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Foley KE, Winder Z, Sudduth TL, Martin BJ, Nelson PT, Jicha GA, Harp JP, Weekman EM, Wilcock DM. Alzheimer's disease and inflammatory biomarkers positively correlate in plasma in the UK-ADRC cohort. Alzheimers Dement 2024; 20:1374-1386. [PMID: 38011580 PMCID: PMC10917006 DOI: 10.1002/alz.13485] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 08/17/2023] [Accepted: 08/20/2023] [Indexed: 11/29/2023]
Abstract
INTRODUCTION Protein-based plasma assays provide hope for improving accessibility and specificity of molecular diagnostics to diagnose dementia. METHODS Plasma was obtained from participants (N = 837) in our community-based University of Kentucky Alzheimer's Disease Research Center cohort. We evaluated six Alzheimer's disease (AD)- and neurodegeneration-related (Aβ40, Aβ42, Aβ42/40, p-tau181, total tau, and NfLight) and five inflammatory biomarkers (TNF𝛼, IL6, IL8, IL10, and GFAP) using the SIMOA-based protein assay platform. Statistics were performed to assess correlations. RESULTS Our large cohort reflects previous plasma biomarker findings. Relationships between biomarkers to understand AD-inflammatory biomarker correlations showed significant associations between AD and inflammatory biomarkers suggesting peripheral inflammatory interactions with increasing AD pathology. Biomarker associations parsed out by clinical diagnosis (normal, MCI, and dementia) reveal changes in strength of the correlations across the cognitive continuum. DISCUSSION Unique AD-inflammatory biomarker correlations in a community-based cohort reveal a new avenue for utilizing plasma-based biomarkers in the assessment of AD and related dementias. HIGHLIGHTS Large community cohorts studying sex, age, and APOE genotype effects on biomarkers are few. It is unknown how biomarker-biomarker associations vary through aging and dementia. Six AD (Aβ40, Aβ42, Aβ42/40, p-tau181, total tau, and NfLight) and five inflammatory biomarkers (TNFα, IL6, IL8, IL10, and GFAP) were used to examine associations between biomarkers. Plasma biomarkers suggesting increasing cerebral AD pathology corresponded to increases in peripheral inflammatory markers, both pro-inflammatory and anti-inflammatory. Strength of correlations, between pairs of classic AD and inflammatory plasma biomarker, changes throughout cognitive progression to dementia.
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Affiliation(s)
- Kate E. Foley
- Sanders Brown Center on AgingUniversity of KentuckyLexingtonKentuckyUSA
- Department of PhysiologyUniversity of KentuckyLexingtonKentuckyUSA
| | - Zachary Winder
- Department of PhysiologyUniversity of KentuckyLexingtonKentuckyUSA
- College of MedicineUniversity of KentuckyLexingtonKentuckyUSA
| | - Tiffany L. Sudduth
- Sanders Brown Center on AgingUniversity of KentuckyLexingtonKentuckyUSA
- Department of PhysiologyUniversity of KentuckyLexingtonKentuckyUSA
| | - Barbara J. Martin
- Sanders Brown Center on AgingUniversity of KentuckyLexingtonKentuckyUSA
| | - Peter T. Nelson
- Sanders Brown Center on AgingUniversity of KentuckyLexingtonKentuckyUSA
- Pathology and Laboratory MedicineUniversity of KentuckyLexingtonKentuckyUSA
| | - Gregory A. Jicha
- Sanders Brown Center on AgingUniversity of KentuckyLexingtonKentuckyUSA
- Neurology, College of Public HealthUniversity of KentuckyLexingtonKentuckyUSA
| | - Jordan P. Harp
- Sanders Brown Center on AgingUniversity of KentuckyLexingtonKentuckyUSA
- Neurology, College of Public HealthUniversity of KentuckyLexingtonKentuckyUSA
| | - Erica M. Weekman
- Sanders Brown Center on AgingUniversity of KentuckyLexingtonKentuckyUSA
- Department of PhysiologyUniversity of KentuckyLexingtonKentuckyUSA
| | - Donna M. Wilcock
- Sanders Brown Center on AgingUniversity of KentuckyLexingtonKentuckyUSA
- Department of PhysiologyUniversity of KentuckyLexingtonKentuckyUSA
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Morrison LJ, Steketee PC, Tettey MD, Matthews KR. Pathogenicity and virulence of African trypanosomes: From laboratory models to clinically relevant hosts. Virulence 2023; 14:2150445. [PMID: 36419235 DOI: 10.1080/21505594.2022.2150445] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 11/17/2022] [Indexed: 11/25/2022] Open
Abstract
African trypanosomes are vector-borne protozoa, which cause significant human and animal disease across sub-Saharan Africa, and animal disease across Asia and South America. In humans, infection is caused by variants of Trypanosoma brucei, and is characterized by varying rate of progression to neurological disease, caused by parasites exiting the vasculature and entering the brain. Animal disease is caused by multiple species of trypanosome, primarily T. congolense, T. vivax, and T. brucei. These trypanosomes also infect multiple species of mammalian host, and this complexity of trypanosome and host diversity is reflected in the spectrum of severity of disease in animal trypanosomiasis, ranging from hyperacute infections associated with mortality to long-term chronic infections, and is also a main reason why designing interventions for animal trypanosomiasis is so challenging. In this review, we will provide an overview of the current understanding of trypanosome determinants of infection progression and severity, covering laboratory models of disease, as well as human and livestock disease. We will also highlight gaps in knowledge and capabilities, which represent opportunities to both further our fundamental understanding of how trypanosomes cause disease, as well as facilitating the development of the novel interventions that are so badly needed to reduce the burden of disease caused by these important pathogens.
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Affiliation(s)
- Liam J Morrison
- Roslin Institute, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, UK
| | - Pieter C Steketee
- Roslin Institute, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, UK
| | - Mabel D Tettey
- Institute for Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, Edinburgh, UK
| | - Keith R Matthews
- Institute for Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, Edinburgh, UK
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3
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Fataki Asina O, Noyes H, Bucheton B, Ilboudo H, MacLeod A, Mumba Ngoyi D. SNPs in IL4 and IFNG show no protective associations with human African trypanosomiasis in the Democratic Republic of the Congo: a case-control study. AAS Open Res 2020; 3:35. [PMID: 32964195 PMCID: PMC7481849 DOI: 10.12688/aasopenres.12999.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2020] [Indexed: 11/20/2022] Open
Abstract
Background: Human African trypanosomiasis (HAT) is a protozoal disease transmitted by tsetse flies. Infection with trypanosomes can lead directly to active HAT or latent infection with no detectable parasites, which may progress to active HAT or to spontaneous self-cure. Genetic variation could explain these differences in the outcome of infection. To test this hypothesis, polymorphisms in 17 candidate genes were tested ( APOL1 [ G1 and G2], CFH, HLA-A, HPR, HP, IL1B, IL12B, IL12RB1, IL10, IL4R, MIF, TNFA , IL6, IL4, IL8, IFNG, and HLA-G). Methods: Samples were collected in Democratic Republic of the Congo. 233 samples were genotyped: 100 active HAT cases, 33 from subjects with latent infections and 100 negative controls. Commercial service providers genotyped polymorphisms at 96 single nucleotide polymorphisms (SNPs) on 17 genes. Data were analyzed using Plink V1.9 software and R. Loci, with suggestive associations (uncorrected p < 0.05) validated using an additional 594 individuals, including 164 cases and 430 controls. Results: After quality control, 87 SNPs remained in the analysis. Two SNPs in IL4 and two in IFNG were suggestively associated (uncorrected p<0.05) with a differential risk of developing a Trypanosoma brucei gambiense infection in the Congolese population. The IFNG minor allele (rs2430561, rs2069718) SNPs were protective in comparison between latent infections and controls. Carriers of the rs2243258_T and rs2243279_A alleles of IL4 and the rs2069728_T allele of IFNG had a reduced risk of developing illness or latent infection, respectively. None of these associations were significant after Bonferroni correction for multiple testing. A validation study using more samples was run to determine if the absence of significant association was due to lack of power. Conclusions: This study showed no evidence of an association of HAT with IL4 and IFNG SNPs or with APOL1 G1 and G2 alleles, which have been found to be protective in other studies.
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Affiliation(s)
- Olivier Fataki Asina
- National Institute of Biomedical Research (INRB), Kinshasa, Democratic Republic of the Congo
- School of Medicine, University of Uele, Isiro, Democratic Republic of the Congo
| | - Harry Noyes
- Center for Genomic Research, University of Liverpool, Liverpool, L69 7ZB, UK
| | | | - Hamidou Ilboudo
- Centre International de Recherche-Développement sur l'Elevage en zones Subhumides (CIRDES), Bobo-Dioulasso, Burkina Faso
- Institut de Recherche en Sciences de la santé ( IRSS)-Unite de Recherche Clinique de Nanoro( URCN), Nanoro, Burkina Faso
| | - Annette MacLeod
- Wellcome Centre for Molecular Parasitology, University of Glasgow, Glasgow, G12 8TA, UK
| | - Dieudonné Mumba Ngoyi
- National Institute of Biomedical Research (INRB), Kinshasa, Democratic Republic of the Congo
- School of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - TrypanoGEN Group, as members of The H3Africa Consortium
- National Institute of Biomedical Research (INRB), Kinshasa, Democratic Republic of the Congo
- School of Medicine, University of Uele, Isiro, Democratic Republic of the Congo
- Center for Genomic Research, University of Liverpool, Liverpool, L69 7ZB, UK
- IRD-CIRAD 177, Montpellier, 34398, France
- Centre International de Recherche-Développement sur l'Elevage en zones Subhumides (CIRDES), Bobo-Dioulasso, Burkina Faso
- Institut de Recherche en Sciences de la santé ( IRSS)-Unite de Recherche Clinique de Nanoro( URCN), Nanoro, Burkina Faso
- Wellcome Centre for Molecular Parasitology, University of Glasgow, Glasgow, G12 8TA, UK
- School of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
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4
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Alvar J, Alves F, Bucheton B, Burrows L, Büscher P, Carrillo E, Felger I, Hübner MP, Moreno J, Pinazo MJ, Ribeiro I, Sosa-Estani S, Specht S, Tarral A, Wourgaft NS, Bilbe G. Implications of asymptomatic infection for the natural history of selected parasitic tropical diseases. Semin Immunopathol 2020; 42:231-246. [PMID: 32189034 PMCID: PMC7299918 DOI: 10.1007/s00281-020-00796-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 03/03/2020] [Indexed: 12/18/2022]
Abstract
Progress has been made in the control or elimination of tropical diseases, with a significant reduction of incidence. However, there is a risk of re-emergence if the factors fueling transmission are not dealt with. Although it is essential to understand these underlying factors for each disease, asymptomatic carriers are a common element that may promote resurgence; their impact in terms of proportion in the population and role in transmission needs to be determined. In this paper, we review the current evidence on whether or not to treat asymptomatic carriers given the relevance of their role in the transmission of a specific disease, the efficacy and toxicity of existing drugs, the Public Health interest, and the benefit at an individual level, for example, in Chagas disease, to prevent irreversible organ damage. In the absence of other control tools such as vaccines, there is a need for safer drugs with good risk/benefit profiles in order to change the paradigm so that it addresses the complete infectious process beyond manifest disease to include treatment of non-symptomatic infected persons.
