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Celi A, Trelis Villanueva M, Tena B, Taroncher S, Soriano JM, Merino Torres JF. [Benefits of using a recommended testing algorithm for the diagnosis and dietary-nutritional management of patients with chronic gastrointestinal disorders]. NUTR HOSP 2023; 40:1017-1024. [PMID: 37522455 DOI: 10.20960/nh.04518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023] Open
Abstract
Introduction Introduction and objective: chronic gastrointestinal disorders such as celiac disease and lactose or fructose intolerance in adulthood are becoming more frequent and are usually accompanied by symptoms that affect daily activities and greatly limit diet. The spectrum of symptoms manifested by those affected is heterogeneous and not very specific; in addition, there is no standardized and agreed protocol for dietary management, which makes a correct diagnosis and effective treatment difficult. Disorders related to malabsorption/food intolerance can originate from primary (genetic) or secondary causes (parasites, allergies, inflammatory bowel disease, drugs, etc.). Using genetic data makes it possible to rule out or confirm primary causes, and when necessary, focus the search on secondary ones. The objective of this algorithmic approach is to guide the dietary-nutritional management of the patient with chronic gastrointestinal disease to optimize the diagnostic process and nutritional treatment. Material and methods: after a review of the literature on the pathologies most frequently associated with these disorders, a testing algorithm is proposed and the successive steps to be followed depending on the results obtained, in order to determine the diagnosis and treatment. Results: the proposed algorithm aims to be a tool for health personnel (gastroenterologists, endocrinologists, nutritionists, etc.) who care for these patients. The aim is to guide the flow of diagnostic tests based on the information provided by the patient and the clinic at the beginning, as well as to recommend the most appropriate treatment (dietary-nutritional and/or pharmacological). Conclusions: the benefit of using an algorithmic approach is that it allows optimising the diagnostic process of primary and secondary causes, and with this, to prescribe a personalised nutritional treatment considering the origin of the disorder, to alleviate the intensity and frequency of the symptoms with the least amount of dietary restrictions possible and minimise the impact on the quality of life of the patients.
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Affiliation(s)
- Alexandra Celi
- Unidad Mixta de Investigación en Endocrinología, Nutrición y Dietética Clínica. Universidad de Valencia-Instituto de Investigación Sanitaria La Fe
| | - María Trelis Villanueva
- Unidad Mixta de Investigación en Endocrinología, Nutrición y Dietética Clínica. Universidad de Valencia-Instituto de Investigación Sanitaria La Fe. Área de Parasitología. Departamento de Farmacia y Tecnología Farmacéutica y Parasitología. Universidad de V
| | - Bárbara Tena
- Área de Parasitología. Departamento de Farmacia y Tecnología Farmacéutica y Parasitología. Universidad de Valencia
| | - Silvia Taroncher
- Clínica Universitaria de Nutrición, Actividad Física y Fisioterapia (CUNAFF). Fundación Lluís Alcanyís-Universidad de Valenci
| | - Jose M Soriano
- Unidad Mixta de Investigación en Endocrinología, Nutrición y Dietética Clínica. Universidad de Valencia-Instituto de Investigación Sanitaria La Fe. Food & Health Lab. Instituto de Ciencia de Materiales. Universidad de Valencia
| | - Juan Francisco Merino Torres
- Unidad Mixta de Investigación en Endocrinología, Nutrición y Dietética Clínica, Universidad de Valencia-Instituto de Investigación Sanitaria La Fe, 46026 Valencia, España
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Tapia-Veloz E, Guillén M, Trelis M, Carpio-Arias TV, Gozalbo M. Assessment of the Health Status of Spanish Schoolchildren Based on Nutrimetry, Lifestyle and Intestinal Parasites. Nutrients 2023; 15:2801. [PMID: 37375703 DOI: 10.3390/nu15122801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 05/31/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023] Open
Abstract
Malnutrition in Spanish schoolchildren, and its relationship with lifestyles, has been studied, but Nutrimetry (a nutritional status indicator), and data on intestinal parasitism and its risk factors, have never before been taken into account. A total of 206 children aged 3-11 years, from two schools in the Valencian Community, participated. Demographic characteristics, diet, lifestyles, behavioural habits and anthropometric (weight, height) and coproparasitological data were collected. Nutrimetry was used to analyse nutritional status. Statistical analyses were performed to ascertain associations between lifestyle, selected parasite species and nutritional status. Multivariate logistic regression analysis was used to assess the strength of the association of the suspected risk factors with the presence of intestinal parasitism. The prevalence of overweight was 32.6%. A total of 43.9% had a high adherence to the Mediterranean Diet, for which mean daily intake was 2428.7 kcal. Intestinal parasitism was identified in 49.5% of the children (Giardia duodenalis: 28.6%). The source of drinking water was found to be a risk factor for intestinal parasitism. No positive association between the variables analysed and nutritional status could be confirmed. Nutrimetry is a good indicator for a complete analysis of nutritional status. It highlights the prevalence of overweight. Intestinal parasitism was identified in almost half of the participants and is a variable that should not be underestimated.
