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Castillo G, Fustamante L, Delgado-Kamiche AD, Camen-Orozco RP, Clark T, Bernal E, Morales-Alvarez J, Ferrufino M, Mamani-Palomino J, Bustos JA, Garcia HH, Gavidia CM, Gilman RH, Verastegui M. Understanding the pathogenic mechanisms and therapeutic effects in neurocysticercosis. Brain Pathol 2024:e13237. [PMID: 38212958 DOI: 10.1111/bpa.13237] [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: 09/25/2023] [Accepted: 01/01/2024] [Indexed: 01/13/2024] Open
Abstract
Despite being a leading cause of acquired seizures in endemic regions, the pathological mechanisms of neurocysticercosis are still poorly understood. This study aims to investigate the impact of anthelmintic treatment on neuropathological features in a rat model of neurocysticercosis. Rats were intracranially infected with Taenia solium oncospheres and treated with albendazole + praziquantel (ABZ), oxfendazole + praziquantel (OXF), or untreated placebo (UT) for 7 days. Following the last dose of treatment, brain tissues were evaluated at 24 h and 2 months. We performed neuropathological assessment for cyst damage, perilesional brain inflammation, presence of axonal spheroids, and spongy changes. Both treatments showed comparable efficacy in cyst damage and inflammation. The presence of spongy change correlated with spheroids counts and were not affected by anthelmintic treatment. Compared to white matter, gray matter showed greater spongy change (91.7% vs. 21.4%, p < 0.0001), higher spheroids count (45.2 vs. 0.2, p = 0.0001), and increased inflammation (72.0% vs. 21.4%, p = 0.003). In this rat model, anthelmintic treatment destroyed brain parasitic cysts at the cost of local inflammation similar to what is described in human neurocysticercosis. Axonal spheroids and spongy changes as markers of damage were topographically correlated, and not affected by anthelmintic treatment.
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Affiliation(s)
- Gino Castillo
- Infectious Diseases Laboratory Research-LID, Facultad de Ciencia e Ingeniería, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Lizbeth Fustamante
- Infectious Diseases Laboratory Research-LID, Facultad de Ciencia e Ingeniería, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Ana D Delgado-Kamiche
- Infectious Diseases Laboratory Research-LID, Facultad de Ciencia e Ingeniería, Universidad Peruana Cayetano Heredia, Lima, Peru
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, United States
| | - Rogger P Camen-Orozco
- Infectious Diseases Laboratory Research-LID, Facultad de Ciencia e Ingeniería, Universidad Peruana Cayetano Heredia, Lima, Peru
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, United States
| | - Taryn Clark
- The Department of International Health, Bloomberg School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Emergency Medicine, SUNY Downstate Medical Center, Kings County Hospital Medical Center, Brooklyn, New York, New York, United States
| | - Edson Bernal
- Infectious Diseases Laboratory Research-LID, Facultad de Ciencia e Ingeniería, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Jemima Morales-Alvarez
- Infectious Diseases Laboratory Research-LID, Facultad de Ciencia e Ingeniería, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Maria Ferrufino
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Javier Mamani-Palomino
- Facultad de Medicina Veterinaria y Salud animal, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Javier A Bustos
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Hector H Garcia
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Cesar M Gavidia
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Robert H Gilman
- The Department of International Health, Bloomberg School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Manuela Verastegui
- Infectious Diseases Laboratory Research-LID, Facultad de Ciencia e Ingeniería, Universidad Peruana Cayetano Heredia, Lima, Peru
- Asociación Benéfica Prisma, Lima, Peru
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2
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Tataje-Lavanda L, Málaga E, Verastegui M, Mayta Huatuco E, Icochea E, Fernández-Díaz M, Zimic M. Identification and evaluation in-vitro of conserved peptides with high affinity to MHC-I as potential protective epitopes for Newcastle disease virus vaccines. BMC Vet Res 2023; 19:196. [PMID: 37805566 PMCID: PMC10559636 DOI: 10.1186/s12917-023-03726-w] [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: 03/15/2023] [Accepted: 09/12/2023] [Indexed: 10/09/2023] Open
Abstract
BACKGROUND Newcastle disease (ND) is a major threat to the poultry industry, leading to significant economic losses. The current ND vaccines, usually based on active or attenuated strains, are only partially effective and can cause adverse effects post-vaccination. Therefore, the development of safer and more efficient vaccines is necessary. Epitopes represent the antigenic portion of the pathogen and their identification and use for immunization could lead to safer and more effective vaccines. However, the prediction of protective epitopes for a pathogen is a major challenge, especially taking into account the immune system of the target species. RESULTS In this study, we utilized an artificial intelligence algorithm to predict ND virus (NDV) peptides that exhibit high affinity to the chicken MHC-I complex. We selected the peptides that are conserved across different NDV genotypes and absent in the chicken proteome. From the filtered peptides, we synthesized the five peptides with the highest affinities for the L, HN, and F proteins of NDV. We evaluated these peptides in-vitro for their ability to elicit cell-mediated immunity, which was measured by the lymphocyte proliferation in spleen cells of chickens previously immunized with NDV. CONCLUSIONS Our study identified five peptides with high affinity to MHC-I that have the potential to serve as protective epitopes and could be utilized for the development of multi-epitope NDV vaccines. This approach can provide a safer and more efficient method for NDV immunization.
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Affiliation(s)
- Luis Tataje-Lavanda
- Research and Development Laboratories, FARVET SAC, Chincha Alta, Ica, Peru.
- Laboratory of Clinical Molecular Virology, Faculty of Biological Sciences, National University of San Marcos, Lima, Peru.
- School of Human Medicine, Private University San Juan Bautista, Lima, Peru.
| | - Edith Málaga
- Research Laboratory On Infectious Diseases, Cayetano Heredia Peruvian University, Lima, Peru
| | - Manuela Verastegui
- Research Laboratory On Infectious Diseases, Cayetano Heredia Peruvian University, Lima, Peru
| | - Egma Mayta Huatuco
- Laboratory of Clinical Molecular Virology, Faculty of Biological Sciences, National University of San Marcos, Lima, Peru
| | - Eliana Icochea
- Avian Pathology Laboratory, Faculty of Veterinary Medicine, National University of San Marcos, Lima, Peru
| | | | - Mirko Zimic
- Research and Development Laboratories, FARVET SAC, Chincha Alta, Ica, Peru
- Bioinformatics, Molecular Biology, and Technological Developments Laboratory, Faculty of Science and Philosophy, Cayetano Heredia Peruvian University, Lima, Peru
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Zavaleta-Cortijo C, Cade J, Ford J, Greenwood DC, Carcamo C, Silvera-Ccallo R, Fernandez-Neyra C, Lancha-Rucoba G, Pizango-Tangoa M, Pizango-Inuma R, Chanchari-Huiñapi J, Velez-Quevedo J, Inuma-Tangoa N, Antazu T, Miranda-Cuadros M, Aparco JP, Aro-Guardia P, Verastegui M, Morales-Ancajima V, Bressan T, Miranda JJ. Does food biodiversity protect against malnutrition and favour the resilience to climate change-related events in Amazon Indigenous communities? A protocol for a mixed methods study. Wellcome Open Res 2023; 7:246. [PMID: 38463717 PMCID: PMC10924752 DOI: 10.12688/wellcomeopenres.18235.1] [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] [Accepted: 06/15/2023] [Indexed: 03/12/2024] Open
Abstract
Background : Undernutrition is projected to be a major consequence of climate change. Biodiversity could enhance climate change resilience by improving nutritional outcomes and providing healthy food resources during and/or after climate-related events. For Indigenous populations who currently base their diet on local biodiversity, rapid climate changes may affect their ability to produce, access or gather food and consequently impact their nutritional status. There is a knowledge gap regarding whether nutritional status among Indigenous populations is better among those who consume a diet with greater biodiversity than those who have a diet with low biodiversity. Objective : This study aims to investigate the role of food biodiversity (FBD) in nutritional resilience to extreme flooding events of Shawi Amazon Indigenous adults living in Peruvian communities that have experienced extreme floods in the past five years. Methods : This study will use a mixed-method sequential explanatory design. The quantitative component includes a cross-sectional survey to assess the association between food biodiversity (FBD) and the prevalence of anaemia in adults aged 15 to 60 years old (n=365). Anaemia will be evaluated using blood hemoglobin and serum ferritin. FBD will be measured with a food frequency questionnaire and a 24-hour dietary recall. Soil-transmitted helminth infections, malaria, and inflammatory biomarkers will also be evaluated. The qualitative component will include a community-based participatory approach to investigate the role of FBD in the responses to extreme floods. Male (n=14) and female (n=14) participants, previously identified in the quantitative phase with high and low levels of FBD, will be invited to participate in a Photovoice activity and semi-structured interviews. A analytical framework for climate change resilience will be used to integrate the data. Discussion : Findings will be integrated to identify nutritional resilience indicators that can inform adaptative interventions to changing climatic conditions in the Amazon and that respect Indigenous worldviews.
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Affiliation(s)
- Carol Zavaleta-Cortijo
- Unidad de Ciudadanía Intercultural y Salud Indígena, Facultad de Salud Pública y Administración,, Universidad Peruana Cayetano Heredia, San Martín de Porres, Lima, 15102, Peru
| | - Janet Cade
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, LS 2 9JT, UK
| | - James Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, LS 2 9JT, UK
| | | | - Cesar Carcamo
- Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, San Martín de Porres, Lima, 15102, Peru
| | - Rosa Silvera-Ccallo
- Unidad de Ciudadanía Intercultural y Salud Indígena, Facultad de Salud Pública y Administración,, Universidad Peruana Cayetano Heredia, San Martín de Porres, Lima, 15102, Peru
| | | | | | | | | | | | - Jorge Velez-Quevedo
- Taller Verde, Caserio San Luis s/n , Carretera Munichis, San Rafael, Yurimaguas, Peru
| | - Nerita Inuma-Tangoa
- Comunidad de Palmiche, Pueblo Indígena Shawi, cuenca del río Sillay, Loreto, Peru
| | - Teresita Antazu
- Programa Mujer, Asociación Interétnica de Desarrollo de la Selva Peruana (AIDESEP), La Victoria, Lima, 15034, Peru
| | - Marianella Miranda-Cuadros
- Centro Nacional de Alimentación y Nutrición, Instituto Nacional de Salud, Jesús María, Lima, 15072, Peru
| | - Juan Pablo Aparco
- Centro Nacional de Alimentación y Nutrición, Instituto Nacional de Salud, Jesús María, Lima, 15072, Peru
| | - Pedro Aro-Guardia
- Centro de Hemoterapia y Banco de Sangre, Hospital Nacional Cayetano Heredia, San Martín de Porres, Lima, 15102, Peru
| | - Manuela Verastegui
- Infectious Diseases Research Laboratory of the LID, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, San Martín de Porres, Lima, 15102, Peru
| | - Valeria Morales-Ancajima
- Unidad de Ciudadanía Intercultural y Salud Indígena, Facultad de Salud Pública y Administración,, Universidad Peruana Cayetano Heredia, San Martín de Porres, Lima, 15102, Peru
| | - Tiana Bressan
- Department of Engineering, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - J. Jaime Miranda
- Facultad de Medicina, Universidad Peruana Cayetano Heredia, Miraflores, Lima, 15074, Peru
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Win S, Miranda-Schaeubinger M, Gustavo Durán Saucedo R, Carballo Jimenez P, Flores J, Mercado-Saavedra B, Camila Telleria L, Raafs A, Verastegui M, Bern C, Tinajeros F, Heymans S, Marcus R, Gilman RH, Mukherjee M. Early identification of patients with Chagas disease at risk of developing cardiomyopathy using 2-D speckle tracking strain. IJC Heart & Vasculature 2022; 41:101060. [PMID: 35647262 PMCID: PMC9136131 DOI: 10.1016/j.ijcha.2022.101060] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/27/2022] [Accepted: 05/17/2022] [Indexed: 11/20/2022]
Abstract
What is already known about this subject? Speckle-tracking strain echocardiography (STE) is added to conventional echocardiography and has been shown to detect subclinical myocardial contractile dysfunction before a reduction in LVEF. What does this study add? In this study, we evaluate the utility of LV STE for predicting worsening CCC in patients with Chagas disease. How might this impact on clinical practice? Screening for changes in STE-based Global Longitudinal Strain (GLS) may provide a non-invasive approach to identify patients who could benefit from earlier management, such as more frequent follow-up or initiation of treatment.
