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Sabino EC, Nunes MCP, Blum J, Molina I, Ribeiro ALP. Cardiac involvement in Chagas disease and African trypanosomiasis. Nat Rev Cardiol 2024:10.1038/s41569-024-01057-3. [PMID: 39009679 DOI: 10.1038/s41569-024-01057-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/13/2024] [Indexed: 07/17/2024]
Abstract
Trypanosomiases are diseases caused by various species of protozoan parasite in the genus Trypanosoma, each presenting with distinct clinical manifestations and prognoses. Infections can affect multiple organs, with Trypanosoma cruzi predominantly affecting the heart and digestive system, leading to American trypanosomiasis or Chagas disease, and Trypanosoma brucei primarily causing a disease of the central nervous system known as human African trypanosomiasis or sleeping sickness. In this Review, we discuss the effects of these infections on the heart, with particular emphasis on Chagas disease, which continues to be a leading cause of cardiomyopathy in Latin America. The epidemiology of Chagas disease has changed substantially since 1990 owing to the emigration of over 30 million Latin American citizens, primarily to Europe and the USA. This movement of people has led to the global dissemination of individuals infected with T. cruzi. Therefore, cardiologists worldwide must familiarize themselves with Chagas disease and the severe, chronic manifestation - Chagas cardiomyopathy - because of the expanded prevalence of this disease beyond traditional endemic regions.
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Affiliation(s)
- Ester Cerdeira Sabino
- Department of Pathology, Instituto de Medicina Tropical da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil.
| | - Maria Carmo P Nunes
- Hospital das Clínicas and Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
| | - Johannes Blum
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Israel Molina
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Antonio Luiz P Ribeiro
- Hospital das Clínicas and Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Settelmeier S, Kessler L, Varasteh Z, Mahabadi AA, Michel L, Papathanasiou M, Laschinsky C, Rischpler C, Fendler WP, Schlosser T, Umutlu L, Herrmann K, Rassaf T, Kersting D. FAPI PET Imaging Supports Clinical Decision Making in Academic Cardiology Practice: A Pictorial Imaging Vignette. JACC Cardiovasc Imaging 2024; 17:811-823. [PMID: 38819338 DOI: 10.1016/j.jcmg.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/03/2024] [Accepted: 04/04/2024] [Indexed: 06/01/2024]
Affiliation(s)
- Stephan Settelmeier
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, Medical Faculty, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Lukas Kessler
- Department of Nuclear Medicine, Medical Faculty, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Department of Diagnostic and Interventional Radiology and Neuroradiology, Medical Faculty, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Zohreh Varasteh
- Department of Nuclear Medicine, Medical Faculty, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Amir A Mahabadi
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, Medical Faculty, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Lars Michel
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, Medical Faculty, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Maria Papathanasiou
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, Medical Faculty, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Department of Cardiology, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Christina Laschinsky
- Department of Nuclear Medicine, Medical Faculty, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Christoph Rischpler
- Department of Nuclear Medicine, Medical Faculty, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Department of Nuclear Medicine, Klinikum Stuttgart, Stuttgart, Germany
| | - Wolfgang P Fendler
- Department of Nuclear Medicine, Medical Faculty, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Thomas Schlosser
- Department of Diagnostic and Interventional Radiology and Neuroradiology, Medical Faculty, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, Medical Faculty, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Ken Herrmann
- Department of Nuclear Medicine, Medical Faculty, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Tienush Rassaf
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, Medical Faculty, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - David Kersting
- Department of Nuclear Medicine, Medical Faculty, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
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Trovo JVS, Weber-Lima MM, Prado-Costa B, Iunklaus GF, Andrade AJ, Sobral-Souza T, Muylaert RL, Alvarenga LM, Toledo MJO. The risk of vector transmission of Trypanosoma cruzi remains high in the State of Paraná. Mem Inst Oswaldo Cruz 2024; 119:e230226. [PMID: 38865577 PMCID: PMC11164317 DOI: 10.1590/0074-02760230226] [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] [Received: 12/02/2023] [Accepted: 04/16/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND Monitoring and analysing the infection rates of the vector of Trypanosoma cruzi, that causes Chagas disease, helps assess the risk of transmission. OBJECTIVES A study was carried out on triatomine in the State of Paraná, Brazil, between 2012 and 2021 and a comparison was made with a previous study. This was done to assess the risk of disease transmission. METHODS Ecological niche models based on climate and landscape variables were developed to predict habitat suitability for the vectors as a proxy for risk of occurrence. FINDINGS A total of 1,750 specimens of triatomines were recorded, of which six species were identified. The overall infection rate was 22.7%. The areas with the highest risk transmission of T. cruzi are consistent with previous predictions in municipalities. New data shows that climate models are more accurate than landscape models. This is likely because climate suitability was higher in the previous period. MAIN CONCLUSION Regardless of uneven sampling and potential biases, risk remains high due to the wide presence of infected vectors and high environmental suitability for vector species throughout the state and, therefore, improvements in public policies aimed at wide dissemination of knowledge about the disease are recommended to ensure the State remains free of Chagas disease.
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Affiliation(s)
- João Vitor S Trovo
- Universidade Estadual de Maringá, Centro de Ciências da Saúde, Programa de Pós-Graduação em Ciências da Saúde, Maringá, PR, Brasil
| | - Michele Martha Weber-Lima
- Universidade Federal do Paraná, Departamento de Patologia Básica, Programa de Pós-Graduação em Microbiologia, Parasitologia e Patologia, Curitiba, PR, Brasil
- Secretaria Estadual da Saúde, Curitiba, PR, Brasil
| | - Bianca Prado-Costa
- Universidade Federal do Paraná, Departamento de Patologia Básica, Programa de Pós-Graduação em Microbiologia, Parasitologia e Patologia, Curitiba, PR, Brasil
| | - Giullia F Iunklaus
- Universidade Estadual de Maringá, Centro de Ciências da Saúde, Programa de Pós-Graduação em Ciências da Saúde, Maringá, PR, Brasil
| | - Andrey J Andrade
- Universidade Federal do Paraná, Departamento de Patologia Básica, Programa de Pós-Graduação em Microbiologia, Parasitologia e Patologia, Curitiba, PR, Brasil
| | - Thadeu Sobral-Souza
- Universidade Federal do Mato Grosso, Instituto de Biociências, Departamento de Botânica e Ecologia, Laboratório de Macroecologia, Cuiabá, MT, Brasil
| | - Renata L Muylaert
- Massey University, Hopkirk Research Institute, Molecular Epidemiology and Public Health Laboratory, Palmerston North, New Zealand
| | - Larissa M Alvarenga
- Universidade Federal do Paraná, Departamento de Patologia Básica, Programa de Pós-Graduação em Microbiologia, Parasitologia e Patologia, Curitiba, PR, Brasil
| | - Max Jean O Toledo
- Universidade Estadual de Maringá, Centro de Ciências da Saúde, Programa de Pós-Graduação em Ciências da Saúde, Maringá, PR, Brasil
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Smith A, Fentanes E, Gore R, Bush KN. A Modified Classification Scheme for Chagas Cardiomyopathy Incorporating Cardiac Magnetic Resonance Imaging. Cureus 2024; 16:e59900. [PMID: 38854227 PMCID: PMC11160959 DOI: 10.7759/cureus.59900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2024] [Indexed: 06/11/2024] Open
Abstract
The public health concerns from Chagas disease warrant improved cardiovascular imaging efforts, and in this report, we review a military service member presenting with electrocardiographic and cardiac magnetic resonance imaging (CMR) findings that recognized a Chagas dilated cardiomyopathy. We present an updated Chagas staging classification incorporating CMR to increase diagnosing cardiomyopathies.
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Affiliation(s)
- Alexandra Smith
- Division of Cardiology, Brooke Army Medical Center, Fort Sam Houston, USA
| | - Emilio Fentanes
- Division of Cardiology, Brooke Army Medical Center, Fort Sam Houston, USA
| | - Rosco Gore
- Division of Cardiology, Brooke Army Medical Center, Fort Sam Houston, USA
| | - Kelvin N Bush
- Division of Cardiology, Brooke Army Medical Center, Fort Sam Houston, USA
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Pavan TBS, Leony LM, de Souza WV, Santos EF, Tavares Daltro R, Erdens Maron Freitas N, Medrado Vasconcelos LC, Lopes Habib F, Silva AAO, Alejandra Fiorani Celedon P, Dias Sampaio D, Tonin Zanchin NI, Longhi SA, Neves Santos FL. Post-therapeutic cure criterion in chronic Chagas disease using Trypanosoma cruzi chimeric proteins. Folia Parasitol (Praha) 2024; 71:2024.004. [PMID: 38526232 DOI: 10.14411/fp.2024.004] [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] [Received: 04/24/2024] [Accepted: 01/19/2024] [Indexed: 03/26/2024]
Abstract
Chagas disease (CD) is a neglected disease caused by Trypanosoma cruzi Chagas, 1909. Causative treatment can be achieved with two drugs: benznidazole or Nifurtimox. There are some gaps that hinder progress in eradicating the disease. There is no test that can efficiently assess cure control after treatment. Currently, the decline in anti-T. cruzi antibody titres is assessed with conventional serological tests, which can take years. However, the search for new markers of cure must continue to fill this gap. The present study aimed to evaluate the decline in serological titres using chimeric proteins after treatment with benznidazole in chronic patients diagnosed with CD. It was a prospective cross-sectional cohort study between 2000 and 2004 of T. cruzi-positive participants from the Añatuya region (Argentina) treated with benznidazole. Serum samples from ten patients were collected before treatment (day zero) and after the end of treatment (2, 3, 6, 12, 24 and 36 months). For the detection of anti-T. cruzi antibodies, an indirect ELISA was performed using two chimeric recombinant proteins (IBMP-8.1 and IBMP-8.4) as antigens. The changes in reactivity index within the groups before and after treatment were evaluated using the Friedman test. All participants experienced a decrease in serological titres after treatment with benznidazole, especially IBMP-8.1. However, due to the small number of samples and the short follow-up period, it is premature to conclude that this molecule serves as a criterion for sustained cure. Further studies are needed to validate tests based on these or other biomarkers to demonstrate parasitological cure.
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Affiliation(s)
- Tycha Bianca Sabaini Pavan
- Advanced Public Health Laboratory, Goncalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz-BA), Salvador, Bahia, Brazil
| | - Leonardo Maia Leony
- Advanced Public Health Laboratory, Goncalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz-BA), Salvador, Bahia, Brazil
| | - Wayner Vieira de Souza
- Department of Public Health, Aggeu Magalhaes Institute, Oswaldo Cruz Foundation (Fiocruz-PE), Recife, Pernambuco, Brazil
| | - Emily Ferreira Santos
- Advanced Public Health Laboratory, Goncalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz-BA), Salvador, Bahia, Brazil
| | - Ramona Tavares Daltro
- Advanced Public Health Laboratory, Goncalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz-BA), Salvador, Bahia, Brazil
| | - Natalia Erdens Maron Freitas
- Advanced Public Health Laboratory, Goncalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz-BA), Salvador, Bahia, Brazil
| | | | - Fernanda Lopes Habib
- Advanced Public Health Laboratory, Goncalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz-BA), Salvador, Bahia, Brazil
| | - Angelo Antonio Oliveira Silva
- Advanced Public Health Laboratory, Goncalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz-BA), Salvador, Bahia, Brazil
| | - Paola Alejandra Fiorani Celedon
- Molecular Biology of Trypanosomatids Laboratory, Carlos Chagas Institute, Oswaldo Cruz Foundation (Fiocruz-PR), Curitiba, Parana, Brazil
| | - Daniel Dias Sampaio
- Department Brazil's Family Health Strategy, Municipal Health Department, Tremedal, Bahia, Brazil
| | - Nilson Ivo Tonin Zanchin
- Structural Biology and Protein Engineering Laboratory, Carlos Chagas Institute, Oswaldo Cruz Foundation (Fiocruz-PR), Curitiba, Parana, Brazil
| | - Silvia Andrea Longhi
- Laboratory of Molecular Biology of Chagas Disease, Institute for Research on Genetic Engineering and Molecular Biology "Dr Hector Torres", National Scientific and Technological Research Council, Buenos Aires, Argentina
| | - Fred Luciano Neves Santos
- Advanced Public Health Laboratory, Goncalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz-BA), Salvador, Bahia, Brazil
- Chagas Disease Translational Research Program (Fio-Chagas), Oswaldo Cruz Foundation (Fiocruz-RJ), Rio de Janeiro, Rio de Janeiro, Brazil
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6
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Espinoza-Chávez RM, Oliveira Rezende Júnior CD, de Souza ML, Pauli I, Valli M, Gomes Ferreira LL, Chelucci RC, Michelan-Duarte S, Krogh R, Romualdo da Silva FB, Cruz FC, de Oliveira AS, Andricopulo AD, Dias LC. Structure-activity relationships of novel N-imidazoylpiperazines with potent anti- Trypanosoma cruzi activity. Future Med Chem 2024; 16:253-269. [PMID: 38193294 DOI: 10.4155/fmc-2023-0185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/06/2023] [Indexed: 01/10/2024] Open
Abstract
Background: Chagas disease is caused by the parasite Trypanosoma cruzi, and the lack of effective and safe treatments makes identifying new classes of compounds with anti-T. cruzi activity of paramount importance. Methods: Hit-to-lead exploration of a metabolically stable N-imidazoylpiperazine was performed. Results: Compound 2, a piperazine derivative active against T. cruzi, was selected to perform the hit-to-lead exploration, which involved the design, synthesis and biological evaluation of 39 new derivatives. Conclusion: Compounds 6e and 10a were identified as optimized compounds with low micromolar in vitro activity, low cytotoxicity and suitable preliminary absorption, distribution, metabolism and excretion and physicochemical properties. Both compounds reduced parasitemia in mouse models of Chagas disease, providing a promising opportunity for further exploration of new antichagasic compounds.
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Affiliation(s)
- Rocío Marisol Espinoza-Chávez
- Laboratory of Synthetic Organic Chemistry, Institute of Chemistry, State University of Campinas, Campinas-SP, 13084-971, Brazil
| | - Celso de Oliveira Rezende Júnior
- Laboratory of Synthetic Organic Chemistry, Institute of Chemistry, State University of Campinas, Campinas-SP, 13084-971, Brazil
- Institute of Chemistry, Federal University of Uberlândia, Uberlândia-MG, 38400-902, Brazil
| | - Mariana Laureano de Souza
- Laboratory of Medicinal & Computational Chemistry, São Carlos Institute of Physics, University of São Paulo, São Carlos-SP, 13563-120, Brazil
| | - Ivani Pauli
- Laboratory of Medicinal & Computational Chemistry, São Carlos Institute of Physics, University of São Paulo, São Carlos-SP, 13563-120, Brazil
| | - Marilia Valli
- Laboratory of Medicinal & Computational Chemistry, São Carlos Institute of Physics, University of São Paulo, São Carlos-SP, 13563-120, Brazil
| | - Leonardo Luiz Gomes Ferreira
- Laboratory of Medicinal & Computational Chemistry, São Carlos Institute of Physics, University of São Paulo, São Carlos-SP, 13563-120, Brazil
| | - Rafael Consolin Chelucci
- Laboratory of Medicinal & Computational Chemistry, São Carlos Institute of Physics, University of São Paulo, São Carlos-SP, 13563-120, Brazil
| | - Simone Michelan-Duarte
- Laboratory of Medicinal & Computational Chemistry, São Carlos Institute of Physics, University of São Paulo, São Carlos-SP, 13563-120, Brazil
| | - Renata Krogh
- Laboratory of Medicinal & Computational Chemistry, São Carlos Institute of Physics, University of São Paulo, São Carlos-SP, 13563-120, Brazil
| | | | - Fábio Cardoso Cruz
- Department of Pharmacology, Federal University of São Paulo - UNIFESP, São Paulo-SP, 04023-062, Brazil
| | - Aldo Sena de Oliveira
- Department of Exact Sciences & Education, Federal University of Santa Catarina, Campus of Blumenau, Santa Catarina-SC, 89036-256, Brazil
| | - Adriano Defini Andricopulo
- Laboratory of Medicinal & Computational Chemistry, São Carlos Institute of Physics, University of São Paulo, São Carlos-SP, 13563-120, Brazil
| | - Luiz Carlos Dias
- Laboratory of Synthetic Organic Chemistry, Institute of Chemistry, State University of Campinas, Campinas-SP, 13084-971, Brazil
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7
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Robertson LJ, Havelaar AH, Keddy KH, Devleesschauwer B, Sripa B, Torgerson PR. The importance of estimating the burden of disease from foodborne transmission of Trypanosoma cruzi. PLoS Negl Trop Dis 2024; 18:e0011898. [PMID: 38329945 PMCID: PMC10852316 DOI: 10.1371/journal.pntd.0011898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024] Open
Abstract
Chagas disease (ChD), caused by infection with the flagellated protozoan, Trypanosoma cruzi, has a complicated transmission cycle with many infection routes. These include vector-borne (via the triatomine (reduviid bug) vector defecating into a skin abrasion, usually following a blood meal), transplacental transmission, blood transfusion, organ transplant, laboratory accident, and foodborne transmission. Foodborne transmission may occur due to ingestion of meat or blood from infected animals or from ingestion of other foods (often fruit juice) contaminated by infected vectors or secretions from reservoir hosts. Despite the high disease burden associated with ChD, it was omitted from the original World Health Organization estimates of foodborne disease burden that were published in 2015. As these estimates are currently being updated, this review presents arguments for including ChD in new estimates of the global burden of foodborne disease. Preliminary calculations suggest a burden of at least 137,000 Disability Adjusted Life Years, but this does not take into account the greater symptom severity associated with foodborne transmission. Thus, we also provide information regarding the greater health burden in endemic areas associated with foodborne infection compared with vector-borne infection, with higher mortality and more severe symptoms. We therefore suggest that it is insufficient to use source attribution alone to determine the foodborne proportion of current burden estimates, as this may underestimate the higher disability and mortality associated with the foodborne infection route.
