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Ghosh P, Chowdhury R, Faisal K, Khan MAA, Hossain F, Rahat MA, Chowdhury MAA, Mithila NT, Kamal M, Maruf S, Nath R, Kobialka RM, Ceruti A, Cameron M, Duthie MS, Wahed AAE, Mondal D. Evaluation of a Point-of-Need Molecular Diagnostic Tool Coupled with Rapid DNA Extraction Methods for Visceral Leishmaniasis. Diagnostics (Basel) 2023; 13:3639. [PMID: 38132223 PMCID: PMC10742398 DOI: 10.3390/diagnostics13243639] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/23/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023] Open
Abstract
A rapid, cost-effective, and simple nucleic acid isolation technique coupled with a point-of-need DNA amplification assay is a desirable goal for programmatic use. For diagnosis of Visceral Leishmaniasis (VL), Recombinase Polymerase Amplification (RPA) rapid tests for the detection of Leishmania DNA are versatile and have operational advantages over qPCR. To facilitate the delivery of the RPA test at point-of-need for VL diagnosis, we compared two rapid DNA extraction methods, SwiftDx (SX) and an in-house Boil and Spin (BS) method, coupled with RPA amplification, versus more widely used methods for DNA extraction and amplification, namely Qiagen (Q) kits and qPCR, respectively. A total of 50 confirmed VL patients and 50 controls, matched for age and gender, were recruited from Mymensingh, Bangladesh, a region highly endemic for VL. Blood samples were collected from each participant and DNA was extracted using Q, SX and BS methods. Following DNA extraction, qPCR and RPA assays were performed to detect L. donovani in downstream analysis. No significant differences in sensitivity of the RPA assay were observed between DNA extraction methods, 94.00% (95% CI: 83.45-98.75%), 90% (95% CI: 78.19-96.67%), and 88% (95% CI: 75.69-95.47%) when using Q, SX, and BS, respectively. Similarly, using qPCR, no significant differences in sensitivity were obtained when using Q or SX for DNA extraction, 94.00% (95% CI: 83.45-98.75%) and 92.00% (80.77-97.78%), respectively. It is encouraging that RPA and qPCR showed excellent agreement (k: 0.919-0.980) when different extraction methods were used and that the DNA impurities using BS had no inhibitory effect on the RPA assay. Furthermore, significantly higher DNA yields were obtained using SX and BS versus Q; however, a significantly higher parasite load was detected using qPCR when DNA was extracted using Q versus SX. Considering the cost, execution time, feasibility, and performance of RPA assay, rapid extraction methods such as the Boil and Spin technique appear to have the potential for implementation in resource-limited endemic settings. Further clinical research is warranted prior to broader application.
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Affiliation(s)
- Prakash Ghosh
- Nutrition Research Division (NRD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh; (R.C.); (K.F.); (F.H.); (M.A.R.); (M.A.A.C.).; (N.T.M.); (M.K.); (S.M.); (R.N.); (D.M.)
| | - Rajashree Chowdhury
- Nutrition Research Division (NRD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh; (R.C.); (K.F.); (F.H.); (M.A.R.); (M.A.A.C.).; (N.T.M.); (M.K.); (S.M.); (R.N.); (D.M.)
| | - Khaledul Faisal
- Nutrition Research Division (NRD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh; (R.C.); (K.F.); (F.H.); (M.A.R.); (M.A.A.C.).; (N.T.M.); (M.K.); (S.M.); (R.N.); (D.M.)
| | - Md. Anik Ashfaq Khan
- Institute of Animal Hygiene and Veterinary Public Health, Leipzig University, D-04103 Leipzig, Germany; (M.A.A.K.); (R.M.K.); (A.C.)
| | - Faria Hossain
- Nutrition Research Division (NRD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh; (R.C.); (K.F.); (F.H.); (M.A.R.); (M.A.A.C.).; (N.T.M.); (M.K.); (S.M.); (R.N.); (D.M.)
| | - Md. Abu Rahat
- Nutrition Research Division (NRD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh; (R.C.); (K.F.); (F.H.); (M.A.R.); (M.A.A.C.).; (N.T.M.); (M.K.); (S.M.); (R.N.); (D.M.)
| | - Md. Arko Ayon Chowdhury
- Nutrition Research Division (NRD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh; (R.C.); (K.F.); (F.H.); (M.A.R.); (M.A.A.C.).; (N.T.M.); (M.K.); (S.M.); (R.N.); (D.M.)
| | - Nishad Tasnim Mithila
- Nutrition Research Division (NRD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh; (R.C.); (K.F.); (F.H.); (M.A.R.); (M.A.A.C.).; (N.T.M.); (M.K.); (S.M.); (R.N.); (D.M.)
| | - Mostafa Kamal
- Nutrition Research Division (NRD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh; (R.C.); (K.F.); (F.H.); (M.A.R.); (M.A.A.C.).; (N.T.M.); (M.K.); (S.M.); (R.N.); (D.M.)
| | - Shomik Maruf
- Nutrition Research Division (NRD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh; (R.C.); (K.F.); (F.H.); (M.A.R.); (M.A.A.C.).; (N.T.M.); (M.K.); (S.M.); (R.N.); (D.M.)
| | - Rupen Nath
- Nutrition Research Division (NRD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh; (R.C.); (K.F.); (F.H.); (M.A.R.); (M.A.A.C.).; (N.T.M.); (M.K.); (S.M.); (R.N.); (D.M.)
| | - Rea Maja Kobialka
- Institute of Animal Hygiene and Veterinary Public Health, Leipzig University, D-04103 Leipzig, Germany; (M.A.A.K.); (R.M.K.); (A.C.)
| | - Arianna Ceruti
- Institute of Animal Hygiene and Veterinary Public Health, Leipzig University, D-04103 Leipzig, Germany; (M.A.A.K.); (R.M.K.); (A.C.)
| | - Mary Cameron
- London School of Hygiene and Tropical Medicine, University of London, London WC1E 7HT, UK;
| | | | - Ahmed Abd El Wahed
- Institute of Animal Hygiene and Veterinary Public Health, Leipzig University, D-04103 Leipzig, Germany; (M.A.A.K.); (R.M.K.); (A.C.)
| | - Dinesh Mondal
- Nutrition Research Division (NRD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh; (R.C.); (K.F.); (F.H.); (M.A.R.); (M.A.A.C.).; (N.T.M.); (M.K.); (S.M.); (R.N.); (D.M.)
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2
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Tenório MDL, Araujo JMS, de Melo EV, Cazzaniga RA, Aragão ALF, Valois LQ, Severo J, Santos-Filho MAA, Menezes-Silva L, Machado JA, Reed SG, Duthie MS, de Almeida RP, Bezerra-Santos M, de Jesus AR. Association between asthma, rhinitis and atopic dermatitis with leprosy: A case-control study. Indian J Dermatol Venereol Leprol 2023; 89:834-841. [PMID: 37067141 DOI: 10.25259/ijdvl_347_2021] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 08/01/2022] [Indexed: 02/05/2023]
Abstract
Background Considering the cross-regulation of Th1 and Th2 responses, we hypothesised that atopic diseases (Th2) inhibit the protective Th1 immune response to Mycobacterium leprae and exacerbates leprosy. Objective In this study, we aimed to evaluate the association between leprosy and atopic diseases. Methods To evaluate the association of atopic diseases with leprosy, we conducted a case-control study that included leprosy patients (n = 333) and their household contacts (n = 93). The questionnaire from the International Study of Asthma and Allergies in Childhood, which is validated in several countries for epidemiological diagnosis of atopic diseases, was applied to determine the occurrence of atopic diseases, allergic rhinitis, asthma, and atopic dermatitis among leprosy patients and the household contacts. Results Considering clinical and epidemiological data, among the leprosy group 51.6% (n = 172) were determined to have at least one atopic disease, while atopy was observed less frequently at 40.86% among household contacts (n = 38). When two or more atopic diseases were assessed, the frequency was significantly higher among the leprosy patients than in the household contacts (21.9% vs. 11.8%; P-value = 0.03). Likewise, the frequency of asthma was significantly higher among leprosy patients (21%) than in the household contacts (10.8%; P-value = 0.02). Thus, our analyses revealed an association of atopic diseases with leprosy, with a significant linear increase in the occurrence of leprosy with an increase in the number of atopic diseases (P-value = 0.01). Limitation Due to the difficulties in recruiting household contacts that have prolonged contact with patients, but are not genetically related to the patient, the household contacts group is smaller than the leprosy patient group. Conclusion The data reveal an association between atopic diseases and leprosy outcomes. This knowledge could improve the treatment of leprosy patients with co-incident atopic diseases.
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Affiliation(s)
- Martha Débora Lira Tenório
- Department of Medicine, Dermathology Clinic, University Hospital, Universidade Federal de Sergipe, Aracaju, SE, Brazil
| | - Jonnia Maria Sherlock Araujo
- Department of Medicine, Dermathology Clinic, University Hospital, Universidade Federal de Sergipe, Aracaju, SE, Brazil
| | - Enaldo Vieira de Melo
- Department of Medicine, Dermathology Clinic, University Hospital, Universidade Federal de Sergipe, Aracaju, SE, Brazil
| | - Rodrigo Anselmo Cazzaniga
- Immunology and Molecular Biology Laboratory, University Hospital, Universidade Federal de Sergipe, Aracaju, SE, Brazil
| | - Ana-Luiza Furtado Aragão
- Department of Medicine, Dermathology Clinic, University Hospital, Universidade Federal de Sergipe, Aracaju, SE, Brazil
| | - Laís Quadros Valois
- Department of Medicine, Dermathology Clinic, University Hospital, Universidade Federal de Sergipe, Aracaju, SE, Brazil
| | - Joanna Severo
- Immunology and Molecular Biology Laboratory, University Hospital, Universidade Federal de Sergipe, Aracaju, SE, Brazil
| | | | - Lucas Menezes-Silva
- Immunology and Molecular Biology Laboratory, University Hospital, Universidade Federal de Sergipe, Aracaju, SE, Brazil
| | - Julianne Alves Machado
- Clinical Immunology Clinic, University Hospital, Universidade Federal de Sergipe, Aracaju, SE, Brazil
| | - Steven G Reed
- Department of Vaccines, Host Directed Therapeutics (HDT) Bio Corp, Seattle, Washington, United States
| | - Malcolm S Duthie
- Department of Vaccines, Host Directed Therapeutics (HDT) Bio Corp, Seattle, Washington, United States
| | - Roque Pacheco de Almeida
- Immunology and Molecular Biology Laboratory, University Hospital, Universidade Federal de Sergipe, Aracaju, SE, Brazil
| | - Marcio Bezerra-Santos
- Immunology and Molecular Biology Laboratory, University Hospital, Universidade Federal de Sergipe, Aracaju, SE, Brazil
| | - Amélia Ribeiro de Jesus
- Immunology and Molecular Biology Laboratory, University Hospital, Universidade Federal de Sergipe, Aracaju, SE, Brazil
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Kimura T, Leal JM, Simpson A, Warner NL, Berube BJ, Archer JF, Park S, Kurtz R, Hinkley T, Nicholes K, Sharma S, Duthie MS, Berglund P, Reed SG, Khandhar AP, Erasmus JH. A localizing nanocarrier formulation enables multi-target immune responses to multivalent replicating RNA with limited systemic inflammation. Mol Ther 2023; 31:2360-2375. [PMID: 37403357 PMCID: PMC10422015 DOI: 10.1016/j.ymthe.2023.06.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/05/2023] [Accepted: 06/28/2023] [Indexed: 07/06/2023] Open
Abstract
RNA vaccines possess significant clinical promise in counteracting human diseases caused by infectious or cancerous threats. Self-amplifying replicon RNA (repRNA) has been thought to offer the potential for enhanced potency and dose sparing. However, repRNA is a potent trigger of innate immune responses in vivo, which can cause reduced transgene expression and dose-limiting reactogenicity, as highlighted by recent clinical trials. Here, we report that multivalent repRNA vaccination, necessitating higher doses of total RNA, could be safely achieved in mice by delivering multiple repRNAs with a localizing cationic nanocarrier formulation (LION). Intramuscular delivery of multivalent repRNA by LION resulted in localized biodistribution accompanied by significantly upregulated local innate immune responses and the induction of antigen-specific adaptive immune responses in the absence of systemic inflammatory responses. In contrast, repRNA delivered by lipid nanoparticles (LNPs) showed generalized biodistribution, a systemic inflammatory state, an increased body weight loss, and failed to induce neutralizing antibody responses in a multivalent composition. These findings suggest that in vivo delivery of repRNA by LION is a platform technology for safe and effective multivalent vaccination through mechanisms distinct from LNP-formulated repRNA vaccines.
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Affiliation(s)
- Taishi Kimura
- HDT Bio, 1616 Eastlake Avenue E #280, Seattle, WA 98102, USA.
| | - Joseph M Leal
- HDT Bio, 1616 Eastlake Avenue E #280, Seattle, WA 98102, USA
| | - Adrian Simpson
- HDT Bio, 1616 Eastlake Avenue E #280, Seattle, WA 98102, USA
| | - Nikole L Warner
- HDT Bio, 1616 Eastlake Avenue E #280, Seattle, WA 98102, USA
| | - Bryan J Berube
- HDT Bio, 1616 Eastlake Avenue E #280, Seattle, WA 98102, USA
| | - Jacob F Archer
- HDT Bio, 1616 Eastlake Avenue E #280, Seattle, WA 98102, USA
| | - Stephanie Park
- HDT Bio, 1616 Eastlake Avenue E #280, Seattle, WA 98102, USA
| | - Ryan Kurtz
- HDT Bio, 1616 Eastlake Avenue E #280, Seattle, WA 98102, USA
| | - Troy Hinkley
- HDT Bio, 1616 Eastlake Avenue E #280, Seattle, WA 98102, USA
| | | | - Shibbu Sharma
- HDT Bio, 1616 Eastlake Avenue E #280, Seattle, WA 98102, USA
| | | | - Peter Berglund
- HDT Bio, 1616 Eastlake Avenue E #280, Seattle, WA 98102, USA
| | - Steven G Reed
- HDT Bio, 1616 Eastlake Avenue E #280, Seattle, WA 98102, USA
| | - Amit P Khandhar
- HDT Bio, 1616 Eastlake Avenue E #280, Seattle, WA 98102, USA
| | - Jesse H Erasmus
- HDT Bio, 1616 Eastlake Avenue E #280, Seattle, WA 98102, USA; Department of Microbiology, University of Washington, 750 Republican Street, Seattle, WA 98109, USA
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4
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Bezerra-Santos M, Bomfim LGS, Santos CNO, Cunha MWN, de Moraes EJR, Cazzaniga RA, Tenório MDL, Araujo JMS, Menezes-Silva L, Magalhães LS, Barreto AS, Reed SG, Duthie MS, Lipscomb MW, de Almeida RP, de Moura TR, de Jesus AR. sTREM-1 and TNF-α levels are associated with the clinical outcome of leprosy patients. Front Med (Lausanne) 2023; 10:1177375. [PMID: 37457576 PMCID: PMC10339318 DOI: 10.3389/fmed.2023.1177375] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 06/05/2023] [Indexed: 07/18/2023] Open
Abstract
Leprosy reaction (LR) and physical disability (PD) are the most significant clinical complications of leprosy. Herein, we assessed the circulating serum-sTREM-1 and TNF-α levels and their genetic polymorphisms in leprosy. Serum-sTREM-1 and TNF-α levels were measured in leprosy patients (LP) before treatment (n = 51) and from their household contacts (HHCs; n = 25). DNA samples were genotyped using TREM-1 rs2234246 and TNF-α rs1800629-SNP in 210 LPs and 168 endemic controls. The circulating sTREM-1 and TNF-α levels are higher in the multibacillary form. The ROC curve of the serum-sTREM-1 levels was able to differentiate LR from non-LR and PD from non-PD. Similarly, LPs with serum-sTREM-1 levels >210 pg/ml have 3-fold and 6-fold higher chances of presenting with LR and PD, respectively. Genotypes CC+CT of the TREM-1 were associated with leprosy. Taken together, our analyses indicated that sTREM-1 and TNF-α play an important role in the pathogenesis of leprosy and provide promising biomarkers to assist in the diagnosis of leprosy complications.
