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Perrone AE, Pinillo M, Rial MS, Fernández M, Milduberger N, González C, Bustos PL, Fichera LE, Laucella SA, Albareda MC, Bua J. Trypanosoma cruzi Secreted Cyclophilin TcCyP19 as an Early Marker for Trypanocidal Treatment Efficiency. Int J Mol Sci 2023; 24:11875. [PMID: 37569250 PMCID: PMC10418876 DOI: 10.3390/ijms241511875] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/06/2023] [Accepted: 07/12/2023] [Indexed: 08/13/2023] Open
Abstract
Cyclophilins (CyPs) are a family of enzymes involved in protein folding. Trypanosoma cruzi, the causative agent of Chagas disease, has a 19-kDa cyclophilin, TcCyP19, that was found to be secreted in parasite stages of the CL Brener clone and recognized by sera from T. cruzi-infected mice and patients. The levels of specific antibodies against TcCyP19 in T. cruzi-infected mice and subjects before and after drug treatment were measured by an in-house enzyme linked immunosorbent assay (ELISA). Mice in the acute and chronic phase of infection, with successful trypanocidal treatments, showed significantly lower anti-TcCyP19 antibody levels than untreated mice. In children and adults chronically infected with T. cruzi, a significant decrease in the anti-TcCyP19 titers was observed after 12 months of etiological treatment. This decrease was maintained in adult chronic patients followed-up 30-38 months post-treatment. These results encourage further studies on TcCyP19 as an early biomarker of trypanocidal treatment efficiency.
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Affiliation(s)
- Alina E. Perrone
- Instituto Nacional de Parasitología Dr. Mario Fatala Chaben—ANLIS-Malbrán, Av. Paseo Colón 568, Buenos Aires 1063, Argentina; (A.E.P.); (M.P.); (M.S.R.); (M.F.); (N.M.); (C.G.); (P.L.B.); (L.E.F.); (S.A.L.); (M.C.A.)
| | - Mariana Pinillo
- Instituto Nacional de Parasitología Dr. Mario Fatala Chaben—ANLIS-Malbrán, Av. Paseo Colón 568, Buenos Aires 1063, Argentina; (A.E.P.); (M.P.); (M.S.R.); (M.F.); (N.M.); (C.G.); (P.L.B.); (L.E.F.); (S.A.L.); (M.C.A.)
| | - Marcela S. Rial
- Instituto Nacional de Parasitología Dr. Mario Fatala Chaben—ANLIS-Malbrán, Av. Paseo Colón 568, Buenos Aires 1063, Argentina; (A.E.P.); (M.P.); (M.S.R.); (M.F.); (N.M.); (C.G.); (P.L.B.); (L.E.F.); (S.A.L.); (M.C.A.)
| | - Marisa Fernández
- Instituto Nacional de Parasitología Dr. Mario Fatala Chaben—ANLIS-Malbrán, Av. Paseo Colón 568, Buenos Aires 1063, Argentina; (A.E.P.); (M.P.); (M.S.R.); (M.F.); (N.M.); (C.G.); (P.L.B.); (L.E.F.); (S.A.L.); (M.C.A.)
| | - Natalia Milduberger
- Instituto Nacional de Parasitología Dr. Mario Fatala Chaben—ANLIS-Malbrán, Av. Paseo Colón 568, Buenos Aires 1063, Argentina; (A.E.P.); (M.P.); (M.S.R.); (M.F.); (N.M.); (C.G.); (P.L.B.); (L.E.F.); (S.A.L.); (M.C.A.)
| | - Carolina González
- Instituto Nacional de Parasitología Dr. Mario Fatala Chaben—ANLIS-Malbrán, Av. Paseo Colón 568, Buenos Aires 1063, Argentina; (A.E.P.); (M.P.); (M.S.R.); (M.F.); (N.M.); (C.G.); (P.L.B.); (L.E.F.); (S.A.L.); (M.C.A.)
| | - Patricia L. Bustos
- Instituto Nacional de Parasitología Dr. Mario Fatala Chaben—ANLIS-Malbrán, Av. Paseo Colón 568, Buenos Aires 1063, Argentina; (A.E.P.); (M.P.); (M.S.R.); (M.F.); (N.M.); (C.G.); (P.L.B.); (L.E.F.); (S.A.L.); (M.C.A.)
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires 1063, Argentina
| | - Laura E. Fichera
- Instituto Nacional de Parasitología Dr. Mario Fatala Chaben—ANLIS-Malbrán, Av. Paseo Colón 568, Buenos Aires 1063, Argentina; (A.E.P.); (M.P.); (M.S.R.); (M.F.); (N.M.); (C.G.); (P.L.B.); (L.E.F.); (S.A.L.); (M.C.A.)