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Affiliation(s)
- Lucy J. Robertson
- Parasitology, Department of Paraclinical Sciences, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Ås, Norway
| | - Arie H. Havelaar
- Emerging Pathogens Institute, Global Food Systems Institute, Animal Sciences Department, University of Florida, Gainesville, Florida, United States of America
| | | | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium; Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium
| | - Banchob Sripa
- Tropical Disease Research Center, Department of Tropical Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Paul R. Torgerson
- Section of Epidemiology, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland
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8
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França EB, Ishitani LH, Carneiro M, Machado IE, Nascimento BR, Martins-Melo FR, Teixeira R, Noronha K, Andrade MV, Molina I, Demacq C, Ralston K, Geissbühler Y, Perel P, Naghavi M, Ribeiro ALP. Chagas disease deaths detected among garbage codes registered in mortality statistics in Brazil: a study from the buRden of ChAgas dISEase in the contemporary world (RAISE) project. Public Health 2024; 227:112-118. [PMID: 38157737 DOI: 10.1016/j.puhe.2023.11.034] [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] [Received: 09/04/2023] [Revised: 11/08/2023] [Accepted: 11/21/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVES The objective of this study was to identify Brazil's most critical garbage codes (GCs) reclassified to Chagas disease (ChD) in mortality data and their proportions. We also estimated the potential impact of misclassification on the number of deaths attributed to ChD. STUDY DESIGN Population-based descriptive study. METHODS We used the Mortality Information System (SIM; in Portuguese) data before and after routine GC investigation in 2015-2019 to evaluate ChD deaths detected among them. We identified priority GCs, which contributed more than 0.1 % to the percentage of total ChD deaths registered. Spearman's correlation was used to evaluate the association between the reclassification of priority GCs and ChD prevalence. Then, we applied the GC correction factors to estimate the number of deaths attributed to ChD. RESULTS 22,154 deaths were reported as ChD in the study period. Among them, 1004 deaths originally listed as priority GCs were deaths reclassified to ChD after an investigation in the SIM final database. Unspecific cardiomyopathy (10.2 %), unspecific heart diseases (4.7 %), and heart failure (2.8 %) were GCs with the highest proportions of reclassification to ChD in Brazil. Higher ChD prevalence at the state level was associated with a higher proportion of GC deaths reclassified as ChD. When applying correction factors identified after investigation, we estimated an increase of 26.4 % in registered ChD deaths, mostly in states with higher endemicity. CONCLUSIONS GCs might conceal deaths due to ChD, particularly in Brazil's states with higher endemicity. The approach suggested in this study may offer an alternative method for estimating ChD-related deaths in endemic countries.
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Affiliation(s)
- E B França
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal de Minas Gerais, Brazil.
| | - L H Ishitani
- Grupo de Pesquisa em Epidemiologia e Avaliação em Saúde, Universidade Federal de Minas Gerais, Brazil
| | - M Carneiro
- Programa de Pós-Graduação em Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Brazil
| | - I E Machado
- Departamento de Medicina de Família Saúde Mental e Coletiva, Universidade Federal de Ouro Preto, Brazil
| | - B R Nascimento
- Departamento de Clinica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Brazil
| | - F R Martins-Melo
- Instituto Federal de Educação, Ciência e Tecnologia do Ceará, Brazil
| | - R Teixeira
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal de Minas Gerais, Brazil
| | - K Noronha
- Centro de Desenvolvimento e Planejamento Regional, Departamento de Ciências Econômicas, Faculdade de Ciências Econômica, Universidade Federal de Minas Gerais, Brazil
| | - M V Andrade
- Centro de Desenvolvimento e Planejamento Regional, Departamento de Ciências Econômicas, Faculdade de Ciências Econômica, Universidade Federal de Minas Gerais, Brazil
| | - I Molina
- Centro de Pesquisa René Rachou, Fundação Oswaldo Cruz, Brazil
| | - C Demacq
- Global Health, Novartis Pharma AG, Brazil
| | | | - Y Geissbühler
- Evidence Generation, Innovative Medicines, Novartis Pharma AG, Switzerland
| | - P Perel
- World Heart Federation, United Kingdom
| | - M Naghavi
- Institute for Health Metrics and Evaluation, University of Washington, United States
| | - A L P Ribeiro
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal de Minas Gerais, Brazil; Programa de Pós-Graduação em Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Brazil; Departamento de Clinica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Brazil; Telehealth Center and Cardiology Service, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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9
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Izquierdo-Condoy JS, Vásconez-Gonzáles J, Morales-Lapo E, Tello-De-la-Torre A, Naranjo-Lara P, Fernández R, Hidalgo MR, Escobar A, Yépez VH, Díaz AM, Oliva C, Ortiz-Prado E. Beyond the acute phase: a comprehensive literature review of long-term sequelae resulting from infectious diseases. Front Cell Infect Microbiol 2024; 14:1293782. [PMID: 38357446 PMCID: PMC10864624 DOI: 10.3389/fcimb.2024.1293782] [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: 09/13/2023] [Accepted: 01/16/2024] [Indexed: 02/16/2024] Open
Abstract
Infectious diseases have consistently served as pivotal influences on numerous civilizations, inducing morbidity, mortality, and consequently redirecting the course of history. Their impact extends far beyond the acute phase, characterized by the majority of symptom presentations, to a multitude of adverse events and sequelae that follow viral, parasitic, fungal, or bacterial infections. In this context, myriad sequelae related to various infectious diseases have been identified, spanning short to long-term durations. Although these sequelae are known to affect thousands of individuals individually, a comprehensive evaluation of all potential long-term effects of infectious diseases has yet to be undertaken. We present a comprehensive literature review delineating the primary sequelae attributable to major infectious diseases, categorized by systems, symptoms, and duration. This compilation serves as a crucial resource, illuminating the long-term ramifications of infectious diseases for healthcare professionals worldwide. Moreover, this review highlights the substantial burden that these sequelae impose on global health and economies, a facet often overshadowed by the predominant focus on the acute phase. Patients are frequently discharged following the resolution of the acute phase, with minimal long-term follow-up to comprehend and address potential sequelae. This emphasizes the pressing need for sustained vigilance, thorough patient monitoring, strategic health management, and rigorous research to understand and mitigate the lasting economic and health impacts of infectious diseases more fully.
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10
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Ribeiro ALP, Machado Í, Cousin E, Perel P, Demacq C, Geissbühler Y, de Souza A, Liprandi AS, Nascimento BR, França EF, Martins-Melo FR, Roth GA, Molina I, Noronha K, Ishitani L, Carneiro M, Quijano M, Andrade MV, Naghavi M, Mosser JF, Piñeiro DJ. The Burden of Chagas Disease in the Contemporary World: The RAISE Study. Glob Heart 2024; 19:2. [PMID: 38222097 PMCID: PMC10785959 DOI: 10.5334/gh.1280] [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: 11/14/2023] [Accepted: 11/21/2023] [Indexed: 01/16/2024] Open
Abstract
Chagas disease (ChD), a Neglected Tropical Disease, has witnessed a transformative epidemiological landscape characterized by a trend of reduction in prevalence, shifting modes of transmission, urbanization, and globalization. Historically a vector-borne disease in rural areas of Latin America, effective control measures have reduced the incidence in many countries, leading to a demographic shift where most affected individuals are now adults. However, challenges persist in regions like the Gran Chaco, and emerging oral transmission in the Amazon basin adds complexity. Urbanization and migration from rural to urban areas and to non-endemic countries, especially in Europe and the US, have redefined the disease's reach. These changing patterns contribute to uncertainties in estimating ChD prevalence, exacerbated by the lack of recent data, scarcity of surveys, and reliance on outdated models. Besides, ChD's lifelong natural history, marked by acute and chronic phases, introduces complexities in diagnosis, particularly in non-endemic regions where healthcare provider awareness is low. The temporal dissociation of infection and clinical manifestations, coupled with underreporting, has rendered ChD invisible in health statistics. Deaths attributed to ChD cardiomyopathy often go unrecognized, camouflaged under alternative causes. Understanding these challenges, the RAISE project aims to reassess the burden of ChD and ChD cardiomyopathy. The project is a collaborative effort of the World Heart Federation, Novartis Global Health, the University of Washington's Institute for Health Metrics and Evaluation, and a team of specialists coordinated by Brazil's Federal University of Minas Gerais. Employing a multidimensional strategy, the project seeks to refine estimates of ChD-related deaths, conduct systematic reviews on seroprevalence and prevalence of clinical forms, enhance existing modeling frameworks, and calculate the global economic burden, considering healthcare expenditures and service access. The RAISE project aspires to bridge knowledge gaps, raise awareness, and inform evidence-based health policies and research initiatives, positioning ChD prominently on the global health agenda.
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Affiliation(s)
- Antonio Luiz Pinho Ribeiro
- Hospital das Clínicas da Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 110 –Santa Efigênia, Belo Horizonte –MG, 30130-100, BR
| | | | - Ísis Machado
- Department of Family Medicine, Mental and Collective Health, Universidade Federal de Ouro Preto, Ouro Preto, Brazil
| | - Ewerton Cousin
- Institute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, United States of America
| | - Pablo Perel
- World Heart Federation, Geneva, Switzerland
- Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | | | - Aline de Souza
- Department of Economics, Faculty of Economic Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Bruno R. Nascimento
- Hospital das Clínicas da Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 110 –Santa Efigênia, Belo Horizonte –MG, 30130-100, BR
| | - Elisabeth F. França
- Postgraduate Program in Public Health, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Gregory A. Roth
- Institute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, United States of America
- Department of Medicine, University of Washington, Seattle, United States of America
| | - Israel Molina
- International Health Unit Vall d’Hebron-Drassanes, Infectious Diseases Department, Vall d’Hebron University Hospital, Barcelona, Spain
| | - Kenya Noronha
- Department of Economics, Faculty of Economic Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Lenice Ishitani
- Epidemiological Surveillance Division, Belo Horizonte Municipal Health Department Belo Horizonte, Brazil
| | - Mariângela Carneiro
- Department of Parasitology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Monica V. Andrade
- Department of Economics, Faculty of Economic Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, United States of America
| | - Jonathan F. Mosser
- Institute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, United States of America
| | - Daniel J. Piñeiro
- World Heart Federation, Geneva, Switzerland
- Cardiology Department, Universidad de Buenos Aires, Buenos Aires, Argentina
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11
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de Almeida EA, Mendes FDSNS, Ramos AN, de Sousa AS, Pavan TBS, Mediano MFF, Ostermayer AL, Hasslocher-Moreno AM, Britto CFDPDC, Novaes CG, Correia D, Santos FLN, da Silva GMS, Fernandez ML, Lima MM, de Carvalho NB, Moreira ODC, Albajar-Viñas P, Leite RM, Palmeira SL, da Costa VM, Yasuda MAS. Guidelines for Trypanosoma cruzi-HIV Co-infection and other Immunosuppressive Conditions: Diagnosis, Treatment, Monitoring, and Implementation from the International Network of Care and Studies - 2023. Rev Soc Bras Med Trop 2023; 56:0549. [PMID: 38088667 PMCID: PMC10706049 DOI: 10.1590/0037-8682-0549-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 11/16/2023] [Indexed: 12/18/2023] Open
Affiliation(s)
- Eros Antonio de Almeida
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Grupo de Estudos em doença de Chagas, Campinas, SP, Brasil
| | | | - Alberto Novaes Ramos
- Universidade Federal do Ceará, Faculdade de Medicina, Programa de Pós-Graduação em Saúde Pública, Fortaleza, CE, Brasil
| | - Andréa Silvestre de Sousa
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil
| | - Tycha Bianca Sabaini Pavan
- Fundação Oswaldo Cruz, Instituto Gonçalo Moniz, Laboratório Avançado de Saúde Pública, Bahia, BA, Brasil
| | | | | | | | | | - Christina Gallafrio Novaes
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, Brasil
| | - Dalmo Correia
- Universidade Federal de Sergipe, São Cristóvão, SE, Brasil
| | - Fred Luciano Neves Santos
- Fundação Oswaldo Cruz, Instituto Gonçalo Moniz, Laboratório Avançado de Saúde Pública, Bahia, BA, Brasil
| | | | - Marisa Liliana Fernandez
- Hospital de Infecciosas FJ Muñiz, Instituto Nacional de Parasitología “Dr. Mario Fatala Chabén”, Administración Nacional de Laboratorios e Institutos de Salud, Buenos Aires, Argentina
| | - Mayara Maia Lima
- Ministério da Saúde, Secretaria de Vigilância em Saúde, Brasília, DF, Brasil
| | - Noêmia Barbosa de Carvalho
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, Brasil
| | - Otacílio da Cruz Moreira
- Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Laboratório de Virologia e Parasitologia Molecular, Rio de Janeiro, RJ, Brasil
| | - Pedro Albajar-Viñas
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Ruth Moreira Leite
- Centro de Vigilância Epidemiológica Professor Alexandre Vranjac. Secretaria de Estado da Saúde do estado de São Paulo, São Paulo, SP, Brasil
| | - Swamy Lima Palmeira
- Ministério da Saúde, Secretaria de Vigilância em Saúde, Brasília, DF, Brasil
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12
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Correia N, Paschoaletto L, Reigada C, Gonçalves TCM, Moreira CJDC, Costa J. Experimental Hybrids of the Triatoma brasiliensis Species Complex Show Higher Susceptibility to the Trypanosoma cruzi Infection Than Their Parentals. Microorganisms 2023; 11:2850. [PMID: 38137994 PMCID: PMC10745812 DOI: 10.3390/microorganisms11122850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/03/2023] [Accepted: 11/09/2023] [Indexed: 12/24/2023] Open
Abstract
The Triatoma brasiliensis species complex is a monophyletic group encompassing two subspecies and six species. Recently, a hybrid zone of members of this complex was recorded in the state of Pernambuco. Questions concerning the capability of the hybrids to become infected with Trypanosoma cruzi have been raised. This study aimed to compare the susceptibility of Triatoma b. brasiliensis, Triatoma juazeirensis, and their experimental hybrids to infection with T. cruzi. We infected the parentals and their experimental hybrids (obtained through reciprocal crosses) through artificial feeding with citrated rabbit blood, to which the TcI 0354 strain of T. cruzi had been added. The insects were weighed before and after feeding on the rabbit blood, and then they were dissected on the 10th, 20th, and 30th day after infection. Both the hybrids and the parentals remained infected throughout the experiment. The parasite was mostly found in the epimastigote form. The number of epimastigotes was significantly lower in the stomach and small intestine of T. juazeirensis than in the hybrids or in T. b. brasiliensis. A significantly higher percentage of metacyclic trypomastigotes was detected in the small intestine and rectum of the hybrids. Hybrids demonstrated higher susceptibility to the TcI 0354 strain than their parentals, opening up new avenues to be investigated.