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Affiliation(s)
- Márcio Bezerra-Santos
- Centro de Ciências Médicas e Enfermagem, Universidade Federal de Alagoas, Maceió, Brazil
- Laboratório de Imunologia e Biologia Molecular, Universidade Federal de Sergipe, Aracaju, Brazil
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Lays G. Santos Bomfim
- Laboratório de Imunologia e Biologia Molecular, Universidade Federal de Sergipe, Aracaju, Brazil
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Camilla N. Oliveira Santos
- Laboratório de Imunologia e Biologia Molecular, Universidade Federal de Sergipe, Aracaju, Brazil
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Maria Wiliane N. Cunha
- Laboratório de Imunologia e Biologia Molecular, Universidade Federal de Sergipe, Aracaju, Brazil
| | | | - Rodrigo A. Cazzaniga
- Laboratório de Imunologia e Biologia Molecular, Universidade Federal de Sergipe, Aracaju, Brazil
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Martha D. L. Tenório
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, Brazil
- Departamento de Dermatologia, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Jonnia M. Sherlock Araujo
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, Brazil
- Departamento de Dermatologia, Hospital Universitário, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Lucas Menezes-Silva
- Laboratório de Imunologia e Biologia Molecular, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Lucas Sousa Magalhães
- Laboratório de Imunologia e Biologia Molecular, Universidade Federal de Sergipe, Aracaju, Brazil
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Aline S. Barreto
- Laboratório de Imunologia e Biologia Molecular, Universidade Federal de Sergipe, Aracaju, Brazil
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Steven G. Reed
- Host Directed Therapeutics (HDT) Bio Corp, Seattle, WA, United States
| | - Malcolm S. Duthie
- Host Directed Therapeutics (HDT) Bio Corp, Seattle, WA, United States
| | - Michael W. Lipscomb
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, United States
| | - Roque Pacheco de Almeida
- Laboratório de Imunologia e Biologia Molecular, Universidade Federal de Sergipe, Aracaju, Brazil
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, Brazil
- Departamento de Medicina, Universidade Federal de Sergipe, Aracaju, Brazil
- Instituto de Investigação em Imunologia (III), Institutos Nacionais de Ciência e Tecnologia (INCTs), Conselho Nacional de Pesquisa e Tecnologia (CNPq), São Paulo, Brazil
| | - Tatiana Rodrigues de Moura
- Laboratório de Imunologia e Biologia Molecular, Universidade Federal de Sergipe, Aracaju, Brazil
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, Brazil
| | - Amélia Ribeiro de Jesus
- Laboratório de Imunologia e Biologia Molecular, Universidade Federal de Sergipe, Aracaju, Brazil
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, Brazil
- Departamento de Medicina, Universidade Federal de Sergipe, Aracaju, Brazil
- Instituto de Investigação em Imunologia (III), Institutos Nacionais de Ciência e Tecnologia (INCTs), Conselho Nacional de Pesquisa e Tecnologia (CNPq), São Paulo, Brazil
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Duthie MS, Machado BAS, Badaró R, Kaye PM, Reed SG. Leishmaniasis Vaccines: Applications of RNA Technology and Targeted Clinical Trial Designs. Pathogens 2022; 11:pathogens11111259. [PMID: 36365010 PMCID: PMC9695603 DOI: 10.3390/pathogens11111259] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/20/2022] [Accepted: 10/27/2022] [Indexed: 11/17/2022] Open
Abstract
Leishmania parasites cause a variety of discrete clinical diseases that present in regions where their specific sand fly vectors sustain transmission. Clinical and laboratory research indicate the potential of immunization to prevent leishmaniasis and a wide array of vaccine candidates have been proposed. Unfortunately, multiple factors have precluded advancement of more than a few Leishmania targeting vaccines to clinical trial. The recent maturation of RNA vaccines into licensed products in the context of COVID-19 indicates the likelihood of broader use of the technology. Herein, we discuss the potential benefits provided by RNA technology as an approach to address the bottlenecks encountered for Leishmania vaccines. Further, we outline a variety of strategies that could be used to more efficiently evaluate Leishmania vaccine efficacy, including controlled human infection models and initial use in a therapeutic setting, that could prioritize candidates before evaluation in larger, longer and more complicated field trials.
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Affiliation(s)
| | - Bruna A S Machado
- SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), University Center SENAI/CIMATEC, Salvador 41650-010, Bahia, Brazil
| | - Roberto Badaró
- SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), University Center SENAI/CIMATEC, Salvador 41650-010, Bahia, Brazil
| | - Paul M Kaye
- York Biomedical Research Institute, Hull York Medical School, University of York, York YO10 5DD, UK
| | - Steven G Reed
- HDT Bio, 1616 Eastlake Ave E, Seattle, WA 98102, USA
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Ebenezer GJ, Pena MT, Daniel AS, Truman RW, Adams L, Duthie MS, Wagner K, Zampino S, Tolf E, Tsottles D, Polydefkis M. Mycobacterium leprae induces Schwann cell proliferation and migration in a denervated milieu following intracutaneous excision axotomy in nine-banded armadillos. Exp Neurol 2022; 352:114053. [PMID: 35341747 DOI: 10.1016/j.expneurol.2022.114053] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 02/15/2022] [Accepted: 03/21/2022] [Indexed: 01/23/2023]
Abstract
Nine-banded armadillos develop peripheral neuropathy after experimental Mycobacterium leprae infection that recapitulates human disease. We used an intracutaneous excision axotomy model to assess the effect of infection duration by M. leprae on axonal sprouting and Schwan cell density. 34 armadillos (17 naïve and 17 M. leprae-infected) underwent 3 mm skin biopsies to create an intracutaneous excision axotomy followed by a concentric 4-mm overlapping biopsy 3 and 12-months post M. leprae inoculation. A traditional distal leg biopsy was obtained at 15mo for intraepidermal nerve fiber (IENF) density. Serial skin sections were immunostained against a axons (PGP9.5, GAP43), and Schwann cells (p75, s100) to visualize regenerating nerves. Regenerative axons and proliferation of Schwann cells was measured and the rate of growth at each time point was assessed. Increasing anti-PGL antibody titers and intraneural M. leprae confirmed infection. 15mo following infection, there was evidence of axon loss with reduced distal leg IENF versus naïve armadillos, p < 0.05. This was associated with an increase in Schwann cell density (11,062 ± 2905 vs. 7561 ± 2715 cells/mm3, p < 0.01). Following excisional biopsy epidermal reinnervation increased monotonically at 30, 60 and 90 days; the regeneration rate was highest at 30 days, and decreased at 60 and 90 days. The reinnervation rate was highest among animals infected for 3mo vs those infected for 12mo or naïve animals (mean ± SD, 27.8 ± 7.2 vs.16.2 ± 5.8vs. 15.3 ± 6.5 mm/mm3, p < 0.05). The infected armadillos displayed a sustained Schwann cell proliferation across axotomy time points and duration of infection (3mo:182 ± 26, 12mo: 256 ± 126, naive: 139 ± 49 cells/day, p < 0.05). M. leprae infection is associated with sustained Schwann cell proliferation and distal limb nerve fiber loss. Rates of epidermal reinnervation were highest 3mo after infection and normalized by 12 mo of infection. We postulate that excess Schwann cell proliferation is the main pathogenic process and is deleterious to sensory axons. There is a compensatory initial increase in regeneration rates that may be an attempt to compensate for the injury, but it is not sustained and eventually followed by axon loss. Aberrant Schwann cell proliferation may be a novel therapeutic target to interrupt the pathogenic cascade of M. leprae.
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Affiliation(s)
| | - Maria T Pena
- DHHS/HRSA/HSB/National Hansen's Disease Program, Baton Rouge, LA 70816, USA
| | | | - Richard W Truman
- DHHS/HRSA/HSB/National Hansen's Disease Program, Baton Rouge, LA 70816, USA
| | - Linda Adams
- DHHS/HRSA/HSB/National Hansen's Disease Program, Baton Rouge, LA 70816, USA
| | | | - Kelly Wagner
- Neurology, Johns Hopkins University, Baltimore, MD, USA
| | | | - Eleanor Tolf
- Neurology, Johns Hopkins University, Baltimore, MD, USA
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7
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Gobbo AR, Bouth RC, Moraes TMP, Pinto P, da Costa PF, Barreto JG, Frade MAC, Ribeiro-dos-Santos ÂK, Conde GADB, Duthie MS, da Silva MB, Spencer JS, Salgado CG. NDO-BSA, LID-1, and NDO-LID Antibody Responses for Infection and RLEP by Quantitative PCR as a Confirmatory Test for Early Leprosy Diagnosis. Front Trop Dis 2022. [DOI: 10.3389/fitd.2022.850886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Diagnostic tests for leprosy are limited, especially to identify early leprosy cases. We performed active case findings of leprosy to validate three potential antigen candidates and one molecular target. Cases were diagnosed by characteristic skin lesions, nerve enlargement, or skin sensation loss. Serum samples obtained from all subjects were tested by ELISA to assess antibody titers to three Mycobacterium leprae specific antigens: NDO-BSA, LID-1, and NDO-LID. Most of the field cases on Mosqueiro Island, northern Brazil, also collected slit skin smear for qPCR. Active case finding diagnosed 105 new cases of leprosy out of 894 subjects (11.7%), revealing a high prevalence of M. leprae in the region. With the use of amplification of the M. leprae-specific RLEP by qPCR, 68/79 (86.07%) of these cases were positive, confirming leprosy in subjects diagnosed in the field. Patients diagnosed at the leprosy reference center showed much higher antibody titers to all three antigens, while titers of patients from the field were significantly lower. Our results support previous findings that active surveillance by experienced leprologists can diagnose additional cases based on clinical findings, that many would not be identified using ELISA assay with the available biomarkers, and that RLEP qPCR may be used to confirm the majority of the field cases.
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Machado BAS, Hodel KVS, Fonseca LMDS, Mascarenhas LAB, Andrade LPCDS, Rocha VPC, Soares MBP, Berglund P, Duthie MS, Reed SG, Badaró R. The Importance of RNA-Based Vaccines in the Fight against COVID-19: An Overview. Vaccines (Basel) 2021; 9:1345. [PMID: 34835276 PMCID: PMC8623509 DOI: 10.3390/vaccines9111345] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [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: 10/09/2021] [Revised: 11/02/2021] [Accepted: 11/15/2021] [Indexed: 12/23/2022] Open
Abstract
In recent years, vaccine development using ribonucleic acid (RNA) has become the most promising and studied approach to produce safe and effective new vaccines, not only for prophylaxis but also as a treatment. The use of messenger RNA (mRNA) as an immunogenic has several advantages to vaccine development compared to other platforms, such as lower coast, the absence of cell cultures, and the possibility to combine different targets. During the COVID-19 pandemic, the use of mRNA as a vaccine became more relevant; two out of the four most widely applied vaccines against COVID-19 in the world are based on this platform. However, even though it presents advantages for vaccine application, mRNA technology faces several pivotal challenges to improve mRNA stability, delivery, and the potential to generate the related protein needed to induce a humoral- and T-cell-mediated immune response. The application of mRNA to vaccine development emerged as a powerful tool to fight against cancer and non-infectious and infectious diseases, for example, and represents a relevant research field for future decades. Based on these advantages, this review emphasizes mRNA and self-amplifying RNA (saRNA) for vaccine development, mainly to fight against COVID-19, together with the challenges related to this approach.
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Affiliation(s)
- Bruna Aparecida Souza Machado
- SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), University Center SENAI/CIMATEC, Salvador 41650-010, Brazil; (K.V.S.H.); (L.M.d.S.F.); (L.A.B.M.); (L.P.C.d.S.A.); (V.P.C.R.); (M.B.P.S.); (R.B.)
| | - Katharine Valéria Saraiva Hodel
- SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), University Center SENAI/CIMATEC, Salvador 41650-010, Brazil; (K.V.S.H.); (L.M.d.S.F.); (L.A.B.M.); (L.P.C.d.S.A.); (V.P.C.R.); (M.B.P.S.); (R.B.)
| | - Larissa Moraes dos Santos Fonseca
- SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), University Center SENAI/CIMATEC, Salvador 41650-010, Brazil; (K.V.S.H.); (L.M.d.S.F.); (L.A.B.M.); (L.P.C.d.S.A.); (V.P.C.R.); (M.B.P.S.); (R.B.)
| | - Luís Alberto Brêda Mascarenhas
- SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), University Center SENAI/CIMATEC, Salvador 41650-010, Brazil; (K.V.S.H.); (L.M.d.S.F.); (L.A.B.M.); (L.P.C.d.S.A.); (V.P.C.R.); (M.B.P.S.); (R.B.)
| | - Leone Peter Correia da Silva Andrade
- SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), University Center SENAI/CIMATEC, Salvador 41650-010, Brazil; (K.V.S.H.); (L.M.d.S.F.); (L.A.B.M.); (L.P.C.d.S.A.); (V.P.C.R.); (M.B.P.S.); (R.B.)
| | - Vinícius Pinto Costa Rocha
- SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), University Center SENAI/CIMATEC, Salvador 41650-010, Brazil; (K.V.S.H.); (L.M.d.S.F.); (L.A.B.M.); (L.P.C.d.S.A.); (V.P.C.R.); (M.B.P.S.); (R.B.)
| | - Milena Botelho Pereira Soares
- SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), University Center SENAI/CIMATEC, Salvador 41650-010, Brazil; (K.V.S.H.); (L.M.d.S.F.); (L.A.B.M.); (L.P.C.d.S.A.); (V.P.C.R.); (M.B.P.S.); (R.B.)
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation (IGM-FIOCRUZ/BA), Salvador 40296-710, Brazil
| | - Peter Berglund
- HDT Bio, 1616 Eastlake Ave E, Seattle, WA 98102, USA; (P.B.); (M.S.D.); (S.G.R.)
| | - Malcolm S. Duthie
- HDT Bio, 1616 Eastlake Ave E, Seattle, WA 98102, USA; (P.B.); (M.S.D.); (S.G.R.)
| | - Steven G. Reed
- HDT Bio, 1616 Eastlake Ave E, Seattle, WA 98102, USA; (P.B.); (M.S.D.); (S.G.R.)
| | - Roberto Badaró
- SENAI Institute of Innovation (ISI) in Health Advanced Systems (CIMATEC ISI SAS), University Center SENAI/CIMATEC, Salvador 41650-010, Brazil; (K.V.S.H.); (L.M.d.S.F.); (L.A.B.M.); (L.P.C.d.S.A.); (V.P.C.R.); (M.B.P.S.); (R.B.)
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9
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Ghosh P, Chowdhury R, Hossain ME, Hossain F, Miah M, Rashid MU, Baker J, Rahman MZ, Rahman M, Ma X, Duthie MS, Wahed AAE, Mondal D. Evaluation of recombinase-based isothermal amplification assays for point-of-need detection of SARS-CoV-2 in resource-limited settings. Int J Infect Dis 2021; 114:105-111. [PMID: 34758392 PMCID: PMC8572376 DOI: 10.1016/j.ijid.2021.11.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 09/25/2021] [Revised: 10/31/2021] [Accepted: 11/02/2021] [Indexed: 12/17/2022] Open
Abstract
Objectives The democratization of diagnostics is one of the key challenges towards containing the transmission of coronavirus disease 2019 (COVID-19) around the globe. The operational complexities of existing PCR-based methods, including sample transfer to advanced central laboratories with expensive equipment, limit their use in resource-limited settings. However, with the advent of isothermal technologies, the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is possible at decentralized facilities. Methods In this study, two recombinase-based isothermal techniques, reverse transcription recombinase polymerase amplification (RT-RPA) and reverse transcription recombinase-aided amplification (RT-RAA), were evaluated for the detection of SARS-CoV-2 in clinical samples. A total of 76 real-time reverse transcription PCR (real-time RT-PCR) confirmed COVID-19 cases and 100 negative controls were evaluated to determine the diagnostic performance of the isothermal methods. Results This investigation revealed equally promising diagnostic accuracy of the two methods, with a sensitivity of 76.32% (95% confidence interval 65.18–85.32%) when the target genes were RdRP and ORF1ab for RT-RPA and RT-RAA, respectively; the combination of N and RdRP in RT-RPA augmented the accuracy of the assay at a sensitivity of 85.53% (95% confidence interval 75.58–92.55%). Furthermore, high specificity was observed for each of the methods, ranging from 94.00% to 98.00% (95% confidence interval 87.40–9.76%). Conclusions Considering the diagnostic accuracies, both RT-RPA and RT-RAA appear to be suitable assays for point-of-need deployment for the detection of the pathogen, understanding its epidemiology, case management, and curbing transmission.
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Affiliation(s)
- Prakash Ghosh
- Emerging Infections and Parasitology Laboratory, NCSD, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, 1212, Bangladesh
| | - Rajashree Chowdhury
- Emerging Infections and Parasitology Laboratory, NCSD, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, 1212, Bangladesh
| | - Mohammad Enayet Hossain
- Virology Laboratory, IDD, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, 1212, Bangladesh
| | - Faria Hossain
- Emerging Infections and Parasitology Laboratory, NCSD, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, 1212, Bangladesh
| | - Mojnu Miah
- Virology Laboratory, IDD, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, 1212, Bangladesh
| | - Md Utba Rashid
- Emerging Infections and Parasitology Laboratory, NCSD, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, 1212, Bangladesh
| | - James Baker
- Laboratory Science and Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, 1212, Bangladesh
| | - Mohammed Ziaur Rahman
- Virology Laboratory, IDD, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, 1212, Bangladesh
| | - Mustafizur Rahman
- Virology Laboratory, IDD, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, 1212, Bangladesh
| | - Xuejun Ma
- Chinese Center for Disease Control and Prevention, National Institute for Viral Disease Control and Prevention, Beijing, 102206, China
| | - Malcolm S Duthie
- HDT Bio Corp, Suite 280, 1616 Eastlake Ave E, Seattle, WA, 98102, USA
| | - Ahmed Abd El Wahed
- Institute of Animal Hygiene and Veterinary Public Health, University of Leipzig, An den Tierkliniken 43, D-04103, Leipzig, Germany.
| | - Dinesh Mondal
- Emerging Infections and Parasitology Laboratory, NCSD, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, 1212, Bangladesh; Laboratory Science and Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, 1212, Bangladesh.
