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Silvestrini MMA, Alessio GD, Frias BED, Sales Júnior PA, Araújo MSS, Silvestrini CMA, Brito Alvim de Melo GE, Martins-Filho OA, Teixeira-Carvalho A, Martins HR. New insights into Trypanosoma cruzi genetic diversity, and its influence on parasite biology and clinical outcomes. Front Immunol 2024; 15:1342431. [PMID: 38655255 PMCID: PMC11035809 DOI: 10.3389/fimmu.2024.1342431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/26/2024] [Indexed: 04/26/2024] Open
Abstract
Chagas disease, caused by Trypanosoma cruzi, remains a serious public health problem worldwide. The parasite was subdivided into six distinct genetic groups, called "discrete typing units" (DTUs), from TcI to TcVI. Several studies have indicated that the heterogeneity of T. cruzi species directly affects the diversity of clinical manifestations of Chagas disease, control, diagnosis performance, and susceptibility to treatment. Thus, this review aims to describe how T. cruzi genetic diversity influences the biology of the parasite and/or clinical parameters in humans. Regarding the geographic dispersion of T. cruzi, evident differences were observed in the distribution of DTUs in distinct areas. For example, TcII is the main DTU detected in Brazilian patients from the central and southeastern regions, where there are also registers of TcVI as a secondary T. cruzi DTU. An important aspect observed in previous studies is that the genetic variability of T. cruzi can impact parasite infectivity, reproduction, and differentiation in the vectors. It has been proposed that T. cruzi DTU influences the host immune response and affects disease progression. Genetic aspects of the parasite play an important role in determining which host tissues will be infected, thus heavily influencing Chagas disease's pathogenesis. Several teams have investigated the correlation between T. cruzi DTU and the reactivation of Chagas disease. In agreement with these data, it is reasonable to suppose that the immunological condition of the patient, whether or not associated with the reactivation of the T. cruzi infection and the parasite strain, may have an important role in the pathogenesis of Chagas disease. In this context, understanding the genetics of T. cruzi and its biological and clinical implications will provide new knowledge that may contribute to additional strategies in the diagnosis and clinical outcome follow-up of patients with Chagas disease, in addition to the reactivation of immunocompromised patients infected with T. cruzi.
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Affiliation(s)
| | - Glaucia Diniz Alessio
- Integrated Biomarker Research Group, René Rachou Institute, Fiocruz Minas, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil
| | - Bruna Estefânia Diniz Frias
- Integrated Biomarker Research Group, René Rachou Institute, Fiocruz Minas, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil
| | - Policarpo Ademar Sales Júnior
- Integrated Biomarker Research Group, René Rachou Institute, Fiocruz Minas, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil
| | - Márcio Sobreira Silva Araújo
- Integrated Biomarker Research Group, René Rachou Institute, Fiocruz Minas, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil
| | | | | | - Olindo Assis Martins-Filho
- Integrated Biomarker Research Group, René Rachou Institute, Fiocruz Minas, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil
| | - Andréa Teixeira-Carvalho
- Integrated Biomarker Research Group, René Rachou Institute, Fiocruz Minas, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil
| | - Helen Rodrigues Martins
- Department of Pharmacy, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
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Bilheiro AB, Costa GDS, Araújo MS, Ribeiro WAR, Finamore-Araújo P, Moreira OC, Medeiros JF, Fontes G, Camargo LMA. Detection and Genotyping of Trypanosoma cruzi Samples in Species of Genus Rhodnius from Different Environments in the Brazilian Amazon. Vector Borne Zoonotic Dis 2024; 24:95-103. [PMID: 38165392 DOI: 10.1089/vbz.2023.0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Background: In the Amazon region, several species of triatomines occur in the natural environments. Among them, species of the genus Rhodnius are a risk to human populations due to their high rates of infection with Trypanosoma cruzi. The aim of this study was to identify the T. cruzi genotypes in Rhodnius specimens and their relationship with sylvatic hosts from different environments in the Brazilian Amazon. Methods: A total of 492 triatomines were collected from the municipalities of Monte Negro, Rondônia state, and Humaitá, Amazonas state, 382 of them being nymphs and 110 adults. Genotyping of T. cruzi in six discrete typing units (DTUs) was performed using conventional multilocus PCR. The triatomines that were positive for T. cruzi and engorged with blood were also targeted for amplification of the cytochrome B (cytB) gene to identify bloodmeal sources. Results: Of the 162 positive samples, the identified DTUs were TcI (87.65%) and TcIV (12.35%). It was observed that 102 specimens were engorged with a variety of bloodmeals. Triatomines infected with TcI were associated with DNA of all identified vertebrates, except Plecturocebus brunneus. TcIV was detected in triatomines that fed on Coendou prehensilis, Didelphis marsupialis, Mabuya nigropunctata, P. brunneus, Pithecia irrorata, Sapajus apella, and Tamandua tetradactyla. Conclusion: Results highlight the need to understand the patterns of T. cruzi genotypes in Rhodnius spp. and their association with sylvatic hosts to better elucidate their role in the transmission of Chagas disease in the Amazon region.
