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Corzo-León DE, Armstrong-James D, Denning DW. Burden of serious fungal infections in Mexico. Mycoses 2016; 58 Suppl 5:34-44. [PMID: 26449505 DOI: 10.1111/myc.12395] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Revised: 08/15/2015] [Accepted: 08/17/2015] [Indexed: 12/29/2022]
Abstract
Serious fungal infections (SFIs) could be more frequent than are recognised. Estimates of the incidence and prevalence of SFIs are essential in order to identify public health problems. We estimated the rates of SFIs in Mexico, following a methodology similar to that used in prior studies. We obtained information about the general population and populations at risk. A systematic literature search was undertaken to identify epidemiological reports of SFIs in Mexico. When Mexican reports were unavailable, we based our estimates on international literature. The most prevalent SFIs in Mexico are recurrent vulvovaginal candidiasis (5999 per 100,000) followed by allergic bronchopulmonary aspergillosis (60 per 100,000), chronic pulmonary aspergillosis (15.9 per 100,000), fungal keratitis (10.4 per 100,000), invasive candidiasis (8.6 per 100,000) and SFIs in HIV (8.2 per 100,000); coccidioidomycosis (7.6 per 100,000), IA (4.56 per 100,000). These correspond to 2,749,159 people affected in any year (2.45% of the population), probably >10,000 deaths and 7000 blind eyes. SFIs affect immunocompromised and healthy populations. Most are associated with high morbidity and mortality rates. Validation of these estimates with epidemiological studies is required. The burdens indicate that an urgent need to improve medical skills, surveillance, diagnosis, and management of SFIs exists.
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Affiliation(s)
- D E Corzo-León
- Infectious Diseases and Epidemiology Department, Hospital General Dr. Manuel Gea González, Mexico City, Mexico
| | - D Armstrong-James
- Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London, UK.,The NIHR Respiratory Rare Diseases Biomedical Research Unit, Royal Brompton and Harefield NHS Trust, London, UK
| | - D W Denning
- National Aspergillosis Centre, The University Hospital of South Manchester, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
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Duong TN, Waldman SE. Importance of a Travel History in Evaluation of Respiratory Infections. CURRENT EMERGENCY AND HOSPITAL MEDICINE REPORTS 2016; 4:141-152. [PMID: 32226655 PMCID: PMC7100244 DOI: 10.1007/s40138-016-0109-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE OF REVIEW International travel has increased at a fast pace and will continue to rapidly rise. Concomitantly, with this increase in travel is the increase in post travel-related diseases, such as respiratory illnesses. Identifying the cause of the posttravel respiratory illness is a complex challenge for many healthcare professionals because similar presentations occur for both infectious and noninfectious causes. Not only is diagnosis important but also transmission prevention. In the last two decades, there have been several severe infectious respiratory syndromes that have spread through international travel causing epidemics in many countries. RECENT FINDINGS A detailed travel history with the chronology of symptoms paired with the patient's medical risk factors and exposures along with some basic knowledge of infectious respiratory illnesses will help facilitate clinical decision making. This framework will help create a broad, but appropriate differential diagnosis to guide clinical workup, prevent delays in diagnosis, and implement the appropriate precautions to prevent transmission if appropriate. SUMMARY The foundation to diagnosing a travel-related respiratory illness lies within integrating the patient's travel history, comorbid conditions, clinical presentation, exposures, and mode of transmission. A timely and accurate diagnosis benefits not only the patient but also the surrounding community to prevent further individual transmission, epidemics, and pandemics.
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Affiliation(s)
- Theresa N. Duong
- Division of Hospital Medicine, Department of Internal Medicine, University of California, Davis Medical Center, Sacramento, CA USA
| | - Sarah E. Waldman
- Division of Infectious Diseases, Department of Internal Medicine, University of California, Davis Medical Center, Sacramento, CA USA
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103
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Di Gangi R, Alves da Costa T, Thomé R, Peron G, Burger E, Verinaud L. Paracoccidioides brasiliensis infection promotes thymic disarrangement and premature egress of mature lymphocytes expressing prohibitive TCRs. BMC Infect Dis 2016; 16:209. [PMID: 27189089 PMCID: PMC4869377 DOI: 10.1186/s12879-016-1561-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Accepted: 05/10/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Paracoccidioidomycosis, a chronic granulomatous fungal disease caused by Paracoccidioides brasiliensis yeast cells affects mainly rural workers, albeit recently cases in immunosuppressed individuals has been reported. Protective immune response against P. brasiliensis is dependent on the activity of helper T cells especially IFN-γ-producing Th1 cells. It has been proposed that Paracoccidioides brasiliensis is able to modulate the immune response towards a permissive state and that the thymus plays a major role in it. METHODS In this paper, we show that acute infection of BALB/c mice with P. brasiliensis virulent isolate (Pb18) might cause alterations in the thymic environment as well as the prohibitive TCR-expressing T cells in the spleens. RESULTS After seven days of infection, we found yeast cells on the thymic stroma, the thymic epithelial cells (TEC) were altered regarding their spatial-orientation and inflammatory mediators gene expression was increased. Likewise, thymocytes (differentiating T cells) presented higher migratory ability in ex vivo experiments. Notwithstanding, P. brasiliensis-infected mice showed an increased frequency of prohibitive TCR-expressing T cells in the spleens, suggesting that the selection processes that occur in the thymus may be compromised during the acute infection. CONCLUSION In this paper, for the first time, we show that acute infection with Paracoccidioides brasiliensis yeast cells promotes thymic alterations leading to a defective repertoire of peripheral T cells. The data presented here may represent new mechanisms by which P. brasiliensis subverts the immune response towards the chronic infection observed in humans.
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Affiliation(s)
- Rosaria Di Gangi
- Department of Structural and Functional Biology, Institute of Biology, State University of Campinas, Rua Monteiro Lobato, 255, Cidade Universitária, SP, Brazil
| | - Thiago Alves da Costa
- Department of Structural and Functional Biology, Institute of Biology, State University of Campinas, Rua Monteiro Lobato, 255, Cidade Universitária, SP, Brazil
| | - Rodolfo Thomé
- Department of Structural and Functional Biology, Institute of Biology, State University of Campinas, Rua Monteiro Lobato, 255, Cidade Universitária, SP, Brazil
| | - Gabriela Peron
- Department of Structural and Functional Biology, Institute of Biology, State University of Campinas, Rua Monteiro Lobato, 255, Cidade Universitária, SP, Brazil
| | - Eva Burger
- Instituto de Ciências Biomédicas, Universidade Federal de Alfenas, Alfenas, MG, Brazil
| | - Liana Verinaud
- Department of Structural and Functional Biology, Institute of Biology, State University of Campinas, Rua Monteiro Lobato, 255, Cidade Universitária, SP, Brazil.
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104
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Gaona-Flores VA, Campos-Navarro LA, Cervantes-Tovar RM, Alcalá-Martínez E. The epidemiology of fungemia in an infectious diseases hospital in Mexico city: A 10-year retrospective review. Med Mycol 2016; 54:600-4. [PMID: 27118806 DOI: 10.1093/mmy/myw017] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 03/10/2016] [Indexed: 11/13/2022] Open
Abstract
The epidemiology of invasive fungal infections has recently changed in immunosuppressed populations as a result of HIV infection, organ transplant, chemotherapy and in elderly patients. The diagnosis of invasive fungal infections by culture is prolonged since fungi grow slowly in vitro. we wanted to estimate the frequency of fungemia diagnoses established through the Clinical Mycology Laboratory over the past 10 years; through a retrospective study; data was obtained from the laboratory patient registry in the Infectious Disease Hospital's laboratory registry of patients with a systemic fungal isolate between 2005 and 2014. One hundred and thirty two (132) systemic fungal infections were identified. They were more prevalent in males, in the age group between 20 and 59 years and in patients with a diagnosis of AIDS. The most frequently isolated agents belonged to the genus Candida and others such as Histoplasma sp., Cryptococcus sp., Aspergillus sp., and Coccidioides sp. Of all blood and bone marrow cultures received 17.9% had fungal development; of these, in 70% of cases it was through blood cultures. In general, fungal agents were not diagnostically suspected. We identified that Sixty percent (60%) of fungemias developed in AIDS patients, followed by patients with sepsis. The most common agents belonged to the genus Candida, predominantly the albicans species. They were more frequently identified by blood culture than by bone marrow culture. Invasive fungal infections have not followed a usual clinical pattern and are not easily recognizable.
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105
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Pereira GH, Lanzoni VPB, Beirão EM, Timerman A, Melhem MDSC. DISSEMINATED FUNGAL INFECTION WITH ADRENAL INVOLVEMENT: REPORT OF TWO HIV NEGATIVE BRAZILIAN PATIENTS. Rev Inst Med Trop Sao Paulo 2016; 57:527-30. [PMID: 27049710 PMCID: PMC4727142 DOI: 10.1590/s0036-46652015000600013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 03/17/2015] [Indexed: 11/22/2022] Open
Abstract
Paracoccidioidomycosis and histoplasmosis are systemic fungal infections endemic in
Brazil. Disseminated clinical forms are uncommon in immunocompetent individuals. We
describe two HIV-negative patients with disseminated fungal infections,
paracoccidioidomycosis and histoplasmosis, who were diagnosed by biopsies of
suprarenal lesions. Both were treated for a prolonged period with oral antifungal
agents, and both showed favorable outcomes.
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Affiliation(s)
- Graziella Hanna Pereira
- Departamento de Doenças Infecciosas, Hospital Edmundo Vasconcelos, São Paulo, SP, Brasil, ; ;
| | | | - Elisa Maria Beirão
- Departamento de Doenças Infecciosas, Hospital Edmundo Vasconcelos, São Paulo, SP, Brasil, ; ;
| | - Artur Timerman
- Departamento de Doenças Infecciosas, Hospital Edmundo Vasconcelos, São Paulo, SP, Brasil, ; ;
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Marques de Macedo P, de Oliveira LC, Freitas DFS, da Rocha JA, Freitas AD, Nucci M, Zancopé-Oliveira RM, Almeida-Paes R, do Valle ACF. Acute Paracoccidioidomycosis Due to Paracoccidioides brasiliensis S1 Mimicking Hypereosinophilic Syndrome with Massive Splenomegaly: Diagnostic Challenge. PLoS Negl Trop Dis 2016; 10:e0004487. [PMID: 27054891 PMCID: PMC4824360 DOI: 10.1371/journal.pntd.0004487] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Priscila Marques de Macedo
- Infectious Dermatology Clinical Research Laboratory, Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
| | - Luã Cardoso de Oliveira
- Mycology Laboratory, Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
| | - Dayvison Francis Saraiva Freitas
- Infectious Dermatology Clinical Research Laboratory, Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
| | - Jaqueline Abel da Rocha
- Nosocomial Infection Surveillance and Control Program, Central Hospital of Military Police (HCPM), Rio de Janeiro, Brazil
| | - Andrea D’Ávila Freitas
- Department of Inpatient Health Care, Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
| | - Marcio Nucci
- Department of Internal Medicine, Universidade Federal do Rio de Janeiro (HUCFF, UFRJ), Rio de Janeiro, Brazil
| | | | - Rodrigo Almeida-Paes
- Mycology Laboratory, Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
| | - Antonio Carlos Francesconi do Valle
- Infectious Dermatology Clinical Research Laboratory, Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
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107
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Alastruey-Izquierdo A, Melhem MSC, Bonfietti LX, Rodriguez-Tudela JL. SUSCEPTIBILITY TEST FOR FUNGI: CLINICAL AND LABORATORIAL CORRELATIONS IN MEDICAL MYCOLOGY. Rev Inst Med Trop Sao Paulo 2016; 57 Suppl 19:57-64. [PMID: 26465371 PMCID: PMC4711191 DOI: 10.1590/s0036-46652015000700011] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
During recent decades, antifungal susceptibility testing has become standardized and nowadays has the same role of the antibacterial susceptibility testing in microbiology laboratories. American and European standards have been developed, as well as equivalent commercial systems which are more appropriate for clinical laboratories. The detection of resistant strains by means of these systems has allowed the study and understanding of the molecular basis and the mechanisms of resistance of fungal species to antifungal agents. In addition, many studies on the correlation of in vitro results with the outcome of patients have been performed, reaching the conclusion that infections caused by resistant strains have worse outcome than those caused by susceptible fungal isolates. These studies have allowed the development of interpretative breakpoints for Candida spp. and Aspergillus spp., the most frequent agents of fungal infections in the world. In summary, antifungal susceptibility tests have become essential tools to guide the treatment of fungal diseases, to know the local and global disease epidemiology, and to identify resistance to antifungals.
