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Inácio MM, Moreira ALE, Cruz-Leite VRM, Mattos K, Silva LOS, Venturini J, Ruiz OH, Ribeiro-Dias F, Weber SS, Soares CMDA, Borges CL. Fungal Vaccine Development: State of the Art and Perspectives Using Immunoinformatics. J Fungi (Basel) 2023; 9:633. [PMID: 37367569 DOI: 10.3390/jof9060633] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/12/2023] [Accepted: 05/19/2023] [Indexed: 06/28/2023] Open
Abstract
Fungal infections represent a serious global health problem, causing damage to health and the economy on the scale of millions. Although vaccines are the most effective therapeutic approach used to combat infectious agents, at the moment, no fungal vaccine has been approved for use in humans. However, the scientific community has been working hard to overcome this challenge. In this sense, we aim to describe here an update on the development of fungal vaccines and the progress of methodological and experimental immunotherapies against fungal infections. In addition, advances in immunoinformatic tools are described as an important aid by which to overcome the difficulty of achieving success in fungal vaccine development. In silico approaches are great options for the most important and difficult questions regarding the attainment of an efficient fungal vaccine. Here, we suggest how bioinformatic tools could contribute, considering the main challenges, to an effective fungal vaccine.
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Affiliation(s)
- Moisés Morais Inácio
- Laboratory of Molecular Biology, Institute of Biological Sciences, Federal University of Goiás, Goiânia 74605-170, Brazil
- Estácio de Goiás University Center, Goiânia 74063-010, Brazil
| | - André Luís Elias Moreira
- Laboratory of Molecular Biology, Institute of Biological Sciences, Federal University of Goiás, Goiânia 74605-170, Brazil
| | | | - Karine Mattos
- Faculty of Medicine, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | - Lana O'Hara Souza Silva
- Laboratory of Molecular Biology, Institute of Biological Sciences, Federal University of Goiás, Goiânia 74605-170, Brazil
| | - James Venturini
- Faculty of Medicine, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | - Orville Hernandez Ruiz
- MICROBA Research Group-Cellular and Molecular Biology Unit-CIB, School of Microbiology, University of Antioquia, Medellín 050010, Colombia
| | - Fátima Ribeiro-Dias
- Laboratório de Imunidade Natural (LIN), Instituto de Patologia Tropical e Saúde Pública, Federal University of Goiás, Goiânia 74001-970, Brazil
| | - Simone Schneider Weber
- Bioscience Laboratory, Faculty of Pharmaceutical Sciences, Food and Nutrition, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | - Célia Maria de Almeida Soares
- Laboratory of Molecular Biology, Institute of Biological Sciences, Federal University of Goiás, Goiânia 74605-170, Brazil
| | - Clayton Luiz Borges
- Laboratory of Molecular Biology, Institute of Biological Sciences, Federal University of Goiás, Goiânia 74605-170, Brazil
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Unraveling the susceptibility of paracoccidioidomycosis: Insights towards the pathogen-immune interplay and immunogenetics. INFECTION GENETICS AND EVOLUTION 2020; 86:104586. [PMID: 33039601 DOI: 10.1016/j.meegid.2020.104586] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 09/27/2020] [Accepted: 10/05/2020] [Indexed: 02/07/2023]
Abstract
Paracoccidioidomycosis (PCM) is a life-threatening systemic mycosis caused by Paracoccidioides spp. This disease comprises three clinical forms: symptomatic acute and chronic forms (PCM disease) and PCM infection, a latent form without clinical symptoms. PCM disease differs markedly according to severity, clinical manifestations, and host immune response. Fungal virulence factors and adhesion molecules are determinants for entry, latency, immune escape and invasion, and dissemination in the host. Neutrophils and macrophages play a paramount role in first-line defense against the fungus through the recognition of antigens by pattern recognition receptors (PRRs), activating their microbicidal machinery. Furthermore, the clinical outcome of the PCM is strongly associated with the variability of cytokines and immunoglobulins produced by T and B cells. While the mechanisms that mediate susceptibility or resistance to infection are dictated by the immune system, some genetic factors may alter gene expression and its final products and, hence, modulate how the organism responds to infection and injury. This review outlines the main findings relative to this topic, addressing the complexity of the immune response triggered by Paracoccidioides spp. infection from preclinical investigations to studies in humans. Here, we focus on mechanisms of fungal pathogenesis, the patterns of innate and adaptive immunity, and the genetic and molecular basis related to immune response and susceptibility to the development of the PCM and its clinical forms. Immunogenetic features such as HLA system, cytokines/cytokines receptors genes and other immune-related genes, and miRNAs are likewise discussed. Finally, we point out the occurrence of PCM in patients with primary immunodeficiencies and call attention to the research gaps and challenges faced by the PCM field.
