register a putative hybrid parasite (7 strains), L. (V.) guyanensis/L. (V.) s. shawi, characterized by a new 6PGDH three-band profile at the level of L. (V.) guyanensis. Its PGM profile, however, was very similar to that of L. (V.) s. shawi. These results suggest that the lower Amazon region – western Pará state, Brazil, represents a biome where L. (V.) guyanensis and L. (V.) s. shawi exchange genetic information.
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Affiliation(s)
- Yara Lins Jennings
- Parasitology Department, Institute Evandro Chagas (Surveillance Secretary of Health, Ministry of Health), Belém, Pará state, Brazil
| | - Adelson Alcimar Almeida de Souza
- Parasitology Department, Institute Evandro Chagas (Surveillance Secretary of Health, Ministry of Health), Belém, Pará state, Brazil
| | - Edna Aoba Ishikawa
- Tropical Medicine Nucleus, Federal University of Pará, Belém, Pará state, Brazil
| | - Jeffrey Shaw
- Biomedical Sciences Institute, São Paulo University, São Paulo, São Paulo state, Brazil
| | - Ralph Lainson
- Parasitology Department, Institute Evandro Chagas (Surveillance Secretary of Health, Ministry of Health), Belém, Pará state, Brazil
| | - Fernando Silveira
- Parasitology Department, Institute Evandro Chagas (Surveillance Secretary of Health, Ministry of Health), Belém, Pará state, Brazil - Tropical Medicine Nucleus, Federal University of Pará, Belém, Pará state, Brazil
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Kuhls K, Cupolillo E, Silva SO, Schweynoch C, Côrtes Boité M, Mello MN, Mauricio I, Miles M, Wirth T, Schönian G. Population structure and evidence for both clonality and recombination among Brazilian strains of the subgenus Leishmania (Viannia). PLoS Negl Trop Dis 2013; 7:e2490. [PMID: 24205418 PMCID: PMC3814519 DOI: 10.1371/journal.pntd.0002490] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Accepted: 09/08/2013] [Indexed: 12/03/2022] Open
Abstract
Background/Objectives: Parasites of the subgenus Leishmania (Viannia) cause varying clinical symptoms ranging from cutaneous leishmaniases (CL) with single or few lesions, disseminated CL (DL) with multiple lesions to disfiguring forms of mucocutaneous leishmaniasis (MCL). In this population genetics study, 37 strains of L. (V.) guyanensis, 63 of L. (V.) braziliensis, four of L. (V.) shawi, six of L. (V.) lainsoni, seven of L. (V.) naiffi, one each of L. (V.) utingensis and L. (V.) lindenbergi, and one L. (V.) lainsoni/L. naiffi hybrid from different endemic foci in Brazil were examined for variation at 15 hyper-variable microsatellite markers. Methodology/Principal findings: The multilocus microsatellite profiles obtained for the 120 strains were analysed using both model- and distance-based methods. Significant genetic diversity was observed for all L. (Viannia) strains studied. The two cluster analysis approaches identified two principal genetic groups or populations, one consisting of strains of L. (V.) guyanensis from the Amazon region and the other of strains of L. (V.) braziliensis isolated along the Atlantic coast of Brazil. A third group comprised a heterogeneous assembly of species, including other strains of L. braziliensis isolated from the north of Brazil, which were extremely polymorphic. The latter strains seemed to be more closely related to those of L. (V.) shawi, L. (V.) naiffi, and L. (V.) lainsoni, also isolated in northern Brazilian foci. The MLMT approach identified an epidemic clone consisting of 13 strains of L. braziliensis from Minas Gerais, but evidence for recombination was obtained for the populations of L. (V.) braziliensis from the Atlantic coast and for L. (V.) guyanensis. Conclusions/Significance: Different levels of recombination versus clonality seem to occur within the subgenus L. (Viannia). Though clearly departing from panmixia, sporadic, but long-term sustained recombination might explain the tremendous genetic diversity and limited population structure found for such L. (Viannia) strains. Cutaneous leishmaniasis (CL) constitutes a significant public health problem in all federal states of Brazil. Most cases are caused by parasites of the subgenus Leishmania (Viannia) which can cause a variety of clinical symptoms ranging from single or few lesions, disseminated CL with multiple lesions, to disfiguring forms of mucocutaneous leishmaniasis. This study has used a multilocus microsatellite typing approach for exploring the genetic diversity and population structure among 120 strains representing different subgenus L. (Viannia) species and different Brazilian CL foci. Genetic diversity within the subgenus was much higher than expected, especially within L. (V.) braziliensis, L. (V.) shawi, L. (V.) naiffi, and L. (V.) lainsoni which were all from the north of Brazil. These strains could not be assigned to well-defined populations, but presented a rather loosely associated group. Strains of L. (V.) braziliensis isolated along the Atlantic coast of Brazil and strains of L. (V.) guyanensis formed, however, two clearly separated populations exhibiting remarkable levels of sexual exchange. The latter finding is in contrast to previous studies suggesting clonal modes of propagation or inbreeding for natural populations of Leishmania parasites and might explain the genetic heterogeneity and limited population structure for Brazilian strains of subgenus L. (Viannia) observed in this study.