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108
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Identification and Analysis of the Role of Superoxide Dismutases Isoforms in the Pathogenesis of Paracoccidioides spp. PLoS Negl Trop Dis 2016; 10:e0004481. [PMID: 26963091 PMCID: PMC4786090 DOI: 10.1371/journal.pntd.0004481] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 02/01/2016] [Indexed: 12/03/2022] Open
Abstract
The ability of Paracoccidioides to defend itself against reactive oxygen species (ROS) produced by host effector cells is a prerequisite to survive. To counteract these radicals, Paracoccidioides expresses, among different antioxidant enzymes, superoxide dismutases (SODs). In this study, we identified six SODs isoforms encoded by the Paracoccidioides genome. We determined gene expression levels of representative isolates of the phylogenetic lineages of Paracoccidioides spp. (S1, PS2, PS3 and Pb01-like) using quantitative RT-PCR. Assays were carried out to analyze SOD gene expression of yeast cells, mycelia cells, the mycelia-to-yeast transition and the yeast-to-mycelia germination, as well as under treatment with oxidative agents and during interaction with phagocytic cells. We observed an increased expression of PbSOD1 and PbSOD3 during the transition process, exposure to oxidative agents and interaction with phagocytic cells, suggesting that these proteins could assist in combating the superoxide radicals generated during the host-pathogen interaction. Using PbSOD1 and PbSOD3 knockdown strains we showed these genes are involved in the response of the fungus against host effector cells, particularly the oxidative stress response, and in a mouse model of infection. Protein sequence analysis together with functional analysis of knockdown strains seem to suggest that PbSOD3 expression is linked with a pronounced extracellular activity while PbSOD1 seems more related to intracellular requirements of the fungus. Altogether, our data suggests that P. brasiliensis actively responds to the radicals generated endogenously during metabolism and counteracts the oxidative burst of immune cells by inducing the expression of SOD isoforms. Paracoccidioidomycosis is a health-threatening human systemic mycosis, endemic to some Latin America countries. The disease is caused by species belonging to the Paracoccidioides genus. Once inside the human host, Paracoccidioides must face the host innate immune system, escaping from the cytotoxic capacity of innate immune cells (ROS production and liberation of polypeptide antibiotics). To do so, they express and synthetize superoxide dismutases (SODs). We aimed to identify and characterize the SOD isoforms present in the Paracoccidioides genome. We identified six isoforms, among which we found an increased expression of PbSOD1 and PbSOD3 during the transition-to-yeast process, exposure to oxidative agents and interaction with phagocytic cells. Additionally, we found that PbSOD3 expression might be linked with a pronounced extracellular activity while PbSOD1 and the other isoforms seem more related to intracellular requirements of the fungus. We propose that the defence against endogenous-produced ROS may depend on intracellular Sods (mostly SOD1, but possibly also SOD2, SOD4 and SOD5), but defence against extracellular ROS (produced during host-pathogen interactions) might rely to a greater extent on SOD3, which is endowed with an extracellular activity.
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109
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Almeida MDA, Pizzini CV, Damasceno LS, Muniz MDM, Almeida-Paes R, Peralta RHS, Peralta JM, Oliveira RDVC, Vizzoni AG, de Andrade CLT, Zancopé-Oliveira RM. Validation of western blot for Histoplasma capsulatum antibody detection assay. BMC Infect Dis 2016; 16:87. [PMID: 26905567 PMCID: PMC4765212 DOI: 10.1186/s12879-016-1427-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 02/10/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Histoplasmosis is worldwide systemic mycoses caused by the dimorphic fungus Histoplasma capsulatum. The isolation and identification of H. capsulatum in culture is the reference test for histoplasmosis diagnosis confirmation. However, in the absence of it, serology has been used as a presumptive diagnosis through antibody and antigen detection. The purpose of the present study was to validate an immunoassay method (western blot) for antibodies detection in the diagnosis of histoplasmosis. METHODS To validate the western blot (WB) a study was conducted using 118 serum samples from patients with histoplasmosis and 118 serum controls collected from January 2000 to December 2013 in residents of the Rio de Janeiro State, Brazil. Diagnostic validation parameters were calculated based on the categorization of results obtained in a 2 × 2 table and subjected to statistical analysis. In addition, the viability of deglycosylated histoplasmin antigen (ptHMIN) onto nitrocellulose membranes previously sensitized was evaluated during the same period. RESULTS The WB test showed sensitivity of 94.9 %, specificity of 94.1 %, positive predictive value of 94.1 %, negative predictive value of 94.9 %, accuracy of 94.5 %, and almost perfect precision. Besides, the strips have proved to be viable for using at least 5 years after ptHMIN antigen sensitization. CONCLUSION Western blot test using ptHMIN provides sensitive, specific, and faster results. Therefore, could be considered a useful tool in the diagnosis of histoplasmosis being used by public health system, even in situations where laboratory facilities are relatively limited.
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Affiliation(s)
- Marcos de Abreu Almeida
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, Brazil.
| | - Cláudia Vera Pizzini
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, Brazil.
| | - Lisandra Serra Damasceno
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, Brazil.
| | - Mauro de Medeiros Muniz
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, Brazil.
| | - Rodrigo Almeida-Paes
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, Brazil.
| | | | - José Mauro Peralta
- Instituto de Microbiologia Prof. Paulo de Goes, Universidade Federal do Rio de Janeiro, Avenida Carlos Chagas Filho, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ, 373, Brazil.
| | | | - Alexandre Gomes Vizzoni
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, Brazil.
| | | | - Rosely Maria Zancopé-Oliveira
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, Brazil.
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110
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Marcos CM, da Silva JDF, de Oliveira HC, Assato PA, Singulani JDL, Lopez AM, Tamayo DP, Hernandez-Ruiz O, McEwen JG, Mendes-Giannini MJS, Fusco-Almeida AM. Decreased expression of 14-3-3 in Paracoccidioides brasiliensis confirms its involvement in fungal pathogenesis. Virulence 2015; 7:72-84. [PMID: 26646480 PMCID: PMC4994830 DOI: 10.1080/21505594.2015.1122166] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 11/05/2015] [Accepted: 11/12/2015] [Indexed: 10/22/2022] Open
Abstract
The interaction between the fungal pathogen Paracoccidioides brasiliensis and host cells is usually mediated by specific binding events between adhesins on the fungal surface and receptors on the host extracellular matrix or cell surface. One molecule implicated in the P. brasiliensis-host interaction is the 14-3-3 protein. The 14-3-3 protein belongs to a family of conserved regulatory molecules that are expressed in all eukaryotic cells and are involved in diverse cellular functions. Here, we investigated the relevance of the 14-3-3 protein to the virulence of P. brasiliensis. Using antisense RNA technology and Agrobacterium tumefaciens-mediated transformation, we generated a 14-3-3-silenced strain (expression reduced by ˜55%). This strain allowed us to investigate the interaction between 14-3-3 and the host and to correlate the functions of P. brasiliensis 14-3-3 with cellular features, such as morphological characteristics and virulence, that are important for pathogenesis.
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Affiliation(s)
- Caroline Maria Marcos
- Faculdade de Ciências Farmacêuticas de Araraquara; UNESP - Univ Estadual Paulista; Departamento de Análises Clínicas; Laboratório de Micologia Clínica; Araraquara, São Paulo, Brazil
| | - Julhiany de Fátima da Silva
- Faculdade de Ciências Farmacêuticas de Araraquara; UNESP - Univ Estadual Paulista; Departamento de Análises Clínicas; Laboratório de Micologia Clínica; Araraquara, São Paulo, Brazil
| | - Haroldo Cesar de Oliveira
- Faculdade de Ciências Farmacêuticas de Araraquara; UNESP - Univ Estadual Paulista; Departamento de Análises Clínicas; Laboratório de Micologia Clínica; Araraquara, São Paulo, Brazil
| | - Patrícia Akemi Assato
- Faculdade de Ciências Farmacêuticas de Araraquara; UNESP - Univ Estadual Paulista; Departamento de Análises Clínicas; Laboratório de Micologia Clínica; Araraquara, São Paulo, Brazil
| | - Junya de Lacorte Singulani
- Faculdade de Ciências Farmacêuticas de Araraquara; UNESP - Univ Estadual Paulista; Departamento de Análises Clínicas; Laboratório de Micologia Clínica; Araraquara, São Paulo, Brazil
| | - Angela Maria Lopez
- Unidad de Biología Celular y Molecular; Corporación para Investigaciones Biológicas (CIB) - Medellín, Colombia
| | - Diana Patricia Tamayo
- Unidad de Biología Celular y Molecular; Corporación para Investigaciones Biológicas (CIB) - Medellín, Colombia
| | - Orville Hernandez-Ruiz
- Unidad de Biología Celular y Molecular; Corporación para Investigaciones Biológicas (CIB) - Medellín, Colombia
- Escuela de Microbiología; Universidad de Antioquia; Medellín, Colombia
| | - Juan G McEwen
- Unidad de Biología Celular y Molecular; Corporación para Investigaciones Biológicas (CIB) - Medellín, Colombia
- Facultad de Medicina; Universidad de Antioquia; Medellín, Colombia
| | - Maria José Soares Mendes-Giannini
- Faculdade de Ciências Farmacêuticas de Araraquara; UNESP - Univ Estadual Paulista; Departamento de Análises Clínicas; Laboratório de Micologia Clínica; Araraquara, São Paulo, Brazil
| | - Ana Marisa Fusco-Almeida
- Faculdade de Ciências Farmacêuticas de Araraquara; UNESP - Univ Estadual Paulista; Departamento de Análises Clínicas; Laboratório de Micologia Clínica; Araraquara, São Paulo, Brazil
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111
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de Oliveira HC, Assato PA, Marcos CM, Scorzoni L, de Paula E Silva ACA, Da Silva JDF, Singulani JDL, Alarcon KM, Fusco-Almeida AM, Mendes-Giannini MJS. Paracoccidioides-host Interaction: An Overview on Recent Advances in the Paracoccidioidomycosis. Front Microbiol 2015; 6:1319. [PMID: 26635779 PMCID: PMC4658449 DOI: 10.3389/fmicb.2015.01319] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 11/09/2015] [Indexed: 11/13/2022] Open
Abstract
Paracoccidioides brasiliensis and P. lutzii are etiologic agents of paracoccidioidomycosis (PCM), an important endemic mycosis in Latin America. During its evolution, these fungi have developed characteristics and mechanisms that allow their growth in adverse conditions within their host through which they efficiently cause disease. This process is multi-factorial and involves host-pathogen interactions (adaptation, adhesion, and invasion), as well as fungal virulence and host immune response. In this review, we demonstrated the glycoproteins and polysaccharides network, which composes the cell wall of Paracoccidioides spp. These are important for the change of conidia or mycelial (26°C) to parasitic yeast (37°C). The morphological switch, a mechanism for the pathogen to adapt and thrive inside the host, is obligatory for the establishment of the infection and seems to be related to pathogenicity. For these fungi, one of the most important steps during the interaction with the host is the adhesion. Cell surface proteins called adhesins, responsible for the first contact with host cells, contribute to host colonization and invasion by mediating this process. These fungi also present the capacity to form biofilm and through which they may evade the host's immune system. During infection, Paracoccidioides spp. can interact with different host cell types and has the ability to modulate the host's adaptive and/or innate immune response. In addition, it participates and interferes in the coagulation system and phenomena like cytoskeletal rearrangement and apoptosis. In recent years, Paracoccidioides spp. have had their endemic areas expanding in correlation with the expansion of agriculture. In response, several studies were developed to understand the infection using in vitro and in vivo systems, including alternative non-mammal models. Moreover, new advances were made in treating these infections using both well-established and new antifungal agents. These included natural and/or derivate synthetic substances as well as vaccines, peptides, and anti-adhesins sera. Because of all the advances in the PCM study, this review has the objective to summarize all of the recent discoveries on Paracoccidioides-host interaction, with particular emphasis on fungi surface proteins (molecules that play a fundamental role in the adhesion and/or dissemination of the fungi to host-cells), as well as advances in the treatment of PCM with new and well-established antifungal agents and approaches.