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Affiliation(s)
- Nathália Correia
- Entomology Laboratory, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro 21040-360, Brazil;
| | - Letícia Paschoaletto
- Molecular Parasitology Laboratory, Federal University of Rio de Janeiro, Rio de Janeiro 21941-901, Brazil;
| | - Carolina Reigada
- Center of Biological and Health Sciences, Department of Ecology and Evolutionary Biology, São Carlos University, UFSCAR, São Carlos 13565-905, Brazil;
| | - Teresa Cristina Monte Gonçalves
- Interdisciplinary Laboratory for Entomological Surveillance of Diptera and Hemiptera, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro 21040-360, Brazil;
| | | | - Jane Costa
- National and International Reference Laboratory in Taxonomy of Triatomines, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro 21040-360, Brazil
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13
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Andrade MV, Noronha KVMDS, de Souza A, Motta-Santos AS, Braga PEF, Bracarense H, de Miranda MCC, Nascimento BR, Molina I, Martins-Melo FR, Perel P, Geissbühler Y, Quijano M, Machado IE, Ribeiro ALP. The economic burden of Chagas disease: A systematic review. PLoS Negl Trop Dis 2023; 17:e0011757. [PMID: 37992061 DOI: 10.1371/journal.pntd.0011757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 12/06/2023] [Accepted: 10/29/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Chagas disease (CD) is a neglected disease affecting millions worldwide, yet little is known about its economic burden. This systematic review is part of RAISE project, a broader study that aims to estimate the global prevalence, mortality, and health and economic burden attributable to chronic CD and Chronic Chagas cardiomyopathy. The objective of this study was to assess the main costs associated with the treatment of CD in both endemic and non-endemic countries. METHODS An electronic search of the Medline, Lilacs, and Embase databases was conducted until 31st, 2022, to identify and select economic studies that evaluated treatment costs of CD. No restrictions on place or language were made. Complete or partial economic analyses were included. RESULTS Fifteen studies were included, with two-thirds referring to endemic countries. The most commonly investigated cost components were inpatient care, exams, surgeries, consultation, drugs, and pacemakers. However, significant heterogeneity in the estimation methods and presentation of data was observed, highlighting the absence of standardization in the measurement methods and cost components. The most common component analyzed using the same metric was hospitalization. The mean annual hospital cost per patient ranges from $25.47 purchasing power parity US dollars (PPP-USD) to $18,823.74 PPP-USD, and the median value was $324.44 PPP-USD. The lifetime hospital cost per patient varies from $209,44 PPP-USD for general care to $14,351.68 PPP-USD for patients with heart failure. DISCUSSION Despite the limitations of the included studies, this study is the first systematic review of the costs of CD treatment. The findings underscore the importance of standardizing the measurement methods and cost components for estimating the economic burden of CD and improving the comparability of cost components magnitude and cost composition analysis. Finally, assessing the economic burden is essential for public policies designed to eliminate CD, given the continued neglect of this disease.
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Affiliation(s)
- Mônica Viegas Andrade
- Department of Economics, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Aline de Souza
- Faculty of Economic Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - André Soares Motta-Santos
- Center for Health Technology Assessment, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Center for Development and Regional Planning, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Henrique Bracarense
- Faculty of Economic Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Bruno Ramos Nascimento
- Department of Internal Medicine, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Telehealth Center and Cardiology Service, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Israel Molina
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | | | | | | | | | - Isis Eloah Machado
- Department of Family Medicine, Mental and Collective Health, Universidade Federal de Ouro Preto, Ouro Preto, Brazil
| | - Antônio Luiz Pinho Ribeiro
- Department of Internal Medicine, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Telehealth Center and Cardiology Service, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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14
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Ledien J, Cucunubá ZM, Parra-Henao G, Rodríguez-Monguí E, Dobson AP, Adamo SB, Castellanos LG, Basáñez MG, Nouvellet P. From serological surveys to disease burden: a modelling pipeline for Chagas disease. Philos Trans R Soc Lond B Biol Sci 2023; 378:20220278. [PMID: 37598701 PMCID: PMC10440172 DOI: 10.1098/rstb.2022.0278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 06/29/2023] [Indexed: 08/22/2023] Open
Abstract
In 2012, the World Health Organization (WHO) set the elimination of Chagas disease intradomiciliary vectorial transmission as a goal by 2020. After a decade, some progress has been made, but the new 2021-2030 WHO roadmap has set even more ambitious targets. Innovative and robust modelling methods are required to monitor progress towards these goals. We present a modelling pipeline using local seroprevalence data to obtain national disease burden estimates by disease stage. Firstly, local seroprevalence information is used to estimate spatio-temporal trends in the Force-of-Infection (FoI). FoI estimates are then used to predict such trends across larger and fine-scale geographical areas. Finally, predicted FoI values are used to estimate disease burden based on a disease progression model. Using Colombia as a case study, we estimated that the number of infected people would reach 506 000 (95% credible interval (CrI) = 395 000-648 000) in 2020 with a 1.0% (95%CrI = 0.8-1.3%) prevalence in the general population and 2400 (95%CrI = 1900-3400) deaths (approx. 0.5% of those infected). The interplay between a decrease in infection exposure (FoI and relative proportion of acute cases) was overcompensated by a large increase in population size and gradual population ageing, leading to an increase in the absolute number of Chagas disease cases over time. This article is part of the theme issue 'Challenges and opportunities in the fight against neglected tropical diseases: a decade from the London Declaration on NTDs'.
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Affiliation(s)
- Julia Ledien
- School of Life Sciences, University of Sussex, Falmer, Brighton BN1 9RH, UK
| | - Zulma M. Cucunubá
- Departamento de Epidemiología Clínica y Bioestadística, Facultad de Medicina, Universidad Pontificia Javeriana, 110231 Bogotá, Colombia
| | - Gabriel Parra-Henao
- Centro de Investigación en Salud para el Trópico, Universidad Cooperativa de Colombia, 470002, Santa Marta, Colombia
- National Institute of Health, 111321 Bogotá, Colombia
| | - Eliana Rodríguez-Monguí
- Departamento de Epidemiología Clínica y Bioestadística, Facultad de Medicina, Universidad Pontificia Javeriana, 110231 Bogotá, Colombia
- Independent consultant to the Neglected, Tropical and Vector Borne Diseases Program, Pan American Health Organization (PAHO), Colombia
| | - Andrew P. Dobson
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ 08544, USA
| | - Susana B. Adamo
- Center for International Earth Science Information Network (CIESIN), Columbia Climate School, Columbia University, New York, NY 10025, USA
| | - Luis Gerardo Castellanos
- Department of Communicable Diseases and Environmental Determinants of Health, Pan American Health Organization (PAHO), Washington, DC 20037, USA
| | - María-Gloria Basáñez
- London Centre for Neglected Tropical Disease Research (LCNTDR) & MRC Centre for Global Infectious Disease Analysis (GIDA), Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London SW7 2AZ, UK
| | - Pierre Nouvellet
- School of Life Sciences, University of Sussex, Falmer, Brighton BN1 9RH, UK
- London Centre for Neglected Tropical Disease Research (LCNTDR) & MRC Centre for Global Infectious Disease Analysis (GIDA), Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London SW7 2AZ, UK
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15
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Santiago PB, da Silva Bentes KL, da Silva WMC, Praça YR, Charneau S, Chaouch S, Grellier P, Dos Santos Silva Ferraz MA, Bastos IMD, de Santana JM, de Araújo CN. Insights into the microRNA landscape of Rhodnius prolixus, a vector of Chagas disease. Sci Rep 2023; 13:13120. [PMID: 37573416 PMCID: PMC10423254 DOI: 10.1038/s41598-023-40353-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 08/09/2023] [Indexed: 08/14/2023] Open
Abstract
The growing interest in microRNAs (miRNAs) over recent years has led to their characterization in numerous organisms. However, there is currently a lack of data available on miRNAs from triatomine bugs (Reduviidae: Triatominae), which are the vectors of the protozoan parasite Trypanosoma cruzi, the causative agent of Chagas disease. A comprehensive understanding of the molecular biology of vectors provides new insights into insect-host interactions and insect control approaches, which are key methods to prevent disease incidence in endemic areas. In this work, we describe the miRNome profiles from gut, hemolymph, and salivary gland tissues of the Rhodnius prolixus triatomine. Small RNA sequencing data revealed abundant expression of miRNAs, along with tRNA- and rRNA-derived fragments. Fifty-two mature miRNAs, previously reported in Ecdysozoa, were identified, including 39 ubiquitously expressed in the three tissues. Additionally, 112, 73, and 78 novel miRNAs were predicted in the gut, hemolymph, and salivary glands, respectively. In silico prediction showed that the top eight most highly expressed miRNAs from salivary glands potentially target human blood-expressed genes, suggesting that R. prolixus may modulate the host's gene expression at the bite site. This study provides the first characterization of miRNAs in a Triatominae species, shedding light on the role of these crucial regulatory molecules.
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Affiliation(s)
- Paula Beatriz Santiago
- Pathogen-Host Interface Laboratory, Department of Cell Biology, Institute of Biology, University of Brasília, Brasília, DF, Brazil
| | - Kaio Luís da Silva Bentes
- Pathogen-Host Interface Laboratory, Department of Cell Biology, Institute of Biology, University of Brasília, Brasília, DF, Brazil
| | | | - Yanna Reis Praça
- Pathogen-Host Interface Laboratory, Department of Cell Biology, Institute of Biology, University of Brasília, Brasília, DF, Brazil
| | - Sébastien Charneau
- Laboratory of Protein Chemistry and Biochemistry, Department of Cell Biology, Institute of Biology, University of Brasília, Brasília, Brazil
| | - Soraya Chaouch
- UMR 7245 Molécules de Communication et Adaptation des Micro-organismes, Muséum National d'Histoire Naturelle, CNRS, CP52, 61 rue Buffon, 0575231, Paris Cedex, France
| | - Philippe Grellier
- UMR 7245 Molécules de Communication et Adaptation des Micro-organismes, Muséum National d'Histoire Naturelle, CNRS, CP52, 61 rue Buffon, 0575231, Paris Cedex, France
| | | | - Izabela Marques Dourado Bastos
- Pathogen-Host Interface Laboratory, Department of Cell Biology, Institute of Biology, University of Brasília, Brasília, DF, Brazil
| | - Jaime Martins de Santana
- Pathogen-Host Interface Laboratory, Department of Cell Biology, Institute of Biology, University of Brasília, Brasília, DF, Brazil
| | - Carla Nunes de Araújo
- Pathogen-Host Interface Laboratory, Department of Cell Biology, Institute of Biology, University of Brasília, Brasília, DF, Brazil.
- Faculty of Ceilândia, University of Brasília, Brasília, DF, Brazil.
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16
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Reperant LA. Putative 14th Century Outbreak of Foodborne Chagas Disease, Mexico. Vector Borne Zoonotic Dis 2023. [PMID: 37327016 DOI: 10.1089/vbz.2022.0092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
Abstract
A severe epidemic erupted in Coyoacán at the southern end of Lake Texcoco, in Central Mexico, around 1330. Chroniclers of the 16th century reported that after disrupted fish supply, the inhabitants of Coyoacán had suffered high morbidity and mortality. They developed edema of their eyelids, face, and feet, and hemorrhagic diarrhea. Many died, mainly the young and the old. Pregnant women miscarried. The disease is classically considered an illness of nutritional origin. However, its clinical picture and the circumstances of its emergence are remarkably consistent with an outbreak of foodborne Chagas disease, possibly acquired upon the hunting and consumption of alternative food sources, such as infected opossums (Didelphis spp.), unique reservoirs of Trypanosoma cruzi.
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17
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Bethencourt-Estrella CJ, Delgado-Hernández S, López-Arencibia A, San Nicolás-Hernández D, Tejedor D, García-Tellado F, Lorenzo-Morales J, Piñero JE. In vitro activity and mechanism of cell death induction of cyanomethyl vinyl ethers derivatives against Trypanosoma cruzi. Int J Parasitol Drugs Drug Resist 2023; 22:72-80. [PMID: 37311268 PMCID: PMC10276036 DOI: 10.1016/j.ijpddr.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/10/2023] [Accepted: 05/12/2023] [Indexed: 06/15/2023]
Abstract
Chagas disease causes a problematic pathology that can lead to megacolon and heart disease, and can even cause the death of the patient. Current therapies for this disease are the same as they were 50 years ago, are not fully effective and have strong side effects. The lack of a safe and effective therapy makes it necessary to search for new, less toxic and totally effective compounds against this parasite. In this work, the antichagasic activity of 46 novel cyanomethyl vinyl ether derivatives was studied. In addition, to elucidate the type of cell death that these compounds produce in parasites, several events related to programmed cell death were studied. The results highlight four more selective compounds, E63, E64, E74 and E83, which also appear to trigger programmed cell death, and are therefore postulated as good candidates to use in future therapeutics for Chagas disease.
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Affiliation(s)
- Carlos J Bethencourt-Estrella
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de La Laguna, Avda. Astrofísico Fco. Sánchez, S/N, 38203, La Laguna, Tenerife, Islas Canarias, Spain; Departamento de Obstetricia y Ginecología, Pediatría, Medicina Preventiva y Salud Pública, Toxicología, Medicina Legal y Forense y Parasitología, Universidad de La Laguna, Tenerife, Islas Canarias, Spain.
| | - Samuel Delgado-Hernández
- Instituto de Productos Naturales y Agrobiología, Consejo Superior de Investigaciones Científicas, Avda. Fco. Sánchez 3, 38206, La Laguna, Tenerife, Islas Canarias, Spain; Departamento de Química, Unidad Departamental de Química Analítica, Universidad de La Laguna (ULL), Tenerife, 38206, Spain.
| | - Atteneri López-Arencibia
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de La Laguna, Avda. Astrofísico Fco. Sánchez, S/N, 38203, La Laguna, Tenerife, Islas Canarias, Spain; Departamento de Obstetricia y Ginecología, Pediatría, Medicina Preventiva y Salud Pública, Toxicología, Medicina Legal y Forense y Parasitología, Universidad de La Laguna, Tenerife, Islas Canarias, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28220, Madrid, Spain.
| | - Desirée San Nicolás-Hernández
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de La Laguna, Avda. Astrofísico Fco. Sánchez, S/N, 38203, La Laguna, Tenerife, Islas Canarias, Spain; Departamento de Obstetricia y Ginecología, Pediatría, Medicina Preventiva y Salud Pública, Toxicología, Medicina Legal y Forense y Parasitología, Universidad de La Laguna, Tenerife, Islas Canarias, Spain.
| | - David Tejedor
- Instituto de Productos Naturales y Agrobiología, Consejo Superior de Investigaciones Científicas, Avda. Fco. Sánchez 3, 38206, La Laguna, Tenerife, Islas Canarias, Spain.
| | - Fernando García-Tellado
- Instituto de Productos Naturales y Agrobiología, Consejo Superior de Investigaciones Científicas, Avda. Fco. Sánchez 3, 38206, La Laguna, Tenerife, Islas Canarias, Spain.
| | - Jacob Lorenzo-Morales
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de La Laguna, Avda. Astrofísico Fco. Sánchez, S/N, 38203, La Laguna, Tenerife, Islas Canarias, Spain; Departamento de Obstetricia y Ginecología, Pediatría, Medicina Preventiva y Salud Pública, Toxicología, Medicina Legal y Forense y Parasitología, Universidad de La Laguna, Tenerife, Islas Canarias, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28220, Madrid, Spain.
| | - José E Piñero
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de La Laguna, Avda. Astrofísico Fco. Sánchez, S/N, 38203, La Laguna, Tenerife, Islas Canarias, Spain; Departamento de Obstetricia y Ginecología, Pediatría, Medicina Preventiva y Salud Pública, Toxicología, Medicina Legal y Forense y Parasitología, Universidad de La Laguna, Tenerife, Islas Canarias, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28220, Madrid, Spain.
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18
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Rao SPS, Manjunatha UH, Mikolajczak S, Ashigbie PG, Diagana TT. Drug discovery for parasitic diseases: powered by technology, enabled by pharmacology, informed by clinical science. Trends Parasitol 2023; 39:260-271. [PMID: 36803572 DOI: 10.1016/j.pt.2023.01.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/19/2023] [Accepted: 01/25/2023] [Indexed: 02/22/2023]
Abstract
While prevention is a bedrock of public health, innovative therapeutics are needed to complement the armamentarium of interventions required to achieve disease control and elimination targets for neglected diseases. Extraordinary advances in drug discovery technologies have occurred over the past decades, along with accumulation of scientific knowledge and experience in pharmacological and clinical sciences that are transforming many aspects of drug R&D across disciplines. We reflect on how these advances have propelled drug discovery for parasitic infections, focusing on malaria, kinetoplastid diseases, and cryptosporidiosis. We also discuss challenges and research priorities to accelerate discovery and development of urgently needed novel antiparasitic drugs.
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Affiliation(s)
| | | | | | - Paul G Ashigbie
- Novartis Institute for Tropical Diseases, Emeryville, CA, USA.
