1
|
Unraveling the susceptibility of paracoccidioidomycosis: Insights towards the pathogen-immune interplay and immunogenetics. INFECTION GENETICS AND EVOLUTION 2020; 86:104586. [PMID: 33039601 DOI: 10.1016/j.meegid.2020.104586] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 09/27/2020] [Accepted: 10/05/2020] [Indexed: 02/07/2023]
Abstract
Paracoccidioidomycosis (PCM) is a life-threatening systemic mycosis caused by Paracoccidioides spp. This disease comprises three clinical forms: symptomatic acute and chronic forms (PCM disease) and PCM infection, a latent form without clinical symptoms. PCM disease differs markedly according to severity, clinical manifestations, and host immune response. Fungal virulence factors and adhesion molecules are determinants for entry, latency, immune escape and invasion, and dissemination in the host. Neutrophils and macrophages play a paramount role in first-line defense against the fungus through the recognition of antigens by pattern recognition receptors (PRRs), activating their microbicidal machinery. Furthermore, the clinical outcome of the PCM is strongly associated with the variability of cytokines and immunoglobulins produced by T and B cells. While the mechanisms that mediate susceptibility or resistance to infection are dictated by the immune system, some genetic factors may alter gene expression and its final products and, hence, modulate how the organism responds to infection and injury. This review outlines the main findings relative to this topic, addressing the complexity of the immune response triggered by Paracoccidioides spp. infection from preclinical investigations to studies in humans. Here, we focus on mechanisms of fungal pathogenesis, the patterns of innate and adaptive immunity, and the genetic and molecular basis related to immune response and susceptibility to the development of the PCM and its clinical forms. Immunogenetic features such as HLA system, cytokines/cytokines receptors genes and other immune-related genes, and miRNAs are likewise discussed. Finally, we point out the occurrence of PCM in patients with primary immunodeficiencies and call attention to the research gaps and challenges faced by the PCM field.
Collapse
|
2
|
Sato PK, Busser FD, Carvalho FMDC, Gomes Dos Santos A, Sadahiro A, Diogo CL, Kono ASG, Moretti ML, Luiz ODC, Shikanai-Yasuda MA. Polymorphism in the Promoter Region of the IL18 Gene and the Association With Severity on Paracoccidioidomycosis. Front Immunol 2020; 11:542210. [PMID: 33117339 PMCID: PMC7559583 DOI: 10.3389/fimmu.2020.542210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 08/21/2020] [Indexed: 01/06/2023] Open
Abstract
Paracoccidioidomycosis (PCM) is an important endemic, systemic disease in Latin America caused by Paracoccidioides spp. This mycosis has been associated with high morbidity and sequels, and its clinical manifestations depend on the virulence of the infecting strain, the degree and type of immune response, infected tissues, and intrinsic characteristics of the host. The T helper(Th)1 and Th17/Th22 cells are related to resistance and control of infection, and a Th2/Th9 response is associated with disease susceptibility. In this study, we focused on interleukin(IL)-12p35 (IL12A), IL-18 (IL18), and IFN-γ receptor 1 (IFNGR1) genetic polymorphisms because their respective roles have been described in human PCM. Real-time PCR was employed to analyze IL12A-504 G/T (rs2243115), IL18-607 C/A (rs1946518), and IFNGR1-611 A/G (rs1327474) single nucleotide polymorphisms (SNP). One hundred forty-nine patients with the acute form (AF), multifocal chronic (MC), or unifocal chronic (UC) forms of PCM and 110 non-PCM individuals as a control group were included. In the unconditional logistic regression analysis adjusted by ethnicity and sex, we observed a high risk of the IL18-607 A-allele for both AF [p = 0.015; OR = 3.10 (95% CI: 1.24–7.77)] and MC groups [p = 0.023; OR = 2.61 (95% CI: 1.14–5.96)] when compared with UC. The IL18-607 A-allele associated risk for the AF and MC groups as well as the protective role of the C-allele in UC are possibly linked to higher levels of IL-18 at different periods of the course of the disease. Therefore, a novel role of IL18-607 C/A SNP is shown in the present study, highlighting its importance in the outcome of PCM.
