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Lozano N, Samblas MG, Calabuig E, Giménez Martí MJ, Gómez Ruiz MD, Arce JMS, Sequera-Arquelladas S, Moreno JMM, Trelis M, Osuna A. Use of sera cell free DNA (cfDNA) and exovesicle-DNA for the molecular diagnosis of chronic Chagas disease. PLoS One 2023; 18:e0282814. [PMID: 37682970 PMCID: PMC10490946 DOI: 10.1371/journal.pone.0282814] [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: 02/21/2023] [Accepted: 07/15/2023] [Indexed: 09/10/2023] Open
Abstract
Chagas disease, a neglected tropical disease, is now considered a worldwide health concern as a result of migratory movements from Central and South America to other regions that were considered free of the disease, and where the epidemiological risk is limited to transplacental transmission or blood or organ donations from infected persons. Parasite detection in chronically ill patients is restricted to serological tests that only determine infection by previous infection and not the presence of the parasite, especially in patients undergoing treatment evaluation or in newborns. We have evaluated the use of nucleic acids from both circulating exovesicles and cell-free DNA (cfDNA) from 50 samples twice randomly selected from a total of 448 serum samples from immunologically diagnosed patients in whom the presence of the parasite was confirmed by nested PCR on amplicons resulting from amplification with kinetoplastid DNA-specific primers 121F-122R. Six samples were randomly selected to quantify the limit of detection by qPCR in serum exovesicles. When the nucleic acids thus purified were assayed as a template and amplified with kinetoplastid DNA and nuclear satellite DNA primers, a 100% positivity rate was obtained for all positive samples assayed with kDNA-specific primers and 96% when SAT primers were used. However, isolation of cfDNA for Trypanosoma cruzi and amplification with SAT also showed 100% positivity. The results demonstrate that serum exovesicles contain DNA of mitochondrial and nuclear origin, which can be considered a mixed population of exovesicles of parasitic origin. The results obtained with serum samples prove that both cfDNA and Exovesicle DNA can be used to confirm parasitaemia in chronically ill patients or in samples where it is necessary to demonstrate the active presence of the parasite. The results confirm for the first time the existence of exovesicles of mitochondrial origin of the parasite in the serum of those affected by Chagas disease.
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Affiliation(s)
- Noelia Lozano
- Area of Parasitology, Department of Pharmacy and Pharmaceutical Technology and Parasitology, University of Valencia, Valencia, Spain
- Servicio de Microbiología y Parasitología Clínica, Hospital Universitario y Politécnico La Fe-IIS La Fe, Valencia, Spain
| | - Mercedes Gomez Samblas
- Grupo de Bioquímica y Parasitología Molecular (CTS 183), Departamento de Parasitología, Campus de Fuentenueva, Instituto de Biotecnología, Universidad de Granada, Granada, Spain
| | - Eva Calabuig
- Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital Universitario y Politécnico La Fe-IIS La Fe, Valencia, Spain
| | - María José Giménez Martí
- Servicio de Microbiología y Parasitología Clínica, Hospital Universitario y Politécnico La Fe-IIS La Fe, Valencia, Spain
| | - Maria Dolores Gómez Ruiz
- Servicio de Microbiología y Parasitología Clínica, Hospital Universitario y Politécnico La Fe-IIS La Fe, Valencia, Spain
| | - José Miguel Sahuquillo Arce
- Servicio de Microbiología y Parasitología Clínica, Hospital Universitario y Politécnico La Fe-IIS La Fe, Valencia, Spain
| | | | - José Miguel Molina Moreno
- Servicio de Microbiología y Parasitología Clínica, Hospital Universitario y Politécnico La Fe-IIS La Fe, Valencia, Spain