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires 1063, Argentina
| | - Susana A. Laucella
- Instituto Nacional de Parasitología Dr. Mario Fatala Chaben—ANLIS-Malbrán, Av. Paseo Colón 568, Buenos Aires 1063, Argentina; (A.E.P.); (M.P.); (M.S.R.); (M.F.); (N.M.); (C.G.); (P.L.B.); (L.E.F.); (S.A.L.); (M.C.A.)
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires 1063, Argentina
| | - María Cecilia Albareda
- Instituto Nacional de Parasitología Dr. Mario Fatala Chaben—ANLIS-Malbrán, Av. Paseo Colón 568, Buenos Aires 1063, Argentina; (A.E.P.); (M.P.); (M.S.R.); (M.F.); (N.M.); (C.G.); (P.L.B.); (L.E.F.); (S.A.L.); (M.C.A.)
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires 1063, Argentina
| | - Jacqueline Bua
- Instituto Nacional de Parasitología Dr. Mario Fatala Chaben—ANLIS-Malbrán, Av. Paseo Colón 568, Buenos Aires 1063, Argentina; (A.E.P.); (M.P.); (M.S.R.); (M.F.); (N.M.); (C.G.); (P.L.B.); (L.E.F.); (S.A.L.); (M.C.A.)
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires 1063, Argentina
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Madeira RP, Meneghetti P, Barros LAD, Buck PDC, Mady C, Ianni BM, Fernandez-Becerra C, Torrecilhas AC. Isolation and molecular characterization of circulating extracellular vesicles from blood of chronic Chagas disease patients. Cell Biol Int 2022; 46:883-894. [PMID: 35253308 DOI: 10.1002/cbin.11787] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 02/21/2022] [Accepted: 03/03/2022] [Indexed: 11/11/2022]
Abstract
Extracellular vesicles (EVs) are lipid bilayer envelopes that encase several types of molecules. Their contents mostly reflect their cell origin and possible targets at other locations in the organism and can be modified in pathological conditions to interfere with intercellular communication, thus promoting disease establishment and development. These characteristics, in addition to their presence in virtually all body fluids, make such vesicles ideal for biomarker discovery in human diseases. Here we describe the effect of different anticoagulants and the combination of two purification methods for isolation and characterization of circulating extracellular vesicles from blood of chronic Chagas disease (CCD) patients. We illustrated this procedure by studying a population of patients with Chagas disease at the indeterminate chronic stage, in which the Trypanosoma cruzi is very scarce in circulation. EVs were harvested from blood collected without or with different anticoagulants. Protein and nanoparticle tracking analysis was used to measure EVs size and concentration. The EVs were purified by ultracentrifugation, followed by size exclusion chromatography and characterized by chemiluminescent ELISA and Dot Blot using antibodies that recognized parasite-derived EVs, such as hyperimmune sera, polyclonal and monoclonal antibodies against trans-sialidase and mucins. In parallel, antibodies against classical human EV markers CD9, CD63, CD81 and CD82, were also analyzed. The results showed that anticoagulants did not interfere with the analyzed parameters and circulating EVs from CCD patients contain T. cruzi antigens and classical human exosomal markers. Overall, our protocol is adequate for the isolation of the total circulating extracellular vesicles and can serve as an important basis for further studies on biomarker discovery in Chagas' disease. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Rafael Pedro Madeira
- Disciplina de Infectologia, Departamento de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brasil.,Laboratório de Imunologia Celular e Bioquímica de Fungos e Protozoários, Departamento de Ciências Farmacêuticas, Universidade Federal de São Paulo (UNIFESP), Diadema, Brasil
| | - Paula Meneghetti
- Laboratório de Imunologia Celular e Bioquímica de Fungos e Protozoários, Departamento de Ciências Farmacêuticas, Universidade Federal de São Paulo (UNIFESP), Diadema, Brasil