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Affiliation(s)
- Katrin Kuhls
- Institut für Mikrobiologie und Hygiene, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Elisa Cupolillo
- Laboratório de Pesquisa em Leishmaniose, Instituto Oswaldo Cruz - Fiocruz, Rio de Janeiro, Brazil
| | - Soraia O. Silva
- Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Carola Schweynoch
- Institut für Mikrobiologie und Hygiene, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Mariana Côrtes Boité
- Laboratório de Pesquisa em Leishmaniose, Instituto Oswaldo Cruz - Fiocruz, Rio de Janeiro, Brazil
| | - Maria N. Mello
- Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Isabel Mauricio
- Instituto de Higiene e Medicina Tropical, Lisboa, Portugal
- Department of Pathogen Molecular Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Michael Miles
- Department of Pathogen Molecular Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Thierry Wirth
- Ecole Pratique des Hautes Etudes, Muséum National d'Histoire Naturelle, Département de Systématique et Évolution, UMR-CNRS 7205, Paris, France
| | - Gabriele Schönian
- Institut für Mikrobiologie und Hygiene, Charité Universitätsmedizin Berlin, Berlin, Germany
- * E-mail:
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Torres DC, Ribeiro-Alves M, Romero GAS, Dávila AMR, Cupolillo E. Assessment of drug resistance related genes as candidate markers for treatment outcome prediction of cutaneous leishmaniasis in Brazil. Acta Trop 2013; 126:132-41. [PMID: 23416123 DOI: 10.1016/j.actatropica.2013.02.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 01/28/2013] [Accepted: 02/05/2013] [Indexed: 12/21/2022]
Abstract
The great public health problem posed by leishmaniasis has substantially worsened in recent years by the emergence of clinical failure. In Brazil, the poor prognosis observed for patients infected by Leishmania braziliensis (Lb) or L. guyanensis (Lg) may be related to parasite drug resistance. In the present study, 19 Lb and 29 Lg isolates were obtained from infected patients with different treatment outcomes. Translated amino acid sequence polymorphisms from four described antimony resistance related genes (AQP1, hsp70, MRPA and TRYR) were tested as candidate markers for antimonial treatment failure prediction. Possibly due to the low intraspecific variability observed in Lg samples, none of the prediction models had good prognosis values. Most strikingly, one mutation (T579A) found in hsp70 of Lb samples could predict 75% of the antimonial treatment failure clinical cases. Moreover, a multiple logistic regression model showed that the change from adenine to guanine at position 1735 of the hsp70 gene, which is responsible for the T579A mutation, significantly increased the chance of Lb clinical isolates to be associated with treatment failure (OR=7.29; CI 95%=[1.17, 45.25]; p=0.0331). The use of molecular markers to predict treatment outcome presents practical and economic advantages as it allows the development of rapid assays to monitor the emergence of drug resistant parasites that can be clinically applied to aid the prognosis of cutaneous leishmaniasis in Brazil.