| | - M. Trelis
- Area of Parasitology, Department of Pharmacy and Pharmaceutical Technology and Parasitology, University of Valencia, Valencia, Spain
- Joint Research Unit on Endocrinology, Nutrition and Clinical Dietetics, University of Valencia-Health Research Institute La Fe, Valencia, Spain
| | - Antonio Osuna
- Grupo de Bioquímica y Parasitología Molecular (CTS 183), Departamento de Parasitología, Campus de Fuentenueva, Instituto de Biotecnología, Universidad de Granada, Granada, Spain
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2
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Candia-Puma MA, Machaca-Luque LY, Roque-Pumahuanca BM, Galdino AS, Giunchetti RC, Coelho EAF, Chávez-Fumagalli MA. Accuracy of Diagnostic Tests for the Detection of Chagas Disease: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2022; 12:2752. [PMID: 36359595 PMCID: PMC9689806 DOI: 10.3390/diagnostics12112752] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 11/02/2023] Open
Abstract
The present systematic review and meta-analysis about the accuracy of diagnostic tests aim to describe the findings of literature over the last thirty years for the diagnosis of Chagas disease (CD). This work aimed to determine the accuracy of diagnostic techniques for CD in the disease's acute and chronic phases. The PubMed database was searched for studies published between 1990 and 2021 on CD diagnostics. Fifty-six published studies that met the criteria were analyzed and included in the meta-analysis, evaluating diagnostic accuracy through sensitivity and specificity. For Enzyme-Linked Immunosorbent Assay (ELISA), Fluorescent Antibody Technique (IFAT), Hemagglutination Test (HmT), Polymerase Chain Reaction (PCR), and Real-Time Polymerase Chain Reaction (qPCR) diagnosis methods, the sensitivity had a median of 99.0%, 78.0%, 75.0%, 76.0%, and 94.0%, respectively; while specificity presented a median of 99.0%, 99.0%, 99.0%, 98.0%, and 98.0%, respectively. This meta-analysis showed that ELISA and qPCR techniques had a higher performance compared to other methods of diagnosing CD in the chronic and acute phases, respectively. It was concluded utilizing the Area Under the Curve restricted to the false positive rates (AUCFPR), that the ELISA diagnostic test presents the highest performance in diagnosing acute and chronic CD, compared to serological and molecular tests. Future studies focusing on new CD diagnostics approaches should be targeted.
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Affiliation(s)
- Mayron Antonio Candia-Puma
- Computational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Arequipa 04000, Peru
- Facultad de Ciencias Farmacéuticas, Bioquímicas y Biotecnológicas, Universidad Católica de Santa María, Arequipa 04000, Peru
| | - Laura Yesenia Machaca-Luque
- Computational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Arequipa 04000, Peru
- Facultad de Ciencias Farmacéuticas, Bioquímicas y Biotecnológicas, Universidad Católica de Santa María, Arequipa 04000, Peru
| | - Brychs Milagros Roque-Pumahuanca
- Computational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Arequipa 04000, Peru
- Facultad de Ciencias Farmacéuticas, Bioquímicas y Biotecnológicas, Universidad Católica de Santa María, Arequipa 04000, Peru
| | - Alexsandro Sobreira Galdino
- Laboratório de Biotecnologia de Microrganismos, Universidade Federal São João Del-Rei, Divinópolis 35501-296, MG, Brazil
| | - Rodolfo Cordeiro Giunchetti
- Laboratório de Biologia das Interações Celulares, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais, INCT-DT, Salvador 40015-970, BA, Brazil
| | - Eduardo Antonio Ferraz Coelho
- Programa de Pós-Graduação em Ciências da Saúde, Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