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19
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Won MM, Baublis A, Burleigh BA. Proximity-dependent biotinylation and identification of flagellar proteins in Trypanosoma cruzi. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.02.16.528900. [PMID: 36824716 PMCID: PMC9949143 DOI: 10.1101/2023.02.16.528900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
The flagellated kinetoplastid protozoan and causative agent of human Chagas disease, Trypanosoma cruzi , inhabits both invertebrate and mammalian hosts over the course of its complex life cycle. In these disparate environments, T. cruzi uses its single flagellum to propel motile life stages and in some instances, to establish intimate contact with the host. Beyond its role in motility, the functional capabilities of the T. cruzi flagellum have not been defined. Moreover, the lack of proteomic information for this organelle, in any parasite life stage, has limited functional investigation. In this study, we employed a proximity-dependent biotinylation approach based on the differential targeting of the biotin ligase, TurboID, to the flagellum or cytosol in replicative stages of T. cruzi , to identify flagellar-enriched proteins by mass spectrometry. Proteomic analysis of the resulting biotinylated protein fractions yielded 218 candidate flagellar proteins in T. cruzi epimastigotes (insect stage) and 99 proteins in intracellular amastigotes (mammalian stage). Forty of these flagellar-enriched proteins were common to both parasite life stages and included orthologs of known flagellar proteins in other trypanosomatid species, proteins specific to the T. cruzi lineage and hypothetical proteins. With the validation of flagellar localization for several of the identified candidates, our results demonstrate that TurboID-based proximity proteomics is an effective tool for probing subcellular compartments in T. cruzi . The proteomic datasets generated in this work offer a valuable resource to facilitate functional investigation of the understudied T. cruzi flagellum.
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Affiliation(s)
- Madalyn M Won
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health Boston, MA 02115, USA
| | - Aaron Baublis
- Harvard Chan Advanced Multi-omics Platform, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, USA
| | - Barbara A Burleigh
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health Boston, MA 02115, USA
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20
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Koh CC, Neves EGA, de Souza-Silva TG, Carvalho AC, Pinto CHR, Sobreira Galdino A, Gollob KJ, Dutra WO. Cytokine Networks as Targets for Preventing and Controlling Chagas Heart Disease. Pathogens 2023; 12:171. [PMID: 36839443 PMCID: PMC9966322 DOI: 10.3390/pathogens12020171] [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: 11/30/2022] [Revised: 01/17/2023] [Accepted: 01/19/2023] [Indexed: 01/24/2023] Open
Abstract
Chagas disease, a neglected disease caused by the protozoan Trypanosoma cruzi, is endemic in 21 Latin American countries, affecting 6-8 million people. Increasing numbers of Chagas disease cases have also been reported in non-endemic countries due to migration, contamination via blood transfusions or organ transplantation, characterizing Chagas as an emerging disease in such regions. While most individuals in the chronic phase of Chagas disease remain in an asymptomatic clinical form named indeterminate, approximately 30% of the patients develop a cardiomyopathy that is amongst the deadliest cardiopathies known. The clinical distinctions between the indeterminate and the cardiac clinical forms are associated with different immune responses mediated by innate and adaptive cells. In this review, we present a collection of studies focusing on the human disease, discussing several aspects that demonstrate the association between chemokines, cytokines, and cytotoxic molecules with the distinct clinical outcomes of human infection with Trypanosoma cruzi. In addition, we discuss the role of gene polymorphisms in the transcriptional control of these immunoregulatory molecules. Finally, we discuss the potential application of cytokine expression and gene polymorphisms as markers of susceptibility to developing the severe form of Chagas disease, and as targets for disease control.
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Affiliation(s)
- Carolina Cattoni Koh
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Eula G. A. Neves
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Thaiany Goulart de Souza-Silva
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Ana Carolina Carvalho
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Cecília Horta Ramalho Pinto
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Alexsandro Sobreira Galdino
- Laboratório de Biotecnologia de Microrganismos, Universidade Federal de São João Del-Rei (UFSJ), Campus Centro Oeste, Divinópolis 35501-296, MG, Brazil
| | - Kenneth J. Gollob
- Hospital Israelita Albert Einstein, São Paulo 05652-900, SP, Brazil
- Instituto Nacional de Ciências e Tecnologia em Doenças Tropicais, INCT-DT, Salvador 40110-160, BA, Brazil
| | - Walderez Ornelas Dutra
- Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
- Instituto Nacional de Ciências e Tecnologia em Doenças Tropicais, INCT-DT, Salvador 40110-160, BA, Brazil
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21
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Savarese G, Becher PM, Lund LH, Seferovic P, Rosano GMC, Coats AJS. Global burden of heart failure: a comprehensive and updated review of epidemiology. Cardiovasc Res 2023; 118:3272-3287. [PMID: 35150240 DOI: 10.1093/cvr/cvac013] [Citation(s) in RCA: 572] [Impact Index Per Article: 572.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 02/08/2022] [Indexed: 01/25/2023] Open
Abstract
Heart Failure (HF) is a multi-faceted and life-threatening syndrome characterized by significant morbidity and mortality, poor functional capacity and quality of life, and high costs. HF affects more than 64 million people worldwide. Therefore, attempts to decrease its social and economic burden have become a major global public health priority. While the incidence of HF has stabilized and seems to be declining in industrialized countries, the prevalence is increasing due to the ageing of the population, improved treatment of and survival with ischaemic heart disease, and the availability of effective evidence-based therapies prolonging life in patients with HF. There are geographical variations in HF epidemiology. There is substantial lack of data from developing countries, where HF exhibits different features compared with that observed in the Western world. In this review, we provide a contemporary overview on the global burden of HF, providing updated estimates on prevalence, incidence, outcomes, and costs worldwide.
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Affiliation(s)
- Gianluigi Savarese
- Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.,Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Peter Moritz Becher
- Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany
| | - Lars H Lund
- Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.,Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Petar Seferovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Serbian Academy of Sciences and Arts, Belgrade, Serbia
| | - Giuseppe M C Rosano
- St George's Hospital Medical School, London, UK.,IRCCS San Raffaele Roma, Rome, Italy
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22
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França IRDE, Caldas EADEL, Barros MF, Silva JTDDA, Pontual JP, Ferraz ÁAB. Peroral endoscopic myotomy for the treatment of achalasia in the Unified Healthcare System (SUS): results of a short-term. Rev Col Bras Cir 2023; 49:e20223244. [PMID: 36629719 PMCID: PMC10578864 DOI: 10.1590/0100-6991e-20223244-en] [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] [Received: 12/06/2021] [Accepted: 07/08/2022] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION achalasia is a chronic disease. Since there is no curative treatment, diagnosed patients have pharmacological and/or surgical techniques available, aimed at minimizing the condition. POEM appears as a promising new type of palliative treatment with good rates of symptom improvement. OBJECTIVE evaluate the profile of POEM at the Clinical Hospital of the Federal University of Pernambuco (HC - UFPE) and correlate it with the world scenario. METHODS data collection was performed retrospectively from September 2017 to October 2019 with all patients undergoing POEM at the HC - UFPE. Sociodemographic, clinical, and hospital variables were evaluated before and three months after the procedure. RESULTS of 27 patients (52.41 ± 19.24 years old) who underwent the procedure, 66.7% had idiopathic etiology and 33.3% had etiology secondary to Chagas disease. 48% patients underwent previous procedures, of which seven used some type of medication for symptom control, two underwent pneumatic endoscopic dilation, and four underwent Heller cardiomyotomy with partial fundoplication. 62.5% of the evaluated patients had type II achalasia before the procedure. Seven (25.9%) patients presented the following adverse events: four presented bleeding, two pneumoperitoneum, and one both complications, all being treated conservatively. The Eckardt score reduced from 8.37 ± 1.45 to 0.85 ± 1.06 (p-value <0.001). CONCLUSION clinical improvement of symptoms and the patient profile followed the worldwide trend, with emphasis on the etiology secondary to Chagas disease, endemic in Brazil. Gastroesophageal reflux remains the main post-operative symptom.
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Affiliation(s)
- Igor Rabelo DE França
- - Universidade Federal de Pernambuco, Departamento de Cirurgia - Recife - PE - Brasil
| | | | | | | | - João Paulo Pontual
- - Universidade Federal de Pernambuco, Departamento de Cirurgia - Recife - PE - Brasil
| | - Álvaro A B Ferraz
- - Universidade Federal de Pernambuco, Departamento de Cirurgia - Recife - PE - Brasil
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23
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Synthesis and investigation of the trypanocidal potential of novel 1,2,3-triazole-selenide hybrids. Eur J Med Chem 2022; 243:114687. [DOI: 10.1016/j.ejmech.2022.114687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 11/18/2022]
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24
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Silgado A, Bosch-Nicolau P, Sánchez-Montalvá A, Cervià A, Gomez-i-Prat J, Bagaria G, Rodriguez C, Goterris L, Serre-Delcor N, Oliveira-Souto I, Salvador F, Molina I, Sulleiro E. Opportunistic Community Screening of Chronic Chagas Disease Using a Rapid Diagnosis Test in Pharmacies in Barcelona (Catalonia, Spain): Study Protocol and Pilot Phase Results. Int J Public Health 2022; 67:1605386. [DOI: 10.3389/ijph.2022.1605386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/14/2022] [Indexed: 12/05/2022] Open
Abstract
Objectives: This study aimed to report the protocol and results from the pilot phase of an opportunistic CP-based CD screening program in Barcelona, Spain.Methods: Three strategies according to recruitment approach were designed: passive, active and active-community. The study process consisted of signing the informed consent form, recording the patient’s data in a web-based database system, and performing the rapid test and blood collection on dry paper.Results: Nineteen pharmacies participated and 64 patients were included during the pilot phase of the study. The rapid diagnostic test (RDT) was positive in 2/64 (3.13%) cases. Of the 49 DBS samples that arrived at the laboratory, 22 (45%) were collected incorrectly. After quantitative and qualitative assessment of the program, the dry paper sample and passive strategy were ruled out.Conclusion: DBS sampling and the passive strategy are not suitable for CD screening in community pharmacies. There is a need to expand the number of participating pharmacies and individuals to determine whether conducting a RDT in community pharmacies is an effective screening method to increase access to CD diagnosis in a non-endemic area.
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25
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Volpini X, Natali L, Brugo MB, de la Cruz-Thea B, Baigorri RE, Cerbán FM, Fozzatti L, Motran CC, Musri MM. Trypanosoma cruzi Infection Promotes Vascular Remodeling and Coexpression of α-Smooth Muscle Actin and Macrophage Markers in Cells of the Aorta. ACS Infect Dis 2022; 8:2271-2290. [PMID: 36083791 DOI: 10.1021/acsinfecdis.2c00318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Chagas disease is an emerging global health problem; however, it remains neglected. Increased aortic stiffness (IAS), a predictor of cardiovascular events, has recently been reported in asymptomatic chronic Chagas patients. After vascular injury, smooth muscle cells (SMCs) can undergo alterations associated with phenotypic switch and transdifferentiation, promoting vascular remodeling and IAS. By studying different mouse aortic segments, we tested the hypothesis that Trypanosoma cruzi infection promotes vascular remodeling. Interestingly, the thoracic aorta was the most affected by the infection. Decreased expression of SMC markers and increased expression of proliferative markers were observed in the arteries of acutely infected mice. In acutely and chronically infected mice, we observed cells coexpressing SMC and macrophage (Mo) markers in the media and adventitia layers of the aorta, indicating that T. cruzi might induce cellular processes associated with SMC transdifferentiation into Mo-like cells or vice versa. In the adventitia, the Mo cell functional polarization was associated with an M2-like CD206+arginase-1+ phenotype despite the T. cruzi presence in the tissue. Only Mo-like cells in inflammatory foci were CD206+iNOS+. In addition to the disorganization of elastic fibers, we found thickening of the aortic layers during the acute and chronic phases of the disease. Our findings indicate that T. cruzi infection induces a vascular remodeling with SMC dedifferentiation and increased cell populations coexpressing α-SMA and Mo markers that could be associated with IAS promotion. These data highlight the importance of studying large vessel homeostasis in Chagas disease.
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Affiliation(s)
- Ximena Volpini
- Instituto de Investigaciones Médicas Mercedes y Martín Ferreyra. Consejo Nacional de Investigaciones Científicas y Tecnicas. Universidad Nacional de Córdoba (INIMEC-CONICET-UNC), Friuli 2434. Colinas de Velez Sarfield, Córdoba, PC X5016NST, Argentina.,Centro de Investigaciones en Bioquímica Clínica e Inmunología. Consejo Nacional de Investigaciones Científicas y Técnicas (CIBICI-CONICET), Haya de la Torre y Medina Allende. Ciudad Universitaria, Córdoba, PC X5000HUA, Argentina.,Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba (FCQ-UNC). Ciudad Universitaria, Córdoba, PC X5000HUA, Argentina
| | - Lautaro Natali
- Instituto de Investigaciones Médicas Mercedes y Martín Ferreyra. Consejo Nacional de Investigaciones Científicas y Tecnicas. Universidad Nacional de Córdoba (INIMEC-CONICET-UNC), Friuli 2434. Colinas de Velez Sarfield, Córdoba, PC X5016NST, Argentina.,Centro de Investigaciones en Bioquímica Clínica e Inmunología. Consejo Nacional de Investigaciones Científicas y Técnicas (CIBICI-CONICET), Haya de la Torre y Medina Allende. Ciudad Universitaria, Córdoba, PC X5000HUA, Argentina
| | - Maria Belén Brugo
- Centro de Investigaciones en Bioquímica Clínica e Inmunología. Consejo Nacional de Investigaciones Científicas y Técnicas (CIBICI-CONICET), Haya de la Torre y Medina Allende. Ciudad Universitaria, Córdoba, PC X5000HUA, Argentina.,Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba (FCQ-UNC). Ciudad Universitaria, Córdoba, PC X5000HUA, Argentina
| | - Benjamin de la Cruz-Thea
- Instituto de Investigaciones Médicas Mercedes y Martín Ferreyra. Consejo Nacional de Investigaciones Científicas y Tecnicas. Universidad Nacional de Córdoba (INIMEC-CONICET-UNC), Friuli 2434. Colinas de Velez Sarfield, Córdoba, PC X5016NST, Argentina
| | - Ruth Eliana Baigorri
- Centro de Investigaciones en Bioquímica Clínica e Inmunología. Consejo Nacional de Investigaciones Científicas y Técnicas (CIBICI-CONICET), Haya de la Torre y Medina Allende. Ciudad Universitaria, Córdoba, PC X5000HUA, Argentina.,Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba (FCQ-UNC). Ciudad Universitaria, Córdoba, PC X5000HUA, Argentina
| | - Fabio Marcelo Cerbán
- Centro de Investigaciones en Bioquímica Clínica e Inmunología. Consejo Nacional de Investigaciones Científicas y Técnicas (CIBICI-CONICET), Haya de la Torre y Medina Allende. Ciudad Universitaria, Córdoba, PC X5000HUA, Argentina.,Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba (FCQ-UNC). Ciudad Universitaria, Córdoba, PC X5000HUA, Argentina
| | - Laura Fozzatti
- Centro de Investigaciones en Bioquímica Clínica e Inmunología. Consejo Nacional de Investigaciones Científicas y Técnicas (CIBICI-CONICET), Haya de la Torre y Medina Allende. Ciudad Universitaria, Córdoba, PC X5000HUA, Argentina.,Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba (FCQ-UNC). Ciudad Universitaria, Córdoba, PC X5000HUA, Argentina
| | - Claudia Cristina Motran
- Centro de Investigaciones en Bioquímica Clínica e Inmunología. Consejo Nacional de Investigaciones Científicas y Técnicas (CIBICI-CONICET), Haya de la Torre y Medina Allende. Ciudad Universitaria, Córdoba, PC X5000HUA, Argentina.,Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba (FCQ-UNC). Ciudad Universitaria, Córdoba, PC X5000HUA, Argentina
| | - Melina Mara Musri
- Instituto de Investigaciones Médicas Mercedes y Martín Ferreyra. Consejo Nacional de Investigaciones Científicas y Tecnicas. Universidad Nacional de Córdoba (INIMEC-CONICET-UNC), Friuli 2434. Colinas de Velez Sarfield, Córdoba, PC X5016NST, Argentina.,Departamento de Fisiología, Facultad de Ciencias Exactas Físicas y Naturales. Universidad Nacional de Córdoba (FCEFyN-UNC). Av. Velez Sarfield 299, Centro, Córdoba, PC X5000JJC, Argentina
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Sabino EC, Franco LAM, Venturini G, Velho Rodrigues M, Marques E, de Oliveira-da Silva LC, Martins LNA, Ferreira AM, Almeida PEC, Silva FDD, Leite SF, Nunes MDCP, Haikal DS, Oliveira CDL, Cardoso CS, Seidman JG, Seidman CE, Casas JP, Ribeiro ALP, Krieger JE, Pereira AC. Genome-wide association study for Chagas Cardiomyopathy identify a new risk locus on chromosome 18 associated with an immune-related protein and transcriptional signature. PLoS Negl Trop Dis 2022; 16:e0010725. [PMID: 36215317 PMCID: PMC9550069 DOI: 10.1371/journal.pntd.0010725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 08/10/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Chronic Chagas Cardiomyopathy (CCC) usually develops between 10 and 20 years after the first parasitic infection and is one of the leading causes of end-stage heart failure in Latin America. Despite the great inter-individual variability in CCC susceptibility (only 30% of infected individuals ever present CCC), there are no known predictors for disease development in those chronically infected. METHODOLOGY/PRINCIPAL FINDINGS We describe a new susceptibility locus for CCC through a GWAS analysis in the SaMi-Trop cohort, a population-based study conducted in a Chagas endemic region from Brazil. This locus was also associated with CCC in the REDS II Study. The newly identified locus (rs34238187, OR 0.73, p-value 2.03 x 10-9) spans a haplotype of approximately 30Kb on chromosome 18 (chr18: 5028302-5057621) and is also associated with 80 different traits, most of them blood protein traits significantly enriched for immune-related biological pathways. Hi-C data show that the newly associated locus is able to interact with chromatin sites as far as 10Mb on chromosome 18 in a number of different cell types and tissues. Finally, we were able to confirm, at the tissue transcriptional level, the immune-associated blood protein signature using a multi-tissue differential gene expression and enrichment analysis. CONCLUSIONS/SIGNIFICANCE We suggest that the newly identified locus impacts CCC risk among T cruzi infected individuals through the modulation of a downstream transcriptional and protein signature associated with host-parasite immune response. Functional characterization of the novel risk locus is warranted.