| | - Lucas Alexandre de Barros
- Laboratório de Imunologia Celular e Bioquímica de Fungos e Protozoários, Departamento de Ciências Farmacêuticas, Universidade Federal de São Paulo (UNIFESP), Diadema, Brasil
| | - Paula de Cassia Buck
- Unidade Clínica de Miocardiopatias, Instituto do Coração, Universidade de São Paulo (USP), São Paulo, Brasil
| | - Charles Mady
- Unidade Clínica de Miocardiopatias, Instituto do Coração, Universidade de São Paulo (USP), São Paulo, Brasil
| | - Barbara Maria Ianni
- Unidade Clínica de Miocardiopatias, Instituto do Coração, Universidade de São Paulo (USP), São Paulo, Brasil
| | - Carmen Fernandez-Becerra
- ISGlobal, Hospital Cl ́ınic - Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigacio ́ en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain.,CIBER de Enfermedades Infecciosas (CIBERINFEC), Spain
| | - Ana Claudia Torrecilhas
- Laboratório de Imunologia Celular e Bioquímica de Fungos e Protozoários, Departamento de Ciências Farmacêuticas, Universidade Federal de São Paulo (UNIFESP), Diadema, Brasil
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Alonso-Vega C, Urbina JA, Sanz S, Pinazo MJ, Pinto JJ, Gonzalez VR, Rojas G, Ortiz L, Garcia W, Lozano D, Soy D, Maldonado RA, Nagarkatti R, Debrabant A, Schijman A, Thomas MC, López MC, Michael K, Ribeiro I, Gascon J, Torrico F, Almeida IC. New chemotherapy regimens and biomarkers for Chagas disease: the rationale and design of the TESEO study, an open-label, randomised, prospective, phase-2 clinical trial in the Plurinational State of Bolivia. BMJ Open 2021; 11:e052897. [PMID: 34972765 PMCID: PMC8720984 DOI: 10.1136/bmjopen-2021-052897] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Chagas disease (CD) affects ~7 million people worldwide. Benznidazole (BZN) and nifurtimox (NFX) are the only approved drugs for CD chemotherapy. Although both drugs are highly effective in acute and paediatric infections, their efficacy in adults with chronic CD (CCD) is lower and variable. Moreover, the high incidence of adverse events (AEs) with both drugs has hampered their widespread use. Trials in CCD adults showed that quantitative PCR (qPCR) assays remain negative for 12 months after standard-of-care (SoC) BZN treatment in ~80% patients. BZN pharmacokinetic data and the nonsynchronous nature of the proliferative mammal-dwelling parasite stage suggested that a lower BZN/NFX dosing frequency, combined with standard or extended treatment duration, might have the same or better efficacy than either drug SoC, with fewer AEs. METHODS AND ANALYSIS New ThErapies and Biomarkers for ChagaS infEctiOn (TESEO) is an open-label, randomised, prospective, phase-2 clinical trial, with six treatment arms (75 patients/arm, 450 patients). Primary objectives are to compare the safety and efficacy of two new proposed chemotherapy regimens of BZN and NFX in adults with CCD with the current SoC for BZN and NFX, evaluated by qPCR and biomarkers for 36 months posttreatment and correlated with CD conventional serology. Recruitment of patients was initiated on 18 December 2019 and on 20 May 2021, 450 patients (study goal) were randomised among the six treatment arms. The treatment phase was finalised on 18 August 2021. Secondary objectives include evaluation of population pharmacokinetics of both drugs in all treatment arms, the incidence of AEs, and parasite genotyping. ETHICS AND DISSEMINATION The TESEO study was approved by the National Institutes of Health (NIH), U.S. Food and Drug Administration (FDA), federal regulatory agency of the Plurinational State of Bolivia and the Ethics Committees of the participating institutions. The results will be disseminated via publications in peer-reviewed journals, conferences and reports to the NIH, FDA and participating institutions. TRIAL REGISTRATION NUMBER NCT03981523.