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Affiliation(s)
- Haroldo C de Oliveira
- Faculdade de Ciências Farmacêuticas, UNESP - Universidade Estadual Paulista, Campus Araraquara, Departamento de Análises Clínicas, Laboratório de Micologia Clínica São Paulo, Brazil
| | - Patrícia A Assato
- Faculdade de Ciências Farmacêuticas, UNESP - Universidade Estadual Paulista, Campus Araraquara, Departamento de Análises Clínicas, Laboratório de Micologia Clínica São Paulo, Brazil
| | - Caroline M Marcos
- Faculdade de Ciências Farmacêuticas, UNESP - Universidade Estadual Paulista, Campus Araraquara, Departamento de Análises Clínicas, Laboratório de Micologia Clínica São Paulo, Brazil
| | - Liliana Scorzoni
- Faculdade de Ciências Farmacêuticas, UNESP - Universidade Estadual Paulista, Campus Araraquara, Departamento de Análises Clínicas, Laboratório de Micologia Clínica São Paulo, Brazil
| | - Ana C A de Paula E Silva
- Faculdade de Ciências Farmacêuticas, UNESP - Universidade Estadual Paulista, Campus Araraquara, Departamento de Análises Clínicas, Laboratório de Micologia Clínica São Paulo, Brazil
| | - Julhiany De Fátima Da Silva
- Faculdade de Ciências Farmacêuticas, UNESP - Universidade Estadual Paulista, Campus Araraquara, Departamento de Análises Clínicas, Laboratório de Micologia Clínica São Paulo, Brazil
| | - Junya de Lacorte Singulani
- Faculdade de Ciências Farmacêuticas, UNESP - Universidade Estadual Paulista, Campus Araraquara, Departamento de Análises Clínicas, Laboratório de Micologia Clínica São Paulo, Brazil
| | - Kaila M Alarcon
- Faculdade de Ciências Farmacêuticas, UNESP - Universidade Estadual Paulista, Campus Araraquara, Departamento de Análises Clínicas, Laboratório de Micologia Clínica São Paulo, Brazil
| | - Ana M Fusco-Almeida
- Faculdade de Ciências Farmacêuticas, UNESP - Universidade Estadual Paulista, Campus Araraquara, Departamento de Análises Clínicas, Laboratório de Micologia Clínica São Paulo, Brazil
| | - Maria J S Mendes-Giannini
- Faculdade de Ciências Farmacêuticas, UNESP - Universidade Estadual Paulista, Campus Araraquara, Departamento de Análises Clínicas, Laboratório de Micologia Clínica São Paulo, Brazil
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Abadio AKR, Kioshima ES, Leroux V, Martins NF, Maigret B, Felipe MSS. Identification of New Antifungal Compounds Targeting Thioredoxin Reductase of Paracoccidioides Genus. PLoS One 2015; 10:e0142926. [PMID: 26569405 PMCID: PMC4646694 DOI: 10.1371/journal.pone.0142926] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Accepted: 10/28/2015] [Indexed: 11/27/2022] Open
Abstract
The prevalence of invasive fungal infections worldwide has increased in the last decades. The development of specific drugs targeting pathogenic fungi without producing collateral damage to mammalian cells is a daunting pharmacological challenge. Indeed, many of the toxicities and drug interactions observed with contemporary antifungal therapies can be attributed to “nonselective” interactions with enzymes or cell membrane systems found in mammalian host cells. A computer-aided screening strategy against the TRR1 protein of Paracoccidioides lutzii is presented here. Initially, a bank of commercially available compounds from Life Chemicals provider was docked to model by virtual screening simulations. The small molecules that interact with the model were ranked and, among the best hits, twelve compounds out of 3,000 commercially-available candidates were selected. These molecules were synthesized for validation and in vitro antifungal activity assays for Paracoccidioides lutzii and P. brasiliensis were performed. From 12 molecules tested, 3 harbor inhibitory activity in antifungal assays against the two pathogenic fungi. Corroborating these findings, the molecules have inhibitory activity against the purified recombinant enzyme TRR1 in biochemical assays. Therefore, a rational combination of molecular modeling simulations and virtual screening of new drugs has provided a cost-effective solution to an early-stage medicinal challenge. These results provide a promising technique to the development of new and innovative drugs.
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Affiliation(s)
| | - Erika Seki Kioshima
- Department of Clinical Analysis and Biomedicine, State University of Maringá, Maringá, Paraná, Brazil
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Nosanchuk JD, Nosanchuk MD, Rodrigues ML, Nimrichter L, de Carvalho ACC, Weiss LM, Spray DC, Tanowitz HB. The Einstein-Brazil Fogarty: A decade of synergy. Braz J Microbiol 2015; 46:945-55. [PMID: 26691452 PMCID: PMC4704644 DOI: 10.1590/s1517-838246420140975] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 03/05/2015] [Indexed: 02/08/2023] Open
Abstract
A rich, collaborative program funded by the US NIH Fogarty program in 2004 has provided for a decade of remarkable opportunities for scientific advancement through the training of Brazilian undergraduate, graduate and postdoctoral students from the Federal University and Oswaldo Cruz Foundation systems at Albert Einstein College of Medicine. The focus of the program has been on the development of trainees in the broad field of Infectious Diseases, with a particular focus on diseases of importance to the Brazilian population. Talented trainees from various regions in Brazil came to Einstein to learn techniques and study fungal, parasitic and bacterial pathogens. In total, 43 trainees enthusiastically participated in the program. In addition to laboratory work, these students took a variety of courses at Einstein, presented their results at local, national and international meetings, and productively published their findings. This program has led to a remarkable synergy of scientific discovery for the participants during a time of rapid acceleration of the scientific growth in Brazil. This collaboration between Brazilian and US scientists has benefitted both countries and serves as a model for future training programs between these countries.
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Affiliation(s)
- Joshua D. Nosanchuk
- Departments of Medicine, Microbiology & Immunology, Albert
Einstein College of Medicine, Bronx, NY, EUA
- Send correspondence to J.D. Nosanchuk. Departments of Medicine,
Microbiology & Immunology, Albert Einstein College of Medicine, Bronx, NY, EUA.
E-mail:
| | - Murphy D. Nosanchuk
- Departments of Medicine, Microbiology & Immunology, Albert
Einstein College of Medicine, Bronx, NY, EUA
- Instituto de Microbiologia Professor Paulo de Góes, Universidade
Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Marcio L. Rodrigues
- Instituto de Microbiologia Professor Paulo de Góes, Universidade
Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Centro de Desenvolvimento Tecnológico em Saúde, Fundação Oswaldo
Cruz, Rio de Janeiro, RJ, Brazil
| | - Leonardo Nimrichter
- Instituto de Microbiologia Professor Paulo de Góes, Universidade
Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | - Louis M. Weiss
- Departments of Pathology and Medicine, Albert Einstein College of
Medicine, Bronx, NY, EUA
| | - David C. Spray
- Departments of Neuroscience and Medicine, Albert Einstein College of
Medicine, Bronx, NY, EUA
| | - Herbert B. Tanowitz
- Departments of Pathology and Medicine, Albert Einstein College of
Medicine, Bronx, NY, EUA
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114
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Li RF, Yan XH, Lu YB, Lu YL, Zhang HR, Chen SH, Liu S, Lu ZF. Anti-candidal activity of a novel peptide derived from human chromogranin A and its mechanism of action against Candida krusei. Exp Ther Med 2015; 10:1768-1776. [PMID: 26640548 PMCID: PMC4665730 DOI: 10.3892/etm.2015.2731] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 08/13/2015] [Indexed: 11/17/2022] Open
Abstract
Candida species (Candida spp.) are important fungal pathogens, which cause numerous clinical diseases associated with significant mortality and morbidity in healthcare settings. In our previous study, we identified a recombinant peptide, chromogranin A (CGA)-N46, corresponding to the N-terminal Pro31-Gln76 sequence of human CGA, that exhibited antifungal activity against Candida albicans. The present study investigated the antifungal activity of CGA-N46, and its underlying mechanism, against numerous Candida spp. CGA-N46 inhibited the growth of all of the tested Candida spp., of which Candida krusei exhibited the greatest sensitivity. CGA-N46 was able to disrupt the stability of the phospholipid monolayer without damaging the integrity and permeability of the outer membrane of C. krusei cells, and induced cytoplasm vacuolization and mitochondrial damage. In addition, treatment of C. krusei with CGA-N46 was associated with decreased levels of intracellular reactive oxygen species, a reduction in the mitochondrial membrane potential, and DNA synthesis inhibition. The results of the present study suggested that CGA-N46 was able to pass through the cell membrane of Candida spp. by temporarily destabilizing the phospholipid membrane, which in turn led to mitochondrial dysfunction and inhibition of DNA synthesis. Therefore, CGA-N46 may be considered a novel antifungal compound for the treatment of patients with C. krusei infections.