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Affiliation(s)
- Adriana Benatti Bilheiro
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de São João del Rei, Divinópolis, MG, Brazil
| | - Glaucilene da Silva Costa
- Laboratório de Saúde Pública-LACEN, Núcleo de Biologia Animal e Entomologia Médica, Porto Velho, RO, Brazil
| | - Maisa Silva Araújo
- Fundação Oswaldo Cruz/Fiocruz Rondônia, Porto Velho, RO, Brazil
- Centro de Pesquisa em Medicina Tropical de Rondônia (CEPEM)/Secretaria de Estado da Saúde de Rondônia, Porto Velho, RO, Brazil
| | | | - Paula Finamore-Araújo
- Laboratório de Virologia e Parasitologia Molecular, Instituto Oswaldo Cruz/IOC, Rio de Janeiro, RJ, Brazil
| | - Otacílio C Moreira
- Laboratório de Virologia e Parasitologia Molecular, Instituto Oswaldo Cruz/IOC, Rio de Janeiro, RJ, Brazil
| | - Jansen Fernandes Medeiros
- Fundação Oswaldo Cruz/Fiocruz Rondônia, Porto Velho, RO, Brazil
- Programa de Pós-Graduação em Biologia Experimental, Fundação Universidade Federal de Rondônia, Porto Velho, RO, Brazil
- Instituto Nacional de Epidemiologia da Amazônia Ocidental INCT-EPIAMO, Porto Velho, RO, Brazil
| | - Gilberto Fontes
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de São João del Rei, Divinópolis, MG, Brazil
- Instituto Nacional de Epidemiologia da Amazônia Ocidental INCT-EPIAMO, Porto Velho, RO, Brazil
| | - Luís Marcelo Aranha Camargo
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de São João del Rei, Divinópolis, MG, Brazil
- Centro de Pesquisa em Medicina Tropical de Rondônia (CEPEM)/Secretaria de Estado da Saúde de Rondônia, Porto Velho, RO, Brazil
- Instituto de Ciências Biomédicas 5, Universidade de São Paulo (ICB-5, USP), Monte Negro, RO, Brazil
- Instituto Nacional de Epidemiologia da Amazônia Ocidental INCT-EPIAMO, Porto Velho, RO, Brazil
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Becker I, Miranda-Ortiz H, Fernández-Figueroa EA, Sánchez-Montes S, Colunga-Salas P, Grostieta E, Juárez-Gabriel J, Lozano-Sardaneta YN, Arce-Fonseca M, Rodríguez-Morales O, Meneses-Ruíz G, Pastén-Sánchez S, López Martínez I, González-Guzmán S, Paredes-Cervantes V, Moreira OC, Finamore-Araujo P, Canseco-Méndez JC, Coquis-Navarrete U, Rengifo-Correa L, González-Salazar C, Alfaro-Cortés MM, Falcón-Lezama JA, Tapia-Conyer R, Stephens CR. The Low Variability of Tc24 in Trypanosoma cruzi TcI as an Advantage for Chagas Disease Prophylaxis and Diagnosis in Mexico. Pathogens 2023; 12:pathogens12030368. [PMID: 36986290 PMCID: PMC10057631 DOI: 10.3390/pathogens12030368] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/28/2023] [Accepted: 02/03/2023] [Indexed: 02/25/2023] Open
Abstract
(1) Background: Chagas disease is the main neglected tropical disease in America. It is estimated that around 6 million people are currently infected with the parasite in Latin America, and 25 million live in endemic areas with active transmission. The disease causes an estimated economic loss of USD 24 billion dollars annually, with a loss of 75,200 working years per year of life; it is responsible for around ~12,000 deaths annually. Although Mexico is an endemic country that recorded 10,186 new cases of Chagas disease during the period of 1990–2017, few studies have evaluated the genetic diversity of genes that could be involved in the prophylaxis and/or diagnosis of the parasite. One of the possible candidates proposed as a vaccine target is the 24 kDa trypomastigote excretory–secretory protein, Tc24, whose protection is linked to the stimulation of T. cruzi-specific CD8+ immune responses. (2) Methods: The aim of the present study was to evaluate the fine-scale genetic diversity and structure of Tc24 in T. cruzi isolates from Mexico, and to compare them with other populations reported in the Americas with the aim to reconsider the potential role of Tc24 as a key candidate for the prophylaxis and improvement of the diagnosis of Chagas disease in Mexico. (3) Results: Of the 25 Mexican isolates analysed, 48% (12) were recovered from humans and 24% (6) recovered from Triatoma barberi and Triatoma dimidiata. Phylogenetic inferences revealed a polytomy in the T. cruzi clade with two defined subgroups, one formed by all sequences of the DTU I and the other formed by DTU II–VI; both subgroups had high branch support. Genetic population analysis detected a single (monomorphic) haplotype of TcI throughout the entire distribution across both Mexico and South America. This information was supported by Nei’s pairwise distances, where the sequences of TcI showed no genetic differences. (4) Conclusions: Given that both previous studies and the findings of the present work confirmed that TcI is the only genotype detected from human isolates obtained from various states of Mexico, and that there is no significant genetic variability in any of them, it is possible to propose the development of in silico strategies for the production of antigens that optimise the diagnosis of Chagas disease, such as quantitative ELISA methods that use this region of Tc24.
