Identification of Trypanosoma cruzi sublineages by the simple method of single-stranded conformation DNA polymorphism (SSCP)

Fifty-eight stocks of Trypanosoma cruzi from Latin America were genetically characterized using the methods of the polymerase chain reaction (PCR) and the single-stranded conformation DNA polymorphism (SSCP) with four genes, mini-exon, 24Salpha rRNA, 18Sr RNA, cruzipain, and a RAPD fragment DNA region, P7-P8. All the isolates examined were assigned to T. cruzi I or subgroups of T. cruzi II by these methods. From these results, the SSCP analysis, which was simple to perform and highly sensitive to sequence variation, seemed to be a good modality for characterizing T. cruzi, particularly for subgroups of T. cruzi II. However, in several isolates of T. cruzi II, the subgroups determined with the SSCP of 24Salpha rRNA were not consistent with those determined with other genes, the SSCP of 18S rRNA and cruzipain, and the PCR of P7-P8, possibly because of the occurrence of rare genetic exchanges or mutations or both in natural populations of this parasite. The SSCP patterns of 24Salpha rRNA and 18S rRNA were highly variable in the T. cruzi I isolates; therefore, analyses using both genes are considered to be one possible method for the characterization of isolates within T. cruzi I.

Screening of New Caledonian and Vanuatu medicinal plants for antiprotozoal activity

Sixty-seven extracts of 30 medicinal plants traditionally used in New Caledonia or Vanuatu by healers to treat inflammation, fever and in cicatrizing remedies were evaluated in vitro for their antiprotozoal activity against Leishmania donovani, Leishmania amazonensis and Trypanosoma cruzi. Among the selected plants, Pagiantha cerifera was the most active against both Leishmania species; four extracts were active against promastigotes of Leishmania donovani at EC(50) values inferior to 5 microg/ml. Garcinia pedicillata extract had an EC(50) value of 12.5 microg/ml against intracellular amastigotes of Leishmania amazonensis. Alone Amborella trichopoda reduced by more of 80% the trypomastigotes of Trypanosoma cruzi in the blood.

Genotypic variation among lineages of Trypanosoma cruzi and its geographic aspects

Isozyme analysis with 18 enzyme loci was conducted on 146 isolates of Trypanosoma cruzi from Mexico, Guatemala, Colombia, Ecuador, Peru, Brazil, Bolivia, Paraguay and Chile. Forty-four different MLGs (groups of isolates with identical multilocus genotypes) were identified and a phylogeny was constructed. The phylogenetic tree consisted of two main groups (T. cruzi I, T. cruzi II), and the latter was further divided into two subgroups (T. cruzi IIa, T. cruzi IIb-e). Evidence of hybridization between different MLGs of T. cruzi II was found, which means that genetic exchanges seem to have occurred in South American T. cruzi. On the other hand, the persistence of characteristic T. cruzi I and T. cruzi II isozyme patterns in single small villages in Bolivia and Guatemala suggested that genetic exchange is very rare between major lineages. A significant difference in genetic diversity was shown between T. cruzi I and T. cruzi II from several indices of population genetics. Two possibilities could explain this genetic variation in the population: differences in evolutionary history and/or different tendencies to exchange genetic material. Broad-scale geographic distributions of T. cruzi I and T. cruzi IIb-e were different; T. cruzi I occurred in Central America and south to Bolivia and Brazil, while T. cruzi IIb-e occurred in the central and southern areas of South America, overlapping with T. cruzi I in Brazil and Bolivia.