Background Chagas disease is an endemic protozoan disease with high prevalence in Latin America. Of those infected, 20–30% will develop chronic Chagas cardiomyopathy (CCC) however, prediction using existing clinical criteria remains poor. In this study, we investigated the utility of left ventricular (LV) echocardiographic speckle-tracking global longitudinal strain (GLS) for early detection of CCC. Methods and results 139 asymptomatic T. cruzi seropositive subjects with normal heart size and normal LV ejection fraction (EF) (stage A or B) were enrolled in this prospective observational study and underwent paired echocardiograms at baseline and 1-year follow-up. Progressors were participants classified as stage C or D at follow-up due to development of symptoms of heart failure, cardiomegaly, or decrease in LVEF. LV GLS was calculated as the average peak systolic strain of 16 LV segments. Measurements were compared between participants who progressed and did not progress by two-sample t-test, and the odds of progression assessed by multivariable logistic regression. Of the 139 participants, 69.8% were female, mean age 55.8 ± 12.5 years, with 12 (8.6%) progressing to Stage C or D at follow-up. Progressors tended to be older, male, with wider QRS duration. LV GLS was −19.0% in progressors vs. –22.4% in non-progressors at baseline, with 71% higher odds of progression per +1% of GLS (adjusted OR 1.71, 95% CI 1.20–2.44, p = 0.003). Conclusion Baseline LV GLS in participants with CCC stage A or B was predictive of progression within 1-year and may guide timing of clinical follow-up and promote early detection or treatment.
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Affiliation(s)
- Sithu Win
- University of California San Francisco, San Francisco, CA, USA
- Corresponding author.
| | | | | | | | - Jorge Flores
- Universidad Católica Boliviana San Pablo, Bolivia
| | | | | | - Anne Raafs
- Maastricht University, Cardiovascular Research Institute Maastricht (CARIM), Division of Cardiology, Maastricht, Netherlands
| | | | - Caryn Bern
- University of California San Francisco, San Francisco, CA, USA
| | | | - Stephane Heymans
- Maastricht University, Cardiovascular Research Institute Maastricht (CARIM), Division of Cardiology, Maastricht, Netherlands
| | - Rachel Marcus
- MedStar Heart & Vascular Institute, Baltimore, MD, USA
| | - Robert H. Gilman
- Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
| | - Monica Mukherjee
- Johns Hopkins University, Division of Cardiology, Baltimore, MD, USA
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5
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Clark T, Verastegui M, Tinajeros F, Calderon M, Colanzi R, Gilman RH. Building Public Health Capacity through a Sustainable South-South-North Training Program. Am J Trop Med Hyg 2020; 103:2581-2583. [PMID: 32901595 PMCID: PMC7695069 DOI: 10.4269/ajtmh.20-0273] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Capacity building in public health is an urgent global priority. Recently, there has been an increasing emphasis on South–South and triangular cooperation. We describe our experience with a public health training collaboration between Peru and Bolivia, with Peru providing capacity building and expertise to Bolivia, while receiving supportive funding and training from the United States. This collaboration has led to a groundswell of research on clinically significant diseases, outreach to more than 800 scientists, several dozen publications, and the start of four institutional review boards. South–South and South–South–North collaborations should publish their experiences, and Northern funding organizations should consider funding such collaborations.
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Affiliation(s)
- Taryn Clark
- Department of Emergency Medicine, SUNY Downstate Medical Center, New York, New York.,A.B Prisma, Lima, Peru.,Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.,Kings County Hospital Center, New York, New York
| | - Manuela Verastegui
- Department of Cellular and Molecular Sciences, Universidad Peruana Cayetano Heredia, Lima, Peru.,A.B Prisma, Lima, Peru
| | | | - Maritza Calderon
- Infectious Diseases Research Laboratory, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Rony Colanzi
- Hospital Universitario Japones, Santa Cruz de la Sierra, Plurinational State of Bolivia
| | - Robert H Gilman
- Infectious Diseases Research Laboratory, Universidad Peruana Cayetano Heredia, Lima, Peru.,A.B Prisma, Lima, Peru.,Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
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Jara LM, Rodriguez M, Altamirano F, Herrera A, Verastegui M, Gímenez-Lirola LG, Gilman RH, Gavidia CM. Development and Validation of a Copro-Enzyme-Linked Immunosorbent Assay Sandwich for Detection of Echinococcus granulosus-Soluble Membrane Antigens in Dogs. Am J Trop Med Hyg 2019; 100:330-335. [PMID: 30526746 DOI: 10.4269/ajtmh.18-0645] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Cystic echinococcosis (CE) is a parasitic zoonosis caused by the larval stage of the tapeworm Echinococcus granulosus. Detection of the adult stage in the canine definitive host is essential for estimating infection rates, surveillance and monitoring of CE control programs. This study sought to develop and validate a coproantigen sandwich enzyme-linked immunosorbent assay (copro-ELISA), based on antibodies against E. granulosus-soluble membrane antigens (EGMA), that is capable of distinguishing infected and noninfected dogs. Anti-E. granulosus polyclonal immunoglobulin G antibodies were obtained from rabbit antiserum against EGMA. Optimization of the test was performed with 51 positive and 56 negative stool samples of canine echinococcosis. Specificity, sensitivity, cross-reactivity, intra- and inter-assay precision, and over time detection were evaluated. According to the receiver operating characteristic analysis, the diagnostic sensitivity and specificity were 96.1% (CI: 85.9-99.6) and 98.2% (CI: 89.5-100), respectively. Negative and positive predictive values were 96.5% (CI: 91.7-100) and 98% (CI: 94.1-100), respectively. No cross-reactivity with Taenia hydatigena, Dipylidium caninum, or Toxocara canis was observed. Intra- and inter-assay repeatability showed values of less than 15% of the variation coefficient. The over time detection was from 20 to 27 days postinfection with E. granulosus. The copro-ELISA based on EGMA detection offers a simplified in-house development of diagnostic testing. This assay showed high specificity and sensitivity and had no cross-reactivity with other parasites. Further studies and development of this test in a kit format may be useful for the detection of active infection in dogs living in CE endemic regions.
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Affiliation(s)
- Luis M Jara
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Magaly Rodriguez
- Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Faride Altamirano
- Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Perú
| | - Antonio Herrera
- Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Perú
| | - Manuela Verastegui
- Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú
| | | | - Robert H Gilman
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Cesar M Gavidia
- Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Perú
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Mayta H, Romero YK, Pando A, Verastegui M, Tinajeros F, Bozo R, Henderson-Frost J, Colanzi R, Flores J, Lerner R, Bern C, Gilman RH. Improved DNA extraction technique from clot for the diagnosis of Chagas disease. PLoS Negl Trop Dis 2019; 13:e0007024. [PMID: 30633743 PMCID: PMC6329489 DOI: 10.1371/journal.pntd.0007024] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 11/26/2018] [Indexed: 11/30/2022] Open
Abstract
Background The detection of Trypanosoma cruzi genetic material in clinical samples is considered an important diagnostic tool for Chagas disease. We have previously demonstrated that PCR using clot samples yields greater sensitivity than either buffy coat or whole blood samples. However, phenol-chloroform DNA extraction from clot samples is difficult and toxic. The objective of the present study was to improve and develop a more sensitive method to recover parasite DNA from clot samples for the diagnosis of Chagas disease. Methodology/Principal findings A total of 265 match pair samples of whole blood–guanidine (GEB) and clot samples were analyzed; 150 were from Chagas seropositive subjects. DNA was extracted from both whole blood-guanidine samples, using a previously standardized methodology, and from clot samples, using a newly developed methodology based on a combination of the FastPrep technique and the standard method for GEB extraction. A qPCR targeting the nuclear satellite sequences was used to compare the sample source and the extraction method. Of the 150 samples from Chagas positive individuals by serology, 47 samples tested positive by qPCR with DNA extracted by both GEB and clot, but an additional 13 samples tested positive only in DNA extracted from clot. No serology-negative samples resulted positive when tested by qPCR. Conclusions The new methodology for DNA extraction from clot samples improves the molecular diagnosis of Chagas disease. Detection of nucleic acid has become an important tool for the diagnosis of Chagas disease. Whole blood samples are usually the source of DNA and qPCR the preferred technique to demonstrate the presence of T. cruzi DNA. Although DNA extracted from clot samples has shown higher sensitivity than from whole blood, DNA extraction is performed using phenol-chloroform, which has biohazard issues. We theorize that a clot traps parasites, making it a better source of DNA for Chagas diagnosis using PCR. The present study describes a new DNA extraction methodology from clot samples which avoids the use of phenol-chloroform. The new methodology was compared to the internationally standardized diagnostic method, which is based on extraction of DNA from whole blood preserved with guanidine EDTA and a commercial kit.
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Affiliation(s)
- Holger Mayta
- Infectious Diseases Research Laboratory, Department of Cellular and Molecular Sciences, School of Science and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Peru.,Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America.,A.B Prisma, Lima, Perú
| | - Yomara K Romero
- Infectious Diseases Research Laboratory, Department of Cellular and Molecular Sciences, School of Science and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Alejandra Pando
- Infectious Diseases Research Laboratory, Department of Cellular and Molecular Sciences, School of Science and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Manuela Verastegui
- Infectious Diseases Research Laboratory, Department of Cellular and Molecular Sciences, School of Science and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Ricardo Bozo
- Hospital Municipal Camiri, Camiri, Plurinational State of Bolivia
| | | | - Rony Colanzi
- Hospital Universitario Japones, Santa Cruz de la Sierra, Plurinational State of Bolivia
| | - Jorge Flores
- Hospital San Juan de Dios, Santa Cruz de la Sierra, Plurinational State of Bolivia
| | - Richard Lerner
- Pan American Zoonotic Research and Prevention, Framingham, Massachusetts, United States of America
| | - Caryn Bern
- Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, California, United States of America
| | - Robert H Gilman
- Infectious Diseases Research Laboratory, Department of Cellular and Molecular Sciences, School of Science and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Peru.,Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America.,A.B Prisma, Lima, Perú
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8
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Alroy KA, Arroyo G, Gilman RH, Gonzales-Gustavson E, Gallegos L, Gavidia CM, Verastegui M, Rodriguez S, Lopez T, Gomez-Puerta LA, Alroy J, Garcia HH, Gonzalez AE, For The Cysticercosis Working Group In Peru. Carotid Taenia solium Oncosphere Infection: A Novel Porcine Neurocysticercosis Model. Am J Trop Med Hyg 2018; 99:380-387. [PMID: 29893202 DOI: 10.4269/ajtmh.17-0912] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Neurocysticercosis (NCC), the infection of the human central nervous system (CNS) with larval cysts of Taenia solium causes widespread neurological morbidity. Animal models are crucial for studying the pathophysiology and treatment of NCC. Some drawbacks of current NCC models include differences in the pathogenesis of the model and wild-type parasite, low rates of infection efficiency and lack of reproducibility. We describe a novel porcine model that recreates infection in the CNS with high efficiency. Activated oncospheres, either in a high (45,000-50,000) or low (10,000) dose were inoculated in the common carotid artery of 12 pigs by ultrasound-guided catheterization. Following oncosphere injection, either a high (30 mL) or low (1-3 mL) volume of saline flush was also administered. Cyst burden in the CNS was evaluated independently according to oncosphere dose and flush volume. Neurocysticercosis was achieved in 8/12 (66.7%) pigs. Cyst burden in the CNS of pigs was higher in the high versus the low oncosphere dose category (median: 4.5; interquartile ranges [IQR]: 1-8 and median: 1; IQR: 0-4, respectively) and in the high versus the low flush volume category (median 5.5; IQR: 1-8 and median: 1; IQR: 0-2, respectively), although not statistically different. All cysts in the CNS were viable, whereas both viable and degenerated cysts were found in the musculature. Carotid injection of activated oncospheres in pigs is effective in reproducing NCC. Oncosphere entry into the CNS by way of vasculature mimics wild-type infection, and provides a useful alternative for future investigations on the pathogenesis and antiparasitic treatment of NCC.
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Affiliation(s)
- Karen A Alroy
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Gianfranco Arroyo
- School of Public Health and Management, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Robert H Gilman
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | | | - Linda Gallegos
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Cesar M Gavidia
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Manuela Verastegui
- Departments of Pathology, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Silvia Rodriguez
- Microbiology of the School of Science, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Teresa Lopez
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Luis A Gomez-Puerta
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Joseph Alroy
- School of Medicine, Tufts University, Boston, Massachusetts
| | - Hector H Garcia
- Microbiology of the School of Science, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Armando E Gonzalez
- Microbiology of the School of Science, Universidad Peruana Cayetano Heredia, Lima, Peru
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Messenger LA, Gilman RH, Verastegui M, Galdos-Cardenas G, Sanchez G, Valencia E, Sanchez L, Malaga E, Rendell VR, Jois M, Shah V, Santos N, Abastoflor MDC, LaFuente C, Colanzi R, Bozo R, Bern C. Toward Improving Early Diagnosis of Congenital Chagas Disease in an Endemic Setting. Clin Infect Dis 2018; 65:268-275. [PMID: 28369287 DOI: 10.1093/cid/cix277] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [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: 01/27/2017] [Accepted: 03/22/2017] [Indexed: 11/13/2022] Open
Abstract
Background Congenital Trypanosoma cruzi transmission is now estimated to account for 22% of new infections, representing a significant public health problem across Latin America and internationally. Treatment during infancy is highly efficacious and well tolerated, but current assays for early detection fail to detect >50% of infected neonates, and 9-month follow-up is low. Methods Women who presented for delivery at 2 urban hospitals in Santa Cruz Department, Bolivia, were screened by rapid test. Specimens from infants of infected women were tested by microscopy (micromethod), quantitative PCR (qPCR), and immunoglobulin (Ig)M trypomastigote excreted-secreted antigen (TESA)-blots at birth and 1 month and by IgG serology at 6 and 9 months. Results Among 487 infants of 476 seropositive women, congenital T. cruzi infection was detected in 38 infants of 35 mothers (7.8%). In cord blood, qPCR, TESA-blot, and micromethod sensitivities/specificities were 68.6%/99.1%, 58.3%/99.1%, and 16.7%/100%, respectively. When birth and 1-month results were combined, cumulative sensitivities reached 84.2%, 73.7%, and 34.2%, respectively. Low birthweight and/or respiratory distress were reported in 11 (29%) infected infants. Infants with clinical signs had higher parasite loads and were significantly more likely to be detected by micromethod. Conclusions The proportion of T. cruzi-infected infants with clinical signs has fallen since the 1990s, but symptomatic congenital Chagas disease still represents a significant, albeit challenging to detect, public health problem. Molecular methods could facilitate earlier diagnosis and circumvent loss to follow-up but remain logistically and economically prohibitive for routine screening in resource-limited settings.