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Affiliation(s)
- Ester Cerdeira Sabino
- Departamento de Moléstias Infecciosas e Parasitárias, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
- Laboratório de Parasitologia Médica (LIM-46), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
| | - Lucas Augusto Moysés Franco
- Departamento de Moléstias Infecciosas e Parasitárias, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
- Laboratório de Parasitologia Médica (LIM-46), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
| | - Gabriela Venturini
- Laboratorio de Genetica e Cardiologia Molecular, Instituto do Coracao (InCor), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazila
- Genetics Department, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Mariliza Velho Rodrigues
- Laboratorio de Genetica e Cardiologia Molecular, Instituto do Coracao (InCor), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazila
| | - Emanuelle Marques
- Laboratorio de Genetica e Cardiologia Molecular, Instituto do Coracao (InCor), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazila
| | - Lea Campos de Oliveira-da Silva
- Departamento de Moléstias Infecciosas e Parasitárias, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
- Laboratório de Parasitologia Médica (LIM-46), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
| | | | - Ariela Mota Ferreira
- Departamento de Moléstias Infecciosas e Parasitárias, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
| | | | - Felipe Dias Da Silva
- Departamento de Moléstias Infecciosas e Parasitárias, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
- Laboratório de Parasitologia Médica (LIM-46), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
| | | | | | | | | | | | - Jonathan G. Seidman
- Genetics Department, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Christine E. Seidman
- Genetics Department, Harvard Medical School, Boston, Massachusetts, United States of America
- Cardiovascular Division, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- Howard Hughes Medical Institute, Chevy Chase, Maryland, United States of America
| | - Juan P. Casas
- Massachusetts Veterans Epidemiology Research and Information Center, Veterans Affairs Boston Healthcare System, Boston, Massachusetts, United States of America
- Division of Aging, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Antonio Luiz Pinho Ribeiro
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Telehealth Center, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Jose E. Krieger
- Laboratorio de Genetica e Cardiologia Molecular, Instituto do Coracao (InCor), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazila
| | - Alexandre C. Pereira
- Laboratorio de Genetica e Cardiologia Molecular, Instituto do Coracao (InCor), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazila
- Genetics Department, Harvard Medical School, Boston, Massachusetts, United States of America
- * E-mail:
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27
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Cirqueira ML, Bortot LO, Bolean M, Aleixo MAA, Luccas PH, Costa-Filho AJ, Ramos AP, Ciancaglini P, Nonato MC. Trypanosoma cruzi nitroreductase: Structural features and interaction with biological membranes. Int J Biol Macromol 2022; 221:891-899. [PMID: 36100001 DOI: 10.1016/j.ijbiomac.2022.09.073] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/28/2022] [Accepted: 09/08/2022] [Indexed: 11/05/2022]
Abstract
Due to its severe burden and geographic distribution, Chagas disease (CD) has a significant social and economic impact on low-income countries. Benznidazole and nifurtimox are currently the only drugs available for CD. These are prodrugs activated by reducing the nitro group, a reaction catalyzed by nitroreductase type I enzyme from Trypanosoma cruzi (TcNTR), with no homolog in the human host. The three-dimensional structure of TcNTR, and the molecular and chemical bases of the selective activation of nitro drugs, are still unknown. To understand the role of TcNTR in the basic parasite biology, investigate its potential as a drug target, and contribute to the fight against neglected tropical diseases, a combined approach using multiple biophysical and biochemical methods together with in silico studies was employed in the characterization of TcNTR. For the first time, the interaction of TcNTR with membranes was demonstrated, with a preference for those containing cardiolipin, a unique dimeric phospholipid that exists almost exclusively in the inner mitochondrial membrane in eukaryotic cells. Prediction of TcNTR's 3D structure suggests that a 23-residue long insertion (199 to 222), absent in the homologous bacterial protein and identified as conserved in protozoan sequences, mediates enzyme specificity, and is involved in protein-membrane interaction.
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Affiliation(s)
- Marília L Cirqueira
- School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo (FCFRP-USP), Ribeirão Preto, SP, Brazil
| | - Leandro O Bortot
- School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo (FCFRP-USP), Ribeirão Preto, SP, Brazil; Laboratory of Computational Biology (LBC), Brazilian Biosciences National Laboratory (LNBio), Brazilian Center for Research in Energy and Materials (CNPEM), Campinas, SP, Brazil
| | - Maytê Bolean
- Chemistry Dept., Faculty of Philosophy, Sciences and Letters at Ribeirão Preto, University of São Paulo (FFCLRP-USP), Ribeirão Preto, SP, Brazil
| | - Mariana A A Aleixo
- School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo (FCFRP-USP), Ribeirão Preto, SP, Brazil; Brazilian Nanotechnology National Laboratory (LNNano), Brazilian Center for Research in Energy and Materials (CNPEM), Campinas, SP, Brazil
| | - Pedro H Luccas
- School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo (FCFRP-USP), Ribeirão Preto, SP, Brazil
| | - Antonio J Costa-Filho
- Physics Dept., Faculty of Philosophy, Sciences and Letters at Ribeirão Preto, University of São Paulo (FFCLRP-USP), Ribeirão Preto, SP, Brazil
| | - Ana Paula Ramos
- Chemistry Dept., Faculty of Philosophy, Sciences and Letters at Ribeirão Preto, University of São Paulo (FFCLRP-USP), Ribeirão Preto, SP, Brazil
| | - Pietro Ciancaglini
- Chemistry Dept., Faculty of Philosophy, Sciences and Letters at Ribeirão Preto, University of São Paulo (FFCLRP-USP), Ribeirão Preto, SP, Brazil
| | - M Cristina Nonato
- School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo (FCFRP-USP), Ribeirão Preto, SP, Brazil.
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Small molecule mediated inhibition of protein cargo recognition by peroxisomal transport receptor PEX5 is toxic to Trypanosoma. Sci Rep 2022; 12:14705. [PMID: 36038611 PMCID: PMC9424529 DOI: 10.1038/s41598-022-18841-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 08/22/2022] [Indexed: 11/08/2022] Open
Abstract
Trypanosomiases are life-threatening infections of humans and livestock, and novel effective therapeutic approaches are needed. Trypanosoma compartmentalize glycolysis into specialized organelles termed glycosomes. Most of the trypanosomal glycolytic enzymes harbor a peroxisomal targeting signal-1 (PTS1) which is recognized by the soluble receptor PEX5 to facilitate docking and translocation of the cargo into the glycosomal lumen. Given its pivotal role in the glycosomal protein import, the PEX5–PTS1 interaction represents a potential target to inhibit import of glycolytic enzymes and thus kill the parasite. We developed a fluorescence polarization (FP)-based assay for monitoring the PEX5–PTS1 interaction and performed a High Throughput Screening (HTS) campaign to identify small molecule inhibitors of the interaction. Six of the identified hits passed orthogonal selection criteria and were found to inhibit parasite growth in cell culture. Our results validate PEX5 as a target for small molecule inhibitors and provide scaffolds suitable for further pre-clinical development of novel trypanocidal compounds.
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Medina-Rivera M, Cárdenas WB, Erickson D, Mehta S. Gold Nanoshells-Based Lateral Flow Assay for the Detection of Chagas Disease at the Point-of-Care. Am J Trop Med Hyg 2022; 107:323-327. [PMID: 35895419 PMCID: PMC9393437 DOI: 10.4269/ajtmh.21-1119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 04/11/2022] [Indexed: 08/03/2023] Open
Abstract
Chagas disease is a neglected parasitic infection and a major public health problem in the Americas. It remains underdiagnosed in the United States and internationally due to the lack of affordable testing and disparities in healthcare, particularly for those most at risk. We describe a proof-of-concept lateral flow immunoassay employing a recombinant Chagas multiantigen conjugated to gold nanoshells (AuNS) to detect circulating human anti-Chagas IgG antibodies. This is one of the first lateral flow immunoassays to capitalize on the larger surface area of AuNS compared with nanoparticles that can help amplify low-magnitude signals. Results were compared with 42 positive and negative Chagas serum samples, of which a subset of 27 samples was validated against an ELISA (Hemagen®). The sensitivity and specificity of our assay were 83% and 95%, respectively. These results suggest that an AuNS-based rapid testing for Chagas disease could facilitate in-field screening/diagnosis with a performance comparable to commercial methods.
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Affiliation(s)
- Melisa Medina-Rivera
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
- Institute for Nutritional Sciences, Global Health, and Technology (INSiGHT), Cornell University, Ithaca, New York
| | - Washington B. Cárdenas
- Laboratorio para Investigaciones Biomédicas, Escuela Superior Politécnica del Litoral, Guayaquil, Guayas, Ecuador
| | - David Erickson
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
- Institute for Nutritional Sciences, Global Health, and Technology (INSiGHT), Cornell University, Ithaca, New York
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, New York
| | - Saurabh Mehta
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
- Institute for Nutritional Sciences, Global Health, and Technology (INSiGHT), Cornell University, Ithaca, New York
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Linear and Machine Learning modelling for spatiotemporal disease predictions: Force-of-Infection of Chagas disease. PLoS Negl Trop Dis 2022; 16:e0010594. [PMID: 35853042 PMCID: PMC9337653 DOI: 10.1371/journal.pntd.0010594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 07/29/2022] [Accepted: 06/18/2022] [Indexed: 12/02/2022] Open
Abstract
Background Chagas disease is a long-lasting disease with a prolonged asymptomatic period. Cumulative indices of infection such as prevalence do not shed light on the current epidemiological situation, as they integrate infection over long periods. Instead, metrics such as the Force-of-Infection (FoI) provide information about the rate at which susceptible people become infected and permit sharper inference about temporal changes in infection rates. FoI is estimated by fitting (catalytic) models to available age-stratified serological (ground-truth) data. Predictive FoI modelling frameworks are then used to understand spatial and temporal trends indicative of heterogeneity in transmission and changes effected by control interventions. Ideally, these frameworks should be able to propagate uncertainty and handle spatiotemporal issues. Methodology/principal findings We compare three methods in their ability to propagate uncertainty and provide reliable estimates of FoI for Chagas disease in Colombia as a case study: two Machine Learning (ML) methods (Boosted Regression Trees (BRT) and Random Forest (RF)), and a Linear Model (LM) framework that we had developed previously. Our analyses show consistent results between the three modelling methods under scrutiny. The predictors (explanatory variables) selected, as well as the location of the most uncertain FoI values, were coherent across frameworks. RF was faster than BRT and LM, and provided estimates with fewer extreme values when extrapolating to areas where no ground-truth data were available. However, BRT and RF were less efficient at propagating uncertainty. Conclusions/significance The choice of FoI predictive models will depend on the objectives of the analysis. ML methods will help characterise the mean behaviour of the estimates, while LM will provide insight into the uncertainty surrounding such estimates. Our approach can be extended to the modelling of FoI patterns in other Chagas disease-endemic countries and to other infectious diseases for which serosurveys are regularly conducted for surveillance. Metrics such as the per susceptible rate of infection acquisition (Force-of-Infection) are crucial to understand the current epidemiological situation and the impact of control interventions for long-lasting diseases in which the infection event might have occurred many years previously, such as Chagas disease. FoI values are estimated from serological age profiles, often obtained in a few locations. However, when using predictive models to estimate the FoI over time and space (including areas where serosurveys had not been conducted), methods able to handle and propagate uncertainty must be implemented; otherwise, overconfident predictions may be obtained. Although Machine Learning (ML) methods are powerful tools, they may not be able to entirely handle this challenge. Therefore, the use of ML must be considered in relation to the aims of the analyses. ML will be more relevant to characterise the central trends of the estimates while Linear Models will help identify areas where further serosurveys should be conducted to improve the reliability of the predictions. Our approaches can be used to generate FoI predictions in other Chagas disease-endemic countries as well as in other diseases for which serological surveillance data are collected.
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Diagnosis and Prevalence of Chagas Disease in an Indigenous Population of Colombia. Microorganisms 2022; 10:microorganisms10071427. [PMID: 35889145 PMCID: PMC9318061 DOI: 10.3390/microorganisms10071427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/12/2022] [Accepted: 07/13/2022] [Indexed: 02/04/2023] Open
Abstract
Chagas disease (CD) is one of the leading neglected tropical diseases. In the Americas, CD is endemic in about 21 countries, but only less than 1% of the patients have access to medical treatment. Indigenous populations are particularly affected because they live in socio-economic and climate conditions that favor CD infections. In this study, diagnostic strategies and regional prevalence of the Chagas disease were assessed. In nine villages of the indigenous tribe Wiwa, 1134 persons were tested with a Chagas-antibody-specific rapid test (RT), two different Chagas-antibody-specific ELISAs and a Chagas-specific real-time polymerase chain reaction. The overall prevalence of CD in the villages was 35.4%, with a variation from 24.9% to 52.8% for the different communities. Rapid tests and ELISAs showed the same results in all cases. The proportion of replication-active infections, defined by positive PCR results, was 8.7%. In conclusion, the assessed indigenous population in Colombia was shown to be severely affected by CD. For a serological diagnosis, one rapid test was shown to be sufficient. Replacements of ELISAs by RT would decrease costs, increase feasibility and would relevantly help detect positive patients, especially if combined with the applied real-time PCR protocol. Real-time PCR can be considered for the detection of acute cases, outbreaks, chronic cases with re-infection/activation, as well as for therapy management and control.
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Morphological Stasis in Time? A Triatoma brasiliensis brasiliensis Study Using Geometric Morphometrics in the Long Run. Animals (Basel) 2022; 12:ani12111362. [PMID: 35681826 PMCID: PMC9179344 DOI: 10.3390/ani12111362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/14/2022] [Accepted: 05/23/2022] [Indexed: 12/04/2022] Open
Abstract
Simple Summary Triatomines are vector insects capable of transmitting the protozoan that causes Chagas disease, thus representing a health risk in several countries, especially in Central and South America. Triatoma brasiliensis brasiliensis, the main triatomine vector in northeastern Brazil, needs frequent monitoring as it is able to colonize various natural and artificial ecotopes as well as to infest domiciles. This research uses geometric morphometrics as a tool to evaluate changes in the morphology and analyze a large temporal dataset of 102 years of collections of T. b. brasiliensis. Finding novelty results which indicate a morphological stasis in the morphology. Abstract Triatoma brasiliensis brasiliensis Neiva, 1911 is one of the most important vectors of Chagas disease in the Brazilian semiarid regions in the north-east. The risk imposed by T. b. brasiliensis to the human populations, due to frequent invasions and/or colonization of the domiciles, demands constant monitoring and control actions as well as an understanding of its evolutionary process. In this context, the following research studies the pattern of shape adaptation over time using a large dataset from 102 years of specimen collections in order to identify the morphological plasticity of this vector in Brazil. This dataset was analyzed using geometric morphometrics tools and the timescale was divided into eight different groups, containing specimens from 1912 to 2014. Geometric morphometrics analysis showed an interesting morphological stasis in the wing shape of T. b. brasiliensis, which allowed us to understand the high capacity of adaptation to changes in climate condition through time, and the invasive status which Triatoma species have around the world. Moreover, these results showed novel findings as an interesting phenotypic pattern, with no modifications in more than 100 years, leading us to understand the shape evolution in Triatominae as a vector species of diseases.