Leishmanicidal activity of two canthin-6-one alkaloids, two major constituents of Zanthoxylum chiloperone var. angustifolium

The crude alkaloidal extract of Zanthoxylum chiloperone stem bark exhibited in vitro activity against various strains of Leishmania ssp. at 100 microg/ml. Two active major constituents were isolated and identified as canthin-6-one and 5-methoxycanthin-6-one. The effect of these compounds was also tested in an in vivo assay using BALB/c mice infected with Leishmania amazonensis. The mice were treated for 5 weeks postinfection with these alkaloids by oral (14 days) or intralesional route (4 days) at 10 mg/kg daily. The reference drug, N-methylglucamine antimonate was administered by subcutaneous injections at 100 mg/kg for 10 days. Intralesional administration of canthin-6-one reduced the parasite burden but not significantly when it was compared with the untreated group, while the reference drug reduced by 91% the parasite loads in the lesion.

Experimental treatment of chronic Trypanosoma cruzi infection in mice with 2-n-propylquinoline

It was reported previously that 2-n-propylquinoline was active against the epimastigote form of Trypanosoma cruzi. The effects of oral treatments with benznidazole and 2-n-propylquinoline were evaluated in Balb/c mice infected with T. cruzi chronically. The reference drug and 2-n-propylquinoline were administered 60 days post-infection for 30 days at 25 mg/mL. At 35 days post-treatment, the serological tests (ELISA) of the 2-n- propylquinoline-treated mice were significantly different from the controls (p = 0.01) and the benznidazole-treated mice (p = 0.03), while this was not the case at 85 days post-treatment. These results are encouraging for continuing the investigation of other analogues of 2-n-propylquinoline in experimental chronic Chagas' disease.

Isoenzyme profiles of Trypanosoma cruzi stocks from different areas of Paraguay

Twenty one Trypanosoma cruzi stocks from humans, domiciliary triatomines and one sylvatic animal of different areas of Paraguay were subjected to isoenzyme analysis. Thirteen enzyme systems (15 loci in total) were studied. MN cl2 (clonets 39) and SO34 cl4 (clonets 20) were used as references. Relationships between stocks were depicted by an UPGMA dendrogram constructed using the Jaccard's distances matrix. Among the Paraguayan stocks 14 zymodemes were identified (Par1 to Par14), Par 5 being the most frequent. Polymorphism rate and clonal diversity were 0.73 and 0.93, respectively. Average number of alleles per polymorphic locus was 2.5 (range 2-4). These measurements show a high diversity, which is confirmed by the dendrogram topology. All stocks belong to the same lineage, as MN cl2 reference strain (T. cruzi II). Moreover three distinct subgroups were identified and two of them correspond to Brazilian and Bolivian zymodemes, respectively. The third subgroup, the most common in Paraguay, is related to Tulahuen stock. The large geographical distribution of some zymodemes agrees with the hypothesis of clonality for T. cruzi populations. However sample size was not adequate to detect genetic recombination in any single locality.

Efficacy of the bisbenzylisoquinoline alkaloids in acute and chronic Trypanosoma cruzi murine model

We have shown previously that daphnoline and cepharanthine are active against Trypanosoma cruzi and inhibited trypanothione reductase. The effects of oral treatments with daphnoline, cepharanthine and benznidazole were examined in Balb/c mice infected with T. cruzi acutely and chronically. In acute infections, parasitaemia was significantly reduced in the daphnoline-treated mice compared with controls and benznidazole-treated mice. The parasitological cure rate was increased in mice treated with daphnoline. Fifty days after infection, the negative serological response in both models was significantly different for the three tested drugs. Daphnoline showed the highest negative serological rate (48%). In chronically infected mice treated with daphnoline, we were unable to detect parasites in 70% of mice. The results obtained of oral treatment of daphnoline suggest that this bisbenzylisoquinoline may be useful in the treatment of acute and chronic Chagas' disease. This was not seen with cepharanthine, an excellent trypanothione reductase inhibitor.

Leishmanicidal activity of combretastatin analogues and heteroanalogues

We have investigated the in vitro leishmanicidal activity of representative members from series II-V of combretastatin analogues and heteroanalogues. Most of them exhibited different degrees of activity against various strains of Leishmania spp. The diaryl(heteroaryl)ethane system or the more complex fused heterocyclic stilbenoids, constitute useful skeletal bases to support some kind of antiparasitic activity. Particularly, the incorporation of 2-furyl substituents led to potent antileishmanial compounds, which have been selected for in vivo testing on murine models.

