Genetic variants of TLR4, including the novel variant, rs5030719, and related genes are associated with susceptibility to clinical malaria in African children

BACKGROUND

Malaria is a deadly disease caused by Plasmodium spp. Several blood phenotypes have been associated with malarial resistance, which suggests a genetic component to immune protection.

METHODS

One hundred and eighty-seven single nucleotide polymorphisms (SNPs) in 37 candidate genes were genotyped and investigated for associations with clinical malaria in a longitudinal cohort of 349 infants from Manhiça, Mozambique, in a randomized controlled clinical trial (RCT) (AgeMal, NCT00231452). Malaria candidate genes were selected according to involvement in known malarial haemoglobinopathies, immune, and pathogenesis pathways.

RESULTS

Statistically significant evidence was found for the association of TLR4 and related genes with the incidence of clinical malaria (p = 0.0005). These additional genes include ABO, CAT, CD14, CD36, CR1, G6PD, GCLM, HP, IFNG, IFNGR1, IL13, IL1A, IL1B, IL4R, IL4, IL6, IL13, MBL, MNSOD, and TLR2. Of specific interest, the previously identified TLR4 SNP rs4986790 and the novel finding of TRL4 SNP rs5030719 were associated with primary cases of clinical malaria.

CONCLUSIONS

These findings highlight a potential central role of TLR4 in clinical malarial pathogenesis. This supports the current literature and suggests that further research into the role of TLR4, as well as associated genes, in clinical malaria may provide insight into treatment and drug development.

Evaluation of morphology and biventricular cardiac function in children with congenital zika syndrome

Introduction

The infection caused by the Zika virus during pregnancy causes microcephaly and brain damage in fetus, and the systemic involvement with diffuse muscle impairment, high frequency of arthrogryposis and microphthalmia, characterizes congenital Zika syndrome (CZS). The cardiac impairment in CZS was rarely evaluated.

Purpose

To evaluate the morphology and biventricular cardiac function in children affected by CZS, using electrocardiogram (EKG), echocardiogram and biomarkers dosage.

Methods

This is a cross-sectional study conducted with 52 children with CZS (GZ) compared with 25 healthy children (CG). Clinical evaluation, EKG, and echocardiogram were performed in all of them. Also, troponin I and natriuretic peptide type B (BNP) dosages were performed in GZ.

Results

The median age of the studied population was 5 years in groups, GZ (3 to 6 years), CG (3 to 8 years), 40.4% (GZ) and 60% (CG) of female gender. The most prevalent electrocardiographic alteration was sinus arrhythmia, GZ: 9 (17.3%) and CG: 4 (16%). The echocardiographic evaluation showed the morphological parameters adjusted for the Z score: left ventricular (LV) end-diastolic diameter in GZ: −2.36 [−5.10, 2.63] vs CG: −1.07 [−3.43, 0.61], p<0.001; LV end-systolic diameter in GZ: −1.02 [−4.49, 0.62] vs CG: −0.06 [−1.98, 2.28], p<0.01; ascending aorta in GZ: −0.09 [−2.08, 1.60] vs CG: 0.43 [−1.47, 2.2], p: 0.021; basal diameter of the right ventricle (RV) in GZ: −2.34 [−4.90, 0.97] vs CG: −0.96 [−2.21, 0.40], p<0.01; pulmonary artery dimension in GZ: −2.13 [−5.99, 0.98] vs CG: −0.24 [−2.53, 0.59], p<0.01. The left atrium volume index (ml/m2) was in GZ: 13.15 [6.80, 18.00] vs CG: 18.80 [5.90, 25.30], p<0.01; right atrium volume index (ml/m2) in GZ: 10.10 [4.90, 15.30] vs CG: 15.80 [4.10, 24.80], p<0.01. The septum systolic excursion of the mitral annular plane (MAPSE, cm) was in GZ: 0.98 [0.78, 1.66] vs CG: 1.25 [1.07, 1.56], p<0.01; and lateral annulus: 1.25 [0.81, 1.86] vs CG: 1.46 [1.07, 1.83], p<0.001; tricuspid annular plane systolic excursion (cm) in GZ: 1.52 [1.13, 2.34] vs CG: 1.90 [1.62, 2.35], p<0.01; S' of the RV (cm/s) was in GZ: 10.60 [6.49, 21.00] vs CG: 12.80 [9.19, 16.20], p<0.01. The peak of late mitral inflow (A wave, cm/s) was in GZ: 64 [24, 134] vs CG: 52 [26, 94], p=0.02; peak of late diastolic mitral annular wave (e') of septum (cm/s) was GZ: 15 [7, 23] vs CG: 17 [12, 27], p<0.01; peak of e' lateral (cm/s) was in GZ: 11 [7, 19], CG: 12 [9, 15], p<0,016; E/e' ratio was GZ: 7.52 [4.57, 10.78] vs CG: 6.41 [4.75, 12.64], p<0.01. The LV longitudinal and circumferential and RV longitudinal strain measurements showed no difference between the groups.