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Affiliation(s)
- Jorge Alvar
- Drugs for Neglected Diseases initiative, Geneva, Switzerland.
| | - Fabiana Alves
- Drugs for Neglected Diseases initiative, Geneva, Switzerland
| | - Bruno Bucheton
- Institut de Recherche pour le Développement, Université de Montpellier, Montpellier, France
| | - Louise Burrows
- Drugs for Neglected Diseases initiative, Geneva, Switzerland
| | | | - Eugenia Carrillo
- WHO Collaborating Cenre for Leishmaniasis, Instituto de Sakud Carlos III, Madrid, Spain
| | - Ingrid Felger
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Marc P Hübner
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Javier Moreno
- WHO Collaborating Cenre for Leishmaniasis, Instituto de Sakud Carlos III, Madrid, Spain
| | | | - Isabela Ribeiro
- Drugs for Neglected Diseases initiative, Geneva, Switzerland
| | - Sergio Sosa-Estani
- Drugs for Neglected Diseases initiative, Centro de Investigación de Epidemiología y Salud Pública (CIESP-IECS), CONICET, Buenos Aires, Argentina
| | - Sabine Specht
- Drugs for Neglected Diseases initiative, Geneva, Switzerland
| | - Antoine Tarral
- Drugs for Neglected Diseases initiative, Geneva, Switzerland
| | | | - Graeme Bilbe
- Drugs for Neglected Diseases initiative, Geneva, Switzerland
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5
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Salvador F, Sánchez-Montalvá A, Martínez-Gallo M, Sulleiro E, Franco-Jarava C, Sao Avilés A, Bosch-Nicolau P, Moure Z, Silgado A, Molina I. Serum IL-10 Levels and Its Relationship with Parasitemia in Chronic Chagas Disease Patients. Am J Trop Med Hyg 2020; 102:159-163. [PMID: 31701864 DOI: 10.4269/ajtmh.19-0550] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
It is known that the immunoregulatory networks in human Chagas disease play a key role in parasitemia control during the acute phase. However, little is known regarding the control of parasitemia during the chronic phase. The aim of the study was to describe the serum cytokine profile of Trypanosoma cruzi chronically infected patients and to evaluate its relationship with the presence or absence of parasitemia in peripheral blood. This is a prospective observational study where adult Chagas disease patients were included. Patients previously treated for Chagas disease, pregnant women, and immunosuppressed patients were excluded. Demographic and clinical information was collected, and T. cruzi real-time polymerase chain reaction (RT-PCR) and serum cytokine profile were determined in peripheral blood. Forty-five patients were included. Trypanosoma cruzi RT-PCR in peripheral blood resulted positive in 19 (42.2%) patients. No differences in the serum cytokine profile were found depending on cardiac or digestive involvement. However, patients with positive T. cruzi RT-PCR had a higher median concentration of IL-10 and IL-1beta and a lower median concentration of IL-8 than those with negative T. cruzi PCR. These results reinforce the key role that this anti-inflammatory cytokine (IL-10) plays in parasitemia control.
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Affiliation(s)
- Fernando Salvador
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Adrián Sánchez-Montalvá
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | | | - Elena Sulleiro
- Department of Microbiology, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | | | - Augusto Sao Avilés
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Pau Bosch-Nicolau
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Zaira Moure
- Department of Microbiology, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Aroa Silgado
- Department of Microbiology, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Israel Molina
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
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6
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Magez S, Pinto Torres JE, Obishakin E, Radwanska M. Infections With Extracellular Trypanosomes Require Control by Efficient Innate Immune Mechanisms and Can Result in the Destruction of the Mammalian Humoral Immune System. Front Immunol 2020; 11:382. [PMID: 32218784 PMCID: PMC7078162 DOI: 10.3389/fimmu.2020.00382] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 02/18/2020] [Indexed: 12/17/2022] Open
Abstract
Salivarian trypanosomes are extracellular parasites that affect humans, livestock, and game animals around the world. Through co-evolution with the mammalian immune system, trypanosomes have developed defense mechanisms that allow them to thrive in blood, lymphoid vessels, and tissue environments such as the brain, the fat tissue, and testes. Trypanosomes have developed ways to circumvent antibody-mediated killing and block the activation of the lytic arm of the complement pathway. Hence, this makes the innate immune control of the infection a crucial part of the host-parasite interaction, determining infection susceptibility, and parasitemia control. Indeed, trypanosomes use a combination of several independent mechanisms to avoid clearance by the humoral immune system. First, perpetuated antigenic variation of the surface coat allows to escape antibody-mediated elimination. Secondly, when antibodies bind to the coat, they are efficiently transported toward the endocytosis pathway, where they are removed from the coat proteins. Finally, trypanosomes engage in the active destruction of the mammalian humoral immune response. This provides them with a rescue solution in case antigenic variation does not confer total immunological invisibility. Both antigenic variation and B cell destruction pose significant hurdles for the development of anti-trypanosome vaccine strategies. However, developing total immune escape capacity and unlimited growth capabilities within a mammalian host is not beneficial for any parasite, as it will result in the accelerated death of the host itself. Hence, trypanosomes have acquired a system of quorum sensing that results in density-dependent population growth arrest in order to prevent overpopulating the host. The same system could possibly sense the infection-associated host tissue damage resulting from inflammatory innate immune responses, in which case the quorum sensing serves to prevent excessive immunopathology and as such also promotes host survival. In order to put these concepts together, this review summarizes current knowledge on the interaction between trypanosomes and the mammalian innate immune system, the mechanisms involved in population growth regulation, antigenic variation and the immuno-destructive effect of trypanosomes on the humoral immune system. Vaccine trials and a discussion on the role of innate immune modulation in these trials are discussed at the end.
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Affiliation(s)
- Stefan Magez
- Laboratory for Biomedical Research, Ghent University Global Campus, Incheon, South Korea.,Department of Biochemistry and Microbiology, Ghent University, Ghent, Belgium.,Laboratory of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Emmanuel Obishakin
- Laboratory for Biomedical Research, Ghent University Global Campus, Incheon, South Korea.,Biotechnology Division, National Veterinary Research Institute, Vom, Nigeria
| | - Magdalena Radwanska
- Laboratory for Biomedical Research, Ghent University Global Campus, Incheon, South Korea.,Department of Biomedical Molecular Biology, Ghent University, Ghent, Belgium
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7
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Dama E, Camara O, Kaba D, Koffi M, Camara M, Compaoré C, Ilboudo H, Courtin F, Kaboré J, N'Gouan EK, Büscher P, Lejon V, Bucheton B, Jamonneau V. Immune trypanolysis test as a promising bioassay to monitor the elimination of gambiense human African trypanosomiasis. ACTA ACUST UNITED AC 2019; 26:68. [PMID: 31755862 PMCID: PMC6873819 DOI: 10.1051/parasite/2019066] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 10/30/2019] [Indexed: 01/07/2023]
Abstract
The World Health Organization (WHO) has set the goal of gambiense-Human African trypanosomiasis (HAT) elimination as a public health problem for 2020 and interruption of transmission in humans for 2030. In this context, it is crucial to monitor progress towards these targets using accurate tools to assess the level of transmission in a given area. The aim of this study was to investigate the relevance of the immune trypanolysis test (TL) as a population-based bioassay to evaluate Trypanosoma brucei gambiense transmission in various epidemiological contexts. Significant correlations were observed between HAT endemicity levels and the percentage of TL-positive individuals in the population. TL therefore appears to be a suitable population-based biomarker of the intensity of transmission. In addition to being used as a tool to assess the HAT status at an individual level, assessing the proportion of TL positive individuals in the population appears as a promising and easy alternative to monitor the elimination of gambiense HAT in a given area.
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Affiliation(s)
- Emilie Dama
- Centre International de Recherche-Développement sur l'Elevage en zones Subhumides (CIRDES), Unité de recherches sur les maladies à vecteurs et biodiversité, 01 BP 454 Bobo-Dioulasso 01, Burkina Faso - Université Nazi Boni, Bobo-Dioulasso, 01 BP 1091 Bobo-Dioulasso, Burkina Faso
| | - Oumou Camara
- Programme National de Lutte contre la Trypanosomose Humaine Africaine, BP 851, Conakry, Guinée
| | - Dramane Kaba
- Institut Pierre Richet, Unité de Recherche « Trypanosomoses », 01 BP 1500, Bouaké, Côte d'Ivoire
| | - Mathurin Koffi
- Université Jean Lorougnon Guédé, Laboratoire de biodiversité et Gestion durable des écosystèmes tropicaux, Unité de Recherche en Génétique et Epidémiologie moléculaire, BP 150 Daloa, Côte d'Ivoire
| | - Mamadou Camara
- Programme National de Lutte contre la Trypanosomose Humaine Africaine, BP 851, Conakry, Guinée
| | - Charlie Compaoré
- Centre International de Recherche-Développement sur l'Elevage en zones Subhumides (CIRDES), Unité de recherches sur les maladies à vecteurs et biodiversité, 01 BP 454 Bobo-Dioulasso 01, Burkina Faso
| | - Hamidou Ilboudo
- Institut de Recherche en Sciences de la Santé (IRSS), Unité de Recherche Clinique de Nanoro (URCN), 11 BP 218 Ouagadougou CMS 11, Burkina Faso
| | - Fabrice Courtin
- Institut Pierre Richet, Unité de Recherche « Trypanosomoses », 01 BP 1500, Bouaké, Côte d'Ivoire - Institut de Recherche pour le Développement (IRD), UMR INTERTRYP IRD-CIRAD, Université de Montpellier, TA A-17/G, Campus International de Baillarguet, F-34398 Montpellier, France
| | - Jacques Kaboré
- Centre International de Recherche-Développement sur l'Elevage en zones Subhumides (CIRDES), Unité de recherches sur les maladies à vecteurs et biodiversité, 01 BP 454 Bobo-Dioulasso 01, Burkina Faso - Université Nazi Boni, Bobo-Dioulasso, 01 BP 1091 Bobo-Dioulasso, Burkina Faso
| | | | - Philippe Büscher
- Institute of Tropical Medicine, Department of Biomedical Sciences, Nationalestraat 155, 2000 Antwerp, Belgium
| | - Veerle Lejon
- Institut de Recherche pour le Développement (IRD), UMR INTERTRYP IRD-CIRAD, Université de Montpellier, TA A-17/G, Campus International de Baillarguet, F-34398 Montpellier, France
| | - Bruno Bucheton
- Programme National de Lutte contre la Trypanosomose Humaine Africaine, BP 851, Conakry, Guinée - Institut de Recherche pour le Développement (IRD), UMR INTERTRYP IRD-CIRAD, Université de Montpellier, TA A-17/G, Campus International de Baillarguet, F-34398 Montpellier, France
| | - Vincent Jamonneau
- Institut Pierre Richet, Unité de Recherche « Trypanosomoses », 01 BP 1500, Bouaké, Côte d'Ivoire - Institut de Recherche pour le Développement (IRD), UMR INTERTRYP IRD-CIRAD, Université de Montpellier, TA A-17/G, Campus International de Baillarguet, F-34398 Montpellier, France
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8
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Kamoto K, Noyes H, Nambala P, Senga E, Musaya J, Kumwenda B, Bucheton B, Macleod A, Cooper A, Clucas C, Herz-Fowler C, Matove E, Chiwaya AM, Chisi JE. Association of APOL1 renal disease risk alleles with Trypanosoma brucei rhodesiense infection outcomes in the northern part of Malawi. PLoS Negl Trop Dis 2019; 13:e0007603. [PMID: 31412021 PMCID: PMC6750591 DOI: 10.1371/journal.pntd.0007603] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 09/18/2019] [Accepted: 07/04/2019] [Indexed: 12/19/2022] Open
Abstract
Trypanosoma brucei (T.b.) rhodesiense is the cause of the acute form of human African trypanosomiasis (HAT) in eastern and southern African countries. There is some evidence that there is diversity in the disease progression of T.b. rhodesiense in different countries. HAT in Malawi is associated with a chronic haemo-lymphatic stage infection compared to other countries, such as Uganda, where the disease is acute with more marked neurological impairment. This has raised the question of the role of host genetic factors in infection outcomes. A candidate gene association study was conducted in the northern region of Malawi. This was a case-control study involving 202 subjects, 70 cases and 132 controls. All individuals were from one area; born in the area and had been exposed to the risk of infection since birth. Ninety-six markers were genotyped from 17 genes: IL10, IL8, IL4, HLA-G, TNFA, IL6, IFNG, MIF, APOL, HLA-A, IL1B, IL4R, IL12B, IL12R, HP, HPR, and CFH. There was a strong significant association with APOL1 G2 allele (p = 0.0000105, OR = 0.14, CI95 = [0.05-0.41], BONF = 0.00068) indicating that carriers of the G2 allele were protected against T.b. rhodesiense HAT. SNP rs2069845 in IL6 had raw p < 0.05, but did not remain significant after Bonferroni correction. There were no associations found with the other 15 candidate genes. Our finding confirms results from other studies that the G2 variant of APOL1 is associated with protection against T.b. rhodesiense HAT.