- Departamento de Patologia Clínica, COLTEC, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Miguel Angel Chávez-Fumagalli
- Computational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Arequipa 04000, Peru
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3
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Flores-Chavez MD, Abras A, Ballart C, Ibáñez-Perez I, Perez-Gordillo P, Gállego M, Muñoz C, Moure Z, Sulleiro E, Nieto J, García Diez E, Simón L, Cruz I, Picado A. Parasitemia Levels in Trypanosoma cruzi Infection in Spain, an Area Where the Disease Is Not Endemic: Trends by Different Molecular Approaches. Microbiol Spectr 2022; 10:e0262822. [PMID: 36190410 PMCID: PMC9603785 DOI: 10.1128/spectrum.02628-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 09/13/2022] [Indexed: 01/04/2023] Open
Abstract
Trypanosoma cruzi infection has expanded globally through human migration. In Spain, the mother-to-child route is the mode of transmission contributing to autochthonous Chagas disease (CD); however, most people acquired the infection in their country of origin and were diagnosed in the chronic phase (imported chronic CD). In this context, we assessed the quantitative potential of the Loopamp Trypanosoma cruzi detection kit (Sat-TcLAMP) based on satellite DNA (Sat-DNA) to determine parasitemia levels compared to those detected by real-time quantitative PCRs (qPCRs) targeting Sat-DNA (Sat-qPCR) and kinetoplast DNA minicircles (kDNA-qPCR). This study included 173 specimens from 39 autochthonous congenital and 116 imported chronic CD cases diagnosed in Spain. kDNA-qPCR showed higher sensitivity than Sat-qPCR and Sat-TcLAMP. According to all quantitative approaches, parasitemia levels were significantly higher in congenital infection than in chronic CD (1 × 10-1 to 5 × 105 versus >1 × 10-1 to 6 × 103 parasite equivalents/mL, respectively [P < 0.001]). Sat-TcLAMP, Sat-qPCR, and kDNA-qPCR results were equivalent at high levels of parasitemia (P = 0.381). Discrepancies were significant for low levels of parasitemia and older individuals. Differences between Sat-TcLAMP and Sat-qPCR were not qualitatively significant, but estimations of parasitemia using Sat-TcLAMP were closer to those by kDNA-qPCR. Parasitemia changes were assessed in 6 individual cases in follow-up, in which trends showed similar patterns by all quantitative approaches. At high levels of parasitemia, Sat-TcLAMP, Sat-qPCR, and kDNA-qPCR worked similarly, but significant differences were found for the low levels characteristic of late chronic CD. A suitable harmonization strategy needs to be developed for low-level parasitemia detection using Sat-DNA- and kDNA-based tests. IMPORTANCE Currently, molecular equipment has been introduced into many health care centers, even in low-income countries. PCR, qPCR, and loop-mediated isothermal amplification (LAMP) are becoming more accessible for the diagnosis of neglected infectious diseases. Chagas disease (CD) is spreading worldwide, and in countries where the disease is not endemic, such as Spain, the parasite Trypanosoma cruzi is transmitted from mother to child (congenital CD). Here, we explore why LAMP, aimed at detecting T. cruzi parasite DNA, is a reliable option for the diagnosis of congenital CD and the early detection of reactivation in chronic infection. When the parasite load is high, LAMP is equivalent to any qPCR. In addition, the estimations of T. cruzi parasitemia in patients living in Spain, a country where the disease is not endemic, resemble natural evolution in areas of endemicity. If molecular tests are introduced into the diagnostic algorithm for congenital infection, early diagnosis and timely treatment would be accomplished, so the interruption of vertical transmission can be an achievable goal.