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10
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Duthie MS, Goto Y. Editorial: Emerging Concepts of Innate Immune Responses to Neglected Tropical Diseases. Front Immunol 2021; 12:658553. [PMID: 34603276 PMCID: PMC8479176 DOI: 10.3389/fimmu.2021.658553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 08/30/2021] [Indexed: 12/04/2022] Open
Affiliation(s)
| | - Yasuyuki Goto
- Department of Animal Resource Sciences, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
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11
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Silva da Paz W, Duthie MS, Ribeiro de Jesus A, Machado de Araújo KCG, Dantas Dos Santos A, Bezerra-Santos M. Population-based, spatiotemporal modeling of social risk factors and mortality from schistosomiasis in Brazil between 1999 and 2018. Acta Trop 2021; 218:105897. [PMID: 33753030 DOI: 10.1016/j.actatropica.2021.105897] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/12/2021] [Accepted: 03/15/2021] [Indexed: 11/29/2022]
Abstract
Schistosomiasis remains a significant public health concern in Brazil. To identify areas at, and social determinants of health (SDH) associated with, high-risk for schistosomiasis-related mortality from Brazil, we conducted a spatial and spatiotemporal modeling assessing all deaths confirmed in Brazil between 1999 and 2018. We used the segmented log-linear regression model to assess temporal trends, and the local empirical Bayesian estimator, the Global and Local Moran Index for spatial analysis. A total of 12,251 schistosomiasis-related deaths were reported in this period. Within the Mortality Information System (SIM) of the Brazilian Ministry of Health, the states of Alagoas (AL), Pernambuco (PE) and Sergipe (SE) recording the highest mortality rates: 2.21, 1.92 and 0.80 deaths/100,000 inhabitants, respectively. Analyses revealed an increase in the mean age of schistosomiasis-related deaths over the time assessed (APC = 0.9; p-value<0.05). Spatial analysis identified a concentration of municipalities presenting high risk of schistosomiasis-related mortality along the coastline of PE and AL. Similarly, we identified the formation of high space-time clusters in municipalities in the states of PE, AL, SE, Bahia, and Minas Gerais. Finally, mortality rates showed a significant correlation with 96.96% of SDH indices. The data reveal additional important changes in schistosomiasis-related deaths in Brazil between 1999 and 2018, such as a slow reduction among males (unlike females that displayed no change). Regardless, our analyses indicates that schistosomiasis continues to have the greatest detrimental impact in poor regions of Brazil and suggest the need for enhancement of current control measures to accelerate progress.
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Affiliation(s)
- Wandklebson Silva da Paz
- Graduate Program in Parasitic Biology, Universidade Federal de Sergipe, São Cristóvão, Sergipe, Brazil.
| | | | - Amélia Ribeiro de Jesus
- Department of Medicine, Universidade Federal de Sergipe, Aracaju, Sergipe, Brazil; Immunology and Molecular Biology Laboratory, University Hospital, Universidade Federal de Sergipe, Aracaju, Brazil; Graduate Program in Health Sciences, Aracaju, Sergipe, Brazil
| | - Karina Conceição G Machado de Araújo
- Graduate Program in Parasitic Biology, Universidade Federal de Sergipe, São Cristóvão, Sergipe, Brazil; Graduate Program in Health Sciences, Aracaju, Sergipe, Brazil; Department of Morphology, Universidade Federal de Sergipe, Aracaju, Sergipe, Brazil
| | - Allan Dantas Dos Santos
- Department of Nursing, Universidade Federal de Sergipe, Lagarto, Sergipe, Brazil; Graduate Program of Nursing, Universidade Federal de Sergipe, Aracaju, Sergipe, Brazil
| | - Márcio Bezerra-Santos
- Graduate Program in Parasitic Biology, Universidade Federal de Sergipe, São Cristóvão, Sergipe, Brazil; Immunology and Molecular Biology Laboratory, University Hospital, Universidade Federal de Sergipe, Aracaju, Brazil; Graduate Program in Health Sciences, Aracaju, Sergipe, Brazil; Department of Morphology, Universidade Federal de Sergipe, Aracaju, Sergipe, Brazil
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12
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Jian L, Xiujian S, Yuangang Y, Yan X, Lianchao Y, Duthie MS, Yan W. Evaluation of antibody detection against the NDO-BSA, LID-1 and NDO-LID antigens as confirmatory tests to support the diagnosis of leprosy in Yunnan province, southwest China. Trans R Soc Trop Med Hyg 2021; 114:193-199. [PMID: 31667502 PMCID: PMC7092950 DOI: 10.1093/trstmh/trz089] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 11/19/2018] [Revised: 06/13/2019] [Accepted: 08/01/2019] [Indexed: 01/26/2023] Open
Abstract
Although multidrug therapy (MDT) has been widely used for the treatment of leprosy for nearly 40 y, the disease remains a public health concern in some areas. The early detection of leprosy cases is vital to interrupt Mycobacterium leprae transmission, but currently diagnosis is typically achieved during the recognition of clinical symptoms by professional staff performing physical examinations in conjunction with microbiological assessment of slit skin smears (SSSs) and histopathology. In the last 10 y, serum antibody detection tests have emerged to aid leprosy diagnosis. Here we evaluated the ability of antigens NDO-BSA and LID-1 (ML0405 and ML2331) and the conjugate of these, NDO-LID, to detect antibodies in the sera of 113 leprosy patients and 166 control individuals in Yunnan province in southwest China. We found that each antigen was readily detected by sera from multibacillary (MB) patients, with sensitivities of 97.3%, 97.3% and 98.6% for NDO-BSA, LID-1 and NDO-LID, respectively. Even among paucibacillary (PB) patients the antigens detected antibodies in 74.4%, 56.4% and 69.2% of serum samples, respectively. Receiver operating characteristics (ROC) curve analysis indicated that, irrespective of the leprosy case classification as MB or PB, the detection efficiency obtained with NDO-LID was better than that obtained with the other two antigens (with LID-1 being a slightly better than NDO-BSA). Our results indicate the utility of NDO-LID in assisting in the diagnosis of PB and MB leprosy patients and that these antibody detection assays represent powerful diagnostic tools. We suggest that could be implemented into the procedures of local health centres in leprosy-endemic regions to assist in earlier diagnosis.
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Affiliation(s)
- Liu Jian
- Beijing Tropical Medicine Research Institute, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.,Beijing Key Laboratory for Research on Prevention and Treatment of Tropical Diseases (100086), Capital Medical University, Beijing 100050, China
| | - Shang Xiujian
- Xinjiang Uygur Autonomous Region Centers for Disease Control and Prevention, Urumqi 830001, China
| | - You Yuangang
- Beijing Tropical Medicine Research Institute, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.,Beijing Key Laboratory for Research on Prevention and Treatment of Tropical Diseases (100086), Capital Medical University, Beijing 100050, China
| | - Xing Yan
- Beijing Tropical Medicine Research Institute, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.,Beijing Key Laboratory for Research on Prevention and Treatment of Tropical Diseases (100086), Capital Medical University, Beijing 100050, China
| | - Yuan Lianchao
- Beijing Tropical Medicine Research Institute, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.,Beijing Key Laboratory for Research on Prevention and Treatment of Tropical Diseases (100086), Capital Medical University, Beijing 100050, China
| | - Malcolm S Duthie
- Infectious Disease Research Institute, 1616 Eastlake Ave. E, Seattle, WA 98102, USA
| | - Wen Yan
- Beijing Tropical Medicine Research Institute, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.,Beijing Key Laboratory for Research on Prevention and Treatment of Tropical Diseases (100086), Capital Medical University, Beijing 100050, China
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13
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Hossain F, Picado A, Owen SI, Ghosh P, Chowdhury R, Maruf S, Khan MAA, Rashid MU, Nath R, Baker J, Ghosh D, Adams ER, Duthie MS, Hossain MS, Basher A, Nath P, Aktar F, Cruz I, Mondal D. Evaluation of Loopamp™ Leishmania Detection Kit and Leishmania Antigen ELISA for Post-Elimination Detection and Management of Visceral Leishmaniasis in Bangladesh. Front Cell Infect Microbiol 2021; 11:670759. [PMID: 33981632 PMCID: PMC8108992 DOI: 10.3389/fcimb.2021.670759] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 03/29/2021] [Indexed: 11/13/2022] Open
Abstract
With reduced prevalence of visceral leishmaniasis (VL) in the Indian subcontinent (ISC), direct and field deployable diagnostic tests are needed to implement an effective diagnostic and surveillance algorithm for post-elimination VL control. In this regard, here we investigated the diagnostic efficacies of a loop-mediated isothermal amplification (LAMP) assay (Loopamp™ Leishmania Detection Kit, Eiken Chemical CO., Ltd, Japan), a real-time quantitative PCR assay (qPCR) and the Leishmania antigen ELISA (CLIN-TECH, UK) with different sampling techniques and evaluated their prospect to incorporate into post-elimination VL control strategies. Eighty clinically and rK39 rapid diagnostic test confirmed VL cases and 80 endemic healthy controls were enrolled in the study. Peripheral blood and dried blood spots (DBS) were collected from all the participants at the time of diagnosis. DNA was extracted from whole blood (WB) and DBS via silica columns (QIAGEN) and boil & spin (B&S) methods and tested with qPCR and Loopamp. Urine was collected from all participants at the time of diagnosis and was directly subjected to the Leishmania antigen ELISA. 41 patients were followed up and urine samples were collected at day 30 and day 180 after treatment and ELISA was performed. The sensitivities of the Loopamp-WB(B&S) and Loopamp-WB(QIA) were 96.2% (95% CI 89·43-99·22) and 95% (95% CI 87·69-98·62) respectively. The sensitivity of Loopamp-DBS(QIA) was 85% (95% CI 75·26- 92·00). The sensitivities of the qPCR-WB(QIA) and qPCR-DBS(QIA) were 93.8% (95% CI 86·01-97·94) and 72.5% (95% CI 61·38-81·90) respectively. The specificity of all molecular assays was 100%. The sensitivity and specificity of the Leishmania antigen ELISA were 97.5% (95% CI 91·47-99·70) and 91.95% (95% CI 84·12-96·70) respectively. The Leishmania antigen ELISA depicted clinical cure at day 180 in all the followed-up cases. Efficacy and sustainability identify the Loopamp-WB(B&S) and the Leishmania antigen ELISA as promising and minimally invasive VL diagnostic tools to support VL diagnostic and surveillance activities respectively in the post-elimination era.
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Affiliation(s)
- Faria Hossain
- Emerging infections and Parasitology laboratory, Nutrition and Clinical Service Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Albert Picado
- Neglected Tropical Diseases, Foundation for Innovative New Diagnostics, Geneva, Switzerland
| | - Sophie I. Owen
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Prakash Ghosh
- Emerging infections and Parasitology laboratory, Nutrition and Clinical Service Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Rajashree Chowdhury
- Emerging infections and Parasitology laboratory, Nutrition and Clinical Service Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Shomik Maruf
- Emerging infections and Parasitology laboratory, Nutrition and Clinical Service Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | | | - Md. Utba Rashid
- Emerging infections and Parasitology laboratory, Nutrition and Clinical Service Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Rupen Nath
- Emerging infections and Parasitology laboratory, Nutrition and Clinical Service Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - James Baker
- Emerging infections and Parasitology laboratory, Nutrition and Clinical Service Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Debashis Ghosh
- Emerging infections and Parasitology laboratory, Nutrition and Clinical Service Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Emily R. Adams
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | | | | | - Ariful Basher
- Department of Medicine, Infectious Disease Hospital, Dhaka, Bangladesh
| | - Proggananda Nath
- Infectious diseases and Tropical Medicine, Mymensingh Medical College and Hospital, Mymensingh, Bangladesh
| | - Fatima Aktar
- Research, HDT Bio-Corp., Seattle, WA, United States
| | - Israel Cruz
- Neglected Tropical Diseases, Foundation for Innovative New Diagnostics, Geneva, Switzerland
- International Health Department, National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Dinesh Mondal
- Laboratory Sciences and Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
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14
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Mohammadi AM, Duthie MS, Reed SG, Javadi A, Khamesipour A. Evolution of antigen-specific immune responses in cutaneous leishmaniasis patients. Parasite Immunol 2021; 43:e12814. [PMID: 33351204 DOI: 10.1111/pim.12814] [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: 06/29/2020] [Revised: 12/18/2020] [Accepted: 12/18/2020] [Indexed: 11/27/2022]
Abstract
AIMS Despite immunization appearing to be the most appropriate strategy for long-term control of the vector-borne leishmaniases, no sustainable vaccine is currently available against any form of leishmaniasis. We therefore evaluated, in the context of vaccine antigen candidates, antigen-specific immune response at various stages of cutaneous leishmaniasis (CL). METHODS AND RESULTS Peripheral blood mononuclear cells (PBMC) isolated from healthy volunteers and CL patients (caused by either Leishmania major or L tropica) were incubated with crude Leishmania proteins (soluble Leishmania antigen; SLA), single recombinant proteins (TSA, LeIF, LmSTI1) or chimeric fusion proteins (LEISH-F2 and LEISH-F3). The concentrations of immune modulatory cytokines were then determined. While we did not detect appreciable antigen-specific IL-5 secretion, SLA induced secretion of interleukin (IL)-10 in cultures from early active lesion CL patients and even from healthy individuals. Conversely, interferon (IFN)-γ responses to SLA and recombinant proteins followed a similar pattern, developing only in the late active CL lesion phase. Once established, antigen-specific IFN-γ responses persisted in cured CL patients. CONCLUSION Together, our results provide further insight into the development of immune responses during CL and further validate the selection of LEISH-F2 and LEISH-F3 as vaccine antigen candidates.
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Affiliation(s)
- Akram Miramin Mohammadi
- Center for Research & Training in Skin Diseases & Leprosy (CRTSDL), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | | | | | - Amir Javadi
- Department of Social Medicines, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Ali Khamesipour
- Center for Research & Training in Skin Diseases & Leprosy (CRTSDL), Tehran University of Medical Sciences (TUMS), Tehran, Iran
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15
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Duthie MS, Reed SG. Skin tests for the detection of Mycobacterial infections: achievements, current perspectives, and implications for other diseases. Appl Microbiol Biotechnol 2021; 105:503-508. [PMID: 33394146 PMCID: PMC7780083 DOI: 10.1007/s00253-020-11062-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 10/13/2020] [Revised: 12/09/2020] [Accepted: 12/15/2020] [Indexed: 01/28/2023]
Abstract
Immunological and molecular advances have modernized diagnostic testing for many diseases. Although interferon gamma-release and polymerase chain reaction assays have been developed to detect Mycobacterium tuberculosis (Mtb) infection, purified protein derivative (PPD)-based tuberculin skin testing (TST) remains the most widely used method. Indeed, the TST is a simple and cost-effective tool that can be easily applied for widespread screening for Mtb infection. However, the lack of specificity has been a limitation of these tests, and, more recently, supply issues have arisen. Building upon the skin tests that historically have been used within TB and leprosy control programs, we discuss recent developments using modern technologies for improving mycobacterial skin testing as well as practical advantages inherent to the technique. Furthermore, we outline how this knowledge could be applied to develop similar tests that could benefit diagnostic strategies for other infections. KEY POINTS: • Skin testing provides a significantly cheaper alternative to most modern technologies. • Skin tests provide a lab-independent diagnostic strategy that can be widely administered. • Diseases for which T cell responses are more robust or durable than antibody responses are accessible for skin testing.
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Affiliation(s)
| | - Steven G Reed
- HDT Bio Corp, 1616 Eastlake Ave E, Seattle, WA, 98102, USA
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16
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Duthie MS, Roferos FO, Maghanoy AA, Balagon MF. Acceptability of rapid diagnostic tests among patients and their contacts in the Philippines is sustained beyond the completion of treatment. LEPROSY REV 2020. [DOI: 10.47276/lr.91.4.328] [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: 11/04/2022]
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17
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Pereira IE, Silva KP, Menegati LM, Pinheiro AC, Assunção EAO, Araújo MDLP, Abass E, Duthie MS, Steinhoff U, Teixeira HC. Performance of recombinant proteins in diagnosis and differentiation of canine visceral leishmaniasis infected and vaccinated dogs. Eur J Microbiol Immunol (Bp) 2020; 10:165-171. [PMID: 32857712 PMCID: PMC7592511 DOI: 10.1556/1886.2020.00018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 07/06/2020] [Accepted: 07/13/2020] [Indexed: 12/01/2022] Open
Abstract
Control of canine visceral leishmaniasis (CVL), a major zoonotic disease in Brazil and many other tropical and subtropical countries, remains difficult as an accurate and reliable diagnosis is still missing. In endemic regions, infected dogs are the main parasitic reservoir host of human Visceral leishmaniasis (VL) infection. Vaccination of dogs against Leishmania infection constitutes an important strategy to prevent or to better control CVL, thus, a serological test that can discriminate between antibodies induced by immunization versus infection is highly desirable in order to improve and simplify diagnosis. Here, four recombinant proteins were evaluated for their ability to detect and differentiate between dogs that are infected with Leishmania or have been immunized with the anti-Leishmania vaccine Leish-Tec®. Receiver operating characteristic (ROC) curve analysis of the four Leishmania-specific IgG ELISA revealed superior performance of rK28, followed by rKLO8, rK39 and rLb6H. The rK28-based ELISA revealed not only the best accuracy against CVL, but also the lowest cross-reactivity with sera from Leish-Tec® immunized dogs. Our data show that the rK28-based ELISA is highly suitable for CVL screening as it shows high sensitivity with simultaneous low cross-reactivity. Further, the high specificity of the rKLO8 indicates its suitability for the confirmation of CVL diagnosis.
