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Medhasi S, Sriwarom A, Permpalung N, Torvorapanit P, Plongla R, Chindamporn A, Worasilchai N. Ex vivo observation of Pythium insidiosum-antigen treated neutrophils on three Pythium insidiosum strains isolated from vascular pythiosis patients. Hum Vaccin Immunother 2024; 20:2304372. [PMID: 38314761 PMCID: PMC10854268 DOI: 10.1080/21645515.2024.2304372] [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: 10/13/2023] [Accepted: 01/08/2024] [Indexed: 02/07/2024] Open
Abstract
The mechanisms of Pythium insidiosum-antigen (PIA) immunotherapy activating a patient's immune system are unknown. We evaluated the interleukin-8 (IL-8) serum levels during P. insidiosum infection and after vaccination with PIA in vascular pythiosis cases. Furthermore, we studied the anti-P. insidiosum activity of neutrophils stimulated with various concentrations of PIA ex vivo in 3 strains of P. insidiosum isolated from vascular pythiosis patients. IL-8 serum levels were evaluated using the ELISA technique. We assessed the effect of PIA-stimulated neutrophils on the viability of zoospores using MTT assay, visualized neutrophil extracellular trap (NET) formation via microscopy, and measured the levels of double-stranded DNA (dsDNA) using PicoGreen dsDNA quantitation assay in 3 strains of P. insidiosum isolated from vascular pythiosis patients. Serum levels of IL-8 gradually lowered from the early to the end phases of vaccination with PIA among the surviving group of vascular pythiosis cases. Neutrophils stimulated with 0.01 µg/ml PIA reduced zoospore viability significantly compared to PIA-unstimulated neutrophils for strain 1 and strain 3 (p < .05). Neutrophils stimulated with 0.01, 0.1, 1, and 10 µg/ml PIA exhibited significantly lower zoospore viability than PIA-unstimulated neutrophils for strain 2 (p < .05). IL-8 can be used as a biomarker for monitoring vascular pythiosis cases treated with the PIA vaccine. Also, anti-P. insidiosum activity of PIA-stimulated neutrophils was probably due to the disruption of cellular activity in zoospores rather than the mechanisms based on the formation of NETs.
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Affiliation(s)
- Sadeep Medhasi
- Department of Transfusion Medicine and Clinical Microbiology, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
- Research Unit of Medical Mycology Diagnosis, Chulalongkorn University, Bangkok, Thailand
| | - Apichaya Sriwarom
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nitipong Permpalung
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Pattama Torvorapanit
- Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
| | - Rongpong Plongla
- Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
| | - Ariya Chindamporn
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Navaporn Worasilchai
- Department of Transfusion Medicine and Clinical Microbiology, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
- Research Unit of Medical Mycology Diagnosis, Chulalongkorn University, Bangkok, Thailand
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Pereira DIB, Botton SA, Ianiski LB, Braga CQ, Maciel AF, Melo LG, Zambrano CG, Bruhn FRP, Santurio JM. Equidae pythiosis in Brazil and the world: a systematic review of the last 63 years (1960-2023). Braz J Microbiol 2024:10.1007/s42770-024-01435-6. [PMID: 38967702 DOI: 10.1007/s42770-024-01435-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 06/24/2024] [Indexed: 07/06/2024] Open
Abstract
This systematic review compiles reports of clinical pythiosis in horses, mules and donkeys from 1960 to 2023 worldwide, focusing on Brazil. We searched databases and included 71 articles detailing clinical characteristics, geographic distribution, epidemiology, diagnostic methods, therapies, and outcomes. The results showed that publications on equine pythiosis have significantly increased since 2010. Brazil reported the highest incidence, comprising 55% of cases, predominantly in the southern, northeastern, and central-western regions during summer and autumn. Cutaneous pythiosis was the most prevalent form, generally presenting as single lesions in the appendicular region, and affected females more than males. Diagnosis typically involved histopathology, used alone or with other methods. Various treatments have been employed, with surgery, often combined with chemotherapy and immunotherapy, being the most common. Notably, 80.84% of treated animals recovered, highlighting the effectiveness of these therapies in enhancing survival rates. The limitations of the study included the lack of data in published case reports, which made it difficult to collect and calculate epidemiological data. Additionally, we recognize that pythiosis in Brazil is underreported, since this disease does not have mandatory notification and several cases are not registered and/or reported in the literature. Lastly, it is hypothesized that equid pythiosis may be more widespread than currently known, and its real occurrence in Brazil remains uncertain.
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Affiliation(s)
- Daniela Isabel Brayer Pereira
- Instituto de Biologia, Departamento de Microbiologia e Parasitologia, Laboratório de Micologia, Programa de Pós Graduação em Microbiologia e Parasitologia, Universidade Federal de Pelotas, Pelotas, Brazil.
| | - Sônia Avila Botton
- Centro de Ciências da Saúde, Departamento de Microbiologia e Parasitologia, Laboratório de Pesquisas Micológicas, Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil
| | - Lara Baccarin Ianiski
- Centro de Ciências da Saúde, Departamento de Microbiologia e Parasitologia, Laboratório de Pesquisas Micológicas, Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil
| | - Caroline Quintana Braga
- Instituto de Biologia, Departamento de Microbiologia e Parasitologia, Laboratório de Micologia, Programa de Pós Graduação em Microbiologia e Parasitologia, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Aline Fontanella Maciel
- Centro de Ciências da Saúde, Departamento de Microbiologia e Parasitologia, Laboratório de Pesquisas Micológicas, Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil
| | - Luíze Garcia Melo
- Instituto de Biologia, Departamento de Microbiologia e Parasitologia, Laboratório de Micologia, Programa de Pós Graduação em Microbiologia e Parasitologia, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Cristina Gomes Zambrano
- Instituto de Biologia, Departamento de Microbiologia e Parasitologia, Laboratório de Micologia, Programa de Pós Graduação em Microbiologia e Parasitologia, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Fábio Raphael Pascoti Bruhn
- Faculdade de Veterinária, Departamento de Medicina Veterinária Preventiva, Universidade Federal de Pelotas, Programa de Pós-Graduação em Medicina Veterinária, Pelotas, RS, Brazil
| | - Janio Morais Santurio
- Centro de Ciências da Saúde, Departamento de Microbiologia e Parasitologia, Laboratório de Pesquisas Micológicas, Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil
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3
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Chagoya-Fuentes JL, Gaona-López J, Hernández-Carbajal GR, Torres-Guerrero H, Lammoglia-Villagómez MA, Huerta-Peña J, Pérez-Brígido CD, Jácome-Sosa E, Nieto-Rosaliano SO, Rojas-Ronquillo R, Grostieta E, Becker I, Sánchez-Montes S. First confirmed case of equine pythiosis in Northern Veracruz, Mexico. Acta Trop 2024; 254:107195. [PMID: 38548212 DOI: 10.1016/j.actatropica.2024.107195] [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: 01/29/2024] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 04/14/2024]
Abstract
A clinical case of an adult horse with invasive, ulcerative, proliferative, pyogranulomatous disease of the skin (tumor) in the shoulder region is presented. The mass had a granulomatous and crater-shaped appearance, with serosanguinous discharge and the presence of fistulas with caseous material. The tumor was removed by surgery and sent to the laboratory for diagnosis. Histopathology was performed using Grocott-Gomori methenamine silver stain. The presence of necrotic material, fibrosis, infiltrated cells, and brown-colored hyphae, characteristic of members of the genus Pythium, were observed. To identify the infecting species, conventional PCRs for the amplification of the ITS-1 was carried out. Histopathological and PCR tests confirmed infection by a Pythium insidiosum strain closely associated with previous records from the US and Central America. Our report represents the first molecularly confirmed case of equine pythiosis in Mexico.
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Affiliation(s)
- Jorge Luis Chagoya-Fuentes
- Laboratorio de Diagnóstico, Facultad de Ciencias Biológicas y Agropecuarias región Tuxpan, Universidad Veracruzana, Tuxpan de Rodríguez Cano, Veracruz, Mexico
| | - Jair Gaona-López
- Facultad de Ciencias Biológicas y Agropecuarias región Poza Rica-Tuxpan, Universidad Veracruzana, Tuxpan de Rodríguez Cano, Veracruz, Mexico
| | - Gabriela R Hernández-Carbajal
- Laboratorio de Diagnóstico, Facultad de Ciencias Biológicas y Agropecuarias región Tuxpan, Universidad Veracruzana, Tuxpan de Rodríguez Cano, Veracruz, Mexico.
| | - Haydee Torres-Guerrero
- Laboratorio de Micología Básica, Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Miguel A Lammoglia-Villagómez
- Laboratorio de Diagnóstico, Facultad de Ciencias Biológicas y Agropecuarias región Tuxpan, Universidad Veracruzana, Tuxpan de Rodríguez Cano, Veracruz, Mexico
| | - Javier Huerta-Peña
- Laboratorio de Diagnóstico, Facultad de Ciencias Biológicas y Agropecuarias región Tuxpan, Universidad Veracruzana, Tuxpan de Rodríguez Cano, Veracruz, Mexico
| | - Carlos D Pérez-Brígido
- Facultad de Ciencias Biológicas y Agropecuarias región Poza Rica-Tuxpan, Universidad Veracruzana, Tuxpan de Rodríguez Cano, Veracruz, Mexico
| | - Edelmira Jácome-Sosa
- Facultad de Ciencias Biológicas y Agropecuarias región Poza Rica-Tuxpan, Universidad Veracruzana, Tuxpan de Rodríguez Cano, Veracruz, Mexico
| | - Sergio Omar Nieto-Rosaliano
- Facultad de Ciencias Biológicas y Agropecuarias región Poza Rica-Tuxpan, Universidad Veracruzana, Tuxpan de Rodríguez Cano, Veracruz, Mexico
| | - Rebeca Rojas-Ronquillo
- Laboratorio de Diagnóstico, Facultad de Ciencias Biológicas y Agropecuarias región Tuxpan, Universidad Veracruzana, Tuxpan de Rodríguez Cano, Veracruz, Mexico
| | - Estefania Grostieta
- Centro de Medicina Tropical, Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Ingeborg Becker
- Centro de Medicina Tropical, Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Sokani Sánchez-Montes
- Laboratorio de Diagnóstico, Facultad de Ciencias Biológicas y Agropecuarias región Tuxpan, Universidad Veracruzana, Tuxpan de Rodríguez Cano, Veracruz, Mexico; Centro de Medicina Tropical, Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, Mexico.
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4
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Nanni IM, Tedesco P, Baldo D, Galuppi R, Collina M. Dimethomorph activity and its effect on morphology in different oomycete species of economic and veterinary interest. JOURNAL OF FISH DISEASES 2024; 47:e13925. [PMID: 38265623 DOI: 10.1111/jfd.13925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 12/28/2023] [Accepted: 01/02/2024] [Indexed: 01/25/2024]
Affiliation(s)
- Irene Maja Nanni
- Department of Agricultural and Food Sciences (DISTAL), University of Bologna, Bologna, Italy
| | - Perla Tedesco
- Department of Veterinary Medical Sciences (DIMEVET), University of Bologna, Bologna, Italy
| | - David Baldo
- Department of Agricultural and Food Sciences (DISTAL), University of Bologna, Bologna, Italy
| | - Roberta Galuppi
- Department of Veterinary Medical Sciences (DIMEVET), University of Bologna, Bologna, Italy
| | - Marina Collina
- Department of Agricultural and Food Sciences (DISTAL), University of Bologna, Bologna, Italy
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5
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Roy M, Borden J, Kasper DJ. Subcutaneous pythiosis in human treated successfully with antimicrobial treatment, debridement and immunotherapy. BMJ Case Rep 2024; 17:e258587. [PMID: 38499351 PMCID: PMC10953300 DOI: 10.1136/bcr-2023-258587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024] Open
Abstract
Pythiosis is caused due to a filamentous eukaryotic micro-organism called Pythium insidiosum and the disease occurs commonly in horses and cattle. Subcutaneous pythiosis infection in humans is rare with no clear clinical guidelines for treatment. We present a case of a man in his 20s with non-resolving ulcers noted over lower extremity after exposure to swamp water draining animal remains. The patient received several courses of oral antibiotics with no improvement in symptoms before getting admitted to our institution. A diagnosis of subcutaneous pythiosis was made after deep wound culture following debridement detected P. insidiosum by use of PCR. Due to the rare incidence of such infection in humans and no clear guidelines available for treatment, the case was discussed with infectious disease specialists outside our institution and with veterinary physicians. An emergent approval for use of immunotherapy in conjunction with surgical debridement and antimicrobials was obtained from Food and Drug administration. The patient underwent successful treatment of infection and skin graft following treatment.
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Affiliation(s)
- Moni Roy
- Department of Internal Medicine, University of Illinois College of Medicine Peoria, Peoria, Illinois, USA
| | - Joel Borden
- Department of Internal Medicine, University of Illinois College of Medicine Peoria, Peoria, Illinois, USA
| | - Douglas J Kasper
- Division of Infectious diseases, Department of Internal Medicine, University of Illinois College of Medicine Peoria, Peoria, Illinois, USA
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6
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Gurnani B, Natarajan R, Mohan M, Kaur K. Breaking-Down Barriers: Proposal of Using Cellulose Biosynthesis Inhibitors and Cellulase Enzyme as a Novel Treatment Modality for Vision Threatening Pythium Insidiosum Keratitis. Clin Ophthalmol 2024; 18:765-776. [PMID: 38495678 PMCID: PMC10941664 DOI: 10.2147/opth.s450665] [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: 12/03/2023] [Accepted: 03/05/2024] [Indexed: 03/19/2024] Open
Abstract
Pythium insidiosum, an Oomycete, causes severe keratitis that endangers vision. Its clinical, morphological, and microbiological characteristics are often indistinguishable from those of fungal keratitis, earning it the moniker "parafungus". Distinctive clinical hallmarks that set it apart from other forms of keratitis include radial keratoneuritis, tentacles, marginal infiltration, and a propensity for rapid limbal spread. The therapeutic approach to Pythium keratitis (PK) has long been a subject of debate, and topical and systemic antifungals and antibacterials have been tried with limited success. Approximately 80% of these eyes undergo therapeutic keratoplasty to salvage the eye. Hence, there is a need to innovate for alternative and better medical therapy to safeguard these eyes. The resistance of Pythium to standard antifungal treatments can be attributed to the absence of ergosterol in its cell wall. Cell walls of plants and algae have cellulose as an essential constituent. Cellulose imparts strength and structure and acts as the "skeleton" of the plant. Fungal and animal cell walls typically lack cellulose. The cellular architecture of Pythium shares a similarity with plant and algal cells through the incorporation of cellulose within its cell wall structure. Inhibitors targeting cellulose biosynthesis (CBI), such as Indaziflam, Isoxaben, and Quinoxyphen, serve as critical tools for elucidating the pathways of cellulose synthesis. Furthermore, the enzymatic action of cellulase is instrumental for the extraction of proteins and DNA. To circumvent this issue, we hypothesize that CBI's and cellulase enzymes can act on the Pythium cell wall and may effectively treat PK. The available literature supporting the hypothesis and proof of concept has also been discussed. We have also discussed these drugs' molecular mechanism of action on the Pythium cell wall. We also aim to propose how these drugs can be procured and used as a potential medical management option for this devastating entity.