Synthesis and in vitro antiprotozoal activity of thiophene ring-containing quinones

A series of quinones (3a-i, 4-9, 11) and aromatic compounds (2a, 2d, 2g) containing the thiophene ring were tested in vitro against the trypomastigote form of Trypanosoma cruzi and the promastigote forms of Leishmania. The quinones 3a-i, 4, 5a, b, 6 and 9 having the thiophene ring fused to a quinone nucleus were the most active members of the series. The electron affinities of the benzo[b]thiophene-4,7-quinones 3, evaluated by their LUMO energies and halfwave potentials, are reported.

Acetogenins and other compounds from Rollinia emarginata and their antiprotozoal activities

Bioactivity-directed fractionation of the MeOH extract of the stem barks of Rollinia emarginata resulted in the isolation of six compounds, four acetogenins, rolliniastatin-1, sylvaticin, squamocin, and rollidecin B, one lignan, lirioresinol B, and an oxoaporphine, liriodenin. Their structures were determined by spectroscopic analysis and their in vitro leishmanicidal and trypanocidal properties are reported.

Chagas disease vector control through different intervention modalities in endemic localities of Paraguay

In a field study carried out in three rural communities in Paraguay in a zone endemic for Chagas disease, we implemented three different vector control interventions--spraying, housing improvement, and a combination of spraying plus housing improvement--which effectively reduced the triatomine infestation. The reduction of triatomine infestation was 100% (47/47) in the combined intervention community, whereas in the community where housing improvement was carried out it was 96.4% (53/55). In the community where fumigation alone was used, the impact was 97.6% (40/41) in terms of domiciliary infestation. In all the houses where an intervention was made, an 18-month follow-up showed reinfestation rates of less than 10%. A serological survey of the population in the pre- and post-intervention periods revealed a shift in positive cases towards older age groups, but no significant differences were observed. The rate of seroconversion was 1.3% (three new cases) in the community with housing improvement only, but none of these cases could have resulted from vector transmission. The most cost-effective intervention was insecticide spraying, which during a 21-month follow-up period had a high impact on triatomine infestation and cost US$ 29 per house as opposed to US$ 700 per house for housing improvement.

Differential expression of systemic cytokine profiles in Chagas' disease is associated with endemicity of Trypanosoma cruzi infections

Chagas' disease is a serious public health problem in Paraguay, however, the immunoepidemiology of the disease has not been well documented. A preliminary cross-sectional survey was carried out in two villages of the Paraguayan Chaco region and in five villages of the Oriental region to assess the endemicity of Trypanosoma cruzi infections. Thereafter, a subset of individuals (ages ranging from 23 to 65 years) participated in a follow-up study to evaluate clinical and parasitological parameters. Physical examinations and electrocardiograms (ECG) were conducted and blood samples collected for parasite detection and serology. The most frequent ECG abnormalities which were observed among chagasic individuals were left anterior hemifascicular block and right bundle branch block. Thirty-two of these subjects, seropositive and non-parasitemic from the high endemic Chaco (n = 16) and low endemic Oriental (n = 16) regions, were randomly selected for an analysis of T. cruzi-induced expression of cytokines IL-2, IFN-gamma, IL-4 and IL-10 by RT-PCR. The individuals were grouped (n = 8) according to the presence or absence of abnormal ECG. In subjects that exhibited abnormal ECG profiles, five of eight (63%) individuals from the high endemic area showed a dominant type 2 (IL-4) response, whereas a comparable number (63%) of subjects from the low endemic area expressed a strong type 1 (IFN-gamma) response; the remainder (37%) presented a Th0-type (IFN-gamma, IL-4) response. Subjects with normal ECG showed a defined cytokine profile according to endemicity. All subjects from the high endemic region showed a Th0 response, whereas 100% of the individuals from the low endemic area demonstrated a type 1 response. In most chagasic patients regardless of ECG profile and endemicity, IL-2 expression was depressed, while IL-10 mRNA transcripts were consistently elevated. Taken together, these data indicate that chronic human chagasic disease is associated with increased systemic production of type 2 cytokines in response to T. cruzi infection and may be involved in the reciprocal down-regulation of IL-2 production.