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Affiliation(s)
- Ingrid E Pereira
- 1Department of Parasitology, Microbiology and Immunology, Institute of Biological Sciences, Federal University of Juiz de Fora, 36036-900, Juiz de Fora, Brazil
| | - Kyssia P Silva
- 1Department of Parasitology, Microbiology and Immunology, Institute of Biological Sciences, Federal University of Juiz de Fora, 36036-900, Juiz de Fora, Brazil
| | - Laura M Menegati
- 1Department of Parasitology, Microbiology and Immunology, Institute of Biological Sciences, Federal University of Juiz de Fora, 36036-900, Juiz de Fora, Brazil
| | - Aimara C Pinheiro
- 2Zoonosis Control Center, Municipal Health Secretariat, 35022-280, Governador Valadares, Brazil
| | - Elaine A O Assunção
- 2Zoonosis Control Center, Municipal Health Secretariat, 35022-280, Governador Valadares, Brazil
| | | | - Elfadil Abass
- 4Department of Clinical Laboratory Science, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | - Ulrich Steinhoff
- 6Institute for Medical Microbiology, Philipps University of Marburg, 35043, Marburg, Germany
| | - Henrique C Teixeira
- 1Department of Parasitology, Microbiology and Immunology, Institute of Biological Sciences, Federal University of Juiz de Fora, 36036-900, Juiz de Fora, Brazil
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18
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Erasmus JH, Khandhar AP, O'Connor MA, Walls AC, Hemann EA, Murapa P, Archer J, Leventhal S, Fuller JT, Lewis TB, Draves KE, Randall S, Guerriero KA, Duthie MS, Carter D, Reed SG, Hawman DW, Feldmann H, Gale M, Veesler D, Berglund P, Fuller DH. An Alphavirus-derived replicon RNA vaccine induces SARS-CoV-2 neutralizing antibody and T cell responses in mice and nonhuman primates. Sci Transl Med 2020; 12:eabc9396. [PMID: 32690628 PMCID: PMC7402629 DOI: 10.1126/scitranslmed.abc9396] [Citation(s) in RCA: 149] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 07/16/2020] [Indexed: 12/11/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic, caused by infection with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is having a deleterious impact on health services and the global economy, highlighting the urgent need for an effective vaccine. Such a vaccine would need to rapidly confer protection after one or two doses and would need to be manufactured using components suitable for scale up. Here, we developed an Alphavirus-derived replicon RNA vaccine candidate, repRNA-CoV2S, encoding the SARS-CoV-2 spike (S) protein. The RNA replicons were formulated with lipid inorganic nanoparticles (LIONs) that were designed to enhance vaccine stability, delivery, and immunogenicity. We show that a single intramuscular injection of the LION/repRNA-CoV2S vaccine in mice elicited robust production of anti-SARS-CoV-2 S protein IgG antibody isotypes indicative of a type 1 T helper cell response. A prime/boost regimen induced potent T cell responses in mice including antigen-specific responses in the lung and spleen. Prime-only immunization of aged (17 months old) mice induced smaller immune responses compared to young mice, but this difference was abrogated by booster immunization. In nonhuman primates, prime-only immunization in one intramuscular injection site or prime/boost immunizations in five intramuscular injection sites elicited modest T cell responses and robust antibody responses. The antibody responses persisted for at least 70 days and neutralized SARS-CoV-2 at titers comparable to those in human serum samples collected from individuals convalescing from COVID-19. These data support further development of LION/repRNA-CoV2S as a vaccine candidate for prophylactic protection against SARS-CoV-2 infection.
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Affiliation(s)
- Jesse H Erasmus
- Department of Microbiology, University of Washington, Seattle, WA 98109, USA
- HDT Bio, Seattle, WA 98102, USA
| | - Amit P Khandhar
- HDT Bio, Seattle, WA 98102, USA
- PAI Life Sciences, Seattle, WA 98102, USA
| | - Megan A O'Connor
- Department of Microbiology, University of Washington, Seattle, WA 98109, USA
- Washington National Primate Research Center, Seattle, WA 98121, USA
| | - Alexandra C Walls
- Department of Biochemistry, University of Washington, Seattle, WA 98195, USA
| | - Emily A Hemann
- Center for Innate Immunity and Immune Disease, University of Washington, Seattle, WA 98109, USA
- Department of Immunology, University of Washington, Seattle, WA 98109, USA
| | - Patience Murapa
- Department of Microbiology, University of Washington, Seattle, WA 98109, USA
| | - Jacob Archer
- Department of Microbiology, University of Washington, Seattle, WA 98109, USA
- PAI Life Sciences, Seattle, WA 98102, USA
| | - Shanna Leventhal
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT 59840, USA
| | - James T Fuller
- Department of Microbiology, University of Washington, Seattle, WA 98109, USA
| | - Thomas B Lewis
- Department of Microbiology, University of Washington, Seattle, WA 98109, USA
- Washington National Primate Research Center, Seattle, WA 98121, USA
| | - Kevin E Draves
- Department of Microbiology, University of Washington, Seattle, WA 98109, USA
| | - Samantha Randall
- Department of Microbiology, University of Washington, Seattle, WA 98109, USA
| | | | | | - Darrick Carter
- HDT Bio, Seattle, WA 98102, USA
- PAI Life Sciences, Seattle, WA 98102, USA
- Center for Innate Immunity and Immune Disease, University of Washington, Seattle, WA 98109, USA
| | - Steven G Reed
- HDT Bio, Seattle, WA 98102, USA
- Center for Innate Immunity and Immune Disease, University of Washington, Seattle, WA 98109, USA
| | - David W Hawman
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT 59840, USA
| | - Heinz Feldmann
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT 59840, USA
| | - Michael Gale
- Washington National Primate Research Center, Seattle, WA 98121, USA
- Center for Innate Immunity and Immune Disease, University of Washington, Seattle, WA 98109, USA
- Department of Immunology, University of Washington, Seattle, WA 98109, USA
| | - David Veesler
- Department of Biochemistry, University of Washington, Seattle, WA 98195, USA
| | | | - Deborah Heydenburg Fuller
- Department of Microbiology, University of Washington, Seattle, WA 98109, USA.
- Washington National Primate Research Center, Seattle, WA 98121, USA
- Center for Innate Immunity and Immune Disease, University of Washington, Seattle, WA 98109, USA
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Badaro R, Machado BAS, Duthie MS, Araujo-Neto CA, Pedral-Sampaio D, Nakatani M, Reed SG. The single recombinant M. tuberculosis protein DPPD provides enhanced performance of skin testing among HIV-infected tuberculosis patients. AMB Express 2020; 10:133. [PMID: 32737693 PMCID: PMC7394993 DOI: 10.1186/s13568-020-01068-6] [Citation(s) in RCA: 6] [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: 05/19/2020] [Accepted: 07/18/2020] [Indexed: 11/10/2022] Open
Abstract
Diagnostic testing for M. tuberculosis infection has advanced with QuantiFERON and GeneXpert, but simple cost-effective alternatives for widespread TB screening has remained elusive and purified protein derivative (PPD)-based tuberculin skin testing (TST) remains the most widely used method. PPD-based tests have reduced performance, however, in BCG vaccinees and in individuals with immune deficiencies. We compared the performance of skin testing with the recombinant DPPD protein against that of a standard PPD-based skin test. Our data indicates similar performance of DPPD and PPD (r2 = 0.7689) among HIV-negative, active TB patients, all of whom presented greater than 10 mm induration following administration. In contrast to results demonstrating that PPD induced indurations greater than 5 mm (i.e., the recommended threshold for positive results in this population) in only half (19 of 38) of the HIV positive TB patients, 89.5% (34 of 38) of these participants developed indurations greater than 5 mm when challenged with DPPD. Importantly, none of the patients that were positive following PPD administration were negative following DPPD administration, indicating markedly improved sensitivity of DPPD among HIV-infected individuals. Our data indicate that DPPD has superior performance in skin testing than the current TST standard.
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Erasmus JH, Khandhar AP, Walls AC, Hemann EA, O'Connor MA, Murapa P, Archer J, Leventhal S, Fuller J, Lewis T, Draves KE, Randall S, Guerriero KA, Duthie MS, Carter D, Reed SG, Hawman DW, Feldmann H, Gale M, Veesler D, Berglund P, Fuller DH. Single-dose replicating RNA vaccine induces neutralizing antibodies against SARS-CoV-2 in nonhuman primates. bioRxiv 2020:2020.05.28.121640. [PMID: 32511417 PMCID: PMC7265689 DOI: 10.1101/2020.05.28.121640] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The ongoing COVID-19 pandemic, caused by infection with SARS-CoV-2, is having a dramatic and deleterious impact on health services and the global economy. Grim public health statistics highlight the need for vaccines that can rapidly confer protection after a single dose and be manufactured using components suitable for scale-up and efficient distribution. In response, we have rapidly developed repRNA-CoV2S, a stable and highly immunogenic vaccine candidate comprised of an RNA replicon formulated with a novel Lipid InOrganic Nanoparticle (LION) designed to enhance vaccine stability, delivery and immunogenicity. We show that intramuscular injection of LION/repRNA-CoV2S elicits robust anti-SARS-CoV-2 spike protein IgG antibody isotypes indicative of a Type 1 T helper response as well as potent T cell responses in mice. Importantly, a single-dose administration in nonhuman primates elicited antibody responses that potently neutralized SARS-CoV-2. These data support further development of LION/repRNA-CoV2S as a vaccine candidate for prophylactic protection from SARS-CoV-2 infection.
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22
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Duthie MS, Goto Y, Ghosh P, Mondal D. Impact of sequelae of visceral leishmaniasis and their contribution to ongoing transmission of Leishmania donovani. Pathog Dis 2020; 77:5582598. [PMID: 31589291 PMCID: PMC6830496 DOI: 10.1093/femspd/ftz057] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 04/19/2019] [Accepted: 10/03/2019] [Indexed: 12/04/2022] Open
Abstract
Visceral leishmaniasis (VL) in the Old World is caused by infection with Leishmania donovani. Although the numbers of new reported cases of VL in Africa have been relatively stable for several years, the low numbers currently reported on the Indian subcontinent suggest a positive impact of new treatments and intervention strategies. In both regions, however, VL relapse and post-kala-azar dermal leishmaniasis (PKDL) maintain infectious reservoirs and therefore present a threat to control programs. In this review, we outline the evolving appreciation of PKDL as an impactful disease in its own right and discuss the various diagnostic methods that can be applied for the detection and characterization of PKDL cases. We also highlight the data that indicate the potential, and likely contribution, of PKDL cases to ongoing transmission of L. donovani.
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Affiliation(s)
- Malcolm S Duthie
- Infectious Disease Research Institute, 1616 Eastlake Ave E, Suite 400, Seattle, WA 98102, USA
| | - Yasuyuki Goto
- Department of Animal Resource Sciences, Graduate School of Agricultural and Life Sciences, University of Tokyo, 1-1-1 Yayoi, Bungkyo-ku, Tokyo 113-8657, Japan
| | - Prakash Ghosh
- 68 Shaheed Tajuddin Ahmed Saranai, Mokakhali, Dhaka-1212, Bangladesh
| | - Dinesh Mondal
- 68 Shaheed Tajuddin Ahmed Saranai, Mokakhali, Dhaka-1212, Bangladesh
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Duthie MS, Pena MT, Khandhar AP, Picone A, MacMIllen Z, Truman RW, Adams LB, Reed SG. Development of LepReact, a defined skin test for paucibacillary leprosy and low-level M. leprae infection. Appl Microbiol Biotechnol 2020; 104:3971-3979. [PMID: 32157423 DOI: 10.1007/s00253-020-10505-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 02/19/2020] [Accepted: 02/28/2020] [Indexed: 11/26/2022]
Abstract
The persistence of new leprosy cases in endemic areas such as India, Brazil, Bangladesh, and the Philippines has encouraged studies of chemoprophylaxis among contacts of patients. Epidemiological screening tools to enable early detection of infected individuals in endemic populations would be critical to target individuals most in need of intervention. Despite decades of attempts, however, there still are no tests available for the early detection of low-level infection with Mycobacterium leprae. In this report, we describe the development of a leprosy skin test using M. leprae-specific antigens. We selected the chimeric LID-1 fusion protein, formulated to achieve maximum performance at a minimal dose, as a skin test candidate based on its ability to elicit delayed-type hypersensitivity (DTH) reactions in M. leprae immune guinea pigs in a sensitive and specific manner, i.e., with no cross-reactivity observed with other mycobacterial species. Importantly, evaluations in armadillos indicated that intradermal inoculation of formulated LID-1 could distinguish uninfected from M. leprae-infected animals manifesting with symptoms distinctly similar to the PB presentation of patients. Together, our data provide strong proof-of-concept for developing an antigen-specific skin test to detect low-level M. leprae infection. Such a test could, when applied with appropriate use of chemo- and/or immunoprophylaxis, be instrumental in altering the evolution of clinical disease and M. leprae transmission, thus furthering the objective of zero leprosy.
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Affiliation(s)
- Malcolm S Duthie
- Host Directed Therapeutics (HDT) Biocorp, 1616 Eastlake Ave E, Seattle, WA, 98102, USA.
- Infectious Disease Research Institute, Seattle, WA, USA.
| | - Maria T Pena
- National Hansens Disease Program, Baton Rouge, LA, USA
| | | | | | | | | | - Linda B Adams
- National Hansens Disease Program, Baton Rouge, LA, USA
| | - Steven G Reed
- Host Directed Therapeutics (HDT) Biocorp, 1616 Eastlake Ave E, Seattle, WA, 98102, USA
- Infectious Disease Research Institute, Seattle, WA, USA
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Duthie MS, Frevol A, Day T, Coler RN, Vergara J, Rolf T, Sagawa ZK, Marie Beckmann A, Casper C, Reed SG. A phase 1 antigen dose escalation trial to evaluate safety, tolerability and immunogenicity of the leprosy vaccine candidate LepVax (LEP-F1 + GLA–SE) in healthy adults. Vaccine 2020; 38:1700-1707. [DOI: 10.1016/j.vaccine.2019.12.050] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 12/09/2019] [Accepted: 12/20/2019] [Indexed: 12/31/2022]
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Duthie MS, Roferos FO, Abellana JF, Taborada T, Sanchez R, Maghanoy A, Balagon MF. Utility and limitations of serodiagnostic tests in monitoring the response to treatment of leprosy patients. Diagn Microbiol Infect Dis 2020; 96:114984. [PMID: 31954594 DOI: 10.1016/j.diagmicrobio.2019.114984] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 12/21/2019] [Accepted: 12/30/2019] [Indexed: 11/16/2022]
Abstract
Simple measures that can facilitate early recognition of leprosy complications are still lacking. We therefore evaluated a lateral flow-based rapid diagnostic test and fast enzyme-linked immunosorbent assay measuring anti-LID-NDO antibody responses among leprosy cases in Cebu, Philippines. Responses were measured at diagnosis, then during and after the provision of standard multidrug therapy. Our data indicate that both platforms are highly sensitive tools for the primary diagnosis of, in particular, multibacillary leprosy. A gradual, quantifiable decline in both magnitude of response and percent positive responders was observed during and after treatment. As a group, patients that developed erythema nodosum leprosum (ENL) had a significantly higher response at diagnosis than patients that either developed reversal reactions or did not develop reactions. Although higher initial anti-NDO-LID responses were a risk factor for ENL, neither platform, however, could reliably predict the time of emergence of reactional episodes.
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Affiliation(s)
- Malcolm S Duthie
- Infectious Disease Research Institute, 1616 Eastlake Ave E, Seattle, WA 98102, USA; Host Directed Therapeutics (HDT), Suite 280, 1616 Eastlake Ave E, Seattle, WA 98102, USA.
| | | | - Junie F Abellana
- Leonard Wood Memorial Center for Leprosy Research, Cebu, Philippines
| | - Tonet Taborada
- Leonard Wood Memorial Center for Leprosy Research, Cebu, Philippines
| | - Riza Sanchez
- Leonard Wood Memorial Center for Leprosy Research, Cebu, Philippines
| | - Armi Maghanoy
- Leonard Wood Memorial Center for Leprosy Research, Cebu, Philippines
| | - Marivic F Balagon
- Leonard Wood Memorial Center for Leprosy Research, Cebu, Philippines
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Nascimento LFM, Miranda DFH, Moura LD, Pinho FA, Werneck GL, Khouri R, Reed SG, Duthie MS, Barral A, Barral-Netto M, Cruz MSP. Allopurinol therapy provides long term clinical improvement, but additional immunotherapy is required for sustained parasite clearance, in L. infantum-infected dogs. Vaccine X 2019; 4:100048. [PMID: 31891152 PMCID: PMC6928333 DOI: 10.1016/j.jvacx.2019.100048] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 06/25/2019] [Revised: 11/01/2019] [Accepted: 11/09/2019] [Indexed: 11/28/2022] Open
Abstract
L. infantum-infected dogs were treated with allopurinol alone or plus Leish-F2 + SLA-SE. Both treatment regimen generated long term clinical improvement. Immunochemotherapy, but not chemotherapy alone, generated sustained parasite control.
There is little evidence that current control strategies for canine leishmaniosis (CanL), the veterinary disease caused by L. infantum infection, are having a positive impact. This is of critical importance because dogs are a primary reservoir for L. infantum and a significant source of parasite transmission to humans. Drugs intended primarily for human use are prohibited for the treatment of CanL because of concerns over the propagation of resistant parasites. Although allopurinol effectively decreases parasite burden in CanL the treatment needs to be maintained for life. We hypothesized that during the allopurinol-induced parasite reduction dogs may become capable of developing a more robust immune response that may permit more effective control of parasites. To test this, we investigated the clinical and parasitological impact of short-term treatment with allopurinol, either alone or in combination with a defined subunit vaccine, on dogs naturally infected with L. infantum. A total of 28 dogs were distributed as follows: untreated; oral allopurinol alone (20 mg/kg, once each day for 90 days); or allopurinol with immunization with the Leish-F2 antigen formulated with the Toll-like receptor (TLR) 4 agonist Second generation Lipid Adjuvant (SLA) in stable emulsion (SE; SLA-SE). Dogs that did not receive treatment had a progressive decline in their clinical condition and an increase in their infection levels, while treatment with allopurinol alone alleviated the clinical symptoms of CanL but did not generate sustained reduction in parasites. Concomitant immunization with Leish-F2 + SLA-SE, however, improved clinical condition while also providing long-term clearance of L. infantum from lymphoid tissues and systemic organs. These results have important implications for both the management of CanL and for limiting L. infantum transmission to humans.
