1
|
Apaza C, Cuna W, Brañez F, Passera R, Rodriguez C. Frequency of Gastrointestinal Parasites, Anemia, and Nutritional Status among Children from Different Geographical Regions of Bolivia. J Trop Med 2023; 2023:5020490. [PMID: 38107388 PMCID: PMC10725312 DOI: 10.1155/2023/5020490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 11/06/2023] [Accepted: 11/14/2023] [Indexed: 12/19/2023] Open
Abstract
The study aimed to measure the frequency of occurrence of infections with helminths, protozoa, and risk factors of undernutrition and anemia among schoolchildren from the Bolivian highland (altiplano) and lowland (subtropical) rural regions, with a high frequency of gastrointestinal parasite infections. Cross-sectional data were collected from 790 children, 5-13 years old. Microscopic examination of stool using the Ritchie technique, hemoglobin testing using the HemoCue analyzer, and anthropometric measurements were performed. Over 60% and 20% of children were infected with protozoa and helminth parasites, respectively. Infections caused by pathogenic Hymenolepis nana (15.7-5.2%), Ascaris lumbricoides (41.9-28.5%), Giardia lamblia (30.1-11.2%), Entamoeba histolytica (5.7-0.7%), and nonpathogenic Entamoeba coli (48.9-16%), Blastocystis hominis (40.2-28.5%), Iodamoeba butschli (16.1-2.5%), Chilomastix mesnili (19.2-7.3%), and Entamoeba histolytica/dispar (7.4-5.5%) parasites, were more prevalent in the highlands than the lowlands. Single parasitic infections were more prevalent in the lowlands; polyparasitism of light or heavy intensity predominated in the highlands. A strongly increased risk of anemia and a low prevalence of wasting were determined in children in the highlands. A higher risk for stunting was associated with children of older age, and a low burden of intestinal helminths would prevent wasting in children of highlands. Infections with A. lumbricoides and G. lamblia pathogens in older children were not significant covariates for stunting. Environmental, nutritional, and parasitic factors may predispose to anemia in the highlands. A nutritional intervention and parasite control effort will substantially improve children´s health in the highlands.
Collapse
Affiliation(s)
- Ceilan Apaza
- Hospital Municipal de Chulumani, Chulumani, La Paz, Bolivia
| | - Washington Cuna
- Unidad de Inmunología Parasitaria, Facultad de Medicina, Universidad Mayor de San Andrés, La Paz, Bolivia
| | - Froilán Brañez
- Unidad de Laboratorio Clínico, Hospital de Caranavi, Caranavi, La Paz, Bolivia
| | - Roberto Passera
- University of Turin, Department of Medical Science, Division of Nuclear Medicine, Corso AM Digliotti 14, Turin 10126, Italy
| | - Celeste Rodriguez
- Unidad de Inmunología Parasitaria, Facultad de Medicina, Universidad Mayor de San Andrés, La Paz, Bolivia
| |
Collapse
|
2
|
Yanagawa Y, Singh U. Diversity and Plasticity of Virulent Characteristics of Entamoeba histolytica. Trop Med Infect Dis 2023; 8:tropicalmed8050255. [PMID: 37235303 DOI: 10.3390/tropicalmed8050255] [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: 04/19/2023] [Revised: 04/27/2023] [Accepted: 04/27/2023] [Indexed: 05/28/2023] Open
Abstract
The complexity of clinical syndromes of amebiasis, caused by the parasite Entamoeba histolytica, stems from the intricate interplay between the host immune system, the virulence of the invading parasite, and the surrounding environment. Although there is still a relative paucity of information about the precise relationship between virulence factors and the pathogenesis of Entamoeba histolytica, by accumulating data from clinical and basic research, researchers have identified essential pathogenic factors that play a critical role in the pathogenesis of amebiasis, providing important insights into disease development through animal models. Moreover, the parasite's genetic variability has been associated with differences in virulence and disease outcomes, making it important to fully understand the epidemiology and pathogenesis of amebiasis. Deciphering the true mechanism of disease progression in humans caused by this parasite is made more difficult through its ability to demonstrate both genomic and pathological plasticity. The objective of this article is to underscore the heterogeneous nature of disease states and the malleable virulence characteristics in experimental models, while also identifying persistent scientific issues that need to be addressed.