Use of trans-Sialidase inhibition assay in a population serologically negative for Trypanosoma cruzi but at a high risk of infection

trans-Sialidase inhibition assay (TIA) was employed in a population at high risk of Trypanosoma cruzi infection. From 20 serum samples that were negative by conventional serologic and parasitologic assays, 18 (90%) were reactive in TIA, providing further evidence of the higher sensitivity of TIA and suggesting that the actual prevalence of T. cruzi infection might be underestimated.

[Eye involvement in Chagas disease (American trypanosomiasis). 1996/1997 studies in Paraguay]

BACKGROUND

Last year's pilot study, which examined for the first time a representative group of patients with Chagas disease, showed that in this parasitosis changes in the ocular fundus can be expected in the form of defects of the retinal pigment epithelium. Examination of more patients in this study should give further information about the character and extent of the alterations found.

MATERIALS AND METHODS

After serological confirmation of the disease, we performed an ophthalmological examination of the anterior and posterior segments.

RESULTS

In 21 out of 23 patients the fundus was unobtrusive; 1 patient showed fibrae medullares and 1 patient clear pigment dispersion on the posterior pole. Together with the pilot study, a total of 102 chagasic patients were examined. In 8 patients (7.8%) defects of the retinal pigment epithelium were found, which did not cause any significant loss of vision.

CONCLUSIONS

We presume that the described defects are a matter of rare and harmless postinflammatory or immunological changes in the American type of trypanosomiasis.

Cytokine responses in Trypanosoma cruzi-infected children in Paraguay

Both parasite and host immune factors may contribute to the development and progression of chronic chagasic cardiomyopathy during Trypanosoma cruzi infections. The present study targeted infected children (5-14 years of age) from an endemic area of Paraguay in an analysis of T. cruzi-specific cytokine profiles. This age group is characteristically the most affected by the early phases of infection. Trypanosoma cruzi-induced cytokine gene expression (interleukin-2 [IL-2], and interferon-gamma [IFN-gamma], IL-4, and IL-10) was studied in 25 seropositive children categorized as being either acute, symptomatic, with Romana's sign (n = 2), or early, indeterminate (postacute, n = 23). Acutely infected children showed a distinct T helper cell-1 (Th1)-type (IFN-gamma) cytokine response to infection. The cytokine pattern that was observed in the seropositive, asymptomatic (early, indeterminate) group was of the Th0 type (expression of both IFN-gamma and IL-4). We hypothesize that selective induction of a Th0-type cytokine pattern is important for development of cell-mediated and humoral immune responses that suppress parasite burden, thereby prolonging the onset or limiting the severity of chronic Chagas' disease later in life.

Experimental treatment of cutaneous leishmaniasis with argentilactone isolated from Annona haematantha

From the hexanic extract of roots of Annona haematantha an alpha,beta-unsaturated delta-lactone was isolated and identified as argentilactone. This compound exhibited in vitro activity against various strains of Leishmania ssp. at 10 micrograms/ml. BALB/c mice infected with Leishmania amazonensis were treated four weeks after infection with argentilactone by oral or subcutaneous routes for 14 days at 25 mg/kg daily. The reference drug, N-methylglucamine antimonate, was administered by subcutaneous injections at 100 mg/kg for 14 days. In these conditions, argentilactone showed the same efficacy as the reference drug, reducing by 96% the parasite loads in the lesion and by 50% the parasite burden in spleen.