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Key Words
- CanL, canine leishmaniosis
- Canine visceral leishmaniasis
- Clinical signs
- Drug
- GLA, glycopyranosyl lipid
- IFN, interferon
- IL, interleukin
- MPL, monophosphoryl lipid A
- Parasite
- SE, stable emulsion
- SLA, Second generation Lipid Adjuvant
- TLR, Toll-like receptor
- Th1, T helper 1-like cells
- VL, visceral leishmaniasis
- Vaccine
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Affiliation(s)
- Leopoldo F M Nascimento
- Universidade Federal do Piauí, Departamento de Morfofisiologia Veterinária, Teresina, PI, Brazil
| | | | - Luana D Moura
- Universidade Federal do Piauí, Departamento de Morfofisiologia Veterinária, Teresina, PI, Brazil
| | - Flaviane A Pinho
- Universidade Federal da Bahia, Faculdade de Medicina, Salvador, BA, Brazil
| | - Guilherme Loureiro Werneck
- Universidade Federal do Rio de Janeiro, Instituto de Estudos em Saúde Coletiva, Rio de Janeiro, RJ, Brazil
| | - Ricardo Khouri
- Fundação Oswaldo Cruz- Fiocruz, Instituto Gonçalo Moniz, Salvador, BA, Brazil.,Universidade Federal da Bahia, Faculdade de Medicina, Salvador, BA, Brazil
| | - Steven G Reed
- Infectious Diseases Research Institute, Seattle, WA 98102, USA.,HDT Biotech Corporation, Seattle, WA 98102, USA
| | - Malcolm S Duthie
- Infectious Diseases Research Institute, Seattle, WA 98102, USA.,HDT Biotech Corporation, Seattle, WA 98102, USA
| | - Aldina Barral
- Fundação Oswaldo Cruz- Fiocruz, Instituto Gonçalo Moniz, Salvador, BA, Brazil.,Universidade Federal da Bahia, Faculdade de Medicina, Salvador, BA, Brazil.,Instituto Nacional de Ciência e Tecnologia, Instituto de Investigação em Imunologia, São Paulo, SP, Brazil
| | - Manoel Barral-Netto
- Fundação Oswaldo Cruz- Fiocruz, Instituto Gonçalo Moniz, Salvador, BA, Brazil.,Universidade Federal da Bahia, Faculdade de Medicina, Salvador, BA, Brazil.,Instituto Nacional de Ciência e Tecnologia, Instituto de Investigação em Imunologia, São Paulo, SP, Brazil
| | - Maria S P Cruz
- Universidade Federal do Piauí, Departamento de Morfofisiologia Veterinária, Teresina, PI, Brazil
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27
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da Silva Ferreira J, de Carvalho FM, Vidal Pessolani MC, de Paula Antunes JMA, de Medeiros Oliveira IVP, Ferreira Moura GH, Truman RW, Peña MT, Sharma R, Duthie MS, de Paula Souza E Guimarães RJ, Nogueira Brum Fontes A, NoelSuffys P, McIntosh D. Serological and molecular detection of infection with Mycobacterium leprae in Brazilian six banded armadillos (Euphractus sexcinctus). Comp Immunol Microbiol Infect Dis 2019; 68:101397. [PMID: 31775113 DOI: 10.1016/j.cimid.2019.101397] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 09/16/2019] [Revised: 11/10/2019] [Accepted: 11/14/2019] [Indexed: 10/25/2022]
Abstract
Leprosy was recognized as a zoonotic disease, associated with nine-banded armadillos (Dasypus novemcinctus) in the Southern United States of America in 2011. In addition, there is growing evidence to support a role for armadillos in zoonotic leprosy in South America. The current study evaluated twenty specimens of the six-banded armadillo (Euphractus sexcinctus), collected from rural locations in the state of Rio Grande do Norte (RN), Brazil for evidence of infection with Mycobacterium leprae. Serum was examined using two "in-house" enzyme-linked immunosorbent assays (ELISAs) and via two commercially available (ML flow and NDO-LID®) immunochromatographic lateral flow (LF) tests, for detection of the PGL-I and/or LID-1 antigens of the bacterium. The presence of M. leprae DNA in liver tissue was examined using the multi-copy, M. leprae-specific repetitive element (RLEP), as target in conventional and nested PCR assays. Molecular and anti-PGL-I-ELISA data indicated that 20/20 (100 %) of the armadillos were infected with M. leprae. The corresponding detection levels recorded with the LF tests were 17/20 (85 %) and 16/20 (85 %), for the NDO-LID® and ML flow tests, respectively. Our results indicate that, in common with D. novemcinctus, six banded armadillos (a species hunted and reared as a food-source in some regions of Brazil, including RN), represent a potential reservoir of M. leprae and as such, their role in a possible zoonotic cycle of leprosy within Brazil warrants further investigation.
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Affiliation(s)
- Jéssica da Silva Ferreira
- Multiuser Molecular Biology Laboratory, Department of Animal Parasitology, Institute of Veterinary Medicine, Federal Rural University of Rio de Janeiro, Seropédica, Brazil
| | | | | | | | | | | | - Richard Wayne Truman
- Department of Health and Humans Services, Health Resources and Services Administration, Healthcare Systems Bureau, National Hansen's Disease Program, Baton Rouge, United States
| | - Maria Teresa Peña
- Department of Health and Humans Services, Health Resources and Services Administration, Healthcare Systems Bureau, National Hansen's Disease Program, Baton Rouge, United States
| | - Rahul Sharma
- Department of Health and Humans Services, Health Resources and Services Administration, Healthcare Systems Bureau, National Hansen's Disease Program, Baton Rouge, United States
| | | | | | - Amanda Nogueira Brum Fontes
- Laboratory of Molecular Biology Applied to Mycobacteria, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, Brazil
| | - Philip NoelSuffys
- Laboratory of Molecular Biology Applied to Mycobacteria, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, Brazil
| | - Douglas McIntosh
- Multiuser Molecular Biology Laboratory, Department of Animal Parasitology, Institute of Veterinary Medicine, Federal Rural University of Rio de Janeiro, Seropédica, Brazil.
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Coutinho De Oliveira B, Duthie MS, Alves Pereira VR. Vaccines for leishmaniasis and the implications of their development for American tegumentary leishmaniasis. Hum Vaccin Immunother 2019; 16:919-930. [PMID: 31634036 DOI: 10.1080/21645515.2019.1678998] [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: 12/31/2022] Open
Abstract
The leishmaniases are a collection of vector-borne parasitic diseases caused by a number of different Leishmania species that are distributed worldwide. Clinical and laboratory research have together revealed several important immune components that control Leishmania infection and indicate the potential of immunization to prevent leishmaniasis. In this review we introduce previous and ongoing experimental research efforts to develop vaccines against Leishmania species. First, second and third generation vaccine strategies that have been proposed to counter cutaneous and visceral leishmaniasis (CL and VL, respectively) are summarized. One of the major bottlenecks in development is the transition from results in animal model studies to humans, and we highlight that although American tegumentary leishmaniasis (ATL; New World CL) can progress to destructive and disfiguring mucosal lesions, most research has been conducted using mouse models and Old World Leishmania species. We conclude that assessment of vaccine candidates in ATL settings therefore appears merited.
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Affiliation(s)
- Beatriz Coutinho De Oliveira
- Pós-Graduação em Inovação Terapêutica, Universidade Federal de Pernambuco (UFPE), Recife, Brazil.,Departamento de Imunologia, Instituto Aggeu Magalhães, Recife, Brazil
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29
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Chowdhury R, ghosh P, Khan MAA, Hossain F, Faisal K, Nath R, Baker J, Wahed AAE, Maruf S, Nath P, Ghosh D, Rashid MM, Duthie MS, Mondal D. Evaluation of rapid extraction methods coupled with Recombinase polymerase amplification assay for point-of-need diagnosis of Post-kala-azar-dermal leishmaniasis.. [DOI: 10.21203/rs.2.17122/v1] [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] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Abstract
Introduction Post kala-azar dermal leishmaniasis (PKDL) usually develops as sequelae of visceral leishmaniasis (VL) and can manifest in multiple dermatological forms. Since PKDL patients harbor Leishmania donovani parasites and can potentially trigger inter-epidemic transmission of the disease, the success of kala-azar elimination programme could be jeopardized by these cases. Although several molecular methods with promising diagnostic efficacy have been developed to detect PKDL cases, albeit complicated and expensive DNA extraction methods limit their application in resource poor settings. To address this, in comparison to a reference DNA extraction method (Qiagen), we evaluated two rapid DNA extraction methods and determined their impact on the detection of the parasite DNA using our newly developed recombinase polymerase amplification (RPA) assay.Methods Thirty suspected PKDL cases were enrolled after diagnosis by clinical examination and a positive rk39 strip test. DNA was extracted from three skin biopsy samples using either a spin column-based method (Qiagen) or one of two rapid DNA extraction methods, (Boil & Spin (B&S) and SpeedXtract (SE)). RPA and qPCR were subsequently performed with the extracted samples to detect L. donovani DNA.Results Using DNA extracted by Qiagen method, the qPCR and RPA assays exhibited sensitivities of 86.7% and 93.3% respectively. In contrast, the sensitivity of RPA assay dropped to 76.7% and 63.3%, respectively, when the B&S and SE rapid extraction methods were performed. Despite this compromised sensitivity, B&S-RPA technique yielded an excellent agreement with both Q-qPCR (k = 0.828) and Q-RPA (k =0.831) techniques. Moreover, SE-RPA showed good agreement with Q-qPCR (k = 0.755), Q-RPA (k =0.692) and B&S-RPA (k =0.635) assays. As expected, with all of the three DNA extraction methods, both qPCR and RPA assay showed absolute specificity.Conclusions This study finding substantiates the superior diagnostic efficacy of Qiagen DNA extraction method over B&S and SE method in detecting LD DNA through RPA assay from skin biopsy of PKDL patients. To apply these rapid DNA extraction methods in resource-constrained settings, further methodological refinement is warranted to improve DNA yield and purity through rigorous experiments.
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Affiliation(s)
| | - prakash ghosh
- International Centre for Diarrhoeal Disease Research Bangladesh
| | | | - Faria Hossain
- International Centre for Diarrhoeal Disease Research Bangladesh
| | - Khaledul Faisal
- International Centre for Diarrhoeal Disease Research Bangladesh
| | - Rupen Nath
- International Centre for Diarrhoeal Disease Research Bangladesh
| | - James Baker
- International Centre for Diarrhoeal Disease Research Bangladesh
| | | | - Shomik Maruf
- International Centre for Diarrhoeal Disease Research Bangladesh
| | | | - Debashis Ghosh
- International Centre for Diarrhoeal Disease Research Bangladesh
| | | | | | - Dinesh Mondal
- International Centre for Diarrhoeal Disease Research Bangladesh
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30
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Mondal D, Ghosh P, Chowdhury R, Halleux C, Ruiz-Postigo JA, Alim A, Hossain F, Khan MAA, Nath R, Duthie MS, Kroeger A, Matlashewski G, Argaw D, Olliaro P. Relationship of Serum Antileishmanial Antibody With Development of Visceral Leishmaniasis, Post-kala-azar Dermal Leishmaniasis and Visceral Leishmaniasis Relapse. Front Microbiol 2019; 10:2268. [PMID: 31649631 PMCID: PMC6795025 DOI: 10.3389/fmicb.2019.02268] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 06/27/2019] [Accepted: 09/18/2019] [Indexed: 01/09/2023] Open
Abstract
Introduction To sustain the achievement of kala-azar elimination program (KEP), early detection and treatment of the visceral leishmaniasis (VL) cases and associated modalities such as treatment failure (TF), relapse VL (RVL), and Post-kala-azar dermal leishmaniasis (PKDL) is the cornerstone. A predictive biomarker for VL development and related complications could also play a crucial role in curtailing disease incidence and transmission. Investigations to find a biomarker with prospective capabilities are, however, scarce. Using samples and known clinical outcomes generated within two previous longitudinal cohort studies, we aimed to determine if fluctuations in serum anti-rK39 antibody levels could provide such predictive value. Materials and Methods Serum samples collected at four different time points (Baseline, 12, 18, and 24 months) from 16 patients who had developed VL within the monitoring period and 15 of their asymptomatic healthy controls counterparts were investigated. To investigate potential prediction of VL related complications, serum samples of 32 PKDL, 10 RVL, 07 TF, and 38 cured VL from a single dose AmBisome trial were analyzed. Of this second panel, all patients were monitored for 5 years and sera were collected at four time points (Baseline then 1, 6, and 12 months after treatment). The level of anti-rK39 antibodies in archived samples was measured by a semi-quantitative ELISA. Results The mean antibody level was significantly higher in VL patients compared to their asymptomatic healthy counterparts at each time point. Likewise, we observed a trend toward elevations in antibody levels for PKDL, RVL, TF relative to the reducing levels observed in cured VL. Receiver operating characteristic (ROC) analysis found a promising predictive power of rK39 antibody levels to reveal progression from asymptomatic Leishmania donovani infection stage to VL, defined as 87.5% sensitive and 95% specific. Following treatment, rk39 antibody notably showed 100% sensitivity and 95% specificity in predicting TF. Conclusion Our data indicate that the relative quantity of serum anti-rK39 antibody has promise within either a predictive or prognostic algorithm for VL and VL-related modalities. These could enable VL control programs to implement more effective measures to eliminate the disease. Further research is, however, imperative to standardize the rK39 antibody ELISA between sites prior to broader use.
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Affiliation(s)
- Dinesh Mondal
- Emerging Infections and Parasitology Laboratory, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Prakash Ghosh
- Emerging Infections and Parasitology Laboratory, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Rajashree Chowdhury
- Emerging Infections and Parasitology Laboratory, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Christine Halleux
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland
| | - Jose A Ruiz-Postigo
- Department of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Abdul Alim
- Emerging Infections and Parasitology Laboratory, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Faria Hossain
- Emerging Infections and Parasitology Laboratory, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Md Anik Ashfaq Khan
- Emerging Infections and Parasitology Laboratory, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Rupen Nath
- Emerging Infections and Parasitology Laboratory, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Malcolm S Duthie
- Infectious Disease Research Institute, Seattle, WA, United States
| | - Axel Kroeger
- Centre for Medicine and Society, University Medical Center Freiburg, Freiburg im Breisgau, Germany
| | - Greg Matlashewski
- Department of Microbiology and Immunology, McGill University, Montreal, QC, Canada
| | - Daniel Argaw
- Department of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Piero Olliaro
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
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Santos MB, Santos ADD, Barreto AS, Souza MDR, Goes MADO, Barreto Alves JA, Barreto IDC, Silva JRS, Oliveira DTD, Araújo KCGMD, Duthie MS, Jesus ARD. Clinical and epidemiological indicators and spatial analysis of leprosy cases in patients under 15 years old in an endemic area of Northeast Brazil: an ecological and time series study. BMJ Open 2019; 9:e023420. [PMID: 31352408 PMCID: PMC6661616 DOI: 10.1136/bmjopen-2018-023420] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE This study aimed to analyse the clinical and epidemiological indicators, temporal trends and the spatial distribution of leprosy in patients under 15 years old in an endemic area of Northeast Brazil. DESIGN Regional surveillance study of all reported cases. SETTING State of Sergipe, endemic area of Northeast Brazil. METHODS An ecological and time series study was conducted, based on secondary data reported by the Brazilian Information System on Notifiable Diseases for leprosy cases diagnosed in Sergipe state (2002-2015). The analysis of temporal trends was performed using the Joinpoint Regression Programme through Poisson regression. We performed spatial analysis by Kernel estimator and Moran index. RESULTS The incidence rate was reduced from 6.29 to 3.78 cases per 100 000 inhabitants in 2002 and 2015, respectively. However, Sergipe was still classified as highly endemicity in 2015. The mean number of household contacts (HHC) examined was significantly lower than those registered. Clinical data indicated that 21.4% of the patients developed leprosy reactions, and 31.3% presented with some physical disability in the multibacillary groups. Patients diagnosed by examination within the HHC presented better indicators, such as lower percentage of leprosy reaction and physical disability. Spatial analysis showed the most risk areas distributed on the northeast and cities around the capital, Aracaju. CONCLUSION The data indicate that there is a persistence of active Myobacterium leprae transmission and a delay in disease detection, following a pattern of high endemicity in many municipalities. The early detection by HHC examination is important to stop transmission and also to detect the cases in a less severe state.