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Sato PK, Busser FD, Carvalho FMDC, Gomes Dos Santos A, Sadahiro A, Diogo CL, Kono ASG, Moretti ML, Luiz ODC, Shikanai-Yasuda MA. Polymorphism in the Promoter Region of the IL18 Gene and the Association With Severity on Paracoccidioidomycosis. Front Immunol 2020; 11:542210. [PMID: 33117339 PMCID: PMC7559583 DOI: 10.3389/fimmu.2020.542210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 08/21/2020] [Indexed: 01/06/2023] Open
Abstract
Paracoccidioidomycosis (PCM) is an important endemic, systemic disease in Latin America caused by Paracoccidioides spp. This mycosis has been associated with high morbidity and sequels, and its clinical manifestations depend on the virulence of the infecting strain, the degree and type of immune response, infected tissues, and intrinsic characteristics of the host. The T helper(Th)1 and Th17/Th22 cells are related to resistance and control of infection, and a Th2/Th9 response is associated with disease susceptibility. In this study, we focused on interleukin(IL)-12p35 (IL12A), IL-18 (IL18), and IFN-γ receptor 1 (IFNGR1) genetic polymorphisms because their respective roles have been described in human PCM. Real-time PCR was employed to analyze IL12A-504 G/T (rs2243115), IL18-607 C/A (rs1946518), and IFNGR1-611 A/G (rs1327474) single nucleotide polymorphisms (SNP). One hundred forty-nine patients with the acute form (AF), multifocal chronic (MC), or unifocal chronic (UC) forms of PCM and 110 non-PCM individuals as a control group were included. In the unconditional logistic regression analysis adjusted by ethnicity and sex, we observed a high risk of the IL18-607 A-allele for both AF [p = 0.015; OR = 3.10 (95% CI: 1.24–7.77)] and MC groups [p = 0.023; OR = 2.61 (95% CI: 1.14–5.96)] when compared with UC. The IL18-607 A-allele associated risk for the AF and MC groups as well as the protective role of the C-allele in UC are possibly linked to higher levels of IL-18 at different periods of the course of the disease. Therefore, a novel role of IL18-607 C/A SNP is shown in the present study, highlighting its importance in the outcome of PCM.
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Affiliation(s)
- Paula Keiko Sato
- Laboratory of Medical Investigation in Immunology (LIM48), Faculdade de Medicina, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.,Institute of Tropical Medicine, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | - Felipe Delatorre Busser
- Laboratory of Medical Investigation in Immunology (LIM48), Faculdade de Medicina, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.,Institute of Tropical Medicine, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | - Flávia Mendes da Cunha Carvalho
- Laboratory of Medical Investigation in Immunology (LIM48), Faculdade de Medicina, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.,Department of Infectious and Parasitic Diseases, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | - Alexandra Gomes Dos Santos
- Laboratory of Medical Investigation in Immunology (LIM48), Faculdade de Medicina, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.,Department of Infectious and Parasitic Diseases, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | - Aya Sadahiro
- Department of Parasitology, Instituto de Ciências Biológicas, Federal University of Amazonas, Manaus, Brazil
| | - Constancia Lima Diogo
- Laboratory of Medical Investigation in Immunology (LIM48), Faculdade de Medicina, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.,Institute of Tropical Medicine, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | | | - Maria Luiza Moretti
- Faculdade de Ciências Médicas, Hospital das Clínicas, State University of Campinas, Campinas, Brazil
| | - Olinda do Carmo Luiz
- Department of Preventive Medicine, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | - Maria Aparecida Shikanai-Yasuda
- Laboratory of Medical Investigation in Immunology (LIM48), Faculdade de Medicina, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.,Institute of Tropical Medicine, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil.,Department of Infectious and Parasitic Diseases, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
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Mendes RP, Cavalcante RDS, Marques SA, Marques MEA, Venturini J, Sylvestre TF, Paniago AMM, Pereira AC, da Silva JDF, Fabro AT, Bosco SDMG, Bagagli E, Hahn RC, Levorato AD. Paracoccidioidomycosis: Current Perspectives from Brazil. Open Microbiol J 2017; 11:224-282. [PMID: 29204222 PMCID: PMC5695158 DOI: 10.2174/1874285801711010224] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 10/10/2017] [Accepted: 10/10/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND This review article summarizes and updates the knowledge on paracoccidioidomycosis. P lutzii and the cryptic species of P. brasiliensis and their geographical distribution in Latin America, explaining the difficulties observed in the serological diagnosis. OBJECTIVES Emphasis has been placed on some genetic factors as predisposing condition for paracoccidioidomycosis. Veterinary aspects were focused, showing the wide distribution of infection among animals. The cell-mediated immunity was better characterized, incorporating the recent findings. METHODS Serological methods for diagnosis were also compared for their parameters of accuracy, including the analysis of relapse. RESULTS Clinical forms have been better classified in order to include the pictures less frequently observesiod. CONCLUSION Itraconazole and the trimethoprim-sulfamethoxazole combination was compared regarding efficacy, effectiveness and safety, demonstrating that azole should be the first choice in the treatment of paracoccidioidomycosis.