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Affiliation(s)
- Davi Coe Torres
- Laboratório de Pesquisa em Leishmaniose/Coleção de Leishmania do Instituto Oswaldo Cruz (IOC) - Fiocruz, Rio de Janeiro, Brazil
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Chrusciak-Talhari A, Dietze R, Chrusciak Talhari C, da Silva RM, Gadelha Yamashita EP, de Oliveira Penna G, Lima Machado PR, Talhari S. Randomized controlled clinical trial to access efficacy and safety of miltefosine in the treatment of cutaneous leishmaniasis Caused by Leishmania (Viannia) guyanensis in Manaus, Brazil. Am J Trop Med Hyg 2011; 84:255-60. [PMID: 21292895 DOI: 10.4269/ajtmh.2011.10-0155] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Miltefosine has been used in the treatment of several new world cutaneous leishmaniasis (CL) species with variable efficacy. Our study is the first evidence on its clinical efficacy in Leishmania (Viannia) guyanensis. In this phase II/III randomized clinical trial, 90 CL patients were randomly allocated (2:1) to oral miltefosine (2.5 mg/kg/day/28 days) (N = 60) or parenteral antimony (15-20 mg/Sb/kg/day/20 days) (N = 30) according to age groups: 2-12 y/o and 13-65 y/o. Patients were human immunodeficiency virus (HIV) noninfected parasitological proven CL without previous treatment. Definitive cure was accessed at 6 months follow-up visit. No severe adverse events occurred. Vomiting was the most frequent adverse event (48.3%) followed by nausea (8.6%) and diarrhea (6.7%). Cure rates were 71.4% (95% confidence interval [CI] = 57.8-82.7) and 53.6% (95% CI = 33.9-72.5) (P = 0.05) for miltefosine and antimonial, respectively. There were no differences in cure rates between age groups within the same treatment arms. Miltefosine was safe and relatively well tolerated and cure rate was higher than antimony.
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Affiliation(s)
- Anette Chrusciak-Talhari
- Fundação de Medicina Tropical do Amazonas and Universidade Estadual do Amazonas, Manaus, AM, Brasil.
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10
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Leishmania (Viannia) braziliensis identification by PCR in the state of Para, Brazil. Trans R Soc Trop Med Hyg 2011; 105:173-8. [DOI: 10.1016/j.trstmh.2010.11.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2009] [Revised: 11/16/2010] [Accepted: 11/16/2010] [Indexed: 11/19/2022] Open
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Characterization of Leishmania spp. causing cutaneous leishmaniasis in Manaus, Amazonas, Brazil. Parasitol Res 2010; 108:671-7. [PMID: 21072540 PMCID: PMC3040821 DOI: 10.1007/s00436-010-2139-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Accepted: 09/30/2010] [Indexed: 11/06/2022]
Abstract
In the State of Amazonas, American tegumentary leishmaniasis is endemic and presents a wide spectrum of clinical variability due to the large diversity of circulating species in the region. Isolates from patients in Manaus and its metropolitan region were characterized using monoclonal antibodies and isoenzymes belonging to four species of the parasite: Leishmania (Viannia) guyanensis, 73% (153/209); Leishmania (Viannia) braziliensis, 14% (30/209); Leishmania (Leishmania) amazonensis, 8% (17/209); and Leishmania (Viannia) naiffii, 4% (9/209). The most prevalent species was L. (V.) guyanensis. The principal finding of this study was the important quantity of infections involving more than one parasite species, representing 14% (29/209) of the total. The findings obtained in this work regarding the parasite are further highlighted by the fact that these isolates were obtained from clinical samples collected from single lesions.
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Matta NE, Cysne-Finkelstein L, Machado GMC, Da-Cruz AM, Leon L. Differences in the antigenic profile and infectivity of murine macrophages of Leishmania (Viannia) parasites. J Parasitol 2010; 96:509-15. [PMID: 20557195 DOI: 10.1645/ge-2241.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The antigenic profile and infectivity were compared between 3 recent Leishmania (Viannia) isolates from the Amazonian region (Instituto Nacional de Pesquisas da Amazonia [INPA] strains) and 3 World Health Organization (WHO) reference species (Leishmania guyanensis, Leishmania braziliensis, and Leishmania naiffi). Differences were observed in the peak and extent of promastigote growth. The WHO reference strains exhibited significantly higher exponential growth as promastigotes than INPA strains. In the immunoblot analyses, the INPA strains revealed several specific peptide fragments, as well as the greatest recognition frequencies by sera from Leishmania sp.-infected patients; among the latter, antigens derived from L. naiffi were the most frequently recognized. In vitro infection was carried out using mice peritoneal macrophages; all strains were able to enter the macrophages, but only L. amazonensis was able to reproduce. A striking observation was that L. naiffi exhibited the longest survival time inside the macrophages. Our data strongly suggest the application of recently isolated parasites as sources of antigen for diagnosis procedures. Moreover, L. naiffi species possesses several characteristics relevant for its use as a source of novel antigens to be explored in the design of diagnostic tools and vaccines.