Collapse
Affiliation(s)
- Paula Keiko Sato
- Laboratory of Medical Investigation in Immunology (LIM48), Faculdade de Medicina, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.,Institute of Tropical Medicine, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | - Felipe Delatorre Busser
- Laboratory of Medical Investigation in Immunology (LIM48), Faculdade de Medicina, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.,Institute of Tropical Medicine, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | - Flávia Mendes da Cunha Carvalho
- Laboratory of Medical Investigation in Immunology (LIM48), Faculdade de Medicina, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.,Department of Infectious and Parasitic Diseases, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | - Alexandra Gomes Dos Santos
- Laboratory of Medical Investigation in Immunology (LIM48), Faculdade de Medicina, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.,Department of Infectious and Parasitic Diseases, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | - Aya Sadahiro
- Department of Parasitology, Instituto de Ciências Biológicas, Federal University of Amazonas, Manaus, Brazil
| | - Constancia Lima Diogo
- Laboratory of Medical Investigation in Immunology (LIM48), Faculdade de Medicina, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.,Institute of Tropical Medicine, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | | | - Maria Luiza Moretti
- Faculdade de Ciências Médicas, Hospital das Clínicas, State University of Campinas, Campinas, Brazil
| | - Olinda do Carmo Luiz
- Department of Preventive Medicine, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | - Maria Aparecida Shikanai-Yasuda
- Laboratory of Medical Investigation in Immunology (LIM48), Faculdade de Medicina, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil.,Institute of Tropical Medicine, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil.,Department of Infectious and Parasitic Diseases, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
3
|
Singi P, Rocha RP, de Carli ML, Hanemann JAC, Pereira AAC, Coelho LFL, Malaquias LCC. Different
DNA
methylation profile is demonstrated in paracoccidioidomycosis patients without oral lesions. Mycoses 2019; 62:1133-1139. [DOI: 10.1111/myc.13000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 09/04/2019] [Accepted: 09/04/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Paola Singi
- Department of Clinic and Surgery School of Dentistry Federal University of Alfenas Alfenas MG Brazil
| | - Raissa P. Rocha
- Graduate Program in Microbiology Federal University of Minas Gerais Belo Horizonte MG Brazil
| | - Marina L. de Carli
- Department of Clinic and Surgery School of Dentistry Federal University of Alfenas Alfenas MG Brazil
| | - João Adolfo C. Hanemann
- Department of Clinic and Surgery School of Dentistry Federal University of Alfenas Alfenas MG Brazil
| | - Alessandro A. C. Pereira
- Department of Pathology and Parasitology Institute of Biomedical Sciences Federal University of Alfenas Alfenas MG Brazil
| | - Luiz Felipe L. Coelho
- Department of Microbiology and Immunology Institute of Biomedical Sciences Federal University of Alfenas Alfenas MG Brazil
| | - Luiz Cosme C. Malaquias
- Department of Microbiology and Immunology Institute of Biomedical Sciences Federal University of Alfenas Alfenas MG Brazil
| |
Collapse
|
4
|
Dhitinanmuang W, Chongtrakool P, Jitmuang A. Undiagnosed Cryptococcus gattii meningitis leading to subsequent ventriculoperitoneal shunt infection in a patient with symptoms of normal pressure hydrocephalus: case report and literature review. BMC Infect Dis 2018; 18:257. [PMID: 29866070 PMCID: PMC5987493 DOI: 10.1186/s12879-018-3165-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 05/25/2018] [Indexed: 11/10/2022] Open
Abstract
Background Cryptococcus gattii is known to be an etiologic agent of human cryptococcosis, particularly in immunocompetent persons. C. gattii infection usually involves the central nervous system, the respiratory tract, or may be disseminated. Here we report an atypical manifestation of C. gattii infection in a patient who had C. gattii meningitis complicating the ventriculoperitoneal (VP) shunt infection and concurrent infected intraabdominal VP shunt pseudocyst. Case presentation A 66-year-old Thai female was initially diagnosed with normal pressure hydrocephalus (NPH) and underwent programmable VP shunt placement. However, she still suffered from recurrent communicating hydrocephalus with in-place VP shunt, and later developed recurrent gait impairment, chronic abdominal pain and abdominal mass. Radiological studies demonstrated recurrent hydrocephalus and a very large intraabdominal VP shunt pseudocyst. C. gattii was isolated from both the cerebrospinal fluid and the pseudocyst aspiration. C. gattii meningitis complicating the VP shunt infection and concurrent infected intraabdominal VP shunt pseudocyst was diagnosed. Prolonged antifungal therapy, removal of the infected VP shunt with subsequent implant of a new shunt provided a good outcome. Conclusion Chronic C. gattii meningitis should be aware in a patient presenting with normal pressure hydrocephalus. Under-diagnosed cryptococcal meningitis following VP shunt insertion for treating the hydrocephalus can render a complicated VP shunt infection including infected VP shunt pseudocyst.