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Affiliation(s)
- Bharat Gurnani
- Department of Cataract, Cornea and Refractive Surgery, ASG Eye Hospital, Jodhpur, Rajasthan, 342008, India
| | - Radhika Natarajan
- Department of Cornea and Refractive Surgery, Sankara Nethralaya Medical Research Foundation, Chennai, Tamil Nadu, 600006, India
| | - Madhuvanthi Mohan
- Department of Cornea and Refractive Surgery, Sankara Nethralaya Medical Research Foundation, Chennai, Tamil Nadu, 600006, India
| | - Kirandeep Kaur
- Department of Pediatric Ophthalmology and Strabismus, ASG Eye Hospital, Jodhpur, Rajasthan, 342008, India
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Hamlin AN, Locker S, Huguet E, Berry CR, Cole R, Iv JFG, Gremillion C, Hecht S, Vilaplana Grosso FR. Computed tomographic characteristics of confirmed and presumed noncutaneous pythiosis in 25 dogs. Vet Radiol Ultrasound 2024; 65:87-98. [PMID: 38192159 DOI: 10.1111/vru.13326] [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: 06/19/2023] [Revised: 11/05/2023] [Accepted: 11/22/2023] [Indexed: 01/10/2024] Open
Abstract
Pythium insidiosum is an aquatic oomycete that causes granulomatous infection in dogs, most commonly cutaneous and gastrointestinal. Ultrasonographic characteristics of gastrointestinal pythiosis have been described; occasionally, CT is utilized in the clinical setting, and CT features of pythiosis have not been published. The purpose of this retrospective, multicenter, descriptive study is to describe CT characteristics of noncutaneous canine pythiosis. The following CT parameters were recorded: lesion anatomic location, number, shape, margination, size, attenuation pre- and postcontrast, enhancement pattern, lymph nodes affected, other lesions identified, and presence of peritoneal effusion or steatitis. Descriptive statistics demonstrating the frequency of lesion appearances were performed. Twenty-five dogs with noncutaneous pythiosis lesions that underwent CT were included; 19 had primarily gastrointestinal infections, four primarily arterial infections, one intrathoracic and intra-abdominal infection, and one primary pulmonary infection. In dogs with primary gastrointestinal infection, lesions were most common at the ileocolic junction and were most frequently focal, well-defined, moderate to marked circumferential wall thickening that was homogeneous and smoothly marginated precontrast, with moderate heterogeneous contrast enhancement. Most dogs had involvement of multiple gastrointestinal regions. Of four dogs with primary arterial involvement, three had large aneurysmal dilatations of the cranial mesenteric artery with severe mural thickening. All dogs had regional lymphadenopathy, which was variable but generally mild. Nine dogs had peritoneal effusion; six dogs had steatitis. CT features of pythiosis can overlap with neoplasia, but pythiosis should be considered as a differential, especially in young dogs. Findings supported using CT as an adjunct imaging test for increasing clinical suspicion of noncutaneous pythiosis.
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Affiliation(s)
- Alessandra N Hamlin
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Seth Locker
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Elodie Huguet
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Clifford R Berry
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Robert Cole
- Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, Alabama, USA
| | - John F Griffin Iv
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Christine Gremillion
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Silke Hecht
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee, USA
| | - Federico R Vilaplana Grosso
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
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Ianiski LB, Maciel AF, Colla ACN, Braga CQ, Sangioni LA, Pal M, Pereira DIB, Santurio JM, Botton SDA. Pythium insidiosum: In vitro oomicidal evaluation of telithromycin and interactions with azithromycin and amorolfine hydrochloride. J Mycol Med 2024; 34:101460. [PMID: 38266397 DOI: 10.1016/j.mycmed.2024.101460] [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: 10/30/2023] [Revised: 12/14/2023] [Accepted: 01/10/2024] [Indexed: 01/26/2024]
Abstract
This study evaluated the repositioning of the ketolide antibacterial telithromycin (TLT) against the oomycete Pythium insidiosum and verified the combination of TLT and the antimicrobials azithromycin (AZM) and amorolfine hydrochloride (AMR), which have known anti-P. insidiosum activity. Susceptibility tests of P. insidiosum isolates (n = 20) against the drugs were carried out according to CLSI protocol M38-A2, and their combinations were evaluated using the checkerboard microdilution method. The minimum inhibitory concentrations were 0.5-4 µg/mL for TLT, 2-32 µg/mL for AZM, and 16-64 µg/mL for AMR. For the TLT+AZM combination, 52.75 % of interactions were indifferent, 43.44 % were antagonistic, and 9.70 % were synergistic. As for interactions of the TLT+AMR combination, 60.43 % were indifferent, 39.12 % were antagonistic, and 10.44 % synergistic interactions. This study is the first to evaluate the repositioning of the antibacterial TLT against mammalian pathogenic oomycetes, and our results show that its isolated action is superior to its combinations with either AZM or AMR. Therefore, we recommend including TLT in future research to evaluate therapeutic approaches in different clinical forms of human and animal pythiosis.
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Affiliation(s)
- Lara Baccarin Ianiski
- Departamento de Medicina Veterinária Preventiva, Laboratório de Saúde Única, Programa de Pós-graduação em Ciências Farmacêuticas (PPGCF) e de Medicina Veterinária (PPGMV), Centro de Ciências Rurais, Universidade Federal de Santa Maria (UFSM), Av. Roraima N° 1000, Prédio 44, sala 5132, CEP, Santa Maria, RS 97105-900, Brazil
| | - Aline Fontanella Maciel
- Departamento de Medicina Veterinária Preventiva, Laboratório de Saúde Única, Programa de Pós-graduação em Ciências Farmacêuticas (PPGCF) e de Medicina Veterinária (PPGMV), Centro de Ciências Rurais, Universidade Federal de Santa Maria (UFSM), Av. Roraima N° 1000, Prédio 44, sala 5132, CEP, Santa Maria, RS 97105-900, Brazil
| | - Ana Carolina Nolasco Colla
- Departamento de Medicina Veterinária Preventiva, Laboratório de Saúde Única, Programa de Pós-graduação em Ciências Farmacêuticas (PPGCF) e de Medicina Veterinária (PPGMV), Centro de Ciências Rurais, Universidade Federal de Santa Maria (UFSM), Av. Roraima N° 1000, Prédio 44, sala 5132, CEP, Santa Maria, RS 97105-900, Brazil
| | | | - Luis Antônio Sangioni
- Departamento de Medicina Veterinária Preventiva, Laboratório de Saúde Única, Programa de Pós-graduação em Ciências Farmacêuticas (PPGCF) e de Medicina Veterinária (PPGMV), Centro de Ciências Rurais, Universidade Federal de Santa Maria (UFSM), Av. Roraima N° 1000, Prédio 44, sala 5132, CEP, Santa Maria, RS 97105-900, Brazil
| | - Mahendra Pal
- Narayan Consultancy on Veterinary Public Health and Microbiology, Bharuch, India
| | | | - Janio Morais Santurio
- Departamento de Medicina Veterinária Preventiva, Laboratório de Saúde Única, Programa de Pós-graduação em Ciências Farmacêuticas (PPGCF) e de Medicina Veterinária (PPGMV), Centro de Ciências Rurais, Universidade Federal de Santa Maria (UFSM), Av. Roraima N° 1000, Prédio 44, sala 5132, CEP, Santa Maria, RS 97105-900, Brazil
| | - Sônia de Avila Botton
- Departamento de Medicina Veterinária Preventiva, Laboratório de Saúde Única, Programa de Pós-graduação em Ciências Farmacêuticas (PPGCF) e de Medicina Veterinária (PPGMV), Centro de Ciências Rurais, Universidade Federal de Santa Maria (UFSM), Av. Roraima N° 1000, Prédio 44, sala 5132, CEP, Santa Maria, RS 97105-900, Brazil.
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9
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Braga CQ, Zambrano CG, Dos Santos Bermann C, Milech A, Ianiski LB, Soares MP, Pötter L, de Avila Botton S, Pereira DIB. In vitro and ex vivo anti-Pythium insidiosum potential of ozonated sunflower oil. Braz J Microbiol 2024; 55:867-873. [PMID: 37999913 PMCID: PMC10920596 DOI: 10.1007/s42770-023-01173-1] [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: 03/07/2023] [Accepted: 10/27/2023] [Indexed: 11/25/2023] Open
Abstract
This study sought to evaluate the in vitro and ex vivo susceptibility of Pythium insidiosum to ozonized sunflower oil (OSO) and verify the morphological alterations of OSO-exposed hyphae. Susceptibility assays were performed according to the broth microdilution protocol M38-A2/CLSI, and the minimal inhibitory (MIC) and minimal oomicidal (MOC) concentrations were also determined. Non-ozonated sunflower oil (SO) was used as the oil control. Additionally, kunkers from equine pythiosis were exposed to OSO. Damages caused by OSO and SO on P. insidiosum hyphae ultrastructure were verified using scanning electron microscopy. The MIC range for OSO was 7000 to 437.5 mg/mL, and the values for SO were higher, ranging from 56000 to 14000 mg/mL. The MOC was equal to MIC for both oil formulations. The OSO fully inhibited the oomycete growth from kunkers, although there was P. insidiosum growth in the kunker control in 24 h of incubation. The SEM analyses showed that both OSO and SO caused morphological alterations in P. insidiosum hyphae, highlighting the presence of cavitation along the hyphae with loss of continuity of the cell wall, which was more evident in the OSO-treated hyphae. The OSO had the best oomicidal activity, leading us to believe that our findings may support future research containing this formulation to be applied in integrative medicine protocols to control pythiosis in animals and humans.
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Affiliation(s)
- Caroline Quintana Braga
- Universidade Federal de Pelotas, Instituto de Biologia, Departamento de Microbiologia e Parasitologia, Laboratório de Micologia, Programa de Pós-Graduação em Microbiologia e Parasitologia, Campus Universitário Capão Do Leão, Prédio 18, Sala 14, Pelotas, RS, Brazil
| | - Cristina Gomes Zambrano
- Universidade Federal de Pelotas, Instituto de Biologia, Departamento de Microbiologia e Parasitologia, Laboratório de Micologia, Programa de Pós-Graduação em Microbiologia e Parasitologia, Campus Universitário Capão Do Leão, Prédio 18, Sala 14, Pelotas, RS, Brazil
| | - Carolina Dos Santos Bermann
- Universidade Federal de Pelotas, Instituto de Biologia, Departamento de Microbiologia e Parasitologia, Laboratório de Micologia, Programa de Pós-Graduação em Microbiologia e Parasitologia, Campus Universitário Capão Do Leão, Prédio 18, Sala 14, Pelotas, RS, Brazil
| | - Angelita Milech
- Universidade Federal de Pelotas, Instituto de Biologia, Departamento de Microbiologia e Parasitologia, Laboratório de Micologia, Programa de Pós-Graduação em Microbiologia e Parasitologia, Campus Universitário Capão Do Leão, Prédio 18, Sala 14, Pelotas, RS, Brazil
| | - Lara Baccarin Ianiski
- Universidade Federal de Santa Maria, Centro de Ciências Rurais, Departamento de Medicina Veterinária e Programa de Pós-graduação em Ciências Farmacêuticas (PPGCF), Santa Maria, RS, Brazil
| | - Mauro Pereira Soares
- Universidade Federal de Pelotas, Faculdade de Veterinária, Laboratório Regional de Diagnostico, Pelotas, RS, Brazil
| | - Luciana Pötter
- Universidade Federal de Santa Maria, Centro de Ciências Rurais, Departamento de Zootecnia, Programa de Pós-Graduação em Zootecnia, Santa Maria, RS, Brazil
| | - Sônia de Avila Botton
- Universidade Federal de Santa Maria, Centro de Ciências Rurais, Departamento de Medicina Veterinária e Programa de Pós-graduação em Ciências Farmacêuticas (PPGCF), Santa Maria, RS, Brazil
- Universidade Federal de Santa Maria, Centro de Ciências Rurais, Departamento de Medicina Veterinária Preventiva, Programa de Pós-graduação em Medicina Veterinária (PPGMV), Santa Maria, RS, Brazil
| | - Daniela Isabel Brayer Pereira
- Universidade Federal de Pelotas, Instituto de Biologia, Departamento de Microbiologia e Parasitologia, Laboratório de Micologia, Programa de Pós-Graduação em Microbiologia e Parasitologia, Campus Universitário Capão Do Leão, Prédio 18, Sala 14, Pelotas, RS, Brazil.
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10
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Leksuwankun S, Plongla R, Eamrurksiri N, Torvorapanit P, Phongkhun K, Langsiri N, Meejun T, Srisurapanont K, Thanakitcharu J, Lerttiendamrong B, Thongkam A, Manothummetha K, Chuleerarux N, Moonla C, Worasilchai N, Chindamporn A, Permpalung N, Nematollahi S. Needs assessment of a pythiosis continuing professional development program. PLoS Negl Trop Dis 2024; 18:e0012004. [PMID: 38408109 PMCID: PMC10919846 DOI: 10.1371/journal.pntd.0012004] [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: 12/17/2023] [Revised: 03/07/2024] [Accepted: 02/16/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Pythiosis is a rare disease with high mortality, with over 94% of cases reported from Thailand and India. Prompt diagnosis and surgery improves patient outcomes. Therefore, continuing professional development (CPD) is essential for early recognition. However, a needs assessment related to a pythiosis CPD program has not been performed. OBJECTIVES We conducted a needs assessment to develop a pythiosis CPD program. PATIENTS/METHODS We conducted a survey study with 267 King Chulalongkorn Memorial Hospital residents (141 internal medicine (IM) residents and 126 surgery residents). A 30-item survey consisting of a knowledge assessment, demographic section, and an attitudes portion was distributed both electronically and via paper. The data was analyzed with descriptive and inferential statistics. RESULTS Sixty-seven percent completed the survey (110/141 IM residents, 70/126 surgery residents). The mean score [95% confidence interval] on the knowledge assessment was 41.67% [39.64%-43.69%] across all objectives. The three domains with the highest scores were pythiosis risk factors (67.22% correct), microbiologic characteristics (50.83%), and radiographic interpretation (50.56%). The three domains with the lowest scores were laboratory investigation (15.00%), epidemiology (29.17%), and symptomatology (30.83%). Most participants noted that the program should be online with both synchronous and asynchronous sessions, with a preferred length of 60-90 minutes per session. CONCLUSION The pythiosis CPD program should emphasize education regarding symptomatology, laboratory investigation, and epidemiology, all of which are critical for the early detection of pythiosis to decrease mortality from this devastating disease. Most respondents felt this program was necessary and should be implemented in a virtual blended format.