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Affiliation(s)
- Márcio Bezerra Santos
- Department of Health Education, Universidade Federal de Sergipe, Lagarto, SE, Brazil
- Laboratory of Immunology and Molecular Biology, Universidade Federal de Sergipe, Sao Cristovao, SE, Brazil
| | | | - Aline Silva Barreto
- Laboratory of Immunology and Molecular Biology, Universidade Federal de Sergipe, Sao Cristovao, SE, Brazil
| | - Mariana do Rosário Souza
- Laboratory of Immunology and Molecular Biology, Universidade Federal de Sergipe, Sao Cristovao, SE, Brazil
| | | | | | - Ikaro Daniel Carvalho Barreto
- Programa de Pos-Graduacao em Biometria e Estatistica Aplicada, Universidade Federal Rural de Pernambuco, Recife, PE, Brazil
| | - José-Rodrigo S Silva
- Statistics and Actuarial Sciences, Universidade Federal de Sergipe, Sao Cristovao, SE, Brazil
| | - Daniela Teles de Oliveira
- Laboratory of Immunology and Molecular Biology, Universidade Federal de Sergipe, Sao Cristovao, SE, Brazil
| | | | - Malcolm S Duthie
- Infectious Diseases Research Institute, Seattle, Washington, USA
| | - Amélia Ribeiro de Jesus
- Laboratory of Immunology and Molecular Biology, Universidade Federal de Sergipe, Sao Cristovao, SE, Brazil
- Department of Medicine, Universidade Federal de Sergipe, Sao Cristovao, SE, Brazil
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32
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Serrano-Coll H, Mora HR, Beltrán JC, Duthie MS, Cardona-Castro N. Social and environmental conditions related to Mycobacterium leprae infection in children and adolescents from three leprosy endemic regions of Colombia. BMC Infect Dis 2019; 19:520. [PMID: 31196008 PMCID: PMC6567403 DOI: 10.1186/s12879-019-4120-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 10/10/2018] [Accepted: 05/22/2019] [Indexed: 11/10/2022] Open
Abstract
Background Leprosy is is still considered a public health issue and in Colombia 7–10% of new cases are found in children, indicating both active transmission and social inequality. We hypothesized that circulating antibodies against Natural Octyl Disaccharide-Leprosy IDRI Diagnostic (NDO-LID) (a combination of Mycobacterium leprae antigens) could reveal the social and environmental aspects associated with higher frequencies of M. leprae infection among children and adolescents in Colombia. Methods An observational cross-sectional study was conducted involving sampling from 82 children and adolescents (younger than 18 years of age) who had household contact with index leprosy patients diagnosed in the last 5 years. Data were analyzed through bivariate analysis made by applying a Pearson x2 test for qualitative variables, while quantitative variables, depending on their distribution, were analyzed using either a Student’s t-test or Mann-Whitney U test. Multivariate analysis was performed using a multiple regression and binomial logistic approach. Results A bivariate analysis demonstrated that antibody titers against NDO-LID were significantly greater in children and adolescents with a low socioeconomic status that had: lived in vulnerable areas of the UAChR shared region; eaten armadillo meat; exposure of over 10 years to an index case and; not received BCG immunization. Moreover, a multivariate analysis showed that residing in the UAChR region has a strong association with a greater possibility of M. leprae infection. Conclusions M. leprae transmission persists among young Colombians, and this is associated with social and environmental conditions. An intensification of efforts to identify new leprosy cases in vulnerable and forgotten populations where M. leprae transmission continues therefore appears necessary. Electronic supplementary material The online version of this article (10.1186/s12879-019-4120-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Hugo Rene Mora
- Instituto Colombiano de Medicina Tropical-Universidad CES, Sabaneta, Colombia
| | - Juan Camilo Beltrán
- Instituto Colombiano de Medicina Tropical-Universidad CES, Sabaneta, Colombia
| | | | - Nora Cardona-Castro
- Instituto Colombiano de Medicina Tropical, Faculty of Medicine, Escuela de Graduados - Universidad CES, Cra 43 A # 52 Sur 99., Sabaneta, Colombia.
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Bezerra-Santos M, do Vale-Simon M, Barreto AS, Cazzaniga RA, de Oliveira DT, Barrios MR, Ferreira AR, Santos-Bio NC, Reed SG, de Almeida RP, Corrêa CB, Duthie MS, de Jesus AR. Mycobacterium leprae Recombinant Antigen Induces High Expression of Multifunction T Lymphocytes and Is Promising as a Specific Vaccine for Leprosy. Front Immunol 2018; 9:2920. [PMID: 30631322 PMCID: PMC6315144 DOI: 10.3389/fimmu.2018.02920] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 11/28/2018] [Indexed: 11/13/2022] Open
Abstract
Leprosy is a chronic disease caused by M. leprae infection that can cause severe neurological complications and physical disabilities. A leprosy-specific vaccine would be an important component within control programs but is still lacking. Given that multifunctional CD4 T cells [i.e., those capable of simultaneously secreting combinations of interferon (IFN)-γ, interleukin (IL)-2, and tumor necrosis factor (TNF)] have now been implicated in the protective response to several infections, we tested the hypothesis if a recombinant M. leprae antigen-specific multifunctional T cells differed between leprosy patients and their healthy contacts. We used whole blood assays and peripheral blood mononuclear cells to characterize the antigen-specific T cell responses of 39 paucibacillary (PB) and 17 multibacillary (MB) leprosy patients and 31 healthy household contacts (HHC). Cells were incubated with either crude mycobacterial extracts (M. leprae cell sonicate–MLCS) and purified protein derivative (PPD) or recombinant ML2028 protein, the homolog of M. tuberculosis Ag85B. Multiplex assay revealed antigen-specific production of IFN-γ and IL-2 from cells of HHC and PB, confirming a Th1 bias within these individuals. Multiparameter flow cytometry then revealed that the population of multifunctional ML2028-specific T cells observed in HHC was larger than that observed in PB patients. Taken together, our data suggest that these multifunctional antigen-specific T cells provide a more effective response against M. leprae infection that prevents the development of leprosy. These data further our understanding of M. leprae infection/leprosy and are instructive for vaccine development.
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Affiliation(s)
- Márcio Bezerra-Santos
- Laboratory of Immunology and Molecular Biology, Federal University of Sergipe, Aracaju, Brazil.,Department of Health Education, Federal University of Sergipe, Lagarto, Brazil
| | - Marise do Vale-Simon
- Laboratory of Immunology and Molecular Biology, Federal University of Sergipe, Aracaju, Brazil
| | - Aline Silva Barreto
- Laboratory of Immunology and Molecular Biology, Federal University of Sergipe, Aracaju, Brazil
| | | | | | - Mônica Rueda Barrios
- Laboratory of Immunology and Molecular Biology, Federal University of Sergipe, Aracaju, Brazil
| | - Alex Ricardo Ferreira
- Laboratory of Immunology and Molecular Biology, Federal University of Sergipe, Aracaju, Brazil.,Infectious Disease Research Institute, Seattle, WA, United States
| | - Nanci C Santos-Bio
- Laboratory of Immunology and Molecular Biology, Federal University of Sergipe, Aracaju, Brazil.,Infectious Disease Research Institute, Seattle, WA, United States
| | - Steven G Reed
- Instituto de Investigação em Imunologia, INCT-CNPq, São Paulo, Brazil
| | - Roque Pacheco de Almeida
- Laboratory of Immunology and Molecular Biology, Federal University of Sergipe, Aracaju, Brazil.,Infectious Disease Research Institute, Seattle, WA, United States.,Department of Medicine, Federal University of Sergipe, Aracaju, Brazil
| | - Cristiane Bani Corrêa
- Laboratory of Immunology and Molecular Biology, Federal University of Sergipe, Aracaju, Brazil
| | - Malcolm S Duthie
- Instituto de Investigação em Imunologia, INCT-CNPq, São Paulo, Brazil
| | - Amélia Ribeiro de Jesus
- Laboratory of Immunology and Molecular Biology, Federal University of Sergipe, Aracaju, Brazil.,Infectious Disease Research Institute, Seattle, WA, United States.,Department of Medicine, Federal University of Sergipe, Aracaju, Brazil
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Michaeli A, Mezan S, Kühbacher A, Finkelmeier D, Elias M, Zatsepin M, Reed SG, Duthie MS, Rupp S, Lerner I, Burger-Kentischer A. Computationally Designed Bispecific MD2/CD14 Binding Peptides Show TLR4 Agonist Activity. J Immunol 2018; 201:3383-3391. [PMID: 30348734 DOI: 10.4049/jimmunol.1800380] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 09/20/2018] [Indexed: 12/28/2022]
Abstract
Toll-like receptor 4 plays an important role in the regulation of the innate and adaptive immune response. The majority of TLR4 activators currently in clinical use are derivatives of its prototypic ligand LPS. The discovery of innovative TLR4 activators has the potential of providing new therapeutic immunomodulators and adjuvants. We used computational design methods to predict and optimize a total of 53 cyclic and linear peptides targeting myeloid differentiation 2 (MD2) and cluster of differentiation 14 (CD14), both coreceptors of human TLR4. Activity of the designed peptides was first assessed using NF-κB reporter cell lines expressing either TLR4/MD2 or TLR4/CD14 receptors, then binding to CD14 and MD2 confirmed and quantified using MicroScale Thermophoresis. Finally, we incubated select peptides in human whole blood and observed their ability to induce cytokine production, either alone or in synergy with LPS. Our data demonstrate the advantage of computational design for the discovery of new TLR4 peptide activators with little structural resemblance to known ligands and indicate an efficient strategy with which to identify TLR4 targeting peptides that could be used as easy-to-produce alternatives to LPS-derived molecules in a variety of settings.
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Affiliation(s)
| | - Shaul Mezan
- Pepticom Ltd., Givat-Ram, 9139002 Jerusalem, Israel
| | - Andreas Kühbacher
- Fraunhofer Institute for Interfacial Engineering and Biotechnology IGB, 70569 Stuttgart, Germany
| | - Doris Finkelmeier
- Fraunhofer Institute for Interfacial Engineering and Biotechnology IGB, 70569 Stuttgart, Germany
| | - Maayan Elias
- Pepticom Ltd., Givat-Ram, 9139002 Jerusalem, Israel
| | | | - Steven G Reed
- Infectious Disease Research Institute, Seattle, WA 98102; and
| | | | - Steffen Rupp
- Fraunhofer Institute for Interfacial Engineering and Biotechnology IGB, 70569 Stuttgart, Germany; .,Institute of Interfacial Process Engineering and Plasma Technology, University of Stuttgart, 70569 Stuttgart, Germany
| | | | - Anke Burger-Kentischer
- Fraunhofer Institute for Interfacial Engineering and Biotechnology IGB, 70569 Stuttgart, Germany; .,Institute of Interfacial Process Engineering and Plasma Technology, University of Stuttgart, 70569 Stuttgart, Germany
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Duthie MS, Van Hoeven N, MacMillen Z, Picone A, Mohamath R, Erasmus J, Hsu FC, Stinchcomb DT, Reed SG. Heterologous Immunization With Defined RNA and Subunit Vaccines Enhances T Cell Responses That Protect Against Leishmania donovani. Front Immunol 2018; 9:2420. [PMID: 30386348 PMCID: PMC6199377 DOI: 10.3389/fimmu.2018.02420] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 10/01/2018] [Indexed: 11/13/2022] Open
Abstract
The rapid generation of strong T cell responses is highly desirable and viral vectors can have potent CD8+ T cell-inducing activity. Immunity to leishmaniasis requires selective T cell responses, with immunization schemes that raise either CD4 or CD8 T cell responses being protective in small animal models. We have defined the leishmaniasis vaccine candidate recombinant fusion antigens, LEISH-F2 and LEISH-F3+, that when formulated in a stable emulsion with a Toll-like receptor (TLR) 4 agonist, induce protective CD4+ T cell responses in animal models as well as providing therapeutic efficacy in canine leishmaniasis and in clinical trials in leishmaniasis patients. We used the genetic sequences of these validated vaccine antigens to design RNA vaccine constructs. Immunization of mice with the RNA replicons induced potent, local innate responses that were surprisingly independent of TLR7 and activated antigen-presenting cells (APC) to prime for extremely potent antigen-specific T helper 1 type responses upon heterologous boosting with either of the subunit vaccines (recombinant antigen with second generation glucopyranosyl lipid A in stable oil-in-water emulsion; SLA-SE). Inclusion of RNA in the immunization schedule also generated MHCI-restricted T cell responses. Immunization with LEISH-F2-expressing RNA vaccine followed later by subunit vaccine afforded protection against challenge with Leishmania donovani. Together, these data indicate the utility of heterologous prime-boost immunization schemes for the induction of potent antigen-specific CD4 and CD8 T cell responses for protection against intracellular pathogens.
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36
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Duthie MS, Casper C, Reed SG. Second coming: the re-emergence and modernization of immunotherapy by vaccines as a component of leprosy control. Future Microbiol 2018; 13:1449-1451. [PMID: 30311780 DOI: 10.2217/fmb-2018-0186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Malcolm S Duthie
- From the Infectious Disease Research Institute, 1616 Eastlake Ave E, Suite 400, Seattle, WA 98102, USA
| | - Corey Casper
- From the Infectious Disease Research Institute, 1616 Eastlake Ave E, Suite 400, Seattle, WA 98102, USA
| | - Steven G Reed
- From the Infectious Disease Research Institute, 1616 Eastlake Ave E, Suite 400, Seattle, WA 98102, USA
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Abstract
Lipopolysaccharide (LPS) is a well-defined agonist of Toll-like receptor (TLR) 4 that activates innate immune responses and influences the development of the adaptive response during infection with Gram-negative bacteria. Many years ago, Dr. Edgar Ribi separated the adjuvant activity of LPS from its toxic effects, an effort that led to the development of monophosphoryl lipid A (MPL). MPL, derived from Salmonella minnesota R595, has progressed through clinical development and is now used in various product-enabling formulations to support the generation of antigen-specific responses in several commercial and preclinical vaccines. We have generated several synthetic lipid A molecules, foremost glucopyranosyl lipid adjuvant (GLA) and second-generation lipid adjuvant (SLA), and have advanced these to clinical trial for various indications. In this review we summarize the potential and current positioning of TLR4-based adjuvant formulations in approved and emerging vaccines.
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Affiliation(s)
- Steven G Reed
- Infectious Disease Research Institute, 1616 Eastlake Ave E, Suite 400, Seattle, WA 98102 USA.
| | - Darrick Carter
- Infectious Disease Research Institute, 1616 Eastlake Ave E, Suite 400, Seattle, WA 98102 USA.
| | - Corey Casper
- Infectious Disease Research Institute, 1616 Eastlake Ave E, Suite 400, Seattle, WA 98102 USA.
| | - Malcolm S Duthie
- Infectious Disease Research Institute, 1616 Eastlake Ave E, Suite 400, Seattle, WA 98102 USA.
| | - Christopher B Fox
- Infectious Disease Research Institute, 1616 Eastlake Ave E, Suite 400, Seattle, WA 98102 USA.
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Duthie MS, Lison A, Courtenay O. Advances toward Diagnostic Tools for Managing Zoonotic Visceral Leishmaniasis. Trends Parasitol 2018; 34:881-890. [PMID: 30131210 PMCID: PMC6168404 DOI: 10.1016/j.pt.2018.07.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 07/23/2018] [Accepted: 07/24/2018] [Indexed: 11/20/2022]
Abstract
Visceral leishmaniasis (VL) is a life-threatening outcome of Leishmania infantum or Leishmania donovani infection. Dogs are the primary domestic reservoir of L. infantum parasites, and ownership of infected dogs increases the risk of human VL. Controlling infection within dog populations is regarded as critical to VL management in endemic countries, both preventing progression of canine disease and limiting parasite transmission to humans and dogs. Here we discuss various strategies that are used to diagnose canine visceral leishmaniasis (CVL) and the possibilities of adapting these for use within population screening and control programs. In addition, given the variable transmissibility of L. infantum to the sand fly vector, we outline some possibilities for the preferential identification of 'super-spreader' dogs among the overall infected population.
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Affiliation(s)
- Malcolm S Duthie
- Infectious Disease Research Institute, 1616 Eastlake Ave E, Suite 400, Seattle, WA 98102, USA.
| | - Aurore Lison
- School of Life Sciences, University of Warwick, Coventry, UK
| | - Orin Courtenay
- School of Life Sciences, University of Warwick, Coventry, UK
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Ghosh P, Hasnain MG, Hossain F, Khan MAA, Chowdhury R, Faisal K, Mural MA, Baker J, Nath R, Ghosh D, Maruf S, Shomik MS, Haque R, Matlashewski G, Hamano S, Duthie MS, Mondal D. Evaluation of Real-time PCR for Diagnosis of Post-Kala-azar Dermal Leishmaniasis in Endemic Foci of Bangladesh. Open Forum Infect Dis 2018; 5:ofy234. [PMID: 30320150 PMCID: PMC6176879 DOI: 10.1093/ofid/ofy234] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 03/01/2018] [Accepted: 09/12/2018] [Indexed: 01/09/2023] Open
Abstract
Background Post-kala-azar dermal leishmaniasis (PKDL) is a sequel to visceral leishmaniasis (VL), which is found in VL-endemic countries including Bangladesh. Because of these enigmatic cases, the success of the National Kala-azar Elimination Program is under threat. To date, diagnostic methods for PKDL cases in endemic regions have been limited to clinical examination and rK39 test or microscopy, and a suitable and accurate alternative method is needed. In this study, we investigated the application of real-time polymerase chain reaction (PCR) as a potential method for diagnosis of PKDL in comparison with microscopy. Methods Ninety-one suspected macular PKDL cases from Mymensingh district, Bangladesh, were enrolled in the study after diagnosis by clinical examination and an rK39 strip test. All of them responded after completion of the treatment with miltefosine. During enrollment, a skin biopsy was done for each patient, and both microscopy and real-time PCR were performed for detection and quantification of Leishmania donovan body (LDB) and LD DNA, respectively. Results Real-time PCR detected 83 cases among all suspected PKDL patients, with an encouraging sensitivity of 91.2% (83.4%–96.1%), whereas microscopy showed 50.6% (39.9%–61.2%) sensitivity. Among all suspected PKDL cases, 42 cases were positive in both microscopy and qPCR, whereas 41 cases were detected as positive through qPCR only. Conclusions This study provides evidence that real-time PCR is a promising tool for diagnosis of PKDL in endemic regions. In addition to diagnosis, the quantitative ability of this method could be further exploited for after-treatment prognosis and cure assessment of PKDL cases.