Conclusion

A reduction in cardiac dimensions and biventricular dysfunction was found in CZS, showing an early cardiac impairment, which will enable to establishment early therapies, avoiding severe heart failure.

Funding Acknowledgement

Type of funding sources: None.

Positive selection over the mitochondrial genome and its role in the diversification of gentoo penguins in response to adaptation in isolation

Although mitochondrial DNA has been widely used in phylogeography, evidence has emerged that factors such as climate, food availability, and environmental pressures that produce high levels of stress can exert a strong influence on mitochondrial genomes, to the point of promoting the persistence of certain genotypes in order to compensate for the metabolic requirements of the local environment. As recently discovered, the gentoo penguins (Pygoscelis papua) comprise four highly divergent lineages across their distribution spanning the Antarctic and sub-Antarctic regions. Gentoo penguins therefore represent a suitable animal model to study adaptive processes across divergent environments. Based on 62 mitogenomes that we obtained from nine locations spanning all four gentoo penguin lineages, we demonstrated lineage-specific nucleotide substitutions for various genes, but only lineage-specific amino acid replacements for the ND1 and ND5 protein-coding genes. Purifying selection (dN/dS < 1) is the main driving force in the protein-coding genes that shape the diversity of mitogenomes in gentoo penguins. Positive selection (dN/dS > 1) was mostly present in codons of the Complex I (NADH genes), supported by two different codon-based methods at the ND1 and ND4 in the most divergent lineages, the eastern gentoo penguin from Crozet and Marion Islands and the southern gentoo penguin from Antarctica respectively. Additionally, ND5 and ATP6 were under selection in the branches of the phylogeny involving all gentoo penguins except the eastern lineage. Our study suggests that local adaptation of gentoo penguins has emerged as a response to environmental variability promoting the fixation of mitochondrial haplotypes in a non-random manner. Mitogenome adaptation is thus likely to have been associated with gentoo penguin diversification across the Southern Ocean and to have promoted their survival in extreme environments such as Antarctica. Such selective processes on the mitochondrial genome may also be responsible for the discordance detected between nuclear- and mitochondrial-based phylogenies of gentoo penguin lineages.

The impact of mitral regurgitation grade on exercise capacity following cardiac rehabilitation program after transcatheter aortic valve implantation

Introduction

Severe aortic stenosis (AS) and mitral regurgitation (MR) often coexist. Transcatheter aortic valve implantation (TAVI) is becoming widely used for the treatment of patients (pts) with symptomatic severe AS. However, conflicting data reside concerning the impact of MR on outcomes after TAVI. Also, very few data exist regarding the benefits of a cardiac rehabilitation program (CRP) following TAVI in pts with MR.

Purpose

To evaluate the effect of a CRP in functional parameters after TAVI, particularly in pts with MR grade ≥ II.

Methods

Retrospective study which included all pts submitted to TAVI between 2014 and 2020 that completed a CRP following the procedure. Cardiopulmonary exercise tests (CPET) were performed after TAVI at baseline (pre-CRP) and post-CRP. We evaluated pre- and post-CRP peak oxygen consumption (pVO2), pVO2 at the anaerobic threshold (AT), respiratory exchange ratio (RER), VE/VCO2 and CPET duration. The exercise protocol included low/medium intensity exercises and consisted of sessions 3 times per week carried over 3 months. MR grading severity was assessed with transthoracic echocardiography performed after TAVI and was divided into 2 groups (grade &lt; II vs grade ≥ II).

Results

Fifty-two pts were included, 59,6% were male, mean age of 78,6±8,6 years-old. Mean Society of Thoracic Surgery (STS) risk score was 4,9. Mean pre-TAVI aortic valve area was 0,68 cm2, with a mean gradient of 45,5 mmHg and a mean ejection fraction (EF) of 51%. The majority of pts implanted a self-expandable prosthesis (55,8%).