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Affiliation(s)
- Kelita Kamoto
- University of Malawi, College of Medicine, Department of Basic Medical Sciences, Blantyre, Malawi
| | - Harry Noyes
- Centre for Genomic Research, University of Liverpool, United Kingdom
| | - Peter Nambala
- University of Malawi, College of Medicine, Department of Basic Medical Sciences, Blantyre, Malawi
| | - Edward Senga
- University of Malawi, College of Medicine, Department of Basic Medical Sciences, Blantyre, Malawi
| | - Janelisa Musaya
- University of Malawi, College of Medicine, Department of Basic Medical Sciences, Blantyre, Malawi
| | - Benjamin Kumwenda
- University of Malawi, College of Medicine, Department of Basic Medical Sciences, Blantyre, Malawi
| | - Bruno Bucheton
- Institut de Recherche pour le Développement (IRD), IRD-CIRAD 177, Montpellier, France
- Programme National de Lutte contre la Trypanosomose Humaine Africaine, Conakry, Guinea
| | - Annette Macleod
- Wellcome Trust Centre for Molecular Parasitology, University Place, Glasgow, United Kingdom
| | - Anneli Cooper
- Wellcome Trust Centre for Molecular Parasitology, University Place, Glasgow, United Kingdom
| | - Caroline Clucas
- Wellcome Trust Centre for Molecular Parasitology, University Place, Glasgow, United Kingdom
| | | | | | | | - John E. Chisi
- University of Malawi, College of Medicine, Department of Basic Medical Sciences, Blantyre, Malawi
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9
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Dauchy FA, Contin-Bordes C, Nzoumbou-Boko R, Bonhivers M, Landrein N, Robinson DR, Rambert J, Courtois P, Daulouède S, Vincendeau P. Trypanosoma brucei gambiense excreted/secreted factors impair lipopolysaccharide-induced maturation and activation of human monocyte-derived dendritic cells. Parasite Immunol 2019; 41:e12632. [PMID: 31099071 DOI: 10.1111/pim.12632] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 05/13/2019] [Accepted: 05/14/2019] [Indexed: 01/10/2023]
Abstract
Trypanosoma brucei gambiense, an extracellular eukaryotic flagellate parasite, is the main etiological agent of human African trypanosomiasis (HAT) or sleeping sickness. Dendritic cells (DCs) play a pivotal role at the interface between innate and adaptive immune response and are implicated during HAT. In this study, we investigated the effects of T gambiense and its excreted/secreted factors (ESF) on the phenotype of human monocyte-derived DCs (Mo-DCs). Mo-DCs were cultured with trypanosomes, lipopolysaccharide (LPS), ESF derived from T gambiense bloodstream strain Biyamina (MHOM/SD/82), or both ESF and LPS. Importantly, ESF reduced the expression of the maturation markers HLA-DR and CD83, as well as the secretion of IL-12, TNF-alpha and IL-10, in LPS-stimulated Mo-DCs. During mixed-leucocyte reactions, LPS- plus ESF-exposed DCs induced a non-significant decrease in the IFN-gamma/IL-10 ratio of CD4 + T-cell cytokines. Based on the results presented here, we raise the hypothesis that T gambiense has developed an immune escape strategy through the secretion of paracrine mediators in order to limit maturation and activation of human DCs. The identification of the factor(s) in the T gambiense ESF and of the DCs signalling pathway(s) involved may be important in the development of new therapeutic targets.
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Affiliation(s)
- Frédéric-Antoine Dauchy
- Laboratoire de Parasitologie, UMR IRD CIRAD INTERTRYP 177, University of Bordeaux, Bordeaux, France.,UMR INTERTRYP 177, IRD-CIRAD-University of Bordeaux, Montpellier, France.,Department of Infectious and Tropical Diseases, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France
| | - Cécile Contin-Bordes
- Laboratoire d'Immunologie et d'Immunogénétique, CHU de Bordeaux, Bordeaux, France.,UMR 5164 CIRID, University of Bordeaux, Bordeaux, France
| | - Romaric Nzoumbou-Boko
- Laboratoire de Parasitologie, UMR IRD CIRAD INTERTRYP 177, University of Bordeaux, Bordeaux, France.,UMR INTERTRYP 177, IRD-CIRAD-University of Bordeaux, Montpellier, France
| | - Mélanie Bonhivers
- Microbiologie Fondamentale et Pathogénicité, UMR 5234, University of Bordeaux, Bordeaux, France.,Microbiologie Fondamentale et Pathogénicité, UMR 5234, CNRS, Bordeaux, France
| | - Nicolas Landrein
- Microbiologie Fondamentale et Pathogénicité, UMR 5234, University of Bordeaux, Bordeaux, France.,Microbiologie Fondamentale et Pathogénicité, UMR 5234, CNRS, Bordeaux, France
| | - Derrick R Robinson
- Microbiologie Fondamentale et Pathogénicité, UMR 5234, University of Bordeaux, Bordeaux, France.,Microbiologie Fondamentale et Pathogénicité, UMR 5234, CNRS, Bordeaux, France
| | - Jérôme Rambert
- Aquiderm, INSERM U 1035, University of Bordeaux, Bordeaux, France
| | - Pierrette Courtois
- Laboratoire de Parasitologie, UMR IRD CIRAD INTERTRYP 177, University of Bordeaux, Bordeaux, France.,UMR INTERTRYP 177, IRD-CIRAD-University of Bordeaux, Montpellier, France
| | - Sylvie Daulouède
- Laboratoire de Parasitologie, UMR IRD CIRAD INTERTRYP 177, University of Bordeaux, Bordeaux, France.,UMR INTERTRYP 177, IRD-CIRAD-University of Bordeaux, Montpellier, France
| | - Philippe Vincendeau
- Laboratoire de Parasitologie, UMR IRD CIRAD INTERTRYP 177, University of Bordeaux, Bordeaux, France.,UMR INTERTRYP 177, IRD-CIRAD-University of Bordeaux, Montpellier, France.,Laboratoire de Parasitologie, CHU de Bordeaux, Bordeaux, France
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10
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Kaboré JW, Camara O, Ilboudo H, Capewell P, Clucas C, Cooper A, Kaboré J, Camara M, Jamonneau V, Hertz-Fowler C, Bélem AMG, Matovu E, Macleod A, Sidibé I, Noyes H, Bucheton B. Macrophage migrating inhibitory factor expression is associated with Trypanosoma brucei gambiense infection and is controlled by trans-acting expression quantitative trait loci in the Guinean population. INFECTION GENETICS AND EVOLUTION 2019; 71:108-115. [PMID: 30914286 DOI: 10.1016/j.meegid.2019.03.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 03/21/2019] [Accepted: 03/22/2019] [Indexed: 02/06/2023]
Abstract
Infection by Trypanosoma brucei gambiense is characterized by a wide array of clinical outcomes, ranging from asymptomatic to acute disease and even spontaneous cure. In this study, we investigated the association between macrophage migrating inhibitory factor (MIF), an important pro-inflammatory cytokine that plays a central role in both innate and acquired immunity, and disease outcome during T. b. gambiense infection. A comparative expression analysis of patients, individuals with latent infection and controls found that MIF had significantly higher expression in patients (n = 141; 1.25 ± 0.07; p < .0001) and latent infections (n = 25; 1.23 ± 0.13; p = .0005) relative to controls (n = 46; 0.94 ± 0.11). Furthermore, expression decreased significantly after treatment (patients before treatment n = 33; 1.40 ± 0.18 versus patients after treatment n = 33; 0.99 ± 0.10, p = .0001). We conducted a genome wide eQTL analysis on 29 controls, 128 cases and 15 latently infected individuals for whom expression and genotype data were both available. Four loci, including one containing the chemokine CXCL13, were found to associate with MIF expression. Genes at these loci are candidate regulators of increased expression of MIF after infection. Our study is the first data demonstrating that MIF expression is elevated in T. b. gambiense-infected human hosts but does not appear to contribute to pathology.
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Affiliation(s)
- Justin Windingoudi Kaboré
- Centre International de Recherche-Développement sur l'Élevage en zone Subhumide (CIRDES), Unité des Maladies à Vecteurs et Biodiversités (UMaVeB), Bobo-Dioulasso, Burkina Faso
| | - Oumou Camara
- Ministère de la Santé et de l'Hygiène Publique, Programme National de Lutte contre la Trypanosomiase Humaine Africaine (PNLTHA), Conakry, Guinea
| | - Hamidou Ilboudo
- Institut de Recherche en Sciences de la Santé (IRSS), Unité de Recherche Clinique de Nanoro (URCN), Nanoro, Burkina Faso
| | - Paul Capewell
- University of Glasgow, Wellcome Trust Centre for Molecular Parasitology, Glasgow, United Kingdom
| | - Caroline Clucas
- University of Glasgow, Wellcome Trust Centre for Molecular Parasitology, Glasgow, United Kingdom
| | - Anneli Cooper
- University of Glasgow, Wellcome Trust Centre for Molecular Parasitology, Glasgow, United Kingdom
| | - Jacques Kaboré
- Centre International de Recherche-Développement sur l'Élevage en zone Subhumide (CIRDES), Unité des Maladies à Vecteurs et Biodiversités (UMaVeB), Bobo-Dioulasso, Burkina Faso; Université Nazi Boni (UNB), Bobo-Dioulasso, Burkina Faso
| | - Mamadou Camara
- Ministère de la Santé et de l'Hygiène Publique, Programme National de Lutte contre la Trypanosomiase Humaine Africaine (PNLTHA), Conakry, Guinea
| | - Vincent Jamonneau
- Institut de Recherche pour le Développement (IRD), UMR IRD-CIRAD 177 INTERTRYP, Montpellier, France
| | | | | | - Enock Matovu
- Makerere University, College of Veterinary Medicine Animal Resources and Biosecurity, Kampala, Uganda
| | - Annette Macleod
- University of Glasgow, Wellcome Trust Centre for Molecular Parasitology, Glasgow, United Kingdom
| | - Issa Sidibé
- Centre International de Recherche-Développement sur l'Élevage en zone Subhumide (CIRDES), Unité des Maladies à Vecteurs et Biodiversités (UMaVeB), Bobo-Dioulasso, Burkina Faso
| | - Harry Noyes
- University of Liverpool, Centre for Genomic Research, Liverpool, United Kingdom
| | - Bruno Bucheton
- Ministère de la Santé et de l'Hygiène Publique, Programme National de Lutte contre la Trypanosomiase Humaine Africaine (PNLTHA), Conakry, Guinea; Institut de Recherche pour le Développement (IRD), UMR IRD-CIRAD 177 INTERTRYP, Montpellier, France.
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11
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Ofon E, Noyes H, Ebo’o Eyanga V, Njiokou F, Koffi M, Fogue P, Hertz-Fowler C, MacLeod A, Matovu E, Simo G. Association between IL1 gene polymorphism and human African trypanosomiasis in populations of sleeping sickness foci of southern Cameroon. PLoS Negl Trop Dis 2019; 13:e0007283. [PMID: 30908482 PMCID: PMC6448947 DOI: 10.1371/journal.pntd.0007283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 04/04/2019] [Accepted: 03/07/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Human African Trypanosomiasis (HAT) is a neglected tropical disease caused by infections due to Trypanosoma brucei subspecies. In addition to the well-established environmental and behavioural risks of becoming infected, there is evidence for a genetic component to the response to trypanosome infection. We undertook a candidate gene case-control study to investigate genetic associations further. METHODOLOGY We genotyped one polymorphism in each of seven genes (IL1A, IL1RN, IL4RN, IL6, HP, HPR, and HLA-G) in 73 cases and 250 controls collected from 19 ethno-linguistic subgroups stratified into three major ethno-linguistic groups, 2 pooled ethno-linguistic groups and 11 ethno-linguistic subgroups from three Cameroonian HAT foci. The seven polymorphic loci tested consisted of three SNPs, three variable numbers of tandem repeat (VNTR) and one INDEL. RESULTS We found that the genotype (TT) and minor allele (T) of IL1A gene as well as the genotype 1A3A of IL1RN were associated with an increased risk of getting Trypanosoma brucei gambiense and develop HAT when all data were analysed together and also when stratified by the three major ethno-linguistic groups, 2 pooled ethno-linguistic subgroups and 11 ethno-linguistic subgroups. CONCLUSION This study revealed that one SNP rs1800794 of IL1A and one VNTR rs2234663 of IL1RN were associated with the increased risk to be infected by Trypanosoma brucei gambiense and develop sleeping sickness in southern Cameroon. The minor allele T and the genotype TT of SNP rs1800794 in IL1A as well as the genotype 1A3A of IL1RN rs2234663 VNTR seem to increase the risk of getting Trypanosoma brucei gambiense infections and develop sleeping sickness in southern Cameroon.