Collapse
Affiliation(s)
- Wutthiseth Dhitinanmuang
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand
| | - Piriyaporn Chongtrakool
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Anupop Jitmuang
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand.
| |
Collapse
|
5
|
Mendes RP, Cavalcante RDS, Marques SA, Marques MEA, Venturini J, Sylvestre TF, Paniago AMM, Pereira AC, da Silva JDF, Fabro AT, Bosco SDMG, Bagagli E, Hahn RC, Levorato AD. Paracoccidioidomycosis: Current Perspectives from Brazil. Open Microbiol J 2017; 11:224-282. [PMID: 29204222 PMCID: PMC5695158 DOI: 10.2174/1874285801711010224] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 10/10/2017] [Accepted: 10/10/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND This review article summarizes and updates the knowledge on paracoccidioidomycosis. P lutzii and the cryptic species of P. brasiliensis and their geographical distribution in Latin America, explaining the difficulties observed in the serological diagnosis. OBJECTIVES Emphasis has been placed on some genetic factors as predisposing condition for paracoccidioidomycosis. Veterinary aspects were focused, showing the wide distribution of infection among animals. The cell-mediated immunity was better characterized, incorporating the recent findings. METHODS Serological methods for diagnosis were also compared for their parameters of accuracy, including the analysis of relapse. RESULTS Clinical forms have been better classified in order to include the pictures less frequently observesiod. CONCLUSION Itraconazole and the trimethoprim-sulfamethoxazole combination was compared regarding efficacy, effectiveness and safety, demonstrating that azole should be the first choice in the treatment of paracoccidioidomycosis.
Collapse
Affiliation(s)
- Rinaldo Poncio Mendes
- Department of Tropical Diseases, Faculdade de Medicina de Botucatu – São Paulo State University – UNESP, São Paulo, Brazil
| | - Ricardo de Souza Cavalcante
- Department of Tropical Diseases, Faculdade de Medicina de Botucatu – São Paulo State University – UNESP, São Paulo, Brazil
| | - Sílvio Alencar Marques
- Department of Dermatology, Faculdade de Medicina de Botucatu – São Paulo State University – UNESP, São Paulo, Brazil
| | | | - James Venturini
- Laboratory of Experimental Immunology, Department of Biological Science, Faculty of Science, São Paulo State University – UNESP, São Paulo, Brazil
| | - Tatiane Fernanda Sylvestre
- Department of Tropical Diseases, Faculdade de Medicina de Botucatu – São Paulo State University – UNESP, São Paulo, Brazil
| | - Anamaria Mello Miranda Paniago
- Department of Infectious and Parasitic Diseases, Faculdade de Medicina – Federal University of Mato Grosso do Sul – UFMS, Brazil
| | | | - Julhiany de Fátima da Silva
- Department of Tropical Diseases, Faculdade de Medicina de Botucatu – São Paulo State University – UNESP, São Paulo, Brazil
| | - Alexandre Todorovic Fabro
- Unit of Experimental Research, Faculdade de Medicina de Botucatu – São Paulo State University – UNESP, São Paulo, Brazil
| | - Sandra de Moraes Gimenes Bosco
- Department of Microbiology and Immunology – Instituto de Biociências de Botucatu – São Paulo State University – UNESP, São Paulo, Brazil
| | - Eduardo Bagagli
- Department of Microbiology and Immunology – Instituto de Biociências de Botucatu – São Paulo State University – UNESP, São Paulo, Brazil
| | - Rosane Christine Hahn
- Laboratory of Investigation and Mycology, Federal University of Mato Grosso, Faculty of Medicine Cuiabá, Mato Grosso, Brazil
| | - Adriele Dandara Levorato
- Department of Tropical Diseases, Faculdade de Medicina de Botucatu – São Paulo State University – UNESP, São Paulo, Brazil
| |
Collapse
|
6
|
Polymorphisms on IFNG, IL12B and IL12RB1 genes and paracoccidioidomycosis in the Brazilian population. INFECTION GENETICS AND EVOLUTION 2016; 43:245-51. [PMID: 27223631 DOI: 10.1016/j.meegid.2016.05.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 04/07/2016] [Accepted: 05/17/2016] [Indexed: 01/16/2023]
Abstract
Paracoccidioidomycosis (PCM) is a systemic chronic mycosis, endemic in Latin America, especially Brazil, and is the eighth leading cause of death among chronic and recurrent infectious diseases. PCM infection is characterized by the presence of Th1 immune response; the acute form, by a mixed Th2/Th9, while the chronic form is characterized by Th17/Th22 profiles. The occurrence and severity of human PCM may also be associated with genetic factors such as single nucleotide polymorphisms (SNP) on cytokines encoding genes. We investigated the association between these polymorphisms and the different clinical forms of PCM. We included 156 patients with PCM (40 with the acute form, 99 with the chronic multifocal and 17 with the chronic unifocal form) and assayed their DNA samples for IFNG +874 T/A SNP by PCR-ARMS (Amplification