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Affiliation(s)
- Maria D. Flores-Chavez
- National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
- Fundación Mundo Sano-España, Madrid, Spain
| | - Alba Abras
- Departament de Biologia, Universitat de Girona, Girona, Spain
| | - Cristina Ballart
- Secció de Parasitologia, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l’Alimentació, Universitat de Barcelona, Barcelona, Spain
| | - Ismael Ibáñez-Perez
- National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Montserrat Gállego
- Secció de Parasitologia, Departament de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l’Alimentació, Universitat de Barcelona, Barcelona, Spain
- ISGlobal, Barcelona, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III (CIBERINFEC, ISCIII), Madrid, Spain
| | - Carmen Muñoz
- Servei de Microbiologia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Institut de Recerca Biomèdica Sant Pau, Barcelona, Spain
- Departament de Genètica i Microbiologia, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Zaira Moure
- Servicio de Microbiología, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Elena Sulleiro
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III (CIBERINFEC, ISCIII), Madrid, Spain
- Microbiology Department, Vall d’Hebron Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Javier Nieto
- National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III (CIBERINFEC, ISCIII), Madrid, Spain
| | - Emilia García Diez
- National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Lorena Simón
- National Centre of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Israel Cruz
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III (CIBERINFEC, ISCIII), Madrid, Spain
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
- Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland
| | - Albert Picado
- Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland
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Acosta IC, Pérez-Tanoira R, Prieto-Pérez L, Úbeda AC, Álvarez Álvarez B, Antoranz PA, Fernández Guerrero M, Fernández Roblas R, Orejas M, Tomás M, Cariñanos I, Górgolas M. Chagas' heart disease: Descriptive analysis of 141 patients in a hospital of Madrid, Spain. Travel Med Infect Dis 2020; 37:101690. [PMID: 32334089 DOI: 10.1016/j.tmaid.2020.101690] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 02/24/2020] [Accepted: 04/19/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Spain is the European country with the highest number of Trypanosoma cruzi infected patients. Due to the cardiac complications that these patients can develop, it is of paramount importance to evaluate the value of the different heart diagnostic tools. METHOD In this observational study, we describe the main characteristics and data from electrocardiogram, chest X-ray, echocardiogram and cardiac magnetic resonance imaging (MRI) of 141 patients with Chagas' disease attended in a tertiary university hospital in Madrid from 2009 to 2018. RESULTS A total of 50 patients (35.4%) had at least one abnormal cardiac test: 34.2% altered electrocardiogram (40/117), 24.5% altered echocardiogram (27/110) and 9.2% abnormal cardiac MRI (13/41). Of those 13 with a pathological MRI, 53.8% had normal results for any other test. The most frequent alterations observed were hypokinesia with decreased LVEF (left ventricular ejection fraction), dilatation of cavities and cardiac fibrosis. Two thirds of patients with abnormal cardiac test were asymptomatic. Altered echocardiogram was found in 43.8% of patients ≥50 years compared to 16.6% under 50 years (p = 0.003). CONCLUSIONS A transthoracic echocardiogram and a MRI of the heart added a 23.8% increment in diagnosing cardiac pathological findings.
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Affiliation(s)
- Irene Carrillo Acosta
- Division of Infectious Diseases, IIS-Fundación Jiménez Díaz, Madrid, Spain; Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
| | - Ramón Pérez-Tanoira
- Division of Infectious Diseases, IIS-Fundación Jiménez Díaz, Madrid, Spain; Department of Microbiology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain.
| | - Laura Prieto-Pérez
- Division of Infectious Diseases, IIS-Fundación Jiménez Díaz, Madrid, Spain; Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
| | - Alfonso Cabello Úbeda
- Division of Infectious Diseases, IIS-Fundación Jiménez Díaz, Madrid, Spain; Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
| | | | | | - Manuel Fernández Guerrero
- Division of Infectious Diseases, IIS-Fundación Jiménez Díaz, Madrid, Spain; Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
| | - Ricardo Fernández Roblas
- Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain; Department of Microbiology, IIS-Fundación Jiménez Díaz, Madrid, Spain.
| | - Miguel Orejas
- Department of Cardiology, IIS-Fundación Jiménez Díaz, Madrid, Spain.
| | - Marta Tomás
- Department of Radiology, IIS-Fundación Jiménez Díaz, Madrid, Spain.
| | - Irune Cariñanos
- Department of Digestive, Universidad Autónoma de Madrid, Madrid, Spain.
| | - Miguel Górgolas
- Division of Infectious Diseases, IIS-Fundación Jiménez Díaz, Madrid, Spain; Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
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Rios LE, Vázquez-Chagoyán JC, Pacheco AO, Zago MP, Garg NJ. Immunity and vaccine development efforts against Trypanosoma cruzi. Acta Trop 2019; 200:105168. [PMID: 31513763 PMCID: PMC7409534 DOI: 10.1016/j.actatropica.2019.105168] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 08/27/2019] [Accepted: 09/07/2019] [Indexed: 12/28/2022]
Abstract
Trypanosoma cruzi (T. cruzi) is the causative agent for Chagas disease (CD). There is a critical lack of methods for prevention of infection or treatment of acute infection and chronic disease. Studies in experimental models have suggested that the protective immunity against T. cruzi infection requires the elicitation of Th1 cytokines, lytic antibodies and the concerted activities of macrophages, T helper cells, and cytotoxic T lymphocytes (CTLs). In this review, we summarize the research efforts in vaccine development to date and the challenges faced in achieving an efficient prophylactic or therapeutic vaccine against human CD.