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Affiliation(s)
- Surachai Leksuwankun
- Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Rongpong Plongla
- Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Nathanich Eamrurksiri
- Department of Surgery, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Pattama Torvorapanit
- Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Thai Red Cross Emerging Infectious Diseases Clinical Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Kasidis Phongkhun
- Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Nattapong Langsiri
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Tanaporn Meejun
- Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Jaedvara Thanakitcharu
- Panyananthaphikkhu Chonprathan Medical Center, Srinakharinwirot University, Nonthaburi, Thailand
| | | | - Achitpol Thongkam
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Kasama Manothummetha
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Nipat Chuleerarux
- Department of Medicine, University of Miami/Jackson Memorial Hospital, Miami, Florida, United States of America
| | - Chatphatai Moonla
- Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Center of Excellence in Translational Hematology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Navaporn Worasilchai
- Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
- Research Unit of Medical Mycology Diagnosis, Chulalongkorn University, Bangkok, Thailand
| | - Ariya Chindamporn
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nitipong Permpalung
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Saman Nematollahi
- Department of Medicine, University of Arizona College of Medicine, Tucson, Arizona, United States of America
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11
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Kittichotirat W, Patumcharoenpol P, Rujirawat T, Tangphatsornruang S, Yurayart C, Krajaejun T. Pins Gene Table v2.0: An Online Genome Database of 37 Pythium insidiosum Strains for Gene Content Exploration and Phylogenomic Analysis. J Fungi (Basel) 2024; 10:112. [PMID: 38392784 PMCID: PMC10889951 DOI: 10.3390/jof10020112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/12/2024] [Accepted: 01/15/2024] [Indexed: 02/24/2024] Open
Abstract
Unlike most pathogenic oomycetes, Pythium insidiosum infects humans and animals instead of plants. P. insidiosum has three clinically relevant genotypes/clades that cause a severe disease called pythiosis. To develop strategies for infection control, it is necessary to understand the biology and pathogenesis of this pathogen. Investigating the evolutionary mechanisms behind the host-specific adaptation is vital, and comparative genomic analysis can help with this. To facilitate genomic analysis, an online bioinformatics tool called P. insidiosum (Pins) Gene Table v2.0 was developed. This tool includes genomic data from 37 genetically diverse P. insidiosum strains and four related species. The database contains 732,686 genes, grouped into 80,061 unique clusters and further divided into core and variable categories at genus, species, and genotype levels. A high-resolution phylogenomic relationship among P. insidiosum strains and other oomycetes was projected through hierarchical clustering and core gene analyses. 3156 P. insidiosum-specific genes were shared among all genotypes and may be responsible for causing disease in humans and animals. After comparing these species-specific genes to the MvirDB database, 112 had significant matches with 66 known virulence proteins, some of which might be involved in vascular occlusion, which is a pathological feature of pythiosis. The correlation of genotypes, geographic origins, and affected hosts of P. insidiosum suggests that clade-I strains are more specific to animals, while clade-II/III strains are more specific to humans. The clade-specific genes might link to host preference. In summary, Pins Gene Table v2.0 is a comprehensive genome database accessible to users with minimal bioinformatics experience for the analysis of P. insidiosum genomes.
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Affiliation(s)
- Weerayuth Kittichotirat
- Bioinformatics and Systems Biology Program, School of Bioresources and Technology and School of Information Technology, King Mongkut's University of Technology Thonburi, Bangkhunthian, Bangkok 10150, Thailand
- Systems Biology and Bioinformatics Research Group, Pilot Plant Development and Training Institute, King Mongkut's University of Technology Thonburi, Bangkhunthin, Bangkok 10150, Thailand
| | - Preecha Patumcharoenpol
- Interdisciplinary Graduate Program in Bioscience, Faculty of Science, Kasetsart University, Bangkok 10900, Thailand
| | - Thidarat Rujirawat
- Research Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 73170, Thailand
| | - Sithichoke Tangphatsornruang
- National Center for Genetic Engineering and Biotechnology, National Science and Technology Development Agency, Pathum Thani 12120, Thailand
| | - Chompoonek Yurayart
- Department of Microbiology and Immunology, Faculty of Veterinary Medicine, Kasetsart University, Bangkok 10900, Thailand
| | - Theerapong Krajaejun
- Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 73170, Thailand
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12
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Barrs VR, Beczkowski PM, Talbot JJ, Hobi S, Teoh SN, Hernandez Muguiro D, Shubitz LF, Sandy J. Invasive Fungal Infections and Oomycoses in Cats: 1. Diagnostic approach. J Feline Med Surg 2024; 26:1098612X231219696. [PMID: 38189288 PMCID: PMC10949879 DOI: 10.1177/1098612x231219696] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
CLINICAL RELEVANCE In contrast to superficial fungal infections, such as dermatophytosis, invasive fungal infections (IFIs) are characterised by penetration of tissues by fungal elements. Disease can spread locally within a region or can disseminate haematogenously or via the lymphatics. The environment is the most common reservoir of infection. Since fungal spores are airborne, indoor cats are also susceptible to IFIs. Some environmental fungi are ubiquitous and present globally, while others are endemic or hyperendemic within specific geographic regions. Zoonotic pathogens include Microsporum canis, Sporothrix schenckii and Sporothrix brasiliensis. AIM In the first of a two-part article series, the approach to the investigation of feline IFIs and oomycoses is reviewed. As well as tips for diagnosis, and information on the ecological niche and distribution of fungal pathogens, the review covers clinical presentation of the most common IFIs, including cryptococcosis, histoplasmosis, blastomycosis, coccidioidomycosis, sporotrichosis, phaeohyphomycosis, aspergillosis and dermatophytic pseudomycetoma, as well as the oomycoses pythiosis, lagenidiosis and paralagenidiosis. In Part 2, the spectrum of activity, mechanisms of action, pharmacokinetic and pharmacodynamic properties and adverse effects of antifungal drugs are reviewed, and the treatment and prognosis for specific IFIs and oomycoses are discussed. EVIDENCE BASE The review draws on published evidence and the authors' combined expertise in feline medicine, mycology, dermatology, clinical pathology and anatomical pathology.
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Affiliation(s)
- Vanessa R Barrs
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong, SAR China
- Centre for Animal Health and Welfare, City University of Hong Kong, Kowloon Tong, Hong Kong, SAR China
| | - Paweł M Beczkowski
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong, SAR China
| | | | - Stefan Hobi
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong, SAR China
| | - Shu Ning Teoh
- Veterinary Specialists Aotearoa, Henderson, Auckland, New Zealand
| | | | - Lisa F Shubitz
- Valley Fever Center for Excellence, The University of Arizona, AZ, USA
| | - Jeanine Sandy
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong, SAR China
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13
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Zhang S, Huang A, Lv X, Zhang J, Zhang M, Chen Y, Yang L, Wang H, Guo D, Luo X, Ren M, Dong P. Anti-Oomycete Effect and Mechanism of Salicylic Acid on Phytophthora infestans. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2023; 71:20613-20624. [PMID: 38100671 DOI: 10.1021/acs.jafc.3c05748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
Pathogenic oomycetes infect a wide variety of organisms, including plants, animals, and humans, and cause massive economic losses in global agriculture, aquaculture, and human health. Salicylic acid (SA), an endogenous phytohormone, is regarded as an inducer of plant immunity. Here, the potato late blight pathogen Phytophthora infestans was used as a model system to uncover the inhibitory mechanisms of SA on pathogenic oomycetes. In this research, SA significantly inhibited the mycelial growth, sporulation, sporangium germination, and virulence of P. infestans. Inhibition was closely related to enhanced autophagy, suppression of translation initiation, and ribosomal biogenesis in P. infestans, as shown by multiomics analysis (transcriptomics, proteomics, and phosphorylated proteomics). Monodansylcadaverine (MDC) staining and Western blotting analysis showed that SA promoted autophagy in P. infestans by probably targeting the TOR signaling pathway. These observations suggest that SA has the potential to control late blight caused by P. infestans.
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Affiliation(s)
- Shumin Zhang
- School of Life Sciences, Chongqing University, Chongqing 401331, China
- Institute of Basic Medicine and Forensic Medicine, North Sichuan Medical College, Nanchong 637000, Sichuan, China
| | - Airong Huang
- School of Life Sciences, Chongqing University, Chongqing 401331, China
| | - Xiulan Lv
- School of Life Sciences, Chongqing University, Chongqing 401331, China
| | - Jiaomei Zhang
- School of Life Sciences, Chongqing University, Chongqing 401331, China
| | - Meiquan Zhang
- School of Life Sciences, Chongqing University, Chongqing 401331, China
| | - Yang Chen
- Research Center for Atmospheric Environment, Chongqing Institute of Green and Intelligent Technology, Chinese Academy of Sciences, Chongqing 400714, China
| | - Liting Yang
- School of Life Sciences, Chongqing University, Chongqing 401331, China
| | - Hanyan Wang
- Institute of Basic Medicine and Forensic Medicine, North Sichuan Medical College, Nanchong 637000, Sichuan, China
| | - Dongmei Guo
- Institute of Basic Medicine and Forensic Medicine, North Sichuan Medical College, Nanchong 637000, Sichuan, China
| | - Xiumei Luo
- School of Life Sciences, Chongqing University, Chongqing 401331, China
- Institute of Urban Agriculture, Chinese Academy of Agricultural Sciences, Chengdu 610213, China
| | - Maozhi Ren
- School of Life Sciences, Chongqing University, Chongqing 401331, China
- Institute of Urban Agriculture, Chinese Academy of Agricultural Sciences, Chengdu 610213, China
- Zhengzhou Research Base State Key Laboratory of Cotton Biology, Zhengzhou University, Zhengzhou 450000, China
- State Key Laboratory of Dao-di Herbs, Beijng 100700, China
| | - Pan Dong
- School of Life Sciences, Chongqing University, Chongqing 401331, China
- Chongqing Key Laboratory of Biology and Genetic Breeding for Tuber and Root Crops, Chongqing 400716, China
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14
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Krajaejun T, Patumcharoenpol P, Rujirawat T, Kittichotirat W, Tangphatsornruang S. MGI short-read genome assemblies of Pythium insidiosum (reclassified as Pythium periculosum) strains Pi057C3 and Pi050C3. BMC Res Notes 2023; 16:316. [PMID: 37932861 PMCID: PMC10629006 DOI: 10.1186/s13104-023-06587-6] [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: 11/28/2022] [Accepted: 10/23/2023] [Indexed: 11/08/2023] Open
Abstract
OBJECTIVES Pythium insidiosum causes a difficult-to-treat infectious condition called pythiosis, with high morbidity and mortality. So far, genome data of at least 10 strains of P. insidiosum, primarily classified in the phylogenetic clades I and II, have been sequenced using various next-generation sequencing platforms. The MGI short-read platform was employed to obtain genome data of 2 clade-III strains of P. insidiosum (recently reclassified as Pythium periculosum) from patients in Thailand and the United States. This work is a part of our attempt to generate a comprehensive genome database from diverse pathogen strains. DATA DESCRIPTION A 150-bp paired-end library was prepared from a gDNA sample of P. insidiosum (P. periculosum) strains Pi057C3 and Pi050C3 (also known as ATCC90586) to generate draft genome sequences using an MGISEQ-2000RS sequencer. As a result, for the strain Pi057C3, we obtained a 42.5-Mb assembled genome (164x coverage) comprising 14,134 contigs, L50 of 241, N50 of 45,748, 57.6% CG content, and 12,147 ORFs. For the strain Pi050C3, we received a 43.3-Mb draft genome (230x coverage) containing 14,511 contigs, L50 of 245, N50 of 45,208, 57.7% CG content, and 12,249 ORFs. The genome sequences have been deposited in the NCBI/DDBJ databases under the accession numbers JAKCXM000000000.1 (strain Pi057C3) and JAKCXL000000000.1 (strain Pi050C3).
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Affiliation(s)
- Theerapong Krajaejun
- Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
| | - Preecha Patumcharoenpol
- Interdisciplinary Graduate Program in Bioscience, Faculty of Science, Kasetsart University, Bangkok, Thailand
| | - Thidarat Rujirawat
- Research Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Weerayuth Kittichotirat
- Systems Biology and Bioinformatics Research Group, Pilot Plant Development and Training Institute, King Mongkut's University of Technology Thonburi, Bangkhuntien, Bangkok, Thailand
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15
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Veldhuis Kroeze EJB, van Elk CE, van de Bildt MWG, van Run PRWA, Foster G, Abou-Chakra N, Hare RK, Kuiken T. Infection with Pythium flevoense in a harbour porpoise (Phocoena phocoena) as a novel cause of dermatitis in marine mammals. Vet Res 2023; 54:102. [PMID: 37919808 PMCID: PMC10623814 DOI: 10.1186/s13567-023-01226-1] [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: 07/09/2023] [Accepted: 10/02/2023] [Indexed: 11/04/2023] Open
Abstract
The oomycete Pythium flevoense was diagnosed as the cause of dermatitis in a young adult female harbour porpoise (Phocoena phocoena) that had been trapped in a pound net in a temperate saltwater environment. Disease from Pythium sp. infection-pythiosis-is infrequently diagnosed in humans, horses, dogs, cattle, and few other mammalian species. Pythiosis is typically associated with exposure to tropical or subtropical freshwater conditions, and typically caused by Pythium insidiosum. However, until now, pythiosis has been reported in neither marine mammals nor temperate saltwater conditions, and P. flevoense is not known as a cause of pythiosis in mammals. This porpoise developed generalised dermatitis despite treatment and euthanasia was necessary. Histopathological evaluation revealed a chronic active erosive dermatitis, with intralesional hyphae morphologically consistent with a Pythium sp. PCR analysis and sequencing of affected skin matched Pythium flevoense with a 100% similarity to the reference strain. Additional diagnostics excluded other pathogens. Based on this case report, P. flevoense needs to be considered as a mammalian pathogen. Furthermore, harbour porpoises and possibly other marine mammals may be at risk of infection with P. flevoense, and pythiosis should be included in the differential diagnosis of dermatitis in marine mammals.
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Affiliation(s)
| | - Cornelis E van Elk
- Department of Viroscience, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Marco W G van de Bildt
- Department of Viroscience, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Peter R W A van Run
- Department of Viroscience, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | | | - Nissrine Abou-Chakra
- Unit for Mycology, Department of Bacteria Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Rasmus Krøger Hare
- Unit for Mycology, Department of Bacteria Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Thijs Kuiken
- Department of Viroscience, Erasmus University Medical Centre, Rotterdam, The Netherlands.
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16
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Sae-Chew P, Rujirawat T, Lohnoo T, Yingyong W, Kumsang Y, Payattikul P, Yurayart N, Yurayart C, Krajaejun T. Generation of protoplasts provides a powerful experimental research tool for biological and pathogenicity studies of Pythium insidiosum. J Mycol Med 2023; 33:101430. [PMID: 37678114 DOI: 10.1016/j.mycmed.2023.101430] [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: 11/03/2022] [Revised: 08/27/2023] [Accepted: 08/28/2023] [Indexed: 09/09/2023]
Abstract
INTRODUCTION Pythiosis is a high-mortality infectious condition in humans and animals. The etiologic agent is Pythium insidiosum. Patients present with an ocular, vascular, cutaneous/subcutaneous, or gastrointestinal infection. Antifungal medication often fails to fight against P. insidiosum. The effective treatment is limited to radical surgery, resulting in organ loss. Fatal outcomes are observed in advanced cases. Pythiosis needs to be studied to discover novel methods for disease control. Genome data of P. insidiosum is publicly available. However, information on P. insidiosum biology and pathogenicity is still limited due to the lack of a cost-effective animal model and molecular tools. MATERIALS AND METHODS We aimed to develop a high-efficiency protocol for generating P. insidiosum protoplast, and used it to set up an animal model, in vitro drug susceptibility assay, and DNA transformation for this pathogen. RESULTS P. insidiosum protoplast was successfully generated to establish a feasible pythiosis model in embryonic chicken eggs and an efficient in vitro drug susceptibility assay. DNA transformation is a critical method for gene manipulation necessary for functional genetic studies in pathogens. Attempts to establish a DNA transformation method for P. insidiosum using protoplast were partly successful. Significant work needs to be done for genetically engineering a more robust selection marker to generate stable transformants at increased efficiency. CONCLUSION This study is the first to report an efficient P. insidiosum protoplast production for clinical and research applications. Such advances are crucial to speeding up the pathogen's biology and pathogenicity exploration.