Twenty-seven (51,9%) pts had MR grade ≥ II. Baseline characteristics were similar between pts with MR grade &lt; II vs MR grade ≥ II, with the exception of the prevalence of coronary artery disease which was higher in MR grade ≥ II (p=0,036). Patients with MR grade &lt; II had higher maximum and median aortic gradients before TAVI (p&lt;0,05 for all). The mean number of cardiac rehabilitation sessions was 21±7, without differences between both groups. In pts with MR grade ≥ II, there was an improvement in CPET duration after CRP (HF protocol from 03:57 min to 05:02 min; p=0,017 and modified Bruce protocol from 06:03 min to 06:41 min; p=0,049) but without significant changes in pVO2 (14,7 mL/kg/min to 14,9 mL/kg/min; p=0,990), RER or VEVCO2/VO2 ratio. Patients with MR grade &lt; II significantly improved pVO2 (13,8 mL/kg/min to 14,7 mL/kg/min; p=0,015), and CPET duration with HF protocol from 05:04 min to 06:23 min; p=0,006 after CRP. There was also an improvement in VEVCO2/VO2 ratio, although not statically significant.

Conclusions

Patients with MR grade &lt; II after TAVI who underwent a CRP significantly improved pVO2 and CPET duration. Although pts with MR grade ≥ II did not improved pVO2 after a CRP, an improvement in CPET duration may translate into a clinical benefit in these pts. These results highlight the importance of further research and personalization among this potentially higher risk subset of pts.

Funding Acknowledgement

Type of funding sources: None.

A Balanced Proinflammatory and Regulatory Cytokine Signature in Young African Children Is Associated With Lower Risk of Clinical Malaria

BACKGROUND

The effect of timing of exposure to first Plasmodium falciparum infections during early childhood on the induction of innate and adaptive cytokine responses and their contribution to the development of clinical malaria immunity is not well established.

METHODS

As part of a double-blind, randomized, placebo-controlled trial in Mozambique using monthly chemoprophylaxis with sulfadoxine-pyrimethamine plus artesunate to selectively control timing of malaria exposure during infancy, peripheral blood mononuclear cells collected from participants at age 2.5, 5.5, 10.5, 15, and 24 months were stimulated ex vivo with parasite schizont and erythrocyte lysates. Cytokine messenger RNA expressed in cell pellets and proteins secreted in supernatants were quantified by reverse-transcription quantitative polymerase chain reaction and multiplex flow cytometry, respectively. Children were followed up for clinical malaria from birth until 4 years of age.

RESULTS

Higher proinflammatory (interleukin [IL] 1, IL-6, tumor necrosis factor) and regulatory (IL-10) cytokine concentrations during the second year of life were associated with reduced incidence of clinical malaria up to 4 years of age, adjusting by chemoprophylaxis and prior malaria exposure. Significantly lower concentrations of antigen-specific T-helper 1 (IL-2, IL-12, interferon-γ) and T-helper 2 (IL-4, IL-5) cytokines by 2 years of age were measured in children undergoing chemoprophylaxis compared to children receiving placebo (P < .03).

CONCLUSIONS

Selective chemoprophylaxis altering early natural exposure to malaria blood stage antigens during infancy had a significant effect on T-helper lymphocyte cytokine production >1 year later. Importantly, a balanced proinflammatory and anti-inflammatory cytokine signature, probably by innate cells, around age 2 years was associated with protective clinical immunity during childhood.

CLINICAL TRIALS REGISTRATION

NCT00231452.

Blueberries effects in experimental diet-induced prediabetes: a focus on renal impairment

Introduction Benefits arising from blueberry (BB) consumption are well-described in type 2 diabetes evolution and inherent complications. Lending further support to this thesis, previous work from our group unequivocally demonstrates BB supplementation efficacy to manage prediabetic hepatic liver steatosis. Whether a similar effect also holds truth in early renal impairment is an unsolved issue.

Objectives To address blueberry juice (BJ) ability to exert renoprotective effects in experimental prediabetes.

Methodology Diet-induced prediabetes [high-sucrose (35% Hsu) and high-fat (60% HF)] was developed in adult male Wistar rats through the ingestion of HSu for 9 weeks supplemented by HF for another 14 weeks (HSuHF, n = 16). On W9, half of the former animals orally received BJ (25g/kg BW, HSuHF+BJ). Control animals (n = 8) received standard diet during the entire protocol. Functional [serum and urinary creatinine, uric acid, glucose; glomerular filtration rate (GFR)], structural [H&E and Oil Red O staining] and molecular [triglycerides content and inflammation (RT-qPCR, WB)] markers of renal injury were assessed along with metabolic profile.