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Affiliation(s)
- Lizette E Rios
- Department of Microbiology & Immunology, University of Texas Medical Branch, Galveston, TX 77555-1070, USA
| | - Juan Carlos Vázquez-Chagoyán
- Centro de Investigación y Estudios Avanzados en Salud Animal, Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma del Estado de México, Toluca, México
| | - Antonio Ortega Pacheco
- Departamento de Salud Animal y Medicina Preventiva, Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma de Yucatán, Mérida, Yucatán, México
| | - M Paola Zago
- Instituto de Patología Experimental, Universidad Nacional de Salta - Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Salta, Argentina
| | - Nisha J Garg
- Department of Microbiology & Immunology, University of Texas Medical Branch, Galveston, TX 77555-1070, USA; Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, TX.
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Zhang Y, Ceylan Koydemir H, Shimogawa MM, Yalcin S, Guziak A, Liu T, Oguz I, Huang Y, Bai B, Luo Y, Luo Y, Wei Z, Wang H, Bianco V, Zhang B, Nadkarni R, Hill K, Ozcan A. Motility-based label-free detection of parasites in bodily fluids using holographic speckle analysis and deep learning. LIGHT, SCIENCE & APPLICATIONS 2018; 7:108. [PMID: 30564314 PMCID: PMC6290798 DOI: 10.1038/s41377-018-0110-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 11/25/2018] [Accepted: 11/25/2018] [Indexed: 05/08/2023]
Abstract
Parasitic infections constitute a major global public health issue. Existing screening methods that are based on manual microscopic examination often struggle to provide sufficient volumetric throughput and sensitivity to facilitate early diagnosis. Here, we demonstrate a motility-based label-free computational imaging platform to rapidly detect motile parasites in optically dense bodily fluids by utilizing the locomotion of the parasites as a specific biomarker and endogenous contrast mechanism. Based on this principle, a cost-effective and mobile instrument, which rapidly screens ~3.2 mL of fluid sample in three dimensions, was built to automatically detect and count motile microorganisms using their holographic time-lapse speckle patterns. We demonstrate the capabilities of our platform by detecting trypanosomes, which are motile protozoan parasites, with various species that cause deadly diseases affecting millions of people worldwide. Using a holographic speckle analysis algorithm combined with deep learning-based classification, we demonstrate sensitive and label-free detection of trypanosomes within spiked whole blood and artificial cerebrospinal fluid (CSF) samples, achieving a limit of detection of ten trypanosomes per mL of whole blood (~five-fold better than the current state-of-the-art parasitological method) and three trypanosomes per mL of CSF. We further demonstrate that this platform can be applied to detect other motile parasites by imaging Trichomonas vaginalis, the causative agent of trichomoniasis, which affects 275 million people worldwide. With its cost-effective, portable design and rapid screening time, this unique platform has the potential to be applied for sensitive and timely diagnosis of neglected tropical diseases caused by motile parasites and other parasitic infections in resource-limited regions.