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Affiliation(s)
- Estephany Tapia-Veloz
- Area of Parasitology, Department of Pharmacy and Pharmaceutical Technology and Parasitology, University of Valencia, 46010 Valencia, Spain
| | - Marisa Guillén
- Department of Medicine and Public Health, Science of the Food, Toxicology and Legal Medicine, University of Valencia, 46010 Valencia, Spain
| | - María Trelis
- Area of Parasitology, Department of Pharmacy and Pharmaceutical Technology and Parasitology, University of Valencia, 46010 Valencia, Spain
- Joint Research Unit on Endocrinology, Nutrition and Clinical Dietetics, University of Valencia-Health Research Institute La Fe, 46026 Valencia, Spain
| | - Tannia Valeria Carpio-Arias
- Research Group on Food and Human Nutrition, Escuela Superior Politécnica de Chimborazo, Riobamba 060101, Ecuador
| | - Mónica Gozalbo
- Department of Medicine and Public Health, Science of the Food, Toxicology and Legal Medicine, University of Valencia, 46010 Valencia, Spain
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Abstract
Data on human gastrointestinal parasites (GIP) infections in the african sub-regions and countries are mainly lacking in terms of prevalence and population stratification by afflicted age group, symptomatology, multi-parasitism, and diagnostic methods. This study aims to describe the GIP reported in african countries and discuss the extent of the burden in the african context. Only 68.42% (39/57) of african countries reported human cases of GIP with helminths (45%, CI: 40-50%, I2: 99.79%) as the predominant parasitic group infecting the african population. On a regional scale, Central Africa had the highest pooled prevalence for GIP (43%, CI: 32-54%, I2: 99.74%), while the Central African Republic led all countries with a pooled prevalence of 90% (CI: 89-92%, I2: 99.96%). The vulnerable population (patients who are minorities, children, old, poor, underfunded, or have particular medical conditions) was the most affected (50%, CI: 37-62%, I2: 99.33%), with the predominance of GIP in the 6 to <20 years age group (48%, CI: 43-54%, I2: 99.68%). Reports on multi-parasitism (44%, CI: 40-48%, I2: 99.73%) were almost double the reports of single infections (43%, CI: 27-59%, I2: 99.77%) with combined molecular and non-molecular techniques demonstrating the best performance for GIP identification. The current review spans more than 40 years of GIP reports from the african continent. Geographical characteristics, environmental factors, habits of its inhabitants, and their health status play a crucial role in GIP modulation and behaviour in its captive hosts. Strategies for regular and enhanced surveillance, policy formation, and high-level community awareness are necessary to identify the true incidence in Africa and the transmission of the pathogens via water and food.
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Affiliation(s)
- Shahira A Ahmed
- Department of Parasitology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Manas Kotepui
- Medical Technology Program, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand
| | - Frederick R Masangkay
- Department of Medical Technology, Faculty of Pharmacy, University of Santo Tomas, Manila, Philippines
| | - Giovanni D Milanez
- Department of Medical Technology, Faculty of Pharmacy, University of Santo Tomas, Manila, Philippines
| | - Panagiotis Karanis
- University of Cologne, Medical Faculty and University Hospital, Cologne, Germany; University of Nicosia Medical School, Nicosia, Cyprus.
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Morales-Luna L, Hernández-Ochoa B, Martínez-Rosas V, Navarrete-Vázquez G, Ortega-Cuellar D, Rufino-González Y, González-Valdez A, Arreguin-Espinosa R, Franco-Vásquez AM, Pérez de la Cruz V, Enríquez-Flores S, Martínez-Conde C, Canseco-Ávila LM, Gómez-Chávez F, Gómez-Manzo S. Giardia lamblia G6PD::6PGL Fused Protein Inhibitors Decrease Trophozoite Viability: A New Alternative against Giardiasis. Int J Mol Sci 2022; 23:ijms232214358. [PMID: 36430836 PMCID: PMC9697976 DOI: 10.3390/ijms232214358] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/08/2022] [Accepted: 11/14/2022] [Indexed: 11/22/2022] Open
Abstract
Treatments to combat giardiasis have been reported to have several drawbacks, partly due to the drug resistance and toxicity of current antiparasitic agents. These constraints have prompted many researchers to investigate new drugs that act against protozoan parasites. Enzyme inhibition is an important means of regulating pathogen metabolism and has recently been identified as a significant alternative target in the search for new treatments. Glucose-6-phosphate dehydrogenase and 6-phosphogluconolactonase (G6PD::6PGL) is a bifunctional enzyme involved in the pentose phosphate pathway (PPP) in Giardia lamblia (G. lamblia). The G. lamblia enzyme is unusual since, unlike the human enzyme, it is a fused enzyme. Here, we show, through inhibition assays, that an in-house chemical library of 120 compounds and four target compounds, named CNZ-7, CNZ-8, CMC-1, and FLP-2, are potent inhibitors of the G. lamblia G6PD::6PGL fused enzyme. With a constant (k2) of 2.3, 3.2, and 2.8 M−1 s−1, respectively, they provoke alterations in the secondary and tertiary protein structure and global stability. As a novel approach, target compounds show antigiardial activity, with IC50 values of 8.7, 15.2, 15.3, and 24.1 µM in trophozoites from G. lamblia. Moreover, these compounds show selectivity against G. lamblia, since, through counter-screening in Caco-2 and HT29 human cells, they were found to have low toxicity. This finding positions these compounds as a potential and attractive starting point for new antigiardial drugs.