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Affiliation(s)
- Pattarana Sae-Chew
- Research Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Thidarat Rujirawat
- Research Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Tassanee Lohnoo
- Research Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Wanta Yingyong
- Research Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Yothin Kumsang
- Research Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Penpan Payattikul
- Research Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Nichapat Yurayart
- Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chompoonek Yurayart
- Department of Microbiology and Immunology, Faculty of Veterinary Medicine, Kasetsart University, Bangkok, Thailand
| | - Theerapong Krajaejun
- Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
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17
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Bowman J, Gull T, Ulmanis EG, Ogunbadewa AJ, Shen Z, Johnson GJ, Odemuyiwa SO. Metagenomic identification of a novel oomycete cultured from a pyogranulomatous mass on the tail of a domestic cat. J Vet Diagn Invest 2023; 35:507-513. [PMID: 37317863 PMCID: PMC10467462 DOI: 10.1177/10406387231180310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
We report here a transiently culturable oomycete pathogen isolated from a pyogranulomatous tail mass in a cat. The organism was morphologically and genetically distinct from Lagenidium and Pythium species. Following next-generation sequencing (NGS) and assembly of contigs, initial phylogenetic analysis using fragments of the cox1 mitochondrial gene identified this specimen as Paralagenidium sp. after nucleotide alignments with sequences obtained from the Barcode of Life Data System (BOLD). However, further analysis of a concatenation of 13 different mitochondrial genes showed that this organism is unique and different from all known oomycetes. A negative PCR result using primers targeting known oomycete pathogens may not be enough to rule out oomycosis in a suspected case. Additionally, the use of a single gene to classify oomycetes may produce misleading results. The advent of metagenomic sequencing and NGS provides a unique opportunity to further explore the diversity of oomycetes as plant and animal pathogens beyond the current capabilities of global barcoding projects that are based on partial genomic sequences.
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Affiliation(s)
- Jesse Bowman
- Veterinary Medical Diagnostic Laboratory, University of Missouri–Columbia, Columbia, MO, USA
| | - Tamara Gull
- Veterinary Medical Diagnostic Laboratory, University of Missouri–Columbia, Columbia, MO, USA
| | | | - Anthony J. Ogunbadewa
- Veterinary Medical Diagnostic Laboratory, University of Missouri–Columbia, Columbia, MO, USA
| | - Zhenyu Shen
- Veterinary Medical Diagnostic Laboratory, University of Missouri–Columbia, Columbia, MO, USA
| | - Gayle J. Johnson
- Veterinary Medical Diagnostic Laboratory, University of Missouri–Columbia, Columbia, MO, USA
| | - Solomon O. Odemuyiwa
- Veterinary Medical Diagnostic Laboratory, University of Missouri–Columbia, Columbia, MO, USA
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18
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Peano A, Min ARM, Fondati A, Romano E, Brachelente C, Porcellato I, Amore A, Pasquetti M. Cutaneous Pythiosis in 2 Dogs, Italy. Emerg Infect Dis 2023; 29:1447-1450. [PMID: 37347828 PMCID: PMC10310393 DOI: 10.3201/eid2907.230320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023] Open
Abstract
We report cutaneous pythiosis in 2 dogs in Italy that had recurrent exposure to the same freshwater habitat. Phylogenetic analysis placed the isolates within Pythium insidiosum complex cluster IV, corresponding to P. periculosum. In Italy, pythiosis should be considered in differential diagnoses by human and veterinary health professionals.
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Billings P, Walton S, Shmalberg J, Santoro D. The Use of Mefenoxam to Treat Cutaneous and Gastrointestinal Pythiosis in Dogs: A Retrospective Study. Microorganisms 2023; 11:1726. [PMID: 37512898 PMCID: PMC10385059 DOI: 10.3390/microorganisms11071726] [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: 04/30/2023] [Revised: 05/24/2023] [Accepted: 05/28/2023] [Indexed: 07/30/2023] Open
Abstract
Pythium insidiosum, an aquatic oomycete with pathogenic potential in mammals, causes gastrointestinal and cutaneous disease in dogs. Mefenoxam, an agricultural anti-oomycotic compound, has a demonstrated the ability to inhibit P. insidiosum growth in vitro and has been associated with efficacy in treating gastrointestinal pythiosis in several case reports. Electronic medical records of dogs seen at University of Florida Small Animal Hospital and treated with mefenoxam between 2013 and 2020 were searched. Dogs were included in this study upon previous definitive diagnosis with either organism identification using culture, PCR, or antibody ELISA, or a combination of these tests with or without supportive histopathological analysis. Since 2013, mefenoxam had been administered to 25 dogs with cutaneous pythiosis and 16 dogs with gastrointestinal pythiosis. In both gastrointestinal and cutaneous pythiosis groups, the administration of mefenoxam was associated with a survivability rate of approximately 51%. There was a statistically significant difference in the time to death between cutaneous (245 days (52-530)) and gastrointestinal (90 days (21-203)) groups; dogs infected with cutaneous pythiosis survived significantly longer after being diagnosed with the disease (p = 0.035). The dogs in this study experienced increased survival rates and time to death, in the absence of side effects due to mefenoxam, compared with previously published literature. The results of this retrospective study, with some limitations, are promising and should prompt further investigation into the use of mefenoxam in the treatment of both gastrointestinal and cutaneous pythiosis.
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Affiliation(s)
- Phillip Billings
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 SW 16th Avenue, Gainesville, FL 32610, USA
| | - Stuart Walton
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 SW 16th Avenue, Gainesville, FL 32610, USA
| | - Justin Shmalberg
- Department of Comparative, Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Domenico Santoro
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 SW 16th Avenue, Gainesville, FL 32610, USA
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20
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Gurnani B, Kaur K. Predicting Prognosis Based on Regional Prevalence, Ulcer Morphology and Treatment Strategy in Vision-Threatening Pythium insidiosum Keratitis. Clin Ophthalmol 2023; 17:1307-1314. [PMID: 37181081 PMCID: PMC10167989 DOI: 10.2147/opth.s412274] [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: 03/13/2023] [Accepted: 04/24/2023] [Indexed: 05/16/2023] Open
Abstract
Pythium insidiosum is an oomycete belonging to the phylum Straminipila and family Pythiaceae. It causes rapidly progressive vision-threatening keratitis. Clinically, microbiologically and morphologically, it closely resembles fungal keratitis; hence it is also labelled as a "parafungus". The clinical features mimicking fungus are subepithelial and stromal infiltrate, endo-exudates, corneal melt and hypopyon. The hallmark features of Pythium are tentacular projections, reticular dot-like infiltrate, peripheral furrowing and thinning, and rapid limbal spread. Microbiological corneal smearing on KOH and Gram stain reveal septate or aseptate, obtuse to perpendicular hyphae which mimic fungal hyphae. Culture on any nutritional agar reveals cream, cottonwool-like, fluffy colonies, and diagnosis is confirmed by zoospore formation by the leaf incarnation method. Medical management with antifungals and antibacterials still presents a dilemma. Early therapeutic keratoplasty has been the proposed treatment in most cases. We hypothesize that the prognosis of Pythium keratitis is governed by regional geographical variations, ulcer size and density on presentation, and initial treatment strategy. The available literature supporting the proposed hypothesis is also discussed, along with the hallmark features of Pythium and how it masquerades as other microorganisms causing keratitis. We also aim to propose a novel diagnostic and treatment algorithm for managing this vision-threatening keratitis.
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Affiliation(s)
- Bharat Gurnani
- Department of Cornea and Refractive Surgery, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, 485334, India
| | - Kirandeep Kaur
- Department of Pediatric Ophthalmology, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, 485334, India
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21
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White PL. Developments in Fungal Serology. CURRENT FUNGAL INFECTION REPORTS 2023; 17:1-12. [PMID: 37360856 PMCID: PMC10099008 DOI: 10.1007/s12281-023-00462-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2023] [Indexed: 06/28/2023]
Abstract
Purpose of Review The true incidence of fungal disease is hampered by conventionally poor diagnostic tests, limited access to advanced diagnostics, and limited surveillance. The availability of serological testing has been available for over two decades and generally underpins the modern diagnosis of the most common forms of fungal disease. This review will focus on technical developments of serological tests for the diagnosis of fungal disease, describing advances in clinical performance when available. Recent Findings Despite their longevity, technical, clinical, and performance limitations remain, and tests specific for fungal pathogens outside the main pathogens are lacking. The availability of LFA and automated systems, capable of running multiple different tests, represents significant developments, but clinical performance data is variable and limited. Summary Fungal serology has significantly advanced the diagnosis of the main fungal infections, with LFA availability increasing accessibility to testing. Combination testing has the potential to overcome performance limitations.
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Affiliation(s)
- P. Lewis White
- Public Health Wales Mycology Reference Laboratory and Cardiff University Centre for Trials Research/Division of Infection and Immunity, UHW, Heath Park, Cardiff, CF14 4XW UK
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22
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Braga CQ, Milech A, dos Santos Bermann C, Ianiski LB, Stibbe PC, de Lemos AB, Bonel J, de Avila Botton S, Pereira DIB. Exposure of Culex quinquefasciatus to the oomycete Pythium insidiosum: A protocol for in vitro studies. Fungal Biol 2023; 127:969-974. [PMID: 37024156 DOI: 10.1016/j.funbio.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 02/06/2023] [Accepted: 03/09/2023] [Indexed: 03/12/2023]
Abstract
Pythium insidiosum causes pythiosis, an infection that affects different species of mammals, including humans, and inhabits marshy ecosystems of tropical, subtropical, and temperate regions worldwide. Therefore, this study proposes a protocol to expose Culex quinquefasciatus to P. insidiosum zoospores. Cx. quinquefasciatus immatures (eggs, larvae, and pupae) were exposed to zoospores (8x103 zoospores/mL) of the oomycete for 24 h. The exposure of Cx. quinquefasciatus to the zoospores from L1 to the emergence of adults was evaluated, and P. insidiosum detection was performed by microbiological culture, polymerase chain reaction, and histopathological analysis of stage 4 larvae. The protocol used to produce Cx. quinquefasciatus colonies and adapted for this study proved viable for research on the interaction between P. insidiosum and this Culicidae species. Moreover, P. insidiosum presence was evident in all larval stages of the mosquito, although the presence of the oomycete was not detected in the eggs, pupae, and adults. This study is a pioneer in the development of a protocol to evaluate Cx. quinquefasciatus exposure to P. insidiosum zoospores, and under experimental conditions, P. insidiosum can establish itself in Cx. quinquefasciatus larval stages. The developed protocol is expected to serve as a basis for developing studies to evaluate the interactions of P. insidiosum with these mosquitoes and shed more light on the participation of culicids in expanding the ecological niche of P. insidiosum.
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Kittichotirat W, Rujirawat T, Patumcharoenpol P, Krajaejun T. Comparative Genomic Analysis Reveals Gene Content Diversity, Phylogenomic Contour, Putative Virulence Determinants, and Potential Diagnostic Markers within Pythium insidiosum Traits. J Fungi (Basel) 2023; 9:jof9020169. [PMID: 36836284 PMCID: PMC9962146 DOI: 10.3390/jof9020169] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/11/2023] [Accepted: 01/17/2023] [Indexed: 01/31/2023] Open
Abstract
Pythium insidiosum has successfully evolved into a human/animal filamentous pathogen, causing pythiosis, a life-threatening disease, worldwide. The specific rDNA-based genotype of P. insidiosum (clade I, II, or III) is associated with the different hosts and disease prevalence. Genome evolution of P. insidiosum can be driven by point mutations, pass vertically to the offspring, and diverge into distinct lineages, leading to different virulence, including the ability to be unrecognized by the host. We conducted comprehensive genomic comparisons of 10 P. insidiosum strains and 5 related Pythium species using our online "Gene Table" software to investigate the pathogen's evolutionary history and pathogenicity. In total, 245,378 genes were found in all 15 genomes and grouped into 45,801 homologous gene clusters. Gene contents among P. insidiosum strains varied by as much as 23%. Our results showed a strong agreement between the phylogenetic analysis of 166 core genes (88,017 bp) identified across all genomes and the hierarchical clustering analysis of gene presence/absence profiles, suggesting divergence of P. insidiosum into two groups, clade I/II and clade III strains, and the subsequent segregation of clade I and clade II. A stringent gene content comparison using the Pythium Gene Table provided 3263 core genes exclusively presented in all P. insidiosum strains but no other Pythium species, which could involve host-specific pathogenesis and serve as biomarkers for diagnostic purposes. More studies focusing on characterizing the biological function of the core genes (including the just-identified putative virulence genes encoding hemagglutinin/adhesin and reticulocyte-binding protein) are needed to explore the biology and pathogenicity of this pathogen.
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Affiliation(s)
- Weerayuth Kittichotirat
- Bioinformatics and Systems Biology Program, School of Bioresources and Technology and School of Information Technology, King Mongkut’s University of Technology Thonburi, Bangkhuntien, Bangkok 10150, Thailand
- Systems Biology and Bioinformatics Research Group, Pilot Plant Development and Training Institute, King Mongkut’s University of Technology Thonburi, Bangkhuntien, Bangkok 10150, Thailand
| | - Thidarat Rujirawat
- Research Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | - Preecha Patumcharoenpol
- Interdisciplinary Graduate Program in Bioscience, Faculty of Science, Kasetsart University, Bangkok 10900, Thailand
| | - Theerapong Krajaejun
- Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Bangkok 10400, Thailand
- Correspondence: ; Tel.: +(662)-201-1452
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Neutrophil extracellular traps and phagocytosis in Pythium insidiosum. PLoS One 2023; 18:e0280565. [PMID: 36693041 PMCID: PMC9873155 DOI: 10.1371/journal.pone.0280565] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 01/02/2023] [Indexed: 01/25/2023] Open
Abstract
Neutrophils are innate immune cells that play crucial roles in response to extracellular pathogens, including bacteria and fungi. Pythium insidiosum (P insidiosum) is a fungus-like pathogen that causes "pythiosis" in mammals. This study investigated in vitro function of human neutrophils against P. insidiosum. We demonstrated the killing mechanism of neutrophils when incubated with P. insidiosum zoospores (infective stage), such as phagocytosis and neutrophil extracellular traps (NETs). Healthy human neutrophils significantly reduced six strains of live zoospores isolated from different sources compared to the condition without neutrophils (p < 0.001), observed by colony count and trypan blue staining. As our results showed the killing ability of neutrophils, we further investigated the neutrophil killing mechanism when incubating with zoospores. Our study found that only two strains of heat-killed zoospores significantly induced phagocytosis (p < 0.01). Co-culture of heat-killed zoospores and neutrophils demonstrated NET formation, which was detected by immunofluorescence staining using DAPI, anti-myeloperoxidase, and anti-neutrophil elastase and quantitated under the fluorescence microscope. In addition, the level of cell-free DNA released from neutrophils (as a marker of NET production) after incubation with zoospores showed significantly increased levels when compared with unstimulated neutrophils (p < 0.001). Our findings demonstrate that neutrophils revealed the NET formation in response to P. insidiosum zoospores. This study is the first observation of the neutrophil mechanism against P. insidiosum, which could provide a better understanding of some parts of the innate immune response during pythiosis.