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Affiliation(s)
- Louisa A Messenger
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, United Kingdom
| | - Robert H Gilman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Manuela Verastegui
- Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Gerson Galdos-Cardenas
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Gerardo Sanchez
- Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Edward Valencia
- Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Leny Sanchez
- Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Edith Malaga
- Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Malasa Jois
- Division of Internal Medicine, Brown University, Providence, Rhode Island
| | - Vishal Shah
- Department of Medicine, New York University, New York
| | - Nicole Santos
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco
| | | | | | | | - Ricardo Bozo
- Hospital Municipal Camiri, Plurinational State of Bolivia
| | - Caryn Bern
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco
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Alyeshmerni DM, Green P, Duran G, Prust M, Tinajeros F, Verastegui M, Mayta H, Flores J, Paula C, Camila L, Bern C, Crawford T, Gilman R, Kolias T. UNDERSTANDING THE ROLE OF STRAIN IMAGING IN THE EARLY DETECTION OF CHAGAS CARDIOMYOPATHY. J Am Coll Cardiol 2017. [DOI: 10.1016/s0735-1097(17)34889-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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11
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Yauri V, Castro-Sesquen YE, Verastegui M, Angulo N, Recuenco F, Cabello I, Malaga E, Bern C, Gavidia CM, Gilman RH. Domestic Pig (Sus scrofa) as an Animal Model for Experimental Trypanosoma cruzi Infection. Am J Trop Med Hyg 2016; 94:1020-7. [PMID: 26928841 DOI: 10.4269/ajtmh.15-0233] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 01/28/2016] [Indexed: 01/09/2023] Open
Abstract
Pigs were infected with a Bolivian strain of Trypanosoma cruzi (genotype I) and evaluated up to 150 days postinoculation (dpi) to determine the use of pigs as an animal model of Chagas disease. Parasitemia was observed in the infected pigs during the acute phase (15-40 dpi). Anti-T. cruzi immunoglobulin M was detected during 15-75 dpi; high levels of anti-T. cruzi immunoglobulin G were detected in all infected pigs from 75 to 150 dpi. Parasitic DNA was observed by western blot (58%, 28/48) and polymerase chain reaction (27%, 13/48) in urine samples, and in the brain (75%, 3/4), spleen (50%, 2/4), and duodenum (25%, 1/4), but no parasitic DNA was found in the heart, colon, and kidney. Parasites were not observed microscopically in tissues samples, but mild inflammation, vasculitis, and congestion was observed in heart, brain, kidney, and spleen. This pig model was useful for the standardization of the urine test because of the higher volume that can be obtained as compared with other small animal models. However, further experiments are required to observe pathological changes characteristic of Chagas disease in humans.
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Affiliation(s)
- Verónica Yauri
- Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Peru; Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Yagahira E Castro-Sesquen
- Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Peru; Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Manuela Verastegui
- Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Peru; Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Noelia Angulo
- Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Peru; Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Fernando Recuenco
- Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Peru; Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Ines Cabello
- Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Peru; Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Edith Malaga
- Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Peru; Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Caryn Bern
- Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Peru; Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Cesar M Gavidia
- Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Peru; Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Robert H Gilman
- Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Peru; Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
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12
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Chile N, Clark T, Arana Y, Ortega YR, Palma S, Mejia A, Angulo N, Kosek JC, Kosek M, Gomez-Puerta LA, Garcia HH, Gavidia CM, Gilman RH, Verastegui M. In Vitro Study of Taenia solium Postoncospheral Form. PLoS Negl Trop Dis 2016; 10:e0004396. [PMID: 26863440 PMCID: PMC4749246 DOI: 10.1371/journal.pntd.0004396] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [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: 04/08/2015] [Accepted: 12/29/2015] [Indexed: 12/04/2022] Open
Abstract
Background The transitional period between the oncosphere and the cysticercus of Taenia solium is the postoncospheral (PO) form, which has not yet been completely characterized. The aim of this work was to standardize a method to obtain T. solium PO forms by in vitro cultivation. We studied the morphology of the PO form and compared the expression of antigenic proteins among the PO form, oncosphere, and cysticerci stages. Methodology/Principal Findings T. solium activated oncospheres were co-cultured with ten cell lines to obtain PO forms, which we studied at three stages of development–days 15, 30, and 60. A high percentage (32%) of PO forms was obtained using HCT-8 cells in comparison to the other cell lines. The morphology was observed by bright field, scanning, and transmission electron microscopy. Morphology of the PO form changed over time, with the six hooks commonly seen in the oncosphere stage disappearing in the PO forms, and vesicles and microtriches observed in the tegument. The PO forms grew as they aged, reaching a diameter of 2.5 mm at 60 days of culture. 15–30 day PO forms developed into mature cysticerci when inoculated into rats. Antigenic proteins expressed in the PO forms are also expressed by the oncosphere and cysticerci stages, with more cysticerci antigenic proteins expressed as the PO forms ages. Conclusions/Significance This is the first report of an in vitro production method of T. solium PO forms. The changes observed in protein expression may be useful in identifying new targets for vaccine development. In vitro culture of PO form will aid in understanding the host-parasite relationship, since the structural changes of the developing PO forms may reflect the parasite’s immunoprotective mechanisms. A wider application of this method could significantly reduce the use of animals, and thus the costs and time required for further experimental investigations. Neurocysticercosis is caused by T. solium, which is a neglected disease. The postoncospheral (PO) form is an intermediate form between the oncosphere, which is the larva, and the fully developed cysticercus, which is a cyst with a scolex. The morphology, development, and protein and antigen expression of the PO form have not previously been characterized. Here, we report the novel in vitro cultivation of T. solium PO forms and characterize the morphology, development, and expression of antigenic proteins. This new method will allow for better study of this transitional form, which is very difficult to study in the intermediate host. With the increased availability of secreted proteins and antigens, in vitro cultivation will help improve diagnostic assays and provide new targets for vaccine development to block transmission.
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Affiliation(s)
- Nancy Chile
- Department of Cellular and Molecular Sciences, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Taryn Clark
- Section of Emergency Medicine, Department of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana, United States of America
| | - Yanina Arana
- Department of Cellular and Molecular Sciences, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Ynes R. Ortega
- Center for Food Safety and Department of Food Science and Technology, University of Georgia, Griffin, Georgia, United States of America
| | - Sandra Palma
- Department of Cellular and Molecular Sciences, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Alan Mejia
- Department of Cellular and Molecular Sciences, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Noelia Angulo
- Department of Cellular and Molecular Sciences, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Jon C. Kosek
- Department of Pathology, School of Medicine, Stanford University, Stanford, California, United States of America
| | - Margaret Kosek
- Department of International Health, Bloomberg School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Luis A. Gomez-Puerta
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Hector H. Garcia
- Department of Cellular and Molecular Sciences, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Cesar M. Gavidia
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Robert H. Gilman
- Department of International Health, Bloomberg School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
- Asociación Benéfica PRISMA, San Miguel, Lima, Peru
| | - Manuela Verastegui
- Department of Cellular and Molecular Sciences, Universidad Peruana Cayetano Heredia, Lima, Peru
- * E-mail:
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13
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Alroy KA, Huang C, Gilman RH, Quispe-Machaca VR, Marks MA, Ancca-Juarez J, Hillyard M, Verastegui M, Sanchez G, Cabrera L, Vidal E, Billig EMW, Cama VA, Náquira C, Bern C, Levy MZ. Correction: Prevalence and Transmission of Trypanosoma cruzi in People of Rural Communities of the High Jungle of Northern Peru. PLoS Negl Trop Dis 2015; 9:e0003910. [PMID: 26147779 PMCID: PMC4492981 DOI: 10.1371/journal.pntd.0003910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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14
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Kaplinski M, Jois M, Galdos-Cardenas G, Rendell VR, Shah V, Do RQ, Marcus R, Pena MSB, Abastoflor MDC, LaFuente C, Bozo R, Valencia E, Verastegui M, Colanzi R, Gilman RH, Bern C. Sustained Domestic Vector Exposure Is Associated With Increased Chagas Cardiomyopathy Risk but Decreased Parasitemia and Congenital Transmission Risk Among Young Women in Bolivia. Clin Infect Dis 2015; 61:918-26. [PMID: 26063720 DOI: 10.1093/cid/civ446] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [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: 01/14/2015] [Accepted: 06/02/2015] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND We studied women and their infants to evaluate risk factors for congenital transmission and cardiomyopathy in Trypanosoma cruzi-infected women. METHODS Women provided data and blood for serology and quantitative polymerase chain reaction (PCR). Infants of infected women had blood tested at 0 and 1 month by microscopy, PCR and immunoblot, and serology at 6 and 9 months. Women underwent electrocardiography (ECG). RESULTS Of 1696 women, 456 (26.9%) were infected; 31 (6.8%) transmitted T. cruzi to their infants. Women who transmitted had higher parasite loads than those who did not (median, 62.0 [interquartile range {IQR}, 25.8-204.8] vs 0.05 [IQR, 0-29.6]; P < .0001). Transmission was higher in twin than in singleton births (27.3% vs 6.4%; P = .04). Women who had not lived in infested houses transmitted more frequently (9.7% vs 4.6%; P = .04), were more likely to have positive results by PCR (65.5% vs 33.9%; P < .001), and had higher parasite loads than those who had lived in infested houses (median, 25.8 [IQR, 0-64.1] vs 0 [IQR, 0-12.3]; P < .001). Of 302 infected women, 28 (9.3%) had ECG abnormalities consistent with Chagas cardiomyopathy; risk was higher for older women (odds ratio [OR], 1.06 [95% confidence interval {CI}, 1.01-1.12] per year) and those with vector exposure (OR, 3.7 [95% CI, 1.4-10.2]). We observed a strong dose-response relationship between ECG abnormalities and reported years of living in an infested house. CONCLUSIONS We hypothesize that repeated vector-borne infection sustains antigen exposure and the consequent inflammatory response at a higher chronic level, increasing cardiac morbidity, but possibly enabling exposed women to control parasitemia in the face of pregnancy-induced Th2 polarization.