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Affiliation(s)
- Laura Morales-Luna
- Laboratorio de Bioquímica Genética, Instituto Nacional de Pediatría, Secretaría de Salud, Mexico City 04530, Mexico
- Posgrado en Ciencias Biológicas, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - Beatriz Hernández-Ochoa
- Laboratorio de Inmunoquímica, Hospital Infantil de México Federico Gómez, Secretaría de Salud, Mexico City 06720, Mexico
| | - Víctor Martínez-Rosas
- Laboratorio de Bioquímica Genética, Instituto Nacional de Pediatría, Secretaría de Salud, Mexico City 04530, Mexico
- Programa de Posgrado en Biomedicina y Biotecnología Molecular, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City 11340, Mexico
| | - Gabriel Navarrete-Vázquez
- Facultad de Farmacia, Universidad Autónoma del Estado de Morelos, Av. Universidad 1001, Chamilpa, Cuernavaca 62209, Mexico
| | - Daniel Ortega-Cuellar
- Laboratorio de Nutrición Experimental, Instituto Nacional de Pediatría, Secretaría de Salud, Mexico City 04530, Mexico
| | - Yadira Rufino-González
- Laboratorio de Parasitología Experimental, Instituto Nacional de Pediatría, Secretaría de Salud, Mexico City 04530, Mexico
| | - Abigail González-Valdez
- Departamento de Biología Molecular y Biotecnología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - Roberto Arreguin-Espinosa
- Departamento de Química de Biomacromoléculas, Instituto de Química, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - Adrián Marcelo Franco-Vásquez
- Departamento de Química de Biomacromoléculas, Instituto de Química, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - Verónica Pérez de la Cruz
- Neurobiochemistry and Behavior Laboratory, National Institute of Neurology and Neurosurgery “Manuel Velasco Suárez”, Mexico City 14269, Mexico
| | - Sergio Enríquez-Flores
- Laboratorio de Biomoléculas y Salud Infantil, Instituto Nacional de Pediatría, Secretaría de Salud, Mexico City 04530, Mexico
| | - Carlos Martínez-Conde
- Facultad de Farmacia, Universidad Autónoma del Estado de Morelos, Av. Universidad 1001, Chamilpa, Cuernavaca 62209, Mexico
| | - Luis Miguel Canseco-Ávila
- Facultad de Ciencias Químicas, Campus IV, Universidad Autónoma de Chiapas, Tapachula City 30700, Mexico
| | - Fernando Gómez-Chávez
- Laboratorio de Enfermedades Osteoarticulares e Inmunológicas, Sección de Estudios de Posgrado e Investigación, Escuela Nacional de Medicina y Homeopatía, Instituto Politécnico Nacional, Mexico City 07320, Mexico
| | - Saúl Gómez-Manzo
- Laboratorio de Bioquímica Genética, Instituto Nacional de Pediatría, Secretaría de Salud, Mexico City 04530, Mexico
- Correspondence: ; Tel.: +52-55-1084-0900 (ext. 1442)
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Tapia-veloz E, Gozalbo M, Tapia-veloz G, Carpio-arias TV, Trelis M, Guillén M. Evaluation of School Children Nutritional Status in Ecuador Using Nutrimetry: A Proposal of an Education Protocol to Address the Determinants of Malnutrition. Nutrients 2022; 14:3686. [PMID: 36145057 PMCID: PMC9502477 DOI: 10.3390/nu14183686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/19/2022] [Accepted: 09/02/2022] [Indexed: 11/19/2022] Open
Abstract
The education sector is a cornerstone in the battle against malnutrition in children. However, there are still no consolidated protocols that outline strategies for how nutrition programs in low- and middle-income countries can be delivered through the education sector. Establishing the correct community diagnosis is essential prior to the elaboration of an intervention plan for a school population that takes into account more than just traditional variables related to the nutritional status. A total of 574 boys and girls aged 3–11 years from three educational institutions in different municipalities in Ecuador participated in the study. Sociodemographic, anthropometric (weight and height) and coproparasitological data were obtained. Nutrimetry, which is a combination of two classical anthropometrics indicators, was used for the analysis of the nutritional status, and the indicators’ frequencies varied among the schools. In order to improve the nutritional status of children, we proposed a framework mainly focusing on establishing alliances with the education sector and taking into account gender equality; respect for the environment; and the customs, beliefs and traditions of each population. The results obtained from the analyses of other variables demonstrated the importance of an adequate diagnosis prior to any type of intervention at the nutritional level, since characteristics could vary by local area and have an impact on the successfulness of the intervention.