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Affiliation(s)
- Rinaldo Poncio Mendes
- Department of Tropical Diseases, Faculdade de Medicina de Botucatu – São Paulo State University – UNESP, São Paulo, Brazil
| | - Ricardo de Souza Cavalcante
- Department of Tropical Diseases, Faculdade de Medicina de Botucatu – São Paulo State University – UNESP, São Paulo, Brazil
| | - Sílvio Alencar Marques
- Department of Dermatology, Faculdade de Medicina de Botucatu – São Paulo State University – UNESP, São Paulo, Brazil
| | | | - James Venturini
- Laboratory of Experimental Immunology, Department of Biological Science, Faculty of Science, São Paulo State University – UNESP, São Paulo, Brazil
| | - Tatiane Fernanda Sylvestre
- Department of Tropical Diseases, Faculdade de Medicina de Botucatu – São Paulo State University – UNESP, São Paulo, Brazil
| | - Anamaria Mello Miranda Paniago
- Department of Infectious and Parasitic Diseases, Faculdade de Medicina – Federal University of Mato Grosso do Sul – UFMS, Brazil
| | | | - Julhiany de Fátima da Silva
- Department of Tropical Diseases, Faculdade de Medicina de Botucatu – São Paulo State University – UNESP, São Paulo, Brazil
| | - Alexandre Todorovic Fabro
- Unit of Experimental Research, Faculdade de Medicina de Botucatu – São Paulo State University – UNESP, São Paulo, Brazil
| | - Sandra de Moraes Gimenes Bosco
- Department of Microbiology and Immunology – Instituto de Biociências de Botucatu – São Paulo State University – UNESP, São Paulo, Brazil
| | - Eduardo Bagagli
- Department of Microbiology and Immunology – Instituto de Biociências de Botucatu – São Paulo State University – UNESP, São Paulo, Brazil
| | - Rosane Christine Hahn
- Laboratory of Investigation and Mycology, Federal University of Mato Grosso, Faculty of Medicine Cuiabá, Mato Grosso, Brazil
| | - Adriele Dandara Levorato
- Department of Tropical Diseases, Faculdade de Medicina de Botucatu – São Paulo State University – UNESP, São Paulo, Brazil
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Polymorphisms on IFNG, IL12B and IL12RB1 genes and paracoccidioidomycosis in the Brazilian population. INFECTION GENETICS AND EVOLUTION 2016; 43:245-51. [PMID: 27223631 DOI: 10.1016/j.meegid.2016.05.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 04/07/2016] [Accepted: 05/17/2016] [Indexed: 01/16/2023]
Abstract
Paracoccidioidomycosis (PCM) is a systemic chronic mycosis, endemic in Latin America, especially Brazil, and is the eighth leading cause of death among chronic and recurrent infectious diseases. PCM infection is characterized by the presence of Th1 immune response; the acute form, by a mixed Th2/Th9, while the chronic form is characterized by Th17/Th22 profiles. The occurrence and severity of human PCM may also be associated with genetic factors such as single nucleotide polymorphisms (SNP) on cytokines encoding genes. We investigated the association between these polymorphisms and the different clinical forms of PCM. We included 156 patients with PCM (40 with the acute form, 99 with the chronic multifocal and 17 with the chronic unifocal form) and assayed their DNA samples for IFNG +874 T/A SNP by PCR-ARMS (Amplification Refractory Mutational System), IL12B +1188 A/C SNP on 3' UTR and IL12RB1 641 A/G SNP on exon 7 by PCR-RFLP (Restriction Fragment Length Polymorphism). We found similar genotypic and allelic frequencies of the investigated SNPs among the clinical forms of PCM. Considering male patients, the IL12RB1 641 AA genotype was more frequent in the chronic multifocal form while heterozygosis was in the chronic unifocal form of PCM (p=0.048). Although our data suggest that the AA genotype (IL12RB1) may be associated with the more disseminated chronic disease, more patients of the chronic unifocal PCM group need to be analyzed as well as the secretion patterns of IFN-γ combined with the IL-12Rβ1 expression for a better comprehension of this association.