Collapse
Affiliation(s)
- Yasuaki Yanagawa
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Upinder Singh
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA 94305, USA
- Division of Infectious Diseases, Department of Internal Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| |
Collapse
|
3
|
Usuda D, Tsuge S, Sakurai R, Kawai K, Matsubara S, Tanaka R, Suzuki M, Takano H, Shimozawa S, Hotchi Y, Tokunaga S, Osugi I, Katou R, Ito S, Mishima K, Kondo A, Mizuno K, Takami H, Komatsu T, Oba J, Nomura T, Sugita M. Amebic liver abscess by Entamoeba histolytica. World J Clin Cases 2022; 10:13157-13166. [PMID: 36683647 PMCID: PMC9851013 DOI: 10.12998/wjcc.v10.i36.13157] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 11/01/2022] [Accepted: 12/08/2022] [Indexed: 12/26/2022] Open
Abstract
Amebic liver abscesses (ALAs) are the most commonly encountered extraintestinal manifestation of human invasive amebiasis, which results from Entamoeba histolytica (E. histolytica) spreading extraintestinally. Amebiasis can be complicated by liver abscess in 9% of cases, and ALAs led to almost 50000 fatalities worldwide in 2010. Although there have been fewer and fewer cases in the past several years, ALAs remain an important public health problem in endemic areas. E. histolytica causes both amebic colitis and liver abscess by breaching the host’s innate defenses and invading the intestinal mucosa. Trophozoites often enter the circulatory system, where they are filtered in the liver and produce abscesses, and develop into severe invasive diseases such as ALAs. The clinical presentation can appear to be colitis, including upper-right abdominal pain accompanied by a fever in ALA cases. Proper diagnosis requires nonspecific liver imaging as well as detecting anti-E. histolytica antibodies; however, these antibodies cannot be used to distinguish between a previous infection and an acute infection. Therefore, diagnostics primarily aim to use PCR or enzyme-linked immunosorbent assay to detect E. histolytica. ALAs can be treated medically, and percutaneous catheter drainage is only necessary in approximately 15% of cases. The indicated treatment is to administer an amebicidal drug (such as tinidazole or metronidazole) and paromomycin or other luminal cysticidal agent for clinical disease. Prognosis is good with almost universal recovery. Establishing which diagnostic methods are most efficacious will necessitate further analysis of similar clinical cases.
Collapse
Affiliation(s)
- Daisuke Usuda
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima 177-8521, Tokyo, Japan
| | - Shiho Tsuge
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima 177-8521, Tokyo, Japan
| | - Riki Sakurai
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima 177-8521, Tokyo, Japan
| | - Kenji Kawai
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima 177-8521, Tokyo, Japan
| | - Shun Matsubara
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima 177-8521, Tokyo, Japan
| | - Risa Tanaka
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima 177-8521, Tokyo, Japan
| | - Makoto Suzuki
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima 177-8521, Tokyo, Japan
| | - Hayabusa Takano
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima 177-8521, Tokyo, Japan
| | - Shintaro Shimozawa
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima 177-8521, Tokyo, Japan
| | - Yuta Hotchi
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima 177-8521, Tokyo, Japan
| | - Shungo Tokunaga
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima 177-8521, Tokyo, Japan
| | - Ippei Osugi
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima 177-8521, Tokyo, Japan
| | - Risa Katou
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima 177-8521, Tokyo, Japan
| | - Sakurako Ito
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima 177-8521, Tokyo, Japan
| | - Kentaro Mishima
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima 177-8521, Tokyo, Japan
| | - Akihiko Kondo
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima 177-8521, Tokyo, Japan
| | - Keiko Mizuno
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima 177-8521, Tokyo, Japan
| | - Hiroki Takami
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima 177-8521, Tokyo, Japan
| | - Takayuki Komatsu
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima 177-8521, Tokyo, Japan
- Department of Sports Medicine, Faculty of Medicine, Juntendo University, Bunkyo 113-8421, Tokyo, Japan
| | - Jiro Oba
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima 177-8521, Tokyo, Japan
| | - Tomohisa Nomura
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima 177-8521, Tokyo, Japan
| | - Manabu Sugita
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima 177-8521, Tokyo, Japan
| |
Collapse
|
4
|
Gupta S, Allegretti JR. Mimics of Crohn's Disease. Gastroenterol Clin North Am 2022; 51:241-269. [PMID: 35595413 DOI: 10.1016/j.gtc.2021.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Crohn's disease is a chronic inflammatory disease that can affect any portion of the gastrointestinal tract. Associated symptoms can vary based on the severity of disease, extent of involvement, presence of extraintestinal manifestations, and development of complications. Diagnosis is based on a constellation of findings. Many diseases can mimic Crohn's disease and lead to diagnostic conundrums. These include entities associated with the gastrointestinal luminal tract, vascular disease, autoimmune processes, various infections, malignancies and complications, drug- or treatment-induced conditions, and genetic diseases. Careful consideration of possible causes is necessary to establish the correct diagnosis.