Refractory Mutational System), IL12B +1188 A/C SNP on 3' UTR and IL12RB1 641 A/G SNP on exon 7 by PCR-RFLP (Restriction Fragment Length Polymorphism). We found similar genotypic and allelic frequencies of the investigated SNPs among the clinical forms of PCM. Considering male patients, the IL12RB1 641 AA genotype was more frequent in the chronic multifocal form while heterozygosis was in the chronic unifocal form of PCM (p=0.048). Although our data suggest that the AA genotype (IL12RB1) may be associated with the more disseminated chronic disease, more patients of the chronic unifocal PCM group need to be analyzed as well as the secretion patterns of IFN-γ combined with the IL-12Rβ1 expression for a better comprehension of this association.
Collapse
|
7
|
Bocca AL, Amaral AC, Teixeira MM, Sato PK, Shikanai-Yasuda MA, Soares Felipe MS. Paracoccidioidomycosis: eco-epidemiology, taxonomy and clinical and therapeutic issues. Future Microbiol 2013; 8:1177-91. [DOI: 10.2217/fmb.13.68] [Citation(s) in RCA: 140] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Acquired by inhalation of the thermal dimorphic fungi Paracoccidioides spp. conidia, paracoccidioidomycosis ranges from symptomatic to severe and potentially fatal disseminated disease. The main focus of this review is to highlight clinical aspects of paracoccidioidomycosis and, its pathogens’ diversity ecology and particularities. In addition, we present strategies for therapy, including DNA vaccines and nanostructured drugs. Molecular and morphological data supported the split of the Paracoccidioides genus into two species, Paracoccidioides brasiliensis and Paracoccidioides lutzii. An acute form of the disease affects approximately 5% of cases and involves the phagocytic mononuclear system, resulting in progressive lymphadenopathy. The chronic form affects adult men and frequently involves lungs, skin and mucous membranes, lymph nodes, and adrenal glands. The clinical manifestations depend on the ability of the host to control the fungal multiplication and dissemination. The long survival time of the fungus in the host tissues allows it to evade immune responses; therefore, successful treatment often requires long-time therapy. The consensus for treatment must consider the severity of the disease and includes sulfone derivatives, amphotericin B and azoles. Novel strategies for therapy, based on DNA vaccines and nanostructured drugs are also presented and discussed in this review.
Collapse
Affiliation(s)
| | - André Corrêa Amaral
- Biotechnology, Institute of Tropical Pathology & Public Health, Universidade Federal de Goiás, Goiania, GO, Brazil
| | | | - Paula Keiko Sato
- Laboratory of Clinical Immunology, Hospital das Clínicas, Faculdade de Medicina, University of São Paulo, Brazil
| | - Maria Aparecida Shikanai-Yasuda
- Laboratory of Clinical Immunology, Hospital das Clínicas, Faculdade de Medicina, University of São Paulo, Brazil
- Department of Infectious & Parasitic Diseases, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | | |
Collapse
|
8
|
Bellissimo-Rodrigues F, Bollela VR, Da Fonseca BAL, Martinez R. Endemic paracoccidioidomycosis: relationship between clinical presentation and patients' demographic features. Med Mycol 2012; 51:313-8. [PMID: 22928923 DOI: 10.3109/13693786.2012.714529] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Paracoccidioidomycosis (PCM) is a systemic fungal disease endemic to Latin America and characterized by two clinical presentations, i.e., patients develop either acute/subacute or chronic clinical manifestations. The differences in clinical presentations are mainly dependent on the host immune response, but may also be related to demographic characteristics of some patients. In this retrospective study, 1,219 PCM cases treated between 1970 and 2009 in a university medical center, located in southeastern Brazil, were analyzed according to their clinical and demographic features. The most affected anatomical sites were lungs (63.8%) and oral mucosa (50.0%), with increasing involvement of these sites in accord with the age of the patients. Generalized lymphadenopathy (28.1%) and skin lesions (29.6%) were more frequent on the first decades of life. Involvement of the larynx (16.1%), gut (7.5%), spleen (4.7%), central nervous system (3.4%), bones and joints (2.2%), and adrenal (2.1%) were also variable according to the age of the host. The acute/subacute form of the disease accounted for 26.4% of PCM cases and, on a multivariate analysis, was inversely associated with aging (OR = 0.8 per year, P < 0.001), and directly associated with female sex (OR = 7.2, P < 0.001), mixed black and white racial background (OR = 2.3, P < 0.001) or black skin color (OR = 4.6, P < 0.001). Based on these findings, we have shown that host immune response, as well as age, gender and ethnicity may influence the clinical presentation of PCM.