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Abstract
The epidemiological characteristics of paracoccidioidomycosis were reviewed and
updated. The new endemic areas in Brazil were discussed in the section regarding the
geographic distribution of the mycosis. Subclinical infection with
Paracoccidioides brasiliensis was discussed on the basis of skin
test surveys with antigens of the fungus, seroepidemiological studies, and disease
cases outside Latin America. Large case series permitted a comparison of the
prevalence of the mycosis in different regions, its estimated incidence and risk
factors for the development of the disease. Aspects modulating the expression of the
clinical forms of paracoccidioidomycosis are also presented. This review also deals
with diseases associated with the mycosis, opportunistic paracoccidioidomycosis,
lethality, mortality and infection and disease in animals.
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Affiliation(s)
- Roberto Martinez
- Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Pedroso VSP, Lyon AC, Araújo SA, Veloso JMR, Pedroso ERP, Teixeira AL. Paracoccidioidomycosis case series with and without central nervous system involvement. Rev Soc Bras Med Trop 2013; 45:586-90. [PMID: 23152341 DOI: 10.1590/s0037-86822012000500009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 05/22/2012] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Paracoccidioidomycosis (PCM) is the most important systemic mycosis in South America. Central nervous system involvement is potentially fatal and can occur in 12.5% of cases. This paper aims to contribute to the literature describing eight cases of neuroparacoccidioidomycosis (NPMC) and compare their characteristics with patients without neurological involvement, to identify unique characteristics of NPCM. METHODS A cohort of 213 PCM cases was evaluated at the Infectious Diseases Clinic of the University Hospital, Federal University of Minas Gerais, Brazil, from October 1976 to August 2008. Epidemiological, clinical, laboratory, therapeutic and follow-up data were registered. RESULTS Eight patients presented NPCM. The observed NPCM prevalence was 3.8%. One patient presented the subacute form of PCM and the other seven presented the chronic form of the disease. The parenchymatous form of NPCM occurred in all patients. 60% of the patients who proceeded from the north/ northeast region of Minas Gerais State developed NPCM. The neurological involvement of a mother and her son was observed. NPCM patients exhibited demographical and clinical profiles similar to what is described in the literature. When NPCM cases were compared to PCM patients, there were differences in relation to origin and positive PCM family history. CONCLUSIONS The results corroborate the clinical view that the neurological findings are extremely important in the evaluation of PCM patients. Despite the limitations of this study, the differences in relation to patient's origins and family history point to the need of further studies to determine the susceptibility factors involved in the neurological compromise.
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Affiliation(s)
- Vinicius Sousa Pietra Pedroso
- Programa de Pós-Graduação em Infectologia e Medicina Tropical, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
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Bellissimo-Rodrigues F, Bollela VR, Da Fonseca BAL, Martinez R. Endemic paracoccidioidomycosis: relationship between clinical presentation and patients' demographic features. Med Mycol 2012; 51:313-8. [PMID: 22928923 DOI: 10.3109/13693786.2012.714529] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Paracoccidioidomycosis (PCM) is a systemic fungal disease endemic to Latin America and characterized by two clinical presentations, i.e., patients develop either acute/subacute or chronic clinical manifestations. The differences in clinical presentations are mainly dependent on the host immune response, but may also be related to demographic characteristics of some patients. In this retrospective study, 1,219 PCM cases treated between 1970 and 2009 in a university medical center, located in southeastern Brazil, were analyzed according to their clinical and demographic features. The most affected anatomical sites were lungs (63.8%) and oral mucosa (50.0%), with increasing involvement of these sites in accord with the age of the patients. Generalized lymphadenopathy (28.1%) and skin lesions (29.6%) were more frequent on the first decades of life. Involvement of the larynx (16.1%), gut (7.5%), spleen (4.7%), central nervous system (3.4%), bones and joints (2.2%), and adrenal (2.1%) were also variable according to the age of the host. The acute/subacute form of the disease accounted for 26.4% of PCM cases and, on a multivariate analysis, was inversely associated with aging (OR = 0.8 per year, P < 0.001), and directly associated with female sex (OR = 7.2, P < 0.001), mixed black and white racial background (OR = 2.3, P < 0.001) or black skin color (OR = 4.6, P < 0.001). Based on these findings, we have shown that host immune response, as well as age, gender and ethnicity may influence the clinical presentation of PCM.