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Affiliation(s)
- Michelle Kaplinski
- Department of Cardiology, Children's Hospital of Philadelphia, Pennsylvania
| | - Malasa Jois
- Division of Internal Medicine, Brown University, Providence, Rhode Island
| | - Gerson Galdos-Cardenas
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland Universidad Católica Boliviana, Santa Cruz, Plurinational State of Bolivia
| | | | - Vishal Shah
- Saint Louis University School of Medicine, Missouri
| | - Rose Q Do
- Department of Cardiology, University of Colorado, Denver
| | - Rachel Marcus
- Department of Cardiology, Washington Hospital Center, Washington, District of Columbia
| | | | | | | | - Ricardo Bozo
- Camiri Municipal Hospital, Camiri, Plurinational State of Bolivia
| | - Edward Valencia
- Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Manuela Verastegui
- Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Rony Colanzi
- Universidad Católica Boliviana, Santa Cruz, Plurinational State of Bolivia
| | - Robert H Gilman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Caryn Bern
- Department of Epidemiology and Biostatistics, University of California, San Francisco School of Medicine
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15
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Nash TE, Mahanty S, Loeb JA, Theodore WH, Friedman A, Sander JW, Singh G, Cavalheiro E, Del Brutto OH, Takayanagui OM, Fleury A, Verastegui M, Preux PM, Montano S, Pretell EJ, White AC, Gonzales AE, Gilman RH, Garcia HH. In response: Multifactorial basis of epilepsy in patients with neurocysticercosis. Epilepsia 2015; 56:975-6. [PMID: 26040533 DOI: 10.1111/epi.12986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Theodore E Nash
- Laboratory of Parasitic Disease, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, U.S.A.
| | - Siddhartha Mahanty
- Laboratory of Parasitic Disease, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, U.S.A
| | - Jeffrey A Loeb
- Department of Neurology and Rehabilitation, University of Illinois at Chicago, Chicago, Illinois, U.S.A
| | - William H Theodore
- Epilepsy Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, U.S.A
| | - Alon Friedman
- The Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Department of Medical Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Josemir W Sander
- Department of Clinical & Experimental Epilepsy, UCL Institute of Neurology, Hospitals Biomedical Research Centre, London, United Kingdom.,London & Epilepsy Society, Buckinghamshire, United Kingdom.,Epilepsy Institute of the Netherlands Foundation, Heemstede, The Netherlands
| | - Gagandeep Singh
- Department of Neurology, Dayan and Medical College, Ludhiana, India
| | - Esper Cavalheiro
- Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, Brazil
| | | | - Osvaldo M Takayanagui
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Agnes Fleury
- Institute of Biomedical Research, National Institute of Neurology and Neurosurgery (INNN), National Autonomous University of Mexico, Mexico City, Mexico
| | - Manuela Verastegui
- Department of Cellular and Molecular Sciences, Faculty of Science and Philosophy, University Peruana Cayetano Heredia, Lima, Peru
| | - Pierre-Marie Preux
- UMR1094 INSERM, CHU Limoges, Institute of Neuroepidemiology and Tropical Neurology, University of Limoges, Limoges, France
| | | | | | - A Clinton White
- Infectious Disease Division, Department of Internal Medicine, University of Texas, Galveston, Texas, U.S.A
| | - Armando E Gonzales
- Department of Veterinary Public Health, School of Veterinary Medicine, National University of San Marcos, Lima, Peru
| | - Robert H Gilman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, U.S.A
| | - Hector H Garcia
- Cysticercosis Unit, Institute of Neurological Diseases, Lima, Peru.,Center for Global Health-Tumbes, University Peruana Cayetano Heredia, Lima, Peru.,Department of Microbiology, University Peruana Cayetano Heredia, Lima, Peru
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16
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Alroy KA, Huang C, Gilman RH, Quispe-Machaca VR, Marks MA, Ancca-Juarez J, Hillyard M, Verastegui M, Sanchez G, Cabrera L, Vidal E, Billig EMW, Cama VA, Náquira C, Bern C, Levy MZ. Prevalence and Transmission of Trypanosoma cruzi in People of Rural Communities of the High Jungle of Northern Peru. PLoS Negl Trop Dis 2015; 9:e0003779. [PMID: 26000770 PMCID: PMC4441511 DOI: 10.1371/journal.pntd.0003779] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [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: 10/04/2014] [Accepted: 04/22/2015] [Indexed: 11/18/2022] Open
Abstract
Background Vector-borne transmission of Trypanosoma cruzi is seen exclusively in the Americas where an estimated 8 million people are infected with the parasite. Significant research in southern Peru has been conducted to understand T. cruzi infection and vector control, however, much less is known about the burden of infection and epidemiology in northern Peru. Methodology A cross-sectional study was conducted to estimate the seroprevalence of T. cruzi infection in humans (n=611) and domestic animals [dogs (n=106) and guinea pigs (n=206)] in communities of Cutervo Province, Peru. Sampling and diagnostic strategies differed according to species. An entomological household study (n=208) was conducted to identify the triatomine burden and species composition, as well as the prevalence of T. cruzi in vectors. Electrocardiograms (EKG) were performed on a subset of participants (n=90 T. cruzi infected participants and 170 age and sex-matched controls). The seroprevalence of T. cruzi among humans, dogs, and guinea pigs was 14.9% (95% CI: 12.2 – 18.0%), 19.8% (95% CI: 12.7- 28.7%) and 3.3% (95% CI: 1.4 – 6.9%) respectively. In one community, the prevalence of T. cruzi infection was 17.2% (95% CI: 9.6 - 24.7%) among participants < 15 years, suggesting recent transmission. Increasing age, positive triatomines in a participant's house, and ownership of a T. cruzi positive guinea pig were independent correlates of T. cruzi infection. Only one species of triatomine was found, Panstrongylus lignarius, formerly P. herreri. Approximately forty percent (39.9%, 95% CI: 33.2 - 46.9%) of surveyed households were infested with this vector and 14.9% (95% CI: 10.4 - 20.5%) had at least one triatomine positive for T. cruzi. The cardiac abnormality of right bundle branch block was rare, but only identified in seropositive individuals. Conclusions Our research documents a substantial prevalence of T. cruzi infection in Cutervo and highlights a need for greater attention and vector control efforts in northern Peru. Chagas disease causes significant morbidity and mortality throughout Central and South America. The epidemiology and control of this disease is subject to unique regional particularities, including the behavior and ecology of the local insect vector species. Significant resources have been allocated towards research and control efforts in southern Peru, yet very little is known about the prevalence and epidemiology of Trypanosoma cruzi in northern Peru. Our study highlights significant T. cruzi infection in northern Peru and is one of the first to document substantial transmission by the insect Panstrongylus lignarius. Our results illustrate major gaps in knowledge and the need for public health interventions targeted at Chagas disease in the region of Cutervo Province of northern Peru.
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Affiliation(s)
- Karen A. Alroy
- American Association for the Advancement of Science (AAAS) Science & Technology Policy Fellow at the Division of Environmental Biology, National Science Foundation, Arlington, Virginia, United States of America
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Christine Huang
- Department of Pediatrics and Department of Emergency Medicine, University of Arizona, Tucson, Arizona, United States of America
| | - Robert H. Gilman
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
- Faculty of Science and Philosophy Alberto Cazorla Talleri, Urbanización Ingeniería, University Peruana Cayetano Heredia, Lima, Peru
| | - Victor R. Quispe-Machaca
- Faculty of Science and Philosophy Alberto Cazorla Talleri, Urbanización Ingeniería, University Peruana Cayetano Heredia, Lima, Peru
| | - Morgan A. Marks
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Jenny Ancca-Juarez
- Faculty of Science and Philosophy Alberto Cazorla Talleri, Urbanización Ingeniería, University Peruana Cayetano Heredia, Lima, Peru
| | - Miranda Hillyard
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Manuela Verastegui
- Faculty of Science and Philosophy Alberto Cazorla Talleri, Urbanización Ingeniería, University Peruana Cayetano Heredia, Lima, Peru
| | - Gerardo Sanchez
- Faculty of Science and Philosophy Alberto Cazorla Talleri, Urbanización Ingeniería, University Peruana Cayetano Heredia, Lima, Peru
| | - Lilia Cabrera
- Faculty of Science and Philosophy Alberto Cazorla Talleri, Urbanización Ingeniería, University Peruana Cayetano Heredia, Lima, Peru
| | - Elisa Vidal
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Erica M. W. Billig
- Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Vitaliano A. Cama
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - César Náquira
- Faculty of Science and Philosophy Alberto Cazorla Talleri, Urbanización Ingeniería, University Peruana Cayetano Heredia, Lima, Peru
| | - Caryn Bern
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, San Francisco, California, United States of America
| | - Michael Z. Levy
- Faculty of Science and Philosophy Alberto Cazorla Talleri, Urbanización Ingeniería, University Peruana Cayetano Heredia, Lima, Peru
- Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- * E-mail:
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Rendell VR, Gilman RH, Valencia E, Galdos-Cardenas G, Verastegui M, Sanchez L, Acosta J, Sanchez G, Ferrufino L, LaFuente C, Abastoflor MDC, Colanzi R, Bern C. Trypanosoma cruzi-infected pregnant women without vector exposure have higher parasitemia levels: implications for congenital transmission risk. PLoS One 2015; 10:e0119527. [PMID: 25807498 PMCID: PMC4373803 DOI: 10.1371/journal.pone.0119527] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [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: 11/26/2014] [Accepted: 01/14/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Congenital transmission is a major source of new Trypanosoma cruzi infections, and as vector and blood bank control continue to improve, the proportion due to congenital infection will grow. A major unanswered question is why reported transmission rates from T. cruzi-infected mothers vary so widely among study populations. Women with high parasite loads during pregnancy are more likely to transmit to their infants, but the factors that govern maternal parasite load are largely unknown. Better understanding of these factors could enable prioritization of screening programs to target women most at risk of transmission to their infants. METHODOLOGY/PRINCIPAL FINDINGS We screened pregnant women presenting for delivery in a large urban hospital in Bolivia and followed infants of infected women for congenital Chagas disease. Of 596 women screened, 128 (21.5%) had confirmed T. cruzi infection; transmission occurred from 15 (11.7%) infected women to their infants. Parasite loads were significantly higher among women who transmitted compared to those who did not. Congenital transmission occurred from 31.3% (9/29), 15.4% (4/26) and 0% (0/62) of women with high, moderate and low parasite load, respectively (χx2 for trend 18.2; p<0.0001). Twin births were associated with higher transmission risk and higher maternal parasite loads. Infected women without reported vector exposure had significantly higher parasite loads than those who had lived in an infested house (median 26.4 vs 0 parasites/mL; p<0.001) with an inverse relationship between years of living in an infested house and parasite load. CONCLUSIONS/SIGNIFICANCE We hypothesize that sustained vector-borne parasite exposure and repeated superinfection by T. cruzi may act as an immune booster, allowing women to maintain effective control of the parasite despite the down-regulation of late pregnancy.
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Affiliation(s)
- Victoria R. Rendell
- Duke Global Health Institute, Duke University, Durham, NC, United States of America
| | - Robert H. Gilman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Edward Valencia
- Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Gerson Galdos-Cardenas
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Manuela Verastegui
- Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Leny Sanchez
- Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Janet Acosta
- Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Gerardo Sanchez
- Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Lisbeth Ferrufino
- Universidad Catolica Boliviana, Santa Cruz, Plurinational State of Bolivia
| | - Carlos LaFuente
- Hospital Universitario Japones, Santa Cruz, Plurinational State of Bolivia
| | | | - Rony Colanzi
- Universidad Catolica Boliviana, Santa Cruz, Plurinational State of Bolivia
| | - Caryn Bern
- Department of Epidemiology and Biostatistics, University of San Francisco School of Medicine, San Francisco, CA, United States of America
- * E-mail:
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Nash TE, Mahanty S, Loeb JA, Theodore WH, Friedman A, Sander JW, Singh G, Cavalheiro E, Del Brutto OH, Takayanagui OM, Fleury A, Verastegui M, Preux PM, Montano S, Pretell EJ, White AC, Gonzales AE, Gilman RH, Garcia HH. Neurocysticercosis: A natural human model of epileptogenesis. Epilepsia 2014; 56:177-83. [PMID: 25534640 DOI: 10.1111/epi.12849] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2014] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To develop a better understanding of mechanisms of seizures and long-term epileptogenesis using neurocysticercosis. METHODS A workshop was held bringing together experts in epilepsy and epileptogenesis and neurocysticercosis. RESULTS Human neurocysticercosis and parallel animal models offer a unique opportunity to understand basic mechanisms of seizures. Inflammatory responses to degenerating forms and later-stage calcified parasite granulomas are associated with seizures and epilepsy. Other mechanisms may also be involved in epileptogenesis. SIGNIFICANCE Naturally occurring brain infections with neurocysticercosis offer a unique opportunity to develop treatments for one of the world's most common causes of epilepsy and for the development of more general antiepileptogenic treatments. Key advantages stem from the time course in which an acute seizure heralds a start of the epileptogenic process, and radiographic changes of calcification and perilesional edema provide biomarkers of a chronic epileptic state.
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Affiliation(s)
- Theodore E Nash
- Laboratory of Parasitic Disease, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, U.S.A
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Martin DL, Marks M, Galdos-Cardenas G, Gilman RH, Goodhew B, Ferrufino L, Halperin A, Sanchez G, Verastegui M, Escalante P, Naquira C, Levy MZ, Bern C. Regional variation in the correlation of antibody and T-cell responses to Trypanosoma cruzi. Am J Trop Med Hyg 2014; 90:1074-81. [PMID: 24710614 DOI: 10.4269/ajtmh.13-0391] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Chagas disease, caused by the protozoan parasite Trypanosoma cruzi, is a major cause of morbidity and mortality in Central and South America. Geographic variations in the sensitivity of serologic diagnostic assays to T. cruzi may reflect differences in T. cruzi exposure. We measured parasite-specific T-cell responses among seropositive individuals in two populations from South America with widely varying antibody titers against T. cruzi. Antibody titers among seropositive individuals were significantly lower in Arequipa, Peru compared with Santa Cruz, Bolivia. Similarly, the proportion of seropositive individuals with positive T-cell responses was lower in Peru than Bolivia, resulting in overall lower frequencies of interferon-γ (IFNγ)-secreting cells from Peruvian samples. However, the magnitude of the IFNγ response was similar among the IFNγ responders in both locations. These data indicate that immunological discrepancies based on geographic region are reflected in T-cell responses as well as antibody responses.