Collapse
Affiliation(s)
- Sanchit Gupta
- Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, 850 Boyslton Street, Suite 201, Chestnut Hill, MA 02467, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Jessica R Allegretti
- Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, 850 Boyslton Street, Suite 201, Chestnut Hill, MA 02467, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
| |
Collapse
|
5
|
Abstract
Although rare in the developed world, amebiasis continues to be a leading cause of diarrhea and illness in developing nations with crowding, poor sanitation, and lack of clean water supply. Recent immigrants or travelers returning from endemic regions after a prolonged stay are at high risk of developing amebiasis. A high index of suspicion for amebiasis should be maintained for other high-risk groups like men having sex with men, people with AIDS/HIV, immunocompromised hosts, residents of mental health facility or group homes. Clinical presentation of intestinal amebiasis varies from diarrhea to colitis and dysentery. Amebic liver abscess (ALA) is the most common form of extraintestinal amebiasis. Various diagnostic tools are available and when amebiasis is suspected, a combination of stool tests and serology should be sent to maximize the yield of testing. Treatment with an amebicidal drug such as metronidazole/tinidazole and a luminal cysticidal agent such as paromomycin for clinical disease is indicated. However, for asymptomatic disease treatment with a luminal cysticidal agent to decrease chances of invasive disease and transmission is recommended.
Collapse
Affiliation(s)
- Shipra Gupta
- West Virginia University School of Medicine, One Medical Center Drive, HSC 9214, Morgantown, WV 26506, USA.
| | - Layne Smith
- West Virginia University School of Pharmacy, One Medical Center Drive, Morgantown, WV-26506, USA
| | - Adriana Diakiw
- West Virginia University School of Medicine, One Medical Center Drive, HSC 9214, Morgantown, WV 26506, USA
| |
Collapse
|
6
|
Sebaa S, Behnke JM, Baroudi D, Hakem A, Abu-Madi MA. Prevalence and risk factors of intestinal protozoan infection among symptomatic and asymptomatic populations in rural and urban areas of southern Algeria. BMC Infect Dis 2021; 21:888. [PMID: 34461837 PMCID: PMC8406907 DOI: 10.1186/s12879-021-06615-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 08/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intestinal parasitic infections are amongst the most common infections worldwide and have been identified as one of the most significant causes of morbidity and mortality among disadvantaged populations. This comparative cross-sectional study was conducted to assess the prevalence of intestinal protozoan infections and to identify the significant risk factors associated with intestinal parasitic infections in Laghouat province, Southern Algeria. METHODS A comparative cross-sectional study was conducted, involving 623 symptomatic and 1654 asymptomatic subjects. Structured questionnaires were used to identify environmental, socio demographic and behavioral factors. Stool specimens were collected and examined using direct wet mount, formalin-ether concentration, xenic in vitro culture and staining methods. RESULTS A highly significant difference of prevalence was found between symptomatic (82.3%) and asymptomatic subjects (14.9%), with the majority attributable to protozoan infection. The most common species in the symptomatic subjects were Blastocystis spp. (43.8%), E. histolytica/dispar (25.4%) and Giardia intestinalis (14.6%) and more rarely Enterobius vermicularis (02.1%), Teania spp. (0.6%) and Trichuris trichiura (0.2%), while in asymptomatic population Blastocystis spp. (8%), Entamoeba coli (3.3%) and Entamoeba histolytica/dispar (2.5%) were the most common parasites detected with no case of helminth infection. Multivariate log-linear analysis showed that contact with animals was the main risk factor for transmission of these protozoa in both populations. Furthermore, living in rural areas was significantly associated with combined protozoan infection in the asymptomatic population, whereas, in the symptomatic population an increasing trend of protozoan infection was detected in the hot season. In addition, Blastocystis spp. and G. intestinalis infection were found to be associated with host sex and contact with animals across the study period. CONCLUSIONS Based on these results, several strategies are recommended in order to effectively reduce these infections including good animal husbandry practices, health education focused on good personal hygiene practices and adequate sanitation.