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Affiliation(s)
- Ingeborg Becker
- Centro de Medicina Tropical, Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
- Correspondence: (I.B.); (C.R.S.)
| | - Haydee Miranda-Ortiz
- Unidad de Secuenciación, Instituto Nacional de Medicina Genómica, Mexico City 14610, Mexico
| | | | - Sokani Sánchez-Montes
- Centro de Medicina Tropical, Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
- Laboratorio de Diagnóstico, Facultad de Ciencias Biológicas y Agropecuarias Región Poza Rica-Tuxpan, Universidad Veracruzana, Tuxpan de Rodríguez Cano 92870, Mexico
| | - Pablo Colunga-Salas
- Centro de Medicina Tropical, Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
- Instituto de Biotecnología y Ecología Aplicada, Universidad Veracruzana, Xalapa de Enríquez 91090, Mexico
| | - Estefanía Grostieta
- Centro de Medicina Tropical, Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - Javier Juárez-Gabriel
- Centro de Medicina Tropical, Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
- Laboratorio de Diagnóstico, Facultad de Ciencias Biológicas y Agropecuarias Región Poza Rica-Tuxpan, Universidad Veracruzana, Tuxpan de Rodríguez Cano 92870, Mexico
| | - Yokomi N. Lozano-Sardaneta
- Centro de Medicina Tropical, Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - Minerva Arce-Fonseca
- Department of Molecular Biology, National Institute of Cardiology “Ignacio Chávez”, Mexico City 14080, Mexico
| | - Olivia Rodríguez-Morales
- Department of Molecular Biology, National Institute of Cardiology “Ignacio Chávez”, Mexico City 14080, Mexico
| | - Gabriela Meneses-Ruíz
- Departamento de Parasitología, Instituto de Diagnóstico y Referencia Epidemiológicos, Secretaría de Salud, Mexico City 01480, Mexico
| | - Sergio Pastén-Sánchez
- Departamento de Parasitología, Instituto de Diagnóstico y Referencia Epidemiológicos, Secretaría de Salud, Mexico City 01480, Mexico
| | - Irma López Martínez
- Departamento de Parasitología, Instituto de Diagnóstico y Referencia Epidemiológicos, Secretaría de Salud, Mexico City 01480, Mexico
| | - Saúl González-Guzmán
- Laboratorio del Banco Central de Sangre del Centro Médico Nacional “La Raza”, Instituto Mexicano del Seguro Social, Mexico City 02990, Mexico
- Departamento de Investigación, Hospital Regional de Alta Especialidad de Zumpango, Zumpango 55600, Mexico
| | - Vladimir Paredes-Cervantes
- Unidad de Investigación Médica en Inmunología e Infectología, Hospital de Infectología, Centro Médico Nacional “La Raza”, Instituto Mexicano del Seguro Social, Mexico City 02990, Mexico
| | - Otacilio C. Moreira
- Laboratorio de Biología Molecular e Doencas Endêmicas, Instituto Oswaldo Cruz, Fiocruz 21040900, RJ, Brazil
| | - Paula Finamore-Araujo
- Laboratorio de Biología Molecular e Doencas Endêmicas, Instituto Oswaldo Cruz, Fiocruz 21040900, RJ, Brazil
| | | | - Uriel Coquis-Navarrete
- Departamento de Genómica Poblacional, Instituto Nacional de Medicina Genómica, Mexico City 14610, Mexico
| | - Laura Rengifo-Correa
- Centro de Ciencias de la Complejidad, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | | | | | - Jorge A. Falcón-Lezama
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa 86100, Mexico
| | - Roberto Tapia-Conyer
- Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - Christopher R. Stephens
- Centro de Ciencias de la Complejidad, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
- Correspondence: (I.B.); (C.R.S.)