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Trelis M, Sáez-Durán S, Puchades P, Castro N, Miquel A, Gozalbo M, Fuentes MV. Survey of the occurrence of Giardia duodenalis cysts and Cryptosporidium spp. oocysts in green leafy vegetables marketed in the city of Valencia (Spain). Int J Food Microbiol 2022; 379:109847. [PMID: 35905648 DOI: 10.1016/j.ijfoodmicro.2022.109847] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 07/13/2022] [Accepted: 07/18/2022] [Indexed: 11/29/2022]
Abstract
The role of vegetables usually consumed without prior culinary treatment is known to contribute to the prevalence of foodborne diseases. Cysts and oocysts can contaminate food, which can then be the source of infection in humans. The aim of the study was to assess the occurrence of Giardia duodenalis and Cryptosporidium spp. (oo)cysts in green leafy vegetables marketed in the city of Valencia (Spain) combining parasitological methods, two real-time qPCRs and light microscopy. An experimental field study was conducted on 129 vegetable samples, 64 from conventional farms and 65 from ecological (organic) farms. The samples were washed with water, and the resulting solution after removing the vegetables, was subjected to 24-hour sedimentation. The concentrated sediment was used for the search for protozoa. A positive result by both real-time PCRs, or a positive result by one qPCR and confirmation by microscopy was established as a positivity criterion. Giardia duodenalis was detected in 23.0 % of the samples, and Cryptosporidium spp. in 7.8 %. G. duodenalis (41.5 %) and Cryptosporidium spp. (20.0 %) were more frequent in ecological crops. The high level of contamination detected in organic vegetables may be due to the type of fertilizers and the quality of the water used for their irrigation and reinforces the need to take extreme hygiene measures in vegetables that are consumed raw.
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Affiliation(s)
- María Trelis
- Parasite & Health Research Group, Department of Pharmacy, Pharmaceutical Technology and Parasitology, Faculty of Pharmacy, University of Valencia, Burjassot, 46100, Valencia, Spain; Joint Research Unit on Endocrinology, Nutrition and Clinical Dietetics, University of Valencia-Health Research Institute La Fe, 46026, Valencia, Spain.
| | - Sandra Sáez-Durán
- Parasite & Health Research Group, Department of Pharmacy, Pharmaceutical Technology and Parasitology, Faculty of Pharmacy, University of Valencia, Burjassot, 46100, Valencia, Spain.
| | - Pablo Puchades
- Parasite & Health Research Group, Department of Pharmacy, Pharmaceutical Technology and Parasitology, Faculty of Pharmacy, University of Valencia, Burjassot, 46100, Valencia, Spain.
| | - Nicole Castro
- Parasite & Health Research Group, Department of Pharmacy, Pharmaceutical Technology and Parasitology, Faculty of Pharmacy, University of Valencia, Burjassot, 46100, Valencia, Spain
| | - Ana Miquel
- Parasite & Health Research Group, Department of Pharmacy, Pharmaceutical Technology and Parasitology, Faculty of Pharmacy, University of Valencia, Burjassot, 46100, Valencia, Spain.
| | - Mónica Gozalbo
- Area of Nutrition and Bromatology, University of Valencia, 46010, Valencia, Spain.
| | - Màrius Vicent Fuentes
- Parasite & Health Research Group, Department of Pharmacy, Pharmaceutical Technology and Parasitology, Faculty of Pharmacy, University of Valencia, Burjassot, 46100, Valencia, Spain.
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Calegar DA, Nunes BC, Monteiro KJL, Bacelar PAA, Evangelista BBC, Almeida MM, Silva J, Santos JP, Boia MN, Jaeger LH, Carvalho-Costa FA. Genotypic and Epidemiologic Profiles of Giardia duodenalis in Four Brazilian Biogeographic Regions. Microorganisms 2022; 10. [PMID: 35630389 DOI: 10.3390/microorganisms10050940] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/25/2022] [Accepted: 03/28/2022] [Indexed: 02/01/2023] Open
Abstract
Human infections with gut protozoan parasites are neglected and not targeted by specific control initiatives, leading to a knowledge gap concerning their regional diversity and epidemiology. The present study aims to explore Giardia duodenalis genetic diversity and assess the epidemiologic scenario of subclinical infections in different Brazilian biogeographic regions. Cross-sectional surveys (n = 1334 subjects) were conducted in four municipalities in order to obtain fecal samples and socioenvironmental data. Microscopy of non-diarrheal feces and nucleotide sequencing of a β-giardin gene fragment were performed. From a total of 51 samples that could be sequenced, 27 (52.9%) β-giardin sequences were characterized as assemblage A and 24 (47.1%) as assemblage B. In the Amazon, assemblage B was the most frequently detected, predominantly BIII, and with two novel sub-assemblages. Assemblage A predominated in the extra-Amazon region, with five novel sub-assemblages. Prevalence reached 17.8% (64/360) in the Amazon, 8.8% (48/544) in the Atlantic Forest, 7.4% (22/299) in Cerrado and 2.3% (3/131) in the Semiarid. People living in poverty and extreme poverty presented significantly higher positivity rates. In conclusion, subclinical giardiasis is endemic in Brazilian communities in different biogeographic regions, presenting high genetic diversity and a heterogeneous genotypic distribution.