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Affiliation(s)
- Nubia E Matta
- Departamento de Biología, Universidad Nacional de Colombia, Bogotá, Colombia.
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Amato VS, Tuon FF, de Andrade, Jr HF, Bacha H, Pagliari C, Fernandes ER, Duarte MIS, Neto VA, Zampieri RA, Floeter-Winter LM, Celeste BJ, Oliveira J, Quiroga MM, Mascheretti M, Boulos M. Immunohistochemistry and polymerase chain reaction on paraffin-embedded material improve the diagnosis of cutaneous leishmaniasis in the Amazon region. Int J Dermatol 2009; 48:1091-5. [DOI: 10.1111/j.1365-4632.2009.04099.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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van der Meide WF, Sabajo LOA, Jensema AJ, Peekel I, Faber WR, Schallig HDFH, Fat RFMLA. Evaluation of treatment with pentamidine for cutaneous leishmaniasis in Suriname. Int J Dermatol 2009; 48:52-8. [DOI: 10.1111/j.1365-4632.2009.03883.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Tojal da Silva AC, Cupolillo E, Volpini AC, Almeida R, Romero GAS. Species diversity causing human cutaneous leishmaniasis in Rio Branco, state of Acre, Brazil. Trop Med Int Health 2006; 11:1388-98. [PMID: 16930261 DOI: 10.1111/j.1365-3156.2006.01695.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Information on Leishmania species diversity in western Brazilian Amazon and the clinical picture of human cutaneous leishmaniasis it causes is scarce. We describe clinical findings, diagnostic procedures and identification of Leishmania species in patients from that region. METHODS The sample consisted of 50 patients, prospectively evaluated for epidemiological and clinical characteristics by means of a structured questionnaire. Conventional and molecular tools were applied to confirm the parasitological diagnosis and identify the species responsible for the disease. RESULTS Patients were predominantly male (76.5%) and living in rural areas. Median average age was 18 years and median average disease evolution was 8 weeks. For the diagnostic procedures of leishmanin skin test, direct visualization of amastigotes in dermal scrapings and parasite culture of aspirates of the ulcer border were positive for 98%, 52% and 34%, respectively. Molecular methods applied to DNA extracted from skin biopsies of the 50 patients yielded 100%, 82% and 44% positivity by PCR minicircle kDNA, PCR-RFLP ITS1rDNA and PCR-glucose-6-phosphate (G6P), respectively. Fourteen samples from 13 patients were successfully isolated and identified. Multilocus enzyme electrophoresis, PCR-RFLP ITS1rDNA and PCR-G6P permitted identification of the Leishmania species responsible for the aetiology of American tegumentary leishmaniasis in 60% of the examined patients: 16 Leishmania (Viannia) braziliensis, 12 Leishmania (Viannia) lainsoni, 1 Leishmania (Viannia) guyanensis and 1 putative hybrid of Leishmania (Viannia) naiffi and L. (V.) lainsoni. CONCLUSION The clinical and epidemiological behaviour of cutaneous leishmaniasis in Acre, Brazil, is similar to other Amazon scenarios previously described; however Acre's complex parasite diversity may be contributed to the concomitant circulation of at least three distinct Leishmania species. The implementation of control interventions in the studied area must take into consideration the possibility of various expected phlebotomine vectors and reservoirs.
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Affiliation(s)
- Anna Christina Tojal da Silva
- Núcleo de Medicina Tropical, Universidade de Brasília, Campus Darcy Ribeiro, Brasília, DF, and Serviço de Imunologia, Hospital Universitário Professor Edgar Santos, Salvador, Brazil
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