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Vester U, Fombah A, Hölscher M, Garba D, Tapgun M, N'Jai PC, Mendy P, Bass G, Muhammad AK, Anderson ST, Sanneh A, Onyeama C, Helmchen U, Bojang K, Hoyer PF, Corrah T. Etiology of Kidney Diseases With Proteinuria in the Gambia/West Africa. Front Pediatr 2022; 10:854719. [PMID: 35386255 PMCID: PMC8978824 DOI: 10.3389/fped.2022.854719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 02/15/2022] [Indexed: 11/13/2022] Open
Abstract
UNLABELLED In West Africa, kidney diseases are frequently seen, but diagnostic and therapeutic options are poor due to limited access to specialized facilities. To unravel the etiology and develop clinical guidelines, we collected clinical data and results of kidney biopsies in 121 pediatric and mostly young adult patients with edema and proteinuria in The Gambia. Workup included clinical examination, urine and serum analysis, and kidney biopsy findings. Selected cases were treated with steroids. RESULTS The median age was 14.9 years (range 1.8-52.0) at presentation. The most frequent underlying histologies were post-infectious glomerulonephritis (PIGN) in 38%, focal-segmental glomerulosclerosis (FSGS) in 30%, minimal change nephrotic syndrome (MCNS) in 15%, and membranous glomerulonephritis (MGN) in 10% of cases. Patients with PIGN were significantly younger and had less proteinuria and higher serum albumin levels than the other three. Infected scabies was seen more often in cases with PIGN. Clinical parameters could not distinguish patients with FSGS, MCNS, and MGN. Steroid response was prompt in patients with MCNS (remission in 10/10 cases) compared to FSGS (4/19) and MGN (0/4). In summary, the clinical histopathological correlation allows a better approach to therapy and can be the basis for urgently needed interventional studies in steroid-resistant cases.
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Affiliation(s)
- Udo Vester
- Helios Klinikum St Johannes, Duisburg, Germany
| | | | - Maite Hölscher
- University Children's Hospital, Kinderheilkunde II, University of Duisburg-Essen, Essen, Germany
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- Kidney Pathology Registry, University Hospital Hamburg, Hamburg, Germany
| | | | - Peter F Hoyer
- University Children's Hospital, Kinderheilkunde II, University of Duisburg-Essen, Essen, Germany
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2
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Bernigaud C, Samarawickrama GR, Jones MK, Gasser RB, Fischer K. The Challenge of Developing a Single-Dose Treatment for Scabies. Trends Parasitol 2019; 35:931-943. [PMID: 31474559 DOI: 10.1016/j.pt.2019.08.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 08/02/2019] [Accepted: 08/04/2019] [Indexed: 11/29/2022]
Abstract
Scabies is a common skin disease with an estimated worldwide incidence of 200 million people infected per year. Its morbidity and mortality is principally due to secondary bacterial infections, a link now well recognized and prompting the recent inclusion of this disease-complex in the WHO list of neglected tropical diseases. The few treatments available are poorly effective against Sarcoptes scabiei eggs and appear to induce resistance in the parasite. An ideal alternative would be a single-dose regimen that kills all developmental stages, including eggs. Drugs used in the veterinary field and applied to other arthropods could be tested experimentally in an established pig-scabies model. Moreover, functional genomics combined with target validation through biochemical research should assist in identifying new drugs.
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Affiliation(s)
- Charlotte Bernigaud
- QIMR Berghofer Medical Research Institute, Infectious Diseases Program, 300 Herston Road, Herston, Brisbane 4006, Australia; Dermatology Department, AP-HP, Hôpital Henri Mondor, Université Paris-Est, Créteil, France; Research group Dynamyc, EA7380, Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, Université Paris-Est Créteil, Créteil, France
| | - Gangi R Samarawickrama
- QIMR Berghofer Medical Research Institute, Infectious Diseases Program, 300 Herston Road, Herston, Brisbane 4006, Australia
| | - Malcolm K Jones
- School of Veterinary Science, The University of Queensland, Gatton Campus, Gatton, Australia
| | - Robin B Gasser
- Department of Veterinary Biosciences, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Melbourne, Australia
| | - Katja Fischer
- QIMR Berghofer Medical Research Institute, Infectious Diseases Program, 300 Herston Road, Herston, Brisbane 4006, Australia.