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Affiliation(s)
- Yibo Zhang
- Electrical and Computer Engineering Department, University of California, Los Angeles, CA 90095 USA
- Bioengineering Department, University of California, Los Angeles, CA 90095 USA
- California NanoSystems Institute, University of California, Los Angeles, CA 90095 USA
| | - Hatice Ceylan Koydemir
- Electrical and Computer Engineering Department, University of California, Los Angeles, CA 90095 USA
- Bioengineering Department, University of California, Los Angeles, CA 90095 USA
- California NanoSystems Institute, University of California, Los Angeles, CA 90095 USA
| | - Michelle M. Shimogawa
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, CA 90095 USA
| | - Sener Yalcin
- Electrical and Computer Engineering Department, University of California, Los Angeles, CA 90095 USA
| | - Alexander Guziak
- Department of Physics and Astronomy, University of California, Los Angeles, CA 90095 USA
| | - Tairan Liu
- Electrical and Computer Engineering Department, University of California, Los Angeles, CA 90095 USA
- Bioengineering Department, University of California, Los Angeles, CA 90095 USA
- California NanoSystems Institute, University of California, Los Angeles, CA 90095 USA
| | - Ilker Oguz
- Electrical and Computer Engineering Department, University of California, Los Angeles, CA 90095 USA
| | - Yujia Huang
- Electrical and Computer Engineering Department, University of California, Los Angeles, CA 90095 USA
| | - Bijie Bai
- Electrical and Computer Engineering Department, University of California, Los Angeles, CA 90095 USA
| | - Yilin Luo
- Electrical and Computer Engineering Department, University of California, Los Angeles, CA 90095 USA
| | - Yi Luo
- Electrical and Computer Engineering Department, University of California, Los Angeles, CA 90095 USA
- Bioengineering Department, University of California, Los Angeles, CA 90095 USA
- California NanoSystems Institute, University of California, Los Angeles, CA 90095 USA
| | - Zhensong Wei
- Electrical and Computer Engineering Department, University of California, Los Angeles, CA 90095 USA
| | - Hongda Wang
- Electrical and Computer Engineering Department, University of California, Los Angeles, CA 90095 USA
- Bioengineering Department, University of California, Los Angeles, CA 90095 USA
- California NanoSystems Institute, University of California, Los Angeles, CA 90095 USA
| | - Vittorio Bianco
- Electrical and Computer Engineering Department, University of California, Los Angeles, CA 90095 USA
| | - Bohan Zhang
- Electrical and Computer Engineering Department, University of California, Los Angeles, CA 90095 USA
| | - Rohan Nadkarni
- Bioengineering Department, University of California, Los Angeles, CA 90095 USA
| | - Kent Hill
- California NanoSystems Institute, University of California, Los Angeles, CA 90095 USA
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, CA 90095 USA
- Molecular Biology Institute, University of California, Los Angeles, CA 90095 USA
| | - Aydogan Ozcan
- Electrical and Computer Engineering Department, University of California, Los Angeles, CA 90095 USA
- Bioengineering Department, University of California, Los Angeles, CA 90095 USA
- California NanoSystems Institute, University of California, Los Angeles, CA 90095 USA
- Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA 90095 USA
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7
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Ramírez JD, Herrera G, Hernández C, Cruz-Saavedra L, Muñoz M, Flórez C, Butcher R. Evaluation of the analytical and diagnostic performance of a digital droplet polymerase chain reaction (ddPCR) assay to detect Trypanosoma cruzi DNA in blood samples. PLoS Negl Trop Dis 2018; 12:e0007063. [PMID: 30586355 PMCID: PMC6324824 DOI: 10.1371/journal.pntd.0007063] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 01/08/2019] [Accepted: 12/10/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The recent development of novel Polymerase Chain Reaction (PCR) technologies that confer theoretical advantages over quantitative PCR has considerable potential in the diagnosis of low load infections, such as Trypanosoma cruzi in the chronic phase of Chagas disease. We evaluated the utility of the digital droplet (dd)PCR platform in the detection of T. cruzi infection. METHODOLOGY/PRINCIPAL FINDINGS We imported a validated qPCR assay targeting the T. cruzi satellite tandem repeat (TcSTR) region to the ddPCR platform. Following optimization, we tested and repeated a standard curve of TcI epimastigotes to characterise the analytical performance of the assay on the ddPCR platform. We compared this to published qPCR performance data, and the performance of the qPCR assay in our own testing. We subsequently tested a panel of 192 previously characterized DNA specimens, extracted from the blood of individuals with and without T. cruzi infection. The assay performed well on the ddPCR platform, showing a limit of detection of 5 copies/μL or 1 parasite/mL. This was higher than the published limit of detection for qPCR, which was 0.46 parasites/mL. The ddPCR platform was not significantly more accurate than qPCR at any concentration tested. However, the clinical sensitivity and specificity of the assay were both 100% with perfect agreement between qPCR and ddPCR positive and negative result calling in clinical specimens. An average of 9,286 copies of TcSTR were detected per parasite. CONCLUSIONS/SIGNIFICANCE The use of the ddPCR platform to run this assay was comparable, but not superior in terms of performance, to the qPCR platform.