Collapse
Affiliation(s)
- Soumia Sebaa
- Laboratory of Exploration and Valorization of Steppic Ecosystems, Faculty SNV, University of Ziane Achour, 17000, Djelfa, Algeria
| | - Jerzy M Behnke
- School of Life Sciences, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Djamel Baroudi
- Food Hygiene Laboratory Quality Analysis System, National Veterinary School, Algiers, Algeria
| | - Ahcene Hakem
- Laboratory of Exploration and Valorization of Steppic Ecosystems, Faculty SNV, University of Ziane Achour, 17000, Djelfa, Algeria.,Research Center in Agropastoralism, Moudjbara Road, 17000, Djelfa, Algeria
| | - Marawan A Abu-Madi
- Department of Biomedical Science, College of Health Sciences, Biomedical and Pharmaceutical Research Unit, QU-Health, Qatar University, P.O. Box 2713, Doha, Qatar.
| |
Collapse
|
7
|
Calegar DA, Monteiro KJL, Bacelar PAA, Evangelista BBC, Almeida MM, Dos Santos JP, Boia MN, Coronato-Nunes B, Jaeger LH, Carvalho-Costa FA. Epidemiology, species composition and genetic diversity of tetra- and octonucleated Entamoeba spp. in different Brazilian biomes. Parasit Vectors 2021; 14:160. [PMID: 33731176 PMCID: PMC7968159 DOI: 10.1186/s13071-021-04672-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/05/2021] [Indexed: 11/16/2022] Open
Abstract
Background Entamoeba species harbored by humans have different degrees of pathogenicity. The present study explores the intra- and interspecific diversity, phylogenetic relationships, prevalence and distribution of tetra- and octonucleated cyst-producing Entamoeba in different Brazilian regions. Methods Cross-sectional studies were performed to collect fecal samples (n = 1728) and sociodemographic data in communities located in four Brazilian biomes: Atlantic Forest, Caatinga, Cerrado, and Amazon. Fecal samples were subjected to molecular analysis by partial small subunit ribosomal DNA sequencing (SSU rDNA) and phylogenetic analysis. Results Light microscopy analysis revealed that tetranucleated cysts were found in all the studied biomes. The highest positivity rates were observed in the age group 6–10 years (23.21%). For octonucleated cysts, positivity rates ranged from 1 to 55.1%. Sixty SSU rDNA Entamoeba sequences were obtained, and four different species were identified: the octonucleated E. coli, and the tetranucleated E. histolytica, E. dispar, and E. hartmanni. Novel haplotypes (n = 32) were characterized; however, new ribosomal lineages were not identified. The Entamoeba coli ST1 subtype predominated in Atlantic Forest and Caatinga, and the ST2 subtype was predominant in the Amazon biome. E. histolytica was detected only in the Amazon biome. In phylogenetic trees, sequences were grouped in two groups, the first containing uni- and tetranucleated and the second containing uni- and octonucleated cyst-producing Entamoeba species. Molecular diversity indexes revealed a high interspecific diversity for tetra- and octonucleated Entamoeba spp. (H ± SD = 0.9625 ± 0.0126). The intraspecific diversity varied according to species or subtype: E. dispar and E. histolytica showed lower diversity than E. coli subtypes ST1 and ST2 and E. hartmanni. Conclusions Tetra- and octonucleated cyst-producing Entamoeba are endemic in the studied communities; E. histolytica was found in a low proportion and only in the Amazon biome. With regard to E. coli, subtype ST2 was predominant in the Amazon biome. The molecular epidemiology of Entamoeba spp. is a field to be further explored and provides information with important implications for public health. ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13071-021-04672-y.
Collapse
Affiliation(s)
- Deiviane Aparecida Calegar
- Laboratório de Epidemiologia e Sistemática Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.