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Taneva I, Grumann D, Schmidt D, Taneva E, von Arnim U, Ansorge T, Wex T. Gene variants of the SLC2A5 gene encoding GLUT5, the major fructose transporter, do not contribute to clinical presentation of acquired fructose malabsorption. BMC Gastroenterol 2022; 22:167. [PMID: 35387598 PMCID: PMC8985300 DOI: 10.1186/s12876-022-02244-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 03/25/2022] [Indexed: 11/24/2022] Open
Abstract
Background While role of ALDOB-related gene variants for hereditary fructose intolerance is well established, contribution of gene variants for acquired fructose malabsorption (e.g. SLC2A5, GLUT5) is not well understood. Methods Patients referred to fructose breath test were further selected to identify those having acquired fructose malabsorption. Molecular analysis of genomic DNA included (I) exclusion of 3 main ALDOB gene variants causing hereditary fructose intolerance and (II) sequencing analysis of SLC2A5 gene comprising complete coding region, at least 20 bp of adjacent intronic regions and 700 bp of proximal promoter. Results Among 494 patients, 35 individuals with acquired fructose malabsorption were identified based on pathological fructose-breath test and normal lactose-breath test. Thirty four of them (97%) had negative tissue anti-transglutaminase and/or deamidated gliadin antibodies in their medical records. Molecular analysis of SLC2A5 gene of all 35 subjects identified 5 frequent and 5 singular gene variants mostly in noncoding regions (promoter and intron). Allele frequencies of gene variants were similar to those reported in public databases strongly implying that none of them was associated with acquired fructose malabsorption. Conclusions Gene variants of coding exons, adjacent intronic regions and proximal promoter region of SLC2A5 gene are unlikely to contribute to genetic predisposition of acquired fructose malabsorption.
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Affiliation(s)
- Irina Taneva
- Department of Molecular Genetics, Medical Laboratory for Clinical Chemistry, Microbiology, Infectious Diseases and Genetics "Prof. Schenk/Dr. Ansorge and Colleagues", Schwiesaustr. 11, 39124, Magdeburg, Germany
| | - Dorothee Grumann
- Department of Molecular Genetics, Medical Laboratory for Clinical Chemistry, Microbiology, Infectious Diseases and Genetics "Prof. Schenk/Dr. Ansorge and Colleagues", Schwiesaustr. 11, 39124, Magdeburg, Germany
| | - Dietmar Schmidt
- Medical Office Internal Medicine and Gastroenterology, Olvenstedter Str. 11, 39108, Magdeburg, Germany
| | - Elina Taneva
- Department of Molecular Genetics, Medical Laboratory for Clinical Chemistry, Microbiology, Infectious Diseases and Genetics "Prof. Schenk/Dr. Ansorge and Colleagues", Schwiesaustr. 11, 39124, Magdeburg, Germany
| | - Ulrike von Arnim
- Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-Von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Thomas Ansorge
- Department of Molecular Genetics, Medical Laboratory for Clinical Chemistry, Microbiology, Infectious Diseases and Genetics "Prof. Schenk/Dr. Ansorge and Colleagues", Schwiesaustr. 11, 39124, Magdeburg, Germany
| | - Thomas Wex
- Department of Molecular Genetics, Medical Laboratory for Clinical Chemistry, Microbiology, Infectious Diseases and Genetics "Prof. Schenk/Dr. Ansorge and Colleagues", Schwiesaustr. 11, 39124, Magdeburg, Germany. .,Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-Von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany.
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Abo-Zaid MA, Hamdi AA. Evaluation of Immune Response and Haematological Parameters in Infected Male Albino Rats by Giardiasis. Parasite Immunol 2022; 44:e12908. [PMID: 35104007 DOI: 10.1111/pim.12908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 01/25/2022] [Accepted: 01/27/2022] [Indexed: 11/27/2022]
Abstract
The present work aimed to study the effects of G. lamblia infection on immunological, haematological studies and to evaluate immunoglobulins and some cytokines. Fifty male albino rats were divided into six groups. The control group including 20 rats and the infected group includes 30 rats. All the estimations were checked all over five checkpoints (CP) (7, 14, 21, 28, and 35 days post-infection). Serum levels of IgA, IgG, IgM and IgE. Cytokines INF-γ, TNF-alpha, IL-4, IL-10, and haematological parameters were determined. Cyst and trophozoite were counted. A considerable increase in the level of immunoglobulins and cytokines in all infected groups compared to the control group was documented. Furthermore, a significant decrease in red blood corpuscles, haemoglobin, and mean corpuscular haemoglobin concentration levels, whereas substantial increases in mean corpuscular volume, mean corpuscular haemoglobin and platelets were observed. Moreover, infected rats had a substantial rise in WBCs, lymphocytes, and eosinophil counts compared to the control group, whereas neutrophils and monocytes had a significant decrease. Number of trophozoites and cysts were significantly increased in infected groups before diminishing after day 28. The current results showed that Th1 and Th2 immune responses, which are characterized by the production of TNF-α, IFN-γ, IL-4 and IL-10, are important for protection against Giardia infections and also verified the balance between these cytokines and the timing of their production was crucial in G. lamblia immune response. Giardia lamblia, Immunity, Antibodies, cytokines, eosinophil.
