Impedimetric evaluation for diagnosis of Chagas’ disease: antigen–antibody interactions on metallic eletrodes

A polypeptide chain formed by recombinant antigens, cytoplasmic repetitive antigen (CRA) and flagellar repetitive antigen (FRA) (CF-Chimera) of Trypanosoma cruzi, was adsorbed on gold and platinum electrodes and investigated by electrochemical impedance spectroscopy on phosphate buffer saline solutions (PBS) containing a redox couple. It was found that the adsorption is strongly sensitive to the oxide layer on the electrode surface. In the majority of the experiments the antigens retained their activity as observed through their interaction with sera from chronic chagasic patients. The results expressed in terms of the charge transfer resistance across the interface, indicate the viability of using the impedance methodology for the development of a biosensor for serological diagnosis of Chagas' disease.

Antibody isotype responses in Balb/c mice immunized with the cytoplasmic repetitive antigen and flagellar repetitive antigen of Trypanosoma cruzi

In the present report we analyzed the levels of IgG1, IgG2a, IgG2b and IgG3 isotypes from Balb/c mice immunized with cytoplasmic repetitive antigen (CRA), and flagellar repetitive antigen (FRA) of Trypanosoma cruzi. The immunization was done by subcutaneous route three times (20 days apart) and the analysis was performed 14 days after each treatment. CRA-immunized mice produced high levels of all IgG isotypes, mainly IgG3 and IgG1. FRA-immunization elicited only high levels of IgG1.

Chagas' disease diagnosis: comparative analysis of recombinant ELISA with conventional ELISA and the haemagglutination test

BACKGROUND AND OBJECTIVES

Serological screening for Chagas' disease in the blood banks of South America is carried out by using two different assays that generally show a high number of inconclusive results. To establish a combination of two tests that can minimize the number of inconclusive results, we compared a recombinant enzyme-linked immunosorbent assay (ELISA) with two conventional tests.

MATERIALS AND METHODS

Serum samples from chagasic patients (n = 112), from non-chagasic individuals (n = 143) and from patients with other diseases (n = 32) were tested using three assays: recombinant ELISA (Rec-ELISA); conventional ELISA (Con-ELISA); and the indirect haemagglutination (IHA) test.

RESULTS

When we evaluated the data by matching the Rec-ELISA and the IHA test, 52 inconclusive results were obtained. When Rec-ELISA and Con-ELISA were matched, only four inconclusive results were observed.

CONCLUSIONS

Our investigation indicates that the use of two ELISAs with different antigen preparations provides an effective test combination for blood bank screening of Chagas' disease.

Protective immunity of single and multi-antigen DNA vaccines against schistosomiasis

We evaluated the usefulness of the combination of three plasmids encoding tegumental (pECL and pSM14) and muscular (pIRV5) antigens of the Schistosoma mansoni on improving the protective immunity over the use of a single antigen as DNA vaccines. Female BALB/c mice were inoculated twice with 25 micro g DNA plasmid within two weeks interval. The challenge was performed with 80 cercarias of a regional isolate of S. mansoni (SLM) one week after the last immunization. Six weeks after challenge, all mice were perfused for worm load determination. The following groups were analyzed: saline; empty vector; monovalent formulations of pECL; pSM14 and pIRV5 and also double combinations of pECL/pIRV5 and pIRV5/pSM14 and a triple combination of pECL/pIRV5/pSM14. The protection was expressed as a percentage of worm loads in each group compared with the saline group. The results obtained were 41% (p < 0.05); 52% (p < 0.05); 51% (p < 0.05); 48% (p < 0.05); 55% (p < 0.05); 45% (p < 0.05); 65% (p < 0.05) for each group respectively.

Antibody isotype responses to egg antigens in human chronic Schistosomiasis mansoni before and after treatment

In the present communication we analyzed the levels of IgG1, IgG2, IgG3, IgG4 and IgE isotypes to soluble egg antigen of Schistosoma mansoni by ELISA in individuals from an endemic area for schistosomiasis in Northeast Brazil. The analysis was performed before and after treatment to evaluate the age-dependent pattern, and to identify differences in the reactivities to antigens. Our results suggest that schistosomiasis treatment would not interfere with this sort of immune response.