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Affiliation(s)
- Diana L Martin
- Centers for Disease Control and Prevention, Atlanta, Georgia; National Institutes of Health, Bethesda, Maryland; Johns Hopkins University, Baltimore, Maryland; Hospital Universitario Japones, Santa Cruz, Bolivia; Asociación Benéfica PRISMA, Lima, Peru; Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Arequipa Ministry of Health, Arequipa, Peru; University of Pennsylvania, Philadelphia, Pennsylvania; Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Morgan Marks
- Centers for Disease Control and Prevention, Atlanta, Georgia; National Institutes of Health, Bethesda, Maryland; Johns Hopkins University, Baltimore, Maryland; Hospital Universitario Japones, Santa Cruz, Bolivia; Asociación Benéfica PRISMA, Lima, Peru; Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Arequipa Ministry of Health, Arequipa, Peru; University of Pennsylvania, Philadelphia, Pennsylvania; Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Gerson Galdos-Cardenas
- Centers for Disease Control and Prevention, Atlanta, Georgia; National Institutes of Health, Bethesda, Maryland; Johns Hopkins University, Baltimore, Maryland; Hospital Universitario Japones, Santa Cruz, Bolivia; Asociación Benéfica PRISMA, Lima, Peru; Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Arequipa Ministry of Health, Arequipa, Peru; University of Pennsylvania, Philadelphia, Pennsylvania; Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Robert H Gilman
- Centers for Disease Control and Prevention, Atlanta, Georgia; National Institutes of Health, Bethesda, Maryland; Johns Hopkins University, Baltimore, Maryland; Hospital Universitario Japones, Santa Cruz, Bolivia; Asociación Benéfica PRISMA, Lima, Peru; Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Arequipa Ministry of Health, Arequipa, Peru; University of Pennsylvania, Philadelphia, Pennsylvania; Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Brook Goodhew
- Centers for Disease Control and Prevention, Atlanta, Georgia; National Institutes of Health, Bethesda, Maryland; Johns Hopkins University, Baltimore, Maryland; Hospital Universitario Japones, Santa Cruz, Bolivia; Asociación Benéfica PRISMA, Lima, Peru; Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Arequipa Ministry of Health, Arequipa, Peru; University of Pennsylvania, Philadelphia, Pennsylvania; Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Lisbeth Ferrufino
- Centers for Disease Control and Prevention, Atlanta, Georgia; National Institutes of Health, Bethesda, Maryland; Johns Hopkins University, Baltimore, Maryland; Hospital Universitario Japones, Santa Cruz, Bolivia; Asociación Benéfica PRISMA, Lima, Peru; Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Arequipa Ministry of Health, Arequipa, Peru; University of Pennsylvania, Philadelphia, Pennsylvania; Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Anthony Halperin
- Centers for Disease Control and Prevention, Atlanta, Georgia; National Institutes of Health, Bethesda, Maryland; Johns Hopkins University, Baltimore, Maryland; Hospital Universitario Japones, Santa Cruz, Bolivia; Asociación Benéfica PRISMA, Lima, Peru; Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Arequipa Ministry of Health, Arequipa, Peru; University of Pennsylvania, Philadelphia, Pennsylvania; Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Gerardo Sanchez
- Centers for Disease Control and Prevention, Atlanta, Georgia; National Institutes of Health, Bethesda, Maryland; Johns Hopkins University, Baltimore, Maryland; Hospital Universitario Japones, Santa Cruz, Bolivia; Asociación Benéfica PRISMA, Lima, Peru; Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Arequipa Ministry of Health, Arequipa, Peru; University of Pennsylvania, Philadelphia, Pennsylvania; Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Manuela Verastegui
- Centers for Disease Control and Prevention, Atlanta, Georgia; National Institutes of Health, Bethesda, Maryland; Johns Hopkins University, Baltimore, Maryland; Hospital Universitario Japones, Santa Cruz, Bolivia; Asociación Benéfica PRISMA, Lima, Peru; Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Arequipa Ministry of Health, Arequipa, Peru; University of Pennsylvania, Philadelphia, Pennsylvania; Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Patricia Escalante
- Centers for Disease Control and Prevention, Atlanta, Georgia; National Institutes of Health, Bethesda, Maryland; Johns Hopkins University, Baltimore, Maryland; Hospital Universitario Japones, Santa Cruz, Bolivia; Asociación Benéfica PRISMA, Lima, Peru; Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Arequipa Ministry of Health, Arequipa, Peru; University of Pennsylvania, Philadelphia, Pennsylvania; Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Cesar Naquira
- Centers for Disease Control and Prevention, Atlanta, Georgia; National Institutes of Health, Bethesda, Maryland; Johns Hopkins University, Baltimore, Maryland; Hospital Universitario Japones, Santa Cruz, Bolivia; Asociación Benéfica PRISMA, Lima, Peru; Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Arequipa Ministry of Health, Arequipa, Peru; University of Pennsylvania, Philadelphia, Pennsylvania; Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Michael Z Levy
- Centers for Disease Control and Prevention, Atlanta, Georgia; National Institutes of Health, Bethesda, Maryland; Johns Hopkins University, Baltimore, Maryland; Hospital Universitario Japones, Santa Cruz, Bolivia; Asociación Benéfica PRISMA, Lima, Peru; Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Arequipa Ministry of Health, Arequipa, Peru; University of Pennsylvania, Philadelphia, Pennsylvania; Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Caryn Bern
- Centers for Disease Control and Prevention, Atlanta, Georgia; National Institutes of Health, Bethesda, Maryland; Johns Hopkins University, Baltimore, Maryland; Hospital Universitario Japones, Santa Cruz, Bolivia; Asociación Benéfica PRISMA, Lima, Peru; Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Arequipa Ministry of Health, Arequipa, Peru; University of Pennsylvania, Philadelphia, Pennsylvania; Universidad Peruana Cayetano Heredia, Lima, Perú
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Arana Y, Verastegui M, Tuero I, Grandjean L, Garcia HH, Gilman RH. Characterization of the carbohydrate components of Taenia solium oncosphere proteins and their role in the antigenicity. Parasitol Res 2013; 112:3569-78. [PMID: 23982308 DOI: 10.1007/s00436-013-3542-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2013] [Accepted: 07/10/2013] [Indexed: 11/27/2022]
Abstract
This study examines the carbohydrate composition of Taenia solium whole oncosphere antigens (WOAs), in order to improve the understanding of the antigenicity of the T. solium. Better knowledge of oncosphere antigens is crucial to accurately diagnose previous exposure to T. solium eggs and thus predict the development of neurocysticercosis. A set of seven lectins conjugates with wide carbohydrate specificity were used on parasite fixations and somatic extracts. Lectin fluorescence revealed that D-mannose, D-glucose, D-galactose and N-acetyl-D-galactosamine residues were the most abundant constituents of carbohydrate chains on the surface of T. solium oncosphere. Lectin blotting showed that posttranslational modification with N-glycosylation was abundant while little evidence of O-linked carbohydrates was observed. Chemical oxidation and enzymatic deglycosylation in situ were performed to investigate the immunoreactivity of the carbohydrate moieties. Linearizing or removing the carbohydrate moieties from the protein backbones did not diminish the immunoreactivity of these antigens, suggesting that a substantial part of the host immune response against T. solium oncosphere is directed against the peptide epitopes on the parasite antigens. Finally, using carbohydrate probes, we demonstrated for the first time that the presence of several lectins on the surface of the oncosphere was specific to carbohydrates found in intestinal mucus, suggesting a possible role in initial attachment of the parasite to host cells.
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Affiliation(s)
- Yanina Arana
- Department of Cellular and Molecular Sciences, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, PO Box 5045, Lima, Peru
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Chile N, Evangelista J, Gilman RH, Arana Y, Palma S, Sterling CR, Garcia HH, Gonzalez A, Verastegui M. Standardization of a fluorescent-based quantitative adhesion assay to study attachment of Taenia solium oncosphere to epithelial cells in vitro. J Immunol Methods 2012; 376:89-96. [PMID: 22178422 DOI: 10.1016/j.jim.2011.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Revised: 12/01/2011] [Accepted: 12/01/2011] [Indexed: 11/18/2022]
Abstract
To fully understand the preliminary stages of Taenia solium oncosphere attachment in the gut, adequate tools and assays are necessary to observe and quantify this event that leads to infection. A fluorescent-based quantitative adhesion assay, using biotinylated activated-oncospheres and monolayers of Chinese hamster ovary cells (CHO-K1) or human intestinal monolayer cells (INT-407, HCT-8 or HT-29), was developed to study initial events during the infection of target cells and to rapidly quantify the in vitro adhesion of T. solium oncospheres. Fluorescein streptavidin was used to identify biotinylated activated-oncospheres adhered to cells. This adherence was quantified using an automated fluorescence plate reader, and the results were expressed as fluorescence intensity values. A series of three assays were performed. The first was to identify the optimum number of biotinylated activated-oncospheres to be used in the adhesion assay. The goal of the second assay was to validate this novel method with the established oncosphere-binding system using the immunofluorescent-antibody assay (IFA) method to quantify oncosphere adhesion. A total of 10,000 biotinylated activated-oncospheres were utilized to assess the role of sera and laminin (LM) in oncosphere adherence to a CHO-K1 cell monolayer. The findings that sera and LM increase the adhesion of oncospheres to monolayer cells were similar to results that were previously obtained using the IFA method. The third assay compared the adherence of biotinylated activated-oncospheres to different types of human intestinal monolayer cells. In this case, the fluorescence intensity was greatest when using the INT-407 cell monolayer. We believe this new method of quantification offers the potential for rapid, large-scale screening to study and elucidate specific molecules and mechanisms involved in oncosphere-host cell attachment.
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Affiliation(s)
- Nancy Chile
- Laboratory of Infectious Diseases Research, Department of Cellular and Molecular Sciences, School of Sciences and Philosophy Universidad Peruana Cayetano Heredia, PO Box 5045, Lima, Peru
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Castro-Sesquen YE, Gilman RH, Yauri V, Angulo N, Verastegui M, Velásquez DE, Sterling CR, Martin D, Bern C. Cavia porcellus as a model for experimental infection by Trypanosoma cruzi. Am J Pathol 2011; 179:281-8. [PMID: 21703410 DOI: 10.1016/j.ajpath.2011.03.043] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2010] [Revised: 03/01/2011] [Accepted: 03/29/2011] [Indexed: 12/18/2022]
Abstract
The guinea pig (Cavia porcellus) is a natural reservoir for Trypanosoma cruzi but has seldom been used as an experimental infection model. We developed a guinea pig infection model for acute and chronic Chagas disease. Seventy-two guinea pigs were inoculated intradermally with 10(4) trypomastigotes of T. cruzi strain Y (experimental group); 18 guinea pigs were used as control group. Eight animals from the experimental group and two from the control group were sacrificed 5, 15, 20, 25, 40, 55, 115, 165, and 365 days after inoculation. During the acute phase (15 to 55 days), we observed parasitemia (with a peak on day 20) and positive IgM and IgG Western blots with anti-shed acute-phase antigen bands. The cardiac tissue showed vasculitis, necrosis (on days 40 to 55), moderate to severe inflammation, and abundant amastigote nests. Smaller numbers of amastigote nests were also present in kidney, brain, and other organs. In the early chronic phase (115 to 165 days), parasitemia disappeared and anti-T. cruzi IgG antibodies were still detectable. In cardiac tissue, the number of amastigote nests and the grade of inflammation decreased. In the chronic phase (365 days), the cardiac tissue showed vasculitis and fibrosis; detectable parasite DNA was associated with higher grades of inflammation. The experimental T. cruzi infection model in guinea pigs shows kinetics and pathologic changes similar to those of the human disease.
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Schwarz A, Juarez JA, Richards J, Rath B, Machaca VQ, Castro YE, Málaga ES, Levy K, Gilman RH, Bern C, Verastegui M, Levy MZ. Anti-triatomine saliva immunoassays for the evaluation of impregnated netting trials against Chagas disease transmission. Int J Parasitol 2011; 41:591-4. [PMID: 21426907 DOI: 10.1016/j.ijpara.2011.02.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2010] [Revised: 02/16/2011] [Accepted: 02/17/2011] [Indexed: 10/18/2022]
Abstract
Insecticide-impregnated nets can kill triatomine bugs, but it remains unclear whether they can protect against Chagas disease transmission. In a field trial in Quequeña, Peru, sentinel guinea pigs placed in intervention enclosures covered by deltamethrin-treated nets showed significantly lower antibody responses to saliva of Triatoma infestans compared with animals placed in pre-existing control enclosures. Our results strongly suggest that insecticide-treated nets prevent triatomine bites and can thereby protect against infection with Trypanosoma cruzi. Anti-salivary immunoassays are powerful new tools to evaluate intervention strategies against Chagas disease.