Collapse
Affiliation(s)
- Fernando Bellissimo-Rodrigues
- Social Medicine Department, Faculdade de Medicina de Ribeirão Preto, São Paulo University, Ribeirão Preto, São Paulo State, Brazil
| | | | | | | |
Collapse
|
9
|
Fortes MRP, Miot HA, Kurokawa CS, Marques MEA, Marques SA. Immunology of paracoccidioidomycosis. An Bras Dermatol 2012; 86:516-24. [PMID: 21738969 DOI: 10.1590/s0365-05962011000300014] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2010] [Indexed: 11/22/2022] Open
Abstract
Paracoccidioidomycosis is the most prevalent systemic mycosis in Latin America, among immunecompetent patients. It's caused by the dimorphic fungus Paracoccidioiddes brasiliensis. Investigations regarding its immunopathogenesis are very important in the understanding of aspects related to natural history, as the protective immunity, and the relationship between host and parasite; also favoring the knowledge about clinical patterns and the elaboration of therapeutic strategies. The disease clinical polymorphism depends, at least, of the immune response profile according to the tissue and blood released citokynes, resulting in tissue damage.
Collapse
|
10
|
Abbas M, Bobo LD, Hsieh YH, Berka N, Dunston G, Bonney GE, Apprey V, Quinn TC, West SK. Human leukocyte antigen (HLA)-B, DRB1, and DQB1 allotypes associated with disease and protection of trachoma endemic villagers. Invest Ophthalmol Vis Sci 2008; 50:1734-8. [PMID: 18824733 DOI: 10.1167/iovs.08-2053] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Trachoma remains the leading preventable infectious cause of blindness in developing countries. Human leukocyte antigen (HLA) associations with ocular disease severity and persistent Chlamydia trachomatis infection of Tanzanians living in trachoma-endemic villages were examined to determine possible protective candidate allotypes for vaccine development. METHODS Buccal swab scrapes were taken from subjects in the Trichiasis Study Group (TSG), which studied females only, and the Family Trachoma Study (FTS), which compared persistently infected probands who had severe disease with disease-free siblings and parents. DNA was purified for polymerase chain reaction sequence-specific oligonucleotide identification of HLA-DRB1, DQB1, and B allotypes. Infection was detected from conjunctival scrapes using a C. trachomatis-specific PCR-enzyme immunoassay for the MOMP-1 gene. RESULTS In the TSG, DR*B11 (odds ratio [OR], 0.48; 95% confidence interval [CI], 0.26-0.90; P=0.02) was significantly associated with lack of trichiasis, whereas HLA-B*07 (OR, 3.26; 95% CI, 1.42-7.49; P=0.004) and HLA-B*08 (OR, 5.12; 95% CI, 1.74-15.05; P=0.001) were associated with trichiasis. In addition, HLA-B*14 was significantly associated with inflammatory trachoma + follicular trachoma (OR, 3.76; 95% CI, 1.70-8.33; P=0.04). There were no significant allele frequencies for the FTS. CONCLUSIONS The data suggest that HLA-DRB*11 may offer protection from trichiasis in trachoma hyperendemic villages. Complete allotype identification and designation of its respective protective CD4(+) T-cell antigens could provide a testable candidate vaccine for blindness prevention. Additionally, buccal swab DNA was sufficiently stable when acquired under harsh field conditions and stored long term in the freezer for low-resolution HLA typing.
Collapse
Affiliation(s)
- Muneer Abbas
- National Human Genome Center, Howard University, Washington, DC, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
11
|
|