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Affiliation(s)
- Rui-Fang Li
- College of Biological Engineering, Henan University of Technology, Zhengzhou, Henan 450001, P.R. China
| | - Xiao-Hui Yan
- College of Biological Engineering, Henan University of Technology, Zhengzhou, Henan 450001, P.R. China
| | - Yan-Bo Lu
- College of Biological Engineering, Henan University of Technology, Zhengzhou, Henan 450001, P.R. China
| | - Ya-Li Lu
- College of Biological Engineering, Henan University of Technology, Zhengzhou, Henan 450001, P.R. China
| | - Hui-Ru Zhang
- College of Biological Engineering, Henan University of Technology, Zhengzhou, Henan 450001, P.R. China
| | - Shi-Hua Chen
- College of Biological Engineering, Henan University of Technology, Zhengzhou, Henan 450001, P.R. China
| | - Shuai Liu
- College of Biological Engineering, Henan University of Technology, Zhengzhou, Henan 450001, P.R. China
| | - Zhi-Fang Lu
- College of Biological Engineering, Henan University of Technology, Zhengzhou, Henan 450001, P.R. China
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Caceres DH, Zuluaga A, Arango-Bustamante K, de Bedout C, Tobón ÁM, Restrepo Á, Gómez BL, Cano LE, González Á. Implementation of a Training Course Increased the Diagnosis of Histoplasmosis in Colombia. Am J Trop Med Hyg 2015; 93:662-7. [PMID: 26123961 PMCID: PMC4559714 DOI: 10.4269/ajtmh.15-0108] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 05/02/2015] [Indexed: 11/07/2022] Open
Abstract
Histoplasmosis causes a significant mortality, especially persons living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) from developing countries where access to both appropriate diagnostic methods and antiretroviral therapy are limited. A total of 81 physicians assigned to 17 Colombian departments (states) received training in the clinical, epidemiological, and diagnostic aspects of histoplasmosis. Once this training was received and during the period of October 2009-November 2012, these physicians sent biological samples for immunodiagnostic, mycological, and molecular tests from their patients with suspicion of histoplasmosis. A total of 1,536 samples from 768 patients were evaluated. Of the 768 patients studied, 463 (60%) were HIV positive, 214 (28%) HIV negative, and in 91 (12%) this diagnosis was unknown, and 538 (70%) were males. The 1,536 specimens studied comprised 722 sera, 439 blood samples, and 241 urines, which were tested by immunodiffusion (ID), culture, and antigenuria, respectively; in addition, 134 specimens were tested by performing a molecular assay. Histoplasmosis was diagnosed in 133 patients (17%). After the training, we observed more diagnoses from 27 to 44 cases per year. In this study, a significantly increased number of histoplasmosis cases reported by year were observed after implementing an educational training program.
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Affiliation(s)
- Diego H Caceres
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia; School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia; School of Microbiology, Universidad de Antioquia, Medellín, Colombia; Basic and Applied Microbiology Research Group (MICROBA), School of Microbiology, Universidad de Antioquia, Medellín, Colombia
| | - Alejandra Zuluaga
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia; School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia; School of Microbiology, Universidad de Antioquia, Medellín, Colombia; Basic and Applied Microbiology Research Group (MICROBA), School of Microbiology, Universidad de Antioquia, Medellín, Colombia
| | - Karen Arango-Bustamante
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia; School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia; School of Microbiology, Universidad de Antioquia, Medellín, Colombia; Basic and Applied Microbiology Research Group (MICROBA), School of Microbiology, Universidad de Antioquia, Medellín, Colombia
| | - Catalina de Bedout
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia; School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia; School of Microbiology, Universidad de Antioquia, Medellín, Colombia; Basic and Applied Microbiology Research Group (MICROBA), School of Microbiology, Universidad de Antioquia, Medellín, Colombia
| | - Ángela Maria Tobón
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia; School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia; School of Microbiology, Universidad de Antioquia, Medellín, Colombia; Basic and Applied Microbiology Research Group (MICROBA), School of Microbiology, Universidad de Antioquia, Medellín, Colombia
| | - Ángela Restrepo
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia; School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia; School of Microbiology, Universidad de Antioquia, Medellín, Colombia; Basic and Applied Microbiology Research Group (MICROBA), School of Microbiology, Universidad de Antioquia, Medellín, Colombia
| | - Beatriz L Gómez
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia; School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia; School of Microbiology, Universidad de Antioquia, Medellín, Colombia; Basic and Applied Microbiology Research Group (MICROBA), School of Microbiology, Universidad de Antioquia, Medellín, Colombia
| | - Luz Elena Cano
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia; School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia; School of Microbiology, Universidad de Antioquia, Medellín, Colombia; Basic and Applied Microbiology Research Group (MICROBA), School of Microbiology, Universidad de Antioquia, Medellín, Colombia
| | - Ángel González
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia; School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia; School of Microbiology, Universidad de Antioquia, Medellín, Colombia; Basic and Applied Microbiology Research Group (MICROBA), School of Microbiology, Universidad de Antioquia, Medellín, Colombia
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116
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Pierrotti LC, Kotton CN. Transplantation in the tropics: lessons on prevention and management of tropical infectious diseases. Curr Infect Dis Rep 2015; 17:492. [PMID: 26031964 DOI: 10.1007/s11908-015-0492-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Tropical infectious diseases (IDs) remain a rare complication in transplant recipients even in tropical settings, but this topic has become increasingly important during the last decade due to multiple factors. Interestingly, non-tropical countries report most of the experiences with tropical diseases. The reported experience from non-endemic regions, however, does not always reflect the experience of endemic areas. Most of the guidelines and recommendations in the literature may not be applicable in tropical settings due to logistical difficulties, cost, and lack of proven benefit. In addition, certain post-transplant prevention measures, as prophylaxis and reducing exposure risk, are not feasible. Nonetheless, risk assessment and post-transplant management of tropical IDs in tropical areas should not be neglected, and clinicians need to have a higher clinical awareness for tropical ID occurring in this population. Herein, we review the more significant tropical ID in transplant patients, focusing on relevant experience reported by tropical settings.
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Affiliation(s)
- Ligia C Pierrotti
- Infectious Diseases Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Eneas de Carvalho Aguiar 255, 4° andar, São Paulo, 05403-900, SP, Brazil,
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117
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Polvi EJ, Li X, O’Meara TR, Leach MD, Cowen LE. Opportunistic yeast pathogens: reservoirs, virulence mechanisms, and therapeutic strategies. Cell Mol Life Sci 2015; 72:2261-87. [PMID: 25700837 PMCID: PMC11113693 DOI: 10.1007/s00018-015-1860-z] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Revised: 02/06/2015] [Accepted: 02/11/2015] [Indexed: 12/21/2022]
Abstract
Life-threatening invasive fungal infections are becoming increasingly common, at least in part due to the prevalence of medical interventions resulting in immunosuppression. Opportunistic fungal pathogens of humans exploit hosts that are immunocompromised, whether by immunosuppression or genetic predisposition, with infections originating from either commensal or environmental sources. Fungal pathogens are armed with an arsenal of traits that promote pathogenesis, including the ability to survive host physiological conditions and to switch between different morphological states. Despite the profound impact of fungal pathogens on human health worldwide, diagnostic strategies remain crude and treatment options are limited, with resistance to antifungal drugs on the rise. This review will focus on the global burden of fungal infections, the reservoirs of these pathogens, the traits of opportunistic yeast that lead to pathogenesis, host genetic susceptibilities, and the challenges that must be overcome to combat antifungal drug resistance and improve clinical outcome.
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Affiliation(s)
- Elizabeth J. Polvi
- Department of Molecular Genetics, University of Toronto, 1 King’s College Circle, Medical Sciences Building, Room 4368, Toronto, ON M5S 1A8 Canada
| | - Xinliu Li
- Department of Molecular Genetics, University of Toronto, 1 King’s College Circle, Medical Sciences Building, Room 4368, Toronto, ON M5S 1A8 Canada
| | - Teresa R. O’Meara
- Department of Molecular Genetics, University of Toronto, 1 King’s College Circle, Medical Sciences Building, Room 4368, Toronto, ON M5S 1A8 Canada
| | - Michelle D. Leach
- Department of Molecular Genetics, University of Toronto, 1 King’s College Circle, Medical Sciences Building, Room 4368, Toronto, ON M5S 1A8 Canada
- Aberdeen Fungal Group, Institute of Medical Sciences, School of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen, UK
| | - Leah E. Cowen
- Department of Molecular Genetics, University of Toronto, 1 King’s College Circle, Medical Sciences Building, Room 4368, Toronto, ON M5S 1A8 Canada
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118
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Histoplasmosis infections worldwide: thinking outside of the Ohio River valley. CURRENT TROPICAL MEDICINE REPORTS 2015; 2:70-80. [PMID: 26279969 DOI: 10.1007/s40475-015-0044-0] [Citation(s) in RCA: 139] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
In the United States, histoplasmosis is generally thought to occur mainly in the Ohio and Mississippi River Valleys, and the classic map of histoplasmosis distribution reflecting this is second nature to many U.S. physicians. With the advent of the HIV pandemic reports of patients with progressive disseminated histoplasmosis and AIDS came from regions of known endemicity, as well as from regions not thought to be endemic for histoplasmosis throughout the world. In addition, our expanding armamentarium of immunosuppressive medications and biologics has increased the diagnosis of histoplasmosis worldwide. While our knowledge of areas in which histoplasmosis is endemic has improved, it is still incomplete. Our contention is that physicians should consider histoplasmosis with the right constellations of symptoms in any febrile patient with immune suppression, regardless of geographic location or travel history.
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Passos AN, Kohara VS, de Freitas RS, Vicentini AP. Immunological assays employed for the elucidation of an histoplasmosis outbreak in São Paulo, SP. Braz J Microbiol 2015; 45:1357-61. [PMID: 25763041 PMCID: PMC4323310 DOI: 10.1590/s1517-83822014000400028] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Accepted: 04/17/2014] [Indexed: 12/28/2022] Open
Abstract
Several reports showed outbreaks of histoplasmosis acquired while bat-inhabited caves were visited by tourists, miners or researchers. We evaluated the performance of double immunodifusion (DI) and immunoblotting (IB) assays, employed for the histoplasmosis outbreak elucidation occurred in Vale do Paraíba, São Paulo. The existence of epidemiologic link, four patients with clinical signs suggestive of histoplasmosis and mycological confirmation has made that all 35 individuals involved to the cave visit were subjected to serological evaluation. By DI, we observed reactivity against H. capsulatum antigen in a single serum examined nearly 20 days after exposure to fungal propagules. On the other hand, IB showed reactivity against H and M fractions in 50% of samples evaluated. The analysis of the second sample batch, collected two months after the exposure showed that 96.7% were reactive by DI with antibodies titers ranging from 1 to 16 and 100% of reactivity against H and M fractions, by IB, suggesting an acute infection. The analysis of the overall agreement between the methods showed to be reasonable (κ = 0.37). This study confirms the importance and efficacy of more sensitive methodologies, such as IB assay, to early elucidation of disease, especially in cases of patients without mycological information.