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Affiliation(s)
- Juan David Ramírez
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Programa de Biología, Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Bogotá, Colombia
| | - Giovanny Herrera
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Programa de Biología, Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Bogotá, Colombia
| | - Carolina Hernández
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Programa de Biología, Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Bogotá, Colombia
| | - Lissa Cruz-Saavedra
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Programa de Biología, Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Bogotá, Colombia
| | - Marina Muñoz
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Programa de Biología, Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Bogotá, Colombia
| | - Carolina Flórez
- Grupo de Parasitología, Instituto Nacional de Salud, Bogotá, Colombia
| | - Robert Butcher
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom
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D’Ávila DA, Galvão LMC, Sousa GR, Britto C, Moreira OC, Chiari E. Monitoring the parasite load in chronic Chagas disease patients: comparison between blood culture and quantitative real time PCR. PLoS One 2018; 13:e0208133. [PMID: 30496249 PMCID: PMC6264508 DOI: 10.1371/journal.pone.0208133] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 11/12/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Despite the improvements in diagnostic tools for detection of Trypanosoma cruzi in human blood samples, the isolation of parasite from bloodstream in the chronic phase of Chagas disease is challenging. Thus, there is an increasing interest in the development of strategies that allow an accurate monitoring of the parasite load in bloodstream of Chagas disease patients. Given that, the comparison of a classical diagnostic method such as blood culture and multiplex quantitative real-time PCR (qPCR) was few explored so far. Therefore, this study aimed to compare the detection and quantification of T. cruzi load in the circulating blood of patients with chronic Chagas disease, using blood culture and qPCR techniques. METHODS⁄PRINCIPAL FINDINGS The multiplex real-time quantitative PCR assay (qPCR) based on TaqMan technology was evaluated in 135 blood samples from 91 patients with chronic Chagas disease presenting indeterminate (asymptomatic, n = 23) and cardiac (chronic cardiomyopathy, n = 68) forms, in comparison with the classical blood culture (BC) technique. The total positivity of qPCR and BC was 58.5% and 49.6%, respectively. The median parasite load of all positive patients was 1.18 [0.39-4.23] par. eq.⁄mL, ranging from 0.01 to 116.10 par. eq.⁄mL. We did not find significant differences between T. cruzi load with age and distinct clinical manifestations of patients. CONCLUSIONS/SIGNIFICANCE Our data suggest that qPCR can be an auxiliary tool for studies that require T. cruzi isolation from the bloodstream of patients with chronic Chagas disease, after the establishment of a parasite load cut-off that guarantees a relative success rate of parasite isolation using BC technique.
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Affiliation(s)
- Daniella Alchaar D’Ávila
- Programa de Pós-Graduação em Parasitologia, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Lúcia Maria C. Galvão
- Programa de Pós-Graduação em Parasitologia, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Giovane R. Sousa
- Section on Immunobiology, Joslin Diabetes Center, Harvard Medical School, Boston, MA, United States of America
| | - Constança Britto
- Laboratório de Biologia Molecular e Doenças Endêmicas, Instituto Oswaldo Cruz, FIOCRUZ, RJ, Brazil
| | - Otacilio C. Moreira
- Laboratório de Biologia Molecular e Doenças Endêmicas, Instituto Oswaldo Cruz, FIOCRUZ, RJ, Brazil
| | - Egler Chiari
- Programa de Pós-Graduação em Parasitologia, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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