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Affiliation(s)
- Elvis Ofon
- Molecular Parasitology and Entomology Unit, Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Harry Noyes
- Centre for Genomic Research, University of Liverpool, Liverpool, United Kingdom
| | - Vincent Ebo’o Eyanga
- MINSANTE, Divisional Centre for Diseases, PNLTHA, Ministry of Public Health, Yaoundé, Cameroon
| | - Flobert Njiokou
- Laboratory of Molecular Biology, Department of Animal Biology, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
| | - Mathurin Koffi
- Université Jean Lorougnon Guédé (UJLoG), UFR Environnement-Santé, Laboratoire des Interactions Hôte- Microorganismes-Environnement et Evolution (LIHME) Daloa, Côte d’Ivoire
| | - Pythagore Fogue
- Molecular Parasitology and Entomology Unit, Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon
| | | | - Annette MacLeod
- Wellcome Centre for Molecular Parasitology, University Place, Glasgow, United Kingdom
| | - Enock Matovu
- College of Veterinary Medicine, Animal Resources and Bio-security, Makerere University, Kampala, Uganda
| | - Gustave Simo
- Molecular Parasitology and Entomology Unit, Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon
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12
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Varikuti S, Jha BK, Volpedo G, Ryan NM, Halsey G, Hamza OM, McGwire BS, Satoskar AR. Host-Directed Drug Therapies for Neglected Tropical Diseases Caused by Protozoan Parasites. Front Microbiol 2018; 9:2655. [PMID: 30555425 PMCID: PMC6284052 DOI: 10.3389/fmicb.2018.02655] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 10/17/2018] [Indexed: 12/11/2022] Open
Abstract
The neglected tropical diseases (NTDs) caused by protozoan parasites are responsible for significant morbidity and mortality worldwide. Current treatments using anti-parasitic drugs are toxic and prolonged with poor patient compliance. In addition, emergence of drug-resistant parasites is increasing worldwide. Hence, there is a need for safer and better therapeutics for these infections. Host-directed therapy using drugs that target host pathways required for pathogen survival or its clearance is a promising approach for treating infections. This review will give a summary of the current status and advances of host-targeted therapies for treating NTDs caused by protozoa.
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Affiliation(s)
- Sanjay Varikuti
- Department of Pathology, Wexner Medical Center, The Ohio State University, Columbus, OH, United States
| | - Bijay Kumar Jha
- Division of Infectious Diseases, Department of Internal Medicine, The Ohio State University, Columbus, OH, United States
| | - Greta Volpedo
- Department of Pathology, Wexner Medical Center, The Ohio State University, Columbus, OH, United States.,Department of Microbiology, The Ohio State University, Columbus, OH, United States
| | - Nathan M Ryan
- Department of Pathology, Wexner Medical Center, The Ohio State University, Columbus, OH, United States
| | - Gregory Halsey
- Department of Pathology, Wexner Medical Center, The Ohio State University, Columbus, OH, United States
| | - Omar M Hamza
- Department of Pathology, Wexner Medical Center, The Ohio State University, Columbus, OH, United States
| | - Bradford S McGwire
- Division of Infectious Diseases, Department of Internal Medicine, The Ohio State University, Columbus, OH, United States
| | - Abhay R Satoskar
- Department of Pathology, Wexner Medical Center, The Ohio State University, Columbus, OH, United States.,Department of Microbiology, The Ohio State University, Columbus, OH, United States
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13
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López-Muñoz RA, Molina-Berríos A, Campos-Estrada C, Abarca-Sanhueza P, Urrutia-Llancaqueo L, Peña-Espinoza M, Maya JD. Inflammatory and Pro-resolving Lipids in Trypanosomatid Infections: A Key to Understanding Parasite Control. Front Microbiol 2018; 9:1961. [PMID: 30186271 PMCID: PMC6113562 DOI: 10.3389/fmicb.2018.01961] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 08/02/2018] [Indexed: 12/30/2022] Open
Abstract
Pathogenic trypanosomatids (Trypanosoma cruzi, Trypanosoma brucei, and Leishmania spp.) are protozoan parasites that cause neglected diseases affecting millions of people in Africa, Asia, and the Americas. In the process of infection, trypanosomatids evade and survive the immune system attack, which can lead to a chronic inflammatory state that induces cumulative damage, often killing the host in the long term. The immune mediators involved in this process are not entirely understood. Most of the research on the immunologic control of protozoan infections has been focused on acute inflammation. Nevertheless, when this process is not terminated adequately, permanent damage to the inflamed tissue may ensue. Recently, a second process, called resolution of inflammation, has been proposed to be a pivotal process in the control of parasite burden and establishment of chronic infection. Resolution of inflammation is an active process that promotes the normal function of injured or infected tissues. Several mediators are involved in this process, including eicosanoid-derived lipids, cytokines such as transforming growth factor (TGF)-β and interleukin (IL)-10, and other proteins such as Annexin-V. For example, during T. cruzi infection, pro-resolving lipids such as 15-epi-lipoxin-A4 and Resolvin D1 have been associated with a decrease in the inflammatory changes observed in experimental chronic heart disease, reducing inflammation and fibrosis, and increasing host survival. Furthermore, Resolvin D1 modulates the immune response in cells of patients with Chagas disease. In Leishmania spp. infections, pro-resolving mediators such as Annexin-V, lipoxins, and Resolvin D1 are related to the modulation of cutaneous manifestation of the disease. However, these mediators seem to have different roles in visceral or cutaneous leishmaniasis. Finally, although T. brucei infections are less well studied in terms of their relationship with inflammation, it has been found that arachidonic acid-derived lipids act as key regulators of the host immune response and parasite burden. Also, cytokines such as IL-10 and TGF-β may be related to increased infection. Knowledge about the inflammation resolution process is necessary to understand the host–parasite interplay, but it also offers an interesting opportunity to improve the current therapies, aiming to reduce the detrimental state induced by chronic protozoan infections.
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Affiliation(s)
- Rodrigo A López-Muñoz
- Instituto de Farmacología y Morfofisiología, Facultad de Ciencias Veterinarias, Universidad Austral de Chile, Valdivia, Chile
| | - Alfredo Molina-Berríos
- Instituto de Investigación en Ciencias Odontológicas, Facultad de Odontología, Universidad de Chile, Santiago, Chile
| | - Carolina Campos-Estrada
- Escuela de Química y Farmacia, Facultad de Farmacia, Universidad de Valparaíso, Valparaíso, Chile.,Centro de Investigación Farmacopea Chilena, Universidad de Valparaíso, Valparaíso, Chile
| | - Patricio Abarca-Sanhueza
- Programa de Farmacología Molecular y Clínica, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Luis Urrutia-Llancaqueo
- Programa de Farmacología Molecular y Clínica, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Miguel Peña-Espinoza
- Instituto de Farmacología y Morfofisiología, Facultad de Ciencias Veterinarias, Universidad Austral de Chile, Valdivia, Chile
| | - Juan D Maya
- Programa de Farmacología Molecular y Clínica, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
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14
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Dama E, Drabo A, Kaboré J, Ouédraogo E, Coulibaly B, Ilboudo H, Kaboré J, Compaoré CF, Sakandé H, Ouédraogo M, Rayaissé JB, Courtin F, Solano P, Drabo F, Jamonneau V. Description of the first sleeping sickness case diagnosed in Burkina Faso since two decades. PLoS Negl Trop Dis 2018; 12:e0006677. [PMID: 30125276 PMCID: PMC6124770 DOI: 10.1371/journal.pntd.0006677] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 09/05/2018] [Accepted: 07/10/2018] [Indexed: 11/30/2022] Open
Abstract
Burkina Faso belongs to a group of countries in which human African trypanosomiasis (HAT), caused by Trypanosoma brucei gambiense, is no longer considered to be a public health problem. Although no native cases have been detected since 1993, there is still the risk of HAT re-emergence due to significant population movements between Burkina Faso and active HAT foci in Côte d’Ivoire. Since 2014, Burkina Faso receives support from the WHO to implement a passive surveillance program. This resulted in the detection in 2015 of the first putative native HAT case since two decades. However, epidemiological entomological and molecular biology investigations have not been able to identify with certainty the origin of this infection or to confirm that it was due to T. b. gambiense. This case emphasises the need to strengthen passive surveillance of the disease for sustained elimination of HAT as a public health problem in Burkina Faso. In 2012, the roadmap for the Control of Neglected Tropical Diseases (NTD) of the World Health Organization (WHO) included human African trypanosomiasis (HAT) to be eliminated as a public health problem by 2020. To reach this ambitious objective in Burkina Faso, where the vector (and consequently a risk of HAT re-emergence) is still present, a passive surveillance system based on sentinel sites was established in the southwestern part of the country, considered to be the most at-risk area. The implementation of this system recently resulted in the diagnosis of the first putative native sleeping sickness case since two decades. Although the origin of this infection and how the patient was infected could not be identified, the detection of this native case confirms that HAT re-emergence in Burkina Faso is still a risk. This demonstrates the importance of implementing, maintaining and reinforcing passive surveillance programs in at-risk areas.
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Affiliation(s)
- Emilie Dama
- Université Nazi Boni, Unité de Formation et de Recherche Sciences et Techniques, Bobo-Dioulasso, Burkina Faso
- Centre International de Recherche-Développement sur l’Elevage en zones Subhumides, Unité de recherches sur les bases biologiques de la lutte intégrée, Bobo-Dioulasso, Burkina Faso
- * E-mail:
| | - Aboubacar Drabo
- Centre Hospitalier Universitaire Yalgado Ouédraogo, Ouagadougou, Burkina Faso
| | - Jacques Kaboré
- Université Nazi Boni, Unité de Formation et de Recherche Sciences et Techniques, Bobo-Dioulasso, Burkina Faso
- Centre International de Recherche-Développement sur l’Elevage en zones Subhumides, Unité de recherches sur les bases biologiques de la lutte intégrée, Bobo-Dioulasso, Burkina Faso
| | - Elie Ouédraogo
- Programme National de Lutte contre les Maladies Tropicales Négligées, Ouagadougou, Burkina Faso
| | - Bamoro Coulibaly
- Institut Pierre Richet, Unité de Recherche “Trypanosomoses”, Bouaké, Côte d’Ivoire
| | - Hamidou Ilboudo
- Centre International de Recherche-Développement sur l’Elevage en zones Subhumides, Unité de recherches sur les bases biologiques de la lutte intégrée, Bobo-Dioulasso, Burkina Faso
| | - Justin Kaboré
- Université Nazi Boni, Unité de Formation et de Recherche Sciences et Techniques, Bobo-Dioulasso, Burkina Faso
- Centre International de Recherche-Développement sur l’Elevage en zones Subhumides, Unité de recherches sur les bases biologiques de la lutte intégrée, Bobo-Dioulasso, Burkina Faso
| | - Charlie Franck Compaoré
- Centre International de Recherche-Développement sur l’Elevage en zones Subhumides, Unité de recherches sur les bases biologiques de la lutte intégrée, Bobo-Dioulasso, Burkina Faso
| | - Hassane Sakandé
- Centre International de Recherche-Développement sur l’Elevage en zones Subhumides, Unité de recherches sur les bases biologiques de la lutte intégrée, Bobo-Dioulasso, Burkina Faso
| | - Micheline Ouédraogo
- Programme National de Lutte contre les Maladies Tropicales Négligées, Ouagadougou, Burkina Faso
| | - Jean-Baptiste Rayaissé
- Centre International de Recherche-Développement sur l’Elevage en zones Subhumides, Unité de recherches sur les bases biologiques de la lutte intégrée, Bobo-Dioulasso, Burkina Faso
| | - Fabrice Courtin
- Institut Pierre Richet, Unité de Recherche “Trypanosomoses”, Bouaké, Côte d’Ivoire
- Institut de Recherche pour le Développement, INTERTRYP, Université de Montpellier-IRD-CIRAD, Montpellier, France
| | - Philippe Solano
- Institut de Recherche pour le Développement, INTERTRYP, Université de Montpellier-IRD-CIRAD, Montpellier, France
| | - François Drabo
- Programme National de Lutte contre les Maladies Tropicales Négligées, Ouagadougou, Burkina Faso
| | - Vincent Jamonneau
- Centre International de Recherche-Développement sur l’Elevage en zones Subhumides, Unité de recherches sur les bases biologiques de la lutte intégrée, Bobo-Dioulasso, Burkina Faso
- Institut Pierre Richet, Unité de Recherche “Trypanosomoses”, Bouaké, Côte d’Ivoire
- Institut de Recherche pour le Développement, INTERTRYP, Université de Montpellier-IRD-CIRAD, Montpellier, France
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15
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Büscher P, Bart JM, Boelaert M, Bucheton B, Cecchi G, Chitnis N, Courtin D, Figueiredo LM, Franco JR, Grébaut P, Hasker E, Ilboudo H, Jamonneau V, Koffi M, Lejon V, MacLeod A, Masumu J, Matovu E, Mattioli R, Noyes H, Picado A, Rock KS, Rotureau B, Simo G, Thévenon S, Trindade S, Truc P, Van Reet N. Do Cryptic Reservoirs Threaten Gambiense-Sleeping Sickness Elimination? Trends Parasitol 2018; 34:197-207. [PMID: 29396200 PMCID: PMC5840517 DOI: 10.1016/j.pt.2017.11.008] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 11/18/2017] [Accepted: 11/27/2017] [Indexed: 12/22/2022]
Abstract
Trypanosoma brucei gambiense causes human African trypanosomiasis (HAT). Between 1990 and 2015, almost 440000 cases were reported. Large-scale screening of populations at risk, drug donations, and efforts by national and international stakeholders have brought the epidemic under control with <2200 cases in 2016. The World Health Organization (WHO) has set the goals of gambiense-HAT elimination as a public health problem for 2020, and of interruption of transmission to humans for 2030. Latent human infections and possible animal reservoirs may challenge these goals. It remains largely unknown whether, and to what extend, they have an impact on gambiense-HAT transmission. We argue that a better understanding of the contribution of human and putative animal reservoirs to gambiense-HAT epidemiology is mandatory to inform elimination strategies.