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Affiliation(s)
| | - Julio A Urbina
- Center for Biochemistry and Biophysics, Venezuelan Institute for Scientific Research (IVIC), Caracas, Distrito Capital, Venezuela, Bolivarian Republic of
| | - Sergi Sanz
- Biostatistics and Data Management Unit, Barcelona Institute for Global Health, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Basic Clinical Practice, Universitat de Barcelona, Barcelona, Spain
| | - María-Jesús Pinazo
- Barcelona Institute for Global Health (ISGLOBAL), Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Jimy José Pinto
- Fundación Ciencia y Estudios Aplicados para el Desarrollo en Salud y Medio Ambiente (CEADES), Cochabamba, Bolivia, Plurinational State of
| | - Virginia R Gonzalez
- Department of Biological Sciences, The University of Texas at El Paso, El Paso, Texas, USA
| | - Gimena Rojas
- Fundación Ciencia y Estudios Aplicados para el Desarrollo en Salud y Medio Ambiente (CEADES), Cochabamba, Bolivia, Plurinational State of
| | - Lourdes Ortiz
- Fundación Ciencia y Estudios Aplicados para el Desarrollo en Salud y Medio Ambiente (CEADES), Tarija, Bolivia, Plurinational State of
- Universidad Autónoma Juan Misael Saracho, Tarija, Bolivia, Plurinational State of
| | - Wilson Garcia
- Centro Plataforma Chagas Sucre, Fundación Ciencia y Estudios Aplicados para el Desarrollo en Salud y Medio Ambiente (CEADES), Sucre, Bolivia, Plurinational State of
- Programa Departamental de Chagas Chuquisaca, Servicio Departamental de Salud de Chuquisaca, Chuquisaca, Bolivia, Plurinational State of
| | - Daniel Lozano
- Fundación Ciencia y Estudios Aplicados para el Desarrollo en Salud y Medio Ambiente (CEADES), Cochabamba, Bolivia, Plurinational State of
| | - Dolors Soy
- Pharmacy Service, Division of Medicines, Hospital Clinic de Barcelona, Barcelona, Spain
- Institut de Investigació Biomèdica Agustí Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Rosa A Maldonado
- Department of Biological Sciences, The University of Texas at El Paso, El Paso, Texas, USA
| | - Rana Nagarkatti
- Division of Emerging and Transfusion Transmitted Diseases, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration (FDA), Silver Spring, Maryland, USA
| | - Alain Debrabant
- Division of Emerging and Transfusion Transmitted Diseases, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration (FDA), Silver Spring, Maryland, USA
| | - Alejandro Schijman
- Laboratorio de Biología Molecular de la Enfermedad de Chagas, Instituto de Investigaciones en Ingeniería Genética y Biología Molecular, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - M Carmen Thomas
- Consejo Superior de Investigaciones Científicas, Instituto de Parasitología y Biomedicina López-Neyra, Granada, Spain
| | - Manuel Carlos López
- Consejo Superior de Investigaciones Científicas, Instituto de Parasitología y Biomedicina López-Neyra, Granada, Spain
| | - Katja Michael
- Department of Chemistry and Biochemistry, The University of Texas at El Paso, El Paso, Texas, USA
| | - Isabela Ribeiro
- Dynamic Portfolio Unit, Drugs for Neglected Diseases initiative, Geneva, Switzerland
| | - Joaquim Gascon
- Barcelona Institute for Global Health (ISGLOBAL), Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Faustino Torrico
- Fundación Ciencia y Estudios Aplicados para el Desarrollo en Salud y Medio Ambiente (CEADES), Cochabamba, Bolivia, Plurinational State of
| | - Igor C Almeida
- Department of Biological Sciences, The University of Texas at El Paso, El Paso, Texas, USA
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Alonso-Padilla J, López MC, Esteva M, Zrein M, Casellas A, Gómez I, Granjon E, Méndez S, Benítez C, Ruiz AM, Sanz S, Gascón J, Thomas MC, Pinazo MJ, Abril M, de Noya BA, Jorge TA, Chatelain E, Grijalva MJ, Guhl F, Hasslocher-Moreno AM, Luquetti AO, Noya O, Ramsey JM, Ribeiro I, Longhi SA, Schijman AG, Sosa-Estani S, Torrico F, Viotti R. Serological reactivity against T. cruzi-derived antigens: Evaluation of their suitability for the assessment of response to treatment in chronic Chagas disease. Acta Trop 2021; 221:105990. [PMID: 34090864 DOI: 10.1016/j.actatropica.2021.105990] [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: 11/19/2020] [Revised: 05/20/2021] [Accepted: 05/26/2021] [Indexed: 10/21/2022]
Abstract
Chagas disease, caused by the protozoan Trypanosoma cruzi, affects more than 6 million people worldwide. Following a mostly asymptomatic acute phase, the disease progresses to a long-lasting chronic phase throughout which life-threatening disorders to the heart and/or gastrointestinal tract will manifest in about 30% of those chronically infected. During the chronic phase, the parasitemia is low and intermittent, while a high level of anti-T. cruzi antibodies persist for years. These two features hamper post-chemotherapeutic follow-up of patients with the tools available. The lack of biomarkers for timely assessment of therapeutic response discourages a greater use of the two available anti-parasitic drugs, and complicates the evaluation of new drugs in clinical trials. Herein, we investigated in a blinded case-control study the serological reactivity over time of a group of parasite-derived antigens to potentially address follow up of T. cruzi chronically infected subjects after treatment. We tested PFR2, KMP11, HSP70, 3973, F29 and the InfYnity multiplexed antigenic array, by means of serological assays on a multi-national retrospective collection of samples. Some of the antigens exhibited promising results, underscoring the need for further studies to determine their potential role as treatment response biomarkers.
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