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Affiliation(s)
- Mabrouk A Abo-Zaid
- Biology department faculty of science, Jazan University, Jazan, Saudi Arabia
| | - Aishah Ali Hamdi
- Biology department faculty of science, Jazan University, Jazan, Saudi Arabia
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Caudet J, Trelis M, Cifre S, Soriano JM, Merino-Torres JF. Presence and significance of intestinal unicellular parasites in a morbidly obese population. Int J Obes (Lond) 2022; 46:220-227. [PMID: 34650200 DOI: 10.1038/s41366-021-00980-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 09/20/2021] [Accepted: 09/29/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND Obesity is a chronic disease whose pathogenesis has been related to changes in the intestinal microbiota. Yet, the role of protozoa and other unicellular eukaryotic parasites in this microenvironment is still largely unknown. Their presence within the gut ecosystem in obese subjects warrants further study, as well as their influence on the host metabolism and comorbidities. METHODS Herein, a single center, cross-sectional study of 104 obese individuals was performed to assess the presence of six intestinal unicellular parasites in stool using a commercially available kit, and to evaluate its relationship with the presence of abdominal symptoms, metabolic comorbidities, variations in body composition and nutritional deficiencies. RESULTS The overall parasitic colonization rate was 51%, with Blastocystis sp., identified as the most frequent (44.2%), followed by Dientamoeba fragilis (11.5%) and Giardia intestinalis (8.7%), and significantly related to the consumption of ecological fruits and vegetables. Contrary to what previous studies pointed out, colonization with parasites species was significantly associated with fewer abdominal symptoms and depositions per day. The presence of parasites did not correlate with any nutritional deficiencies nor differences in body composition, while it did with significant lower HOMA-IR levels and a lower trend towards metabolic syndrome. CONCLUSION Obese subjects frequently harbor unicellular enteric parasites, apparently without clinical nor nutritional harm. This evidence suggests that carrying these microorganisms, from an endocrinological perspective, has a beneficial effect, especially on insulin resistance and possibly on the development of related comorbidities.
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Affiliation(s)
- J Caudet
- Department of Endocrinology and Nutrition, University and Polytechnic Hospital La Fe, Valencia, Spain.,Joint Research Unit on Endocrinology, Nutrition and Clinical Dietetics, University of Valencia-Health Research Institute La Fe, Valencia, Spain
| | - M Trelis
- Joint Research Unit on Endocrinology, Nutrition and Clinical Dietetics, University of Valencia-Health Research Institute La Fe, Valencia, Spain. .,Parasite & Health Research Group, Department of Pharmacy, Pharmaceutical Technology and Parasitology, University of Valencia, Valencia, Spain.
| | - S Cifre
- Joint Research Unit on Endocrinology, Nutrition and Clinical Dietetics, University of Valencia-Health Research Institute La Fe, Valencia, Spain
| | - J M Soriano
- Joint Research Unit on Endocrinology, Nutrition and Clinical Dietetics, University of Valencia-Health Research Institute La Fe, Valencia, Spain.,Food & Health Lab, Institute of Materials Science, University of Valencia, Valencia, Spain
| | - J F Merino-Torres
- Department of Endocrinology and Nutrition, University and Polytechnic Hospital La Fe, Valencia, Spain.,Joint Research Unit on Endocrinology, Nutrition and Clinical Dietetics, University of Valencia-Health Research Institute La Fe, Valencia, Spain.,Department of Medicine, Faculty of Medicine, University of Valencia, Valencia, Spain
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11
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Abstract
Parasites have coevolved with humans. Several of them colonize the human body and establish a symbiotic relationship. Other parasites cause severe and lethal diseases. Prevalence of parasitic infections is decreased in highly industrialized countries, largely due to enforced hygienic practices. In contrast, parasites cause significant morbidity and mortality in parts of the world with barriers to effective public hygiene. Some parasites have emerged as potent pathogens in specific patient populations, such as immune suppressed individuals, regardless of sanitation. This article reviews common parasites encountered in clinical practice and, in the setting of host-parasite symbiosis, discusses their immune regulatory role.
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Affiliation(s)
- Annie L Braseth
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Iowa, Carver College of Medicine, Iowa City, IA 52242, USA
| | - David E Elliott
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Iowa, Carver College of Medicine, 4546 JCP, 200 Hawkins Drive, Iowa City, IA 52242, USA
| | - M Nedim Ince
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Iowa, Carver College of Medicine, 4546 JCP, 200 Hawkins Drive, Iowa City, IA 52242, USA.
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12
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Saura-Carretero Z, Villanueva-Alarcón M, Pérez-Olaso O, Aleixandre-Górriz I, Real-Fernández A, Sánchez-Thevenet P, Gregori-Roig P. Giardiasis in a paediatric population of the province of Castellon. Clinical details and impact. Anales de Pediatría (English Edition) 2021. [DOI: 10.1016/j.anpede.2020.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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13
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Abstract
This review intends to act as an overview of fructose malabsorption (FM) and its role in the aetiology of diseases including, but not limited to, irritable bowel syndrome (IBS) and infantile colic and the relationship between fructose absorption and the propagation of some cancers. IBS results in a variety of symptoms including stomach pains, cramps and bloating. Patients can be categorised into two groups, depending on whether the patients’ experiences either constipation (IBS-C) or diarrhoea (IBS-D). FM has been proposed as a potential cause of IBS-D and other diseases, such as infantile colic. However, our knowledge of FM is limited by our understanding of the biochemistry related to the absorption of fructose in the small intestine and FM’s relationship with small intestinal bacterial overgrowth. It is important to consider the dietary effects on FM and most importantly, the quantity of excess free fructose consumed. The diagnosis of FM is difficult and often requires indirect means that may result in false positives. Current treatments of FM include dietary intervention, such as low fermentable oligo-, di-, monosaccharides and polyols diets and enzymatic treatments, such as the use of xylose isomerase. More research is needed to accurately diagnose and effectively treat FM. This review is designed with the goal of providing a detailed outline of the issues regarding the causes, diagnosis and treatment of FM.