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25
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Nucleic Acid-Based Detection of Pythium insidiosum: A Systematic Review. J Fungi (Basel) 2022; 9:jof9010027. [PMID: 36675848 PMCID: PMC9863793 DOI: 10.3390/jof9010027] [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] [Received: 11/07/2022] [Revised: 12/10/2022] [Accepted: 12/15/2022] [Indexed: 12/28/2022] Open
Abstract
Pythiosis, a life-threatening infectious condition caused by Pythium insidiosum, has been increasingly reported in humans and animals worldwide. Antifungal drugs usually fail to control the pathogen. The surgical removal of an infected organ is the treatment of choice. Many affected patients die due to advanced infection. A timely and accurate diagnosis could lead to a better prognosis in pythiosis patients and save their lives. Although a standard culture method is available in microbiological laboratories, it is time-consuming, laborious, and insensitive for P. insidiosum identification. Immunological assays have been developed to improve the diagnosis of pythiosis. However, immunological methods are commercially unavailable and primarily detect anti-P. insidiosum antibodies, which constitute indirect evidence of pythiosis, making it challenging to differentiate a past from a recent infection. Moreover, such immunological tests cannot diagnose patients with a local infection, such as in the eye. Nucleic acid-based tests (NATs) are efficient for the direct and rapid detection of P. insidiosum DNA in trace-amount or culture-negative specimens. The reagents and equipment required for NATs are usually available in molecular diagnostic laboratories. Herein, we provide a systematic review to comprehensively present the principal and clinical usages, advantages, and limitations of such NATs in the detection of P. insidiosum. Various NATs have been established to detect P. insidiosum, which can be classified into amplification-based (i.e., PCR assays, isothermal tests, and next-generation sequencing methods) and non-amplification-based (i.e., DNA hybridization) techniques. This concise review on NATs constitutes an up-to-date reference with which healthcare professionals can learn about and decide upon which detection method is suitable for their respective laboratory environments.
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26
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Sukanan P, Suparp B, Yongsiri S, Chansiripornchai P, Kesdangsakonwut S. Successful management of colonic pythiosis in two dogs in Thailand using antifungal therapy. Vet Med Sci 2022; 8:2283-2291. [PMID: 36173734 PMCID: PMC9677377 DOI: 10.1002/vms3.955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2023] Open
Abstract
Gastrointestinal pythiosis is a severe, progressive and often a fatal disease, which is caused by the aquatic pathogen Pythium insidiosum. Treatment is challenging due to the disease's resistance to antifungal drugs. Surgical resection is frequently attempted in cases of pythiosis; however, it can be technically challenging. This report presents two dogs with decreased appetite, abdominal pain, progressive haematochezia, tenesmus and significant weight loss. With the medical histories of both being young canines, living in areas with access to natural water resources and with the main chronic gastrointestinal symptoms having not responded to symptomatic treatment, pythiosis was taken into consideration. Abdominal ultrasound revealed severe, diffuse thickening and loss of normal layering of the colonic wall. These findings led to a differential diagnosis between intestinal neoplasia and fungal disease. Full-thickness biopsies were later performed, and immunohistochemistry staining was suggested for colonic pythiosis. Medical treatment for pythiosis was successful with a combination of oral terbinafine and prednisolone. However, therapy with itraconazole in case 1 did not improve the clinical signs, and in case 2, itraconazole was used after all clinical signs have improved for clinical control. Since then, there has been no recurrence of clinical signs until the time of preparing this report (19 months for case 1, 11 months for case 2 since the cessation of treatment). The treatment was successful based on clinical signs and ultrasonographic data, and the disease remission was not confirmed by advance imaging, monitoring of pythiosis enzyme-linked immunosorbent essay concentration or repeat sampling.
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Affiliation(s)
| | | | | | - Piyarat Chansiripornchai
- Department of Veterinary Pharmacology, Faculty of Veterinary ScienceChulalongkorn UniversityBangkokThailand
| | - Sawang Kesdangsakonwut
- Department of Pathology, Faculty of Veterinary ScienceChulalongkorn UniversityBangkokThailand
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27
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Yolanda H, Lohnoo T, Rujirawat T, Yingyong W, Kumsang Y, Sae-Chew P, Payattikul P, Krajaejun T. Selection of an Appropriate In Vitro Susceptibility Test for Assessing Anti- Pythium insidiosum Activity of Potassium Iodide, Triamcinolone Acetonide, Dimethyl Sulfoxide, and Ethanol. J Fungi (Basel) 2022; 8:1116. [PMID: 36354883 PMCID: PMC9692648 DOI: 10.3390/jof8111116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 02/12/2024] Open
Abstract
The orphan but highly virulent pathogen Pythium insidiosum causes pythiosis in humans and animals. Surgery is a primary treatment aiming to cure but trading off losing affected organs. Antimicrobial drugs show limited efficacy in treating pythiosis. Alternative drugs effective against the pathogen are needed. In-house drug susceptibility tests (i.e., broth dilution, disc diffusion, and radial growth assays) have been established, some of which adapted the standard protocols (i.e., CLSI M38-A2 and CLSI M51) designed for fungi. Hyphal plug, hyphal suspension, and zoospore are inocula commonly used in the drug susceptibility assessment for P. insidiosum. A side-by-side comparison demonstrated that each method had advantages and limitations. Minimum inhibitory and cidal concentrations of a drug varied depending on the selected method. Material availability, user experience, and organism and drug quantities determined which susceptibility assay should be used. We employed the hyphal plug and a combination of broth dilution and radial growth methods to screen and validate the anti-P. insidiosum activities of several previously reported chemicals, including potassium iodide, triamcinolone acetonide, dimethyl sulfoxide, and ethanol, in which data on their anti-P. insidiosum efficacy are limited. We tested each chemical against 29 genetically diverse isolates of P. insidiosum. These chemicals possessed direct antimicrobial effects on the growth of the pathogen in a dose- and time-dependent manner, suggesting their potential application in pythiosis treatment. Future attempts should focus on standardizing these drug susceptibility methods, such as determining susceptibility/resistant breakpoints, so healthcare workers can confidently interpret a result and select an effective drug against P. insidiosum.
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Affiliation(s)
- Hanna Yolanda
- Program in Translational Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
- Department of Parasitology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta 14440, Indonesia
| | - Tassanee Lohnoo
- Research Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | - Thidarat Rujirawat
- Research Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | - Wanta Yingyong
- Research Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | - Yothin Kumsang
- Research Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | - Pattarana Sae-Chew
- Research Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | - Penpan Payattikul
- Research Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | - Theerapong Krajaejun
- Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
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28
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Gurnani B, Kaur K, Agarwal S, Lalgudi VG, Shekhawat NS, Venugopal A, Tripathy K, Srinivasan B, Iyer G, Gubert J. Pythium insidiosum Keratitis: Past, Present, and Future. Ophthalmol Ther 2022; 11:1629-1653. [PMID: 35788551 PMCID: PMC9255487 DOI: 10.1007/s40123-022-00542-7] [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: 04/28/2022] [Accepted: 06/15/2022] [Indexed: 11/30/2022] Open
Abstract
Pythium insidiosum (PI) is an oomycete, a protist belonging to the clade Stramenopila. PI causes vision-threatening keratitis closely mimicking fungal keratitis (FK), hence it is also labeled as "parafungus". PI keratitis was initially confined to Thailand, USA, China, and Australia, but with growing clinical awareness and improvement in diagnostic modalities, the last decade saw a massive upsurge in numbers with the majority of reports coming from India. In the early 1990s, pythiosis was classified as vascular, cutaneous, gastrointestinal, systemic, and ocular. Clinically, morphologically, and microbiologically, PI keratitis closely resembles severe FK and requires a high index of clinical suspicion for diagnosis. The clinical features such as reticular dot infiltrate, tentacular projections, peripheral thinning with guttering, and rapid limbal spread distinguish it from other microorganisms. Routine smearing with Gram and KOH stain reveals perpendicular septate/aseptate hyphae, which closely mimic fungi and make the diagnosis cumbersome. The definitive diagnosis is the presence of dull grey/brown refractile colonies along with zoospore formation upon culture by leaf induction method. However, culture is time-consuming, and currently polymerase chain reaction (PCR) method is the gold standard. The value of other diagnostic modalities such as confocal microscopy and immunohistopathological assays is limited due to cost, non-availability, and limited diagnostic accuracy. PI keratitis is a relatively rare disease without established treatment protocols. Because of its resemblance to fungus, it was earlier treated with antifungals but with an improved understanding of its cell wall structure and absence of ergosterol, this is no longer recommended. Currently, antibacterials have shown promising results. Therapeutic keratoplasty with good margin (1 mm) is mandated for non-resolving cases and corneal perforation. In this review, we have deliberated on the evolution of PI keratitis, covered all the recently available literature, described our current understanding of the diagnosis and treatment, and the potential future diagnostic and management options for PI keratitis.
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Affiliation(s)
- Bharat Gurnani
- Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Pondicherry, 605007, India.
| | - Kirandeep Kaur
- Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Pondicherry, 605007 India
| | - Shweta Agarwal
- Dr G Sitalakshmi Memorial Clinic for Ocular Surface Disorders, CJ Shah Cornea Services, Medical Research Foundation, Sankara Nethralaya, 18 College Road, Chennai, Tamil Nadu 600006 India
| | | | - Nakul S. Shekhawat
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Anitha Venugopal
- Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Tirunelveli, Tamil Nadu India
| | | | - Bhaskar Srinivasan
- Dr G Sitalakshmi Memorial Clinic for Ocular Surface Disorders, CJ Shah Cornea Services, Medical Research Foundation, Sankara Nethralaya, 18 College Road, Chennai, Tamil Nadu 600006 India
| | - Geetha Iyer
- Dr G Sitalakshmi Memorial Clinic for Ocular Surface Disorders, CJ Shah Cornea Services, Medical Research Foundation, Sankara Nethralaya, 18 College Road, Chennai, Tamil Nadu 600006 India
| | - Joseph Gubert
- Department of Microbiology, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Pondicherry, 605007 India
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29
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Zhang H, Zhou F, Huang J, Liu X, Xu H, Liang J, Wang J, Chen J, Liu L, Li Y, Hu X, Chen X, Liu C, Zhang K. Severe skin and subcutaneous pythiosis in China: Metagenomic identification and characterization of Pythium insidiosum. Front Microbiol 2022; 13:1002460. [PMID: 36246283 PMCID: PMC9561815 DOI: 10.3389/fmicb.2022.1002460] [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: 07/25/2022] [Accepted: 09/06/2022] [Indexed: 11/13/2022] Open
Abstract
Pythium insidiosum is a rare fungus-like pathogen that is known to cause pythiosis in mammals with high morbidity and mortality. Identification of the pathogen is essential for timely treatment and rational use of antibiotics. However, Pythium insidiosum is difficult to detect via conventional microbiological tests. The current gold standard is polymerase chain reaction, which is lacking in most hospitals since human pythiosis is rare in China. In this study, we used metagenomic Next-Generation Sequencing and identified Pythium insidiosum in a 56-year-old Chinese male who was hospitalized due to severe edema in the right lower limb with scattered darkening indurations. The patient had a history of cirrhosis and occupational exposure to swamp water. Serological level of immune biomarkers indicated immunodeficiency, and Proteinase 3-Anti-Neutrophil Cytoplasmic Antibody was positive. Surgical incision of the lesions revealed radiating and reticular cutaneous ulcers. Microbial infections were suspected but conventional tests failed to discover the etiology. Empirical use of penicillin, vancomycin, and ceftriaxone had no effect. As a result, the peripheral blood and tissue biopsies were sent for metagenomic Next-Generation Sequencing, which reported Pythium insidiosum. This finding was corroborated by pathological staining, whole-genome sequencing, and internal transcribed spacer sequencing. Notably, antifungal treatment was ineffective, but the patient responded well to oral trimethoprim–sulfamethoxazole, which may be due to the folp gene found in Pythium insidiosum genome. Our study prompts future studies to determine the optimal treatment of skin pythiosis.
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Affiliation(s)
- Haiyan Zhang
- Department of General Practice, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Fengli Zhou
- Department of General Practice, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jiabao Huang
- Department of General Practice, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xiaoyun Liu
- Department of General Practice, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Hui Xu
- Department of General Practice, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jiayin Liang
- Department of Clinical Laboratory, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jun Wang
- Hangzhou Matridx Biotechnology Co., Ltd, Hangzhou, China
| | - Jing Chen
- Hangzhou Matridx Biotechnology Co., Ltd, Hangzhou, China
| | - Lingling Liu
- Department of General Practice, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yiting Li
- Department of General Practice, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xuan Hu
- Department of General Practice, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xuanrong Chen
- Department of General Practice, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Chao Liu
- Hangzhou Matridx Biotechnology Co., Ltd, Hangzhou, China
- *Correspondence: Chao Liu, Kouxing Zhang,
| | - Kouxing Zhang
- Department of General Practice, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Department of General Intensive Care Unit, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- *Correspondence: Chao Liu, Kouxing Zhang,
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Use of different stains for microscopic evaluation for the diagnosis of Pythium keratitis. Indian J Med Microbiol 2022; 40:521-524. [PMID: 36041948 DOI: 10.1016/j.ijmmb.2022.08.003] [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: 01/30/2022] [Revised: 07/28/2022] [Accepted: 08/02/2022] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the efficacy of various staining techniques for detection of Pythium in keratitis cases. METHODS Data of nineteen consecutive culture-positive cases of Pythium keratitis were retrospectively analysed. Corneal scrapings and corneal buttons (in the cases which underwent therapeutic penetrating keratoplasty [TPK]) were sent for microbiological and histopathological examination. The direct smears were stained with Potassium hydroxide and calcofluor white (KOH + CFW), Gram and Iodine-Potassium Iodide-Sulphuric Acid (IKI-H2SO4) stains. The corneal buttons were stained with Gomori's Methanamine Silver (GMS), Periodic Acid-Schiff (PAS) and Iodine-Potassium Iodide-Sulphuric Acid (IKI-H2SO4) stains. The positivity of various stains in detecting Pythium was studied. RESULTS Gram and KOH + CFW staining from smear was done in 16 out of 19 (84.2%) cases. KOH + CFW and Gram stains were suggestive of Pythium in 10 (62.5%) and 7 (43.8%) cases, respectively. IKI-H2SO4 staining in scraping samples was positive for Pythium in all the 4 (100%) cases in which it was performed. Half corneal buttons were positive for Pythium with IKI-H2SO4 stain as well as GMS stain in all the 18 cases that underwent TPK (100%). PAS stain showed weak to faint pink staining of Pythium filaments in 7 out of 18 cases (38.9%). CONCLUSION IKI-H2SO4 stain followed by KOH + CFW stain detects Pythium filaments most accurately in corneal scraping samples from keratitis patients, although the differences were not statistically significant. The positivity of the stains depends on astute observation by an experienced ocular microbiologist and pathologist.