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Swe PM, Zakrzewski M, Waddell R, Sriprakash KS, Fischer K. High-throughput metagenome analysis of the Sarcoptes scabiei internal microbiota and in-situ identification of intestinal Streptomyces sp. Sci Rep 2019; 9:11744. [PMID: 31409870 PMCID: PMC6692375 DOI: 10.1038/s41598-019-47892-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 06/24/2019] [Indexed: 10/29/2022] Open
Abstract
Multiple parasitic arthropods of medical importance depend on symbiotic bacteria. While the link between scabies and secondary bacterial infections causing post infective complications of Group A streptococcal and staphylococcal pyoderma is increasingly recognized, very little is known about the microbiota of Sarcoptes scabiei. Here we analyze adult female mite and egg metagenome datasets. The majority of adult mite bacterial reads matched with Enterobacteriaceae (phylum Proteobacteria), followed by Corynebacteriaceae (phylum Actinobacteria). Klebsiella was the most dominant genus (78%) and Corynebacterium constituted 9% of the assigned sequences. Scabies mite eggs had a more diverse microbial composition with sequences from Proteobacteria being the most dominant (75%), while Actinobacteria, Bacteroidetes and Firmicutes accounted for 23% of the egg microbiome sequences. DNA sequences of a potential endosymbiont, namely Streptomyces, were identified in the metagenome sequence data of both life stages. The presence of Streptomyces was confirmed by conventional PCR. Digital droplet PCR indicated higher Streptomyces numbers in adult mites compared to eggs. Streptomyces were localized histologically in the scabies mite gut and faecal pellets by Fluorescent In Situ Hybridization (FISH). Streptomyces may have essential symbiotic roles in the scabies parasite intestinal system requiring further investigation.
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Affiliation(s)
- Pearl M Swe
- Infectious Diseases Program, Cell and Molecular Biology Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Martha Zakrzewski
- Medical Genomics Program, Genetics & Computational Biology Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Rebecca Waddell
- Infectious Diseases Program, Cell and Molecular Biology Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Kadaba S Sriprakash
- Infectious Diseases Program, Cell and Molecular Biology Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Katja Fischer
- Infectious Diseases Program, Cell and Molecular Biology Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia.
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Esposito L, Veraldi S. Skin bacterial colonizations and superinfections in immunocompetent patients with scabies. Int J Dermatol 2018; 57:1218-1220. [PMID: 29974940 DOI: 10.1111/ijd.14123] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 05/31/2018] [Accepted: 06/07/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Skin bacterial colonizations and superinfections are well-known complications of scabies, in particular, in tropical and subtropical countries. However, only very rare studies on skin bacterial colonizations and superinfections have been carried out in immunocompetent patients with scabies living in Western countries. METHODS Eighty-nine Caucasian adult immunocompetent patients with scabies living in Milan, Italy, were subjected to bacteriologic examinations of the skin. Clinical diagnosis of scabies was confirmed in all patients by means of microscopic examinations: they were considered positive when adults or eggs or feces of Sarcoptes scabiei var. hominis were visible. In all patients, six skin swabs (three for aerobic and three for anaerobic bacteria) were taken in three different areas before the beginning of the treatment. RESULTS No clinical manifestations of pyoderma were observed. Bacteriologic examinations were positive in 5/89 patients (5.6%). Bacteriologic cultures were positive for Staphylococcus aureus in all five patients; in one patient, they were also positive for Escherichia coli. No growth of anaerobic bacteria was recorded. CONCLUSIONS According to the results of this study, skin bacterial colonizations and superinfections in immunocompetent adult patients with scabies living in Milan are uncommon. Bacteriologic examinations may therefore be considered as an unnecessary routine procedure.
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Affiliation(s)
- Luigi Esposito
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, I.R.C.C.S. Foundation, Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefano Veraldi
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, I.R.C.C.S. Foundation, Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
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Fernando DD, Marr EJ, Zakrzewski M, Reynolds SL, Burgess STG, Fischer K. Gene silencing by RNA interference in Sarcoptes scabiei: a molecular tool to identify novel therapeutic targets. Parasit Vectors 2017; 10:289. [PMID: 28601087 PMCID: PMC5466799 DOI: 10.1186/s13071-017-2226-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 06/01/2017] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Scabies is one of the most common and widespread parasitic skin infections globally, affecting a large range of mammals including humans, yet the molecular biology of Sarcoptes scabiei is astonishingly understudied. Research has been hampered primarily due to the difficulty of sampling or culturing these obligatory parasitic mites. A further and major impediment to identify and functionally analyse potential therapeutic targets from the recently emerging molecular databases is the lack of appropriate molecular tools. METHODS We performed standard BLAST based searches of the existing S. scabiei genome databases using sequences of genes described to be involved in RNA interference in Drosophila and the mite model organism Tetranychus urticae. Experimenting with the S. scabiei mu-class glutathione S-transferase (SsGST-mu1) as a candidate gene we explored the feasibility of gene knockdown in S. scabiei by double-stranded RNA-interference (dsRNAi). RESULTS We provide here an analysis of the existing S. scabiei draft genomes, confirming the presence of a double stranded RNA (dsRNA) - mediated silencing machinery. We report for the first time experimental gene silencing by RNA interference (RNAi) in S. scabiei. Non-invasive immersion of S. scabiei in dsRNA encoding an S. scabiei glutathione S-transferase mu-class 1 enzyme (SsGST-mu1) resulted in a 35% reduction in the transcription of the target gene compared to controls. CONCLUSIONS A series of experiments identified the optimal conditions allowing systemic experimental RNAi without detrimental side effects on mite viability. This technique can now be used to address the key questions on the fundamental aspects of mite biology and pathogenesis, and to assess the potential therapeutic benefits of silencing S. scabiei target genes.