| | - Kerla Joeline Lima Monteiro
- Centro/Norte, Escritório Técnico Regional - Fundação Oswaldo Cruz, Piauí, Rua Magalhães Filho, 519, Teresina, Piauí, Brazil
| | - Polyanna Araújo Alves Bacelar
- Laboratório de Epidemiologia e Sistemática Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.,Centro/Norte, Escritório Técnico Regional - Fundação Oswaldo Cruz, Piauí, Rua Magalhães Filho, 519, Teresina, Piauí, Brazil
| | - Brenda Bulsara Costa Evangelista
- Laboratório de Epidemiologia e Sistemática Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.,Centro/Norte, Escritório Técnico Regional - Fundação Oswaldo Cruz, Piauí, Rua Magalhães Filho, 519, Teresina, Piauí, Brazil
| | - Mayron Morais Almeida
- Laboratório de Epidemiologia e Sistemática Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Jéssica Pereira Dos Santos
- Laboratório de Epidemiologia e Sistemática Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.,Centro/Norte, Escritório Técnico Regional - Fundação Oswaldo Cruz, Piauí, Rua Magalhães Filho, 519, Teresina, Piauí, Brazil
| | - Márcio Neves Boia
- Laboratório de Biologia e Parasitologia de Mamíferos Silvestres Reservatórios, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Beatriz Coronato-Nunes
- Laboratório de Epidemiologia e Sistemática Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.,Faculdade de Medicina de Petrópolis (FMP)/Faculdade Arthur Sá Earp Neto (FASE), Rua Machado Fagundes, 326, Cascatinha, Petrópolis, Rio de Janeiro, Brazil
| | - Lauren Hubert Jaeger
- Laboratório de Epidemiologia e Sistemática Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.,Faculdade de Farmácia, Universidade Federal de Juiz de Fora, Rua José Lourenço Kelmer, s/n - Campus Universitário, Bairro São Pedro, Juiz de Fora, Minas Gerais, Brazil
| | - Filipe Anibal Carvalho-Costa
- Laboratório de Epidemiologia e Sistemática Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| |
Collapse
|
8
|
Shirley DA, Sharma I, Warren CA, Moonah S. Drug Repurposing of the Alcohol Abuse Medication Disulfiram as an Anti-Parasitic Agent. Front Cell Infect Microbiol 2021; 11:633194. [PMID: 33777846 PMCID: PMC7991622 DOI: 10.3389/fcimb.2021.633194] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 02/18/2021] [Indexed: 01/24/2023] Open
Abstract
Parasitic infections contribute significantly to worldwide morbidity and mortality. Antibiotic treatment is essential for managing patients infected with these parasites since control is otherwise challenging and there are no vaccines available for prevention. However, new antimicrobial therapies are urgently needed as significant problems exist with current treatments such as drug resistance, limited options, poor efficacy, as well as toxicity. This situation is made worse by the challenges of drug discovery and development which is costly especially for non-profitable infectious diseases, time-consuming, and risky with a high failure rate. Drug repurposing which involves finding new use for existing drugs may help to more rapidly identify therapeutic candidates while drastically cutting costs of drug research and development. In this perspective article, we discuss the importance of drug repurposing, review disulfiram pharmacology, and highlight emerging data that supports repurposing disulfiram as an anti-parasitic, exemplified by the major diarrhea-causing parasite Entamoeba histolytica.
Collapse
Affiliation(s)
- Debbie-Ann Shirley
- Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Virginia, Charlottesville, VA, United States
| | - Ishrya Sharma
- Division of Infectious Diseases & International Health, Department of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Cirle A Warren
- Division of Infectious Diseases & International Health, Department of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Shannon Moonah
- Division of Infectious Diseases & International Health, Department of Medicine, University of Virginia, Charlottesville, VA, United States
| |
Collapse
|
9
|
Shirley DA, Moonah S. COVID-19 and Corticosteroids: Unfamiliar but Potentially Fatal Infections That Can Arise following Short-Course Steroid Treatment. Am J Trop Med Hyg 2021; 104:790-793. [PMID: 33410395 PMCID: PMC7941796 DOI: 10.4269/ajtmh.20-1471] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 12/07/2020] [Indexed: 12/19/2022] Open
Abstract
Corticosteroid use is increasing worldwide as recent studies confer survival benefit of corticosteroids in the management of patients with severe COVID-19. Strongyloides and amebic infections are neglected diseases that can progress to catastrophic complications in patients exposed to corticosteroids, even with short treatment courses. To prevent lethal outcomes, clinicians should be aware of the threat these two parasitic infections pose to at-risk patients receiving corticosteroids, especially in the era of COVID-19.