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Affiliation(s)
- Fernando Bellissimo-Rodrigues
- Social Medicine Department, Faculdade de Medicina de Ribeirão Preto, São Paulo University, Ribeirão Preto, São Paulo State, Brazil
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Abstract
Lobomycosis is a cutaneous infection of tropical and subtropical regions caused by the fungus Lacazia loboi, which still has a controversial taxonomical position. The first description of the disease and fungus was made in 1930 by Jorge Lobo. It is a chronic disease with predominance of lesions similar to keloids, in exposed areas, limited to skin and semimucosa. There is no systemic involvement and patients maintain a good general health. Diagnosis is confirmed by direct or histopathologic exam and, until present, the fungus has not been cultivated. Surgery is the treatment of choice for isolated lesions, but there are frequent recurrences. Good therapeutic responses have been reported with clofazimine, with or without itraconazole, and with 5-fluorocytosine. This disease should be recognized by dermatologists worldwide because, although restricted to the Amazon region, it has been observed in other locations. Research development and achievement of new knowledge in molecular biology and genetic engineering of lobomycosis are of utmost importance because they may, in the future, lead to the culture of the fungus in the laboratory and to a better understanding of its pathogenesis, transmission mechanism, and new methods of diagnosis, prevention and treatment.
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Cardoso MAG, Tambor JHM, Nobrega FG. The mitochondrial genome from the thermal dimorphic fungus Paracoccidioides brasiliensis. Yeast 2007; 24:607-16. [PMID: 17492801 DOI: 10.1002/yea.1500] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
We present here the sequence of the mitochondrial DNA of the pathogenic thermodimorphic fungus Paracoccidioides brasiliensis, agent of an endemic disease in most South American countries. The sequenced genome has 71 334 bp and is organized as a circular molecule with two gaps of unknown size flanking the middle exon of the nad5 gene. We located genes coding for the three subunits of the ATP synthase (atp6, atp8 and atp9), the apocytochrome b (cob), three subunits of the cytochrome c oxidase enzyme complex (cox1, cox2 and cox3), seven subunits of the reduced nicotinamide adenine dinucleotide ubiquinone oxidoreductase (nad1, nad2, nad3, nad4, nad5, nad6 and nad4L) and the large (rnl) and small (rns) subunits of ribosomal RNA. Two maturases and a ribosomal protein (rms5) are located inside introns. Twenty-five tRNAs were identified with acceptors for all 20 amino acids. Seven polypurine/polypyrimidine tracts (140-240 bp) have been found in this genome. All genes are in the same orientation over the genome, while their order is closest to the mitochondrial genomes from Penicillium marneffei and Aspergillus nidulans.
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Affiliation(s)
- Maria Angélica G Cardoso
- Instituto de Pesquisa e Desenvolvimento, Universidade do Vale do Paraíba, Av. Shishima Hifumi 2911, Urbanova 12244-000, São José dos Campos, Brazil
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Paniago AMM, de Oliveira PA, Aguiar ESA, Aguiar JIA, da Cunha RV, Leme LM, Salgado PR, Domingos JA, Ferraz RL, Chang MR, Bóia MN, Wanke B. Neuroparacoccidioidomycosis: analysis of 13 cases observed in an endemic area in Brazil. Trans R Soc Trop Med Hyg 2007; 101:414-20. [PMID: 17011605 DOI: 10.1016/j.trstmh.2006.07.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2006] [Revised: 07/29/2006] [Accepted: 07/31/2006] [Indexed: 10/24/2022] Open
Abstract
The epidemiological, clinical and laboratory features of 13 cases of neuroparacoccidioidomycosis (NPCM) were analysed. All patients were men, with a mean age of 41.6 years. The lungs were involved in 11 cases (84.6%) and only two cases had mycosis limited to the central nervous system. Co-morbidity was observed in four patients (malignant neoplasm in three and diabetes mellitus in one). The most frequent neurological manifestations were paresis (eight cases), headache (five cases) and gait disturbance (four cases). Neuroimaging diagnosis showed a predominance of multiple round lesions with ring enhancement following contrast medium injection. Lesions were seen in the brain hemispheres (nine cases), thalamus (nine cases), cerebellum (four cases), brainstem (four cases) and spinal cord (four cases). Most cases responded well to therapy. Lesions with enhancement following contrast medium injection persisted in four patients for a period of 6 months to 8 years. These findings emphasize the importance of considering NPCM in the differential diagnosis of brain and spinal cord lesions in endemic areas of paracoccidioidomycosis.
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Sadahiro A, Roque ACM, Shikanai-Yasuda MA. Generic human leukocyte antigen class II (DRB1 and DQB1) alleles in patients with paracoccidioidomycosis. Med Mycol 2007; 45:35-40. [PMID: 17325942 DOI: 10.1080/13693780600999132] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Human leukocyte antigen (HLA) class II alleles are involved in antigen processing and in the presentation of antigens to T lymphocytes. Few studies have investigated HLA genes in paracoccidioidomycosis. In the present investigation, we analyzed the distribution of the HLA class II alleles DRB1 and DQB1 in 45 healthy volunteers and in 80 patients with paracoccidioidomycosis. The patients presented with various clinical forms of the disease, and allele distribution was evaluated individually in each presentation type. In patients with the unifocal chronic form of the disease, a mild clinical presentation in which lesions are restricted or localized, the HLA allele most commonly seen was DRB1*11 (p<0.039). This suggests that the participation of HLA antigens may influence the outcome of the host-parasite interaction in paracoccidioidomycosis, regulating the immune response to Paracoccidioides brasiliensis antigens.