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Elshafie NO, Hanlon J, Malkawi M, Sayedahmed EE, Guptill LF, Jones-Hall YL, Santos AP. Nested PCR Detection of Pythium sp. from Formalin-Fixed, Paraffin-Embedded Canine Tissue Sections. Vet Sci 2022; 9:vetsci9080444. [PMID: 36006359 PMCID: PMC9412607 DOI: 10.3390/vetsci9080444] [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: 06/09/2022] [Revised: 08/11/2022] [Accepted: 08/13/2022] [Indexed: 12/03/2022] Open
Abstract
Simple Summary Pythium insidiosum is a waterborne fungus-like organism commonly present in tropical and subtropical areas that causes a disease named pythiosis in dogs and other animals. This disease can cause inflammatory lesions on the skin and gastrointestinal tract and, if left untreated, may be fatal. Because this mold lacks the distinctive features of true fungi, it requires specific treatment. Diagnosis of pythiosis is commonly achieved by microscope visualization after staining the tissue sections (histopathology). Although some stains highlight hyphae, these techniques are challenging to distinguish P. insidiosum from other fungi. Our study aimed to develop a molecular technique (nested PCR) to specifically detect P. insidiosum DNA in biopsy specimens to aid in diagnosing this organism. Archived biopsies from 26 dogs suspected of pythiosis were examined by histopathology with special stains and tested by the novel nested PCR. Agreement between histopathology and nested PCR occurred in 18/26 cases. The microscopic examination identified hyphae consistent with Pythium sp. in 57.7% of the samples, whereas the nested PCR detected P. insidiosum DNA in 76.9% of samples, aiding in the sensitivity of the diagnosis of pythiosis in dogs. Using this combination of techniques, we report 20 canine cases of pythiosis over 18 years in Indiana and Kentucky, an unexpectedly high incidence for temperate climatic regions. Thus, we recommend using our nested PCR test in addition to the microscopic examination to increase the sensitivity of the diagnosis. Abstract Pythium insidiosum is an infectious oomycete affecting dogs that develop the cutaneous or gastrointestinal form of pythiosis with a poor prognosis. If left untreated, pythiosis may be fatal. This organism is not a true fungus because its cell wall and cell membrane lack chitin and ergosterol, respectively, requiring specific treatment. Identifying the organism is challenging, as a hematoxylin and eosin (H&E) stain poorly stain the P. insidiosum hyphae and cannot be differentiated conclusively from other fungal or fungal-like organisms (such as Lagenidium sp.) morphologically. Our study aimed to develop a nested PCR to detect P. insidiosum and compare it with the traditional histopathologic detection of hyphae. Formalin-fixed, paraffin-embedded (FFPE) tissue scrolls from 26 dogs with lesions suggesting the P. insidiosum infection were assessed histologically, and DNA was extracted from the FFPE tissue sections for nested PCR. Agreement between the histologic stains, (H&E), periodic acid–Schiff (PAS), and/or Grocott methenamine silver (GMS) and the nested PCR occurred in 18/26 cases. Hyphae consistent with Pythium sp. were identified via histopathology in 57.7% of the samples, whereas the nested PCR detected P. insidiosum in 76.9% of samples, aiding in the sensitivity of the diagnosis of pythiosis in dogs. Using this combination of techniques, we report 20 canine cases of pythiosis over 18 years in Indiana and Kentucky, an unexpectedly high incidence for temperate climatic regions. Using a combination of histopathology evaluation and nested PCR is recommended to aid in the accurate diagnosis of pythiosis.
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Affiliation(s)
- Nelly O. Elshafie
- Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA
| | - Jessica Hanlon
- Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA
| | - Mays Malkawi
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA
| | - Ekramy E. Sayedahmed
- Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA
| | - Lynn F. Guptill
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA
| | - Yava L. Jones-Hall
- Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA
| | - Andrea P. Santos
- Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA
- Correspondence:
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Stibbe PC, Ianiski LB, Weiblen C, Maciel AF, Machado ML, da Silveira TL, Soares FAA, Santurio JM, Soares MP, Pereira DIB, Sangioni LA, de Avila Botton S. Mefenoxam and pyraclostrobin: toxicity and in vitro inhibitory activity against Pythium insidiosum. Lett Appl Microbiol 2022; 75:1383-1388. [PMID: 35971818 DOI: 10.1111/lam.13808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 08/02/2022] [Accepted: 08/08/2022] [Indexed: 11/26/2022]
Abstract
The objective of this study to verify in vitro susceptibility of Pythium insidiosum against the agricultural fungicides mefenoxam and pyraclostrobin and evaluate toxicity of both compounds. Twenty-one P. insidiosum isolates were tested against mefenoxam and pyraclostrobin using the broth microdilution method. Minimum inhibitory and oomicidal concentrations for both compounds were established. Additionally, scanning electron microscopy (SEM) was performed on P. insidiosum hyphae treated with the sublethal concentration of each fungicide. The toxicity of the compounds was evaluated in vivo Caenorhabditis elegans model. The concentration to inhibit 100% of P. insidiosum growth ranged from 0.625 to 10 μg ml-1 for mefenoxam and from 0.019 to 5 μg ml-1 for pyraclostrobin. The SEM analysis revealed changes on the surface of the hyphae treated with the fungicides, suggesting possible damage caused by these compounds. There was no evidence of toxicity in vivo models. Mefenoxam and pyraclostrobin did not show toxicity at the doses evaluated and have inhibitory effects on the pathogenic oomycete P. insidiosum. However, further evaluations of their pharmacokinetics and toxicity in different animal species and possible pharmacological interactions are necessary to infer a possible use in the clinical management of pythiosis.
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Affiliation(s)
| | | | - Carla Weiblen
- Universidade Regional Integrada do Alto Uruguai e das Missões (URI), Santiago, RS, Brasil
| | | | | | | | | | | | - Mauro Pereira Soares
- Universidade Federal de Pelotas (UFPel), Instituto de Biologia, Pelotas, RS, Brasil
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Souto E, Kommers G, Souza A, Neto EGM, Assis D, Riet-Correa F, Galiza G, Dantas A. A Retrospective Study of Pythiosis in Domestic Animals in Northeastern Brazil. J Comp Pathol 2022; 195:34-50. [DOI: 10.1016/j.jcpa.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/18/2022] [Accepted: 05/25/2022] [Indexed: 11/27/2022]
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Secretome Profiling by Proteogenomic Analysis Shows Species-Specific, Temperature-Dependent, and Putative Virulence Proteins of Pythium insidiosum. J Fungi (Basel) 2022; 8:jof8050527. [PMID: 35628782 PMCID: PMC9144242 DOI: 10.3390/jof8050527] [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: 03/26/2022] [Revised: 05/15/2022] [Accepted: 05/16/2022] [Indexed: 02/04/2023] Open
Abstract
In contrast to most pathogenic oomycetes, which infect plants, Pythium insidiosum infects both humans and animals, causing a difficult-to-treat condition called pythiosis. Most patients undergo surgical removal of an affected organ, and advanced cases could be fetal. As a successful human/animal pathogen, P. insidiosum must tolerate body temperature and develop some strategies to survive and cause pathology within hosts. One of the general pathogen strategies is virulence factor secretion. Here, we used proteogenomic analysis to profile and validate the secretome of P. insidiosum, in which its genome contains 14,962 predicted proteins. Shotgun LC–MS/MS analysis of P. insidiosum proteins prepared from liquid cultures incubated at 25 and 37 °C mapped 2980 genome-predicted proteins, 9.4% of which had a predicted signal peptide. P. insidiosum might employ an alternative secretory pathway, as 90.6% of the validated secretory/extracellular proteins lacked the signal peptide. A comparison of 20 oomycete genomes showed 69 P. insidiosum–specific secretory/extracellular proteins, and these may be responsible for the host-specific infection. The differential expression analysis revealed 14 markedly upregulated proteins (particularly cyclophilin and elicitin) at body temperature which could contribute to pathogen fitness and thermotolerance. Our search through a microbial virulence database matched 518 secretory/extracellular proteins, such as urease and chaperones (including heat shock proteins), that might play roles in P. insidiosum virulence. In conclusion, the identification of the secretome promoted a better understanding of P. insidiosum biology and pathogenesis. Cyclophilin, elicitin, chaperone, and urease are top-listed secreted/extracellular proteins with putative pathogenicity properties. Such advances could lead to developing measures for the efficient detection and treatment of pythiosis.
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Severe skin and soft tissue pythiosis acquired in a hot sp. Travel Med Infect Dis 2022; 48:102349. [DOI: 10.1016/j.tmaid.2022.102349] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 03/25/2022] [Accepted: 04/25/2022] [Indexed: 12/14/2022]
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Gurnani B, Kaur K, Venugopal A, Srinivasan B, Bagga B, Iyer G, Christy J, Prajna L, Vanathi M, Garg P, Narayana S, Agarwal S, Sahu S. Pythium insidiosum keratitis - A review. Indian J Ophthalmol 2022; 70:1107-1120. [PMID: 35325996 PMCID: PMC9240499 DOI: 10.4103/ijo.ijo_1534_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Pythium insidiosum is an oomycete and is also called “parafungus” as it closely mimics fungal keratitis. The last decade saw an unprecedented surge in Pythium keratitis cases, especially from Asia and India, probably due to growing research on the microorganism and improved diagnostic and treatment modalities. The clinical features such as subepithelial infiltrate, cotton wool-like fluffy stromal infiltrate, satellite lesions, corneal perforation, endoexudates, and anterior chamber hypopyon closely resemble fungus. The classical clinical features of Pythium that distinguish it from other microorganisms are reticular dots, tentacular projections, peripheral furrowing, and early limbal spread, which require a high index of clinical suspicion. Pythium also exhibits morphological and microbiological resemblance to fungus on routine smearing, revealing perpendicular or obtuse septate or aseptate branching hyphae. Culture on blood agar or any other nutritional agar is the gold standard for diagnosis. It grows as cream-colored white colonies with zoospores formation, further confirmed using the leaf incarnation method. Due to limited laboratory diagnostic modalities and delayed growth on culture, there was a recent shift toward various molecular diagnostic modalities such as polymerase chain reaction, confocal microscopy, ELISA, and immunodiffusion. As corneal scraping (10% KOH, Gram) reveals fungal hyphae, antifungals are started before the culture results are available. Recent in vitro molecular studies have suggested antibacterials as the first-line drugs in the form of 0.2% linezolid and 1% azithromycin. Early therapeutic keratoplasty is warranted in nonresolving cases. This review aims to describe the epidemiology, clinical features, laboratory and molecular diagnosis, and treatment of Pythium insidiosum keratitis.
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Affiliation(s)
- Bharat Gurnani
- Cataract, Cornea, External Disease, Trauma and Refractive Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Pondicherry, India
| | - Kirandeep Kaur
- Pediatric and Squint Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Pondicherry, India
| | - Anitha Venugopal
- Cornea, Ocular surface, Trauma and Refractive services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Tirunelveli, Tamil Nadu, India
| | - Bhaskar Srinivasan
- Dr G Sitalakshmi Memorial Clinic for Ocular Surface Disorders, CJ Shah Cornea Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Bhupesh Bagga
- Cornea Clinic, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, India
| | - Geetha Iyer
- Dr G Sitalakshmi Memorial Clinic for Ocular Surface Disorders, CJ Shah Cornea Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Josephine Christy
- Cataract, Cornea and Refractive Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Pondicherry, India
| | - Lalitha Prajna
- Microbiology Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, Tamil Nadu, India
| | - Murugesan Vanathi
- Cornea and Ocular Surface, Cataract and Refractive Services, Dr R P Centre, AIIMS, New Delhi, India
| | - Prashant Garg
- Director and Kallam Anji Reddy Chair of Ophthalmology Paul Dubord Chair of Cornea, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, India
| | - Shivanand Narayana
- Cataract, Cornea, External Diseases, Trauma and Refractive Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Pondicherry, India
| | - Shweta Agarwal
- Dr G Sitalakshmi Memorial Clinic for Ocular Surface Disorders, CJ Shah Cornea Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Srikant Sahu
- Cornea and Anterior Segment, Contact Lens, Cataract, Laser Refractive Surgery Services, Mithu Tulsi Chanrai Campus, LV Prasad Eye Institute, Bhubaneswar, Orissa, India
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Medhasi S, Chindamporn A, Worasilchai N. A Review: Antimicrobial Therapy for Human Pythiosis. Antibiotics (Basel) 2022; 11:antibiotics11040450. [PMID: 35453202 PMCID: PMC9029071 DOI: 10.3390/antibiotics11040450] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/16/2022] [Accepted: 03/22/2022] [Indexed: 01/14/2023] Open
Abstract
Human pythiosis is associated with poor prognosis with significant mortality caused by Pythium insidiosum. Antimicrobials’ in vitro and in vivo results against P. insidiosum are inconsistent. Although antimicrobials are clinically useful, they are not likely to achieve therapeutic success alone without surgery and immunotherapy. New therapeutic options are therefore needed. This non-exhaustive review discusses the rationale antimicrobial therapy, minimum inhibitory concentrations, and efficacy of antibacterial and antifungal agents against P. insidiosum. This review further provides insight into the immunomodulating effects of antimicrobials that can enhance the immune response to infections. Current data support using antimicrobial combination therapy for the pharmacotherapeutic management of human pythiosis. Also, the success or failure of antimicrobial treatment in human pythiosis might depend on the immunomodulatory effects of drugs. The repurposing of existing drugs is a safe strategy for anti-P. insidiosum drug discovery. To improve patient outcomes in pythiosis, we suggest further research and a deeper understanding of P. insidiosum virulence factors, host immune response, and host immune system modification by antimicrobials.
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Affiliation(s)
- Sadeep Medhasi
- Department of Transfusion Medicine and Clinical Microbiology, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok 10330, Thailand;
| | - Ariya Chindamporn
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand;
| | - Navaporn Worasilchai
- Department of Transfusion Medicine and Clinical Microbiology, Faculty of Allied Health Sciences, Immunomodulation of Natural Products Research Group, Chulalongkorn University, Bangkok 10330, Thailand
- Correspondence: ; Tel.: +66-2218-1065
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de Souza Silveira J, Brasil CL, Braga CQ, da Silva Moreira Â, Franz HC, Zamboni R, Sallis ES, Albano AP, Zambrano CG, Araujo LC, de Bona da Silva C, Pötter L, de Avila Botton S, Pereira DIB. Melaleuca alternifolia formulations in the treatment of experimental pythiosis. Braz J Microbiol 2022; 53:1011-1017. [PMID: 35239152 PMCID: PMC9151964 DOI: 10.1007/s42770-022-00720-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 02/15/2022] [Indexed: 02/01/2023] Open
Abstract
Essential oils (EO) are aromatic compounds from the plant secondary metabolism. Melaleuca alternifolia EO is well known for its medicinal properties and promising use as an antimicrobial agent. Pythiosis is a difficult-to-treat and emerging disease caused by the oomycete Pythium insidiosum. This study evaluated a nanoemulsion formulation of M. alternifolia (NEMA) in topical and intralesional application to treat experimental pythiosis. Dermal toxicity tests were performed on M. alternifolia EO in Wistar rats. Pythiosis was reproduced in rabbits (n = 9) that were divided into groups: group 1 (control), cutaneous lesions with daily topical application of a non-ionizable gel-based formulation and intralesional application of sterile distilled water every 48 h; group 2 (topical formulation), lesions treated daily with topical application of a non-ionizable gel-based formulation containing 5 mg/ml of NEMA; and group 3 (intralesional formulation), lesions treated with NEMA at 5 mg/ml in aqueous solution applied intralesionally/48 h. The animals were treated for 45 days, and the subcutaneous lesion areas were measured every 5 days. M. alternifolia EO showed no dermal toxicity. The lesion areas treated with intralesional NEMA reduced at the end of treatment, differing from groups 1 and 2 (P < 0.05). In the topically treated group, the lesion areas did not differ from the control group, although the number of hyphae significantly reduced (P < 0.05). Under the experimental conditions of this study, the NEMA formulations presented a favorable safety profile. However, further studies are required to evaluate if this safety applies to higher concentrations of NEMA and to validate its use in clinical pythiosis.