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14
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Schnedl WJ, Meier-Allard N, Lackner S, Enko D, Mangge H, Holasek SJ. Increasing Expiratory Hydrogen in Lactose Intolerance Is Associated with Additional Food Intolerance/Malabsorption. Nutrients 2020; 12:E3690. [PMID: 33265924 PMCID: PMC7761160 DOI: 10.3390/nu12123690] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 11/25/2020] [Accepted: 11/27/2020] [Indexed: 12/12/2022] Open
Abstract
Single and/or combined food intolerance/malabsorption may cause nonspecific, functional gastrointestinal (GI) complaints. In lactose-intolerant patients we evaluated the influence of additional food intolerance/malabsorption with hydrogen (H2) breath tests. In a retrospective analysis of charts from 279 lactose-intolerant patients, we found 128 patients with only lactose intolerance (LIT). Then, we identified 106 LIT patients with additional histamine intolerance (HIT). Additionally, 45 LIT and HIT patients also had fructose malabsorption (FM). A hydrogen (H2) breath test was performed to evaluate LIT and FM. A serum diamine oxidase value of <10 U/mL and a response to a histamine-reduced diet was used to identify HIT. Using pairwise comparison with the Kruskal-Wallis test to associate the area under the curve (AUC) of LIT patients and, LIT with HIT, to LIT with HIT and FM it was found, that the exhaled hydrogen values were significantly higher in patients with two-fold and triple combined food intolerance/malabsorption (p < 0.004 and p < 0.001, respectively). Within the pool of 170 LIT patients with >20 ppm increase of expiratory H2 from baseline, there were 74 LIT-only patients, 60 LIT with HIT patients, and 36 LIT patients with additional HIT and FM. With the Kruskal-Wallis test AUCs demonstrated a significant difference between all three groups (p = 0.024). In patients with LIT, the presence of additional food intolerance/malabsorption, significantly increases expiratory H2 values. We demonstrate evidence, which may suggest HIT to embody an own GI disorder as food intolerance/malabsorption.
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Affiliation(s)
- Wolfgang J. Schnedl
- General Internal Medicine Practice, Theodor Körnerstrasse 19b, A-8600 Bruck, Austria
| | - Nathalie Meier-Allard
- Division of Immunology and Pathophysiology, Otto Loewi Research Center, Medical University of Graz, Heinrichstrasse 31a, A-8010 Graz, Austria; (N.M.-A.); (S.L.); (S.J.H.)
| | - Sonja Lackner
- Division of Immunology and Pathophysiology, Otto Loewi Research Center, Medical University of Graz, Heinrichstrasse 31a, A-8010 Graz, Austria; (N.M.-A.); (S.L.); (S.J.H.)
| | - Dietmar Enko
- Clinical Institute of Medical and Chemical Laboratory Diagnosis, Medical University of Graz, Auenbruggerplatz 30, A-8036 Graz, Austria; (D.E.); (H.M.)
| | - Harald Mangge
- Clinical Institute of Medical and Chemical Laboratory Diagnosis, Medical University of Graz, Auenbruggerplatz 30, A-8036 Graz, Austria; (D.E.); (H.M.)
| | - Sandra J. Holasek
- Division of Immunology and Pathophysiology, Otto Loewi Research Center, Medical University of Graz, Heinrichstrasse 31a, A-8010 Graz, Austria; (N.M.-A.); (S.L.); (S.J.H.)
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15
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Gozalbo M, Guillen M, Taroncher-Ferrer S, Cifre S, Carmena D, Soriano JM, Trelis M. Assessment of the Nutritional Status, Diet and Intestinal Parasites in Hosted Saharawi Children. Children (Basel) 2020; 7:E264. [PMID: 33260311 DOI: 10.3390/children7120264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/20/2020] [Accepted: 11/27/2020] [Indexed: 01/15/2023]
Abstract
Since the early 1990s, Spanish humanitarian associations have welcomed Saharawi children from the refugee camps in Tindouf (Argelia). These children are the most affected by the lack of food, water, hygienic measures and health care. The main objective of this study was to analyze the anthropometric, nutritional and parasitological data of 38 Saharawi boys and girls (from 10 to 13 years old) under a holiday host program in the city of Valencia. Our results confirm that malnutrition and multiparasitism are highly frequent, so it is understood that living conditions in refugee camps continue to be precarious with a lack of proper hygiene and nutrition. Furthermore, biochemical alterations, lactose malabsorption and the risk of celiac disease, also detected in our study as a secondary objective, will complicate nutritional management and restoration of health. For this reason, sustainable feeding alternatives and interventions from a hygienic and nutritional point of view are proposed, emphasizing in an improvement in the education of parents and children.