Results Even though diet-induced glucose intolerance, insulin insensitivity and plasmatic hypertriglyceridemia were significantly ameliorated upon BJ treatment, this nutraceutical intervention was unable to halt or slow down renal lipidosis and glomerular crescent-like lesions apart from a slight amelioration of both GFR and IL-6 levels in HSuHF-treated rats.

Conclusion Unlike previous results clearly demonstrating the ability of BJ nutraceutical intervention to afford protection against metabolic impairment and hepatic steatosis evolution in experimentally diet-induced prediabetes, only a modest renoprotective effect was observed in functional and morphological renal endpoints. Future studies are warranted to dissect the divergent effects of BJ on early liver and kidney impairment.

Antidepressant-like Effect of Baccharis Ilimita in the Forced Swimming Test in Mice

The aim of the present work was to investigate if flowers extract (FE) and leaf extract (LE) of Baccharis ilimita (Asteraceae) induced antidepressant-like effect. Previous phytochemical investigations have shown the presence of structurally and biogenetically diverse secondary metabolites in this gene, such as flavonoids, diterpenes and triterpenes. Male Swiss mice were injected with FE and LE (12.5; 25.0 or 50.0 mg/kg; i.p.) or saline (S) and after 30 min, they were tested in the forced swimming test (FST). The results showed that FE and LE (50 mg/kg) decreased the duration of immobility time in comparison to the control group (S: 114.8s ± 10.23; FE50: 47.52s ± 9.45; LE50: 53.36s ± 10.38). However, the 12.5 and 25.0 mg/kg doses had no effect on the immobility time in comparison to the control group. The FE and LE did not produce any change in ambulation in mice when tested in an open field. The imipramine (IMP; 15.0 mg/kg i.p.) was used as the positive control. Our results suggested that FE and LE of Baccharis ilimita presents antidepressant-like effect in mice. Such results suggest that the antidepressant-like effect may be attributed at lest partially the flavonoids or the interaction of the active(s) principle(s) present in this plant.

Descritores:

Baccharis ilimita. Forced swimming test. Depression. Mice.

Relational ethics and psychiatry

In relationship centred medicine perspective it is essential to take into account an ethical principle model for our actions, in a meta-analytical foundational perspective, facing concrete and at the same time complex problems in health care, we have to frame them not in terms of strictly defined principles, either formulate them by general acontextual interpretations or resolve them through abstract procedures.

Clinical ethics has been enriched by several contributions that deepen a strict principalist perspective. It is from the observation that the clinic relationship creates, in a space and a time, conditions for the emergence of experiential values of the patient and of the professionals through which you can build a relationship of trust (and not through a process merely procedural), that other ethical questionings emerged in this problematization area (ethics of care, hermeneutics, narrative ethics, responsibility ethics).

We describe the way this theoretical and deliberative relational ethical model can be easily applied to different ethical issues in psychiatry practice and research.

Relational ethics integrates three basic polarities: creating conditions of personhood authenticity, developing a process of reciprocal mutuality and generating an opportunity of growth, development and enhancement. The hermeneutic helical deliberative process takes always in consideration the context relativity and contingency, the other's perspectives and, by creative co-authorship cooperation, allows the emergence of new possibilities of transformative developmental issues.

Adult-onset systemic autoinflammatory disorders: a clinical approach

Autoinflammatory disorders (AIDs) are a subgroup of immune-mediated syndromes that result from a primary dysfunction of the innate immune system. AIDs can be either monogenic or polygenic diseases. Unlike organspecific AIDs, systemic AIDs are characterized by fever and/or elevation of acute-phase reactants. This review aims to describe the most common adult-onset systemic AIDs, focusing mostly on polygenic and mixed-pattern diseases which are expected to be more prevalent in adult patients than monogenic AIDs overall. The literature was searched in Medline database. Organ-specific or childhood-onset systemic AIDs were excluded. AIDs were divided in three distinct groups: mixed-pattern, polygenic and adult-onset monogenic AIDs. Most adult-onset AIDs are polygenic but late-onset disease is not rare among monogenic AIDs such as familial Mediterranean fever (FMF). The diagnosis of systemic AIDs in adults is often delayed due to several factors and sometimes it is only established when amyloidosis or other complications are present. Therefore, it probably makes sense to primarily exclude common AIDs in adult patients with fever of unknown origin (and probably different presentations such as polyserositis) since a high prevalence of adult-onset Still's disease or FMF is usually expected. Colchicine, nonsteroidal anti-inflammatory drugs, steroids, immunosuppressive agents, interleukin-1 inhibitors and tumor necrosis factor antagonists constitute common therapeutic options for systemic AIDs.