Use of the EIE-recombinant-Chagas-biomanguinhos kit to monitor cure of human Chagas' disease

We used the EIE-Recombinant-Chagas-Biomanguinhos kit (EIE-Rec kit) developed by the Oswaldo Cruz Foundation, Brazil, to monitor cure of chagasic patients who were treated during the acute phase of T. cruzi infection. Treated patients were previously studied by parasitological and serological tests and classified as cured patients (CP) (n = 10), dissociated patients (DP) (n = 6), and noncured patients (NCP) (n = 6). When sera of these patients were assayed by EIE-Rec kit all sera from NCP and all sera from CP showed positive and negative reactions, respectively. These results were in full agreement with those obtained previously by the classical tests. Two DP showed a positive reaction; the remaining four displayed a negative reaction, similar to that observed in sera from nonchagasic (NCh) individuals, and could therefore be considered CP. Our results suggest that the EIE-Rec kit could be used to monitor the efficacy of Chagas' disease treatment.

Excretory-secretory antigens of Trypanosoma cruzi are potentially useful for serodiagnosis of chronic Chagas' disease

The reactivities of sera from chronic chagasic patients against the trypomastigote excreted-secreted antigens (TESA) of Trypanosoma cruzi strains with different biodemes were analyzed by TESA-blot and TESA-enzyme-linked immunosorbent assay (ELISA). Although both tests presented high sensitivity and specificity, TESA-ELISA is more appropriate for screening a larger number of samples.

Serodiagnosis of chronic Chagas infection by using EIE-Recombinant-Chagas-Biomanguinhos kit

A kit based on an enzyme immunoassay, EIE-Recombinant-Chagas-Biomanguinhos, developed by the Oswaldo Cruz Foundation, was evaluated for the serodiagnosis of chronic Chagas disease. Evaluation was performed with 368 serum samples collected from individuals living in an endemic area for Chagas disease: 131 patients in the chronic phase with confirmed clinical, epidemiological, and serological diagnosis (indirect immunofluorescence, indirect hemagglutination or enzyme-linked immunosorbent assay) and 237 nonchagasic seronegative individuals were considered negative control. The EIE-Recombinant-Chagas-Biomanguinhos kit showed high sensitivity, 100% (CI 95%: 96.4-100%) and high specificity, 100% (CI 95%: 98-100%). The data obtained were in full agreement with clinical and conventional serology data. In addition, no cross-reaction was observed with sera from patients with cutaneous (n=14) and visceral (n=3) leishmaniasis. However, when these sera were tested by conventional serological assays for Chagas disease, cross-reactions were detected in 14.3% and 33.3% of the patients with cutaneous and visceral leishmaniasis, respectively. No cross-reactions were observed when sera from nonchagasic seronegative patients bearing other infectious disease (syphilis, n=8; HTLV, n=8; HCV, n=7 and HBV, n=12) were tested. In addition, sera of patients with inconclusive results for Chagas disease by conventional serology showed results in agreement with clinical evaluation, when tested by the kit. These results are relevant and indicate that the referred kit provides a safe immunodiagnosis of Chagas disease and could be used in blood bank screening.

Dynamics of the antibody response in patients with therapeutic or spontaneous cure of American cutaneous leishmaniasis

The antigen specificity and the level of the antibody response were analysed in Perambuco State, Brazil, in sera collected in 1995-96 from 58 patients with clinical American cutaneous leishmaniasis (ACL), 25 ACL patients with apparent cure after chemotherapy with meglumine antimonate, and 10 ACL patients with spontaneous cure. Assessment was by immunoblot analysis, ELISA and indirect immunofluorescence, with Leishmania (Viannia) braziliensis antigens, with a particular interest in evaluating whether the dynamics of the antibody response could be useful to monitor clinical cure. A clear decrease of IgG antibody reactivity was noticed after clinical healing, for all of the antigens analysed, with the exception of the 19 kDa antigen, whose recognition frequency in fact increased in the spontaneously cured patients, suggesting that this antigen may play a role in protective immunity against cutaneous leishmaniasis. The recognition frequencies of the most frequently recognized antigens (27 and 30 kDa antigens) diminished approximately 2-fold in patients clinically healed, suggesting that they could be useful as a marker of cure of ACL. In addition, some of the healthy individuals living in endemic areas presented the same immunoblotting pattern of reactivity observed in active ACL, possibly representing asymptomatically infected individuals.

Characterization of Sm13, a tegumental antigen of Schistosoma mansoni

Sm13, a 13-kDa Schistosoma mansoni tegumental antigen, is one of the principal polypeptides recognized by antibodies from mice protectively vaccinated with adult-worm tegumental membranes. To obtain the complete gene encoding Sm13 we subcloned and sequenced a cDNA and a fragment of a genomic clone. The collated sequence contains 1,088 nucleotides and represents the full-length open reading frame of the gene, encoding a protein of 104 amino acids with a calculated molecular mass of 11,923 Da, compatible with the native protein identified in the tegumental membranes. The sequence derived from genomic DNA contains a 45-nucleotide intron. The analysis of the predicted protein suggests the presence of both N- and C-terminal hydrophobic membrane-spanning segments, and the coding region contains no homology in the currently available data bases. Additionally, the coding region is preceded by putative CCAAT and TATA boxes that may be involved in the control of expression. Western-blot analysis and indirect immunofluorescence resulted in the identification of a 13-kDa protein (Sm13) in the tegument of adult worms. The present study reveals that Sm13 behaves as an integral membrane protein upon partitioning in Triton X-1 14 and that it is present in worms of 3 weeks or older but not in schistosomula or miracidia. Moreover, it is also specifically recognized by sera from some schistosomiasis patients in enzyme-linked immunosorbent assay and Western-blot analysis, suggesting that it is immunogenic in human schistosomiasis.