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Affiliation(s)
- Aya Sadahiro
- Department of Parasitology, Federal University of Amazonas, Biological Sciences Institute, Manaus, Brazil
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Marcos EVC, Souza FCD, Torres EA, Lauris JRP, Opromolla DVDA. Estudo de associação entre antígenos leucocitários humanos e doença de Jorge Lobo. Rev Soc Bras Med Trop 2005; 38:399-401. [PMID: 16172755 DOI: 10.1590/s0037-86822005000500007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A doença de Jorge Lobo é uma micose cutânea/subcutânea de evolução crônica, causada pelo fungo Lacazia loboi. Devido às características epidemiológicas e poucos estudos relacionados aos aspectos imunológicos dessa doença, o objetivo do trabalho foi investigar uma possível associação das especificidades HLA de classe II em 21 pacientes portadores da doença de Jorge Lobo, comparando com indivíduos sadios de mesma etnia. As tipificações HLA foram realizadas pelo método de PCR-SSP. O resultado não revelou qualquer tipo de associação entre os antígenos HLA e doença de Jorge Lobo. Embora sem significância estatística, foi observada a diminuição da freqüência do antígeno HLA-DR7 no grupo dos pacientes em relação aos controles (0% x 18%), sugerindo uma associação negativa (protetora) entre HLA-DR7 e doença de Jorge Lobo. Contudo, estudos devem ser continuados, objetivando melhor entendimento nos mecanismos envolvidos na suscetibilidade e/ou proteção dessa doença.
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Dias MF, Pereira AC, Pereira A, Alves MS. The role of HLA antigens in the development of paracoccidioidomycosis. J Eur Acad Dermatol Venereol 2000; 14:166-71. [PMID: 11032058 DOI: 10.1046/j.1468-3083.2000.00070.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Paracoccidioidomycosis is a systemic granulomatous disease that involves primarily the lungs and may disseminate to other organs and systems. It is caused by Paracoccidioides brasiliensis, a fungus that exhibits reversible thermal dimorphism and whose natural habitat is presently unknown. There are two main clinical forms: the acute (subacute) juvenile form and the chronic adult form. The former runs a more rapid course and is more severe than the latter. This mycosis is found throughout Latin America. Brazil accounts for 80% of reported cases. Presumably P. brasiliensis thrives in humid and hot places, especially near forests or farms. The infection is endemic in certain areas, especially in Brazil, Colombia and Venezuela, where nearly 100% of the population show cutaneous paracoccidioidina positive skin tests, indicating previous contact with the fungus, although a small percentage show clinical manifestations of the disease. METHODS We compared the expression of HLA class I antigens in a healthy group (control) and in a group of patients with paracoccidioidomycosis (chronic adult form) using the Terasaki lymphocytotoxicity test modified by Amos for HLA antigen analysis. AIMS To discover indications of whether or not individual susceptibility to P. brasiliensis might depend on some specific immunological defect. RESULTS There is no evidence of association between a specific HLA antigen and paracoccidioidomycosis in the subjects studied. Further investigations are recommended.
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Affiliation(s)
- M F Dias
- Depto de Dermatologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Brasil.
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16
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Abstract
The role of ABO blood groups in the carriage rate of dermatophytosis was studied. Blood grouping was done for 108 culture-proven dermatophytosis patients. Forty-nine patients belonged to blood group A, 54 to blood group O, three to blood group B and two to blood group AB. The incidence of dermatophytosis was found to be high in patients of blood group O and A. However, chronicity of the disease was more frequent in those in blood group A. The control group consisted of 100 healthy subjects. Sixteen out of 29 control subjects belonging to blood group A had a history of skin infections. None of the O blood group control subjects had a history of skin infections. Our study suggests that A blood group subjects may be prone to chronic dermatophytosis.