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Tavares de Oliveira M, Fuzo CA, da Silva MC, Donadi EA, da Silva JS, Moreira HT, Schmidt A, Marin-Neto JA. Correlation of TcII discrete typing units with severe chronic Chagas cardiomyopathy in patients from various Brazilian geographic regions. PLoS Negl Trop Dis 2022; 16:e0010713. [PMID: 36508471 PMCID: PMC9794067 DOI: 10.1371/journal.pntd.0010713] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 12/27/2022] [Accepted: 11/16/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Chagas disease (ChD) is caused by Trypanosoma cruzi. The genetic structure of the species is divided into seven distinct genetic groups, TcI to TcVI, and Tcbat, which have shown differences in terms of geographic distribution, biological properties, and susceptibility to drugs. However, the association between genetic variability and clinical forms of ChD has not yet been fully elucidated. The predominance of TcII and TcVI discrete typing units (DTUs) (genetic groups) is known to occur in several Brazilian regions and is associated with both the domestic and the wild cycles of ChD. Thus, this study aimed to verify the genotypes of the parasites present in 330 patients with chronic Chagas cardiomyopathy (CCC) from different Brazilian states attended at the Clinical Hospital of the Ribeirão Preto Medical School and to assess the existence of a correlation between the clinical forms with the main cardiovascular risk factors and the genetics of the parasite. METHODOLOGY PRINCIPAL FINDINGS All patients with CCC were clinically evaluated through anamnesis, physical examination, biochemical tests, 12-lead electrocardiogram, echocardiogram and chest X-ray. Peripheral blood (5 mL) was collected in guanidine/ethylenediaminetetraacetic acid from each patient for DNA extraction and real-time polymerase chain reaction (PCR) for Chagas disease and genotyping of the parasite in the 7 DTUs. Parasite genotyping was performed using conventional multilocus PCR. Samples of only 175 patients were positive after amplification of the specific genes contained in the T. cruzi genotyping criteria. TcII (64/175), TcVI (9/175), and TcI (3/175) DTUs were predominant, followed by TcII/TcV/TcVI (74/175), and TcII/TcVI (23/175). The TcIII and TcIV DTU´s was detected in only one sample of CCC patients. CONCLUSIONS/SIGNIFICANCE Our data corroborate previous findings, indicating the predominance of the TcII genotype in patients with CCC of Brazilian origin. Moreover, this study pioneered disclosing a direct correlation between the TcII DTU and severe CCC.
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Affiliation(s)
- Maykon Tavares de Oliveira
- Department of Internal Medicine, Cardiology Division, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- * E-mail:
| | - Carlos Alessandro Fuzo
- Department of Clinical Analyses, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Maria Cláudia da Silva
- Fiocruz-Bi-Institutional Translational Medicine Plataform, Ribeirão Preto, São Paulo, Brazil
| | - Eduardo Antônio Donadi
- Department of Internal Medicine, Division of Clinical Immunology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - João Santana da Silva
- Fiocruz-Bi-Institutional Translational Medicine Plataform, Ribeirão Preto, São Paulo, Brazil
| | - Henrique Turin Moreira
- Department of Internal Medicine, Cardiology Division, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - André Schmidt
- Department of Internal Medicine, Cardiology Division, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - José Antônio Marin-Neto
- Department of Internal Medicine, Cardiology Division, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Valença-Barbosa C, Finamore-Araujo P, Moreira OC, Alvarez MVN, Borges-Veloso A, Barbosa SE, Diotaiuti L, de Souza RDCM. High Parasitic Loads Quantified in Sylvatic Triatoma melanica, a Chagas Disease Vector. Pathogens 2022; 11:1498. [PMID: 36558833 PMCID: PMC9785645 DOI: 10.3390/pathogens11121498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 12/13/2022] Open
Abstract
Triatoma melanica is a sylvatic vector species in Brazil. In We aimed to characterize the Trypanosoma cruzi discrete typing units (DTUs), the parasitic loads, and the blood meal sources of insects collected in rocky outcrops in rural areas in the state of Minas Gerais. An optical microscope (OM) and kDNA-PCR were used to examine natural infection by T. cruzi, and positive samples were genotyped by conventional multilocus PCR. Quantification of the T. cruzi load was performed using qPCR, and the blood meal sources were identified by Sanger sequencing the 12S rRNA gene. A total of 141 T. melanica were captured. Of these, ~55% (61/111) and ~91% (63/69) were positive by OM and KDNA-PCR, respectively. We genotyped ~89% (56/63) of the T. cruzi-positive triatomines, with TcI (~55%, 31/56) being the most prevalent DTU, followed by TcIII (~20%, 11/56) and TcII (~7%, 4/56). Only TcI+TcIII mixed infections were detected in 10 (~18%) specimens. A wide range of variation in the parasitic loads of T. melanica was observed, with an overall median value of 104 parasites/intestine, with females having higher T. cruzi loads than N2, N4, and N5. TcII showed lower parasitic loads compared to TcI and TcIII. The OM positive diagnosis odds ratio between T. cruzi infection when the parasite load is 107 compared to 103 was approximately 29.1. The most frequent blood meal source was Kerodon rupestris (~58%), followed by Thrichomys apereoides (~18%), Wiedomys cerradensis (~8%), Galactis cuja (~8%) and Gallus gallus (~8%). Our findings characterize biological and epidemiological aspects of the sylvatic population of T. melanica in the study area, highlighting the need to extend surveillance and control to this vector.