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Affiliation(s)
- Angela Noronha Passos
- Laboratório de Imunodiagnóstico das Micoses Centro de Imunologia Instituto Adolfo Lutz São PauloSP Brazil Laboratório de Imunodiagnóstico das Micoses, Centro de Imunologia, Instituto Adolfo Lutz, São Paulo, SP, Brazil. ; Programa de Pós-Graduação em Ciências Coordenadoria de Controle de Doenças Secretaria de Estado da Saúde de São Paulo São PauloSP Brazil Programa de Pós-Graduação em Ciências, Coordenadoria de Controle de Doenças, Secretaria de Estado da Saúde de São Paulo, São Paulo, SP, Brazil
| | - Valdelene Sayuri Kohara
- Laboratório de Imunodiagnóstico das Micoses Centro de Imunologia Instituto Adolfo Lutz São PauloSP Brazil Laboratório de Imunodiagnóstico das Micoses, Centro de Imunologia, Instituto Adolfo Lutz, São Paulo, SP, Brazil
| | - Roseli Santos de Freitas
- Laboratório de Micologia Médica Instituto de Medicina Tropical Universidade de São Paulo São PauloSP Brazil Laboratório de Micologia Médica, Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Adriana Pardini Vicentini
- Laboratório de Imunodiagnóstico das Micoses Centro de Imunologia Instituto Adolfo Lutz São PauloSP Brazil Laboratório de Imunodiagnóstico das Micoses, Centro de Imunologia, Instituto Adolfo Lutz, São Paulo, SP, Brazil. ; Programa de Pós-Graduação em Ciências Coordenadoria de Controle de Doenças Secretaria de Estado da Saúde de São Paulo São PauloSP Brazil Programa de Pós-Graduação em Ciências, Coordenadoria de Controle de Doenças, Secretaria de Estado da Saúde de São Paulo, São Paulo, SP, Brazil
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Paracoccidioides lutzii Plp43 is an active glucanase with partial antigenic identity with P. brasiliensis gp43. PLoS Negl Trop Dis 2014; 8:e3111. [PMID: 25166744 PMCID: PMC4148228 DOI: 10.1371/journal.pntd.0003111] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 07/12/2014] [Indexed: 11/29/2022] Open
Abstract
Background Paracoccidioides brasiliensis and P. lutzii cause paracoccidioidomycosis (PCM). P. brasiliensis main diagnostic antigen is glycoprotein gp43, and its peptide sequence is 81% identical with a P. lutzii ortholog here called Plp43. P. lutzii (“Pb01-like”) apparently predominates in Midwestern/Northern Brazil, where high percentages of false-negative reactions using P. brasiliensis antigens have recently been reported. The aim of this work was to produce recombinant Plp43 to study its antigenic identity with gp43. Methodology We expressed rPlp43 as a secreted major component in Pichia pastoris and studied its reactivity in immunoblot with PCM patients' sera from Southwestern and Midwestern Brazil. Principal Findings We showed that rPlp43 is not glycosylated and bears glucanase activity. The protein did not react with anti-gp43 monoclonal antibodies in immunoblot, suggesting absence of the corresponding gp43 epitopes. Nevertheless, common epitope(s) might exist, considering that gp43-positive PCM sera recognized rPlp43 in immunoblot, while gp43-negative sera (33 out of 51) from patients resident in Midwestern Brazil were also rPlp43-negative. Two genotyped P. lutzii were from patients with gp43-negative sera, suggesting that non-reactive sera are from patients infected with this species. Conclusion Our data suggest that gp43 and Plp43 bear one or only a few common epitopes and that gp43 cannot be used in diagnosis of PCM patients infected with P. lutzii probably because Plp43 is poorly expressed during infection. Paracoccidioides lutzii is currently recognized as a distinct species from P. brasiliensis that until then was solely responsible for paracoccidioidomycosis (PCM). Serological diagnostic of this primary systemic mycosis is quite sensitive due to the expression of P. brasiliensis antigen gp43, which has specific peptide epitopes recognized by patients' sera. Unexpected PCM false-negative reactions have recently been reported for patients from Midwestern/Northern Brazil, where P. lutzii (“Pb01-like”) apparently predominates. In our work, 33 PCM false-negative sera from Midwestern Brazil, including two cases of P. lutzii genotyped isolates, did not recognize recombinant Plp43 (gp43 ortholog from Pb01) or gp43 (native purified or recombinant), suggesting Plp43 is possibly underexpressed in vivo. Gp43-positive sera reacted with rPl43 showing that common epitopes do exist, although anti-gp43 MAbs did not recognize the orthologous P. lutzii protein. The main finding of our work is that gp43 cannot be used in diagnosis of PCM patients infected with P. lutzii.
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121
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Adenis A, Nacher M, Hanf M, Vantilcke V, Boukhari R, Blachet D, Demar M, Aznar C, Carme B, Couppie P. HIV-associated histoplasmosis early mortality and incidence trends: from neglect to priority. PLoS Negl Trop Dis 2014; 8:e3100. [PMID: 25144374 PMCID: PMC4140672 DOI: 10.1371/journal.pntd.0003100] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 07/07/2014] [Indexed: 12/18/2022] Open
Abstract
Background Histoplasmosis is an endemic fungal infection in French Guiana. It is the most common AIDS-defining illness and the leading cause of AIDS-related deaths. Diagnosis is difficult, but in the past 2 decades, it has improved in this French overseas territory which offers an interesting model of Amazonian pathogen ecology. The objectives of the present study were to describe the temporal trends of incidence and mortality indicators for HIV-associated histoplasmosis in French Guiana. Methods A retrospective study was conducted to describe early mortality rates observed in persons diagnosed with incident cases of HIV-associated Histoplasma capsulatum var. capsulatum histoplasmosis admitted in one of the three main hospitals in French Guiana between 1992 and 2011. Early mortality was defined by death occurring within 30 days after antifungal treatment initiation. Data were collected on standardized case report forms and analysed using standard statistical methods. Results There were 124 deaths (45.3%) and 46 early deaths (16.8%) among 274 patients. Three time periods of particular interest were identified: 1992–1997, 1998–2004 and 2005–2011. The two main temporal trends were: the proportion of early deaths among annual incident histoplasmosis cases significantly declined four fold (χ2, p<0.0001) and the number of annual incident histoplasmosis cases increased three fold between 1992–1997 and 1998–2004, and subsequently stabilized. Conclusion From an occasional exotic diagnosis, AIDS-related histoplasmosis became the top AIDS-defining event in French Guiana. This was accompanied by a spectacular decrease of early mortality related to histoplasmosis, consistent with North American reference center mortality rates. The present example testifies that rapid progress could be at reach if awareness increases and leads to clinical and laboratory capacity building in order to diagnose and treat this curable disease. Histoplasmosis is an endemic fungal infection in French Guiana. It is the most common AIDS-defining illness and the leading cause of AIDS-related deaths. Diagnosis is difficult, but in the past 2 decades, it has improved. The objectives of the present study were to describe the temporal trends of incidence and mortality indicators for HIV-associated histoplasmosis in French Guiana. A retrospective study was conducted to describe early mortality rates observed in persons diagnosed with incident cases of HIV-associated histoplasmosis admitted in one of the three main hospitals of French Guiana between 1992 and 2011. Early mortality was defined by death occurring within 30 days after antifungal treatment initiation. Data were collected on standardized case report forms and analysed using standard statistical methods. Among 274 patients there were 46 early deaths (16.8%). The two main temporal trends were: the proportion of early deaths significantly divided four fold and the number of annual incident histoplasmosis cases increased three fold. The present example testifies that rapid progress could be at reach if awareness increases and leads to clinical and laboratory capacity building in order to diagnose and treat this curable disease.
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Affiliation(s)
- Antoine Adenis
- Inserm CIC 1424, Centre d'Investigation Clinique Antilles Guyane, Centre Hospitalier de Cayenne, Cayenne, France
- Equipe EA3593, Epidémiologie des Parasitoses et des Mycoses Tropicales, Université des Antilles et de la Guyane, Cayenne, France
- * E-mail:
| | - Mathieu Nacher
- Inserm CIC 1424, Centre d'Investigation Clinique Antilles Guyane, Centre Hospitalier de Cayenne, Cayenne, France
- Equipe EA3593, Epidémiologie des Parasitoses et des Mycoses Tropicales, Université des Antilles et de la Guyane, Cayenne, France
| | - Matthieu Hanf
- Inserm CIC 1424, Centre d'Investigation Clinique Antilles Guyane, Centre Hospitalier de Cayenne, Cayenne, France
- Equipe EA3593, Epidémiologie des Parasitoses et des Mycoses Tropicales, Université des Antilles et de la Guyane, Cayenne, France
| | - Vincent Vantilcke
- Service de Médecine Interne, Centre Hospitalier de l'Ouest Guyanais, Saint Laurent du Maroni, France
| | - Rachida Boukhari
- Laboratoire de Biologie Médicale, Centre Hospitalier de l'Ouest Guyanais, Saint Laurent du Maroni, France
| | - Denis Blachet
- Equipe EA3593, Epidémiologie des Parasitoses et des Mycoses Tropicales, Université des Antilles et de la Guyane, Cayenne, France
- Laboratoire Hospitalo-Universitaire de Parasitologie-Mycologie, Centre Hospitalier de Cayenne, Cayenne, France
| | - Magalie Demar
- Equipe EA3593, Epidémiologie des Parasitoses et des Mycoses Tropicales, Université des Antilles et de la Guyane, Cayenne, France
- Laboratoire Hospitalo-Universitaire de Parasitologie-Mycologie, Centre Hospitalier de Cayenne, Cayenne, France
- Unité des Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne, Cayenne, France
| | - Christine Aznar
- Equipe EA3593, Epidémiologie des Parasitoses et des Mycoses Tropicales, Université des Antilles et de la Guyane, Cayenne, France
- Laboratoire Hospitalo-Universitaire de Parasitologie-Mycologie, Centre Hospitalier de Cayenne, Cayenne, France
| | - Bernard Carme
- Inserm CIC 1424, Centre d'Investigation Clinique Antilles Guyane, Centre Hospitalier de Cayenne, Cayenne, France
- Equipe EA3593, Epidémiologie des Parasitoses et des Mycoses Tropicales, Université des Antilles et de la Guyane, Cayenne, France
- Laboratoire Hospitalo-Universitaire de Parasitologie-Mycologie, Centre Hospitalier de Cayenne, Cayenne, France
| | - Pierre Couppie
- Equipe EA3593, Epidémiologie des Parasitoses et des Mycoses Tropicales, Université des Antilles et de la Guyane, Cayenne, France
- Service de Dermatologie Vénérologie, Centre Hospitalier de Cayenne, Cayenne, France
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122
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Validation of an enzyme-linked immunosorbent assay that detects Histoplasma capsulatum antigenuria in Colombian patients with AIDS for diagnosis and follow-up during therapy. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2014; 21:1364-8. [PMID: 25008902 DOI: 10.1128/cvi.00101-14] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We validated an antigen capture enzyme-linked immunosorbent assay (ELISA) in Colombian persons with AIDS and proven histoplasmosis and evaluated the correlation between antigenuria and clinical improvement during follow-up. The sensitivity of the Histoplasma capsulatum ELISA was 86%, and the overall specificity was 94%. The antigen test successfully monitored the response to therapy.
