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Silva KA, do Prado VB, Silva RR, Rocha MVP, de Oliveira RAR, Falcão TDJR, Serpa CC, Rocha MA, Pereira SP, Silva LS, Machado JM, Machado-de-Ávila RA, Fujiwara RT, Chávez-Fumagalli MA, Coelho EAF, Giunchetti RC, Campos-da-Paz M, Gonçalves AAM, Galdino AS. A Mini-Review of Diagnostic Methods for the Antigen and Antibody Detection of Rocky Mountain and Brazilian Spotted Fever. Biomedicines 2024; 12:1501. [PMID: 39062074 PMCID: PMC11274458 DOI: 10.3390/biomedicines12071501] [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: 04/27/2024] [Revised: 06/05/2024] [Accepted: 06/08/2024] [Indexed: 07/28/2024] Open
Abstract
Rocky Mountain or Brazilian spotted fever, caused by Rickettsia rickettsii, is a fulminant, seasonal, and neglected disease that occurs in focal points of North America and South America. Its rapid detection is essential for the better prognosis and survival rate of infected individuals. However, disease diagnosis still faces challenges as the accuracy of many of the available laboratory tests fluctuates. This review aimed to analyze methods for antibody or antigen detection, their gaps, and their evolution over time. A search was conducted to find all studies in the Pubmed database that described the antibody or antigen detection of R. rickettsii infections. Initially, a total of 403 articles were screened. Of these articles, only 17 fulfilled the pre-established inclusion criteria and were selected. Among the different methods applied, the IFA technique was the one most frequently found in the studies. However, it presented varied results such as a low specificity when using the indirect method. Other techniques, such as ELISA and immunohistochemistry, were also found, although in smaller numbers and with their own limitations. Although some studies showed promising results, there is a pressing need to find new techniques to develop a rapid and effective diagnosis of R. rickettssi infection.
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Affiliation(s)
- Kamila Alves Silva
- Programas de Pós-graduação em Biotecnologia (PPGBIOTEC) e Multicêntrico em Bioquimica e Biologia Molecular (PMBqBM), Disciplina Biotecnologia & Inovações, Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil; (K.A.S.); (V.B.d.P.); (R.R.S.); (M.v.P.R.); (R.A.R.d.O.); (T.d.J.R.F.); (C.C.S.); (M.A.R.); (S.P.P.)
- Laboratório de Biotecnologia de Microrganismos, National Institute of Science and Technology in Industrial Biotechnology (INCT-BIO), Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil; (L.S.S.); (J.M.M.); (A.A.M.G.)
| | - Vanesa Borges do Prado
- Programas de Pós-graduação em Biotecnologia (PPGBIOTEC) e Multicêntrico em Bioquimica e Biologia Molecular (PMBqBM), Disciplina Biotecnologia & Inovações, Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil; (K.A.S.); (V.B.d.P.); (R.R.S.); (M.v.P.R.); (R.A.R.d.O.); (T.d.J.R.F.); (C.C.S.); (M.A.R.); (S.P.P.)
| | - Rafael Rodrigues Silva
- Programas de Pós-graduação em Biotecnologia (PPGBIOTEC) e Multicêntrico em Bioquimica e Biologia Molecular (PMBqBM), Disciplina Biotecnologia & Inovações, Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil; (K.A.S.); (V.B.d.P.); (R.R.S.); (M.v.P.R.); (R.A.R.d.O.); (T.d.J.R.F.); (C.C.S.); (M.A.R.); (S.P.P.)
| | - Marcelo van Petten Rocha
- Programas de Pós-graduação em Biotecnologia (PPGBIOTEC) e Multicêntrico em Bioquimica e Biologia Molecular (PMBqBM), Disciplina Biotecnologia & Inovações, Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil; (K.A.S.); (V.B.d.P.); (R.R.S.); (M.v.P.R.); (R.A.R.d.O.); (T.d.J.R.F.); (C.C.S.); (M.A.R.); (S.P.P.)
| | - Rafael Almeida Ribeiro de Oliveira
- Programas de Pós-graduação em Biotecnologia (PPGBIOTEC) e Multicêntrico em Bioquimica e Biologia Molecular (PMBqBM), Disciplina Biotecnologia & Inovações, Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil; (K.A.S.); (V.B.d.P.); (R.R.S.); (M.v.P.R.); (R.A.R.d.O.); (T.d.J.R.F.); (C.C.S.); (M.A.R.); (S.P.P.)