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Affiliation(s)
- Carolina Valença-Barbosa
- Grupo Triatomíneos, Instituto René Rachou-Fiocruz Minas Gerais, Belo Horizonte, Minas Gerais 30190-002, Brazil
| | - Paula Finamore-Araujo
- Plataforma de PCR em Tempo Real RPT09A, Laboratório de Virologia Molecular, Instituto Oswaldo Cruz/Fiocruz, Rio de Janeiro 21040-360, Brazil
| | - Otacílio Cruz Moreira
- Plataforma de PCR em Tempo Real RPT09A, Laboratório de Virologia Molecular, Instituto Oswaldo Cruz/Fiocruz, Rio de Janeiro 21040-360, Brazil
| | | | - André Borges-Veloso
- Grupo Triatomíneos, Instituto René Rachou-Fiocruz Minas Gerais, Belo Horizonte, Minas Gerais 30190-002, Brazil
| | - Silvia Ermelinda Barbosa
- Grupo Triatomíneos, Instituto René Rachou-Fiocruz Minas Gerais, Belo Horizonte, Minas Gerais 30190-002, Brazil
| | - Liléia Diotaiuti
- Grupo Triatomíneos, Instituto René Rachou-Fiocruz Minas Gerais, Belo Horizonte, Minas Gerais 30190-002, Brazil
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Flores-Chavez MD, Abras A, Ballart C, Ibáñez-Perez I, Perez-Gordillo P, Gállego M, Muñoz C, Moure Z, Sulleiro E, Nieto J, García Diez E, Simón L, Cruz I, Picado A. Parasitemia Levels in Trypanosoma cruzi Infection in Spain, an Area Where the Disease Is Not Endemic: Trends by Different Molecular Approaches. Microbiol Spectr 2022; 10:e0262822. [PMID: 36190410 PMCID: PMC9603785 DOI: 10.1128/spectrum.02628-22] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 09/13/2022] [Indexed: 01/04/2023] Open
Abstract
Trypanosoma cruzi infection has expanded globally through human migration. In Spain, the mother-to-child route is the mode of transmission contributing to autochthonous Chagas disease (CD); however, most people acquired the infection in their country of origin and were diagnosed in the chronic phase (imported chronic CD). In this context, we assessed the quantitative potential of the Loopamp Trypanosoma cruzi detection kit (Sat-TcLAMP) based on satellite DNA (Sat-DNA) to determine parasitemia levels compared to those detected by real-time quantitative PCRs (qPCRs) targeting Sat-DNA (Sat-qPCR) and kinetoplast DNA minicircles (kDNA-qPCR). This study included 173 specimens from 39 autochthonous congenital and 116 imported chronic CD cases diagnosed in Spain. kDNA-qPCR showed higher sensitivity than Sat-qPCR and Sat-TcLAMP. According to all quantitative approaches, parasitemia levels were significantly higher in congenital infection than in chronic CD (1 × 10-1 to 5 × 105 versus >1 × 10-1 to 6 × 103 parasite equivalents/mL, respectively [P < 0.001]). Sat-TcLAMP, Sat-qPCR, and kDNA-qPCR results were equivalent at high levels of parasitemia (P = 0.381). Discrepancies were significant for low levels of parasitemia and older individuals. Differences between Sat-TcLAMP and Sat-qPCR were not qualitatively significant, but estimations of parasitemia using Sat-TcLAMP were closer to those by kDNA-qPCR. Parasitemia changes were assessed in 6 individual cases in follow-up, in which trends showed similar patterns by all quantitative approaches. At high levels of parasitemia, Sat-TcLAMP, Sat-qPCR, and kDNA-qPCR worked similarly, but significant differences were found for the low levels characteristic of late chronic CD. A suitable harmonization strategy needs to be developed for low-level parasitemia detection using Sat-DNA- and kDNA-based tests. IMPORTANCE Currently, molecular equipment has been introduced into many health care centers, even in low-income countries. PCR, qPCR, and loop-mediated isothermal amplification (LAMP) are becoming more accessible for the diagnosis of neglected infectious diseases. Chagas disease (CD) is spreading worldwide, and in countries where the disease is not endemic, such as Spain, the parasite Trypanosoma cruzi is transmitted from mother to child (congenital CD). Here, we explore why LAMP, aimed at detecting T. cruzi parasite DNA, is a reliable option for the diagnosis of congenital CD and the early detection of reactivation in chronic infection. When the parasite load is high, LAMP is equivalent to any qPCR. In addition, the estimations of T. cruzi parasitemia in patients living in Spain, a country where the disease is not endemic, resemble natural evolution in areas of endemicity. If molecular tests are introduced into the diagnostic algorithm for congenital infection, early diagnosis and timely treatment would be accomplished, so the interruption of vertical transmission can be an achievable goal.