[Intraocular involvement of Chagas disease (American trypanosomiasis). Studies in Paraguay/South America]

BACKGROUND

In Central and South America, Chagas' disease is of great epidemiologic importance. The epidemiologic agent is represented by Trypanosoma cruzi, a monocellular parasite, instrumental in human infection is the presence of vectors, which are various species of hematophagous bugs. The eye is one of the most important entrance sites of the parasite, and relatively little information about the relationship between Chagas' disease and eye complications is available.

PATIENTS AND METHODS

We examined 79 chagasic patients in order to detect changes in the retina. As a control group, we examined 48 patients with negative serology within the same age range and from the same regions. For every patient we completed a routine ophthalmologic examination, with inspection of the retina using direct and indirect ophthalmoscopy.

RESULTS

In most of the chagasic patients, the ocular fundus was unobtrusive; in only 6 out of 79 cases (7.6%) we did observe small parafoveolar retinal pigment epithelium defects and in 1 case (1.3%) distinct pigment epithelium atrophy of the posterior pole. No comparable findings were observed in the control group.

CONCLUSION

Compared with the examination results of the control group, in the patients with intermediate and chronic Chagas' disease we observed an accumulation of retinal pigment epithelium defects, which, however, did not cause a significant loss of vision.

Activity of compounds isolated from Chilean lichens against experimental cutaneous leishmaniasis

Three secondary metabolites isolated from Chilean lichens, (+) usnic acid, pannarine and 1'-chloropannarine, were tested against promastigotes forms of three strains of Leishmania ssp. Pannarine and 1'-chloropannarine exhibited in vitro activity at 50 micrograms/ml and (+) usnic acid at 25 micrograms/ml. BALB/c mice infected with Leishmania amazonensis were treated 4 weeks post-infection with (+) usnic acid by subcutaneous or oral routes for 15 days at 25 mg/kg or by five intralesional injections at interval of 4 days at 25 mg/kg of body weight. The reference drug, N-methylglucamine antimonate (Glucantime), was administered by subcutaneous injections (regimens of 28 mg of pentavalent antimony) for 15 days. The subcutaneous and oral treatments with (+) usnic did not produce any effect, but by intralesional administration we observed a significant effect that reduced by 43.34% the weight lesions and by 72.28% the parasites loads in infected footpads.

Chemical constituents of essential oils of muña, Bolivian plants traditionally used as pesticides, and their insecticidal properties against Chagas' disease vectors

The composition of essential oils from two muña, Bolivian medicinal plants, derived from Minthostachys andina and Hedomea mandonianum, were analyzed by gas chromatography/mass spectrometry. Major differences were observed in their chemical composition. Pulegone was the major component of H. mandonianum oil (44.6%) and M. andina oil (25.5%); menthone and isomenthone were around 33% of these oils. Differences were also observed in their insecticidal activity against the Chagas' disease vector, Rhodnius neglectus or Triatoma infestans bugs exposed on impregnated oil filter papers. While M. andina oil showed 30%-50% of mortality in both triatomine species after a period of 1 week, H. mandonianum oil did not show any insecticidal activity. Nevertheless, both species had insecticidal activity (33.3% and 50%) when oils were topically applied. The significance of these results is discussed in relation to the variability of the chemical composition and their potential use in Chasgas' disease vector control.

Trypanosoma cruzi: polymerase chain reaction-based detection in dried feces of Triatoma infestans

PCR was employed to detect Trypanosoma cruzi DNA in Triatoma infestans dry fecal spots collected on filter papers. Both insects fed on experimentally infected monkeys and insects collected in a Paraguayan endemic area for Chagas' disease were examined. When the insects fed on a chronically infected monkey with low parasitemia as revealed by direct microscopic observation (DMO), T. cruzi was detected in the insect feces by PCR as soon as 2 days postfeeding. When the same experiment was performed on monkeys with parasitemia levels below the limit of detection by DMO, the degree of positivity found through PCR-Southern hybridization, applied on Day 8 postfeeding, was superior to that obtained through xenoculture. These results suggest that PCR can be used to speed the xenodiagnosis results with great sensitivity. On the other hand, when applied to the feces of triatomines collected in the field, 84% were positive by PCR-Southern hybridization, whereas only 26% were positive by DMO. Therefore, PCR could also be applied to the monitoring of the infection status of triatomines which infest rural dwellings by examining only the feces left on paper sensors hung on the walls of the houses.