| | - Tarumim de Jesus Rodrigues Falcão
- Programas de Pós-graduação em Biotecnologia (PPGBIOTEC) e Multicêntrico em Bioquimica e Biologia Molecular (PMBqBM), Disciplina Biotecnologia & Inovações, Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil; (K.A.S.); (V.B.d.P.); (R.R.S.); (M.v.P.R.); (R.A.R.d.O.); (T.d.J.R.F.); (C.C.S.); (M.A.R.); (S.P.P.)
| | - Clara Cristina Serpa
- Programas de Pós-graduação em Biotecnologia (PPGBIOTEC) e Multicêntrico em Bioquimica e Biologia Molecular (PMBqBM), Disciplina Biotecnologia & Inovações, Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil; (K.A.S.); (V.B.d.P.); (R.R.S.); (M.v.P.R.); (R.A.R.d.O.); (T.d.J.R.F.); (C.C.S.); (M.A.R.); (S.P.P.)
| | - Marina Andrade Rocha
- Programas de Pós-graduação em Biotecnologia (PPGBIOTEC) e Multicêntrico em Bioquimica e Biologia Molecular (PMBqBM), Disciplina Biotecnologia & Inovações, Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil; (K.A.S.); (V.B.d.P.); (R.R.S.); (M.v.P.R.); (R.A.R.d.O.); (T.d.J.R.F.); (C.C.S.); (M.A.R.); (S.P.P.)
| | - Sabrina Paula Pereira
- Programas de Pós-graduação em Biotecnologia (PPGBIOTEC) e Multicêntrico em Bioquimica e Biologia Molecular (PMBqBM), Disciplina Biotecnologia & Inovações, Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil; (K.A.S.); (V.B.d.P.); (R.R.S.); (M.v.P.R.); (R.A.R.d.O.); (T.d.J.R.F.); (C.C.S.); (M.A.R.); (S.P.P.)
- Laboratório de Biotecnologia de Microrganismos, National Institute of Science and Technology in Industrial Biotechnology (INCT-BIO), Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil; (L.S.S.); (J.M.M.); (A.A.M.G.)
| | - Líria Souza Silva
- Laboratório de Biotecnologia de Microrganismos, National Institute of Science and Technology in Industrial Biotechnology (INCT-BIO), Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil; (L.S.S.); (J.M.M.); (A.A.M.G.)
| | - Juliana Martins Machado
- Laboratório de Biotecnologia de Microrganismos, National Institute of Science and Technology in Industrial Biotechnology (INCT-BIO), Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil; (L.S.S.); (J.M.M.); (A.A.M.G.)
| | - Ricardo Andrez Machado-de-Ávila
- Laboratório de Fisiopatologia Experimental, Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma 88806-000, Santa Catarina, Brazil;
| | - Ricardo Toshio Fujiwara
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Minas Gerais, Brazil;
| | - Miguel Angel Chávez-Fumagalli
- Computational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Arequipa 04000, Peru;
| | - Eduardo Antônio Ferraz Coelho
- Postgraduate Program in Health Sciences: Infectious Diseases and Tropical Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte 30130-100, Minas Gerais, Brazil;
| | - Rodolfo Cordeiro Giunchetti
- Laboratory of Biology of Cell Interactions, National Institute of Science and Technology in Tropical Diseases (INCT-DT), Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, Minas Gerais, Brazil;
| | - Mariana Campos-da-Paz
- Laboratório de Bioativos e Nanobiotecnologia, Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil;
| | - Ana Alice Maia Gonçalves
- Laboratório de Biotecnologia de Microrganismos, National Institute of Science and Technology in Industrial Biotechnology (INCT-BIO), Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil; (L.S.S.); (J.M.M.); (A.A.M.G.)
| | - Alexsandro Sobreira Galdino
- Programas de Pós-graduação em Biotecnologia (PPGBIOTEC) e Multicêntrico em Bioquimica e Biologia Molecular (PMBqBM), Disciplina Biotecnologia & Inovações, Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil; (K.A.S.); (V.B.d.P.); (R.R.S.); (M.v.P.R.); (R.A.R.d.O.); (T.d.J.R.F.); (C.C.S.); (M.A.R.); (S.P.P.)
- Laboratório de Biotecnologia de Microrganismos, National Institute of Science and Technology in Industrial Biotechnology (INCT-BIO), Universidade Federal de São João Del-Rei, Divinópolis 35501-296, Minas Gerais, Brazil; (L.S.S.); (J.M.M.); (A.A.M.G.)