Relação entre escore de condição corporal e escore de locomoção em vacas leiteiras submetidas a manejo semiextensivo de alimentação

RESUMO Métodos observacionais subjetivos, como escore de locomoção (EL) e escore de condição corporal (ECC), têm sido amplamente utilizados para avaliação populacional de diferentes graus de claudicação e estado nutricional em bovinos. Este estudo objetivou verificar a associação longitudinal entre o escore de condição corporal e o escore de locomoção em vacas da raça Holandesa submetidas a um regime alimentar semiextensivo. O período experimental compreendeu dois anos de observações, em uma propriedade localizada no sul do Rio Grande do Sul. O grupo experimental foi constituído por 900 vacas lactantes, que foram avaliadas trimestralmente por dinâmica ortopédica pelo EL e do estado metabólico pelo ECC. A coleta desses dados foi realizada por três veterinários treinados. A fim de se verificar a correlação entre variáveis, utilizou-se o programa SAS, por meio do método de correlação de Pearson, para determinar a associação entre as variáveis avaliadas (EL e ECC), com nível de significância de 5%. A distribuição dos diferentes escores de locomoção durante o período foi a seguinte: 57,2% dos animais tiveram o escore de locomoção 1, ou seja, estavam saudáveis em relação ao sistema locomotor. O restante dos animais que apresentou algum grau de dificuldade de locomoção distribuiu-se da seguinte forma, segundo a intensidade: 21,6% dos animais apresentaram EL2, 15,5% deles EL3, 3,5% deles EL4 e 2,2% deles EL5. Quanto ao resultado da correlação, observou-se associação negativa (r= -0,57) entre ECC e EL (P= 0,03), com ECC médio de 2,97±0,33 e EL de 1,35±0,24 durante o período experimental. Portanto, há uma correlação negativa entre o escore de condição corporal e o escore de locomoção em vacas da raça Holandesa submetidas ao regime alimentar semiextensivo.

Cord Blood IL-12 Confers Protection to Clinical Malaria in Early Childhood Life

Using a well-designed longitudinal cohort, we aimed to identify cytokines that were protective against malaria and to explore how they were influenced by genetic and immunological factors. 349 Mozambican pregnant women and their newborn babies were recruited and followed up for malaria outcomes until 24 months of age. Six Th1 cytokines in cord blood were screened for correlation with malaria incidence, of which IL-12 was selected for further analyses. We genotyped IL-12 polymorphisms in children/mothers and evaluated the genotype-phenotype associations and genetic effects on IL-12 levels. Maternal IL-12 concentrations were also investigated in relation to Plasmodium infections and cord blood IL-12 levels. Our data showed that high background IL-12 levels were prospectively associated with a low incidence of clinical malaria, while IL-12 production after parasite stimulation had the opposite effect on malaria incidence. IL-12 genotypes (IL-12b rs2288831/rs17860508) and the haplotype CGTTAGAG distribution were related to malaria susceptibility and background IL-12 levels. Maternal genotypes also exhibited an evident impact on host genotype-phenotype associations. Finally, a positive correlation in background IL-12 levels between maternal and cord blood was identified. Thus, cord blood background IL-12 concentrations are important for protecting children from clinical malaria, likely mediated by both genotypes (children&mothers) and maternal immunity.

IgM and IgG against Plasmodium falciparum lysate as surrogates of malaria exposure and protection during pregnancy

Background

Difficulties to disentangle the protective versus exposure role of anti-malarial antibodies hamper the identification of clinically-relevant immune targets. Here, factors affecting maternal IgG and IgMs against Plasmodium falciparum antigens, as well as their relationship with parasite infection and clinical outcomes, were assessed in mothers and their children. Antibody responses among 207 Mozambican pregnant women at delivery against MSP1₁₉, EBA175, AMA1, DBLα and parasite lysate (3D7, R29 and E8B parasite lines), as well as the surface of infected erythrocytes, were assessed by enzyme-linked immunosorbent assay and flow cytometry. The relationship between antibody levels, maternal infection and clinical outcomes was assessed by multivariate regression analysis.