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Affiliation(s)
- Philippe Büscher
- Department of Biomedical Sciences, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium.
| | - Jean-Mathieu Bart
- INTERTRYP, IRD, CIRAD, Univ Montpellier, Montpellier, France; Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III, Calle Sinesio Delgado 4, 28029 Madrid, Spain
| | - Marleen Boelaert
- Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium
| | - Bruno Bucheton
- INTERTRYP, IRD, CIRAD, Univ Montpellier, Montpellier, France
| | - Giuliano Cecchi
- Sub-regional Office for Eastern Africa, Food and Agriculture Organization of the United Nations, CMC Road, Bole Sub City, Kebele 12/13, P O Box 5536, Addis Ababa, Ethiopia
| | - Nakul Chitnis
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, Postfach, 4002 Basel, Switzerland; University of Basel, Switzerland
| | - David Courtin
- Université Paris Descartes, Institut de Recherche pour le Développement, Unité MERIT, Mère et enfant face aux infections tropicales, 4 avenue de l'Observatoire, 75006 Paris, France
| | - Luisa M Figueiredo
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Avenida Prof Egas Moniz, 1649-028 Lisboa, Portugal
| | - José-Ramon Franco
- Control of Neglected Tropical Diseases, Innovative and Intensified Disease Management, World Health Organization, Via Appia 20, 1202 Geneva, Switzerland
| | - Pascal Grébaut
- INTERTRYP, IRD, CIRAD, Univ Montpellier, Montpellier, France
| | - Epco Hasker
- Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium
| | - Hamidou Ilboudo
- Institut de Recherche sur les Bases Biologiques de la Lutte Intégrée, Centre International de Recherche-Développement sur l'Élevage en zone Subhumide, 01 BP 454 Bobo-Dioulasso 01, Burkina Faso
| | | | - Mathurin Koffi
- Université Jean Lorougnon Guédé, BP 150 Daloa, Côte d'Ivoire
| | - Veerle Lejon
- INTERTRYP, IRD, CIRAD, Univ Montpellier, Montpellier, France
| | - Annette MacLeod
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Henry Wellcome Building, 464 Bearsden Road, Glasgow, UK
| | - Justin Masumu
- Département de Parasitologie, Institut National de Recherche Biomédicale, Avenue de la Démocratie, BP 1197 Kinshasa 1, République Démocratique du Congo
| | - Enock Matovu
- College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, P O Box 7062 Kampala, Uganda
| | - Raffaele Mattioli
- Animal Production and Health Division, Food and Agriculture Organization of the United Nations, Viale delle Terme di Caracalla, 00153 Rome, Italy
| | - Harry Noyes
- Institute of Integrative Biology, University of Liverpool, Liverpool L69 7ZB, UK
| | - Albert Picado
- Foundation for Innovative New Diagnostics, 9 Chemin des Mines, 1202 Geneva, Switzerland
| | - Kat S Rock
- Zeeman Institute for Systems Biology & Infectious Disease Research, University of Warwick, Gibbet Hill Road, Coventry CV4 7AL, UK
| | - Brice Rotureau
- Trypanosome Transmission Group, Trypanosome Cell Biology Unit, INSERM U1201 and Department of Parasites and Insect Vectors, Institut Pasteur, 25, rue du Docteur Roux, 75015 Paris, France
| | - Gustave Simo
- Department of Biochemistry, Faculty of Science, University of Dschang, P O Box 67 Dschang, Cameroon
| | - Sophie Thévenon
- INTERTRYP, IRD, CIRAD, Univ Montpellier, Montpellier, France; CIRAD, INTERTRYP, Montpellier, France
| | - Sandra Trindade
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Avenida Prof Egas Moniz, 1649-028 Lisboa, Portugal
| | - Philippe Truc
- INTERTRYP, IRD, CIRAD, Univ Montpellier, Montpellier, France
| | - Nick Van Reet
- Department of Biomedical Sciences, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium
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16
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A polymorphism in the haptoglobin, haptoglobin related protein locus is associated with risk of human sleeping sickness within Cameroonian populations. PLoS Negl Trop Dis 2017; 11:e0005979. [PMID: 29077717 PMCID: PMC5697879 DOI: 10.1371/journal.pntd.0005979] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 11/21/2017] [Accepted: 09/20/2017] [Indexed: 12/13/2022] Open
Abstract
Background Human African Trypanosomiasis (HAT) is a neglected disease targeted for elimination as a public health problem by 2020. Elimination requires a better understanding of the epidemiology and clinical evolution of HAT. In addition to the classical clinical evolution of HAT, asymptomatic carriers and spontaneous cure have been reported in West Africa. A genetic component to human susceptibility to HAT has been suggested to explain these newly observed responses to infection. In order to test for genetic associations with infection response, genetic polymorphism in 17 genes were tested (APOL1, IL1B, IL4, IL4R, IL6, IL8, IL12B, IL12RB1, IL10, TNFA, INFG, MIF, HLA-G, HLA-A, HP, HPR and CFH). Methodology A case-control study was performed on 180 blood samples collected from 56 cases and 124 controls from Cameroon. DNA was extracted from blood samples. After quality control, 25 samples (24 controls and 1 case) were eliminated. The genotyping undertaken on 155 individuals including 55 cases and 100 controls were investigated at 96 loci (88 SNPs and 8 indels) located on 17 genes. Associations between these loci and HAT were estimated via a case-control association test. Results Analyses of 64 SNPs and 4 indels out of 96 identified in the selected genes reveal that the minor allele (T) of rs8062041 in haptoglobin (HP) appeared to be protective against HAT (p = 0.0002395, OR 0.359 (CI95 [0.204–0.6319])); indicating higher frequency in cases compared to controls. This minor allele with adjusted p value of 0.0163 is associated with a lower risk (protective effect) of developing sleeping sickness. Conclusion The haptoglobin related protein HPR and HP are tightly linked and both are duplicated in some people and may lead to higher activity. This increased production could be responsible of the protection associated with rs8062041 even though this SNP is within HP. Human African trypanosomiasis (HAT) or sleeping sickness is a neglected tropical disease targeted for elimination by 2020. This elimination requires a better understanding of the epidemiology and clinical evolution of this disease. Beside the classical clinical evolution, asymptomatic carriers, seropositive and spontaneous cure of infected persons have been reported in West Africa. Arguments in favor of human genetic susceptibility to HAT have been raised to explain this variability in clinical presentation. This study investigated the genetic polymorphism of 17 genes between controls and sleeping sickness patients in Southern Cameroon in order to improve our knowledge of human susceptibility to trypanosome infections. We identified single nucleotide polymorphisms and indels in 17 selected genes involved in immune responses and carried out a case-control candidate gene association study and demonstrated differences between variants associated with the disease. From these genes, only haptoglobin (HP) at the SNP rs8062041 was found to have polymorphisms which were strongly associated with trypanosomiasis. The minor allele (T) at this SNP position appeared to be protective against HAT (p = 0.0002395, OR 0.359 (CI95 [0.204–0.6319])) reducing the risk of developing disease approximately threefold. The haptoglobin related protein (HPR) is adjacent to HP and is a component of the Trypanolytic factor that kills trypanosomes. The HP and HPR locus is duplicated in some people. The rs8062041 variant may be associated with this duplication and it is possible that increased production of HPR is the cause of the protection associated with rs8062041. The results reported here will contribute to the knowledge of the role of human genetics in disease progression, and thus lead to the identification of novel biomarkers which could involve development of new diagnostics, treatments and intervention strategies.
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17
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Ahouty B, Koffi M, Ilboudo H, Simo G, Matovu E, Mulindwa J, Hertz-Fowler C, Bucheton B, Sidibé I, Jamonneau V, MacLeod A, Noyes H, N’Guetta SP. Candidate genes-based investigation of susceptibility to Human African Trypanosomiasis in Côte d'Ivoire. PLoS Negl Trop Dis 2017; 11:e0005992. [PMID: 29059176 PMCID: PMC5695625 DOI: 10.1371/journal.pntd.0005992] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 11/02/2017] [Accepted: 09/25/2017] [Indexed: 01/31/2023] Open
Abstract
Human African Trypanosomiasis (HAT) or sleeping sickness is a Neglected Tropical Disease. Long regarded as an invariably fatal disease, there is increasing evidence that infection by T. b. gambiense can result in a wide range of clinical outcomes, including latent infections, which are long lasting infections with no parasites detectable by microscopy. The determinants of this clinical diversity are not well understood but could be due in part to parasite or host genetic diversity in multiple genes, or their interactions. A candidate gene association study was conducted in Côte d’Ivoire using a case-control design which included a total of 233 subjects (100 active HAT cases, 100 controls and 33 latent infections). All three possible pairwise comparisons between the three phenotypes were tested using 96 SNPs in16 candidate genes (IL1, IL4, IL4R, IL6, IL8, IL10, IL12, IL12R, TNFA, INFG, MIF, APOL1, HPR, CFH, HLA-A and HLA-G). Data from 77 SNPs passed quality control. There were suggestive associations at three loci in IL6 and TNFA in the comparison between active cases and controls, one SNP in each of APOL1, MIF and IL6 in the comparison between latent infections and active cases and seven SNP in IL4, HLA-G and TNFA between latent infections and controls. No associations remained significant after Bonferroni correction, but the Benjamini Hochberg false discovery rate test indicated that there were strong probabilities that at least some of the associations were genuine. The excess of associations with latent infections despite the small number of samples available suggests that these subjects form a distinct genetic cluster different from active HAT cases and controls, although no clustering by phenotype was observed by principle component analysis. This underlines the complexity of the interactions existing between host genetic polymorphisms and parasite diversity. Since it was first identified, human African trypanosomiasis (HAT) or sleeping sickness has been described as invariably fatal. Recent data however suggest that infection by T. b. gambiense can result in a wide range of clinical outcomes in its human host including long lasting infections, that can be detected by the presence of antibodies, but in which parasites cannot be seen by microscopy; these cases are known as latent infections. While the factors determining, this varied response have not been clearly characterized, the effectors of the immune responses have been partially implicated as key players. We collected samples from people with active HAT, latent infections and controls in endemic foci in the Côte d’Ivoire. We tested the role of single nucleotide polymorphisms (SNPs) in 16 genes on susceptibility/resistance to HAT by means of a candidate gene association study. There was some evidence that variants of the genes for IL4, IL6, APOL1, HLAG, MIF and TNFA modified the risk of developing HAT. These proteins regulate the inflammatory response to many infections or are directly involved in killing the parasites. In this study, the results were statistically weak and would be inconclusive on their own, however other studies have also found associations in these genes, increasing the chance that the variants that we have identified play a genuine role in the response to trypanosome infection in Côte D’Ivoire.