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Affiliation(s)
- Maria D. Flores-Chavez
- National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
- Fundación Mundo Sano-España, Madrid, Spain
| | - Alba Abras
- Departament de Biologia, Universitat de Girona, Girona, Spain
| | - Cristina Ballart
- Secció de Parasitologia, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l’Alimentació, Universitat de Barcelona, Barcelona, Spain
| | - Ismael Ibáñez-Perez
- National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Montserrat Gállego
- Secció de Parasitologia, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l’Alimentació, Universitat de Barcelona, Barcelona, Spain
- ISGlobal, Barcelona, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III (CIBERINFEC, ISCIII), Madrid, Spain
| | - Carmen Muñoz
- Servei de Microbiologia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Institut de Recerca Biomèdica Sant Pau, Barcelona, Spain
- Departament de Genètica i Microbiologia, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Zaira Moure
- Servicio de Microbiología, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Elena Sulleiro
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III (CIBERINFEC, ISCIII), Madrid, Spain
- Microbiology Department, Vall d’Hebron Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Javier Nieto
- National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III (CIBERINFEC, ISCIII), Madrid, Spain
| | - Emilia García Diez
- National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Lorena Simón
- National Centre of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Israel Cruz
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III (CIBERINFEC, ISCIII), Madrid, Spain
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
- Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland
| | - Albert Picado
- Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland
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Silpa MAC, Rodriguez F, Reavill D, Biswell E, Waldrup K, Maldonado RA. Trypanosoma cruzi infection in a bat-eared fox (Otocyon megalotis) with severe focally extensive suppurative myocarditis. J Exot Pet Med 2021. [DOI: 10.1053/j.jepm.2021.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Surveillance of Trypanosoma cruzi infection in Triatomine vectors, feral dogs and cats, and wild animals in and around El Paso county, Texas, and New Mexico. PLoS Negl Trop Dis 2021; 15:e0009147. [PMID: 33600455 PMCID: PMC7924784 DOI: 10.1371/journal.pntd.0009147] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 03/02/2021] [Accepted: 01/14/2021] [Indexed: 01/03/2023] Open
Abstract
The causative agent of Chagas disease, Trypanosoma cruzi, is transmitted by triatomine vectors. The insect is endemic in the Americas, including the United States, where epidemiological studies are limited, particularly in the Southwestern region. Here, we have determined the prevalence of T. cruzi in triatomines, feral cats and dogs, and wild animals, the infecting parasite genotypes and the mammalian host bloodmeal sources of the triatomines at four different geographical sites in the U.S.-Mexico border, including El Paso County, Texas, and nearby cities in New Mexico. Using qualitative polymerase chain reaction to detect T. cruzi infections, we found 66.4% (n = 225) of triatomines, 45.3% (n = 95) of feral dogs, 39.2% (n = 24) of feral cats, and 71.4% (n = 7) of wild animals positive for T. cruzi. Over 95% of T. cruzi genotypes or discrete typing units (DTUs) identified were TcI and some TcIV. Furthermore, Triatoma rubida was the triatomine species most frequently (98.2%) collected in all samples analyzed. These findings suggest a high prevalence of T. cruzi infections among triatomines, and feral and wild animals in the studied sites. Therefore, our results underscore the urgent need for implementation of a systematic epidemiological surveillance program for T. cruzi infections in insect vectors, and feral and wild animals, and Chagas disease in the human population in the southwestern region of the United States. Chagas disease is caused by the parasite Trypanosoma cruzi and one of the major transmission routes is the contaminated feces of blood-feeding triatomine insect vectors, popularly known as kissing bugs. In recent years, this disease has become an important public health concern to the United States and other nonendemic regions of the world. Despite many studies about the prevalence of T. cruzi in triatomines, and domestic, feral and wild animals in central and southern Texas, there have been no studies in west Texas and New Mexico. In this study, we report the presence of triatomines in residences in El Paso County, TX, and surrounding communities in New Mexico (cities of Anthony and Las Cruces), as well as T. cruzi infections in feral and wild animals. Using two molecular techniques to analyze the bloodmeal source in triatomines, we detected 12 different mammalian bloodmeal sources, including human and canine. Finally, parasite genotyping showed that most (95%) of the samples belonged to the genotype TcI, which is prevalent in North America. Our findings indicate that the El Paso County and surrounding communities (>950,000 people) are high risk areas for T. cruzi transmission to humans, feral cats and dogs, and wild animals. Thus, there is an urgent necessity for a public health epidemiological surveillance program for T. cruzi infections in kissing bugs, feral and wild animals, and in the human population in the U.S.-Mexico border region.