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Affiliation(s)
- S A Balajee
- Department of Microbiology, Dr. A. L. M. Postgraduate Institute of Basic Medical Sciences, University of Madras, India
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Pedroza-Seres M, Quiroz-Mercado H, Granados J, Taylor ML. The syndrome of presumed ocular histoplasmosis in Mexico: a preliminary study. JOURNAL OF MEDICAL AND VETERINARY MYCOLOGY : BI-MONTHLY PUBLICATION OF THE INTERNATIONAL SOCIETY FOR HUMAN AND ANIMAL MYCOLOGY 1994; 32:83-92. [PMID: 8064547 DOI: 10.1080/02681219480000131] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
A study to screen for the syndrome of presumed ocular histoplasmosis (SPOH) among native populations from three Mexican states was performed. Two of these states, Guerrero and Querétaro, were selected as histoplasmosis is endemic there, whereas Tlaxcala was considered a control, due to the absence of reported cases. A total of 253 individuals were submitted to ocular fundus examination to obtain evidence of SPOH. A high percentage of positive reactors to histoplasmin skin test (ST) was observed in Guerrero (83%) and Querétaro (53%), whereas in Tlaxcala positive ST were almost absent (2.04%). Only five individuals had retinal lesions, although these lesions were not characteristic of the syndrome. Stimulation of these individual's cells showed different patterns in the histoplasmin-induced lymphocyte transformation response, and two out of five individuals with retinal lesions presented a stimulated response, as well as three controls without lesions. Histocompatibility antigens (HLA) were determined in a sample of each population and no particular allele, including HLA-B7, was found to be related to SPOH as reported in the USA; however, HLA-B22 was found in three individuals who developed pulmonary histoplasmosis. Results do not provide clinical evidence or data on specific HLA risk factors, for the presence of SPOH in the population studied.
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Affiliation(s)
- M Pedroza-Seres
- Asociación para Evitar la Ceguera en México Hospital Dr Luis Sanchez Bulnes, México D.F
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18
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Balarin MA, Freire-Maia DV. [The association between glyoxalase I and paracoccidioidomycosis infection]. Rev Soc Bras Med Trop 1993; 26:141-3. [PMID: 8146387 DOI: 10.1590/s0037-86821993000300002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
With the purpose to study the genetic susceptibility to paracoccidioidomycosis infection we searched for a possible association between glyoxalase I and the intradermic paracoccidioidin reaction. The phenotype GLO 1 was significantly more frequent among positive reactors.
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Affiliation(s)
- M A Balarin
- Departamento de Ciências Biológicas, Faculdade de Medicina do Triângulo Mineiro, Uberaba, MG, Brasil
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19
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Abstract
This review summarizes knowledge on various aspects of paracoccidioidomycosis. Mycelial propagules, chlamydospores, and arthroconidia exhibit thermal dimorphism; arthroconidia are infectious in animals and, by electron microscopy, appear well provided for survival. The mycelial-to-yeast-phase transformation requires a strict control of glucan synthesis probably mediated by membrane enzymes. Hormonal influences on the transformation of the fungus (mycelium or conidium to yeast phase) have been demonstrated. Estrogen-binding proteins have been detected in the fungal cytosol, and during the transformation novel proteins are produced as a result of estradiol incorporation. Clinical forms have been better defined on the basis of better experimental models. Emphasis has been placed on the lungs as the portal of entry and on the existence of silent pulmonary infections. A specific Paracoccidioides brasiliensis antigen, the 43-kDa glycoprotein (Gp43), has been identified, characterized, and cloned. This has led to improved reproducibility and specificity of serologic tests. The depression of cell-mediated immune responses has been associated with severe disease in humans and in the experimental host. T-cell subsets in patients' tissues were characterized by means of monoclonal antibodies, and a reduced CD4/CD8 ratio was demonstrated. This has been related to alterations in lymphokine and tumor necrosis factor production, production of antigen-antibody complexes, etc. Amphotericin B has provided effective therapy. Azole derivatives have also improved prognosis and facilitated therapy. Itraconazole is presently the drug of choice, yet incapacitating sequelae (mainly pulmonary fibrosis) still constitute major problems.
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Affiliation(s)
- E Brummer
- Department of Medicine, California Institute for Medical Research, Santa Clara Valley Medical Center, San Jose 95128
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21
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de Almeida OP, Jorge J, Scully C, Bozzo L. Oral manifestations of paracoccidioidomycosis (South American blastomycosis). ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1991; 72:430-5. [PMID: 1923441 DOI: 10.1016/0030-4220(91)90554-p] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Paracoccidioidomycosis (South American blastomycosis) is an uncommon, progressive systemic mycosis, potentially fatal if untreated. It is virtually restricted to persons spending time in Latin America. Reports of oral lesions are extremely rare in the English-language literature. Three adults with oral lesions as the first sign of paracoccidioidomycosis are described; this appears to be the largest series in the dental literature. The oral lesions had a characteristic appearance with a granular purpuric surface. The upper gingiva was a typical site, but lesions were also seen in the palate, tongue, and buccal mucosa. Two of the patients proved to have detectable pulmonary involvement. Long-term systemic ketoconazole therapy produced resolution of oral lesions in all cases.