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Saura-Carretero Z, Villanueva-Alarcón M, Pérez-Olaso O, Aleixandre-Górriz I, Real-Fernández A, Sánchez-Thevenet P, Gregori-Roig P. [Giardiasis in a paediatric population of the province of castellon. Clinical details and impact]. An Pediatr (Barc) 2020; 94:278-284. [PMID: 32988766 DOI: 10.1016/j.anpedi.2020.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 06/21/2020] [Accepted: 06/30/2020] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Giardiasis is a gastrointestinal parasitosis that has a great public health impact. PATIENTS AND METHODS Observational case study - in children under 15 years old in the Health Department 3 of the Province of Castellon (Spain), during the period 2012-2019. RESULTS A total of 190 cases of giardiasis were recorded in children under 15 years old. The number of cases varied significantly according to age group and month of the year. There were 115 males. The most frequent symptoms were diarrhea and abdominal pain. The most commonly used treatment was standard metronidazole (80% of patients). Co-infection occurred in 13% of cases, and comorbidities in 36%, especially atopic dermatitis and lactose/fructose intolerance. Relapses and/or re-infections were recorded in 8%. All cases were diagnosed by conventional parasitological stool tests and complementary immunochromatography (63 cases). Thirty-five samples were positive for Giardia duodenalis by qPCR. The direct health cost per patient was 117€. A disease notification bias was detected between 2012-2016 at a national scale. CONCLUSIONS Giardiasis is a current disease in Castellon, and should be considered as a probable diagnosis of gastrointestinal disease in a child under 4 years-old with diarrhea and abdominal pain. Its correct clinical and therapeutic management could reduce the possibility of worsening of the patient's condition and, additionally, would reduce the economic impact of the disease in terms of direct health costs.
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Affiliation(s)
- Zoser Saura-Carretero
- Facultad de Ciencias de la Salud-Centro de Castellón, Universidad Cardenal Herrera-CEU, CEU Universities, Castellón, España
| | - Miriam Villanueva-Alarcón
- Facultad de Ciencias de la Salud-Centro de Castellón, Universidad Cardenal Herrera-CEU, CEU Universities, Castellón, España
| | - Oscar Pérez-Olaso
- Servicio de Microbiología, Hospital Universitario de La Plana, Villarreal, España
| | - Isabel Aleixandre-Górriz
- Facultad de Ciencias de la Salud-Centro de Castellón, Universidad Cardenal Herrera-CEU, CEU Universities, Castellón, España
| | - Antonio Real-Fernández
- Facultad de Ciencias de la Salud-Centro de Castellón, Universidad Cardenal Herrera-CEU, CEU Universities, Castellón, España
| | - Paula Sánchez-Thevenet
- Facultad de Ciencias de la Salud-Centro de Castellón, Universidad Cardenal Herrera-CEU, CEU Universities, Castellón, España
| | - Pasqual Gregori-Roig
- Facultad de Ciencias de la Salud-Centro de Castellón, Universidad Cardenal Herrera-CEU, CEU Universities, Castellón, España; Servicio de Pediatría, Hospital Universitario de La Plana, Villarreal, España.
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17
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Mejia R, Damania A, Jeun R, Bryan PE, Vargas P, Juarez M, Cajal PS, Nasser J, Krolewiecki A, Lefoulon E, Long C, Drake E, Cimino RO, Slatko B. Impact of intestinal parasites on microbiota and cobalamin gene sequences: a pilot study. Parasit Vectors 2020; 13:200. [PMID: 32306993 PMCID: PMC7168842 DOI: 10.1186/s13071-020-04073-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 04/10/2020] [Indexed: 01/10/2023] Open
Abstract
Background Approximately 30% of children worldwide are infected with gastrointestinal parasites. Depending on the species, parasites can disrupt intestinal bacterial microbiota affecting essential vitamin biosynthesis. Methods Stool samples were collected from 37 asymptomatic children from a previous cross-sectional Argentinian study. A multi-parallel real-time quantitative PCR was implemented for Ascaris lumbricoides, Ancylostoma duodenale, Necator americanus, Strongyloides stercoralis, Trichuris trichiura, Cryptosporidium spp., Entamoeba histolytica and Giardia duodenalis. In addition, whole-genome sequencing analysis was conducted for bacterial microbiota on all samples and analyzed using Livermore Metagenomic Analysis Toolkit and DIAMOND software. Separate analyses were carried out for uninfected, Giardia-only, Giardia + helminth co-infections, and helminth-only groups. Results For Giardia-only infected children compared to uninfected children, DNA sequencing data showed a decrease in microbiota biodiversity that correlated with increasing Giardia burden and was statistically significant using Shannonʼs alpha diversity (Giardia-only > 1 fg/µl 2.346; non-infected group 3.253, P = 0.0317). An increase in diversity was observed for helminth-only infections with a decrease in diversity for Giardia + helminth co-infections (P = 0.00178). In Giardia-only infections, microbiome taxonomy changed from Firmicutes towards increasing proportions of Prevotella, with the degree of change related to the intensity of infection compared to uninfected (P = 0.0317). The abundance of Prevotella bacteria was decreased in the helminths-only group but increased for Giardia + helminth co-infections (P = 0.0262). Metagenomic analysis determined cobalamin synthesis was decreased in the Giardia > 1 fg/µl group compared to both the Giardia < 1 fg/µl and the uninfected group (P = 0.0369). Giardia + helminth group also had a decrease in cobalamin CbiM genes from helminth-only infections (P = 0.000754). Conclusion The study results may provide evidence for an effect of parasitic infections enabling the permissive growth of anaerobic bacteria such as Prevotella, suggesting an altered capacity of vitamin B12 (cobalamin) biosynthesis and potential impact on growth and development in children .
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Affiliation(s)
- Rojelio Mejia
- National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA. .,Universidad Nacional de Salta, Salta, Argentina.
| | - Ashish Damania
- National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Rebecca Jeun
- National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Patricia E Bryan
- National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA
| | | | | | | | | | | | | | | | - Evan Drake
- New England Biolabs, Inc, Ipswich, MA, USA
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