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Nielebock MAP, Moreira OC, Xavier SCDC, Miranda LDFC, de Lima ACB, Pereira TODJS, Hasslocher-Moreno AM, Britto C, Sangenis LHC, Saraiva RM. Association between Trypanosoma cruzi DTU TcII and chronic Chagas disease clinical presentation and outcome in an urban cohort in Brazil. PLoS One 2020; 15:e0243008. [PMID: 33264350 PMCID: PMC7710061 DOI: 10.1371/journal.pone.0243008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 11/12/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The specific roles of parasite characteristics and immunological factors of the host in Chagas disease progression and prognosis are still under debate. Trypanosoma cruzi genotype may be an important determinant of the clinical chronic Chagas disease form and prognosis. This study aimed to identify the potential association between T. cruzi genotypes and the clinical presentations of chronic Chagas disease. METHODOLOGY/PRINCIPAL FINDINGS This is a retrospective study using T. cruzi isolated from blood culture samples of 43 patients with chronic Chagas disease. From 43 patients, 42 were born in Brazil, mainly in Southeast and Northeast Brazilian regions, and one patient was born in Bolivia. Their mean age at the time of blood collection was 52.4±13.2 years. The clinical presentation was as follows 51.1% cardiac form, 25.6% indeterminate form, and 23.3% cardiodigestive form. Discrete typing unit (DTU) was determined by multilocus conventional PCR. TcII (n = 40) and TcVI (n = 2) were the DTUs identified. DTU was unidentifiable in one patient. The average follow-up time after blood culture was 5.7±4.4 years. A total of 14 patients (32.5%) died and one patient underwent heart transplantation. The cause of death was sudden cardiac arrest in six patients, heart failure in five patients, not related to Chagas disease in one patient, and ignored in two patients. A total of 8 patients (18.6%) progressed, all of them within the cardiac or cardiodigestive forms. CONCLUSIONS/SIGNIFICANCE TcII was the main T. cruzi DTU identified in chronic Chagas disease Brazilian patients (92.9%) with either cardiac, indeterminate or cardiodigestive forms, born at Southeast and Northeast regions. Other DTU found in much less frequency was TcVI (4.8%). TcII was also associated to patients that evolved with heart failure or sudden cardiac arrest, the two most common and ominous consequences of the cardiac form of Chagas disease.
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Affiliation(s)
- Marco Antonio Prates Nielebock
- Clinical Research Laboratory in Chagas Disease, Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
| | - Otacílio C. Moreira
- Molecular Biology and Endemic Diseases Laboratory, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil
| | | | | | | | | | - Alejandro Marcel Hasslocher-Moreno
- Clinical Research Laboratory in Chagas Disease, Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
| | - Constança Britto
- Molecular Biology and Endemic Diseases Laboratory, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil
| | - Luiz Henrique Conde Sangenis
- Clinical Research Laboratory in Chagas Disease, Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
| | - Roberto Magalhães Saraiva
- Clinical Research Laboratory in Chagas Disease, Evandro Chagas National Institute of Infectious Diseases, Fiocruz, Rio de Janeiro, Brazil
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Tavares de Oliveira M, Sulleiro E, Silgado Gimenez A, de Lana M, Zingales B, Santana da Silva J, Marin-Neto JA, Molina I. Quantification of parasite burden of Trypanosoma cruzi and identification of Discrete Typing Units (DTUs) in blood samples of Latin American immigrants residing in Barcelona, Spain. PLoS Negl Trop Dis 2020; 14:e0008311. [PMID: 32497037 PMCID: PMC7271996 DOI: 10.1371/journal.pntd.0008311] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 04/20/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Trypanosoma cruzi has a high genetic and biological diversity and has been subdivided into seven genetic lineages, named TcI-TcVI and TcBat. DTUs TcI-TcII-TcV and TcVI are agents of ChD in different regions of Latin America. Due to population movements, the disease is an emergent global public health problem. Thus, the aim of this study was to quantify the parasitic load and identify the presence of T. cruzi DTUs in 101 Latin American immigrants with chronic ChD, residing in Barcelona, Spain. METHODOLOGY / PRINCIPAL FINDINGS 5ml of peripheral blood were collected in guanidine/EDTA from each patient for DNA extraction, quantification of the parasitic load and genotyping. A great variation of the parasitic load of the patients was verified: from 0.001 to 22.2 T. cruzi DNA (fg) / Blood DNA (ng). In patients from Bolivia the parasitic load was 3.76±4.43 T. cruzi DNA (fg) / Blood DNA (ng) (mean ± SD), in patients of other countries was 0.95±1.38 T. cruzi DNA (fg) / Blood DNA (ng). No statistically significant difference was observed in the parasitic load between patients with the indeterminate and cardiac forms of ChD (p = 0,57). Parasite genotyping was performed by multilocus conventional PCR. In patients from Bolivia there was a nearly equal prevalence of DTUs TcV (27/77), TcII/TcV/TcVI (26/77), and TcII/TcVI (22/77). TcVI was detected in only 2 samples (2/77). A higher prevalence of TcII/TcVI (19/24) was verified in patients of other countries, with low prevalence of TcII/TcV/TcVI (4/24) and TcV (1/24). CONCLUSIONS/SIGNIFICANCE In this study, low/medium parasitic load was found in all patients evaluated. Our data corroborate previous conclusions indicating that patients from the Bolivia, living in Spain, are predominantly infected by TcV, and TcVI DTUs. On the other hand, in Non-Bolivians patients TcII/TcVI predominated. Surprisingly, in our cohort of 101 patients no infection by TcI DTU was observed.