Collapse
Affiliation(s)
- Debbie-Ann Shirley
- Division of Infectious Diseases and International Health, University of Virginia COVID-19 Clinic, University of Virginia Health System, Charlottesville, Virginia
| | - Shannon Moonah
- Division of Infectious Diseases and International Health, University of Virginia COVID-19 Clinic, University of Virginia Health System, Charlottesville, Virginia
| |
Collapse
|
10
|
Toychiev A, Navruzov B, Pazylova D, Davis N, Badalova N, Osipova S. Intestinal protozoa and helminths in ulcerative colitis and the influence of anti-parasitic therapy on the course of the disease. Acta Trop 2021; 213:105755. [PMID: 33188747 DOI: 10.1016/j.actatropica.2020.105755] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 10/29/2020] [Accepted: 11/02/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE The aim of this study is to determine the prevalence of intestinal helminths and protozoa in patients with ulcerative colitis (UC) and to estimate the influence of the anti-parasitic therapy on the course of the disease. METHODS The study was conducted at the Research Institute of Epidemiology, Microbiology and Infectious Diseases and Coloproctology Department of the Republic Clinical Hospital №1 of the Ministry of Health of the Republic of Uzbekistan. One hundred UC patients and 200 healthy individuals were examined by triple coproscopy. Additionally, 20, 25 and 22 UC patients with Blastocystis infection were treated with nitazoxanide (1.0 g/day), mesalazine (1.5-2 g/day) or a combination of nitazoxanide (1.0 g/day) and mesalazine (≥1.5-2 g/day) for 14 consecutive days, respectively. Parasitological, clinical and endoscopic examinations were conducted before therapy, immediately after and 6 and 12 weeks after therapy completion. RESULTS The overall prevalence of helminths in UC patients and control individuals was not significantly different: 14±3.4% and 8.5±1.9%, respectively (OR: 1.7524; 95% CI: 0.8258 to 3.7186; P=0.1). Giardia lamblia was the most prevalent parasite in both groups, but the difference compared to the control was insignificant (OR: 0.4565; 95% CI: 0.2020 to 1.0318; P=0.05). A significantly higher prevalence of Blastocystis sp., Chilomastix mesnili and Iodamoeba butschlii in UC patients compared to control individuals was found (P<0.0005): 65.0%, 14.0% and 22.0%, respectively. During all follow-up periods, the clinical response and clinical remission were not statistically different between the groups (P>0.05). Mucosal healing immediately and 6 weeks after therapy with a combination of nitazoxanide with mesalazine was significantly better than with a monotherapy of nitazoxanide, respectively (P<0.05). UC patients treated with a combination of nitazoxanide with mesalazine showed better mucosal healing than in patients treated with a monotherapy of mesalazine (P>0.05). CONCLUSIONS Diagnosis of Blastocystis sp. should be introduced in the complex examination of UC patients. Further clinical studies are necessary for assessment of the efficiency of anti-Blastocystis therapy in UC patients.
Collapse
|
11
|
Kaiser RWJ, Allgeier J, Philipp AB, Mayerle J, Rothe C, Wallrauch C, Op den Winkel M. Development of amoebic liver abscess in early pregnancy years after initial amoebic exposure: a case report. BMC Gastroenterol 2020; 20:424. [PMID: 33317457 PMCID: PMC7734812 DOI: 10.1186/s12876-020-01567-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 12/01/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Infection with Entamoeba histolytica and associated complications are relatively rare in developed countries. The overall low prevalence in the Western world as well as the possibly prolonged latency period between infection with the causing pathogen and onset of clinical symptoms may delay diagnosis of and adequate treatment for amoebiasis. Amoebic liver abscess (ALA) is the most common extraintestinal manifestation of invasive amoebiasis. Pregnancy has been described as a risk factor for development of invasive amoebiasis and management of these patients is especially complex. CASE PRESENTATION A 30-year-old Caucasian woman in early pregnancy presented to our emergency department with abdominal pain alongside elevated inflammatory markers and liver function tests. Travel history revealed multiple journeys to tropic and subtropic regions during the past decade and a prolonged episode of intermittently bloody diarrhea during a five month stay in Indonesia seven years prior to admission. Sonographic and magnetic resonance imaging revealed a 5 × 4 cm hepatic abscess. After ultrasound-guided transcutaneous liver drainage, both abscess fluids and blood cultures showed neither bacterial growth nor microscopic signs of parasitic disease. Serological testing confirmed an infection with Entamoeba histolytica, which was treated with metronidazole, followed by eradication therapy with paromomycin. Subsequent clinical, laboratory and imaging follow-up exams showed regression of the ALA. In addition, the pregnancy completed without complications and a healthy baby boy was born 7 months after termination of treatment. CONCLUSIONS This case of invasive amoebiasis in early pregnancy outside of endemic regions and several years after exposure demonstrates the importance of broad differential diagnostics in the context of liver abscesses. The complex interdisciplinary decisions regarding the choice of imaging techniques as well as interventional and antibiotic therapy in the context of pregnancy are discussed. Furthermore, we present possible explanations for pregnancy as a risk factor for an invasive course of amoebiasis.