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Tamayo D, Hernández O, Muñoz-Cadavid C, Cano LE, González A. Interaction between Paracoccidioides brasiliensis conidia and the coagulation system: involvement of fibrinogen. Mem Inst Oswaldo Cruz 2014; 108:488-93. [PMID: 23827999 DOI: 10.1590/s0074-0276108042013015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Accepted: 04/04/2013] [Indexed: 11/21/2022] Open
Abstract
The infectious process starts with an initial contact between pathogen and host. We have previously demonstrated that Paracoccidioides brasiliensis conidia interact with plasma proteins including fibrinogen, which is considered the major component of the coagulation system. In this study, we evaluated the in vitro capacity of P. brasiliensis conidia to aggregate with plasma proteins and compounds involved in the coagulation system. We assessed the aggregation of P. brasiliensis conidia after incubation with human serum or plasma in the presence or absence of anticoagulants, extracellular matrix (ECM) proteins, metabolic and protein inhibitors, monosaccharides and other compounds. Additionally, prothrombin and partial thromboplastin times were determined after the interaction of P. brasiliensis conidia with human plasma. ECM proteins, monosaccharides and human plasma significantly induced P. brasiliensis conidial aggregation; however, anticoagulants and metabolic and protein inhibitors diminished the aggregation process. The extrinsic coagulation pathway was not affected by the interaction between P. brasiliensis conidia and plasma proteins, while the intrinsic pathway was markedly altered. These results indicate that P. brasiliensis conidia interact with proteins involved in the coagulation system. This interaction may play an important role in the initial inflammatory response, as well as fungal disease progression caused by P. brasiliensis dissemination.
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Affiliation(s)
- Diana Tamayo
- Molecular and Cell Biology Unit, Corporación para Investigaciones Biológicas, Medellín, Colombia
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124
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de Souza SP, Jorge VM, Xavier MO. Paracoccidioidomycosis in southern Rio Grande do Sul: a retrospective study of histopathologically diagnosed cases. Braz J Microbiol 2014; 45:243-7. [PMID: 24948940 PMCID: PMC4059305 DOI: 10.1590/s1517-83822014000100035] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2012] [Accepted: 09/09/2013] [Indexed: 11/23/2022] Open
Abstract
Paracoccidioidomycosis (PCM) is a systemic mycosis caused by the fungus Paracoccidioides brasiliensis and is endemic to Brazil. The aim of this study was to perform a retrospective analysis of the PCM cases in the countryside south of Rio Grande do Sul, Brazil. The files from four histopathology laboratories located in the city of Pelotas were obtained, and all of the epidemiological and clinical data from the PCM diagnosed cases were collected for analysis. A total of 123 PCM cases diagnosed between 1966 and 2009 were selected. Of these patients, 104 (84.5%) were male, and 17 were female. The patients ranged from 02 to 92 years of age. Fifty-two cases (41.9%) were obtained from the oral pathology laboratory, and the remaining 71 cases (58.1%) were obtained from the three general pathology laboratories. Of all of the patients studied, 65.2% lived in rural zones and worked in agriculture or other related fields. Data on the evolution of this disease was available for 43 cases, and the time frame ranged from 20 to 2920 days (mean = 572.3 days). An accurate diagnosis performed in less than 30 days only occurred in 21% of the cases. PCM is endemic to the countryside of Rio Grande do Sul. Therefore, it is recommended that PCM be included as a differential diagnosis, mainly for individuals between 30 and 60 years of age, living in rural zones and who have respiratory signs and associated-oropharyngeal lesions.
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Affiliation(s)
| | - Valéria Magalhães Jorge
- Faculdade de Odontologia Universidade Federal de Pelotas PelotasRS Brazil ; Santa Casa de Misericórdia de Pelotas PelotasRS Brazil
| | - Melissa Orzechowski Xavier
- Faculdade de Medicina Universidade Federal do Rio Grande Rio GrandeRS Brazil ; Programa de Pós-Graduação em Ciências da Saúde Universidade Federal do Rio Grande Rio GrandeRS Brazil
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125
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Moreno L, Figueredo M, Sadigursky M, Badaro R. A Man With Newly Diagnosed HIV/AIDS With Unusual Severe Opportunistic Infection and No AIDS-Defining Disease. Clin Infect Dis 2014. [DOI: 10.1093/cid/ciu147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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126
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Scheel CM, Gómez BL. Diagnostic Methods for Histoplasmosis: Focus on Endemic Countries with Variable Infrastructure Levels. CURRENT TROPICAL MEDICINE REPORTS 2014; 1:129-137. [PMID: 31187020 DOI: 10.1007/s40475-014-0020-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Diagnosis of histoplasmosis remains challenging in resource-limited regions where HIV/AIDS is epidemic and histoplasmosis is endemic. Early and rapid detection of histoplasmosis is essential to preventing morbidity and mortality, yet few diagnostic options are available in low-resource areas of the world. The aim of this review is to provide an overview of the current status of the diagnosis of histoplasmosis, including an update on recent developments and utilization of new technologies. We discuss the specific diagnostic challenges faced in endemic regions, emphasizing the need for greater availability and standardization of rapid diagnostics for this endemic and neglected disease. While significant progress has been made in the development of new methods, clinical utility must be established by means of formal and extensive clinical studies.
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Affiliation(s)
- Christina M Scheel
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS G11, Atlanta, GA, USA
| | - Beatriz L Gómez
- Corporación para Investigaciones Biólogicas, Cra. 72 No 78 B 141, Medellín, Colombia
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127
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Adenis AA, Aznar C, Couppié P. Histoplasmosis in HIV-Infected Patients: A Review of New Developments and Remaining Gaps. CURRENT TROPICAL MEDICINE REPORTS 2014; 1:119-128. [PMID: 24860719 PMCID: PMC4030124 DOI: 10.1007/s40475-014-0017-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Histoplasma capsulatum is responsible for histoplasmosis, a fungal disease with worldwide distribution that can affect both immunocompromised and imunocompetent individuals. During the highly active antiretroviral therapy (HAART) era, morbidity and mortality due to histoplasmosis remained a public heatlh problem in low-income and high-income countries. The true burden of HIV-associated histoplasmosis is either not fully known or neglected since it is not a notifiable disease. Progress has been made in DNA patterns of strains and understanding of pathogenesis, and hopefully these will help identify new therapeutic targets. Unfortunately, histoplasmosis is still widely mistaken for multidrug-resistant tuberculosis, leading to numerous avoidable deaths, even if they are easily distinguishable. The new diagnostic tools and therapeutics developments have still not been made available in most endemic regions. Still, recent developments are promising because of their good clinical characteristics and also because they will be commercially available and affordable. This review of published data and gaps may help define and guide future research.
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Affiliation(s)
- Antoine A. Adenis
- Inserm CIC 1424, Centre d’Investigation Clinique Antilles-Guyane, Centre Hospitalier de Cayenne, avenue des flamboyants, BP 6006, 97 300 Cayenne, France
- UAG EA 3593, Epidémiologie des Parasitoses et des Mycoses Tropicales, Université des Antilles et de la Guyane, Cayenne, France
| | - Christine Aznar
- UAG EA 3593, Epidémiologie des Parasitoses et des Mycoses Tropicales, Université des Antilles et de la Guyane, Cayenne, France
- Laboratoire Hospitalo-Universitaire de Parasitologie-Mycologie, Centre Hospitalier de Cayenne, Cayenne, France
| | - Pierre Couppié
- UAG EA 3593, Epidémiologie des Parasitoses et des Mycoses Tropicales, Université des Antilles et de la Guyane, Cayenne, France
- Service de Dermatologie Vénérologie,, Centre Hospitalier de Cayenne, Cayenne, France
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128
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Epidemiology, Clinical, and Therapeutic Aspects of Paracoccidioidomycosis. CURRENT TROPICAL MEDICINE REPORTS 2014. [DOI: 10.1007/s40475-014-0013-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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129
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Dourado IBZ, Batista WL, Longo LVG, Mortara RA, Puccia R. Dual localization of Mdj1 in pathogenic fungi varies with growth temperature. Med Mycol 2014; 52:187-95. [DOI: 10.1093/mmy/myt002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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130
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Nacher M, Adenis A, Blanchet D, Vantilcke V, Demar M, Basurko C, Gaubert-Maréchal E, Dufour J, Aznar C, Carme B, Couppié P. Risk factors for disseminated histoplasmosis in a cohort of HIV-infected patients in French Guiana. PLoS Negl Trop Dis 2014; 8:e2638. [PMID: 24498446 PMCID: PMC3907336 DOI: 10.1371/journal.pntd.0002638] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Accepted: 11/27/2013] [Indexed: 11/29/2022] Open
Abstract
Disseminated histoplasmosis is the first AIDS-defining infection in French Guiana. A retrospective cohort study studied predictive factors of disseminated histoplasmosis in HIV-infected patients between 1996 and 2008. Cox proportional hazards models were used. The variables studied were age, sex, last CD4/CD8 count, CD4 nadir, herpes or pneumocystosis, cotrimoxazole and fluconazole use, antiretroviral treatment and the notion of recent initiation of HAART. A total of 1404 patients were followed for 6833 person-years. The variables independently associated with increased incidence of disseminated histoplasmosis were CD4 count<50 per mm3, CD4 count between 50 and 200 per mm3, a CD4 nadir <50 per mm3, CD8 count in the lowest quartile, herpes infection, and recent antiretroviral treatment initiation (less than 6 months). The variables associated with decreased incidence of histoplasmosis were antiretroviral treatment for more than 6 months, fluconazole treatment, and pneumocystosis. There were 13.5% of deaths at 1 month, 17.5% at 3 months, and 22.5% at 6 months after the date of diagnosis of histoplasmosis. The most important predictive factors for death within 6 months of diagnosis were CD4 counts and antiretroviral treatment. The present study did not study environmental/occupational factors but provides predictive factors for disseminated histoplasmosis and its outcome in HIV patients in an Amazonian environment during the HAART era. Disseminated histoplasmosis is the first AIDS-related disease in French Guiana, and probably in the Amazonian area. In order to determine the factors that are associated with histoplasmosis, a retrospective looked at a cohort of HIV-infected patients between 1996 and 2008. Multiple models were used to study the relation of age, sex, last CD4/CD8 count, CD4 nadir, herpes or pneumocystosis, cotrimoxazole and fluconazole use, antiretroviral treatment and the notion of recent initiation of antiretroviral treatment with the occurrence of disseminated histoplasmosis. A total of 1404 patients were followed for 6833 person-years. The variables independently associated with the incidence of disseminated histoplasmosis were low CD4 counts, the lowest CD4 counts were most at risk; Patients with the lowest CD8 counts were also at increased risk; Antiretroviral treatment was generally associated with lower histoplasmosis incidence, but for the first 6 months following antiretroviral treatment initiation there was a transient period of increased risk of diagnosing histoplasmosis; Herpes was also associated with more histoplasmosis; Pneumocystosis and Fluconazole treatment were negatively associated with histoplasmosis. Of 156 patients with histoplasmosis, there were 13.5% of deaths at 1 month, 17.5% at 3 months, and 22.5% at 6 months after the date of diagnosis of histoplasmosis. The most important predictive factors for death within 6 months of diagnosis were low CD4 counts and no antiretroviral treatment. The present study did not study environmental/occupational factors but provides predictive factors for disseminated histoplasmosis and its outcome in HIV patients in an Amazonian environment during the HAART era. These results are useful to guide clinicians working in an area where this diagnosis is often overlooked.