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Affiliation(s)
- Júlia de Souza Silveira
- grid.411221.50000 0001 2134 6519Programa de Pós Graduação em Microbiologia e Parasitologia, Laboratório de Micologia, Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Prédio 18, Sala 14. Campus Universitário Capão do Leão, s/n◦, Pelotas, RS CEP: 96160-000 Brazil
| | - Carolina Litchina Brasil
- grid.411221.50000 0001 2134 6519Programa de Pós Graduação em Microbiologia e Parasitologia, Laboratório de Micologia, Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Prédio 18, Sala 14. Campus Universitário Capão do Leão, s/n◦, Pelotas, RS CEP: 96160-000 Brazil
| | - Caroline Quintana Braga
- grid.411221.50000 0001 2134 6519Programa de Pós Graduação em Microbiologia e Parasitologia, Laboratório de Micologia, Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Prédio 18, Sala 14. Campus Universitário Capão do Leão, s/n◦, Pelotas, RS CEP: 96160-000 Brazil
| | - Ândrios da Silva Moreira
- grid.411221.50000 0001 2134 6519Programa de Pós Graduação em Microbiologia e Parasitologia, Laboratório de Micologia, Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Prédio 18, Sala 14. Campus Universitário Capão do Leão, s/n◦, Pelotas, RS CEP: 96160-000 Brazil
| | - Helen Cabaldi Franz
- grid.411239.c0000 0001 2284 6531Centro de Ciências da Saúde, Universidade Federal de Santa Maria, Santa Maria, RS Brazil
| | - Rosimeri Zamboni
- grid.411221.50000 0001 2134 6519Faculdade de Veterinária, Universidade Federal de Pelotas, Pelotas, RS Brazil
| | - Eliza Simone Sallis
- grid.411221.50000 0001 2134 6519Faculdade de Veterinária, Universidade Federal de Pelotas, Pelotas, RS Brazil
| | - Ana Paula Albano
- grid.411221.50000 0001 2134 6519Faculdade de Veterinária, Universidade Federal de Pelotas, Pelotas, RS Brazil
| | - Cristina Gomes Zambrano
- grid.411221.50000 0001 2134 6519Programa de Pós Graduação em Microbiologia e Parasitologia, Laboratório de Micologia, Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Prédio 18, Sala 14. Campus Universitário Capão do Leão, s/n◦, Pelotas, RS CEP: 96160-000 Brazil
| | - Lara Colles Araujo
- grid.411239.c0000 0001 2284 6531Centro de Ciências da Saúde, Universidade Federal de Santa Maria, Santa Maria, RS Brazil
| | - Cristiane de Bona da Silva
- grid.411239.c0000 0001 2284 6531Centro de Ciências da Saúde, Universidade Federal de Santa Maria, Santa Maria, RS Brazil
| | - Luciana Pötter
- grid.411239.c0000 0001 2284 6531Departamento de Medicina Veterinária Preventiva, Centro de Ciências Rurais, Universidade Federal de Santa Maria, Santa Maria, RS Brazil
| | - Sônia de Avila Botton
- grid.411239.c0000 0001 2284 6531Departamento de Medicina Veterinária Preventiva, Centro de Ciências Rurais, Universidade Federal de Santa Maria, Santa Maria, RS Brazil
| | - Daniela Isabel Brayer Pereira
- Programa de Pós Graduação em Microbiologia e Parasitologia, Laboratório de Micologia, Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Prédio 18, Sala 14. Campus Universitário Capão do Leão, s/n◦, Pelotas, RS, CEP: 96160-000, Brazil.
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Miraglia BM, Mendoza L, Rammohan R, Vilela L, Vilela C, Vilela G, Huebner M, Mani R, Vilela R. Pythium insidiosum complex hides a cryptic novel species: Pythium periculosum. Fungal Biol 2022; 126:366-374. [DOI: 10.1016/j.funbio.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/14/2022] [Indexed: 11/28/2022]
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Yolanda H, Krajaejun T. Global Distribution and Clinical Features of Pythiosis in Humans and Animals. J Fungi (Basel) 2022; 8:jof8020182. [PMID: 35205934 PMCID: PMC8879638 DOI: 10.3390/jof8020182] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/06/2022] [Accepted: 02/08/2022] [Indexed: 01/27/2023] Open
Abstract
Pythiosis is a difficult-to-treat infectious disease caused by Pythium insidiosum. The condition is unfamiliar among healthcare workers. Manifestation of pythiosis is similar to other fungal infections, leading to misdiagnosis and delayed treatment. The geographical extent of pythiosis at a global scale is unclear. This study aimed to analyze the clinical information recorded in the scientific literature to comprehensively project epidemiological characteristics, clinical features, and future trends of pythiosis. From 1980 to 2021, 4203 cases of pythiosis in humans (n = 771; 18.3%) and animals (primarily horse, dog, and cow; n = 3432; 81.7%), with an average of 103 cases/year, were recruited. Pythiosis case reports significantly increased in the last decade. Pythiosis spanned 23 tropical, subtropical, and temperate countries worldwide. Some patients acquired pythiosis from a trip to an endemic country. Strikingly, 94.3% of human cases were in India and Thailand, while 79.2% of affected animals were in the U.S.A. and Brazil. Clinical features of pythiosis varied. Vascular and ocular pythiosis were only observed in humans, whereas cutaneous/subcutaneous and gastrointestinal infections were predominant in animals. Mortality depended on host species and clinical forms: for example, none in patients with ocular pythiosis, 0.7% in cows with a cutaneous lesion, 26.8% in humans with vascular disease, 86.4% in dogs with gastrointestinal pathology, and 100% in several animals with disseminated infection. In summary, this study reports up-to-date epidemiological and clinical features of pythiosis in humans and animals. It increases awareness of this life-threatening disease, as the illness or outbreak can exist in any country, not limited to the endemic areas.
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Affiliation(s)
- Hanna Yolanda
- Program in Translational Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand;
- Department of Parasitology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta 14440, Indonesia
| | - Theerapong Krajaejun
- Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
- Correspondence: ; Tel.: +662-201-1452
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Denardi LB, Weiblen C, Ianiski LB, Stibbe PC, Pinto SC, Santurio JM. Anti-Pythium insidiosum activity of MSI-78, LL-37, and magainin-2 antimicrobial peptides. Braz J Microbiol 2022; 53:509-512. [PMID: 35018604 PMCID: PMC8882752 DOI: 10.1007/s42770-022-00678-5] [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: 10/24/2021] [Accepted: 12/31/2021] [Indexed: 01/13/2023] Open
Abstract
We investigated the anti-Pythium insidiosum activity of the antimicrobial peptides (AMPs) MSI-78, LL-37, and magainin-2. To detect the minimum inhibitory concentration (MIC), fourteen clinical strains were incubated with the AMPs following the CLSI M38-A2 protocol. All three AMPs showed antimicrobial activity with an MIC range of 20-80 mg/L against all strains. We concluded that the evaluated AMPs have great potential as anti-Pythium insidiosum agents, and their activity deserves to be more explored in further research. Antimicrobial peptides were tested against Pythium insidiosum, a microorganism that causes a difficult-to-treat disease in animals and humans. These peptides have been shown to be able to kill P. insidiosum and may be candidates for use in the treatment of this infection.
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Affiliation(s)
- Laura Bedin Denardi
- grid.411239.c0000 0001 2284 6531Department of Microbiology and Parasitology, Federal University of Santa Maria (UFSM), Santa Maria, RS Brazil ,grid.411239.c0000 0001 2284 6531Pharmacology Postgraduate Program, Federal University of Santa Maria (UFSM), Santa Maria, RS Brazil
| | - Carla Weiblen
- Regional Integrated University of Alto Uruguay and the Missions (URI – Santiago), Santiago, RS Brazil
| | - Lara Baccarin Ianiski
- grid.411239.c0000 0001 2284 6531Department of Microbiology and Parasitology, Federal University of Santa Maria (UFSM), Santa Maria, RS Brazil ,grid.411239.c0000 0001 2284 6531Pharmaceutical Sciences Postgraduate Program, Federal University of Santa Maria (UFSM), Santa Maria, RS Brazil
| | - Paula Cristina Stibbe
- grid.411239.c0000 0001 2284 6531Department of Microbiology and Parasitology, Federal University of Santa Maria (UFSM), Santa Maria, RS Brazil ,grid.411239.c0000 0001 2284 6531Pharmaceutical Sciences Postgraduate Program, Federal University of Santa Maria (UFSM), Santa Maria, RS Brazil
| | - Stefania Campos Pinto
- grid.411239.c0000 0001 2284 6531Department of Microbiology and Parasitology, Federal University of Santa Maria (UFSM), Santa Maria, RS Brazil
| | - Janio M. Santurio
- grid.411239.c0000 0001 2284 6531Department of Microbiology and Parasitology, Federal University of Santa Maria (UFSM), Santa Maria, RS Brazil ,grid.411239.c0000 0001 2284 6531Pharmacology Postgraduate Program, Federal University of Santa Maria (UFSM), Santa Maria, RS Brazil
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Zambrano CG, Braga CQ, Dal Ben V, Silveira JS, Scheid HV, Melo LG, Sallis ES, Botton SA, Pereira DI. Experimental Pythium aphanidermatum Infection in Rabbits. J Comp Pathol 2022; 190:30-35. [DOI: 10.1016/j.jcpa.2021.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 12/02/2021] [Accepted: 12/11/2021] [Indexed: 11/28/2022]
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Nguyen D, Vilela R, Miraglia BM, Vilela G, Jasem-Alali N, Rohn R, Glass R, Hansen RD, Mendoza L. Geographic distribution of Pythium insidiosum infections in the United States. J Am Vet Med Assoc 2021; 260:530-534. [PMID: 34968184 DOI: 10.2460/javma.20.10.0595] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To describe the geographic distribution of infections caused by Pythium insidiosum in dogs, horses, and other animal species in the US. ANIMALS For the last 20 years, we have collected data from cases of pythiosis in 1,150 horses, 467 dogs, and other species (59) from various geographic locations in the US. PROCEDURES Due to lost data (from 2006 to 2016), the selected cases include years 2000 to 2005 and 2016 to 2020. The selection of cases was based on infected host clinical features, serum samples demonstrating strong positive anti-P insidiosum IgG titers in serologic assays, and positive results on ≥ 1 of the following diagnostic modalities: microbial culture on 2% Sabouraud dextrose agar, histologic evaluation, PCR assay, and wet mount cytologic evaluation (with potassium hydroxide). RESULTS Most confirmed P insidiosum infections were found in horses and dogs in the southeastern US. Interestingly, in Texas, no cases were found west of longitude 100°W. Few pythiosis cases were diagnosed in west-coast states. Equine cases were more often diagnosed during summer and fall months, but canine cases were more often diagnosed between September and February. Cases in other species were discovered in the same geographic areas as those in dogs and horses. CLINICAL RELEVANCE To our knowledge, this is the first report providing the ecological distribution of P insidiosum infection in affected species in the US. Results of this study illustrated the importance of including P insidiosum in the differential diagnostic scheme of nonhealing skin lesions or intestinal granulomatous masses, particularly in dogs and horses inhabiting or having visited endemic areas.
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Affiliation(s)
- Don Nguyen
- Department of Microbiology and Molecular Genetics, Michigan State University, East Lansing, MI
| | - Raquel Vilela
- Biomedical Laboratory Diagnostics Program, Michigan State University, East Lansing, MI.,Faculty of Pharmacy, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Bruno M Miraglia
- Faculty of Pharmacy, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Gabriella Vilela
- Biomedical Laboratory Diagnostics Program, Michigan State University, East Lansing, MI
| | - Noora Jasem-Alali
- Biomedical Laboratory Diagnostics Program, Michigan State University, East Lansing, MI
| | - Riann Rohn
- Biomedical Laboratory Diagnostics Program, Michigan State University, East Lansing, MI
| | - Robert Glass
- Pan American Veterinary Laboratories, Lexington, TX
| | | | - Leonel Mendoza
- Department of Microbiology and Molecular Genetics, Michigan State University, East Lansing, MI.,Biomedical Laboratory Diagnostics Program, Michigan State University, East Lansing, MI
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Pythium insidiosum keratitis reported in China, raising the alertness to this fungus-like infection: a case series. J Med Case Rep 2021; 15:619. [PMID: 34915928 PMCID: PMC8680372 DOI: 10.1186/s13256-021-03189-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 11/08/2021] [Indexed: 11/24/2022] Open
Abstract
Background The objective of this study is to report typical clinical and laboratory characteristics of three cases of keratitis caused by Pythium insidiosum in China. Case presentation Three Chinese patients of Han nationality diagnosed with Pythium keratitis from 2017 to 2019 were included. One 45-year-old female and one 55-year-old male were exposed to river water, and one 51-year-old female was burned by ash in the eyes. All of them are of Han ethnicity. Upon slit-lamp examination, subepithelial and superficial stromal opacities were observed in a reticular pattern. After conventional treatment with antifungal agents, the clinical status worsened and therapeutic penetrating keratoplasty was performed. Unfortunately, enucleation was performed to remove all infected tissue and relieve pain. Pythium insidiosum was identified in culture and confirmed by internal transcribed spacer ribosomal RNA gene sequencing analysis. Following the systemic and local antibiotic regimens, the patients were cured ultimately and no regression of infection was observed. Conclusions It is significant for ophthalmologists and microbiologist to be alert to this eye-threatening infection, especially in patients who are resistant to antifungal treatments and with water-related exposure.
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Ubiali DG, Pereira AHB, Boabaid FM, Dutra V, Nakazato L, Campos CG, Colodel EM, Pescador CA, Riet-Correa F. Successful potassium iodide treatment for rhinofacial pythiosis in sheep. J Mycol Med 2021; 32:101233. [PMID: 34902797 DOI: 10.1016/j.mycmed.2021.101233] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/13/2021] [Accepted: 12/03/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND Pythiosis in sheep is an important disease in Brazil, which could cause rhinitis, dermatitis and alimentary tract inflammation. It is caused by the aquatic oomycete, Pythium insidiosum. The rhinofacial pythiosis causes facial deformity and upper respiratory tract clinical signs associated with necroproliferative masses occupying the rostral nasal cavity and hard palate. Little is known regarding the therapy, prophylaxis and pathogenesis of this disease. METHODOLOGY During the 6-year study, we examined 13 sheep presenting rhinofacial pythiosis. The diagnosis was performed through biopsy of the rhinofacial lesions followed by histopathology and immunohistochemistry using specific antibodies against P insidiosum, polymerase chain reaction and an indirect enzyme-linked immunosorbent assay. RESULTS This study presents the clinical findings of a potassium iodide treatment of rhinofacial pythiosis in sheep. All sheep were treated with 10 ml of 10% potassium iodide solution, administered orally every day during 63-120 (mean 85) days. Among treated sheep, 84.6% demonstrated complete recovery. CONCLUSION Potassium iodide therapy may treat rhinofacial pythiosis in sheep.