Collapse
Affiliation(s)
- Rainer W J Kaiser
- Department of Medicine I, LMU Klinikum, Ludwig-Maximilians-University, Munich, Germany. .,DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany.
| | - Julian Allgeier
- Department of Medicine II, LMU Klinikum, Ludwig-Maximilians-University, Munich, Germany
| | - Alexander B Philipp
- Department of Medicine II, LMU Klinikum, Ludwig-Maximilians-University, Munich, Germany
| | - Julia Mayerle
- Department of Medicine II, LMU Klinikum, Ludwig-Maximilians-University, Munich, Germany
| | - Camilla Rothe
- Department of Tropical Medicine, LMU Klinikum, Ludwig-Maximilians-University, Munich, Germany
| | - Claudia Wallrauch
- Department of Tropical Medicine, LMU Klinikum, Ludwig-Maximilians-University, Munich, Germany
| | - Mark Op den Winkel
- Department of Medicine II, LMU Klinikum, Ludwig-Maximilians-University, Munich, Germany
| |
Collapse
|
12
|
Ghosh S, Farr L, Singh A, Leaton LA, Padalia J, Shirley DA, Sullivan D, Moonah S. COP9 signalosome is an essential and druggable parasite target that regulates protein degradation. PLoS Pathog 2020; 16:e1008952. [PMID: 32960936 PMCID: PMC7531848 DOI: 10.1371/journal.ppat.1008952] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 10/02/2020] [Accepted: 09/01/2020] [Indexed: 02/06/2023] Open
Abstract
Understanding how the protozoan protein degradation pathway is regulated could uncover new parasite biology for drug discovery. We found the COP9 signalosome (CSN) conserved in multiple pathogens such as Leishmania, Trypanosoma, Toxoplasma, and used the severe diarrhea-causing Entamoeba histolytica to study its function in medically significant protozoa. We show that CSN is an essential upstream regulator of parasite protein degradation. Genetic disruption of E. histolytica CSN by two distinct approaches inhibited cell proliferation and viability. Both CSN5 knockdown and dominant negative mutation trapped cullin in a neddylated state, disrupting UPS activity and protein degradation. In addition, zinc ditiocarb (ZnDTC), a main metabolite of the inexpensive FDA-approved globally-available drug disulfiram, was active against parasites acting in a COP9-dependent manner. ZnDTC, given as disulfiram-zinc, had oral efficacy in clearing parasites in vivo. Our findings provide insights into the regulation of parasite protein degradation, and supports the significant therapeutic potential of COP9 inhibition.
Collapse
Affiliation(s)
- Swagata Ghosh
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States of America
| | - Laura Farr
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States of America
| | - Aditya Singh
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States of America
| | - Laura-Ann Leaton
- Division of Biomedical Informatics and Personalized Medicine, University of Colorado, Aurora, CO, United States of America
| | - Jay Padalia
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States of America
| | - Debbie-Ann Shirley
- Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, VA, United States of America
| | - David Sullivan
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Shannon Moonah
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States of America
| |
Collapse
|
13
|
Quintanilla-Licea R, Vargas-Villarreal J, Verde-Star MJ, Rivas-Galindo VM, Torres-Hernández ÁD. Antiprotozoal Activity against Entamoeba histolytica of Flavonoids Isolated from Lippia graveolens Kunth. Molecules 2020; 25:molecules25112464. [PMID: 32466359 PMCID: PMC7321152 DOI: 10.3390/molecules25112464] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/21/2020] [Accepted: 05/25/2020] [Indexed: 12/15/2022] Open
Abstract
Amebiasis caused by Entamoeba histolytica is nowadays a serious public health problem worldwide, especially in developing countries. Annually, up to 100,000 deaths occur across the world. Due to the resistance that pathogenic protozoa exhibit against commercial antiprotozoal drugs, a growing emphasis has been placed on plants used in traditional medicine to discover new antiparasitics. Previously, we reported the in vitro antiamoebic activity of a methanolic extract of Lippia graveolens Kunth (Mexican oregano). In this study, we outline the isolation and structure elucidation of antiamoebic compounds occurring in this plant. The subsequent work-up of this methanol extract by bioguided isolation using several chromatographic techniques yielded the flavonoids pinocembrin (1), sakuranetin (2), cirsimaritin (3), and naringenin (4). Structural elucidation of the isolated compounds was achieved by spectroscopic/spectrometric analyses and comparing literature data. These compounds revealed significant antiprotozoal activity against E. histolytica trophozoites using in vitro tests, showing a 50% inhibitory concentration (IC50) ranging from 28 to 154 µg/mL. Amebicide activity of sakuranetin and cirsimaritin is reported for the first time in this study. These research data may help to corroborate the use of this plant in traditional Mexican medicine for the treatment of dyspepsia.