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Affiliation(s)
- Bernardin Ahouty
- Laboratoire de Génétique, Félix Houphouët Boigny University, Abidjan, Côte d’Ivoire
| | - Mathurin Koffi
- Unité de Recherche en Génétique et Epidémiology Moléculaire, Jean Lorougnon Guédé University, Daloa, Côte d’Ivoire
- * E-mail:
| | - Hamidou Ilboudo
- Unité Maladies à Vecteurs et Biodiversité, Centre International de Recherche-Développement sur l’Elevage en zone Subhumide, Bobo-Dioulasso, Burkina Faso
| | - Gustave Simo
- Department of Biochemistry, University of Dchang, Dchang, Cameroon
| | - Enock Matovu
- School of Veterinary Medicine, Makerere University, Kampala, Uganda
| | - Julius Mulindwa
- School of Veterinary Medicine, Makerere University, Kampala, Uganda
| | | | - Bruno Bucheton
- Unité Mixte de Recherche 177 IRD-CIRAD, Institut de Recherche pour le Développement, Montpellier, France
| | - Issa Sidibé
- Unité Maladies à Vecteurs et Biodiversité, Centre International de Recherche-Développement sur l’Elevage en zone Subhumide, Bobo-Dioulasso, Burkina Faso
| | - Vincent Jamonneau
- Unité Mixte de Recherche 177 IRD-CIRAD, Institut de Recherche pour le Développement, Montpellier, France
- Unité de Recherche Glossines et Trypanosomes, Institut Pierre Richet, Bouaké, Côte d’Ivoire
| | - Annette MacLeod
- Wellcome Center for Molecular Parasitology, University of Glasgow, Glasgow, United Kingdom
| | - Harry Noyes
- Centre for Genomic Research, University of Liverpool, Liverpool, United Kingdom
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18
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Candidate gene polymorphisms study between human African trypanosomiasis clinical phenotypes in Guinea. PLoS Negl Trop Dis 2017; 11:e0005833. [PMID: 28827791 PMCID: PMC5595334 DOI: 10.1371/journal.pntd.0005833] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 09/12/2017] [Accepted: 07/25/2017] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Human African trypanosomiasis (HAT), a lethal disease induced by Trypanosoma brucei gambiense, has a range of clinical outcomes in its human host in West Africa: an acute form progressing rapidly to second stage, spontaneous self-cure and individuals able to regulate parasitaemia at very low levels, have all been reported from endemic foci. In order to test if this clinical diversity is influenced by host genetic determinants, the association between candidate gene polymorphisms and HAT outcome was investigated in populations from HAT active foci in Guinea. METHODOLOGY AND RESULTS Samples were collected from 425 individuals; comprising of 232 HAT cases, 79 subjects with long lasting positive and specific serology but negative parasitology and 114 endemic controls. Genotypes of 28 SNPs in eight genes passed quality control and were used for an association analysis. IL6 rs1818879 allele A (p = 0.0001, OR = 0.39, CI95 = [0.24-0.63], BONF = 0.0034) was associated with a lower risk of progressing from latent infection to active disease. MIF rs36086171 allele G seemed to be associated with an increased risk (p = 0.0239, OR = 1.65, CI95 = [1.07-2.53], BONF = 0.6697) but did not remain significant after Bonferroni correction. Similarly MIF rs12483859 C allele seems be associated with latent infections (p = 0.0077, OR = 1.86, CI95 = [1.18-2.95], BONF = 0.2157). We confirmed earlier observations that APOL1 G2 allele (DEL) (p = 0.0011, OR = 2.70, CI95 = [1.49-4.91], BONF = 0.0301) is associated with a higher risk and APOL1 G1 polymorphism (p = 0.0005, OR = 0.45, CI95 = [0.29-0.70], BONF = 0.0129) with a lower risk of developing HAT. No associations were found with other candidate genes. CONCLUSION Our data show that host genes are involved in modulating Trypanosoma brucei gambiense infection outcome in infected individuals from Guinea with IL6 rs1818879 being associated with a lower risk of progressing to active HAT. These results enhance our understanding of host-parasite interactions and, ultimately, may lead to the development of new control tools.
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19
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Abstract
Two gene variants provide different levels of protection against sleeping sickness, but this comes with an increased risk of developing chronic kidney disease.
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Affiliation(s)
| | - Karl Skorecki
- Department of Medical and Research Development, Rambam Heath Care Campus, Haifa, Israel.,Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
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20
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Performance of the SD BIOLINE® HAT rapid test in various diagnostic algorithms for gambiense human African trypanosomiasis in the Democratic Republic of the Congo. PLoS One 2017; 12:e0180555. [PMID: 28672036 PMCID: PMC5495481 DOI: 10.1371/journal.pone.0180555] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 06/16/2017] [Indexed: 01/22/2023] Open
Abstract
We carried out a study to compare the performance, in terms of sensitivity and specificity, of the new SD BIOLINE® HAT rapid diagnostic test (RDT) with the card agglutination test for trypanosomiasis (CATT) for diagnosis of human African trypanosomiasis (HAT) in the Democratic Republic of the Congo (DRC). Participants were enrolled actively by four mobile teams, and passively at four health facilities in three provinces. Consenting participants were tested concurrently with the RDT and CATT on whole blood. Those found positive by either test were tested with CATT on serial dilutions of plasma, and with a parasitological composite reference standard (CRS). Cases were only the individuals found positive by the CRS, while controls were negative by both CATT and RDT, as well as those that were positive by CATT or RDT, but were negative by the CRS, and had no history of HAT. Over five months, 131 cases and 13,527 controls were enrolled. The sensitivity of the RDT was 92.0% (95% confidence interval (CI) = 86.1-95.5), which was significantly higher than CATT (sensitivity 69.1%; 95% CI = 60.7-76.4). The sensitivity of CATT on plasma at a dilution of 1:8 was 59.0% (95% CI = 50.2-67.2). The specificity of the RDT was 97.1% (95% CIs = 96.8-97.4) while that of CATT was 98.0% (95% CIs = 97.8, 98.2) and specificities of algorithms involving CATT at 1:8 dilution were 99.6% (95% CI = 99.5-99.7). Reproducibility of results was excellent. We concluded that an algorithm in which the SD BIOLINE® HAT RDT is used for screening is optimal for case detection in both passive and active screening settings. However, the lower specificity of the RDT compared to that of CATT would result in a larger number of false positive individuals undergoing confirmatory testing.
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21
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Cooper A, Ilboudo H, Alibu VP, Ravel S, Enyaru J, Weir W, Noyes H, Capewell P, Camara M, Milet J, Jamonneau V, Camara O, Matovu E, Bucheton B, MacLeod A. APOL1 renal risk variants have contrasting resistance and susceptibility associations with African trypanosomiasis. eLife 2017; 6. [PMID: 28537557 PMCID: PMC5495568 DOI: 10.7554/elife.25461] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 05/22/2017] [Indexed: 12/17/2022] Open
Abstract
Reduced susceptibility to infectious disease can increase the frequency of otherwise deleterious alleles. In populations of African ancestry, two apolipoprotein-L1 (APOL1) variants with a recessive kidney disease risk, named G1 and G2, occur at high frequency. APOL1 is a trypanolytic protein that confers innate resistance to most African trypanosomes, but not Trypanosoma brucei rhodesiense or T.b. gambiense, which cause human African trypanosomiasis. In this case-control study, we test the prevailing hypothesis that these APOL1 variants reduce trypanosomiasis susceptibility, resulting in their positive selection in sub-Saharan Africa. We demonstrate a five-fold dominant protective association for G2 against T.b. rhodesiense infection. Furthermore, we report unpredicted strong opposing associations with T.b. gambiense disease outcome. G2 associates with faster progression of T.b. gambiense trypanosomiasis, while G1 associates with asymptomatic carriage and undetectable parasitemia. These results implicate both forms of human African trypanosomiasis in the selection and persistence of otherwise detrimental APOL1 kidney disease variants. DOI:http://dx.doi.org/10.7554/eLife.25461.001 African-Americans have a greater risk of developing chronic kidney disease than Americans with European ancestry. Much of this increased risk is explained by two versions of a gene called APOL1 that are common in people with African ancestry. These two versions of the gene, known as G1 and G2, suddenly became much more common in people in sub-Saharan Africa in the last 10,000 years. One theory for their rapid spread is that they might protect against a deadly parasitic disease known as African sleeping sickness. This disease is caused by two related parasites of a species known as Trypanosoma brucei, one of which is found in East Africa, while the other affects West Africa. Laboratory studies have shown that blood from individuals who carry the G1 and G2 variants is better at killing the East African parasites. However, it is not clear if these gene versions help people living in the rural communities, where African sleeping sickness is common, to fight off the disease. Now, Cooper, Ilboudo et al. show that G1 and G2 do indeed influence how susceptible individuals in these communities are to African sleeping sickness. Individuals with the G2 version were five-times less likely to get the disease from the East African parasite. Neither version could protect individuals from infection with the West African parasite, but infected individuals with the G1 version had fewer parasites in their blood and were less likely to become severely ill. The ability of the G1 version to control the disease and prolong life could explain why this gene version has become so common amongst people in West Africa. Unexpectedly, the experiments also revealed that people with the G2 version were more likely to become severely unwell when they were infected by the West African parasite. This indicates that whether this gene variant is helpful or harmful depends on where an individual lives. The next step following on from this work will be to investigate exactly how the G1 version reduces the severity of the West African disease. This may aid the development of new drugs for African sleeping sickness and kidney disease. DOI:http://dx.doi.org/10.7554/eLife.25461.002
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Affiliation(s)
- Anneli Cooper
- Wellcome Trust Centre for Molecular Parasitology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Hamidou Ilboudo
- Centre International de Recherche-Développement sur l'Elevage en zone Subhumide, Bobo-Dioulasso, Burkina Faso.,TrypanoGEN, H3Africa Consortium, Makerere University, Kampala, Uganda
| | - V Pius Alibu
- TrypanoGEN, H3Africa Consortium, Makerere University, Kampala, Uganda.,College of Natural Sciences, Makerere University, Kampala, Uganda
| | - Sophie Ravel
- Unité Mixte de Recherche IRD-CIRAD 177, Institut de Recherche pour le Développement, Montpellier, France
| | - John Enyaru
- TrypanoGEN, H3Africa Consortium, Makerere University, Kampala, Uganda.,College of Natural Sciences, Makerere University, Kampala, Uganda
| | - William Weir
- Wellcome Trust Centre for Molecular Parasitology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Harry Noyes
- Wellcome Trust Centre for Molecular Parasitology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom.,TrypanoGEN, H3Africa Consortium, Makerere University, Kampala, Uganda.,Institute of Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Paul Capewell
- Wellcome Trust Centre for Molecular Parasitology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Mamadou Camara
- TrypanoGEN, H3Africa Consortium, Makerere University, Kampala, Uganda.,Programme National de Lutte contre la Trypanosomiase Humaine Africaine, Conakry, Guinea
| | - Jacqueline Milet
- Unité Mixte de Recherche IRD-CIRAD 177, Institut de Recherche pour le Développement, Montpellier, France
| | - Vincent Jamonneau
- Centre International de Recherche-Développement sur l'Elevage en zone Subhumide, Bobo-Dioulasso, Burkina Faso.,TrypanoGEN, H3Africa Consortium, Makerere University, Kampala, Uganda.,Unité Mixte de Recherche IRD-CIRAD 177, Institut de Recherche pour le Développement, Montpellier, France
| | - Oumou Camara
- Programme National de Lutte contre la Trypanosomiase Humaine Africaine, Conakry, Guinea
| | - Enock Matovu
- TrypanoGEN, H3Africa Consortium, Makerere University, Kampala, Uganda.,College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Bruno Bucheton
- TrypanoGEN, H3Africa Consortium, Makerere University, Kampala, Uganda.,Unité Mixte de Recherche IRD-CIRAD 177, Institut de Recherche pour le Développement, Montpellier, France.,Programme National de Lutte contre la Trypanosomiase Humaine Africaine, Conakry, Guinea
| | - Annette MacLeod
- Wellcome Trust Centre for Molecular Parasitology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom.,TrypanoGEN, H3Africa Consortium, Makerere University, Kampala, Uganda
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22
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Ponte-Sucre A. An Overview of Trypanosoma brucei Infections: An Intense Host-Parasite Interaction. Front Microbiol 2016; 7:2126. [PMID: 28082973 PMCID: PMC5183608 DOI: 10.3389/fmicb.2016.02126] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Accepted: 12/16/2016] [Indexed: 12/14/2022] Open
Abstract
Trypanosoma brucei rhodesiense and T. brucei gambiense, the causative agents of Human African Trypanosomiasis, are transmitted by tsetse flies. Within the vector, the parasite undergoes through transformations that prepares it to infect the human host. Sequentially these developmental stages are the replicative procyclic (in which the parasite surface is covered by procyclins) and trypo-epimastigote forms, as well as the non-replicative, infective, metacyclic form that develops in the vector salivary glands. As a pre-adaptation to their life in humans, metacyclic parasites begin to express and be densely covered by the Variant Surface Glycoprotein (VSG). Once the metacyclic form invades the human host the parasite develops into the bloodstream form. Herein the VSG triggers a humoral immune response. To avoid this humoral response, and essential for survival while in the bloodstream, the parasite changes its cover periodically and sheds into the surroundings the expressed VSG, thus evading the consequences of the immune system activation. Additionally, tools comparable to quorum sensing are used by the parasite for the successful parasite transmission from human to insect. On the other hand, the human host promotes clearance of the parasite triggering innate and adaptive immune responses and stimulating cytokine and chemokine secretion. All in all, the host–parasite interaction is extremely active and leads to responses that need multiple control sites to develop appropriately.