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Silva ACO, Bonfim M, Fontes JLM, Dos-Santos WLC, Mengel J, Cardillo F. C57BL/6 Mice Pretreated With Alpha-Tocopherol Show a Better Outcome of Trypanosoma cruzi Infection With Less Tissue Inflammation and Fibrosis. Front Immunol 2022; 13:833560. [PMID: 35154155 PMCID: PMC8832012 DOI: 10.3389/fimmu.2022.833560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 01/11/2022] [Indexed: 11/20/2022] Open
Abstract
Chagas disease is accompanied by a multisystem inflammatory disorder that follows Trypanosoma cruzi infection. Alpha-tocopherol has been described as an antioxidant and a potential adjuvant to enhance immune responses to vaccines. Therefore, we have evaluated the immune response to T. cruzi infection upon alpha-tocopherol pre-administration. The results show that administration of alpha-tocopherol before the infection results in lower parasitemia and lower mortality of C57BL/6 mice infected with the Tulahuen T. cruzi strain. Alpha-tocopherol administration in normal C57BL/6 mice resulted in higher levels of IFN-γ production by T and NK cells before and after the infection with T. cruzi. More importantly, previous administration of alpha-tocopherol increased the production of IL-10 by T and myeloid suppressor cells and the formation of effector memory T cells while decreasing the expression of PD-1 on T cells. These results suggest that alpha-tocopherol may limit the appearance of dysfunctional T cells during the acute and early chronic phases of T. cruzi infection, contributing to control infection. In addition, alpha-tocopherol could diminish tissue inflammation and fibrosis in late acute disease. These results strongly suggest that alpha-tocopherol may be a helpful agent to be considered in Chagas disease.
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Affiliation(s)
- Amanda C O Silva
- Laboratory of Molecular and Structural Pathology, Gonçalo Moniz Institute, Fiocruz, Salvador, Brazil
| | - Maiara Bonfim
- Laboratory of Molecular and Structural Pathology, Gonçalo Moniz Institute, Fiocruz, Salvador, Brazil
| | - Jonathan L M Fontes
- Laboratory of Molecular and Structural Pathology, Gonçalo Moniz Institute, Fiocruz, Salvador, Brazil
| | - Washington L C Dos-Santos
- Laboratory of Molecular and Structural Pathology, Gonçalo Moniz Institute, Fiocruz, Salvador, Brazil.,Department of Pathology, Faculty of Medicine, Federal University of Bahia, UFBA, Salvador, Brazil
| | - José Mengel
- Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil.,Petrópolis Medical School, UNIFASE, Petrópolis, Brazil
| | - Fabíola Cardillo
- Laboratory of Molecular and Structural Pathology, Gonçalo Moniz Institute, Fiocruz, Salvador, Brazil
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Braggion-Santos MF, Moreira HT, Volpe GJ, Koenigkam-Santos M, Marin-Neto JA, Schmidt A. Electrocardiogram abnormalities in chronic Chagas cardiomyopathy correlate with scar mass and left ventricular dysfunction as assessed by cardiac magnetic resonance imaging. J Electrocardiol 2022; 72:66-71. [PMID: 35344746 DOI: 10.1016/j.jelectrocard.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/28/2022] [Accepted: 03/07/2022] [Indexed: 11/26/2022]
Abstract
Electrocardiographic (ECG) abnormalities are frequently identified in Chronic Chagas cardiomyopathy (CCC) patients and advanced abnormalities are related to a worse prognosis. Cardiac Magnetic Resonance (CMR) can precisely assess ventricular systolic dysfunction and quantify myocardial fibrosis (MF), both identified as prognostic factors. We sought to investigate if ECG abnormalities in CCC patients were associated with more severe myocardial involvement as evaluated by CMR. METHODS CCC patients with 12‑lead ECG and CMR closely obtained were included. ECG analysis evaluated rhythm, presence, and type of intraventricular conduction disturbances (IVCD) and, ventricular premature beats (VPB). CMR short-axis cine and late gadolinium enhancement images were evaluated to obtain left and right ventricular ejection fractions and MF mass, respectively. Statistical significance was set in 5%. RESULTS 194 CCC patients (98 women, 56 ± 14 years) were evaluated, and no IVCD was detected in 71. The most common IVCD was the association of right bundle branch block and left anterior fascicular block (RBBB+LAFB) in 58 patients, followed by isolated RBBB in 34, isolated LAFB in 17, and left bundle branch block (LBBB) in 14 patients. Of patients with no IVCD, 63% had MF and the burden of fibrosis (no IVCD - 7.4 ± 8.6%; RBBB - 6.6 ± 6.5%; p = 1.00), as well as left ventricular ejection fraction (LVEF) (no IVCD - 52 ± 14%; RBBB - 55 ± 10%; p = 1.00) were similar to patients with isolated RBBB. Left conduction system impairment was associated with lower LVEF (LAFB - 39 ± 15%; RBBB+LAFB- 41 ± 15%; and LBBB - 35 ± 15%; p < 0.001) and more MF (RBBB+LAFB - 12.2 ± 10.4%; LBBB - 10.6 ± 7.5%; and LAFB - 12.0 ± 7.0%; p < 0.001). The univariable model showed that the presence of MF was related to RBBB+LAFB (OR 5.0; p = 0.001) and VPB (OR 6.3; p = 0.014). After adjustment for age, gender, and different risk factors in a multivariable model, the same findings were still significantly related to CMR myocardial fibrosis (RBBB+LAFB OR 5.0; p = 0.002 / VPB OR 6.9; p = 0.015). CONCLUSIONS ECG without IVCD does not exclude serious cardiac abnormalities in CCC, and isolated RBBB seems to have a benign course. The presence of VPB and left branch conduction impairment, especially LAFB associated with RBBB, indicate a more severe cardiac involvement.
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Affiliation(s)
- Maria Fernanda Braggion-Santos
- Cardiology Division, Department of Internal Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirao Preto, Brazil
| | - Henrique T Moreira
- Cardiology Division, Department of Internal Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirao Preto, Brazil
| | - Gustavo J Volpe
- Cardiology Division, Department of Internal Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirao Preto, Brazil
| | - Marcel Koenigkam-Santos
- Department of Radiology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - José Antonio Marin-Neto
- Cardiology Division, Department of Internal Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirao Preto, Brazil
| | - André Schmidt
- Cardiology Division, Department of Internal Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirao Preto, Brazil.
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Barbosa Da Silva E, Sharma V, Hernandez-Alvarez L, Tang AH, Stoye A, O’Donoghue AJ, Gerwick WH, Payne RJ, McKerrow JH, Podust LM. Intramolecular Interactions Enhance the Potency of Gallinamide A Analogues against Trypanosoma cruzi. J Med Chem 2022; 65:4255-4269. [DOI: 10.1021/acs.jmedchem.1c02063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Elany Barbosa Da Silva
- Skaggs School of Pharmacy and Pharmaceutical Sciences, Center for Discovery and Innovation in Parasitic Diseases, University of California San Diego, La Jolla, California 92093, United States
| | - Vandna Sharma
- Skaggs School of Pharmacy and Pharmaceutical Sciences, Center for Discovery and Innovation in Parasitic Diseases, University of California San Diego, La Jolla, California 92093, United States
| | - Lilian Hernandez-Alvarez
- Skaggs School of Pharmacy and Pharmaceutical Sciences, Center for Discovery and Innovation in Parasitic Diseases, University of California San Diego, La Jolla, California 92093, United States
- Departamento de Física, Instituto de Biociências, Letras e Ciências Exatas, Universidade Estadual Paulista Julio de Mesquita Filho, São José do Rio Preto, São Paulo, CEP 15054-000, Brazil
| | - Arthur H. Tang
- School of Chemistry, The University of Sydney, Sydney, New South Wales 2006, Australia
- Australian Research Council Centre of Excellence for Innovations in Peptide and Protein Science, The University of Sydney, Sydney, New South Wales 2006, Australia
| | - Alexander Stoye
- School of Chemistry, The University of Sydney, Sydney, New South Wales 2006, Australia
- Australian Research Council Centre of Excellence for Innovations in Peptide and Protein Science, The University of Sydney, Sydney, New South Wales 2006, Australia
| | - Anthony J. O’Donoghue
- Skaggs School of Pharmacy and Pharmaceutical Sciences, Center for Discovery and Innovation in Parasitic Diseases, University of California San Diego, La Jolla, California 92093, United States
| | - William H. Gerwick
- Skaggs School of Pharmacy and Pharmaceutical Sciences, Center for Discovery and Innovation in Parasitic Diseases, University of California San Diego, La Jolla, California 92093, United States
- Center for Marine Biotechnology and Biomedicine, Scripps Institution of Oceanography, University of California San Diego, La Jolla, California 92093, United States
| | - Richard J. Payne
- School of Chemistry, The University of Sydney, Sydney, New South Wales 2006, Australia
- Australian Research Council Centre of Excellence for Innovations in Peptide and Protein Science, The University of Sydney, Sydney, New South Wales 2006, Australia
| | - James H. McKerrow
- Skaggs School of Pharmacy and Pharmaceutical Sciences, Center for Discovery and Innovation in Parasitic Diseases, University of California San Diego, La Jolla, California 92093, United States
| | - Larissa M. Podust
- Skaggs School of Pharmacy and Pharmaceutical Sciences, Center for Discovery and Innovation in Parasitic Diseases, University of California San Diego, La Jolla, California 92093, United States
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Fleitas PE, Floridia-Yapur N, Nieves EE, Echazu A, Vargas PA, Caro NR, Aveldaño R, Lopez W, Fernandez M, Crudo F, Cimino RO, Krolewiecki AJ. Strongyloides stercoralis and Trypanosoma cruzi coinfections in a highly endemic area in Argentina. PLoS Negl Trop Dis 2022; 16:e0010179. [PMID: 35120117 PMCID: PMC8865657 DOI: 10.1371/journal.pntd.0010179] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 02/23/2022] [Accepted: 01/19/2022] [Indexed: 11/18/2022] Open
Abstract
Background Strongyloidiasis and Chagas disease are endemic in northern Argentina. In this study we evaluate the association between S. stercoralis and T. cruzi infections in villages with diverse prevalence levels for these parasites. Further understanding in the relationship between these Neglected Tropical Diseases of South America is relevant for the design of integrated control measures as well as exploring potential biologic interactions. Methodology Community based cross-sectional studies were carried in different villages of the Chaco and Yungas regions in Argentina. Individuals were diagnosed by serology for S. stercoralis and T. cruzi. The association between S. stercoralis and T. cruzi, and between anemia and the two parasites was evaluated using two approaches: marginal (Ma) and multilevel regression (Mu). Results A total of 706 individuals from six villages of northern Argentina were included. A total of 37% were positive for S. stercoralis, 14% were positive for T. cruzi and 5% were positive for both. No association was found between infection with S. stercoralis and T. cruzi in any of the models, but we found a negative correlation between the prevalence of these species in the different villages (r = -0.91). Adults (> 15 years) presented association with S. stercoralis (Ma OR = 2.72; Mu OR = 2.84) and T. cruzi (Ma OR = 5.12; Mu OR = 5.48). Also, 12% and 2% of the variance of infection with S. stercoralis and T. cruzi, respectively, could be explained by differences among villages. On the other hand, anemia was associated with infection with S. stercoralis (Ma OR = 1.73; Mu OR = 1.78) and was more prevalent in adults (Ma OR = 2.59; Mu OR = 2.69). Conclusion We found that coinfection between S. stercoralis and T. cruzi is not more frequent than chance in endemic areas. However, the high prevalence for both parasites, raises the need for an integrated strategy for the control of STH and Chagas disease. Infections with S. stercoralis and T. cruzi belong to the group of neglected tropical diseases (NTDs). NTDs are influenced by climate and the presence of their vectors and host reservoirs in areas with structural poverty. S. stercoralis and T. cruzi have high prevalence in northern Argentina. Due to the high prevalence and chronicity of infections by these parasites, coinfection with both is possible. We conducted a cross sectional study in six villages in the north of Argentina. These villages have different prevalence for the two parasites and are located in different ecoregions (Chaco, Yungas and the border between these two). We found that coinfection between S. stercoralis and T. cruzi occurs only by chance; and the most affected groups for S. stercoralis and T. cruzi infection are adults. We also found that adults or individual with infection with S. stercoralis were more likely to have anemia. In addition, each village represents a different setting for infection with S. stercoralis and T. cruzi, and individuals in different villages presented differences in the probability of infection.
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Affiliation(s)
- Pedro E Fleitas
- Universidad Nacional de Salta. Sede Regional Orán. Instituto de Investigación de Enfermedades Tropicales (IIET), Salta, Argentina
- Universidad Nacional de Salta, Facultad de Ciencias Naturales, Cátedra de Química Biológica, Salta, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Noelia Floridia-Yapur
- Universidad Nacional de Salta, Facultad de Ciencias Naturales, Cátedra de Química Biológica, Salta, Argentina
- Instituto de Patología Experimental, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Salta, Argentina
| | - Elvia E Nieves
- Universidad Nacional de Salta. Sede Regional Orán. Instituto de Investigación de Enfermedades Tropicales (IIET), Salta, Argentina
| | - Adriana Echazu
- Universidad Nacional de Salta. Sede Regional Orán. Instituto de Investigación de Enfermedades Tropicales (IIET), Salta, Argentina
- Universidad Nacional de Salta, Facultad de Ciencias de la Salud, Cátedra de Parasitología, Salta, Argentina
| | - Paola A Vargas
- Universidad Nacional de Salta. Sede Regional Orán. Instituto de Investigación de Enfermedades Tropicales (IIET), Salta, Argentina
- Biotecnología, Universidad Católica de Boliviana San Pablo, Santa Cruz, Bolivia
| | - Nicolás R Caro
- Universidad Nacional de Salta. Sede Regional Orán. Instituto de Investigación de Enfermedades Tropicales (IIET), Salta, Argentina
| | - Ramiro Aveldaño
- Universidad Nacional de Salta. Sede Regional Orán. Instituto de Investigación de Enfermedades Tropicales (IIET), Salta, Argentina
| | - Walter Lopez
- Universidad Nacional de Salta. Sede Regional Orán. Instituto de Investigación de Enfermedades Tropicales (IIET), Salta, Argentina
| | - Mariana Fernandez
- Asociación para el Desarrollo Sanitario Regional (ADESAR), San Antonio de Areco, Buenos Aires, Argentina
- Fundación Mundo Sano, Buenos Aires, Argentina
| | - Favio Crudo
- Asociación para el Desarrollo Sanitario Regional (ADESAR), San Antonio de Areco, Buenos Aires, Argentina
- Fundación Mundo Sano, Buenos Aires, Argentina
- Universidad Nacional de San Antonio de Areco, San Antonio de Areco, Buenos Aires, Argentina
| | - Rubén O Cimino
- Universidad Nacional de Salta. Sede Regional Orán. Instituto de Investigación de Enfermedades Tropicales (IIET), Salta, Argentina
- Universidad Nacional de Salta, Facultad de Ciencias Naturales, Cátedra de Química Biológica, Salta, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Alejandro J Krolewiecki
- Universidad Nacional de Salta. Sede Regional Orán. Instituto de Investigación de Enfermedades Tropicales (IIET), Salta, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
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Ledien J, Cucunubá ZM, Parra-Henao G, Rodríguez-Monguí E, Dobson AP, Basáñez MG, Nouvellet P. Spatiotemporal variations in exposure: Chagas disease in Colombia as a case study. BMC Med Res Methodol 2022; 22:13. [PMID: 35027002 PMCID: PMC8759231 DOI: 10.1186/s12874-021-01477-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 11/15/2021] [Indexed: 11/29/2022] Open
Abstract
Age-stratified serosurvey data are often used to understand spatiotemporal trends in disease incidence and exposure through estimating the Force-of-Infection (FoI). Typically, median or mean FoI estimates are used as the response variable in predictive models, often overlooking the uncertainty in estimated FoI values when fitting models and evaluating their predictive ability. To assess how this uncertainty impact predictions, we compared three approaches with three levels of uncertainty integration. We propose a performance indicator to assess how predictions reflect initial uncertainty. In Colombia, 76 serosurveys (1980–2014) conducted at municipality level provided age-stratified Chagas disease prevalence data. The yearly FoI was estimated at the serosurvey level using a time-varying catalytic model. Environmental, demographic and entomological predictors were used to fit and predict the FoI at municipality level from 1980 to 2010 across Colombia. A stratified bootstrap method was used to fit the models without temporal autocorrelation at the serosurvey level. The predictive ability of each model was evaluated to select the best-fit models within urban, rural and (Amerindian) indigenous settings. Model averaging, with the 10 best-fit models identified, was used to generate predictions. Our analysis shows a risk of overconfidence in model predictions when median estimates of FoI alone are used to fit and evaluate models, failing to account for uncertainty in FoI estimates. Our proposed methodology fully propagates uncertainty in the estimated FoI onto the generated predictions, providing realistic assessments of both central tendency and current uncertainty surrounding exposure to Chagas disease.