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Affiliation(s)
- Mathieu Nacher
- Centre d'Investigation Clinique, Epidémiologie Clinique Antilles Guyane (CIC EC CIE802), Centre Hospitalier de Cayenne, Cayenne, French Guiana
- COREVIH Guyane, CH de Cayenne, Cayenne, French Guiana
- Equipe EA 3593 Epidemiologie des Parasitoses et Mycoses Tropicales, Université Antilles Guyane, Campus Saint Denis, Cayenne, French Guiana
- * E-mail:
| | - Antoine Adenis
- Centre d'Investigation Clinique, Epidémiologie Clinique Antilles Guyane (CIC EC CIE802), Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Denis Blanchet
- Equipe EA 3593 Epidemiologie des Parasitoses et Mycoses Tropicales, Université Antilles Guyane, Campus Saint Denis, Cayenne, French Guiana
- Laboratoire Hospitalo Universitaire de Parasitologie Mycologie, CH de Cayenne, Cayenne, French Guiana
| | - Vincent Vantilcke
- Service de Médecine, Centre Hospitalier de l'Ouest Guyanais, Saint Laurent du Maroni, French Guiana
| | - Magalie Demar
- Equipe EA 3593 Epidemiologie des Parasitoses et Mycoses Tropicales, Université Antilles Guyane, Campus Saint Denis, Cayenne, French Guiana
- Unité des Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Célia Basurko
- Centre d'Investigation Clinique, Epidémiologie Clinique Antilles Guyane (CIC EC CIE802), Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | | | - Julie Dufour
- Service Dermatologie, CH de Cayenne, Cayenne, French Guiana
| | - Christine Aznar
- Equipe EA 3593 Epidemiologie des Parasitoses et Mycoses Tropicales, Université Antilles Guyane, Campus Saint Denis, Cayenne, French Guiana
- Laboratoire Hospitalo Universitaire de Parasitologie Mycologie, CH de Cayenne, Cayenne, French Guiana
| | - Bernard Carme
- Equipe EA 3593 Epidemiologie des Parasitoses et Mycoses Tropicales, Université Antilles Guyane, Campus Saint Denis, Cayenne, French Guiana
- Laboratoire Hospitalo Universitaire de Parasitologie Mycologie, CH de Cayenne, Cayenne, French Guiana
| | - Pierre Couppié
- Equipe EA 3593 Epidemiologie des Parasitoses et Mycoses Tropicales, Université Antilles Guyane, Campus Saint Denis, Cayenne, French Guiana
- Service Dermatologie, CH de Cayenne, Cayenne, French Guiana
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Lanternier F, Cypowyj S, Picard C, Bustamante J, Lortholary O, Casanova JL, Puel A. Primary immunodeficiencies underlying fungal infections. Curr Opin Pediatr 2013; 25:736-47. [PMID: 24240293 PMCID: PMC4098727 DOI: 10.1097/mop.0000000000000031] [Citation(s) in RCA: 145] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
PURPOSE OF REVIEW We review the primary immunodeficiencies (PIDs) underlying an increasing variety of superficial and invasive fungal infections. We also stress that the occurrence of such fungal infections should lead physicians to search for the corresponding single-gene inborn errors of immunity. Finally, we suggest that other fungal infections may also result from hitherto unknown inborn errors of immunity, at least in some patients with no known risk factors. RECENT FINDINGS An increasing number of PIDs are being shown to underlie fungal infectious diseases in children and young adults. Inborn errors of the phagocyte NADPH oxidase complex (chronic granulomatous disease), severe congenital neutropenia (SCN) and leukocyte adhesion deficiency type I confer a predisposition to invasive aspergillosis and candidiasis. More rarely, inborn errors of interferon-γ immunity underlie endemic mycoses. Inborn errors of interleukin-17 immunity have recently been shown to underlie chronic mucocutaneous candidiasis (CMC), while inborn errors of caspase recruitment domain-containing protein 9 (CARD9) immunity underlie deep dermatophytosis and invasive candidiasis. SUMMARY CMC, invasive candidiasis, invasive aspergillosis, deep dermatophytosis, pneumocystosis, and endemic mycoses can all be caused by PIDs. Each type of infection is highly suggestive of a specific type of PID. In the absence of overt risk factors, single-gene inborn errors of immunity should be sought in children and young adults with these and other fungal diseases.
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MESH Headings
- Adolescent
- Adult
- Aspergillosis/genetics
- Aspergillosis/immunology
- Autoantibodies
- Candidiasis, Chronic Mucocutaneous/genetics
- Candidiasis, Chronic Mucocutaneous/immunology
- Child
- Child, Preschool
- Disease Susceptibility
- Female
- Genetic Diseases, Inborn/genetics
- Genetic Diseases, Inborn/immunology
- Humans
- Immunity, Cellular/genetics
- Immunologic Deficiency Syndromes/complications
- Immunologic Deficiency Syndromes/genetics
- Immunologic Deficiency Syndromes/immunology
- Infant
- Infant, Newborn
- Interleukin-17/immunology
- Male
- Mycoses/genetics
- Mycoses/immunology
- Pneumonia, Pneumocystis/genetics
- Pneumonia, Pneumocystis/immunology
- Risk Factors
- T-Lymphocytes, Helper-Inducer/immunology
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Affiliation(s)
- Fanny Lanternier
- aLaboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U980 Necker Medical School, Imagine Institute and Paris Descartes University, Sorbonne Paris Cité bInfectious Diseases and Tropical Medicine Unit, Necker-Enfants Malades Hospital, AP-HP and Paris Descartes University cPasteur Institute, National Reference Center of Invasive Mycoses and Antifungals, Paris, France dSt Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, New York, USA eStudy Center for Immunodeficiency fPediatric Hematology-Immunology Unit, Necker Enfants-Malades Hospital, AP-HP, and Paris Descartes University, Sorbonne Paris Cité, Paris, France
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132
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Nacher M, Adenis A, Aznar C, Blanchet D, Vantilcke V, Demar M, Carme B, Couppié P. How many have died from undiagnosed human immunodeficiency virus-associated histoplasmosis, a treatable disease? Time to act. Am J Trop Med Hyg 2013; 90:193-4. [PMID: 24277783 DOI: 10.4269/ajtmh.13-0226] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Human immunodeficiency virus (HIV)-associated disseminated Histoplasma capsulatum capsulatum infection often mimics tuberculosis. This disease is well know in the United States but is dramatically underdiagnosed in Central and South America. In the Amazon region, given the available incidence data and the regional HIV prevalence, it is expected that, every year, 1,500 cases of histoplasmosis affect HIV patients in that region alone. Given the mortality in undiagnosed patients, at least 600 patients would be expected to die from an undiagnosed but treatable disease. The lack of a simple diagnostic tool and the lack of awareness by clinicians spiral in a vicious cycle and made a major problem invisible for 30 years. The HIV/acquired immunodeficiency syndrome community should tackle this problem now to prevent numerous avoidable deaths from HIV-associated histoplasmosis in the region and elsewhere.
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Affiliation(s)
- Mathieu Nacher
- Centre d'Investigation Clinique Epidémiologie Clinique Antilles Guyane CIC-EC CIE 802, Cayenne General Hospital, Cayenne, French Guiana; Coordination Regionale de la Lutte Contre le VIH de Guyane, Laboratoire Hospitalo-Universitaire de Parasitologie Mycologie, Unité des Maladies Infectieuses et Tropicale, et Service de Dermatologie Vénéréologie, Centre Hospitalier de Cayenne, Cayenne, French Guiana; Equipe EPaT EA3593 Epidemiologie des Parasitoses et Mycoses Tropicales, Université Antilles Guyane, Cayenne, French Guiana
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133
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Disseminated histoplasmosis in HIV-infected patients in South America: a neglected killer continues on its rampage. PLoS Negl Trop Dis 2013; 7:e2319. [PMID: 24278485 PMCID: PMC3836721 DOI: 10.1371/journal.pntd.0002319] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Arango-Bustamante K, Restrepo A, Cano LE, de Bedout C, Tobón AM, González A. Diagnostic value of culture and serological tests in the diagnosis of histoplasmosis in HIV and non-HIV Colombian patients. Am J Trop Med Hyg 2013; 89:937-42. [PMID: 24043688 DOI: 10.4269/ajtmh.13-0117] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
We determined the value of culture and serological tests used to diagnose histoplasmosis. The medical records of 391 histoplasmosis patients were analyzed. Diagnosis of the mycosis was assessed by culture, complement fixation, and immunodiffusion tests; 310 patients (79.5%) were male, and 184 patients (47.1%) were infected with human immunodeficiency virus (HIV). Positivity value for cultures was 35.7% (74/207), reactivity of serological tests was 95.2% (160/168), and a combination of both methodologies was 16.9% (35/207) for non-HIV patients. Positivity value for cultures was 75.0% (138/184), reactivity of serological tests was 92.4% (85/92), and a combination of both methodologies was 26.0% (48/184) for HIV/acquired immunodeficiency syndrome (AIDS) patients; 48.1% (102/212) of extrapulmonary samples from HIV/AIDS patients yielded positive cultures compared with 23.1% (49/212) in non-HIV patients. Lymphocyte counts made for 33.1% (61/184) of HIV/AIDS patients showed a trend to low CD4+ numbers and higher proportion of positive cultures. These results indicate that culture is the most reliable fungal diagnostic method for HIV/AIDS patients, and contrary to what is generally believed, serological assays are useful for diagnosing histoplasmosis in these patients.