Results

Placental infection was associated with an increase in maternal levels of IgGs and IgMs against a broad range of parasite antigens. The multivariate analysis including IgGs and IgMs showed that the newborn weight increased with increasing IgG levels against a parasite lysate, whereas the opposite association was found with IgMs. IgGs are markers of protection against poor pregnancy outcomes and IgMs of parasite exposure.

Conclusions

Adjusting the analysis for the simultaneous effect of IgMs and IgGs can contribute to account for heterogeneous exposure to P. falciparum when assessing immune responses effective against malaria in pregnancy.

Electronic supplementary material

The online version of this article (10.1186/s12936-018-2331-4) contains supplementary material, which is available to authorized users.

High production of pro-inflammatory cytokines by maternal blood mononuclear cells is associated with reduced maternal malaria but increased cord blood infection

Background

Increased susceptibility to malaria during pregnancy is not completely understood. Cellular immune responses mediate both pathology and immunity but the effector responses involved in these processes have not been fully characterized. Maternal and fetal cytokine and chemokine responses to malaria at delivery, and their association with pregnancy and childhood outcomes, were investigated in 174 samples from a mother and child cohort from Mozambique. Peripheral and cord mononuclear cells were stimulated with Plasmodium falciparum lysate and secretion of IL-12p70, IFN-γ, IL-2, IL-10, IL-8, IL-6, IL-4, IL-5, IL-1β, TNF, TNF-β was quantified in culture supernatants by multiplex flow cytometry while cellular mRNA expression of IFN-γ, TNF, IL-2, IL-4, IL-6, IL-10 and IL-13 was measured by quantitative PCR.

Results

Higher concentrations of IL-6 and IL-1β were associated with a reduced risk of P. falciparum infection in pregnant women (p < 0.049). Pro-inflammatory cytokines IL-6, IL-1β and TNF strongly correlated among themselves (ρ > 0.5, p < 0.001). Higher production of IL-1β was significantly associated with congenital malaria (p < 0.046) and excessive TNF was associated with peripheral infection and placental lesions (p < 0.044).

Conclusions

Complex network of immuno-pathological cytokine mechanisms in the placental and utero environments showed a potential trade-off between positive and negative effects on mother and newborn susceptibility to infection.

Electronic supplementary material

The online version of this article (10.1186/s12936-018-2317-2) contains supplementary material, which is available to authorized users.

Clinical relevance of radiographic linear branching mineral opacities in the canine liver

OBJECTIVES

To assess the prevalence, clinical significance and breed distribution of linear branching mineralisation superimposed on the hepatic radiographic silhouette in dogs.

MATERIALS AND METHODS

Retrospective review of radiographs or ultrasound images of dogs showing branching mineralisation in the liver.

RESULTS

Over the 30-year review period, 17 cases were identified and the mineralisation had a predominantly ventral distribution. Seven of the 17 were cavalier King Charles spaniels, and four of the total 17 dogs were diagnosed with hepatobiliary system disease. Five dogs had repeat radiographs, of which four showed no change in the pattern and one developed the pattern 6 years after being diagnosed with cholangiohepatitis. Serum calcium concentrations were normal in all patients. Liver enzymes were markedly elevated only in the dog diagnosed with cholangiohepatitis. Histology performed on three patients showed no convincing evidence of primary liver disease.

CLINICAL SIGNIFICANCE

Branching mineralisation in the liver parenchyma is a rare finding in dogs with little or no clinical significance and cavalier King Charles spaniels may be predisposed. Biopsy of the liver of affected dogs with no clinical or clinicopathological evidence of liver disease is unlikely to be helpful in these cases.

Trypanosomiasis in an Australian little red flying fox (Pteropus scapulatus)

Case report

An adult female Australian little red flying fox (Pteropus scapulatus) presented with icterus and anaemia. Examination of a blood smear revealed numerous trypanosomes 20.4–30.8 µm long with tapered ends. Necropsy and histological findings were consistent with trypanosome infection of lymphoid tissue and intravascular haemolysis. Sequence and phylogenetic analysis demonstrated this trypanosome species to be genetically distinct and most similar to Trypanosoma minasense and Trypanosoma rangeli (with a genetic distance of 1% at the 18S rRNA locus for both).

Conclusion

To the authors’ knowledge this is the first report of a trypanosome infection associated with clinical disease in bats.