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Ramos RCF, Barbosa ADS, Aleixo ALQDC, Arruda IF, Amendoeira MRR. Comparison of immunological and molecular methods for laboratory diagnosis of ocular toxoplasmosis in blood, serum and tears in Brazil. PLoS One 2024; 19:e0298393. [PMID: 38319921 PMCID: PMC10846737 DOI: 10.1371/journal.pone.0298393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 01/23/2024] [Indexed: 02/08/2024] Open
Abstract
Ocular toxoplasmosis (OT) is caused by protozoan T. gondii. Ophthalmological examination is considered the gold standard for OT diagnosis, and laboratory tests are used for diagnostic confirmation. However, these tests can present different results, which change depending on their basis, on sample type and on patients' clinical alteration. Thus, the aim of the present study is to assess immunodiagnostic and molecular techniques applied in blood, serum and tear fluid to diagnose T. gondii infection in patients seen at an Ophthalmology Clinic. In total, 160 patients were included in the study, 40 of them had OT with active lesions (G1); 40 had OT with healed lesions (G2), 40 had non-toxoplasmic uveitis (G3) and 40 had no ocular alterations (G4). Serum samples were subjected to Immunoenzymatic Assay (ELISA) and to Indirect Immunofluorescence Reaction (IFAT) to search for anti-T. gondii IgM and IgG. Tear fluid samples were analyzed through ELISA for IgA research. All blood and tear fluid samples were subjected to conventional polymerase chain reaction (cPCR) and in a Nested PCR model for T. gondii DNA amplification with targets B1, GRA7 and REP 529. IgG and IgM anti-T. gondii was detected in serum samples from 106 and 15 patients, respectively, when combining ELISA and IFAT results. Anti-T.gondii IgA antibodies were detected in 9.2% of the tear material. Nested PCR with GRA7 target showed higher positivity in blood samples (24.4%); Nested PCR with B1 target showed a higher frequency of positivity in tears (15%). Biological samples of patients with active lesions showed the highest positivity frequencies in all immunodiagnostic assays, as well as in most PCR models. The present results highlighted the need of associating techniques with different fundamentals to confirm OT diagnosis. Furthermore, further tear fluid analyses should be performed to validate this biological material as lesser invasive alternative for the more accurate OT diagnosis.
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Affiliation(s)
| | - Alynne da Silva Barbosa
- Laboratory of Toxoplasmosis and Other Protozooses, Oswaldo Cruz/Fiocruz Institute, Rio de Janeiro, Brazil
- Department of Microbiology and Parasitology, Biomedical Institute / Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Ana Luisa Quintella do Couto Aleixo
- Laboratory of Clinical Research in Infectious Ophthalmology–Evandro Chagas National Institute of Infectology/Fiocruz, Rio de Janeiro, Brazil
| | - Igor Falco Arruda
- Laboratory of Toxoplasmosis and Other Protozooses, Oswaldo Cruz/Fiocruz Institute, Rio de Janeiro, Brazil
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Perce-da-Silva DDS, Joaquim TE, Aleixo ALQDC, Motta JPR, Lima-Junior JDC, Ribeiro-Alves M, de Oliveira-Ferreira J, Porto LCDMS, Banic DM, Amendoeira MRR. Influence of killer immunoglobulin-like receptors genes on the recurrence rate of ocular toxoplasmosis in Brazil. Mem Inst Oswaldo Cruz 2023; 118:e220203. [PMID: 37018796 PMCID: PMC10065411 DOI: 10.1590/0074-02760220203] [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: 08/31/2022] [Accepted: 02/14/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Recurrence is a hallmark of ocular toxoplasmosis (OT), and conditions that influence its occurrence remain a challenge. Natural killer cells (NK) are effectors cells whose primary is cytotoxic function against many parasites, including Toxoplasma gondii. Among the NK cell receptors, immunoglobulin-like receptors (KIR) deserve attention due to their high polymorphism. OBJECTIVES This study aimed to analyse the influence of KIR gene polymorphism in the course of OT infection and its association with recurrences after an active episode. METHODS Ninety-six patients from the Ophthalmologic Clinic of the National Institute of Infectology Evandro Chagas were followed for up to five years. After DNA extraction, genotyping of the patients was performed by polymerase chain reaction sequence-specific oligonucleotide (PCR-SSO) utilising Luminex equipment for reading. During follow-up, 60.4% had a recurrence. FINDINGS We identified 25 KIR genotypes and found a higher frequency of genotype 1 (31.7%) with worldwide distribution. We note that the KIR2DL2 inhibitor gene and the gene activator KIR2DS2 were more frequent in patients without recurrence. Additionally, we observed that individuals who carry these genes progressed recurrence episodes slowly compared to individuals who do not carry these genes. MAIN CONCLUSIONS The KIR2DL2 and KIR2DS2 are associated as possible protection markers against ocular toxoplasmosis recurrence (OTR).