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Affiliation(s)
- Alexandra Schwarz
- Laboratory of Genomics and Proteomics of Disease Vectors, Institute of Parasitology, Biology Centre of the Academy of Sciences of Czech Republic, České Budĕjovice, Czech Republic
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Zimic MJ, Infantes J, López C, Velásquez J, Farfán M, Pajuelo M, Sheen P, Verastegui M, Gonzalez A, Garciá HH, Gilman RH. Comparison of the peptidase activity in the oncosphere excretory/secretory products of Taenia solium and Taenia saginata. J Parasitol 2010; 93:727-34. [PMID: 17918349 DOI: 10.1645/ge-959r.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
We compared the peptidase activities of the excretory/secretory (E/S) antigens of oncospheres of Taenia solium and related, but nonpathogenic, Taenia saginata. Taenia solium and T. saginata oncospheres were cultured, and the spent media of 24-, 48-, 72-, and 96-hr fractions were analyzed. Activities for serine peptidases (chymotrypsin-, trypsin-, and elastase-like), cysteine peptidases (cathepsin B-, cathepsin L-, and calpaine-like), and aminopeptidase (B-like peptidases) were tested fluorometrically with peptides coupled to 7-amino-4-methylcoumarin. In both species, the E/S antigens showed cysteine, serine, and aminopeptidase activities. Although no particular peptidase had high activity in T. solium, and was absent in T. saginata, or vice versa, different patterns of activity were found. A chymotrypsin-like peptidase showed the highest activity in both parasites, and it had 10 times higher activity in T. solium than in T. saginata. Trypsin-like and cathepsin B-like activities were significantly higher in T. solium. Minimal levels of cathepsin B were present in both species, and higher levels of elastase-like and cathepsin L-like activity were observed in T. saginata. Taenia solium and T. saginata have different levels and temporal activities of proteolytic enzymes that could play a modulator role in the host specificity for larval invasion through penetration of the intestinal mucosa.
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Affiliation(s)
- Mirko J Zimic
- Laboratorios de Investigación y Desarrollo, Facultad de Ciencias, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, SMP, Lima, Perú
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Hidron AI, Gilman RH, Justiniano J, Blackstock AJ, LaFuente C, Selum W, Calderon M, Verastegui M, Ferrufino L, Valencia E, Tornheim JA, O'Neal S, Comer R, Galdos-Cardenas G, Bern C. Chagas cardiomyopathy in the context of the chronic disease transition. PLoS Negl Trop Dis 2010; 4:e688. [PMID: 20502520 PMCID: PMC2872643 DOI: 10.1371/journal.pntd.0000688] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [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: 01/05/2010] [Accepted: 03/29/2010] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Patients with Chagas disease have migrated to cities, where obesity, hypertension and other cardiac risk factors are common. METHODOLOGY/PRINCIPAL FINDINGS The study included adult patients evaluated by the cardiology service in a public hospital in Santa Cruz, Bolivia. Data included risk factors for T. cruzi infection, medical history, physical examination, electrocardiogram, echocardiogram, and contact 9 months after initial data collection to ascertain mortality. Serology and PCR for Trypanosoma cruzi were performed. Of 394 participants, 251 (64%) had confirmed T. cruzi infection by serology. Among seropositive participants, 109 (43%) had positive results by conventional PCR; of these, 89 (82%) also had positive results by real time PCR. There was a high prevalence of hypertension (64%) and overweight (body mass index [BMI] >25; 67%), with no difference by T. cruzi infection status. Nearly 60% of symptomatic congestive heart failure was attributed to Chagas cardiomyopathy; mortality was also higher for seropositive than seronegative patients (p = 0.05). In multivariable models, longer residence in an endemic province, residence in a rural area and poor housing conditions were associated with T. cruzi infection. Male sex, increasing age and poor housing were independent predictors of Chagas cardiomyopathy severity. Males and participants with BMI =25 had significantly higher likelihood of positive PCR results compared to females or overweight participants. CONCLUSIONS Chagas cardiomyopathy remains an important cause of congestive heart failure in this hospital population, and should be evaluated in the context of the epidemiological transition that has increased risk of obesity, hypertension and chronic cardiovascular disease.
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Affiliation(s)
- Alicia I. Hidron
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Robert H. Gilman
- Asociacion Benefica PRISMA, Lima, Peru
- Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Juan Justiniano
- Hospital Universitario Japones, Santa Cruz de la Sierra, Bolivia
| | - Anna J. Blackstock
- Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Atlanta Research and Education Foundation, Decatur, Georgia, United States of America
| | - Carlos LaFuente
- Hospital Universitario Japones, Santa Cruz de la Sierra, Bolivia
| | - Walter Selum
- Hospital Universitario Japones, Santa Cruz de la Sierra, Bolivia
| | - Martiza Calderon
- Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Manuela Verastegui
- Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Eduardo Valencia
- Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Jeffrey A. Tornheim
- Mount Sinai School of Medicine, New York, New York, United States of America
| | - Seth O'Neal
- Oregon Health Sciences University, Portland, Oregon, United States of America
| | - Robert Comer
- Wake Forest University Health Sciences, Winston-Salem, North Carolina, United States of America
| | | | - Caryn Bern
- Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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Nunez S, Mayta H, Verastegui M, Lafuente C, Bern C, Gilman R. Trypanosoma cruzi expressing luciferase for drug screening using a bolivian strain. Int J Infect Dis 2010. [DOI: 10.1016/j.ijid.2010.02.603] [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: 11/15/2022] Open
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Sesquen YC, Gilman R, Verastegui M, Yauri V, Angulo N, Portocarrero DV, Bern C. Cavia porcellus as a model for experimental infection by Trypanosoma cruzi. Int J Infect Dis 2010. [DOI: 10.1016/j.ijid.2010.02.380] [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: 10/19/2022] Open
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28
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Palma S, Chile N, Evangelista J, Arana Y, Verastegui M, Gilman R. Fibronectin increases the adherence of Taenia solium oncosphere in CHO –K1 cells in vitro. Int J Infect Dis 2010. [DOI: 10.1016/j.ijid.2010.02.2148] [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: 10/19/2022] Open
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29
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Santivañez SJ, Hernández-González A, Chile N, Oleaga A, Arana Y, Palma S, Verastegui M, Gonzalez AE, Gilman R, Garcia HH, Siles-Lucas M. Proteomic study of activated Taenia solium oncospheres. Mol Biochem Parasitol 2010; 171:32-9. [PMID: 20144663 DOI: 10.1016/j.molbiopara.2010.01.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2009] [Revised: 01/26/2010] [Accepted: 01/27/2010] [Indexed: 12/26/2022]
Abstract
Taenia solium cysticerci are a major cause of human seizures and epilepsy in the world. In the gastrointestinal tract of infected individuals, taeniid eggs release the oncospheres, which are then activated by intestinal stimuli, getting ready to penetrate the gut wall and reach distant locations where they transform in cysticerci. Information about oncospheral molecules is scarce, and elucidation of the oncosphere proteome could help understanding the host-parasite relationship during the first steps of infection. In this study, using liquid chromatography and tandem mass spectrometry (LC-MS/MS) analysis, we could identify a set of oncospheral proteins involved in adhesion, protein folding, detoxification and proteolysis, among others. In addition, we have characterized one of the identified molecules, the parasite 14-3-3, by immunoblot and immunolocalization. The identification of these oncospheral proteins represents the first step to elucidate their specific roles in the biology of the host-parasite relationship.
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Affiliation(s)
- S J Santivañez
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
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Bern C, Verastegui M, Gilman RH, LaFuente C, Galdos-Cardenas G, Calderon M, Pacori J, Abastoflor MDC, Aparicio H, Brady MF, Ferrufino L, Angulo N, Marcus S, Sterling C, Maguire JH. Congenital Trypanosoma cruzi transmission in Santa Cruz, Bolivia. Clin Infect Dis 2009; 49:1667-74. [PMID: 19877966 PMCID: PMC5454522 DOI: 10.1086/648070] [Citation(s) in RCA: 128] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND We conducted a study of congenital Trypanosoma cruzi infection in Santa Cruz, Bolivia. Our objective was to apply new tools to identify weak points in current screening algorithms, and find ways to improve them. METHODS Women presenting for delivery were screened by rapid and conventional serological tests. For infants of infected mothers, blood specimens obtained on days 0, 7, 21, 30, 90, 180, and 270 were concentrated and examined microscopically; serological tests were performed for the day 90, 180, and 270 specimens. Maternal and infant specimens, including umbilical tissue, were tested by polymerase chain reaction (PCR) targeting the kinetoplast minicircle and by quantitative PCR. RESULTS Of 530 women, 154 (29%) were seropositive. Ten infants had congenital T. cruzi infection. Only 4 infants had positive results of microscopy evaluation in the first month, and none had positive cord blood microscopy results. PCR results were positive for 6 (67%) of 9 cord blood and 7 (87.5%) of 8 umbilical tissue specimens. PCR-positive women were more likely to transmit T. cruzi than were seropositive women with negative PCR results (P < .05). Parasite loads determined by quantitative PCR were higher for mothers of infected infants than for seropositive mothers of uninfected infants P < .01). Despite intensive efforts, only 58% of at-risk infants had a month 9 specimen collected. CONCLUSIONS On the basis of the low sensitivity of microscopy in cord blood and high rate of loss to follow-up, we estimate that current screening programs miss one-half of all infected infants. Molecular techniques may improve early detection.
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Affiliation(s)
- Caryn Bern
- Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta Georgia
| | | | - Robert H. Gilman
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
- Universidad Peruana Cayetano Heredia
| | | | - Gerson Galdos-Cardenas
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | | | | | | | - Hugo Aparicio
- Asociación Benéfica Proyectos en Informática, Salud, Medicina y Agricultura, Lima, Perú
| | - Mark F. Brady
- Asociación Benéfica Proyectos en Informática, Salud, Medicina y Agricultura, Lima, Perú
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31
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Verani JR, Seitz A, Gilman RH, LaFuente C, Galdos-Cardenas G, Kawai V, de LaFuente E, Ferrufino L, Bowman NM, Pinedo-Cancino V, Levy MZ, Steurer F, Todd CW, Kirchhoff LV, Cabrera L, Verastegui M, Bern C. Geographic variation in the sensitivity of recombinant antigen-based rapid tests for chronic Trypanosoma cruzi infection. Am J Trop Med Hyg 2009; 80:410-415. [PMID: 19270291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
Chagas disease affects 8-11 million people throughout the Americas. Early detection is crucial for timely treatment and to prevent non-vectorial transmission. Recombinant antigen-based rapid tests had high sensitivity and specificity in laboratory evaluations, but no Peruvian specimens were included in previous studies. We evaluated Stat-Pak and Trypanosoma Detect rapid tests in specimens from Bolivia and Peru. Specimens positive by three conventional assays were confirmed positives; specimens negative by two or more assays were confirmed negatives. In Bolivian specimens, Stat-Pak and Trypanosoma Detect tests were 87.5% and 90.7% sensitive, respectively; both showed 100% specificity. Sensitivity in Peruvian specimens was much lower: 26.6-33.0% (Stat-Pak) and 54.3-55.2% (Trypanosoma Detect); both had specificities > 98%. Even in Bolivian specimens, these sensitivities are inadequate for stand-alone screening. The low sensitivity in Peru may be related to parasite strain differences. Chagas disease rapid tests should be field tested in each geographic site before widespread implementation for screening.
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Affiliation(s)
- Jennifer R Verani
- Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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32
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Verani JR, Gilman RH, Kirchhoff LV, Cabrera L, Pinedo-Cancino V, Bowman NM, Seitz A, Ferrufino L, Levy MZ, Galdos-Cardenas G, Verastegui M, Bern C, LaFuente C, Steurer F, Todd CW, de LaFuente E, Kawai V. Geographic Variation in the Sensitivity of Recombinant Antigen-based Rapid Tests for Chronic Trypanosoma cruzi Infection. Am J Trop Med Hyg 2009. [DOI: 10.4269/ajtmh.2009.80.410] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Fitzwater S, LaFuente C, Bern C, Gilman RH, Calderon M, Galdos-Cardenas G, Verastegui M, Ferrufino L. Polymerase Chain Reaction for Chronic Trypanosoma cruzi Infection Yields Higher Sensitivity in Blood Clot Than Buffy Coat or Whole Blood Specimens. Am J Trop Med Hyg 2008. [DOI: 10.4269/ajtmh.2008.79.768] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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34
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Fitzwater S, Calderon M, Lafuente C, Galdos-Cardenas G, Ferrufino L, Verastegui M, Gilman RH, Bern C. Polymerase chain reaction for chronic Trypanosoma cruzi infection yields higher sensitivity in blood clot than buffy coat or whole blood specimens. Am J Trop Med Hyg 2008; 79:768-770. [PMID: 18981520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
Trypanosoma cruzi polymerase chain reaction (PCR) is widely used, but sensitivity varies widely. We compared PCR using 121/122 primers targeting kinetoplast minicircle DNA in whole blood, buffy coat, and clot from Bolivian women. Sensitivity was significantly higher in clot (60.1%) than buffy coat (46.5%) or whole blood (40%). The use of clot could simplify specimen collection while improving sensitivity.