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Affiliation(s)
- Daniel G Ubiali
- Pathological Anatomy Sector (SAP), Department of Epidemiology and Public Health, Federal Rural University of Rio de Janeiro (UFRuralRJ), BR-465 Km 7, Seropédica, RJ 23.890-001, Brazil.
| | - Asheley H B Pereira
- Pathological Anatomy Sector (SAP), Department of Epidemiology and Public Health, Federal Rural University of Rio de Janeiro (UFRuralRJ), BR-465 Km 7, Seropédica, RJ 23.890-001, Brazil
| | - Fabiana M Boabaid
- Centro Universitario de Tacuarembó, Universidad de la República, Ruta 5 Km 386, Tacuarembó, TA 45000, Uruguay
| | - Valéria Dutra
- Microbiology Laboratory, Veterinary Medicine Faculty, Universidade Federal de Mato Grosso (UFMT), Av. Fernando Corrêa 2367, Coxipó, Cuiabá, MT 78060-900, Brazil
| | - Luciano Nakazato
- Microbiology Laboratory, Veterinary Medicine Faculty, Universidade Federal de Mato Grosso (UFMT), Av. Fernando Corrêa 2367, Coxipó, Cuiabá, MT 78060-900, Brazil
| | - Camila G Campos
- Veterinary Pathology Laboratory, Veterinary Medicine Faculty, Universidade Federal de Mato Grosso (UFMT), Av. Fernando Corrêa 2367, Coxipó, Cuiabá, MT 78060-900, Brazil
| | - Edson M Colodel
- Veterinary Pathology Laboratory, Veterinary Medicine Faculty, Universidade Federal de Mato Grosso (UFMT), Av. Fernando Corrêa 2367, Coxipó, Cuiabá, MT 78060-900, Brazil
| | - Caroline A Pescador
- Veterinary Pathology Laboratory, Veterinary Medicine Faculty, Universidade Federal de Mato Grosso (UFMT), Av. Fernando Corrêa 2367, Coxipó, Cuiabá, MT 78060-900, Brazil
| | - Franklin Riet-Correa
- Post-Graduate Program in Animal Science in the Tropics, Federal University of Bahia, Salvador, BA, Brazil
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Rodríguez N, Whitfield-Cargile CM, Chamoun-Emanuelli AM, Hildreth E, Jordan W, Coleman MC. Nasopharyngeal bacterial and fungal microbiota in normal horses and horses with nasopharyngeal cicatrix syndrome. J Vet Intern Med 2021; 35:2897-2911. [PMID: 34783081 PMCID: PMC8692226 DOI: 10.1111/jvim.16307] [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: 01/29/2021] [Revised: 10/15/2021] [Accepted: 10/19/2021] [Indexed: 12/28/2022] Open
Abstract
Background The nasopharyngeal bacterial and fungal microbiota of normal horses and those with nasopharyngeal cicatrix syndrome (NCS) are unknown. Hypotheses/Objectives To describe the microbiota from nasopharyngeal washes of healthy horses and of horses acutely affected with NCS. Animals Twenty‐six horses acutely affected with NCS horses and 14 unaffected horses. Methods Prospective, observational cohort study. Horses were recruited by investigators through personal communications in central Texas. Bacterial (16s RNA) and fungal (internal transcribed spacer) microbiota from nasopharyngeal washes were evaluated. Polymerase chain reaction for detection of Pythium insidiosum was performed. Results Results indicated that 6 fungal genera (Alternaria, Bipolaris, Microascus, Spegazzinia, Paraconiothyrium, Claviceps) and 1 bacterial genera (Staphylococcus) were significantly different between affected and unaffected horses. The fungal genus Bipolaris had increased abundance in NCS affected horses and on NCS affected farms. Pythium insidiosum was absent in the nasopharyngeal wash of all horses, irrespective of health status. Conclusion and Clinical Importance Significant differences were identified in the fungal microbiota in horses affected with NCS and farms affected with NCS compared to those unaffected. Therefore, Bipolaris warrants further investigation.
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Affiliation(s)
- Natalia Rodríguez
- Department of Large Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
| | | | - Ana M Chamoun-Emanuelli
- Department of Large Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
| | | | - Will Jordan
- Jordan Equine Sports Medicine & Surgery, Waller, Texas, USA
| | - Michelle C Coleman
- Department of Large Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
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Souto EPF, Maia LA, Neto EGM, Kommers GD, Junior FG, Riet-Correa F, Galiza GJN, Dantas AFM. Pythiosis in Equidae in Northeastern Brazil: 1985-2020. J Equine Vet Sci 2021; 105:103726. [PMID: 34607686 DOI: 10.1016/j.jevs.2021.103726] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/01/2021] [Accepted: 08/02/2021] [Indexed: 10/20/2022]
Abstract
The epidemiologic, clinical, pathologic, microbiological and immunohistochemical findings of pythiosis in equidae in northeastern Brazil are described. From January 1985 to December 2020 the Laboratory of Animal Pathology of the Federal University of Campina Grande received 1,331 tissue samples of equidae, 202 (15.17%) of which were diagnosed as pythiosis. Equidae of both sexes with ages varying from 4 months to 25 years were affected. Most animals were mixed breed (79.7%) and reared in an extensive system (73.26%). The disease occurred throughout the year but the highest incidence (70.29%) was noted after the rainy season. The clinical course was always chronic. The lesions were preferentially located on the limbs and ventral thoracoabdominal wall and characterized by nodules or tumor-like masses with ulcerations and serosanguineous discharge. The cut surface showed fistulous tracts containing kunkers. The direct examination of the kunkers and microbiological culture revealed sparsely septate and branched hyaline hyphae. Histopathology revealed a marked inflammatory infiltrate of eosinophils with multifocal well-defined areas of eosinophil necrosis and collagenolysis and intralesional negatively-stained hyphal profiles; in the donkey, a pyogranulomatous inflammatory infiltrate was noted surrounding these areas. Immunohistochemistry for Pythium insidiosum revealed strong immunolabelling of the hyphae. Pythiosis occurs endemically in equidae in northeastern Brazil, with seasonal variation in the incidence. The intralesional kunkers establishes an accurate presumptive diagnosis, but confirmation should preferably be performed through histopathology associated with immunohistochemistry, culture-based or molecular methods.
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Affiliation(s)
- Erick Platiní F Souto
- Laboratory of Animal Pathology, Federal University of Campina Grande, Patos, Paraiba, Brazil.
| | - Lisanka A Maia
- Laboratory of Animal Pathology, Federal Institute of Paraiba, Sousa, Paraiba, Brazil
| | - Eldine G Miranda Neto
- Large Animal Medical Clinic, Federal University of Campina Grande, Patos, Paraíba, Brazil
| | - Glaucia D Kommers
- Pathology Department, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Felício Garino Junior
- Laboratory of Animal Pathology, Federal University of Campina Grande, Patos, Paraiba, Brazil
| | - Franklin Riet-Correa
- Post-Graduate Program in Animal Science in the Tropics, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Glauco J N Galiza
- Laboratory of Animal Pathology, Federal University of Campina Grande, Patos, Paraiba, Brazil
| | - Antonio F M Dantas
- Laboratory of Animal Pathology, Federal University of Campina Grande, Patos, Paraiba, Brazil
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History and Perspective of Immunotherapy for Pythiosis. Vaccines (Basel) 2021; 9:vaccines9101080. [PMID: 34696188 PMCID: PMC8539095 DOI: 10.3390/vaccines9101080] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/27/2021] [Accepted: 09/08/2021] [Indexed: 12/24/2022] Open
Abstract
The fungus-like microorganism Pythium insidiosum causes pythiosis, a life-threatening infectious disease increasingly reported worldwide. Antimicrobial drugs are ineffective. Radical surgery is an essential treatment. Pythiosis can resume post-surgically. Immunotherapy using P. insidiosum antigens (PIA) has emerged as an alternative treatment. This review aims at providing up-to-date information of the immunotherapeutic PIA, with the focus on its history, preparation, clinical application, outcome, mechanism, and recent advances, in order to promote the proper use and future development of this treatment modality. P. insidiosum crude extract is the primary source of immunotherapeutic antigens. Based on 967 documented human and animal (mainly horses) pythiosis cases, PIA immunotherapy reduced disease morbidity and mortality. Concerning clinical outcomes, 19.4% of PIA-immunized human patients succumbed to vascular pythiosis instead of 41.0% in unimmunized cases. PIA immunotherapy may not provide an advantage in a local P. insidiosum infection of the eye. Both PIA-immunized and unimmunized horses with pythiosis showed a similar survival rate of ~70%; however, demands for surgical intervention were much lesser in the immunized cases (22.8% vs. 75.2%). The proposed PIA action involves switching the non-protective T-helper-2 to protective T-helper-1 mediated immunity. By exploring the available P. insidiosum genome data, synthetic peptides, recombinant proteins, and nucleic acids are potential sources of the immunotherapeutic antigens worth investigating. The PIA therapeutic property needs improvement for a better prognosis of pythiosis patients.
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Ianiski LB, Stibbe PC, Denardi LB, Weiblen C, Soares MP, Valente JDSS, Sangioni LA, Pereira DIB, Santurio JM, Botton SDA. In vitro anti-Pythium insidiosum activity of amorolfine hydrochloride and azithromycin, alone and in combination. Med Mycol 2021; 59:67-73. [PMID: 32400872 DOI: 10.1093/mmy/myaa032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/18/2020] [Accepted: 04/13/2020] [Indexed: 11/14/2022] Open
Abstract
Pythium insidiosum infections have been widely studied in an attempt to develop an effective therapeutic protocol for the treatment of human and animal pythiosis. Several antifungal agents are still prescribed against this oomycete, although they present contradictory results. To evaluate the susceptibility profile and to verify the morphological alterations in P. insidiosum isolates treated with amorolfine hydrochloride and azithromycin, alone or in combination. Susceptibility tests for P. insidiosum isolates (n = 20) against amorolfine hydrochloride (AMR) and azithromycin (AZM) were performed according to Clinical and Laboratory Standards Institutes (CLSI) protocol M38-A2. Combinations of both drugs were evaluated using the checkerboard microdilution method. Additionally, transmission and scanning electron microscopy were performed in order to verify the morphological alterations in P. insidiosum isolates in response to these drugs. All P. insidiosum isolates had a minimum inhibitory concentration (MIC) ranging from 16 to 64 mg/l and 8 to 64 mg/l for amorolfine hydrochloride and azithromycin, respectively. Synergistic interactions between the drugs were not observed, with antagonism in 59.8% of isolates, and indifferent interactions in 36.2%. Electron microscopy showed changes in the surface of P. insidiosum hyphae, disorganization of intracellular organelles, and changes in the plasma membrane and cell wall of oomycetes treated with the drugs. This is the first study to demonstrate in vitro anti-P. insidiosum effect of amorolfine hydrochloride. These results indicate the therapeutic potential of this drug against cutaneous and subcutaneous forms of pythiosis, but further studies are necessary to confirm this potential.
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Affiliation(s)
- Lara Baccarin Ianiski
- Universidade Federal de Santa Maria (UFSM), Centro de Ciências da Saúde (CCS), Programa de Pós-Graduação em Ciências Farmacêuticas, Santa Maria, RS, Brazil.,UFSM, CCS, Departamento de Microbiologia e Parasitologia, Laboratório de Pesquisas Micológicas, Santa Maria, RS, Brazil
| | - Paula Cristina Stibbe
- Universidade Federal de Santa Maria (UFSM), Centro de Ciências da Saúde (CCS), Programa de Pós-Graduação em Ciências Farmacêuticas, Santa Maria, RS, Brazil.,UFSM, CCS, Departamento de Microbiologia e Parasitologia, Laboratório de Pesquisas Micológicas, Santa Maria, RS, Brazil
| | - Laura Bedin Denardi
- UFSM, CCS, Departamento de Microbiologia e Parasitologia, Laboratório de Pesquisas Micológicas, Santa Maria, RS, Brazil
| | - Carla Weiblen
- UFSM, CCS, Departamento de Microbiologia e Parasitologia, Laboratório de Pesquisas Micológicas, Santa Maria, RS, Brazil.,UFSM, Centro de Ciências Rurais, Departamento de Medicina Veterinária Preventiva. Programa de Pós-Graduação em Medicina Veterinária, Santa Maria, RS, Brazil
| | - Mauro Pereira Soares
- Universidade Federal de Pelotas (UFPel), Faculdade de Veterinária, Laboratório Regional de Diagnóstico. Pelotas, RS, Brazil
| | - Julia de Souza Silveira Valente
- Universidade Federal de Pelotas (UFPel), Programa de Pós-Graduação em Microbiologia e Parasitologia, Instituto de Biologia, Departamento de Microbiologia e Parasitologia. Pelotas, RS, Brazil
| | - Luís Antônio Sangioni
- UFSM, Centro de Ciências Rurais, Departamento de Medicina Veterinária Preventiva. Programa de Pós-Graduação em Medicina Veterinária, Santa Maria, RS, Brazil
| | - Daniela Isabel Brayer Pereira
- Universidade Federal de Pelotas (UFPel), Programa de Pós-Graduação em Microbiologia e Parasitologia, Instituto de Biologia, Departamento de Microbiologia e Parasitologia. Pelotas, RS, Brazil
| | | | - Sônia de Avila Botton
- Universidade Federal de Santa Maria (UFSM), Centro de Ciências da Saúde (CCS), Programa de Pós-Graduação em Ciências Farmacêuticas, Santa Maria, RS, Brazil.,UFSM, Centro de Ciências Rurais, Departamento de Medicina Veterinária Preventiva. Programa de Pós-Graduação em Medicina Veterinária, Santa Maria, RS, Brazil
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Gómez-Pérez D, Kemen E. Predicting Lifestyle from Positive Selection Data and Genome Properties in Oomycetes. Pathogens 2021; 10:807. [PMID: 34202069 PMCID: PMC8308905 DOI: 10.3390/pathogens10070807] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/19/2021] [Accepted: 06/21/2021] [Indexed: 11/30/2022] Open
Abstract
As evidenced in parasitism, host and niche shifts are a source of genomic and phenotypic diversification. Exemplary is a reduction in the core metabolism as parasites adapt to a particular host, while the accessory genome often maintains a high degree of diversification. However, selective pressures acting on the genome of organisms that have undergone recent lifestyle or host changes have not been fully investigated. Here, we developed a comparative genomics approach to study underlying adaptive trends in oomycetes, a eukaryotic phylum with a wide and diverse range of economically important plant and animal parasitic lifestyles. Our analysis reveals converging evolution on biological processes for oomycetes that have similar lifestyles. Moreover, we find that certain functions, in particular carbohydrate metabolism, transport, and signaling, are important for host and environmental adaptation in oomycetes. Given the high correlation between lifestyle and genome properties in our oomycete dataset, together with the known convergent evolution of fungal and oomycete genomes, we developed a model that predicts plant pathogenic lifestyles with high accuracy based on functional annotations. These insights into how selective pressures correlate with lifestyle may be crucial to better understand host/lifestyle shifts and their impact on the genome.
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Affiliation(s)
| | - Eric Kemen
- Center for Plant Molecular Biology (ZMBP), University of Tübingen, 72074 Tübingen, Germany;
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