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Affiliation(s)
- Alicia Ponte-Sucre
- Laboratory of Molecular Physiology, Institute of Experimental Medicine, Luis Razetti School of Medicine, Faculty of Medicine, Universidad Central de Venezuela Caracas, Venezuela
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23
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Systems analysis uncovers inflammatory Th/Tc17-driven modules during acute GVHD in monkey and human T cells. Blood 2016; 128:2568-2579. [PMID: 27758873 DOI: 10.1182/blood-2016-07-726547] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 09/22/2016] [Indexed: 01/30/2023] Open
Abstract
One of the central challenges of transplantation is the development of alloreactivity despite the use of multiagent immunoprophylaxis. Effective control of this immune suppression-resistant T-cell activation represents one of the key unmet needs in the fields of both solid-organ and hematopoietic stem cell transplant (HCT). To address this unmet need, we have used a highly translational nonhuman primate (NHP) model to interrogate the transcriptional signature of T cells during breakthrough acute graft-versus-host disease (GVHD) that occurs in the setting of clinically relevant immune suppression and compared this to the hyperacute GVHD, which develops in unprophylaxed or suboptimally prophylaxed transplant recipients. Our results demonstrate the complex character of the alloreactivity that develops during ongoing immunoprophylaxis and identify 3 key transcriptional hallmarks of breakthrough acute GVHD that are not observed in hyperacute GVHD: (1) T-cell persistence rather than proliferation, (2) evidence for highly inflammatory transcriptional programming, and (3) skewing toward a T helper (Th)/T cytotoxic (Tc)17 transcriptional program. Importantly, the gene coexpression profiles from human HCT recipients who developed GVHD while on immunosuppressive prophylactic agents recapitulated the patterns observed in NHP, and demonstrated an evolution toward a more inflammatory signature as time posttransplant progressed. These results strongly implicate the evolution of both inflammatory and interleukin 17-based immune pathogenesis in GVHD, and provide the first map of this evolving process in primates in the setting of clinically relevant immunomodulation. This map represents a novel transcriptomic resource for further systems-based efforts to study the breakthrough alloresponse that occurs posttransplant despite immunoprophylaxis and to develop evidence-based strategies for effective treatment of this disease.
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24
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Gineau L, Courtin D, Camara M, Ilboudo H, Jamonneau V, Dias FC, Tokplonou L, Milet J, Mendonça PB, Castelli EC, Camara O, Camara M, Favier B, Rouas-Freiss N, Moreau P, Donadi EA, Bucheton B, Sabbagh A, Garcia A. Human Leukocyte Antigen-G: A Promising Prognostic Marker of Disease Progression to Improve the Control of Human African Trypanosomiasis. Clin Infect Dis 2016; 63:1189-1197. [PMID: 27470243 DOI: 10.1093/cid/ciw505] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 07/21/2016] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Human African trypanosomiasis (HAT) caused by Trypanosoma brucei gambiense can be diagnosed in the early hemolymphatic stage (stage 1 [S1]) or meningoencephalitic stage (stage 2 [S2]). Importantly, individuals harbouring high and specific antibody responses to Tbg antigens but negative parasitology are also diagnosed in the field (seropositive [SERO]). Whereas some develop the disease in the months following their initial diagnosis (SERO/HAT), others remain parasitologically negative for long periods (SERO) and are apparently able to control infection. Human leucocyte antigen (HLA)-G, an immunosuppressive molecule, could play a critical role in this variability of progression between infection and disease. METHODS Soluble HLA-G (sHLA-G) was measured in plasma for patients in the SERO (n = 65), SERO/HAT (n = 14), or HAT (n = 268) group and in cerebrospinal fluid for patients in S1 (n = 55), early S2 (n = 93), or late S2 (n = 110). Associations between these different statuses and the soluble level or genetic polymorphisms of HLA-G were explored. RESULTS Plasma sHLA-G levels were significantly higher in HAT (P = 6 × 10-7) and SERO/HAT (P = .007) than SERO patients. No difference was observed between the SERO/HAT and HAT groups. Within the HAT group, specific haplotypes (HG010102 and HG0103) displayed increased frequencies in S1 (P = .013) and late S2 (P = .036), respectively. CONCLUSIONS These results strongly suggest the involvement of HLA-G in HAT disease progression. Importantly, high plasma sHLA-G levels in SERO patients could be predictive of subsequent disease development and could represent a serological marker to help guide therapeutic decision making. Further studies are necessary to assess the predictive nature of HLA-G and to estimate both sensitivity and specificity.
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Affiliation(s)
- Laure Gineau
- Institut de Recherche pour le Développement, UMR216 MERIT, Mère et Enfant face aux Infections Tropicales Faculté de Pharmacie, Université Paris Descartes, Sorbonne Paris Cité
| | - David Courtin
- Institut de Recherche pour le Développement, UMR216 MERIT, Mère et Enfant face aux Infections Tropicales Faculté de Pharmacie, Université Paris Descartes, Sorbonne Paris Cité
| | - Mamadou Camara
- Ministère de la Santé et de l'Hygiène Publique, Programme National de Lutte contre la Trypanosomose Humaine Africaine, Conakry, Guinea
| | - Hamidou Ilboudo
- Centre International de Recherche-Développement sur l'Elevage en Zones Subhumides, Unité de Recherches sur les Bases Biologiques de la Lutte Intégrée, Bobo-Dioulasso, Burkina Faso
| | - Vincent Jamonneau
- Centre International de Recherche-Développement sur l'Elevage en Zones Subhumides, Unité de Recherches sur les Bases Biologiques de la Lutte Intégrée, Bobo-Dioulasso, Burkina Faso Institut de Recherche Pour le Développement, Campus International de Baillarguet, Montpellier, France
| | - Fabricio C Dias
- Division of Clinical Immunology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto
| | - Leonidas Tokplonou
- Institut de Recherche Pour le Développement, UMR 216, Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance, Faculté des Sciences de la Santé, Cotonou, Bénin
| | - Jacqueline Milet
- Institut de Recherche pour le Développement, UMR216 MERIT, Mère et Enfant face aux Infections Tropicales Faculté de Pharmacie, Université Paris Descartes, Sorbonne Paris Cité
| | - Priscila B Mendonça
- Division of Clinical Immunology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto
| | - Erick C Castelli
- Department de Pathology, School of Medicine, UNESP-Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Oumou Camara
- Ministère de la Santé et de l'Hygiène Publique, Programme National de Lutte contre la Trypanosomose Humaine Africaine, Conakry, Guinea
| | - Mariam Camara
- Ministère de la Santé et de l'Hygiène Publique, Programme National de Lutte contre la Trypanosomose Humaine Africaine, Conakry, Guinea
| | - Benoit Favier
- Commissariat à l'Energie Atomique et aux Energies Alternatives, Institut des Maladies Emergentes et des Thérapies Innovantes, Service de Recherches en Hémato-Immunologie, Hôpital Saint-Louis Université Paris Diderot, Sorbonne Paris Cité, UMRE5, Institut Universitaire d'Hématologie, Hôpital Saint-Louis
| | - Nathalie Rouas-Freiss
- Commissariat à l'Energie Atomique et aux Energies Alternatives, Institut des Maladies Emergentes et des Thérapies Innovantes, Service de Recherches en Hémato-Immunologie, Hôpital Saint-Louis Université Paris Diderot, Sorbonne Paris Cité, UMRE5, Institut Universitaire d'Hématologie, Hôpital Saint-Louis
| | - Philippe Moreau
- Commissariat à l'Energie Atomique et aux Energies Alternatives, Institut des Maladies Emergentes et des Thérapies Innovantes, Service de Recherches en Hémato-Immunologie, Hôpital Saint-Louis Université Paris Diderot, Sorbonne Paris Cité, UMRE5, Institut Universitaire d'Hématologie, Hôpital Saint-Louis
| | - Eduardo A Donadi
- Division of Clinical Immunology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto
| | - Bruno Bucheton
- Ministère de la Santé et de l'Hygiène Publique, Programme National de Lutte contre la Trypanosomose Humaine Africaine, Conakry, Guinea Institut de Recherche Pour le Développement, Campus International de Baillarguet, Montpellier, France
| | - Audrey Sabbagh
- Institut de Recherche pour le Développement, UMR216 MERIT, Mère et Enfant face aux Infections Tropicales Faculté de Pharmacie, Université Paris Descartes, Sorbonne Paris Cité
| | - André Garcia
- Institut de Recherche pour le Développement, UMR216 MERIT, Mère et Enfant face aux Infections Tropicales Faculté de Pharmacie, Université Paris Descartes, Sorbonne Paris Cité Institut de Recherche Pour le Développement, UMR 216, Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance, Faculté des Sciences de la Santé, Cotonou, Bénin
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25
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Cnops J, Kauffmann F, De Trez C, Baltz T, Keirsse J, Radwanska M, Muraille E, Magez S. Maintenance of B cells during chronic murine Trypanosoma brucei gambiense infection. Parasite Immunol 2016; 38:642-7. [PMID: 27353256 DOI: 10.1111/pim.12344] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Accepted: 06/24/2016] [Indexed: 12/01/2022]
Abstract
African trypanosomosis is a debilitating parasitic disease occurring in large parts of sub-Saharan Africa. Trypanosoma brucei gambiense accounts for 98% of the reported HAT infections and causes a chronic, gradually progressing disease. Multiple experimental murine models for trypanosomosis have demonstrated inflammation-dependent apoptosis of splenic follicular B (FoB) cells and the destruction of B-cell memory against previously encountered pathogens. Here, we report that during murine infection with a chronic T. b. gambiense field isolate, FoB cells are retained. This coincided with reduced levels of IFN-γ and TNF-α during the acute phase of the infection. This result suggests that in chronic infections with low virulent parasites, less inflammation is elicited and consequently no FoB cell destruction occurs.
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Affiliation(s)
- J Cnops
- Laboratory of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium.,Structural Biology Research Center, Vlaams Instituut voor Biotechnologie (VIB), Brussels, Belgium
| | - F Kauffmann
- Laboratory of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium.,Structural Biology Research Center, Vlaams Instituut voor Biotechnologie (VIB), Brussels, Belgium
| | - C De Trez
- Laboratory of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium.,Structural Biology Research Center, Vlaams Instituut voor Biotechnologie (VIB), Brussels, Belgium
| | - T Baltz
- UMR 5234, Centre National de Recherche Scientifique, IFR66, Université Bordeaux 2, Bordeaux, France
| | - J Keirsse
- Laboratory of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium.,VIB Laboratory of Myeloid Cell Immunology, Brussels, Belgium
| | - M Radwanska
- Ghent University Global Campus, Incheon, Korea
| | - E Muraille
- Unité de Recherche en Biologie des Microorganismes, Laboratoire d'Immunologie et de Microbiologie, Université de Namur, Namur, Belgium.,Laboratoire de Parasitologie, Université Libre de Bruxelles, Campus Erasme, Brussels, Belgium
| | - S Magez
- Laboratory of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium. .,Structural Biology Research Center, Vlaams Instituut voor Biotechnologie (VIB), Brussels, Belgium. .,Ghent University Global Campus, Incheon, Korea.
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26
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Matthews KR, McCulloch R, Morrison LJ. The within-host dynamics of African trypanosome infections. Philos Trans R Soc Lond B Biol Sci 2016; 370. [PMID: 26150654 PMCID: PMC4528486 DOI: 10.1098/rstb.2014.0288] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
African trypanosomes are single-celled protozoan parasites that are capable of long-term survival while living extracellularly in the bloodstream and tissues of mammalian hosts. Prolonged infections are possible because trypanosomes undergo antigenic variation-the expression of a large repertoire of antigenically distinct surface coats, which allows the parasite population to evade antibody-mediated elimination. The mechanisms by which antigen genes become activated influence their order of expression, most likely by influencing the frequency of productive antigen switching, which in turn is likely to contribute to infection chronicity. Superimposed upon antigen switching as a contributor to trypanosome infection dynamics is the density-dependent production of cell-cycle arrested parasite transmission stages, which limit the infection while ensuring parasite spread to new hosts via the bite of blood-feeding tsetse flies. Neither antigen switching nor developmental progression to transmission stages is driven by the host. However, the host can contribute to the infection dynamic through the selection of distinct antigen types, the influence of genetic susceptibility or trypanotolerance and the potential influence of host-dependent effects on parasite virulence, development of transmission stages and pathogenicity. In a zoonotic infection cycle where trypanosomes circulate within a range of host animal populations, and in some cases humans, there is considerable scope for a complex interplay between parasite immune evasion, transmission potential and host factors to govern the profile and outcome of infection.