Characterization of Paraguayan Trypanosoma cruzi strains isolated from acute patients of Chagas disease

Five Paraguayan Trypanosoma cruzi strains, isolated from acute chagasic patients, were studied by their behavior in BALB/c mice, metacyelogenesis, bio-metry of metacyclic forms and lectin agglutination. Early and intermediate parasitemic peaks were observed and the strains did not show high virulence. Metacyclogenesis capacity was not higher than 50% in all cases and there were no considerable differences in the biometry. They all belong to WGA-type strains according to the lectin agglutination assays except for one strain that agglutinated with WGA and PNA lectins. Although previous schizodeme analysis of these strains showed rather homogeneous profiles, biological features were quite heterogeneous.

Mutagenicity, insecticidal and trypanocidal activity of some Paraguayan Asteraceae

The insecticidal, moulting inhibition and trypanocidal effects of crude extracts of 7 Paraguayan Asteraceae were evaluated on Triatoma infestans and bloodstream forms of Trypanosoma cruzi, respectively. Both mutagenicity and toxicity were evaluated by sister chromatid exchange (SCE) in human peripheral lymphocyte culture and by the lethality test of Artemia salina. The ethanolic extracts from Chromolaena christieana (stem and bark), Achyrocline satureoides (leaves and flowers) and Mikania cordifolia (root and stem), at a concentration of 250 micrograms/ml, showed the highest percentage of lysis on bloodstream forms of Trypanosoma cruzi. The extracts of Chromolaena christieana and Achyrocline satureoides also presented high mutagenic and toxic capacity when they were evaluated by the SCEs assay and Artemia salina test, respectively. Insecticidal activity was only observed in the hexane extract of flowers of Achyrocline satureoides (45% of mortality), when 0.05 microgram of crude concentration was applied on Triatoma infestans. The ethanolic extracts of stem from Mikania cordifolia and Vernonia brasiliana inhibited the moulting of Triatoma infestans when it was compared with their controls. Since no ethnobotanical information on these plants has been found related to similar use in Paraguay, our findings suggest, for the first time, the potential anti-trypanocidal and moulting inhibition of these Asteraceae.

New aporphine alkaloids from guatteria foliosa

Four new alkaloids were obtained from Guatteria foliosa, namely, the noraporphines (-)-3-methoxyputerine [1] and (+)-norguattevaline [2], the more highly oxidized (+)-3-methoxyguattescidine [3], and the oxoaporphine 3-methoxyoxoputerine [4]. Among several other known alkaloids also found in this same plant, (-)-3-hydroxynornuciferine, (-)-isoguattouregidine, and argentinine exhibited significant activity against Trypanosoma cruzi.

Prevalence of Chagas' disease in Ayoreo communities of the Paraguayan Chaco

The prevalence of Chagas' disease in Ayoreo amerindians living in their traditional habitat of the Paraguayan Chaco was assessed by ELISA and indirect immunofluorescence techniques. The Ayoreo is the last hunther-gatherer tribe of the Paraguayan Chaco and was "pacified" between 1965 and 1975. They still maintain a seminomadic way of life. Chagas' disease prevalence in the Ayoreo communities probably represents their natural prevalence in Chaco Amerindians before settlement. Triatoma sordida was identified as the insect vector in the settlements of Gesudi and Chovoreca, while the highly domiciliary Triatoma infestans was found in Campo Loro. The prevalence of Chagas' disease in Gesudi and Chovoreca, based on our serological surveys was 12-13%. Other authors reported a 72.9% of Chagas' disease prevalence in amerindians settled in the Chaco since 1930-1940.