Immunodiagnosis of chronic Chagas' disease using the Tc 46 and Tc 58 antigens

The polypeptides of 46 and 58 kDa were recognized in different T. cruzi strains (Y, WSL and Colombiana) by serum of all chagasic patients studied. These polypeptides were isolated from T. cruzi Y strain and used in ELISA. The sensitivity and specificity were 97.6% [CI 95%: 86-100%] and 100% [CI 95%: 89.3-100%], respectively when Tc 46 was used. When Tc 58 was used the sensitivity and specificity were 100% [CI 95%: 89.6-100%] and 90.2% [CI 95%: 75.9-96.8%], respectively.

Identification of potentially diagnostic Leishmania braziliensis antigens in human cutaneous leishmaniasis by immunoblot analysis

The antibody response in patients with American cutaneous leishmaniasis was analyzed by immunoblotting with soluble and insoluble antigens of Leishmania braziliensis. The recognition of the 27- and/or 30-kDa soluble antigens was considered relevant for the diagnosis of cutaneous leishmaniasis. Immunoblotting was found to be significantly more sensitive and specific than indirect immunofluorescence and enzyme-linked immunosorbent assay.

[Hemoglobin "S" positive newborn detected by cord blood and its characteristics]

OBJECTIVE: To evaluate the prevalence of hemoglobin "S" (Hb "S") in babies born at the Instituto Materno Infantil de Pernambuco (IMIP) and its occurrence according to sex, birth weight and Apgar score. METHODS: We carried out a cross-sectional descriptive study of all babies born in the IMIP from October 1996 to March 1997. We used alkaline electrophoresis to analyze cord blood samples (1,988). Data for other variables were collected from medical reports. EPI-Info 6.0 was used to analyze the data.RESULTS: We found 105 (5.3%) newborns with Hb "S": 102 (5.1%.) as sickle cell trait (Hb "FAS"), and 3 (0.2%) as sickle cell disease (Hb "SC"). No cases of homozygosis were found. Newborns with and without Hb "S" did not differ in relation to sex, birth weight and Apgar score. CONCLUSIONS: We suggest the implementation of neonatal screening for hemoglobinopathies for all the newborns in Recife, Brazil, with further follow up focusing on genetic counseling for suspected and positive cases.

Partial protection of mice against Trypanosoma cruzi after immunizing with the TcY 72 antigenic preparation

A 72 kDa Trypanosoma cruzi glycoprotein recognized by the 164C11 monoclonal antibody (IgM isotype) was purified by preparative electrophoresis. The antigenic preparation obtained, named TcY 72, was used to immunize C57Bl/10 mice. The following results were observed after immunization: (1) induction of higher titres of IgG than IgM antibodies, as evaluated by indirect immunofluorescence; (2) significant DTH after injection of epimastigotes in mice footpads; (3) peak parasitemia in immunized mice was significantly reduced and animals were negative by 13 days post-infection, although the mice still succumb to infection; (4) the phenotypic analysis of spleen cell populations showed a decrease in the CD4/CD8 ratio in immunized mice. Taken as a whole, these findings indicate that TcY 72 is immunogenic and potentially important for protective immunity.

Vaccines against human parasitic diseases: an overview

There are no vaccines currently available to control the major human parasitic diseases, although there is evidence of acquired immunity and resistance to reinfection in most of the parasitic infections. The present manuscript concentrates on the vaccines for parasitic diseases that are in the most advanced stages of development: malaria, leishmaniasis and schistosomiasis. Vaccines for malaria and leishmaniasis have been taken to clinical trials while vaccines for schistosomiasis are being considered for Phase I (assessment of safety and immune responsiveness in volunteers). We have attempted to give a factual account of the present status of knowledge of vaccines against human parasitic diseases, emphasizing both the successes and setbacks. We do not intend to cover the enormous literature in the field but have concentrated on the most promising antigenic preparations. Finally, some new approaches for the development of vaccines are discussed including nucleic acid vaccines and the use of cytokines as adjuvants.