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Affiliation(s)
- Julia Ledien
- School of Life Sciences, University of Sussex, Brighton, UK.
| | - Zulma M Cucunubá
- London Centre for Neglected Tropical Disease Research & MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK.,Departamento de Epidemiología Clínica y Bioestadística, Facultad de Medicina, Universidad Javeriana, Bogotá, Colombia
| | - Gabriel Parra-Henao
- Centro de Investigación en Salud para el Trópico, Universidad Cooperativa de Colombia, Santa Marta, Colombia.,National Institute of Health, Bogotá, Colombia
| | - Eliana Rodríguez-Monguí
- Neglected, Tropical and Vector Borne Diseases Program, Pan American Health Organization (PAHO), Bogotá, Colombia
| | - Andrew P Dobson
- Ecology & Evolutionary Biology, Princeton University, Princeton, USA
| | - María-Gloria Basáñez
- London Centre for Neglected Tropical Disease Research & MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK
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The Colombian Strain of Trypanosoma cruzi Induces a Proinflammatory Profile, Neuronal Death, and Collagen Deposition in the Intestine of C57BL/6 Mice Both during the Acute and Early Chronic Phase. Mediators Inflamm 2022; 2022:7641357. [PMID: 35069009 PMCID: PMC8769873 DOI: 10.1155/2022/7641357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 12/01/2021] [Accepted: 12/17/2021] [Indexed: 12/14/2022] Open
Abstract
The objective of this study was to evaluate the histopathological changes caused by infection with the Colombian strain of Trypanosoma cruzi (T. cruzi) in the acute and chronic experimental phases. C57Bl/6 mice were infected with 1000 trypomastigote forms of the Colombian strain of T. cruzi. After 30 days (acute phase) and 90 days (early chronic phase) of infection, the animals were euthanized, and the colon was collected and divided into two parts: proximal and distal. The distal portion was used for histopathological analysis, whereas the proximal portion was used for quantification of pro- and anti-inflammatory cytokines. In addition, the weight of the animals and parasitemia were assessed. The infection induced gradual weight loss in the animals. In addition, the infection induced an increase in interferon gamma (IFNγ) and tumor necrosis factor-alpha (TNF-α) in the intestine in the acute phase, in which this increase continued until the early chronic phase. The same was observed in relation to the presence of intestinal inflammatory infiltrates. In relation to interleukin (IL)-10, there was an increase only in the early chronic phase. The Colombian strain infection was also able to induce neuronal loss in the myenteric plexus and deposition of the collagen fibers during the acute phase. The Colombian strain of T. cruzi is capable of causing histopathological changes in the intestine of infected mice, especially in inducing neuronal destructions. Thus, this strain can also be used to study the intestinal form of Chagas disease in experimental models.
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Chakravarti I, Miranda-Schaeubinger M, Ruiz-Remigio A, Briones-Garduño C, Fernández-Figueroa EA, Villanueva-Cabello CC, Borge-Villareal A, Bejar-Ramírez Y, Pérez-González A, Rivera-Benitez C, Oren E, Brown HE, Becker I, Gilman RH. Chagas Disease in Pregnant Women from Endemic Regions Attending the Hospital General de Mexico, Mexico City. Trop Med Infect Dis 2022; 7:8. [PMID: 35051124 PMCID: PMC8779423 DOI: 10.3390/tropicalmed7010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/06/2021] [Accepted: 12/07/2021] [Indexed: 02/01/2023] Open
Abstract
Trypanosoma cruzi infection leads to Chagas disease (CD), a neglected tropical infection of significant public health importance in South and Central America and other, non-endemic, countries. Pregnant women and their children are of particular importance to screen as T. cruzi can be transmitted vertically. The objective of this study was to screen for T. cruzi infection among pregnant women from endemic areas seen at the Hospital General de Mexico for prenatal care, so that they and their children may be quickly connected to CD treatment. Pregnant women were recruited through the hospital prenatal clinic and screened for T. cruzi infection using a series of serological and molecular tests. Of 150 screened patients, mean age 26.8 (SD 6.4), 30 (20.0%) were positive by at least one diagnostic test. Of these, only nine (6%) were positive as determined by PCR. Diagnosis of chronic CD is difficult in endemic places like Mexico due to the limitations of current commercially available diagnostic tests. Further evaluation of diagnostic performance of various assays could improve current CD diagnostic algorithms and proper care management in these regions. Genetic variability in the parasite may also play a role in the differing assay performances seen in this study, and this may be a valuable avenue of further research.
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Affiliation(s)
- Indira Chakravarti
- Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD 21215, USA;
| | | | - Adriana Ruiz-Remigio
- Centro de Medicina Tropical, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico; (A.R.-R.); (E.A.F.-F.); (C.C.V.-C.)
| | - Carlos Briones-Garduño
- Servicio de Ginecología y Obstetricia, Hospital General de México “Dr. Eduardo Liceaga”, Ciudad de México 06720, Mexico; (C.B.-G.); (A.B.-V.)
| | - Edith A. Fernández-Figueroa
- Centro de Medicina Tropical, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico; (A.R.-R.); (E.A.F.-F.); (C.C.V.-C.)
- Computational and Integrative Genomics, National Institute of Genomic Medicine, Ciudad de México 14610, Mexico
| | - Concepción Celeste Villanueva-Cabello
- Centro de Medicina Tropical, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico; (A.R.-R.); (E.A.F.-F.); (C.C.V.-C.)
| | - Alejandra Borge-Villareal
- Servicio de Ginecología y Obstetricia, Hospital General de México “Dr. Eduardo Liceaga”, Ciudad de México 06720, Mexico; (C.B.-G.); (A.B.-V.)
| | - Yadira Bejar-Ramírez
- Banco de Sangre, Hospital General de México “Dr. Eduardo Liceaga”, Ciudad de México 06720, Mexico; (Y.B.-R.); (A.P.-G.)
| | - Alejandro Pérez-González
- Banco de Sangre, Hospital General de México “Dr. Eduardo Liceaga”, Ciudad de México 06720, Mexico; (Y.B.-R.); (A.P.-G.)
| | - César Rivera-Benitez
- Servicio de Infectología, Hospital General de México “Dr. Eduardo Liceaga”, Ciudad de México 06720, Mexico;
| | - Eyal Oren
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA 92182, USA;
| | - Heidi E. Brown
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA;
| | - Ingeborg Becker
- Centro de Medicina Tropical, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico; (A.R.-R.); (E.A.F.-F.); (C.C.V.-C.)
| | - Robert H. Gilman
- Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD 21215, USA;
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FRANÇA IGORRABELODE, CALDAS EDUARDAAUGUSTADELUCENA, BARROS MARCELLAFERREIRA, SILVA JOSETARCÍSIODIASDA, PONTUAL JOÃOPAULO, FERRAZ ÁLVAROAB. Miotomia endoscópica peroral para o tratamento de acalásia no Sistema Único de Saúde (SUS): resultados de seguimento no curto-prazo. Rev Col Bras Cir 2022. [DOI: 10.1590/0100-6991e-20223244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
RESUMO Introdução: a acalasia é uma doença crônica. Por não haver tratamento curativo, os pacientes diagnosticados dispõem de técnicas farmacológicas e/ou cirúrgicas, visando minimizar o quadro. A POEM surge como um novo tipo de tratamento paliativo promissor com boas taxas de melhora dos sintomas. Objetivo: avaliar o perfil das POEM realizadas no Hospital das Clínicas da Universidade Federal de Pernambuco (HC - UFPE) e correlacioná-lo com o cenário mundial. Métodos: a coleta de dados foi realizada retrospectivamente no período de setembro de 2017 a outubro de 2019 com todos os pacientes submetidos a POEM no HC - UFPE. Variáveis sociodemográficas, clínicas e hospitalares foram avaliadas antes e três meses após o procedimento. Resultados: total de 27 pacientes (52,41 ± 19,24 anos) que realizaram o procedimento, 66,7% com etiologia idiopática e 33,3% com etiologia secundária à doença de Chagas. 48% tinham sido submetidos a procedimentos prévios, dos quais sete usaram algum tipo de medicamento para controle dos sintomas, dois foram submetidos à dilatação endoscópica pneumática e quatro à cardiomiotomia a Heller com fundoplicatura parcial. 62,5% dos pacientes avaliados tinham acalasia tipo ii antes do procedimento. Sete (25,9%) apresentaram eventos adversos: quatro sangramentos, dois pneumoperitônio e um ambas as complicações, todos foram tratados de forma conservadora. O escore de Eckardt reduziu de 8,37 ± 1,45 para 0,85 ± 1,06 (valor de p<0,001). Conclusão: melhora clínica e o perfil dos pacientes acompanhou a tendência mundial, destaque para a etiologia secundária à doença de Chagas, endêmica no Brasil. O refluxo gastroesofágico continua sendo o principal sintoma pós-operatório.
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Medina-Rincón GJ, Gallo-Bernal S, Jiménez PA, Cruz-Saavedra L, Ramírez JD, Rodríguez MJ, Medina-Mur R, Díaz-Nassif G, Valderrama-Achury MD, Medina HM. Molecular and Clinical Aspects of Chronic Manifestations in Chagas Disease: A State-of-the-Art Review. Pathogens 2021; 10:pathogens10111493. [PMID: 34832648 PMCID: PMC8619182 DOI: 10.3390/pathogens10111493] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 11/03/2021] [Accepted: 11/08/2021] [Indexed: 12/11/2022] Open
Abstract
Chronic manifestations of Chagas disease present as disabling and life-threatening conditions affecting mainly the cardiovascular and gastrointestinal systems. Although meaningful research has outlined the different molecular mechanisms underlying Trypanosoma cruzi’s infection and the host-parasite interactions that follow, prompt diagnosis and treatment remain a challenge, particularly in developing countries and also in those where the disease is considered non-endemic. This review intends to present an up-to-date review of the parasite’s life cycle, genetic diversity, virulence factors, and infective mechanisms, as well as the epidemiology, clinical presentation, diagnosis, and treatment options of the main chronic complications of Chagas disease.
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Affiliation(s)
- Germán J. Medina-Rincón
- School of Medicine and Health Sciences, Universidad del Rosario, Bogotá 111221, Colombia; (S.G.-B.); (M.D.V.-A.); (H.M.M.)
- Correspondence: ; Tel.: +57-310-817-2369
| | - Sebastián Gallo-Bernal
- School of Medicine and Health Sciences, Universidad del Rosario, Bogotá 111221, Colombia; (S.G.-B.); (M.D.V.-A.); (H.M.M.)
- Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Radiology, Harvard Medical School, Boston, MA 02114, USA
| | - Paula A. Jiménez
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá 111221, Colombia; (P.A.J.); (L.C.-S.); (J.D.R.)
| | - Lissa Cruz-Saavedra
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá 111221, Colombia; (P.A.J.); (L.C.-S.); (J.D.R.)
| | - Juan David Ramírez
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá 111221, Colombia; (P.A.J.); (L.C.-S.); (J.D.R.)
| | - María Juliana Rodríguez
- Division of Cardiology, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá 110131, Colombia; (M.J.R.); (R.M.-M.)
| | - Ramón Medina-Mur
- Division of Cardiology, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá 110131, Colombia; (M.J.R.); (R.M.-M.)
| | - Gustavo Díaz-Nassif
- Division of Gastroenterology and Liver Diseases, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá 111221, Colombia;
| | | | - Héctor M. Medina
- School of Medicine and Health Sciences, Universidad del Rosario, Bogotá 111221, Colombia; (S.G.-B.); (M.D.V.-A.); (H.M.M.)
- Division of Cardiology, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá 110131, Colombia; (M.J.R.); (R.M.-M.)
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Rojas-Cortez M, Pinazo MJ, Gascon J, Gamarra E, Grageda RM, Fernandez R, Rueda E, Pinto J, Anzoleaga HM, Caballero YE, Urioste GS, Sanchez J, Saravia R, Castellon M, Garcia W, Daza LO, Mur IG, Lozano D, Carvalho-Costa FA, Monteiro FA, Torrico F. Community-based entomological surveillance in three Chagas disease-endemic regions in sub-Andean Bolivia. Trans R Soc Trop Med Hyg 2021; 115:1251-1259. [PMID: 34580735 DOI: 10.1093/trstmh/trab150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 08/29/2021] [Accepted: 09/15/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Chagas disease is endemic throughout most of Bolivia, with prevalence rates of 25% observed in some geographic areas located mainly in the sub-Andean region. METHODS Community-based entomological surveillance was carried out in the sub-Andean departments of Cochabamba (municipalities of Cochabamba, Punata and Sacaba), Tarija (municipality of Tarija) and Chuquisaca (municipality of Sucre). The surveillance parameters evaluated were: (i) the proportion of cards with the presence of triatomines; (ii) the distribution of positive cards by area; and (iii) the proportion of cards with the presence of infected triatomines. RESULTS Of the cards returned, in 852 (3.1%) there was a mention of the presence of triatomines. The species Triatoma infestans, Triatoma sordida and Triatoma guasayana were identified in 812 (95.3%), 39 (4.6%) and 1 (0.1%), respectively. The median monthly positivity rate of the cards during 2011-2018 was higher in Punata (9.1%; IQR=3.2-15.4%). The median monthly rate was highest in 2012 (2.7%; IQR=0-5.6%). Fifty positive cards (5.8%) presented insects that were positive for trypanosomatids, mainly in Cochabamba and Punata. CONCLUSIONS The report of triatomines foci by inhabitants represents an effective surveillance system coordinated by a network of specialized and multidisciplinary health centers. These strategies, which should be included in the health policies of endemic countries, enable extending and deepening the dialogue among technicians, communities and their local authorities.
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Affiliation(s)
| | | | - Joaquim Gascon
- ISGlobal, Barcelona, Hospital Clinic - Universitat de Barcelona, Spain
| | - Enzo Gamarra
- Ministerio de Salud, Programa Nacional de Chagas, Bolivia
| | | | | | | | - Jimy Pinto
- Fundación CEADES, Cochabamba, Bolivia.,Centro Plataforma Chagas Cercado, Cochabamba
| | | | | | - Gloria Sandy Urioste
- Fundación CEADES, Cochabamba, Bolivia.,Centro Plataforma Chagas Sacaba, Cochabamba
| | - Jareth Sanchez
- Fundación CEADES, Cochabamba, Bolivia.,Centro Plataforma Chagas Punata, Cochabamba
| | | | | | - Wilson Garcia
- Fundación CEADES, Cochabamba, Bolivia.,Centro Plataforma Chagas Sucre, Chuquisaca
| | - Lourdes Ortiz Daza
- Centro Plataforma Chagas Tarija.,Universidad Juan Misael Saracho, Tarija
| | | | | | - Filipe Anibal Carvalho-Costa
- Labóratory of Molecular Epidemiology and Systemátics, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Fernando Araújo Monteiro
- Labóratory of Molecular Epidemiology and Systemátics, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Silgado A, Gual-Gonzalez L, Sánchez-Montalvá A, Oliveira-Souto I, Goterris L, Serre-Delcor N, Esperalba J, Gomez-I-Prat J, Fernández-Naval C, Molina I, Pumarola T, Sulleiro E. Analytical Evaluation of Dried Blood Spot and Rapid Diagnostic Test as a New Strategy for Serological Community Screening for Chronic Chagas Disease. Front Cell Infect Microbiol 2021; 11:736630. [PMID: 34604116 PMCID: PMC8479190 DOI: 10.3389/fcimb.2021.736630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 08/26/2021] [Indexed: 11/23/2022] Open
Abstract
Background Chagas disease is a public health problem not only in Latin America, but also in other regions, including Spain, due to migration movements. Conventional serological diagnosis requires an invasive sample (plasma or serum) and a well-equipped laboratory. To circumvent those limitations, blood samples dried on filter paper (DBS) or Rapid Diagnostic Test (RDT) could be a practical alternative to reference protocol for serological screening in epidemiological studies. We evaluated the usefulness of dried blood sampling and a rapid diagnostic test (Trypanosoma Detect™) for the detection of antibodies against T. cruzi for their use in community-based screening. Methodology/Principal Findings A total of 162 stored paired whole-blood and serum samples from Latin American migrants and 25 negative-control blood samples were included. Diagnosis of chronic Chagas disease was performed in serum according to WHO algorithms. Blood samples were retrospectively collected as dried spots and then analyzed using two different serological techniques, enzyme-linked immunosorbent assay (ELISA) and electrochemiluminescence immunoassay (E-CLIA). Whole-blood samples were also used to evaluate a rapid diagnostic test based on immunochromatography. A better correlation with conventional serum was observed in dried blood elutes using E-CLIA than ELISA (97% vs. 77% sensitivity, respectively). Both assays reported 100% specificity. The median cut-off index values of E-CLIA for dried blood were significantly lower than those for serum (138.1 vs. 243.3, P<0.05). The Trypanosoma Detect™ test presented a sensitivity and specificity of 89.6% and 100%, respectively. Conclusions The detection of antibodies against T. cruzi in dried blood samples shows a higher sensitivity when using E-CLIA compared with ELISA. Trypanosoma Detect™ is easier to use but has a lower sensitivity. Hence, we propose a sequential strategy based on performing the rapid test first, and a negative result will be confirmed by DBS-ECLIA for use in community Chagas disease screening programs.