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Affiliation(s)
- Prakash Ghosh
- Nutrition and Clinical Service Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.,Infectious Disease Research Institute, Seattle, Washington, USA
| | - Md Golam Hasnain
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, New South Wales, Australia
| | - Faria Hossain
- Nutrition and Clinical Service Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Md Anik Ashfaq Khan
- Nutrition and Clinical Service Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Rajashree Chowdhury
- Nutrition and Clinical Service Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Khaledul Faisal
- Nutrition and Clinical Service Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Moshtaq Ahmed Mural
- Nutrition and Clinical Service Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - James Baker
- Nutrition and Clinical Service Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Rupen Nath
- Nutrition and Clinical Service Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Debashis Ghosh
- Nutrition and Clinical Service Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Shomik Maruf
- Nutrition and Clinical Service Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Mohammad Sohel Shomik
- Nutrition and Clinical Service Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Rashidul Haque
- Nutrition and Clinical Service Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Greg Matlashewski
- Department of Microbiology and Immunology, McGill University, Montreal, Québec, Canada
| | - Shinjiro Hamano
- Department of Parasitology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | | | - Dinesh Mondal
- Nutrition and Clinical Service Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
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40
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Serrano-Coll H, Muñoz M, Camilo Beltrán J, Duthie MS, Cardona-Castro N. Anti-natural octyl disaccharide-leprosy IDRI diagnostic (NDO-LID) antibodies as indicators of leprosy reactions and neuritis. Trans R Soc Trop Med Hyg 2018. [PMID: 28633333 DOI: 10.1093/trstmh/trx026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background Leprosy is a complex infectious and neurological disease caused by Mycobacterium leprae. Nerve damage is related to immunological hypersensitivity responses known as leprosy reactions (LRs). Diagnostic tools to predict LRs are not available. We hypothesized that natural octyl disaccharide-leprosy IDRI diagnostic (NDO-LID) would be helpful as an indicator of LRs and neuritis. Methods To assess the utility of NDO-LID in indicating reactions, ELISA were used to detect specific antibodies in serum samples from 80 Colombian leprosy patients (40 with and 40 without history of LRs). Responses were detected using a range of detection reagents detecting IgG, IgM or both isotypes. Results Patients with a history of LRs had an increased seropositivity rate for anti-NDO-LID antibodies compared to patients without (anti-NDO-LID protein A [p=0.02], IgG anti-NDO-LID [p=0.01] and IgM anti-NDO-LID [p=0.01]). Further analyses of patients with a history of LRs indicated that both seropositivity rate and magnitude of responses were elevated among patients with neuritis versus those without neuritis (anti-NDO-LID protein A [p=0.03], IgG anti-NDO-LID [p=0.001] and IgM anti-NDO-LID [p=0.06]). Conclusions Our data indicate that testing for serum anti-NDO-LID antibodies can be a useful screen to identify patients at risk of developing LRs and neuritis.
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Affiliation(s)
- Héctor Serrano-Coll
- Instituto Colombiano de Medicina Tropical - Universidad CES, Medellín, Colombia
| | - Mónica Muñoz
- Instituto Colombiano de Medicina Tropical - Universidad CES, Medellín, Colombia
| | - Juan Camilo Beltrán
- Instituto Colombiano de Medicina Tropical - Universidad CES, Medellín, Colombia
| | | | - Nora Cardona-Castro
- Instituto Colombiano de Medicina Tropical - Universidad CES, Medellín, Colombia
- Facultad de Medicina Universidad CES
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41
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Duthie MS, Pena MT, Ebenezer GJ, Gillis TP, Sharma R, Cunningham K, Polydefkis M, Maeda Y, Makino M, Truman RW, Reed SG. Erratum: Author Correction: LepVax, a defined subunit vaccine that provides effective pre-exposure and post-exposure prophylaxis of M. leprae infection. NPJ Vaccines 2018; 3:18. [PMID: 29799551 PMCID: PMC5954111 DOI: 10.1038/s41541-018-0055-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Malcolm S Duthie
- 1Infectious Disease Research Institute, 1616 Eastlake Ave E, Suite 400, Seattle, WA 98102 USA
| | - Maria T Pena
- National Hansens Disease Programs, Baton Rouge, LA USA
| | - Gigi J Ebenezer
- 3Department of Neurology, Johns Hopkins University, Baltimore, MD 21209 USA
| | - Thomas P Gillis
- 4Department of Microbiology, Immunology and Parasitology, LSU School of Medicine, New Orleans, LA USA
| | - Rahul Sharma
- National Hansens Disease Programs, Baton Rouge, LA USA
| | - Kelly Cunningham
- 3Department of Neurology, Johns Hopkins University, Baltimore, MD 21209 USA
| | - Michael Polydefkis
- 3Department of Neurology, Johns Hopkins University, Baltimore, MD 21209 USA
| | - Yumi Maeda
- 5Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Masahiko Makino
- 5Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Richard W Truman
- 6Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA USA
| | - Steven G Reed
- 1Infectious Disease Research Institute, 1616 Eastlake Ave E, Suite 400, Seattle, WA 98102 USA
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42
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Duthie MS, Pena MT, Ebenezer GJ, Gillis TP, Sharma R, Cunningham K, Polydefkis M, Maeda Y, Makino M, Truman RW, Reed SG. LepVax, a defined subunit vaccine that provides effective pre-exposure and post-exposure prophylaxis of M. leprae infection. NPJ Vaccines 2018; 3:12. [PMID: 29619252 PMCID: PMC5871809 DOI: 10.1038/s41541-018-0050-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 02/15/2018] [Accepted: 02/20/2018] [Indexed: 12/19/2022] Open
Abstract
Sustained elimination of leprosy as a global health concern likely requires a vaccine. The current standard, BCG, confers only partial protection and precipitates paucibacillary (PB) disease in some instances. When injected into mice with the T helper 1 (Th1)-biasing adjuvant formulation Glucopyranosyl Lipid Adjuvant in stable emulsion (GLA-SE), a cocktail of three prioritized antigens (ML2055, ML2380 and ML2028) reduced M. leprae infection levels. Recognition and protective efficacy of a single chimeric fusion protein incorporating these antigens, LEP-F1, was confirmed in similar experiments. The impact of post-exposure immunization was then assessed in nine-banded armadillos that demonstrate a functional recapitulation of leprosy. Armadillos were infected with M. leprae 1 month before the initiation of post-exposure prophylaxis. While BCG precipitated motor nerve conduction abnormalities more rapidly and severely than observed for control infected armadillos, motor nerve injury in armadillos treated three times, at monthly intervals with LepVax was appreciably delayed. Biopsy of cutaneous nerves indicated that epidermal nerve fiber density was not significantly altered in M. leprae-infected animals although Remak Schwann cells of the cutaneous nerves in the distal leg were denser in the infected armadillos. Importantly, LepVax immunization did not exacerbate cutaneous nerve involvement due to M. leprae infection, indicating its safe use. There was no intraneural inflammation but a reduction of intra axonal edema suggested that LepVax treatment might restore some early sensory axonal function. These data indicate that post-exposure prophylaxis with LepVax not only appears safe but, unlike BCG, alleviates and delays the neurologic disruptions caused by M. leprae infection. A leprosy vaccine candidate has been developed that raises immune responses against targets gleaned from naturally resistant individuals. Researchers from the United States and Japan, led by Malcolm Duthie, of Seattle’s Infectious Disease Research Institute, tested a Mycobacterium leprae vaccine candidate that generated immune responses mimicking those found in partially-resistant patients, and immune co-inhabitants of the severely infected. The candidate, dubbed LepVax, inhibited infection in mice and, when administered post-infection, delayed and mitigated nerve damage in armadillos. This contrasts with the current vaccine, BCG, which can precipitate leprosy symptoms when given after infection. This study also revealed that M. leprae infection can induce ‘silent’ pre-clinical nerve aberations. High-risk populations may already be infected with M. leprae, making safe and effective post-exposure prophylaxis a landmark step in combating both the individual and global burden of leprosy.
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Affiliation(s)
- Malcolm S Duthie
- 1Infectious Disease Research Institute, 1616 Eastlake Ave E, Suite 400, Seattle, WA 98102 USA
| | - Maria T Pena
- National Hansens Disease Programs, Baton Rouge, LA USA
| | - Gigi J Ebenezer
- 3Department of Neurology, Johns Hopkins University, Baltimore, MD 21209 USA
| | - Thomas P Gillis
- 4Department of Microbiology, Immunology and Parasitology, LSU School of Medicine, New Orleans, LA USA
| | - Rahul Sharma
- National Hansens Disease Programs, Baton Rouge, LA USA
| | - Kelly Cunningham
- 3Department of Neurology, Johns Hopkins University, Baltimore, MD 21209 USA
| | - Michael Polydefkis
- 3Department of Neurology, Johns Hopkins University, Baltimore, MD 21209 USA
| | - Yumi Maeda
- 5Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Masahiko Makino
- 5Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Richard W Truman
- 6Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA USA
| | - Steven G Reed
- 1Infectious Disease Research Institute, 1616 Eastlake Ave E, Suite 400, Seattle, WA 98102 USA
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43
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Marçal PHF, Fraga LADO, Mattos AMMD, Menegati L, Coelho ADCO, Pinheiro RO, Sarno EN, Duthie MS, Teixeira HC. Utility of immunoglobulin isotypes against LID-1 and NDO-LID for, particularly IgG1, confirming the diagnosis of multibacillary leprosy. Mem Inst Oswaldo Cruz 2018. [PMID: 29513821 PMCID: PMC5851060 DOI: 10.1590/0074-02760170467] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Leprosy remains a health problem in many countries, with difficulties in
diagnosis resulting in delayed treatment and more severe disabilities.
Antibodies against several Mycobacterium leprae antigens
have, however, shown value as diagnostic and/or prognostic markers. OBJECTIVES The objective of this study was to evaluate serum immunoglobulin (Ig) IgM
and IgG subclass reactivity against three M. leprae
specific antigens: NDO-HSA, a conjugate formed by natural octyl disaccharide
bound to human serum albumin; LID-1, the fusion protein product of the
ml0405 and ml2331 genes; and NDO-LID, a combination of LID-1 and NDO. METHODS Sera from healthy controls, paucibacillary (PB) and multibacillary (MB)
leprosy patients, and their respective household contacts, were evaluated
for the presence of antigen-specific IgM, IgG, and IgG subclass antibodies
by enzyme-linked immunosorbent assay (ELISA). The sensitivity and
specificity of each ELISA were evaluated by receiver operating
characteristic (ROC) curve analysis. FINDINGS Our data confirm that serum IgM antibodies against NDO-HSA and IgG
antibodies against LID-1, as well as IgG/M antibodies against NDO-LID, are
markedly increased in MB patients. For the first time, our data reveal a
selective increase in IgG1 and IgG3 antibodies against LID-1 and NDO-LID in
MB patients, demonstrating that these antibody isotypes are suitable for
differentiation between MB and PB patients. ROC curve analysis indicates an
improved capacity for diagnosing MB leprosy patients using the detection of
IgG antibodies, particularly the IgG1 isotype, specific to LID-1 and NDO-LID
over the performance levels attained with NDO-HSA. CONCLUSIONS Our findings indicate that serological tests based on the detection of
antigen-specific IgG1 antibodies are a useful tool to differentiate MB from
PB patients, and indicate the enhanced performance of the LID-1 and NDO-LID
antigens in the serodiagnosis of leprosy.
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Affiliation(s)
- Pedro Henrique Ferreira Marçal
- Departamento de Parasitologia, Microbiologia e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brasil
| | | | - Ana Márcia Menezes de Mattos
- Departamento de Parasitologia, Microbiologia e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brasil
| | - Laura Menegati
- Departamento de Parasitologia, Microbiologia e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brasil
| | | | - Roberta Olmo Pinheiro
- Laboratório de Hanseníase, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz-Fiocruz, Rio de Janeiro, RJ, Brasil
| | - Euzenir Nunes Sarno
- Laboratório de Hanseníase, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz-Fiocruz, Rio de Janeiro, RJ, Brasil
| | | | - Henrique Couto Teixeira
- Departamento de Parasitologia, Microbiologia e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brasil
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Muñoz M, Beltrán-Alzate JC, Duthie MS, Serrano-Coll H, Cardona-Castro N. Comparison of Enzyme-Linked Immunosorbent Assay Using Either Natural Octyl Disaccharide-Leprosy IDRI Diagnostic or Phenolic Glycolipid-I Antigens for the Detection of Leprosy Patients in Colombia. Am J Trop Med Hyg 2018; 98:274-277. [PMID: 29141725 DOI: 10.4269/ajtmh.17-0500] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Leprosy is a chronic infectious disease with a broad spectrum of manifestations. Delays in attaining correct diagnosis permit progressive peripheral nerve damage that can produce irreversible disabilities. Tests detecting antigen-specific antibodies can aid the diagnostic process and potentially detect patients earlier. Reported tests have lacked optimal sensitivity and specificity; however, the need to develop new tests to aid early diagnosis still remains. In this study, we determined the sensitivity, specificity, positive predictive value, and negative predictive value of enzyme-linked immunosorbent assay (ELISA) using natural octyl disaccharide-leprosy IDRI diagnostic (NDO-LID). Serum samples from confirmed multibacillary patients (N = 338) and paucibacillary patients (N = 58) were evaluated and contrasted against samples from individuals without leprosy (100 healthy persons, 36 leishmaniasis or tuberculosis patients). ELISA detecting either antigen-specific IgM, IgG, or the combination of IgG and IgM (with protein A) were conducted. At a sensitivity of 78% among all patients, serum IgM antibodies against the NDO-LID conjugate were detected at a greater level than those recognizing phenolic glycolipid-I antigen (64% overall sensitivity), while providing similar specificity (97% versus 100%, respectively). Given the inclusion of the LID-1 protein within NDO-LID, we also detected conjugate-specific IgG within patient sera at a sensitivity of 81.6%. The use of protein A to simultaneously detect both antigen-specific IgG and IgM isotypes yielded the highest overall sensitivity of 86.3%. Taken together, our data indicate that the detection of both IgG and IgM antibodies against NDO-LID with protein A provided the best overall ability to detect Colombian leprosy patients.
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Affiliation(s)
- Mónica Muñoz
- Instituto Colombiano de Medicina Tropical-Universidad CES, Sabaneta, Antioquia, Colombia
| | | | | | | | - Nora Cardona-Castro
- Instituto Colombiano de Medicina Tropical-Universidad CES, Sabaneta, Antioquia, Colombia.,Facultad de Medicina Universidad CES, Medellín, Antioquia, Colombia
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45
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Abstract
Developing new vaccines against emerging pathogens or pathogens where variability of antigenic sites presents a challenge, the inclusion of stimulators of the innate immune system is critical to mature the immune response in a way that allows high avidity recognition while preserving the ability to react to drifted serovars. The innate immune system is an ancient mechanism for recognition of nonself and the first line of defense against pathogen insult. By triggering innate receptors, adjuvants can boost responses to vaccines and enhance the quality and magnitude of the resulting immune response. This chapter: (1) describes the innate immune system, (2) provides examples of how adjuvants are formulated to optimize their effectiveness, and (3) presents examples of how adjuvants can improve outcomes of immunization.
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Affiliation(s)
- Darrick Carter
- PAI Life Sciences Inc., 1616 Eastlake Ave E, Suite 550, Seattle, WA, 98102, USA.
- Adjuvant Technologies, IDRI, 1616 Eastlake Avenue E., Suite 400, Seattle, WA, 98102, USA.
- Global Health, University of Washington, 1616 Eastlake Ave E, Suite 400, Seattle, WA, 98102, USA.
| | - Malcolm S Duthie
- Adjuvant Technologies, IDRI, 1616 Eastlake Avenue E., Suite 400, Seattle, WA, 98102, USA
- Global Health, University of Washington, 1616 Eastlake Ave E, Suite 400, Seattle, WA, 98102, USA
| | - Steven G Reed
- Adjuvant Technologies, IDRI, 1616 Eastlake Avenue E., Suite 400, Seattle, WA, 98102, USA
- Global Health, University of Washington, 1616 Eastlake Ave E, Suite 400, Seattle, WA, 98102, USA
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46
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Duthie MS, Pereira L, Favila M, Hofmeyer KA, Reed SJ, Metangmo S, Townsend S, Laurance JD, Picone A, Misquith A, Hossain F, Ghosh P, Khan MAA, Guderian J, Bailor HR, Liang H, Vergara J, Oliveira F, Howard RF, Kamhawi S, Mondal D, Coler RN, Valenzuela JG, Reed SG. A defined subunit vaccine that protects against vector-borne visceral leishmaniasis. NPJ Vaccines 2017; 2:23. [PMID: 29263878 PMCID: PMC5627294 DOI: 10.1038/s41541-017-0025-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 06/21/2017] [Accepted: 06/29/2017] [Indexed: 11/09/2022] Open
Abstract
Vaccine development for vector-borne pathogens may be accelerated through the use of relevant challenge models, as has been the case for malaria. Because of the demonstrated biological importance of vector-derived molecules in establishing natural infections, incorporating natural challenge models into vaccine development strategies may increase the accuracy of predicting efficacy under field conditions. Until recently, however, there was no natural challenge model available for the evaluation of vaccine candidates against visceral leishmaniasis. We previously demonstrated that a candidate vaccine against visceral leishmaniasis containing the antigen LEISH-F3 could provide protection in preclinical models and induce potent T-cell responses in human volunteers. In the present study, we describe a next generation candidate, LEISH-F3+, generated by adding a third antigen to the LEISH-F3 di-fusion protein. The rationale for adding a third component, derived from cysteine protease (CPB), was based on previously demonstrated protection achieved with this antigen, as well as on recognition by human T cells from individuals with latent infection. Prophylactic immunization with LEISH-F3+formulated with glucopyranosyl lipid A adjuvant in stable emulsion significantly reduced both Leishmania infantum and L. donovani burdens in needle challenge mouse models of infection. Importantly, the data obtained in these infection models were validated by the ability of LEISH-F3+/glucopyranosyl lipid A adjuvant in stable emulsion to induce significant protection in hamsters, a model of both infection and disease, following challenge by L. donovani-infected Lutzomyia longipalpis sand flies, a natural vector. This is an important demonstration of vaccine protection against visceral leishmaniasis using a natural challenge model.