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Affiliation(s)
- O P de Almeida
- Department of Oral Pathology, Faculty of Odontology, UNICAMP, Piracicaba, São Paulo, Brazil
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22
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Goldani LZ, Monteiro CM, Donadi EA, Martinez R, Voltarelli JC. HLA antigens in Brazilian patients with paracoccidioidomycosis. Mycopathologia 1991; 114:89-91. [PMID: 1875988 DOI: 10.1007/bf00436427] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Eighty patients with paracoccidioidomycosis were typed for 43 HLA specificities from loci A, B, C and DR. A highly significant increased frequency of HLA-B40 (relative risk 29.2) and HLA-Cw1 (relative risk 8.8) were found in patients compared to control subjects. The frequencies HLA-A2, B7 and B21 were also increased in patients and haplotypes-B40-Cw1 and -A2-B40 were positively correlated with the disease. DR antigen frequencies were not significantly altered in the patients and evidence of a protective effect was not found for any of the 43 antigens tested. These findings further support the involvement of the HLA system in the genetic susceptibility to paracoccidioidomycosis and the importance of ethnic variability in this association.
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Affiliation(s)
- L Z Goldani
- Department of Internal Medicine, Ribeirão Preto School of Medicine, University of São Paulo, Brazil
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Tsuneto LT, Arce-Gomez B, Petzl-Erler ML, Queiroz-Telles F. HLA-A29 and genetic susceptibility to chromoblastomycosis. JOURNAL OF MEDICAL AND VETERINARY MYCOLOGY : BI-MONTHLY PUBLICATION OF THE INTERNATIONAL SOCIETY FOR HUMAN AND ANIMAL MYCOLOGY 1989; 27:181-5. [PMID: 2778577 DOI: 10.1080/02681218980000241] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The distribution of 12 HLA-A, 14 HLA-B, seven HLA-C, seven HLA-DR and three HLA-DQ antigens was determined in 32 non-consanguineous white Brazilians suffering from chromoblastomycosis and 77 healthy controls, matched for ethnic background, sex and age and living in the same geographical area. A significant difference between the two groups was seen only in respect to one HLA-A antigen: A29 was present in 28% of patients as opposed to 4% of the controls (P corrected = 0.03). This finding indicates that susceptibility to chromoblastomycosis may be influenced by a gene located on chromosome 6, in the region of the major histocompatibility complex. The relative risk for an HLA-A29 carrier to develop chromoblastomycosis was estimated as 10.
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Affiliation(s)
- L T Tsuneto
- Immunology Laboratory, University of Maringa, Brazil
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24
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Lacerda GB, Arce-Gomez B, Telles Filho FQ. Increased frequency of HLA-B40 in patients with paracoccidioidomycosis. JOURNAL OF MEDICAL AND VETERINARY MYCOLOGY : BI-MONTHLY PUBLICATION OF THE INTERNATIONAL SOCIETY FOR HUMAN AND ANIMAL MYCOLOGY 1988; 26:253-6. [PMID: 3216280 DOI: 10.1080/02681218880000351] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The presence of 9 HLA-A and 14 HLA-B specificities was determined in 83 patients with paracoccidioidomycosis. The finding of a higher than normal incidence of HLA-B40 (chi 2 = 10.8; corrected P less than 0.026) supports the hypothesis that genetic factors may play a role in susceptibility to paracoccidioidomycosis. The risk of developing paracoccidioidomycosis is 4.3 times higher for individuals carrying HLA-B40 than for those lacking this antigen.
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Affiliation(s)
- G B Lacerda
- Departamento de Genética, Universidade Federal do Paraná, Curitaba-PR, Brazil
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Franco M. Host-parasite relationships in paracoccidioidomycosis. JOURNAL OF MEDICAL AND VETERINARY MYCOLOGY : BI-MONTHLY PUBLICATION OF THE INTERNATIONAL SOCIETY FOR HUMAN AND ANIMAL MYCOLOGY 1987; 25:5-18. [PMID: 3553526 DOI: 10.1080/02681218780000021] [Citation(s) in RCA: 194] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
A viewpoint of host-parasite relationships in paracoccidioidomycosis is presented. The characteristics of the fungus which are important to the host-parasite interaction are discussed. Aspects of inhibition of mycelium-to-yeast transformation by estrogens acting at receptors on the fungal wall and in the cytoplasm, and the role of polysaccharide components of the cell wall in virulence are reviewed. The natural mechanisms of host defense are also examined, including phagocytosis, complement system, natural-killer cells and genetic control of resistance and susceptibility. Finally, a discussion of granuloma morphogenesis and its relationship to the humoral and cellular anti-P. brasiliensis immune response is presented.
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