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Affiliation(s)
- Keith R Matthews
- Centre for Immunity, Infection and Evolution, Institute for Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, West Mains Road, Edinburgh EH9 3JT, UK
| | - Richard McCulloch
- Wellcome Trust Centre for Molecular Parasitology, Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Sir Graeme Davies Building, 120 University Place, Glasgow G12 8TA, UK
| | - Liam J Morrison
- Roslin Institute, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, Midlothian EH25 9RG, UK
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27
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Bisser S, Lumbala C, Nguertoum E, Kande V, Flevaud L, Vatunga G, Boelaert M, Büscher P, Josenando T, Bessell PR, Biéler S, Ndung’u JM. Sensitivity and Specificity of a Prototype Rapid Diagnostic Test for the Detection of Trypanosoma brucei gambiense Infection: A Multi-centric Prospective Study. PLoS Negl Trop Dis 2016; 10:e0004608. [PMID: 27058033 PMCID: PMC4825971 DOI: 10.1371/journal.pntd.0004608] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Accepted: 03/14/2016] [Indexed: 01/03/2023] Open
Abstract
Background A major challenge in the control of human African trypanosomiasis (HAT) is lack of reliable diagnostic tests that are rapid and easy to use in remote areas where the disease occurs. In Trypanosoma brucei gambiense HAT, the Card Agglutination Test for Trypanosomiasis (CATT) has been the reference screening test since 1978, usually on whole blood, but also in a 1/8 dilution (CATT 1/8) to enhance specificity. However, the CATT is not available in a single format, requires a cold chain for storage, and uses equipment that requires electricity. A solution to these challenges has been provided by rapid diagnostic tests (RDT), which have recently become available. A prototype immunochromatographic test, the SD BIOLINE HAT, based on two native trypanosomal antigens (VSG LiTat 1.3 and VSG LiTat 1.5) has been developed. We carried out a non-inferiority study comparing this prototype to the CATT 1/8 in field settings. Methodology/Principal Findings The prototype SD BIOLINE HAT, the CATT Whole Blood and CATT 1/8 were systematically applied on fresh blood samples obtained from 14,818 subjects, who were prospectively enrolled through active and passive screening in clinical studies in three endemic countries of central Africa: Angola, the Democratic Republic of the Congo and the Central African Republic. One hundred and forty nine HAT cases were confirmed by parasitology. The sensitivity and specificity of the prototype SD BIOLINE HAT was 89.26% (95% confidence interval (CI) = 83.27–93.28) and 94.58% (95% CI = 94.20–94.94) respectively. The sensitivity and specificity of the CATT on whole blood were 93.96% (95% CI = 88.92–96.79) and 95.91% (95% CI = 95.58–96.22), and of the CATT 1/8 were 89.26% (95% CI = 83.27–93.28) and 98.88% (95% CI = 98.70–99.04) respectively. Conclusion/Significance After further optimization, the prototype SD BIOLINE HAT could become an alternative to current screening methods in primary healthcare settings in remote, resource-limited regions where HAT typically occurs. Early diagnosis and treatment of human African trypanosomiasis is essential for safe and effective treatment. The tests used to screen suspected patients and populations at risk are difficult to implement in remote rural settings where the disease occurs. Availability of simple, easy to use, instrument-free rapid diagnostic tests would improve screening and coverage of the population at risk and contribute to elimination of the disease. It would enable technicians with limited training and clinicians in emergency or medical wards to make rapid differential diagnosis for neurological syndromes or malaria-like illnesses. Introduction of such tests in all healthcare facilities in endemic regions would enable early detection of cases, hence reducing the time lost by patients before they get adequate and safe treatment. Treatment delay occurs when such patients attend non-specialized health centres that are unable to perform diagnosis of the disease. We evaluated a prototype rapid diagnostic test for HAT, the SD BIOLINE HAT in Angola, the Democratic Republic of the Congo and the Central African Republic. We show here that the test is as sensitive as the CATT in a 1/8 dilution and less sensitive than CATT on whole blood, although this latter difference was not statistically significant. The prototype RDT is a promising alternative for serodiagnosis of HAT.
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Affiliation(s)
- Sylvie Bisser
- INSERM UMR1094, Institute of Neuroepidemiology and Tropical Neurology, Limoges, France
- * E-mail:
| | - Crispin Lumbala
- Programme National de Lutte contre la Trypanosomiase Humaine Africaine (PNLTHA), Kinshasa, Democratic Republic of the Congo
| | - Etienne Nguertoum
- Institut Centrafricain de la Recherche Agronomique (ICRA), Bangui, Central African Republic
| | - Victor Kande
- Programme National de Lutte contre la Trypanosomiase Humaine Africaine (PNLTHA), Kinshasa, Democratic Republic of the Congo
| | - Laurence Flevaud
- Médecins Sans Frontières (MSF) Operational Centre Barcelona-Athens (OCBA), Barcelona, Spain
| | - Gedeao Vatunga
- Instituto de Combate e Controlo das Tripanossomiases, Luanda, Angola
| | | | | | | | | | - Sylvain Biéler
- Foundation for Innovative New Diagnostics, Campus Biotech, Geneva, Switzerland
| | - Joseph M. Ndung’u
- Foundation for Innovative New Diagnostics, Campus Biotech, Geneva, Switzerland
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28
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Ilboudo H, Jamonneau V, Koffi M, Kaboré J, Amoussa R, Holzmuller P, Garcia A, Bucheton B, Courtin D. Trypanosome-induced Interferon-γ production in whole blood stimulation assays is associated with latent Trypanosoma brucei gambiense infections. Microbes Infect 2016; 18:436-440. [PMID: 26993030 DOI: 10.1016/j.micinf.2016.03.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 02/22/2016] [Accepted: 03/04/2016] [Indexed: 10/22/2022]
Abstract
Control of human African trypanosomiasis (HAT) is highly dependent on the ability to detect and treat infected individuals. However, a number of individuals exposed to Trypanosoma brucei gambiense are able to control infection to undetectable levels in blood. They are long-term potential reservoirs and thus a threat for control strategies. Cytokine responses in whole blood stimulation assays were quantified in individuals with contrasting HAT status. Trypanosome-induced IFN-γ production was only observed in "trypanotolerant" subjects suspected of harboring latent infections. This result contributes new insights into the immune responses associated with infection control and opens novel diagnosis perspectives regarding HAT elimination.
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Affiliation(s)
- Hamidou Ilboudo
- Centre International de Recherche-Développement sur l'Elevage en zones Subhumides (CIRDES), Unité de recherches sur les bases biologiques de la lutte intégrée, 01 BP 454 Bobo-Dioulasso 01, Burkina Faso
| | - Vincent Jamonneau
- Centre International de Recherche-Développement sur l'Elevage en zones Subhumides (CIRDES), Unité de recherches sur les bases biologiques de la lutte intégrée, 01 BP 454 Bobo-Dioulasso 01, Burkina Faso; Institut de Recherche pour le Développement, Unité Mixte de Recherche, UMR Intertryp, IRD-CIRAD 177, TA A-17/G, Campus International de Baillarguet, F-34398 Montpellier, France
| | - Mathurin Koffi
- Université Jean Lorougnon Guédé, UFR Environnement, Unité de Génétique Moléculaire et Evolution des Maladies Infectieuses Tropicales, BP 150 Daloa, Côte d'Ivoire
| | - Jacques Kaboré
- Centre International de Recherche-Développement sur l'Elevage en zones Subhumides (CIRDES), Unité de recherches sur les bases biologiques de la lutte intégrée, 01 BP 454 Bobo-Dioulasso 01, Burkina Faso; Université Polytechnique de Bobo-Dioulasso, UFR Sciences et Techniques, 01 BP 1091 Bobo-Dioulasso 01, Burkina Faso
| | - Roukiyath Amoussa
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance (CERPAGE), Cotonou, Benin
| | - Philippe Holzmuller
- Centre de coopération International en Recherche Agronomique pour le Développement (CIRAD), UMR CIRAD-INRA Contrôle des maladies animales exotiques et émergentes CMAEE, TA A-15/G, Campus International de Baillarguet, F-34398 Montpellier, France
| | - André Garcia
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance (CERPAGE), Cotonou, Benin
| | - Bruno Bucheton
- Institut de Recherche pour le Développement, Unité Mixte de Recherche, UMR Intertryp, IRD-CIRAD 177, TA A-17/G, Campus International de Baillarguet, F-34398 Montpellier, France; Programme National de Lutte contre la Trypanosomose Humaine Africaine, BP 851, Conakry, Guinéa
| | - David Courtin
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance (CERPAGE), Cotonou, Benin; Institut de Recherche pour le Développement, UMR 216 Mère et enfant face aux infections tropicales, Paris, France; Communauté d'universités et d'établissements (COMUE) Sorbonne Paris Cité, Université Paris Descartes, Faculté des Sciences Pharmaceutiques et Biologiques, Paris, France.
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29
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Biteau N, Asencio C, Izotte J, Rousseau B, Fèvre M, Pillay D, Baltz T. Trypanosoma brucei gambiense Infections in Mice Lead to Tropism to the Reproductive Organs, and Horizontal and Vertical Transmission. PLoS Negl Trop Dis 2016; 10:e0004350. [PMID: 26735855 PMCID: PMC4703293 DOI: 10.1371/journal.pntd.0004350] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 12/11/2015] [Indexed: 01/06/2023] Open
Abstract
Trypanosoma brucei gambiense, transmitted by the tsetse fly, is the main causative agent of Human African trypanosomosis in West Africa and poses a significant health risk to 70 million people. Disease progression varies depending on host immunity, but usually begins with a haemo-lymphatic phase, followed by parasite invasion of the central nervous system. In the current study, the tropism of T. b. gambiense 1135, causing a low level chronic ‘silent’ infection, was monitored in a murine model using bioluminescence imaging and PCR. A tropism to the reproductive organs, in addition to the central nervous system, after 12–18 months of infection was observed. Bioluminescent analysis of healthy females crossed with infected males showed that 50%, 62.5% and 37.5% of the female mice were subsequently positive for parasites in their ovaries, uteri and brain respectively. Although PCR confirmed the presence of parasites in the uterus of one of these mice, the blood of all mice was negative by PCR and LAMP. Subsequently, bioluminescent imaging of the offspring of infected female mice crossed with healthy males indicated parasites were present in the reproductive organs of both male (80%) and female (60%) offspring. These findings imply that transmission of T. b. gambiense 1135 occurs horizontally, most probably via sexual contact, and vertically in a murine model, which raises the possibility of a similar transmission in humans. This has wide reaching implications. Firstly, the observations made in this study are likely to be valid for wild animals acting as a reservoir for T. b. gambiense. Also, the reproductive organs may act as a refuge for parasites during drug treatment in a similar manner to the central nervous system. This could leave patients at risk of a relapse, ultimately allowing them to act as a reservoir for subsequent transmission by tsetse and possibly, horizontally and vertically. Human African trypanosomosis (HAT) caused by Trypanosoma brucei gambiense is a serious disease threatening 70 million people in West Africa. The parasite is transmitted by the tsetse fly, and initially multiplies in the bloodstream of the mammalian host, before progressing to the central nervous system. Using a strain of T. b. gambiense transfected with a gene for luminescent detection that causes a chronic infection with very low parasitaemia, we found that the parasite is capable of entering the reproductive organs of both male and female mice. Subsequently, crossing infected male mice with healthy females resulted in some female mice becoming infected. Furthermore, female mice infected directly with T. b. gambiense parasites and crossed with healthy males, produced offspring which were also shown to be positive for parasites. These experiments demonstrated that T. b. gambiense 1135 is transmitted both horizontally, most probably by sexual contact, and vertically in mice. If these alternate modes of transmission are analogous to the situation in humans, this has drastic implications for future control measures of HAT as parasites may avoid the immune system and treatment by accumulating in the reproductive organs as well as the CNS.
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Affiliation(s)
- Nicolas Biteau
- Microbiologie Fondamentale et Pathogénicité, UMR 5234, Centre National de la Recherche Scientifique (CNRS), Université de Bordeaux, Bordeaux, France
| | - Corinne Asencio
- Microbiologie Fondamentale et Pathogénicité, UMR 5234, Centre National de la Recherche Scientifique (CNRS), Université de Bordeaux, Bordeaux, France
| | - Julien Izotte
- Microbiologie Fondamentale et Pathogénicité, UMR 5234, Centre National de la Recherche Scientifique (CNRS), Université de Bordeaux, Bordeaux, France
| | | | - Muriel Fèvre
- Animalerie A2, Université de Bordeaux, Bordeaux, France
| | - Davita Pillay
- Microbiologie Fondamentale et Pathogénicité, UMR 5234, Centre National de la Recherche Scientifique (CNRS), Université de Bordeaux, Bordeaux, France
- * E-mail:
| | - Théo Baltz
- Microbiologie Fondamentale et Pathogénicité, UMR 5234, Centre National de la Recherche Scientifique (CNRS), Université de Bordeaux, Bordeaux, France
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