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Affiliation(s)
- Karen Arango-Bustamante
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia; Escuela de Microbiología, Universidad de Antioquia, Medellín, Colombia; Basic and Applied Microbiology Research Group (MICROBA), Escuela de Microbiología, Universidad de Antioquia, Medellín, Colombia
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Brazão-Silva MT, Mancusi GW, Bazzoun FV, Ishisaki GY, Marcucci M. A gingival manifestation of histoplasmosis leading diagnosis. Contemp Clin Dent 2013; 4:97-101. [PMID: 23853464 PMCID: PMC3703707 DOI: 10.4103/0976-237x.111621] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Histoplasmosis is a world-wide distributed deep mycosis caused by Histoplasma capsulatum which has been endemic in many countries. We present a case involving an immunocompetent man evidencing the necessity of a multidisciplinary approach and rational requisition of exams. The disease has started as a pulmonary disease mimicking tuberculosis, although the exams have been negative. Immunodiffusion test indicate histoplasmosis, not confirmed by culture of sputum. After days the patient was forwarded by a private doctor for evaluation of oral lesions at our Department of Stomatology. An incisional biopsy revealed a nonspecific granulomatous inflammation and the Grocott-Gomori methenamine silver stain identified scarce oval structures that could represent fungal yeast. Sampling oral lesions with swab, it was observed the typical growth of H. capsulatum on culture. This case highlights the importance of doctor's integration diagnosing histoplasmosis, while a wide spectrum of clinical manifestations should be expected. Oral lesions may be the critical manifestation leading diagnosis.
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Abstract
Coccidioidomycosis consists of a spectrum of disease, ranging from a mild, self-limited, febrile illness to severe, life-threatening infection. It is caused by the soil-dwelling fungi, Coccidioides immitis and C. posadasii, which are present in diverse endemic areas. Climate changes and environmental factors affect the Coccidioides lifecycle and influence infection rates. The incidence of coccidioidomycosis has risen substantially over the past two decades. The vast majority of Coccidioides infections occur in the endemic zones, such as California, Arizona, Mexico, and Central America. Infections occurring outside those zones appear to be increasingly common, and pose unique clinical and public health challenges. It has long been known that elderly persons, pregnant women, and members of certain ethnic groups are at risk for severe or disseminated coccidioidomycosis. In recent years, it has become evident that persons with immunodeficiency diseases, diabetics, transplant recipients, and prisoners are also particularly vulnerable.
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Affiliation(s)
- Jennifer Brown
- Department of Internal Medicine, Division of Infectious Diseases, University of California, Davis Medical Center, Sacramento, CA, USA
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137
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Scorzoni L, de Lucas MP, Mesa-Arango AC, Fusco-Almeida AM, Lozano E, Cuenca-Estrella M, Mendes-Giannini MJ, Zaragoza O. Antifungal efficacy during Candida krusei infection in non-conventional models correlates with the yeast in vitro susceptibility profile. PLoS One 2013; 8:e60047. [PMID: 23555877 PMCID: PMC3610750 DOI: 10.1371/journal.pone.0060047] [Citation(s) in RCA: 110] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Accepted: 02/20/2013] [Indexed: 12/28/2022] Open
Abstract
The incidence of opportunistic fungal infections has increased in recent decades due to the growing proportion of immunocompromised patients in our society. Candida krusei has been described as a causative agent of disseminated fungal infections in susceptible patients. Although its prevalence remains low among yeast infections (2-5%), its intrinsic resistance to fluconazole makes this yeast important from epidemiologic aspects. Non mammalian organisms are feasible models to study fungal virulence and drug efficacy. In this work we have used the lepidopteran Galleria mellonella and the nematode Caenorhabditis elegans as models to assess antifungal efficacy during infection by C. krusei. This yeast killed G. mellonella at 25, 30 and 37°C and reduced haemocytic density. Infected larvae melanized in a dose-dependent manner. Fluconazole did not protect against C. krusei infection, in contrast to amphotericin B, voriconazole or caspofungin. However, the doses of these antifungals required to obtain larvae protection were always higher during C. krusei infection than during C. albicans infection. Similar results were found in the model host C. elegans. Our work demonstrates that non mammalian models are useful tools to investigate in vivo antifungal efficacy and virulence of C. krusei.
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Affiliation(s)
- Liliana Scorzoni
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
- Laboratório de Micologia Clínica, Faculdade de Ciências Farmacêuticas, Universidade Estadual Paulista de São Paulo, Araraquara, Brazil
| | - Maria Pilar de Lucas
- Department of Cellular Biology, National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Cecilia Mesa-Arango
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
- Group of Investigative Dermatology, University of Antioquia, Medellín, Colombia
| | - Ana Marisa Fusco-Almeida
- Laboratório de Micologia Clínica, Faculdade de Ciências Farmacêuticas, Universidade Estadual Paulista de São Paulo, Araraquara, Brazil
| | - Encarnación Lozano
- Department of Cellular Biology, National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Manuel Cuenca-Estrella
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Maria Jose Mendes-Giannini
- Laboratório de Micologia Clínica, Faculdade de Ciências Farmacêuticas, Universidade Estadual Paulista de São Paulo, Araraquara, Brazil
- * E-mail: (MJMG); (OZ)
| | - Oscar Zaragoza
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
- * E-mail: (MJMG); (OZ)
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138
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Bitterman R, Oren I, Geffen Y, Sprecher H, Schwartz E, Neuberger A. Prolonged fever and splinter hemorrhages in an immunocompetent traveler with disseminated histoplasmosis. J Travel Med 2013; 20:57-9. [PMID: 23279234 DOI: 10.1111/jtm.12000] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Revised: 10/22/2012] [Accepted: 10/25/2012] [Indexed: 11/30/2022]
Abstract
We present a case of progressive disseminated histoplasmosis in an immunocompetent traveler. Histoplasmosis was acquired in South America; its manifestations included prolonged fever, splinter hemorrhages, erythema multiforme, arthritis, and mediastinal lymphadenopathy. To the best of our knowledge no splinter hemorrhages had previously been reported in a patient with histoplasmosis.
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Affiliation(s)
- Roni Bitterman
- Internal Medicine B, Rambam Medical Center, Haifa, Israel
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139
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Valim CXR, Basso LR, dos Reis Almeida FB, Reis TF, Damásio ARL, Arruda LK, Martinez R, Roque-Barreira MC, Oliver C, Jamur MC, Coelho PSR. Characterization of PbPga1, an antigenic GPI-protein in the pathogenic fungus Paracoccidioides brasiliensis. PLoS One 2012; 7:e44792. [PMID: 23024763 PMCID: PMC3443090 DOI: 10.1371/journal.pone.0044792] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Accepted: 08/14/2012] [Indexed: 12/21/2022] Open
Abstract
Paracoccidioides brasiliensis is the etiologic agent of paracoccidioidomycosis (PCM), one of the most prevalent mycosis in Latin America. P. brasiliensis cell wall components interact with host cells and influence the pathogenesis of PCM. Cell wall components, such as glycosylphosphatidylinositol (GPI)-proteins play a critical role in cell adhesion and host tissue invasion. Although the importance of GPI-proteins in the pathogenesis of other medically important fungi is recognized, little is known about their function in P. brasiliensis cells and PCM pathogenesis. We cloned the PbPga1 gene that codifies for a predicted GPI-anchored glycoprotein from the dimorphic pathogenic fungus P. brasiliensis. PbPga1 is conserved in Eurotiomycetes fungi and encodes for a protein with potential glycosylation sites in a serine/threonine-rich region, a signal peptide and a putative glycosylphosphatidylinositol attachment signal sequence. Specific chicken anti-rPbPga1 antibody localized PbPga1 on the yeast cell surface at the septum between the mother cell and the bud with stronger staining of the bud. The exposure of murine peritoneal macrophages to rPbPga1 induces TNF-α release and nitric oxide (NO) production by macrophages. Furthermore, the presence of O-glycosylation sites was demonstrated by β-elimination under ammonium hydroxide treatment of rPbPga1. Finally, sera from PCM patients recognized rPbPga1 by Western blotting indicating the presence of specific antibodies against rPbPga1. In conclusion, our findings suggest that the PbPga1gene codifies for a cell surface glycoprotein, probably attached to a GPI-anchor, which may play a role in P. brasiliensis cell wall morphogenesis and infection. The induction of inflammatory mediators released by rPbPga1 and the reactivity of PCM patient sera toward rPbPga1 imply that the protein favors the innate mechanisms of defense and induces humoral immunity during P. brasiliensis infection.
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Affiliation(s)
- Clarissa X. R. Valim
- Departamento de Biologia Celular e Molecular e Biagentes Patogênicos, Faculdade de Medicina de Ribeirão Preto, São Paulo, Brazil
| | - Luiz Roberto Basso
- Departamento de Biologia Celular e Molecular e Biagentes Patogênicos, Faculdade de Medicina de Ribeirão Preto, São Paulo, Brazil
| | - Fausto B. dos Reis Almeida
- Departamento de Biologia Celular e Molecular e Biagentes Patogênicos, Faculdade de Medicina de Ribeirão Preto, São Paulo, Brazil
| | - Thaila Fernanda Reis
- Departamento de Biologia Celular e Molecular e Biagentes Patogênicos, Faculdade de Medicina de Ribeirão Preto, São Paulo, Brazil
| | | | - Luisa Karla Arruda
- Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, São Paulo, Brazil
| | - Roberto Martinez
- Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, São Paulo, Brazil
| | - Maria Cristina Roque-Barreira
- Departamento de Biologia Celular e Molecular e Biagentes Patogênicos, Faculdade de Medicina de Ribeirão Preto, São Paulo, Brazil
| | - Constance Oliver
- Departamento de Biologia Celular e Molecular e Biagentes Patogênicos, Faculdade de Medicina de Ribeirão Preto, São Paulo, Brazil
| | - Maria Célia Jamur
- Departamento de Biologia Celular e Molecular e Biagentes Patogênicos, Faculdade de Medicina de Ribeirão Preto, São Paulo, Brazil
| | - Paulo Sergio Rodrigues Coelho
- Departamento de Biologia Celular e Molecular e Biagentes Patogênicos, Faculdade de Medicina de Ribeirão Preto, São Paulo, Brazil
- * E-mail:
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140
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Sifuentes-Osornio J, Corzo-León DE, Ponce-de-León LA. Epidemiology of Invasive Fungal Infections in Latin America. CURRENT FUNGAL INFECTION REPORTS 2012; 6:23-34. [PMID: 22363832 PMCID: PMC3277824 DOI: 10.1007/s12281-011-0081-7] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The pathogenic role of invasive fungal infections (IFIs) has increased during the past two decades in Latin America and worldwide, and the number of patients at risk has risen dramatically. Working habits and leisure activities have also been a focus of attention by public health officials, as endemic mycoses have provoked a number of outbreaks. An extensive search of medical literature from Latin America suggests that the incidence of IFIs from both endemic and opportunistic fungi has increased. The increase in endemic mycoses is probably related to population changes (migration, tourism, and increased population growth), whereas the increase in opportunistic mycoses may be associated with the greater number of people at risk. In both cases, the early and appropriate use of diagnostic procedures has improved diagnosis and outcome.
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Affiliation(s)
- Jose Sifuentes-Osornio
- Laboratory of Microbiology, Salvador Zubiran National Institute of Medical Science and Nutrition, 15 Vasco de Quiroga, sección XVI, Tlalpan, México City, ZC 14000 Mexico
| | - Dora E. Corzo-León
- Infectious Diseases, Salvador Zubiran National Institute of Medical Science and Nutrition, México City, Mexico
| | - L. Alfredo Ponce-de-León
- Laboratory of Microbiology, Salvador Zubiran National Institute of Medical Science and Nutrition, 15 Vasco de Quiroga, sección XVI, Tlalpan, México City, ZC 14000 Mexico
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