PCR and sero-diagnosis of chronic Chagas' disease. Biotechnological advances

In the acute phase of Chagas' disease, when the parasitemia is high, diagnosis can be easily made using conventional parasitological methods. During the chronic phase, due to the low parasitemia, diagnosis is performed mainly by immunological methods. Conventional serological techniques are limited by cross-reactivity with other parasitic diseases, non-standardization of reagents, and the diversity of technical procedures. Methods are being developed to improve the sensitivity and specificity of diagnosis using molecular approaches. PCR-based detection systems and the use of recombinant antigens in ELISA are the most promising.

A monoclonal antibody against blood forms of Trypanosoma cruzi lyses the parasite in vitro and inhibits host cell invasion

Monoclonal antibodies (mAbs) of the IgM isotypes were produced from mice immunized with blood forms of Trypansoma cruzi Y strain. Characterization of the epitope recognized by one of the mAbs, 164C11, as well as the effects of this mAb on complement-mediated lysis and host cell invasion are reported. Immunocytochemical analysis showed that the mAb was reactive with various strains of T. cruzi (Y, WSL, and Colombiana) as well as other trypanosomatids. The mAb 164C11 demonstrated a high complement-mediated lytic activity against bloodstream trypomastigotes, being more effective than chronic mouse serum. A protein with an apparent molecular weight of 72 kDa was detected by this mAb on all developmental stages of T. cruzi. Studies using periodate and endoglycosidase treatments suggested that the epitope is not a carbohydrate and seems to be located on the parasite membrane. In addition, preliminary results are presented, suggesting that the 72-kDa protein is involved in adhesion/or internalization of bloodstream trypomastigotes.

A simple method for detection of monoclonal isotypes

A simple rapid method of enzyme labeled anti-isotype assay (ELIA) for detection of monoclonal isotype on hybridoma cells is proposed. This alternative method was first carried out on hybridoma cell lines 147C11 and 257C11 produced against Trypanosoma cruzi and male accessory secretion of Panstrongylus megistus, respectively. The monoclonal antibodies produced by these hybridoma were characterized by this method as IgM (147C11) and IgG1 (257C23) isotypes, allowing evaluation of isotype without having to wait until the concentration of antibody present in the supernatant itself rises. Results were confirmed by Ouchterlony immunodiffusion. The proposed method offers the advantages of a permanent rapid procedure for light microscopy.

Isolation of Trypanosoma cruzi from blood by histopaque and continuous percoll gradient centrifugations

Separation of the blood forms of trypanosomes from the blood of infected animals is difficult, especially in the case of Trypanosoma cruzi Y strain. Two procedures to isolate the Y strain blood forms of T. cruzi using polyvinyl pyrrolidone-coated silica (percoll) and histopaque are reported in this study. The recovery rates of parasites were 16 +/- 5 and 68 +/- 16%, respectively. The parasites isolated by these methods presented normal motility and morphology and were infective to albino mice with prepatent periods, parasitemia curves, and polymorphism patterns during the infection that were similar to those of control parasites. In addition, the preservation of surface antigens was confirmed by immunocytochemical studies.

Natural lectin activity in the haemolymph of Panstrongylus megistus (Heteroptera: Reduviidae)

The haemolymph of Panstrongylus megistus showed a natural lectin activity for a wide range of vertebrate erythrocytes. Agglutination was observed against all vertebrate erythrocytes tested (human ABO, duck, rabbit, mouse, sheep, chicken and cow). Cow erythrocytes showed the lowest titre. Concerning human erythrocytes, the lectin activity was similar in the types A+, B+ and AB+ while the highest activity was observed in the type O+. Determination of minimal inhibitory concentrations was carried out with human erythrocytes type O+. Agglutination was inhibited by several carbohydrates (rhamnose, D-galactose, raffinose, D-lactose and D-fucose). Rhamnose was reported as the strongest inhibitor (0.78 mM). The results suggest the presence of more than one lectin in the haemolymph of P. megistus.

The use of non-specific immunopotentiators in experimental Trypanosoma cruzi infection

The effects of levamisole, isoprinosine and Corynebacterium parvum on Trypanosoma cruzi (Y strain) experimental infection of mice were studied. In prophylactic treatment these drugs reduced the peak of parasitaemia, and had no apparent effect on mortality rate or on histopathological and electrocardiographic findings. Levamisole and isoprinosine had no effect when used after infection. Electrocardiograms were obtained from all chronic chagasic mice. The most frequent changes were left atrial overload and first degree atrio-ventricular block. These findings became more frequent the longer the animals survived. The net effect of the non-specific immunopotentiators seems to depend on several factors: host immune state, severity of infection, dose and timing of drug administration. This probably explains the variable published results and the paradoxical findings of different laboratories.