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Gonzales Y Tucker RD, Addepalli A. Fever and Rash. Emerg Med Clin North Am 2024; 42:303-334. [PMID: 38641393 DOI: 10.1016/j.emc.2024.01.005] [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: 04/21/2024]
Abstract
Infectious causes of fever and rash pose a diagnostic challenge for the emergency provider. It is often difficult to discern rashes associated with rapidly progressive and life-threatening infections from benign exanthems, which comprise the majority of rashes seen in the emergency department. Physicians must also consider serious noninfectious causes of fever and rash. A correct diagnosis depends on an exhaustive history and head-to-toe skin examination as most emergent causes of fever and rash remain clinical diagnoses. A provisional diagnosis and immediate treatment with antimicrobials and supportive care are usually required prior to the return of confirmatory laboratory testing.
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Affiliation(s)
- Richard Diego Gonzales Y Tucker
- Department of Emergency Medicine, University of California San Francisco, Box 0209, 505 Parnassus Avenue, San Francisco, CA 94143, USA; Department of Emergency Medicine, Alameda Health System - Wilma Chan Highland Hospital, 1411 E 31st Street, Oakland, CA 94602, USA.
| | - Aravind Addepalli
- Department of Emergency Medicine, University of California San Francisco, Box 0209, 505 Parnassus Avenue, San Francisco, CA 94143, USA
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Zychowski DL, Alvarez C, Abernathy H, Giandomenico D, Choudhary SK, Vorobiov JM, Boyce RM, Nelson AE, Commins SP. Tick-Borne Disease Infections and Chronic Musculoskeletal Pain. JAMA Netw Open 2024; 7:e2351418. [PMID: 38206624 PMCID: PMC10784854 DOI: 10.1001/jamanetworkopen.2023.51418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/21/2023] [Indexed: 01/12/2024] Open
Abstract
Importance Tick-borne diseases (TBDs) other than Lyme disease, such as spotted fever group rickettsiosis, ehrlichiosis, and galactose-α-1,3-galactose (α-gal) syndrome, are an emerging public health issue. Long-term sequelae secondary to Ehrlichia or Rickettsia infection are uncommon; however, musculoskeletal symptoms are often attributed to prior tick exposure. Objective To evaluate the potential associations between prior exposure to TBDs and musculoskeletal symptoms, including radiographic osteoarthritis. Design, Setting, and Participants This cross-sectional study analyzed serum samples from the fourth visit (2017-2018) of the Johnston County Osteoarthritis (JoCo OA) project, an ongoing longitudinal, population-based study in Johnston County, North Carolina. Biospecimen testing and analysis were performed between May 2022 and November 2023. Participants in the JoCo OA project are noninstitutionalized White and Black Johnston County residents 45 years or older. Main Outcome and Measures The primary outcome was seropositivity with Ehrlichia IgG, Rickettsia IgG, and/or α-gal IgE and musculoskeletal symptoms. Secondary outcomes included risk factors associated with elevated α-gal IgE and weighted population point prevalence rates. Participants completed questionnaires, underwent physical assessments, and provided biospecimens for serological testing. Multivariable models were used to estimate associations of interest. Results Of the 605 participants who completed the fourth visit of the JoCo OA project, 488 (80.7%) had serum samples available for testing. The 488 participants had a median (IQR) age of 72 (68-78) years and included 336 females (68.9%) and 161 Black (33.0%) and 327 White (67.0%) individuals. The overall weighted point prevalence was 8.6% (95% CI, 5.9%-11.3%) for Ehrlichia IgG, 17.1% (95% CI, 12.6%-21.5%) for Rickettsia IgG, and 19.6% (95% CI, 15.3%-23.8%) for α-gal IgE level greater than 0.1 IU/mL. Only α-gal IgE was associated with knee pain, aching or stiffness (mean ratio, 1.30; 95% CI, 1.09-1.56). Antibodies to Rickettsia, Ehrlichia, and α-gal were not associated with symptomatic radiographic knee osteoarthritis. Male sex (odds ratio [OR], 2.63; 95% CI, 1.55-4.47), current smoker status (OR, 3.55; 95% CI, 1.38-9.18), and an attached tick bite in the past 5 years (OR, 3.99; 95% CI, 2.22-7.15) were all risk factors that were associated with α-gal IgE level greater than 0.1 IU/mL. Despite only 84 individuals (17.2%) recalling a tick bite in the past 5 years, 178 (36.5%) had evidence of prior tick-borne exposure, suggesting frequent human-tick interactions. Conclusions and Relevance Results of this cross-sectional study indicate no association between Ehrlichia or Rickettsia seropositivity and chronic musculoskeletal symptoms or osteoarthritis. Further investigation is needed into the pathogenesis of α-gal syndrome and interventions to reduce human-tick interactions.