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Affiliation(s)
- Aroa Silgado
- Department of Microbiology, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
| | - Lídia Gual-Gonzalez
- Laboratory of Vector-Borne and Zoonotic Diseases, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Adrián Sánchez-Montalvá
- Department of Infectious Diseases-Drassanes, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
| | - Inés Oliveira-Souto
- Department of Infectious Diseases-Drassanes, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
| | - Lidia Goterris
- Department of Microbiology, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
| | - Nuria Serre-Delcor
- Department of Infectious Diseases-Drassanes, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
| | - Juliana Esperalba
- Department of Microbiology, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
| | - Jordi Gomez-I-Prat
- Department of Infectious Diseases-Drassanes, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
| | - Candela Fernández-Naval
- Department of Microbiology, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
| | - Israel Molina
- Department of Infectious Diseases-Drassanes, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
| | - Tomas Pumarola
- Department of Microbiology, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
| | - Elena Sulleiro
- Department of Microbiology, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
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Marcus R, Henao-Martínez AF, Nolan M, Livingston E, Klotz SA, Gilman RH, Miranda-Schaeubinger M, Meymandi S. Recognition and screening for Chagas disease in the USA. Ther Adv Infect Dis 2021; 8:20499361211046086. [PMID: 34589212 PMCID: PMC8474340 DOI: 10.1177/20499361211046086] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 08/24/2021] [Indexed: 12/01/2022] Open
Abstract
Chagas disease (CD), caused by the protozoan Trypanosoma cruzi,
is a public health concern, mainly among countries in South and Central America.
However, despite the large number of immigrants from endemic countries living in
the USA, awareness of CD is poor in the medical community, and therefore it is
significantly underdiagnosed. To avoid the catastrophic cardiac complications of
CD and to prevent maternal–fetal transmission, widespread educational programs
highlighting the need for diagnosis are urgently needed.
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Affiliation(s)
- Rachel Marcus
- LASOCHA, MedStar Union Memorial Hospital, Baltimore, MD 21218-2829, USA
| | - Andrés F Henao-Martínez
- Division of Infectious Diseases, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Melissa Nolan
- Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Elizabeth Livingston
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA
| | - Stephen A Klotz
- Division of Infectious Diseases, University of Arizona, Tucson, AZ, USA
| | - Robert H Gilman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Sheba Meymandi
- Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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A Rapid Review on the Efficacy and Safety of Pharmacological Treatments for Chagas Disease. Trop Med Infect Dis 2021; 6:tropicalmed6030128. [PMID: 34287382 PMCID: PMC8293415 DOI: 10.3390/tropicalmed6030128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 07/02/2021] [Accepted: 07/08/2021] [Indexed: 11/17/2022] Open
Abstract
Chagas disease remains a neglected tropical disease, causing significant burden in the Americas and countries that receive immigrants from endemic nations. Current pharmaceutical treatments are suboptimal, not only varying drastically in efficacy, depending on the stage of disease, but also presenting significant risk of adverse events. The objective of this review is to provide a timely update on the efficacy and safety of current trypanocidals. Eligible studies published from January 2015 to December 2020 were retrieved by one reviewer from six electronic databases. Ana-lysis was done with review management software and risk of bias was assessed using tools appropriate for the type of study (i.e., experimental or observational). Thirteen studies (10 observational and three RCTs) were included in the analysis. All 13 studies tested Benznidazole (BNZ) or Nifurtimox (NFX), and two studies also tested Posaconazole (POS) or E1224 (Ravucanazole). BNZ was found to be the most efficacious trypanocidal drug compared to Nifurtimox, POS, and E1224; it also resulted in the highest percentage of adverse effects (AEs) and treatment discontinuation due to its toxicity. Adults experienced higher frequency of neurological AEs while taking BNZ or NFX compared to children. Children had a higher frequency of general AEs compared to adults while taking BNZ. Overall, BNZ is still the most efficacious, but development of new, less toxic drugs is paramount for the quality of life of patients. Studies testing combination therapies and shorter regimens are needed, as is the devising of better clinical parameters and laboratory biomarkers to evaluate treatment efficacy. Considering the variability in methodology and reporting of the studies included in the present analysis, we offer some recommendations for the improvement and replicability of clinical studies investigating pharmacological treatment of Chagas disease. These include full disclosure of methodology, standardization of outcome measures, and always collecting and reporting data on both the efficacy of trypanocidals and on safety outcomes.
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Dos Santos JP, da Silva R, Ricardo-Silva AH, Verly T, Britto C, Evangelista BBC, Rocha-Silva L, da Silva DFM, Oliveira RA, Pereira E, Monteiro KJL, Carvalho-Costa FA, Mallet JDS. Assessing the entomo-epidemiological situation of Chagas disease in rural communities in the state of Piauí, Brazilian semi-arid region. Trans R Soc Trop Med Hyg 2021; 114:820-829. [PMID: 32797206 DOI: 10.1093/trstmh/traa070] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/01/2020] [Accepted: 07/24/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND In northeastern Brazil, the wild nature of Trypanosoma cruzi vectors has challenged control actions. This study aims to describe the entomological and epidemiological scenario of Chagas disease in rural communities in the state of Piauí. METHODS A cross-sectional study (n=683 individuals/244 dwellings) was carried out to obtain serum samples, sociodemographic data and intra- and peridomestic triatomines. RESULTS The overall seroprevalence rate was 8.1%, with no positive tests among subjects <30 y of age. Prevalence rates reached 34.3% and 39.1% among subjects 61-75 and >75 y of age, respectively; 1474 triatomines were collected, of which 90.3% were found in peridomiciliary structures and 9.7% inside houses; 87.2% were classified as Triatoma brasiliensis. T. cruzi infection rates in insects were 0.5% by light microscopy and 0.9% by culture in NNN/LIT medium. Five cultivated isolates were submitted to molecular genotyping, three of which were identified as T. cruzi I and two as T. cruzi II. CONCLUSIONS Although no vector transmission currently occurs, prevalence rates are high in adults and the elderly. This disease should be targeted by primary healthcare providers. Insect surveillance and control activities should not be discontinued in an environment favourable to the perpetuation of house colonization by triatomines.
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Affiliation(s)
- Jessica P Dos Santos
- Laboratory of Molecular Epidemiology and Systematics, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, RJ 21040-900, Brazil.,Fiocruz Piauí Regional Office, Teresina, Piauí, Brazil
| | - Renato da Silva
- Laboratory of Entomological Surveillance of Diptera and Hemiptera, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, RJ 21040-900, Brazil
| | - Alice Helena Ricardo-Silva
- Laboratory of Entomological Surveillance of Diptera and Hemiptera, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, RJ 21040-900, Brazil
| | - Thaiane Verly
- Laboratory of Molecular Biology and Endemic Diseases, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, RJ 21040-900, Brazil
| | - Constança Britto
- Laboratory of Molecular Biology and Endemic Diseases, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, RJ 21040-900, Brazil
| | - Brenda B C Evangelista
- Laboratory of Molecular Epidemiology and Systematics, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, RJ 21040-900, Brazil.,Fiocruz Piauí Regional Office, Teresina, Piauí, Brazil
| | - Liliene Rocha-Silva
- Laboratory of Molecular Biology and Endemic Diseases, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, RJ 21040-900, Brazil
| | - Darlane F M da Silva
- Federal Institute of Education, Science and Technology of the State of Piauí, São João do Piauí, Piauí, Brazil
| | - Rony A Oliveira
- Federal Institute of Education, Science and Technology of the State of Piauí, São João do Piauí, Piauí, Brazil
| | - Edvan Pereira
- Federal Institute of Education, Science and Technology of the State of Piauí, São João do Piauí, Piauí, Brazil
| | | | - Filipe A Carvalho-Costa
- Laboratory of Molecular Epidemiology and Systematics, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, RJ 21040-900, Brazil.,Fiocruz Piauí Regional Office, Teresina, Piauí, Brazil
| | - Jacenir Dos S Mallet
- Laboratory of Molecular Biology and Endemic Diseases, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, RJ 21040-900, Brazil.,Fiocruz Piauí Regional Office, Teresina, Piauí, Brazil
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Carmona-Galindo VD, Sheppard CC, Bastin ML, Kehrig MR, Marín-Recinos MF, Choi JJ, Castañeda de Abrego V. Chromatic and Morphological Differentiation of Triatoma dimidiata (Hemiptera: Reduviidae) with Land Use Diversity in El Salvador. Pathogens 2021; 10:pathogens10060753. [PMID: 34198542 PMCID: PMC8231922 DOI: 10.3390/pathogens10060753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 05/24/2021] [Accepted: 06/09/2021] [Indexed: 12/03/2022] Open
Abstract
Chagas disease is caused by the parasite Trypanosoma cruzi, which is transmitted by insect-vectors in the taxonomic subfamily Triatominae and affects approximately 8,000,000 people world-wide. Current mitigation strategies for Chagas focus on insecticides, infrastructure improvements, and management of symptoms, which are largely unsustainable in underserved communities where the disease is widespread. Transmission patterns of vector-borne diseases are known to adaptively respond to habitat change; as such, the objective of our study was to evaluate how the physical characteristics of Triatoma dimidiata would vary in relation to land use in El Salvador. We hypothesized that the color and morphology of T. dimidiata would change with municipal levels of urban and natural green space, natural green space, and agricultural space, as well as municipal diversity, richness, and evenness of land use types. Our results characterize how T. dimidiata color and morphology vary directly with anthropogenic changes to natural and agricultural environments, which are reflective of a highly adaptable population primed to respond to environmental change. Mitigation studies of Chagas disease should exploit the relationships between anthropogenic land use and T. dimidiata morphology to evaluate how the transmission pattern of T. cruzi and Chagas disease symptomology are impacted.
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Affiliation(s)
- Víctor D. Carmona-Galindo
- Biology Department, University of Detroit Mercy, Detroit, MI 48221, USA; (C.C.S.); (M.L.B.); (M.R.K.)
- Centro de Investigación y Desarrollo en Salud, Universidad de El Salvador, San Salvador CP1101, El Salvador;
- Correspondence: ; Tel.: +1-313-993-1182
| | - Claire C. Sheppard
- Biology Department, University of Detroit Mercy, Detroit, MI 48221, USA; (C.C.S.); (M.L.B.); (M.R.K.)
| | - Madelyn L. Bastin
- Biology Department, University of Detroit Mercy, Detroit, MI 48221, USA; (C.C.S.); (M.L.B.); (M.R.K.)
| | - Megan R. Kehrig
- Biology Department, University of Detroit Mercy, Detroit, MI 48221, USA; (C.C.S.); (M.L.B.); (M.R.K.)
| | | | - Joyce J. Choi
- School for Environment and Sustainability, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Vianney Castañeda de Abrego
- Centro de Investigación y Desarrollo en Salud, Universidad de El Salvador, San Salvador CP1101, El Salvador;
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48
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Costa J, Dale C, Galvão C, Almeida CE, Dujardin JP. Do the new triatomine species pose new challenges or strategies for monitoring Chagas disease? An overview from 1979-2021. Mem Inst Oswaldo Cruz 2021; 116:e210015. [PMID: 34076075 PMCID: PMC8186471 DOI: 10.1590/0074-02760210015] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 05/04/2021] [Indexed: 11/22/2022] Open
Abstract
Chagas disease persists as one of the most important, and yet most neglected, diseases in the world, and several changes in its epidemiological aspects have been recorded since its discovery. Currently, some of the most relevant changes are related to: (i) the reduction in the incidence of the endemic due to the control of the most important vectors, Triatoma infestans and Rhodnius prolixus, in many countries; (ii) the migration of human populations spreading cases of the disease throughout the world, from endemic to non-endemic areas, transforming Chagas disease into a global threat; and (iii) new acute cases and deaths caused by oral transmission, especially in the north of Brazil. Despite the reduction in the number of cases, new challenges need to be responded to, including monitoring and control activities aiming to prevent house infestation by the secondary vectors from occurring. In 1979, Lent & Wygodzinsky(1) published the most complete review of the subfamily Triatominae, encompassing 111 recognised species in the taxon. Forty-two years later, 46 new species and one subspecies have been described or revalidated. Here we summarise the new species and contextualise them regarding their ecology, epidemiologic importance, and the obstacles they pose to the control of Chagas disease around the world.
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Affiliation(s)
- Jane Costa
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Biodiversidade Entomológica, Rio de Janeiro, RJ, Brasil
| | - Carolina Dale
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Biodiversidade Entomológica, Rio de Janeiro, RJ, Brasil
| | - Cleber Galvão
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório Nacional e Internacional de Referência em Taxonomia de Triatomíneos, Rio de Janeiro, RJ, Brasil
| | - Carlos Eduardo Almeida
- Universidade Federal da Bahia, Salvador, BA, Brasil
- Universidade Estadual de Campinas, Instituto de Biologia, Campinas, SP, Brasil
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Chagas Cardiomyopathy: From Romaña Sign to Heart Failure and Sudden Cardiac Death. Pathogens 2021; 10:pathogens10050505. [PMID: 33922366 PMCID: PMC8145478 DOI: 10.3390/pathogens10050505] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/10/2021] [Accepted: 04/13/2021] [Indexed: 12/16/2022] Open
Abstract
Despite nearly a century of research and accounting for the highest disease burden of any parasitic disease in the Western Hemisphere, Chagas disease (CD) is still a challenging diagnosis, primarily due to its poor recognition outside of Latin America. Although initially considered endemic to Central and South America, globalization, urbanization, and increased migration have spread the disease worldwide in the last few years, making it a significant public health threat. The international medical community’s apparent lack of interest in this disease that was previously thought to be geographically restricted has delayed research on the complex host–parasite relationship that determines myocardial involvement and its differential behavior from other forms of cardiomyopathy, particularly regarding treatment strategies. Multiple cellular and molecular mechanisms that contribute to degenerative, inflammatory, and fibrotic myocardial responses have been identified and warrant further research to expand the therapeutic arsenal and impact the high burden attributed to CD. Altogether, cardiac dysautonomia, microvascular disturbances, parasite-mediated myocardial damage, and chronic immune-mediated injury are responsible for the disease’s clinical manifestations, ranging from asymptomatic disease to severe cardiac and gastrointestinal involvement. It is crucial for healthcare workers to better understand CD transmission and disease dynamics, including its behavior on both its acute and chronic phases, to make adequate and evidence-based decisions regarding the disease. This review aims to summarize the most recent information on the epidemiology, pathogenesis, clinical presentation, diagnosis, screening, and treatment of CD, emphasizing on Chagasic cardiomyopathy’s (Ch-CMP) clinical presentation and pathobiological mechanisms leading to sudden cardiac death.
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Metacyclogenesis of Trypanosoma cruzi in B. ferroae (Reduviidae: Triatominae) and feces infectivity under laboratory conditions. ACTA ACUST UNITED AC 2021; 41:179-186. [PMID: 33761201 PMCID: PMC8055595 DOI: 10.7705/biomedica.5394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Indexed: 11/21/2022]
Abstract
Introduction: Belminus ferroae is a triatominae with entomophagous behavior. However, it may occasionally feed on vertebrates. Currently, there is no evidence of natural infection with Trypanosoma cruzi or the occurrence of metacyclogenesis in this species.
Objective: To test T. cruzi metacyclogenesis in B. ferroae and the infectivity of their feces or intestinal contents in rodents under laboratory conditions.
Materials and methods: Twenty nymphs of B. ferroae were infected with an autochthonous strain of T. cruzi (M/HOM/VE/09/P6). Fecal and urine samples were collected from spontaneous droppings or by compressing the bugs’ abdomens and, eventually, by removing their gut contents, and then examined at 10, 20, 30, 40, 50, and 60 days. We quantified T. cruzi parasitic load, as well as the evolutionary forms in feces, urine, and intestinal contents by Giemsa staining. Similarly, we evaluated the infectivity of T. cruzi metacyclic trypomastigotes in albino mice.
Results: The parasitological analysis showed three insects (15%) infected with T. cruzi at 30 (n=1), 40 (n=1), and 50 (n=1) days post-infection. We observed parasitic loads of up to 1.62 x 105 trypanosomes/mm3 and metacyclogenesis percentages between 3.5% and 6.78%.
Conclusions: This is the first time that T. cruzi metacyclogenesis is reported in a species of the genus Belminus under laboratory conditions and the infectivity of Belminus’ feces is demonstrated on a vertebrate host.
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