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Affiliation(s)
- Maykon Tavares de Oliveira
- Department of Infectious Diseases, Universitat Autònoma de Barcelona, Vall d’Hebron University Hospital. PROSICS, Barcelona. Spain
- Department of Internal Medicine, Cardiology Division, Medical School of Ribeirão Preto, University of São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | - Elena Sulleiro
- Department of Microbiology, Vall d’Hebron University Hospital. Universitat Autònoma de Barcelona. PROSICS Barcelona. Spain
| | - Aroa Silgado Gimenez
- Department of Microbiology, Vall d’Hebron University Hospital. Universitat Autònoma de Barcelona. PROSICS Barcelona. Spain
| | - Marta de Lana
- School of Pharmacy and Center for Research in Biological Sciences (NUPEB), Federal University of Ouro Preto (UFOP), Ouro Preto, MG, Brazil
| | - Bianca Zingales
- Department of Biochemistry, Institute of Chemistry, University of São Paulo (USP), São Paulo, SP, Brazil
| | - João Santana da Silva
- Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil.
| | - J. Antônio Marin-Neto
- Department of Internal Medicine, Cardiology Division, Medical School of Ribeirão Preto, University of São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | - Israel Molina
- Department of Infectious Diseases, Universitat Autònoma de Barcelona, Vall d’Hebron University Hospital. PROSICS, Barcelona. Spain
- * E-mail:
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Cardoso GVF, Lima JS, Oliveira ACDSD, Silva JBD, Roos TB, Moraes CMD. SYBR Green qPCR Technique for the Detection of Trypanosoma cruzi in Açaí Pulp. Foodborne Pathog Dis 2020; 17:466-469. [PMID: 32077756 DOI: 10.1089/fpd.2019.2745] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Chagas disease, which is found widely in Latin America and has a great impact on public health, is caused by the parasite Trypanosoma cruzi. It is a neglected parasitic disease that urgently requires rapid diagnostic methods. The objective of this study was to develop a SYBR Green real-time quantitative polymerase chain reaction (qPCR) technique for the direct identification and quantification of T. cruzi from experimentally contaminated açai fruit samples. We used discrete typing units, TcI, containing 3.5 × 104 cells/mL, to infect the pulp of the açai fruit. This was followed by DNA extraction using a standardized procedure. The DNA samples were quantified and amplified at specific time and temperature intervals. The specificity of the oligoinitiators used in the qPCR assays was estimated by calculating the primer dissociation curve (melting curve) along with a detection threshold using different concentrations of DNA. The method used here demonstrated good efficiency and precision for the detection and quantification of T. cruzi DNA, with a detection limit of 2.65 × 10-14 g/μL DNA. The qPCR technique presented here could serve as an important tool for the diagnosis of T. cruzi parasites in açai.
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Affiliation(s)
| | - Joelson Sousa Lima
- Laboratory of Hygiene and Food Quality, Institute of Veterinary Medicine, Federal University of Pará (UFPA), Castanhal, Brazil
| | | | - Josyane Brasil da Silva
- Laboratory of Hygiene and Food Quality, Institute of Veterinary Medicine, Federal University of Pará (UFPA), Castanhal, Brazil
| | - Talita Bandeira Roos
- Laboratory of Hygiene and Food Quality, Institute of Veterinary Medicine, Federal University of Pará (UFPA), Castanhal, Brazil
| | - Carina Martins de Moraes
- Laboratory of Hygiene and Food Quality, Institute of Veterinary Medicine, Federal University of Pará (UFPA), Castanhal, Brazil
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