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Affiliation(s)
- Diana L. Zychowski
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill
| | - Carolina Alvarez
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill
| | - Haley Abernathy
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill
| | - Dana Giandomenico
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill
| | - Shailesh K. Choudhary
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill
| | - Julia M. Vorobiov
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill
| | - Ross M. Boyce
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill
| | - Amanda E. Nelson
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill
| | - Scott P. Commins
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill
- Departments of Medicine and Pediatrics, Division of Allergy and Immunology, University of North Carolina at Chapel Hill, Chapel Hill
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Cente M, Danchenko M, Skultety L, Filipcik P, Sekeyova Z. Rickettsia Deregulates Genes Coding for the Neurotoxic Cell Response Pathways in Cerebrocortical Neurons In Vitro. Cells 2023; 12:cells12091235. [PMID: 37174635 PMCID: PMC10177168 DOI: 10.3390/cells12091235] [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: 02/23/2023] [Revised: 04/20/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023] Open
Abstract
Rickettsial infections of the central nervous system (CNS) are manifested by severe neurological symptoms and represent a serious life-threatening condition. Despite the considerable health danger, only a few studies have been conducted focusing on the pathogenesis induced by Rickettsia sp. in CNS. To investigate the signaling pathways associated with the neurotoxic effects of rickettsiae, we employed an experimental model of cerebrocortical neurons combined with molecular profiling and comprehensive bioinformatic analysis. The cytopathic effect induced by Rickettsia akari and Rickettsia slovaca was demonstrated by decreased neuronal viability, structural changes in cell morphology, and extensive fragmentation of neurites in vitro. Targeted profiling revealed the deregulation of genes involved in the neuroinflammatory and neurotoxic cell response pathways. Although quantitative analysis showed differences in gene expression response, functional annotation revealed that the biological processes are largely shared between both Rickettsia species. The identified enriched pathways are associated with cytokine signaling, chemotaxis of immune cells, responses to infectious agents, interactions between neurons, endothelial and glial cells, and regulation of neuronal apoptotic processes. The findings of our study provide new insight into the etiopathogenesis of CNS infection and further expand the understanding of molecular signaling associated with neuroinvasive Rickettsia species.
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Affiliation(s)
- Martin Cente
- Institute of Neuroimmunology, Slovak Academy of Sciences, Dubravska cesta 9, 845 10 Bratislava, Slovakia
| | - Monika Danchenko
- Department of Rickettsiology, Biomedical Research Center, Slovak Academy of Sciences, Dubravska cesta 9, 845 05 Bratislava, Slovakia
| | - Ludovit Skultety
- Department of Rickettsiology, Biomedical Research Center, Slovak Academy of Sciences, Dubravska cesta 9, 845 05 Bratislava, Slovakia
| | - Peter Filipcik
- Institute of Neuroimmunology, Slovak Academy of Sciences, Dubravska cesta 9, 845 10 Bratislava, Slovakia
| | - Zuzana Sekeyova
- Department of Rickettsiology, Biomedical Research Center, Slovak Academy of Sciences, Dubravska cesta 9, 845 05 Bratislava, Slovakia
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Sajib MI, Lamba P, Spitzer ED, Marcos LA. False-Positive Serology for Rocky Mountain Spotted Fever in Long Island, New York, during 2011-2021. Pathogens 2023; 12:pathogens12030503. [PMID: 36986426 PMCID: PMC10057202 DOI: 10.3390/pathogens12030503] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/14/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
Cases of rocky mountain spotted fever (RMSF) are increasingly reported every year in Long Island, New York. In clinical practice, an uncommonly high number of referrals with a positive RMSF IgG test result have been seen in our tick-borne disease clinic. The aim of this study is to describe the clinical-epidemiological characteristics and outcomes of hospitalized patients with positive serologies for RMSF in our academic center in Long Island, NY. We found that out of twenty-four patients with a positive serology for RMSF, only one case met the case definition per CDC criteria, two had suspected RMSF, and the other twenty-one did not have a clinical picture consistent with RMSF. A high number of false-positive RMSF serology may be due to other spotted fever rickettsioses in Long Island. Further studies are needed to investigate the presence of another Rickettsia spp. (such as Rickettsia amblyommatis) in this area that may affect humans.
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Affiliation(s)
- Monirul I Sajib
- Infectious Disease Division, Department of Medicine, Stony Brook University, Stony Brook, NY 11794, USA
| | - Pooja Lamba
- Infectious Disease Division, Department of Medicine, Stony Brook University, Stony Brook, NY 11794, USA
| | - Eric D Spitzer
- Department of Pathology, Stony Brook University, Stony Brook, NY 11794, USA
| | - Luis A Marcos
- Infectious Disease Division, Department of Medicine, Stony Brook University, Stony Brook, NY 11794, USA
- Department of Microbiology and Immunology, Stony Brook University, Stony Brook, NY 11794, USA
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