Collapse
Affiliation(s)
- Ramiro Quintanilla-Licea
- Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León (UANL), Av. Universidad S/N, Cd. Universitaria, San Nicolás de los Garza, C.P. 66455 Nuevo León, Mexico; (M.J.V.-S.); (Á.D.T.-H.)
- Correspondence: ; Tel.: +52-81-83763668
| | - Javier Vargas-Villarreal
- Laboratorio de Bioquímica y Biología Celular, Centro de Investigaciones Biomédicas del Noreste (CIBIN), Dos de abril esquina con San Luis Potosí, C.P. 64720 Monterrey, Mexico;
| | - María Julia Verde-Star
- Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León (UANL), Av. Universidad S/N, Cd. Universitaria, San Nicolás de los Garza, C.P. 66455 Nuevo León, Mexico; (M.J.V.-S.); (Á.D.T.-H.)
| | - Verónica Mayela Rivas-Galindo
- Facultad de Medicina, Universidad Autónoma de Nuevo León (UANL), Madero y Aguirre Pequeño, Mitras Centro, Monterrey, C.P. 64460 Nuevo León, Mexico;
| | - Ángel David Torres-Hernández
- Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León (UANL), Av. Universidad S/N, Cd. Universitaria, San Nicolás de los Garza, C.P. 66455 Nuevo León, Mexico; (M.J.V.-S.); (Á.D.T.-H.)
| |
Collapse
|
14
|
Norman FF, Comeche B, Chamorro S, López-Vélez R. Overcoming challenges in the diagnosis and treatment of parasitic infectious diseases in migrants. Expert Rev Anti Infect Ther 2020; 18:127-143. [PMID: 31914335 DOI: 10.1080/14787210.2020.1713099] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Introduction: Recent increases in population movements have created novel health challenges in many areas of the World, and health policies have been adapted accordingly in several countries. However, screening guidelines for infectious diseases are not standardized and generally do not include comprehensive screening for parasitic infections.Areas covered: Malaria, Chagas disease, leishmaniasis, amebiasis, filariases, strongyloidiasis, and schistosomiasis are reviewed, focusing on the challenges posed for their diagnosis and management in vulnerable populations such as migrants. The methodology included literature searches in public databases such as PubMed.gov and Google Scholar and search of the US National Library of Medicine online database of privately and publicly funded clinical studies (ClinicalTrials.gov) until November 2019.Expert opinion: Parasitic infections which may remain asymptomatic for prolonged periods, leading to chronic infection and complications, and/or may be transmitted in non-endemic areas are ideal candidates for screening. Proposed strategies to improve diagnosis in vulnerable groups such as migrants include facilitating access to healthcare in a multi-dimensional manner considering location, individual characteristics, and timing. Limitations and availability of specific diagnostic techniques should be addressed and focus on drug and vaccine development for these neglected infections should be prioritized through collaborative initiatives with public disclosure of results.
Collapse
Affiliation(s)
- Francesca F Norman
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Belen Comeche
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Sandra Chamorro
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Rogelio López-Vélez
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| |
Collapse
|
15
|
Shirley DAT, Watanabe K, Moonah S. Significance of amebiasis: 10 reasons why neglecting amebiasis might come back to bite us in the gut. PLoS Negl Trop Dis 2019; 13:e0007744. [PMID: 31725715 PMCID: PMC6855409 DOI: 10.1371/journal.pntd.0007744] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Debbie-Ann T. Shirley
- Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Virginia, United States of America
| | - Koji Watanabe
- AIDS Clinical Center, National Center for Global Health and Medicine, Shinjuku, Tokyo, Japan
| | - Shannon Moonah
- Department of Medicine, University of Virginia School of Medicine Charlottesville, Virginia, United States of America
- * E-mail:
| |
Collapse
|
16
|
Ögren J, Dienus O, Matussek A. Optimization of routine microscopic and molecular detection of parasitic protozoa in SAF-fixed faecal samples in Sweden. Infect Dis (Lond) 2019; 52:87-96. [DOI: 10.1080/23744235.2019.1682188] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Affiliation(s)
- Jessica Ögren
- Clinical Microbiology, Region Jönköping County, Jönköping, Sweden
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Olaf Dienus
- Clinical Microbiology, Region Jönköping County, Jönköping, Sweden
| | - Andreas Matussek
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Laboratory Medicine, Region Jönköping County, Jönköping, Sweden
- Karolinska University Laboratory, Stockholm, Sweden
| |
Collapse
|