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Silva JAX, Albertini AVP, Fonseca CSM, Silva DCN, Carvalho VCO, Lima VLM, Fontes A, Costa EVL, Nogueira RA. Biomechanical and biochemical investigation of erythrocytes in late stage human leptospirosis. ACTA ACUST UNITED AC 2020; 53:e9268. [PMID: 32578717 PMCID: PMC7307891 DOI: 10.1590/1414-431x20209268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 04/01/2020] [Indexed: 12/22/2022]
Abstract
Leptospirosis is a zoonotic disease caused by bacteria of the genus
Leptospira, which can cause lipid changes in the
erythrocyte membrane. Optical tweezers were used to characterize rheological
changes in erythrocytes from patients with leptospirosis in the late stage.
Biochemical methods were also used for quantification of plasma lipid,
erythrocyte membrane lipid, and evaluation of liver function. Our data showed
that the mean elastic constant of erythrocytes from patients with leptospirosis
was around 67% higher than the control (healthy individuals), indicating that
patient’s erythrocytes were less elastic. In individuals with leptospirosis,
several alterations in relation to control were observed in the plasma lipids,
however, in the erythrocyte membrane, only phosphatidylcholine showed a
significant difference compared to control, increasing around 41%. With respect
to the evaluation of liver function of individuals with leptospirosis, there was
a significant increase in levels of alanine transaminase (154%) and aspartate
transaminase (150%), whereas albumin was 43.8% lower than control (P<0.01).
The lecithin-cholesterol acyltransferase fractional activity was 3.6 times lower
in individuals with leptospirosis than in the healthy individuals (P<0.01).
The decrease of the erythrocyte elasticity may be related to the changes of
erythrocyte membrane phospholipids composition caused by disturbances that occur
during human leptospirosis, with phosphatidylcholine being a strong candidate in
the erythrocyte rheological changes.
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Affiliation(s)
- J A X Silva
- Laboratório de Biofísica Teórico-Experimental e Computacional, Departamento de Morfologia e Fisiologia Animal, Universidade Federal Rural de Pernambuco, Dois Irmãos, Recife, PE, Brasil.,Centro de Apoio è Pesquisa, Universidade Federal Rural de Pernambuco, Dois Irmãos, Recife, PE, Brasil
| | - A V P Albertini
- Laboratório de Biofísica Teórico-Experimental e Computacional, Departamento de Morfologia e Fisiologia Animal, Universidade Federal Rural de Pernambuco, Dois Irmãos, Recife, PE, Brasil.,Centro de Apoio è Pesquisa, Universidade Federal Rural de Pernambuco, Dois Irmãos, Recife, PE, Brasil
| | - C S M Fonseca
- Laboratório de Química e Metabolismo de Lipídios e Lipoproteínas, Departamento de Bioquímica, Centro de Biociências, Universidade Federal de Pernambuco, Recife, PE, Brasil
| | - D C N Silva
- Colegiado de Ciências Biológicas, Universidade Federal do Vale do São Francisco, Petrolina, PE, Brasil
| | - V C O Carvalho
- Laboratório de Química e Metabolismo de Lipídios e Lipoproteínas, Departamento de Bioquímica, Centro de Biociências, Universidade Federal de Pernambuco, Recife, PE, Brasil
| | - V L M Lima
- Laboratório de Química e Metabolismo de Lipídios e Lipoproteínas, Departamento de Bioquímica, Centro de Biociências, Universidade Federal de Pernambuco, Recife, PE, Brasil
| | - A Fontes
- Departamento de Biofísica e Radiobiologia, Universidade Federal de Pernambuco, Recife, PE, Brasil
| | - E V L Costa
- Laboratório de Biofísica Teórico-Experimental e Computacional, Departamento de Morfologia e Fisiologia Animal, Universidade Federal Rural de Pernambuco, Dois Irmãos, Recife, PE, Brasil.,Centro de Apoio è Pesquisa, Universidade Federal Rural de Pernambuco, Dois Irmãos, Recife, PE, Brasil
| | - R A Nogueira
- Laboratório de Biofísica Teórico-Experimental e Computacional, Departamento de Morfologia e Fisiologia Animal, Universidade Federal Rural de Pernambuco, Dois Irmãos, Recife, PE, Brasil.,Centro de Apoio è Pesquisa, Universidade Federal Rural de Pernambuco, Dois Irmãos, Recife, PE, Brasil
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Rajapakse S, Weeratunga P, Niloofa MJR, Fernando N, Rodrigo C, Maduranga S, de Silva NL, Fernando NL, de Silva HJ, Karunanayake L, Handunnetti S. Clinical and laboratory associations of severity in a Sri Lankan cohort of patients with serologically confirmed leptospirosis: a prospective study. Trans R Soc Trop Med Hyg 2016; 109:710-6. [PMID: 26464233 DOI: 10.1093/trstmh/trv079] [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] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Leptospirosis results in significant morbidity and mortality. This study elucidates markers of severity in a cohort of Sri Lankan patients. METHODS Patients presenting to three healthcare institutions in the Western province of Sri Lanka with leptospirosis serological confirmed by the microscopic agglutination test (MAT) were included. Prospective data regarding demographic, clinical and laboratory parameters was extracted. Univariate associations and subsequent multivariate logistic regression models were constructed. RESULTS The study included 232 patients, with 68.5% (159) demonstrating severe disease. Significant associations of severe disease at a significance level of p<0.05 were fever >38.8°C on presentation, age >40 years, muscle tenderness, tachycardia on admission, highest white cell count >12 350/mm(3) and <7900/mm(3), highest neutrophil percentage >84%, haemoglobin >11.2 g/dL and <10.2 g/dL, packed cell volume (PCV) >33.8% and <29.8%, lowest platelet count <63 500/mm(3), highest alanine transaminase (ALT) >70 IU/L and hyponatremia with sodium <131 mEq/L. On multivariate analysis, PCV <29.8% (p=0.011; OR 3.750; CI: 1.394-10.423), ALT >70 IU/L (p=0.044; OR 2.639; CI: 1.028-6.774) and hyponatremia <131 mEq/L (p=0.019; OR 6.413; CI: 1.353-30.388) were independent associations of severe disease. CONCLUSIONS Severity associations were demonstrated with both clinical and laboratory parameters. There is a need for novel biomarkers for prediction of severity in leptospirosis.
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Affiliation(s)
- Senaka Rajapakse
- Tropical Medicine Research Unit, Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo 08, Sri Lanka
| | - Praveen Weeratunga
- Tropical Medicine Research Unit, Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo 08, Sri Lanka
| | - M J Roshan Niloofa
- Institute of Biochemistry, Molecular Biology and Biotechnology, University of Colombo, Colombo 03, Sri Lanka
| | - Narmada Fernando
- Institute of Biochemistry, Molecular Biology and Biotechnology, University of Colombo, Colombo 03, Sri Lanka
| | - Chathuraka Rodrigo
- Tropical Medicine Research Unit, Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo 08, Sri Lanka
| | - Sachith Maduranga
- Tropical Medicine Research Unit, Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo 08, Sri Lanka
| | - Nipun Lakshitha de Silva
- Tropical Medicine Research Unit, Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo 08, Sri Lanka
| | - Nipun Lakshitha Fernando
- Tropical Medicine Research Unit, Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo 08, Sri Lanka
| | - H Janaka de Silva
- Department of Medicine, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Lilani Karunanayake
- Department of Bacteriology, Medical Research Institute, Colombo 08, Sri Lanka
| | - Shiroma Handunnetti
- Institute of Biochemistry, Molecular Biology and Biotechnology, University of Colombo, Colombo 03, Sri Lanka
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