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Affiliation(s)
- Daiana de Souza Perce-da-Silva
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Imunologia Clínica, Rio de Janeiro, RJ, Brasil
- Centro Universitário Arthur Sá Earp Neto, Faculdade de Medicina de Petrópolis, Laboratório de Imunologia Básica e Aplicada, Petrópolis, RJ, Brasil
- + Corresponding authors: /
| | - Thays Euzebio Joaquim
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Toxoplasmose e outras Protozooses, Rio de Janeiro, RJ, Brasil
| | - Ana Luisa Quintella do Couto Aleixo
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Pesquisa Clínica em Oftalmologia Infecciosa, Rio de Janeiro, RJ, Brasil
| | | | - Josué da Costa Lima-Junior
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Imunoparasitologia, Rio de Janeiro, RJ, Brasil
| | - Marcelo Ribeiro-Alves
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Centro de Pesquisa Clínica HIV/AIDS, Rio de Janeiro, RJ, Brasil
| | - Joseli de Oliveira-Ferreira
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Imunoparasitologia, Rio de Janeiro, RJ, Brasil
| | | | - Dalma Maria Banic
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Imunologia Clínica, Rio de Janeiro, RJ, Brasil
| | - Maria Regina Reis Amendoeira
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Toxoplasmose e outras Protozooses, Rio de Janeiro, RJ, Brasil
- + Corresponding authors: /
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Benjamin ESDP, Santana JCD, Azevedo LGBD, Aleixo ALQDC, Biancardi AL, Moraes HVD. Manejo da coroidite interna punctata complicada por membrana neovascular sub-retiniana. Revista Brasileira de Oftalmologia 2021. [DOI: 10.37039/1982.8551.20210009] [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: 11/20/2022] Open
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Arinelli A, Aleixo ALQDC, Freitas DFS, do Valle ACF, Almeida-Paes R, Gutierrez-Galhardo MC, Curi ALL. Ocular Sporotrichosis: 26 Cases with Bulbar Involvement in a Hyperendemic Area of Zoonotic Transmission. Ocul Immunol Inflamm 2019; 28:764-771. [PMID: 31411512 DOI: 10.1080/09273948.2019.1624779] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 10/26/2022]
Abstract
PURPOSE To describe 26 cases of bulbar conjunctival sporotrichosis. METHODS Review of clinical records of patients with bulbar conjunctivitis due to culture-proven Sporothrix spp. infection, in Rio de Janeiro, from 2007 to 2017. RESULTS Twenty-six patients were identified. Median age was 25 years. Adults were more affected (53.8%), followed by adolescents (26.9%). There was a predominance of women (73.1%). Twenty-four patients (96%) reported contact with cats with sporotrichosis. Twenty-one patients (80.8%) presented a primary ocular sporotrichosis. Five patients presented associated eyelid lesions, and 21 (80.8%) tarsal conjunctivitis. Parinaud oculoglandular syndrome was observed in 17 (81%) patients. Eight patients (36.4%) reported the use of steroid drops before diagnosis was made. All patients but one were treated with oral itraconazole. Twenty-three patients (88.5%) were completely cured and three (11.5%) were lost to follow-up. Eight patients (34.8%) developed ocular sequelae. CONCLUSION Bulbar conjunctivitis is an important clinical presentation of ocular sporotrichosis. It can lead to ocular sequelae. Sporotrichosis should be considered in the differential diagnosis of ophthalmic external diseases, especially in patients with cat contact history.
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Affiliation(s)
- Andrea Arinelli
- Laboratory of Clinical Research in Infectious Ophthalmology, Oswaldo Cruz Foundation (FIOCRUZ) , Rio de Janeiro, Brazil
| | | | | | | | - Rodrigo Almeida-Paes
- Laboratory of Mycology, at Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ) , Rio de Janeiro, Brazil
| | | | - André Luiz Land Curi
- Laboratory of Clinical Research in Infectious Ophthalmology, Oswaldo Cruz Foundation (FIOCRUZ) , Rio de Janeiro, Brazil
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Aleixo ALQDC, Vasconcelos C. de Oliveira R, Cavalcanti Albuquerque M, Biancardi AL, Land Curi AL, Israel Benchimol E, Reis Amendoeira MR. Toxoplasmic retinochoroiditis: The influence of age, number of retinochoroidal lesions and genetic polymorphism for IFN-γ +874 T/A as risk factors for recurrence in a survival analysis. PLoS One 2019; 14:e0211627. [PMID: 30753197 PMCID: PMC6372150 DOI: 10.1371/journal.pone.0211627] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 01/17/2019] [Indexed: 02/06/2023] Open
Abstract
Purpose To analyze risk factors for recurrent toxoplasmic retinochoroiditis. Design Single center prospective case series. Population and Methods A total of 230 patients with toxoplasmic retinochoroiditis were prospectively followed to assess recurrences. All patients were treated with a specific drug regime for toxoplasmosis in each episode of active retinochoroiditis. Individuals with chronic diseases and pregnant women were excluded. Survival analysis by extended Cox regression model (Prentice-Williams-Peterson counting process model) was performed to evaluate the time between recurrences according to some potential risk factors: age, number of retinochoroidal lesions at initial evaluation, sex and interferon gamma +874 T/A gene polymorphism. Hazard Ratios (HR) and 95% confidence intervals (CI) were provided to interpret the risk effects. Results One hundred sixty-two recurrence episodes were observed in 104 (45.2%) patients during follow-up that lasted from 269 to 1976 days. Mean age at presentation was 32.8 years (Standard deviation = 11.38). The risk of recurrence during follow up was influenced by age (HR = 1.02, 95% CI = 1.01–1.04) and number of retinochoroidal lesions at the beginning of the study (HR = 1.60, 95% CI = 1.07–2.40). Heterozygosis for IFN-γ gene polymorphism at position +874 T/A was also associated with recurrence (HR = 1.49, 95% CI = 1.04–2.14). Conclusion The risk of ocular toxoplasmosis recurrence after an active episode increased with age and was significantly higher in individuals with primary lesions, which suggests that individuals with this characteristic and the elderly could benefit from recurrence prophylactic strategies with antimicrobials. Results suggest an association between IFN-γ gene polymorphism at position +874T/A and recurrence.