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Affiliation(s)
- Sean Fitzwater
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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35
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Gavidia CM, Gonzalez AE, Zhang W, McManus DP, Lopera L, Ninaquispe B, Garcia HH, Rodríguez S, Verastegui M, Calderon C, Pan WKY, Gilman RH. Diagnosis of cystic echinococcosis, central Peruvian Highlands. Emerg Infect Dis 2008; 14:260-6. [PMID: 18258119 PMCID: PMC2600205 DOI: 10.3201/eid1402.061101] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [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: 12/28/2022] Open
Abstract
High prevalence was confirmed by ultrasonography, radiography, and 2 serologic tests, although usefulness of serologic testing in the field was limited. We evaluated prevalence of cystic echinococcosis (CE) in a central Peruvian Highland district by using 4 diagnostic methods: ultrasonography for 949 persons, radiography for 829, and 2 serologic tests for 929 (2 immunoblot formats using bovine hydatid cyst fluid [IBCF] and recombinant EpC1 glutathione S-transferase [rEpC1-GST] antigens). For the IBCF and rEpC1-GST testing, prevalence of liver and pulmonary CE was 4.7% and 1.1% and seropositivity was 8.9% and 19.7%, respectively. Frequency of seropositive results for IBCF and rEpC1-GST testing was 35.7% and 16.7% (all hepatic cysts), 47.1% and 29.4% (hepatic calcifications excluded), and 22.2% and 33.3% (lung cysts), respectively. Weak immune response against lung cysts, calcified cysts, small cysts, and cysts in sites other than lung and liver might explain the poor performance of the serodiagnostic tests. We confirm that CE is highly endemic to Peru and emphasize the limited performance of available serologic assays in the field.
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Affiliation(s)
- Cesar M Gavidia
- Universidad Nacional Mayor de San Marcos, San Borja, Lima, Peru.
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36
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Verastegui M, Gilman RH, Arana Y, Barber D, Velásquez J, Farfán M, Chile N, Kosek JC, Kosek M, Garcia HH, Gonzalez A. Taenia solium oncosphere adhesion to intestinal epithelial and Chinese hamster ovary cells in vitro. Infect Immun 2007; 75:5158-66. [PMID: 17698575 PMCID: PMC2168301 DOI: 10.1128/iai.01175-06] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The specific mechanisms underlying Taenia solium oncosphere adherence and penetration in the host have not been studied previously. We developed an in vitro adhesion model assay to evaluate the mechanisms of T. solium oncosphere adherence to the host cells. The following substrates were used: porcine intestinal mucosal scrapings (PIMS), porcine small intestinal mucosal explants (PSIME), Chinese hamster ovary cells (CHO cells), epithelial cells from ileocecal colorectal adenocarcinoma (HCT-8 cells), and epithelial cells from colorectal adenocarcinoma (Caco-2 cells). CHO cells were used to compare oncosphere adherence to fixed and viable cells, to determine the optimum time of oncosphere incubation, to determine the role of sera and monolayer cell maturation, and to determine the effect of temperature on oncosphere adherence. Light microscopy, scanning microscopy, and transmission microscopy were used to observe morphological characteristics of adhered oncospheres. This study showed in vitro adherence of activated T. solium oncospheres to PIMS, PSIME, monolayer CHO cells, Caco-2 cells, and HCT-8 cells. The reproducibility of T. solium oncosphere adherence was most easily measured with CHO cells. Adherence was enhanced by serum-binding medium with >5% fetal bovine serum, which resulted in a significantly greater number of oncospheres adhering than the number adhering when serum at a concentration less than 2.5% was used (P < 0.05). Oncosphere adherence decreased with incubation of cells at 4 degrees C compared with the adherence at 37 degrees C. Our studies also demonstrated that T. solium oncospheres attach to cells with elongated microvillus processes and that the oncospheres expel external secretory vesicles that have the same oncosphere processes.
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Affiliation(s)
- Manuela Verastegui
- Department of Microbiology, Universidad Peruana Cayetano Heredia, P.O. Box 5045, Lima, Peru
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37
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Mayta H, Hancock K, Levine MZ, Gilman RH, Farfán MJ, Verastegui M, Lane WS, Garcia HH, Gonzalez AE, Tsang VCW. Characterization of a novel Taenia solium oncosphere antigen. Mol Biochem Parasitol 2007; 156:154-61. [PMID: 17850901 PMCID: PMC2082053 DOI: 10.1016/j.molbiopara.2007.07.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2007] [Revised: 07/26/2007] [Accepted: 07/26/2007] [Indexed: 11/29/2022]
Abstract
Infections due to Taenia solium in humans (taeniasis/cysticercosis) remain a complex health problem, particularly in developing countries. We identified two oncosphere proteins that might protect the porcine intermediate host against cysticercosis and therefore help prevent disease in humans. One of these proteins was further identified by two-dimensional gel electrophoresis and micro-sequencing. The gene encoding this protective protein was also identified, cloned and characterized. The native 31.5 kDa protein Tso31 has four variants at the cDNA level. The longest sequence from which the others seem to derive, encodes a 253 amino acid peptide. The predicted protein has a molecular weight of 25.1 kDa, one putative N-glycosylation site, two fibronectin type III domains, and one C terminal transmembrane domain. The gene structure of the protein consists of four exons and three introns. The finding of one gene and four different cDNAs for Tso31 suggests the existence of a possible mechanism of differential splicing in this parasite. The Tso31 protein is exclusive to T. solium oncospheres with a putative protein structure of an extra-cellular receptor-like protein. The Tso31 protein was expressed as a recombinant protein fused to GST and tested in a vaccine to determine its effectiveness in protecting pigs against cysticercosis. Only two pigs out of eight vaccinated were protected and although the total median number of cyst decreased in vaccinated pigs compared to controls this decrease was not statistically significant (P = 0.09).
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MESH Headings
- Amino Acid Motifs/genetics
- Animals
- Antigens, Helminth/chemistry
- Antigens, Helminth/genetics
- Antigens, Helminth/immunology
- Antigens, Helminth/isolation & purification
- Binding Sites/genetics
- Cloning, Molecular
- Cysticercosis/prevention & control
- DNA, Complementary/isolation & purification
- DNA, Helminth/chemistry
- DNA, Helminth/genetics
- Electrophoresis, Gel, Two-Dimensional
- Glycosylation
- Helminth Proteins/chemistry
- Helminth Proteins/genetics
- Helminth Proteins/immunology
- Helminth Proteins/isolation & purification
- Molecular Sequence Data
- Molecular Weight
- RNA Splicing/physiology
- Sequence Analysis, DNA
- Sequence Analysis, Protein
- Swine
- Taenia solium/genetics
- Taenia solium/immunology
- Vaccines, Subunit/immunology
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Affiliation(s)
- Holger Mayta
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Kathy Hancock
- DPD/NCID, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Min Z. Levine
- DPD/NCID, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Robert H. Gilman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru
- *Corresponding author. Mailing address: Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street W5515, Baltimore, MD 21205. Phone: (410) 614-3959, Fax: (410) 614-6060. E-mail:
| | - Marilú J. Farfán
- Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Manuela Verastegui
- Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - William S. Lane
- Microchemistry and Proteomics Analysis Facility, Harvard University, Cambridge, Massachusetts
| | - Hector H. Garcia
- Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas
| | - Armando E. Gonzalez
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
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38
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Garcia HH, Gonzalez AE, Gilman RH, Moulton LH, Verastegui M, Rodriguez S, Gavidia C, Tsang VCW. Combined human and porcine mass chemotherapy for the control of T. solium. Am J Trop Med Hyg 2006; 74:850-5. [PMID: 16687692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023] Open
Abstract
A combined (human and porcine) mass chemotherapy program was tested in a controlled design in 12 village hamlets in the Peruvian highlands. A single dose of 5 mg of praziquantel was given to eliminate intestinal taeniasis in humans, and two rounds of oxfendazole (30 mg/kg) were administered to all pigs. The total population in the study villages was 5,658 resident individuals, and the porcine population at the beginning of the study was 716 pigs. Human treatment coverage was 75%, ranging from 69% to 80%. There were only a few refusals of owners for porcine treatment of their animals. The effect of the intervention was measured by comparing incidence rates (seroconversion in pigs who were seronegative 4 months before) in treatment versus control villages, before and up to 18 months after treatment. There was a clear effect in decreasing prevalence (odds ratio, 0.51; P < 0.001) and incidence (odds ratio, 0.39; P < 0.013) in the treatment area after the intervention, which did not leave to extinction of the parasite but stabilized in slightly decreased rates persisting along the follow-up period. Mass chemotherapy was effective in decreasing infection pressure in this hyperendemic area. However, the magnitude of the effect was small and did not attain the goal of eliminating transmission.
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Affiliation(s)
- H H Garcia
- Department of Microbiology, Universidad Peruana Cayetano Heredia, San Martin de Porras, Lima, Peru.
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39
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Uddin J, Gonzalez AE, Gilman RH, Garcia HH, Verastegui M, Moore LJ, Evans CAW, Read RC, Friedland JS. Neurocysticercal antigens stimulate chemokine secretion from human monocytes via an NF-kappaB-dependent pathway. Microbes Infect 2006; 8:1732-40. [PMID: 16815071 DOI: 10.1016/j.micinf.2006.02.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2005] [Revised: 01/13/2006] [Accepted: 02/02/2006] [Indexed: 10/24/2022]
Abstract
Neurocysticercosis, infection with larval Taenia solium, is a common, serious neuroparasitic infection. Larval degeneration results in inflammatory cell influx and granuloma formation which leads to clinical symptomatology. The role of chemokines in such cell influx is unknown. We demonstrate that monocyte stimulation by T. solium larval antigen (TsAg) results in a differential profile of CXCL8/IL-8 (146.5+/-8.5ng/ml after 24h), CCL2/MCP-1 (267+/-4 ng/ml after 48 h) and CCL3/MIP-1alpha (1.72+/-0.43 ng/ml after 8 h) secretion. There was coordinate mRNA accumulation reaching maximum at 1h for CCL3 and 2 h for CXCL8 and CCL2. TsAg induced maximal nuclear binding of p65, p50 and c-rel subunits of the transcriptional regulator NF-kappaB by 2 h. IkappaBalpha but not IkappaBbeta was degraded within 10 min before resynthesis by 2 h. Pre-treatment with the broad-spectrum NF-kappaB inhibitor pyrrolidine dithiocarbamate caused complete abrogation of TsAg-induced CCL2 secretion (p=0.005) and 91% reduction of CXCL8 secretion (p=0.0003). TsAg was unable to induce CXCL8 promoter activity in Toll-like receptor (TLR)-2 or TLR-4/MD-2 transfected HeLa cells in the absence of lectins or other adaptor molecules. In summary, our data demonstrate that TsAg induces chemokine secretion via specific pathways dependent on NF-kappaB but not TLR-4/TLR-2, and indicate a potential mechanism whereby larval degeneration results in brain inflammation.
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Affiliation(s)
- Jasim Uddin
- Department of Infectious Diseases and Immunity, Faculty of Medicine and Wellcome Trust Centre for Clinical Tropical Medicine, Imperial College, Hammersmith Hospital, London, UK
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40
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Rodrìguez ML, Rodriguez S, Gonzalez AE, Verastegui M, Bernal T, Jimenez JA, Garcia HH. Can Taenia solium Latent Post-Oncospheral Stages be Found in Muscle Tissue of Cysticercosis-Infected Pigs (Sus scrofa)? J Parasitol 2006; 92:199-201. [PMID: 16629340 DOI: 10.1645/ge-571r1.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The existence of latent Taenia solium post-oncospheral stages in the tissues of infected pigs has been postulated. To assess whether such structures exist and can be detected, we examined muscle samples from cysticercosis-infected and uninfected pigs. Pork samples were homogenized, centrifuged, and resuspended in saline solution. Round microscopic structures of approximately 10 microm with variable refringence were found in the pellets of all samples from both infected and uninfected pigs. These became homogeneously red after staining with Sudan IV and disappeared after ether extraction. The only difference between samples from infected and uninfected pigs was the presence of inflammatory cells and tissue necrosis debris in the former group. Taenia solium oncospheres were stained and observed for comparative purposes, before and after inoculation into pork. Control oncospheres were ellipsoidal, had nucleated basophile cells in their interior, and showed red aggregates on their surfaces when stained with 3% Sudan IV. While rounded microscopical structures similar to those previously reported were found, these differed morphologically from oncospheres, were of a lipid nature, and occurred in both infected and uninfected animals. No evidence supporting the presence of latent post-oncospheral stages of Taenia solium was generated in this series of experiments.
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Affiliation(s)
- Mary L Rodrìguez
- Department of Microbiology, Universidad Peruana Cayetano Heredia, Av. H. Delgado 430, SMP, Lima 31, Lima, Peru
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41
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Gonzalez AE, Gauci CG, Barber D, Gilman RH, Tsang VCW, Garcia HH, Verastegui M, Lightowlers MW. Vaccination of pigs to control human neurocysticercosis. Am J Trop Med Hyg 2005; 72:837-9. [PMID: 15964973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023] Open
Abstract
Taenia solium taeniasis/cysticercosis is a zoonotic disease complex in which the pig is an obligate intermediate host. The infection is widespread, particularly in the developing world, and neurocysticercosis is a major cause of human neurologic disease where the parasite is endemic. Despite easy availability, effective anti-parasitic drugs have not been deployed effectively to control disease transmission. We have investigated a vaccine strategy to prevent parasite infection of the pig intermediate host. Such a strategy would interrupt the parasite's life cycle and eliminate the source of infection for humans. Two recombinant antigens selected from the parasite oncosphere life cycle stage were tested in vaccination trials in pigs that were challenged orally with Taenia solium eggs. Both antigens were highly effective in protecting the pigs against infection with the parasite (98.6% and 99.9% protection, respectively). No viable cysts were found in eight pigs vaccinated with one of the antigens. A recombinant subunit vaccine based on oncosphere antigens has the potential to improve the available control measures for T. solium and thereby reduce or eliminate neurocysticercosis.