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Affiliation(s)
- Malcolm S. Duthie
- Infectious Disease Research Institute, 1616 Eastlake Avenue East, Suite 400, Seattle, WA 98102 USA
| | - Lais Pereira
- Vector Molecular Biology Section, Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD 20852 USA
| | - Michelle Favila
- Infectious Disease Research Institute, 1616 Eastlake Avenue East, Suite 400, Seattle, WA 98102 USA
| | - Kimberly A. Hofmeyer
- Infectious Disease Research Institute, 1616 Eastlake Avenue East, Suite 400, Seattle, WA 98102 USA
| | - S. Jim Reed
- Infectious Disease Research Institute, 1616 Eastlake Avenue East, Suite 400, Seattle, WA 98102 USA
| | - Sonia Metangmo
- Vector Molecular Biology Section, Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD 20852 USA
| | - Shannon Townsend
- Vector Molecular Biology Section, Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD 20852 USA
| | - John D. Laurance
- Infectious Disease Research Institute, 1616 Eastlake Avenue East, Suite 400, Seattle, WA 98102 USA
| | - Alessandro Picone
- Infectious Disease Research Institute, 1616 Eastlake Avenue East, Suite 400, Seattle, WA 98102 USA
| | - Ayesha Misquith
- Infectious Disease Research Institute, 1616 Eastlake Avenue East, Suite 400, Seattle, WA 98102 USA
| | - Faria Hossain
- International Center for Diarrhoeal Diseases Research, Laboratory Sciences Division, Dhaka, Bangladesh
| | - Prakash Ghosh
- International Center for Diarrhoeal Diseases Research, Laboratory Sciences Division, Dhaka, Bangladesh
| | - Md Anik Ashfaq Khan
- International Center for Diarrhoeal Diseases Research, Laboratory Sciences Division, Dhaka, Bangladesh
| | - Jeffery Guderian
- Infectious Disease Research Institute, 1616 Eastlake Avenue East, Suite 400, Seattle, WA 98102 USA
| | - H. Remy Bailor
- Infectious Disease Research Institute, 1616 Eastlake Avenue East, Suite 400, Seattle, WA 98102 USA
| | - Hong Liang
- Infectious Disease Research Institute, 1616 Eastlake Avenue East, Suite 400, Seattle, WA 98102 USA
| | - Julie Vergara
- Infectious Disease Research Institute, 1616 Eastlake Avenue East, Suite 400, Seattle, WA 98102 USA
| | - Fabiano Oliveira
- Vector Molecular Biology Section, Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD 20852 USA
| | - Randall F. Howard
- Infectious Disease Research Institute, 1616 Eastlake Avenue East, Suite 400, Seattle, WA 98102 USA
| | - Shaden Kamhawi
- Vector Molecular Biology Section, Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD 20852 USA
| | - Dinesh Mondal
- International Center for Diarrhoeal Diseases Research, Laboratory Sciences Division, Dhaka, Bangladesh
| | - Rhea N. Coler
- Infectious Disease Research Institute, 1616 Eastlake Avenue East, Suite 400, Seattle, WA 98102 USA
| | - Jesus G. Valenzuela
- Vector Molecular Biology Section, Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD 20852 USA
| | - Steven G. Reed
- Infectious Disease Research Institute, 1616 Eastlake Avenue East, Suite 400, Seattle, WA 98102 USA
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47
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Santos MB, de Oliveira DT, Cazzaniga RA, Varjão CS, Dos Santos PL, Santos MLB, Correia CB, Faria DR, Simon MDV, Silva JS, Dutra WO, Reed SG, Duthie MS, de Almeida RP, de Jesus AR. Distinct Roles of Th17 and Th1 Cells in Inflammatory Responses Associated with the Presentation of Paucibacillary Leprosy and Leprosy Reactions. Scand J Immunol 2017; 86:40-49. [PMID: 28426172 DOI: 10.1111/sji.12558] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 04/13/2017] [Indexed: 01/08/2023]
Abstract
It is well established that helper T cell responses influence resistance or susceptibility to Mycobacterium leprae infection, but the role of more recently described helper T cell subsets in determining severity is less clear. To investigate the involvement of Th17 cells in the pathogenesis of leprosy, we determined the immune profile with variant presentations of leprosy. Firstly, IL-17A, IFN-γ and IL-10 were evaluated in conjunction with CD4+ T cell staining by confocal microscopy of lesion biopsies from tuberculoid (TT) and lepromatous leprosy (LL) patients. Secondly, inflammatory cytokines were measured by multiplex assay of serum samples from Multibacillary (MB, n = 28) and Paucibacillary (PB, n = 23) patients and household contacts (HHC, n = 23). Patients with leprosy were also evaluated for leprosy reaction occurrence: LR+ (n = 8) and LR- (n = 20). Finally, peripheral blood mononuclear cells were analysed by flow cytometry used to determine the phenotype of cytokine-producing cells. Lesions from TT patients were found to have more CD4+ IL-17A+ cells than those from LL patients. Higher concentrations of IL-17A and IL-1β were observed in serum from PB than MB patients. The highest serum IFN-γ concentrations were, however, detected in sera from MB patients that developed leprosy reactions (MB LR+ ). Together, these results indicate that Th1 cells were associated with both the PB presentation and also with leprosy reactions. In contrast, Th17 cells were associated with an effective inflammatory response that is present in the PB forms but were not predictive of leprosy reactions in MB patients.
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Affiliation(s)
- M B Santos
- Laboratory of Molecular Biology, Universidade Federal de Sergipe (UFS), Sao Cristovao, Brazil.,Infectious Diseases Research Institute (IDRI), Seattle, WA, USA
| | - D T de Oliveira
- Laboratory of Molecular Biology, Universidade Federal de Sergipe (UFS), Sao Cristovao, Brazil
| | - R A Cazzaniga
- Laboratory of Molecular Biology, Universidade Federal de Sergipe (UFS), Sao Cristovao, Brazil
| | - C S Varjão
- Laboratory of Molecular Biology, Universidade Federal de Sergipe (UFS), Sao Cristovao, Brazil
| | - P L Dos Santos
- Laboratory of Molecular Biology, Universidade Federal de Sergipe (UFS), Sao Cristovao, Brazil
| | - M L B Santos
- Laboratory of Molecular Biology, Universidade Federal de Sergipe (UFS), Sao Cristovao, Brazil
| | - C B Correia
- Laboratory of Molecular Biology, Universidade Federal de Sergipe (UFS), Sao Cristovao, Brazil
| | - D R Faria
- Laboratory of Biologia das Interações Celulares, Department of Morphology, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - M do V Simon
- Laboratory of Molecular Biology, Universidade Federal de Sergipe (UFS), Sao Cristovao, Brazil
| | - J S Silva
- Department of Biochemistry and Immunology, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, Brazil
| | - W O Dutra
- Laboratory of Biologia das Interações Celulares, Department of Morphology, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - S G Reed
- Infectious Diseases Research Institute (IDRI), Seattle, WA, USA
| | - M S Duthie
- Infectious Diseases Research Institute (IDRI), Seattle, WA, USA
| | - R P de Almeida
- Laboratory of Molecular Biology, Universidade Federal de Sergipe (UFS), Sao Cristovao, Brazil.,Departament of Medicine (UFS), Sergipe, Brazil.,Instituto de Investigacão em Imunologia, INCT, CNPq, São Paulo, Brazil
| | - A R de Jesus
- Laboratory of Molecular Biology, Universidade Federal de Sergipe (UFS), Sao Cristovao, Brazil.,Departament of Medicine (UFS), Sergipe, Brazil.,Instituto de Investigacão em Imunologia, INCT, CNPq, São Paulo, Brazil
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48
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Silva RLL, Santos MB, Almeida PLS, Barros TS, Magalhães L, Cazzaniga RA, Souza PRM, Luz NF, França-Costa J, Borges VM, Lima-Junior DS, Lipscomb MW, Duthie MS, Reed SG, Almeida RP, Jesus AR. sCD163 levels as a biomarker of disease severity in leprosy and visceral leishmaniasis. PLoS Negl Trop Dis 2017; 11:e0005486. [PMID: 28355218 PMCID: PMC5386291 DOI: 10.1371/journal.pntd.0005486] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 04/10/2017] [Accepted: 03/13/2017] [Indexed: 01/10/2023] Open
Abstract
Background CD163, receptor for the haptoglobin–hemoglobin complex, is expressed on monocytes/macrophages and neutrophils. A soluble form of CD163 (sCD163) has been associated with the M2 macrophage phenotype, and M2 macrophages have been shown to down-modulate inflammatory responses. In particular, previous studies have shown that M2 is closely associated with the most severe clinical presentation of leprosy (i.e. lepromatous leprosy (LL)), as well as tuberculosis. We hypothesized that sCD163 correlates with severity of diseases caused by intracellular pathogens. Methodology/Principal findings To assess this hypothesis, sCD163 levels were measured in the serum of leprosy and visceral leishmaniasis (VL) patients stratified by severity of the clinical presentation. sCD163 levels were significantly higher in patients with these diseases than those observed in healthy control individuals. Further analyses on infection and disease status of leprosy and VL patients revealed a clear association of sCD163 levels with clinical parameters of disease severity. In vitro culture assays revealed that Leishmania infection induced CD163 expression on the surface of both monocyte/macrophages and neutrophils, suggesting these cells as possible sources of sCD163. FACS analyses shows that the cells expressing CD163 produces both TNF-α and IL-4. Conclusions/Significance Taken together, our results reveal sCD163 as a potential biomarker of severity of diseases caused by intracellular pathogens M. leprae and Leishmania spp. and have a modulatory role, with a mix of an inflammatory property induced by TNF-α release, but that potentially induces an anti-inflammatory T cell response, related to IL-4 release. Visceral leishmaniasis (VL) is a systemic, and most severe form of leishmaniasis. Soluble CD163 (sCD163) levels can serve as biomarker for disease severity in several inflammatory disorders. However, no linkage has been reported for its relationship with Leishmania infections. We now demonstrate, for the first time, that sCD163 is increased in VL patients, and its presence is directly correlated to clinical parameters of disease severity. In vitro infection of monocyte-derived macrophages and neutrophils with L. infantum and L. amazonensis induces, while BCG reduce the expression of CD163 on macrophage surface Furthermore, presence of sCD163 is reduced during clinical improvements. Taken together, results reveal an important role for sCD163 in immune modulation during disease progression, and suggest a potential role as biomarker for determining disease severity and clearance.
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Affiliation(s)
- Ricardo Luís Louzada Silva
- Laboratório de Biologia Molecular–Hospital Universitário–Universidade Federal de Sergipe–Aracaju—Brazil
- Departamento de Educação em Saúde de Lagarto–Universidade Federal de Sergipe–Lagarto–Brazil
| | - Marcio B. Santos
- Laboratório de Biologia Molecular–Hospital Universitário–Universidade Federal de Sergipe–Aracaju—Brazil
- Departamento de Educação em Saúde de Lagarto–Universidade Federal de Sergipe–Lagarto–Brazil
| | - Priscila L. S. Almeida
- Laboratório de Biologia Molecular–Hospital Universitário–Universidade Federal de Sergipe–Aracaju—Brazil
- Departamento de Educação em Saúde de Lagarto–Universidade Federal de Sergipe–Lagarto–Brazil
| | - Thayse S. Barros
- Laboratório de Biologia Molecular–Hospital Universitário–Universidade Federal de Sergipe–Aracaju—Brazil
| | - Lucas Magalhães
- Laboratório de Biologia Molecular–Hospital Universitário–Universidade Federal de Sergipe–Aracaju—Brazil
| | - Rodrigo A. Cazzaniga
- Laboratório de Biologia Molecular–Hospital Universitário–Universidade Federal de Sergipe–Aracaju—Brazil
| | - Patrícia R. M. Souza
- Laboratório de Biologia Molecular–Hospital Universitário–Universidade Federal de Sergipe–Aracaju—Brazil
- Departamento de Educação em Saúde de Lagarto–Universidade Federal de Sergipe–Lagarto–Brazil
| | - Nívea F. Luz
- Centro de Pesquisas Gonçalo Moniz (CPqGM), Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Brazil
| | - Jaqueline França-Costa
- Centro de Pesquisas Gonçalo Moniz (CPqGM), Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Brazil
| | - Valeria M. Borges
- Centro de Pesquisas Gonçalo Moniz (CPqGM), Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Brazil
| | - Djalma S. Lima-Junior
- Departamento de Bioquímica e Imunologia–Faculdade de Medicina de Ribeirão Preto–Universidade de São Paulo–Ribeirão Preto–Brazil
| | - Michael W. Lipscomb
- Department of Biology, Howard University, Washington–DC–United States of America
| | - Malcolm S. Duthie
- Infectious Diseases Research Institute (IDRI)–Seattle–WA–United States of America
| | - Steven G. Reed
- Infectious Diseases Research Institute (IDRI)–Seattle–WA–United States of America
| | - Roque Pacheco Almeida
- Laboratório de Biologia Molecular–Hospital Universitário–Universidade Federal de Sergipe–Aracaju—Brazil
| | - Amélia Ribeiro Jesus
- Laboratório de Biologia Molecular–Hospital Universitário–Universidade Federal de Sergipe–Aracaju—Brazil
- * E-mail:
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49
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Rada EM, Duthie MS, BELLORÍN D, Morales S, Crespo L. Clinical Presentation and Serum Antibody Reactivity of Leprosy Patients Attending a Dermatology Clinic in Caracas, Venezuela. LEPROSY REV 2017. [DOI: 10.47276/lr.88.1.131] [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: 11/04/2022]
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50
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Frade MAC, de Paula NA, Gomes CM, Vernal S, Bernardes Filho F, Lugão HB, de Abreu MMM, Botini P, Duthie MS, Spencer JS, Soares RCFR, Foss NT. Unexpectedly high leprosy seroprevalence detected using a random surveillance strategy in midwestern Brazil: A comparison of ELISA and a rapid diagnostic test. PLoS Negl Trop Dis 2017; 11:e0005375. [PMID: 28231244 PMCID: PMC5358972 DOI: 10.1371/journal.pntd.0005375] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Revised: 03/20/2017] [Accepted: 01/30/2017] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Leprosy diagnosis is mainly based on clinical evaluation, although this approach is difficult, especially for untrained physicians. We conducted a temporary campaign to detect previously unknown leprosy cases in midwestern Brazil and to compare the performance of different serological tests. METHODS A mobile clinic was stationed at the main bus terminal in Brasília, Brazil. Volunteers were quizzed and given a clinical exam to allow categorization as either patients, known contacts of patients or non-contacts, and blood was collected to determine anti-PGL-I and anti-LID-1 antibody titers by ELISA and by the NDO-LID rapid test. New cases of leprosy and the impact of performing this broad random surveillance strategy were evaluated. Accuracy values and concordance between the test results were evaluated among all groups. RESULTS Four hundred thirty-four individuals were evaluated, and 44 (10.1%) were diagnosed with leprosy. Borderline forms were the most frequent presentation. Both tests presented higher positivity in those individuals with multibacillary disease. Serological tests demonstrated specificities arround 70% for anti-PGL-1 and anti-LID ELISA; and arround 40% for NDO-LID. Sensitivities ranged from 48 to 62%. A substantial agreement between NDO-LID and ELISA with concomitant positive results was found within leprosy patients (Kappa index = 0.79 CI95% 0.36-1.22). CONCLUSIONS The unexpectedly high leprosy prevalence in this population indicates ongoing community-based exposure to Mycobacterium leprae antigens and high rates of subclinical infection. All tests showed low specificity and sensitivity values and therefore cannot be considered for use as stand-alone diagnostics. Rather, considering their positivity among MB patients and non-patients, these tests can be considered effective tools for screening and identifying individuals at high risk who might benefit from regular monitoring.
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Affiliation(s)
- Marco Andrey C. Frade
- Dermatology Division, Department of Medical Clinics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- * E-mail:
| | - Natália A. de Paula
- Dermatology Division, Department of Medical Clinics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Ciro M. Gomes
- Dermatology Division, Department of Medical Clinics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- Dermatology Division, Department of Medical Clinics, Faculty of Medicine, University of Brasília, Brasília, Brazil
| | - Sebastian Vernal
- Dermatology Division, Department of Medical Clinics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Fred Bernardes Filho
- Dermatology Division, Department of Medical Clinics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Helena B. Lugão
- Dermatology Division, Department of Medical Clinics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Patrícia Botini
- Service of Dermatology, University of Oeste Paulista, Presidente Prudente, Brazil
| | - Malcolm S. Duthie
- Infectious Diseases Research Institute, 1616 Eastlake Av. E, Seattle, WA, United States of America
| | - John S. Spencer
- Colorado State University, Department of Microbiology, Immunology and Pathology, Fort Collins, CO, United States of America
| | - Rosa Castália F. R. Soares
- General Coordination of Leprosy and Eliminating Diseases, Surveillance Secretariat in Health, Brazilian Health Ministry, Brasília, Distrito Federal, Brazil
| | - Norma T. Foss
- Dermatology Division, Department of Medical Clinics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
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