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Affiliation(s)
| | | | | | | | - André Luiz Land Curi
- Infectious Ophthalmology Laboratory, Evandro Chagas National Institute of Infectious Diseases—FIOCRUZ, Rio de Janeiro, Brazil
| | - Eliezer Israel Benchimol
- Infectious Ophthalmology Laboratory, Evandro Chagas National Institute of Infectious Diseases—FIOCRUZ, Rio de Janeiro, Brazil
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Albuquerque MCD, Aleixo ALQDC, Benchimol EI, Leandro ACCS, das Neves LB, Vicente RT, Bonecini-Almeida MDG, Amendoeira MRR. The IFN-gamma +874T/A gene polymorphism is associated with retinochoroiditis toxoplasmosis susceptibility. Mem Inst Oswaldo Cruz 2009; 104:451-5. [PMID: 19547871 DOI: 10.1590/s0074-02762009000300009] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2008] [Accepted: 03/03/2009] [Indexed: 11/21/2022] Open
Abstract
Toxoplasmosis is a worldwide zoonosis that generally produces an asymptomatic infection. In some cases, however, toxoplasmosis infection can lead to ocular damage. The immune system has a crucial role in both the course of the infection and in the evolution of toxoplasmosis disease. In particular, IFN-gamma plays an important role in resistance to toxoplasmosis. Polymorphisms in genes encoding cytokines have been shown to have an association with susceptibility to parasitic diseases. The aim of this work was to analyse the occurrence of polymorphisms in the gene encoding IFN-gamma (+874T/A) among Toxoplasma gondii seropositive individuals, including those with ocular lesions caused by the parasite, from a rural population of Santa Rita de Cássia, Barra Mansa, state of Rio de Janeiro, Brazil. Further, we verified which of these polymorphisms could be related to susceptibility to the development of ocular toxoplasmosis. This study included 34 individuals with ocular toxoplasmosis (ocular group) and 134 without ocular lesions (control group). The differences between A and T allele distributions were not statistically significant between the two groups. However, we observed that a higher frequency of individuals from the ocular group possessed the A/A genotype, when compared with the control group, suggesting that homozygocity for the A allele could enhance susceptibility to ocular toxoplasmosis in T. gondii infection.
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Aleixo ALQDC, Benchimol EI, Neves EDS, Silva CSP, Coura LC, Amendoeira MRR. [Frequency of lesions suggestive of ocular toxoplasmosis among a rural population in the State of Rio de Janeiro]. Rev Soc Bras Med Trop 2009; 42:165-9. [PMID: 19448935 DOI: 10.1590/s0037-86822009000200014] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2008] [Accepted: 03/05/2009] [Indexed: 11/21/2022] Open
Abstract
To determine the prevalence of ocular toxoplasmosis among the general population of the district of Santa Rita de Cassia, Barra Mansa, State of Rio de Janeiro, a cross-sectional study on 1,071 individuals was performed. These subjects underwent serological tests (anti-Toxoplasma IgG and IgM) and physical and ophthalmological examinations. The diagnosis of presumed ocular toxoplasmosis was based on clinical and serological criteria and the appearance of the retinochoroidal lesion. The lesions were classified into three morphological types: 1. Limits marked with a halo of hyperpigmentation and an area of central chorioretinal atrophy; 2. Hypopigmented halo and hyperpigmented central area; and 3. Hyperpigmented or hypopigmented. The prevalence of healed lesions compatible with ocular toxoplasmosis was 3.8% among the general population and 5.8% among individuals who were seropositive for Toxoplasma gondii (65.9% of the individuals evaluated). Type-1 lesions (41.5%), female sex (68.3%), peripheral lesions (58.5%) and lesions smaller than three disc diameters predominated.
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