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Affiliation(s)
- Armando E Gonzalez
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
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42
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Moro PL, Garcia HH, Gonzales AE, Bonilla JJ, Verastegui M, Gilman RH. Screening for cystic echinococcosis in an endemic region of Peru using portable ultrasonography and the enzyme-linked immunoelectrotransfer blot (EITB) assay. Parasitol Res 2005; 96:242-6. [PMID: 15875215 DOI: 10.1007/s00436-005-1350-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2004] [Accepted: 03/10/2005] [Indexed: 10/25/2022]
Abstract
Cystic echinococcosis (CE) caused by the larval form of Echinococcus granulosus is a major public health problem in sheep-raising regions of the World. This study compared portable ultrasound with the enzyme-linked immunoelectrotransfer blot (EITB) assay as screening methods to estimate the prevalence of human CE in a remote village in the Peruvian Andes. Three hundred eighty-nine villagers were examined by portable ultrasound and blood samples were drawn by venipuncture. Sera were collected and tested for antibodies against CE using an EITB assay. Cystic lesions were classified based on their ultrasound morphologic characteristics. The prevalence of human CE using portable ultrasound and the EITB assay were 4.9% and 2.6%, respectively. Fifty-three percent of subjects with CE were EITB positive. Portable ultrasound was well received by the community, augmented CE detection and allowed a faster estimate of human infection than the EITB assay.
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Affiliation(s)
- Pedro L Moro
- National Immunization Program, Centers for Disease Control and Prevention, 1600 Clifton Rd, 61, Atlanta, GA, USA.
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43
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Henríquez C, Hinojosa JC, Ventosilla P, Infante B, Merello J, Mallqui V, Verastegui M, Maguiña C. Report of an unusual case of persistent bacteremia by Bartonella bacilliformis in a splenectomized patient. Am J Trop Med Hyg 2004; 71:53-5. [PMID: 15238689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023] Open
Abstract
We report a case of a 56-year-old man with a history of splenectomy for idiopathic thrombocytopenic purpura who developed persistent bacteremia in the acute phase of human bartonellosis. This patient did not develop hemolytic anemia. Only after several courses of antibiotic treatment was the infection eradicated. This is an unusual case of overwhelming post-splenectomy infection by Bartonella bacilliformis, which provides clinical evidence that the spleen is a critical effector organ of clearance of this infection as well as the effector organ of bartonellosis-associated hemolytic anemia.
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Affiliation(s)
- César Henríquez
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, AP 4314, Lima 100, Peru.
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44
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Verastegui M, Gilman RH, Garcia HH, Gonzalez AE, Arana Y, Jeri C, Tuero I, Gavidia CM, Levine M, Tsang VCW. Prevalence of antibodies to unique Taenia solium oncosphere antigens in taeniasis and human and porcine cysticercosis. Am J Trop Med Hyg 2003; 69:438-44. [PMID: 14640505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
The presence of two oncosphere antigens (OAs) of 22.5 and 31.3 kD in whole and excretory/secretory (ES) OA preparations of both Taenia solium and T. saginata or in antigen preparations from T. solium metacestodes or immature tapeworms was assessed. This included an evaluation of whether antibodies to other cestodes cross-reacted to these OAs. The OAs were present in whole oncosphere extract and E/S antigens of T. solium, but were not present in other stages (immature tapeworm or metacestode) or in OAs of T. saginata. The majority (95%) of T. solium tapeworm carriers had antibodies to these OAs, while only 20% of active neurocysticercosis cases were positive. No antibodies to the OAs were found in healthy controls, subjects infected with Hymenolepis nana, patients with hydatid disease, T. saginata tapeworm carriers, hamsters infected with immature T. solium tapeworms, or dogs infected with Echinococcus granulosus. The OAs are stage and species specific to T. solium and antibodies to OAs are usually present in tapeworm carriers.
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Affiliation(s)
- Manuela Verastegui
- Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru
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45
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Dueger EL, Verastegui M, Gilman RH. Evaluation of the enzyme-linked immunoelectrotransfer blot (EITB) for ovine hydatidosis relative to age and cyst characteristics in naturally infected sheep. Vet Parasitol 2003; 114:285-93. [PMID: 12809754 DOI: 10.1016/s0304-4017(03)00128-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
An enzyme-linked immunoelectrotransfer blot (EITB) for ovine echinococcosis was evaluated in an endemic area of the Peruvian central sierra. An overall test sensitivity of 91.4% was determined for 199 sheep. EITB sensitivity reached a plateau of nearly 100% at 3 years of age, while the prevalence of cystic disease peaked at 95% in sheep >/=6 years of age. In this highly endemic area, 61.7% of sheep without detectable cystic disease at necropsy (n=47) had positive EITB results. Relationships between EITB sensitivity, age, and cyst location, size, number, type, fertility, and viability were evaluated with logistic regression models. EITB sensitivity increased 14-fold in sheep with calcified cysts and 4-fold for each 1cm increase in pulmonary cyst size.
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Affiliation(s)
- Erica L Dueger
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
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46
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Moro PL, Lopera L, Bonifacio N, Gilman RH, Silva B, Verastegui M, Gonzales A, Garcia HH, Cabrera L. Taenia solium infection in a rural community in the Peruvian Andes. Ann Trop Med Parasitol 2003; 97:373-9. [PMID: 12831523 DOI: 10.1179/000349803235002371] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
An epidemiological study was conducted in a highland, rural community in Peru, to determine the seroprevalences of human and porcine infection with Taenia solium and the risk factors associated with human infection. The seroprevalences, determined using an assay based on enzyme-linked-immuno-electrotransfer blots (EITB), were 21% (66/316) in the humans and 65% (32/49) in the pigs. The human subjects aged <30 years were more likely to be positive for anti-T. solium antibodies than the older subjects (P < 0.001). The risk factors associated with human seropositivity were lack of education beyond the elementary level [odds ratio (OR)=2.69; 95% confidence interval (CI)=1.09-6.65] and pig-raising (OR=1.68; CI=0.96-2.92). Curiously, sheep-raising was inversely associated with human T. solium infection (OR=0.50; CI=0.28-0.90). The study site appears to be a new endemic focus for T. solium in the central Peruvian Andes. Although, in earlier studies, the seroprevalence of T. solium infection has generally been found to increase with age, the opposite trend was observed in the present study. The results of follow-up studies should help determine if the relatively high seroprevalence in the young subjects of the present study is the result of a transient antibody response.
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Affiliation(s)
- P L Moro
- Asociacion Benefica PRISMA, C Gonzalez 251, Maranga, San Miguel, Lima, Peru.
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47
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Garcia HH, Gonzalez AE, Gavidia C, Falcon N, Bernal T, Verastegui M, Rodriguez S, Tsang VCW, Gilman RH. Seroincidence of porcine T. solium infection in the Peruvian highlands. Prev Vet Med 2003; 57:227-36. [PMID: 12609467 DOI: 10.1016/s0167-5877(02)00234-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We performed repeated serological sampling of pigs in an endemic area of the Peruvian highlands (eight villages) to assess the feasibility of detecting incident cases of Taenia solium infection as indicators of ongoing transmission of the parasite. A total of 2245 samples corresponding to 1548 pigs were collected in three sampling rounds (n=716, 926, and 603, respectively). Village-period specific seroprevalences of antibodies by enzyme-linked immunoelectrotransfer blot (EITB) assay varied from 39% (95% CI: 34, 44) to 76% (95% CI: 72, 79). The prevalence of cysticercosis increased with the age of the pigs (similarly for both sexes). Around 40% of pigs were re-sampled at the end of each 4-month period. Crude incidence risks were 48% (57/120, 95% CI: 43-52) and 58% (111/192, 95% CI: 54-61) for each period. A proportion of seropositive animals became seronegative at the end of each period (23 and 15%). Incidence varied by the village, and the exposure period, and was higher in males than females (but did not differ by age).
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Affiliation(s)
- H H Garcia
- Department of Microbiology, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martin de Porras, Lima, Peru
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48
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García HH, Gilman RH, Gonzalez AE, Verastegui M, Rodriguez S, Gavidia C, Tsang VCW, Falcon N, Lescano AG, Moulton LH, Bernal T, Tovar M. Hyperendemic human and porcine Taenia solium infection in Perú. Am J Trop Med Hyg 2003; 68:268-75. [PMID: 12685628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
The prevalence and characteristics of human taeniasis/cysticercosis and porcine cysticercosis were assessed in an endemic area of the Peruvian highlands. Individuals from 10 communities had stool examinations (N = 2,951) and serologic testing for Taenia solium antibodies (N = 2,583). The total porcine population present (N = 703) was also examined by serology. Cysticercosis is hyperendemic in this area and is associated with an important number of seizure cases. Human seroprevalence by village ranged from 7.1-26.9% (mean, 13.9%). Seroprevalence was higher among individuals with a history of seizures but not in those reporting a history of headache or intestinal taeniasis. Prevalence of taeniasis ranged from 0-6.7% (median, 2.5%). Coproantigen detection found 2.4 times more taeniasis cases than did microscopy (direct and after concentration). Age distribution for taeniasis showed a peak at younger ages than for seroprevalence. Porcine seroprevalence ranged from 42-75%. Random effects logistic regression models for human seropositivity demonstrated both in-house clustering of cases and a large increase in risk associated with a tapeworm carrier in the house. Besides confirming the close relationship between taeniasis and cysticercosis cases, this large-scale field study demonstrated early age of tapeworm and cysticercosis infections in humans, and short duration of taeniasis infections.
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Affiliation(s)
- Héctor H García
- Department of Microbiology, Universidad Peruana Cayetano Heredia, Lima, Perú.
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49
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Verastegui M, Gilman RH, Gonzales A, Garcia HH, Gavidia C, Falcon N, Bernal T, Arana Y, Tsang VCW. Taenia solium oncosphere antigens induce immunity in pigs against experimental cysticercosis. Vet Parasitol 2002; 108:49-62. [PMID: 12191899 DOI: 10.1016/s0304-4017(02)00182-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Immunity to Taenia solium infection was investigated using an experimental intramuscular oncosphere infection assay (IMOA) model in pigs. Three naturally infected pigs with cysticercosis were treated with oxfendazole (OFZ), a drug demonstrated to kill cysts in porcine muscle. These animals were then challenged with oncospheres but did not develop any cysts while three uninfected pigs that were similarly challenged, did develop intramuscular cysts. In another study, two groups of three pigs each were immunized with crude T. solium oncosphere and metacestode antigens, respectively, and tested with the IMOA. Immunization with crude oncosphere antigens (OAs) induced 100% protection, while metacestode antigens provided only partial protection. Immunoblots showed that pigs with complete immune protection to oncosphere intramuscular challenge had antibodies to two OAs at 31.3 and 22.5 kDa, respectively. Antibody to these two antigens was absent in pigs immunized with metacestodes or in uninfected control pigs. This study demonstrated the presence of two antigens that are unique to the oncosphere. Although, antibody to these two antigens is consistently present in pigs that are protected from an oncosphere intramuscular challenge their role in preventing infection by T. solium larval cysts is still hypothetical.
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Affiliation(s)
- Manuela Verastegui
- Department of Pathology and Microbiology, Universidad Peruana Cayetano Heredia, Lima, Peru
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50
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Bern C, Ortega Y, Checkley W, Roberts JM, Lescano AG, Cabrera L, Verastegui M, Black RE, Sterling C, Gilman RH. Epidemiologic differences between cyclosporiasis and cryptosporidiosis in Peruvian children. Emerg Infect Dis 2002; 8:581-5. [PMID: 12023913 PMCID: PMC2738493 DOI: 10.3201/eid0806.01-0331] [Citation(s) in RCA: 79] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
We compared the epidemiologic characteristics of cyclosporiasis and cryptosporidiosis in data from a cohort study of diarrhea in a periurban community near Lima, Peru. Children had an average of 0.20 episodes of cyclosporiasis/year and 0.22 episodes of cryptosporidiosis/year of follow-up. The incidence of cryptosporidiosis peaked at 0.42 for 1-year-old children and declined to 0.06 episodes/child-year for 5- to 9-year-old children. In contrast, the incidence of cyclosporiasis was fairly constant among 1- to 9-year-old children (0.21 to 0.28 episodes/child-year). Likelihood of diarrhea decreased significantly with each episode of cyclosporiasis; for cryptosporidiosis, this trend was not statistically significant. Both infections were more frequent during the warm season (December to May) than the cooler season (June to November). Cryptosporidiosis was more frequent in children from houses without a latrine or toilet. Cyclosporiasis was associated with ownership of domestic animals, especially birds, guinea pigs, and rabbits.
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Affiliation(s)
- Caryn Bern
- Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
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