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Affiliation(s)
- Deepani D. Fernando
- QIMR Berghofer Medical Research Institute, Infectious Diseases Department, 300 Herston Road, Herston, Brisbane, 4006 Australia
- School of Veterinary Sciences, University of Queensland, Gatton, QLD 4343 Australia
- Department of Veterinary Pathobiology, Faculty of Veterinary Medicine and Animal Science, University of Peradeniya, Peradeniya, Sri Lanka
| | - Edward J. Marr
- Parasitology Division, Moredun Research Institute, Pentlands Science Park, Bush Loan, Edinburgh, Midlothian, Scotland EH26 0PZ UK
| | - Martha Zakrzewski
- QIMR Berghofer Medical Research Institute, Infectious Diseases Department, 300 Herston Road, Herston, Brisbane, 4006 Australia
| | - Simone L. Reynolds
- QIMR Berghofer Medical Research Institute, Infectious Diseases Department, 300 Herston Road, Herston, Brisbane, 4006 Australia
| | - Stewart T. G. Burgess
- Parasitology Division, Moredun Research Institute, Pentlands Science Park, Bush Loan, Edinburgh, Midlothian, Scotland EH26 0PZ UK
| | - Katja Fischer
- QIMR Berghofer Medical Research Institute, Infectious Diseases Department, 300 Herston Road, Herston, Brisbane, 4006 Australia
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Bernigaud C, Fang F, Fischer K, Lespine A, Aho LS, Dreau D, Kelly A, Sutra JF, Moreau F, Lilin T, Botterel F, Guillot J, Chosidow O. Preclinical Study of Single-Dose Moxidectin, a New Oral Treatment for Scabies: Efficacy, Safety, and Pharmacokinetics Compared to Two-Dose Ivermectin in a Porcine Model. PLoS Negl Trop Dis 2016; 10:e0005030. [PMID: 27732588 PMCID: PMC5061321 DOI: 10.1371/journal.pntd.0005030] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 09/09/2016] [Indexed: 11/08/2022] Open
Abstract
Background Scabies is one of the commonest dermatological conditions globally; however it is a largely underexplored and truly neglected infectious disease. Foremost, improvement in the management of this public health burden is imperative. Current treatments with topical agents and/or oral ivermectin (IVM) are insufficient and drug resistance is emerging. Moxidectin (MOX), with more advantageous pharmacological profiles may be a promising alternative. Methodology/Principal Findings Using a porcine scabies model, 12 pigs were randomly assigned to receive orally either MOX (0.3 mg/kg once), IVM (0.2 mg/kg twice) or no treatment. We evaluated treatment efficacies by assessing mite count, clinical lesions, pruritus and ELISA-determined anti-S. scabiei IgG antibodies reductions. Plasma and skin pharmacokinetic profiles were determined. At day 14 post-treatment, all four MOX-treated but only two IVM-treated pigs were mite-free. MOX efficacy was 100% and remained unchanged until study-end (D47), compared to 62% (range 26–100%) for IVM, with one IVM-treated pig remaining infected until D47. Clinical scabies lesions, pruritus and anti-S. scabiei IgG antibodies had completely disappeared in all MOX-treated but only 75% of IVM-treated pigs. MOX persisted ~9 times longer than IVM in plasma and skin, thereby covering the mite’s entire life cycle and enabling long-lasting efficacy. Conclusions/Significance Our data demonstrate that oral single-dose MOX was more effective than two consecutive IVM-doses, supporting MOX as potential therapeutic approach for scabies. Scabies caused by the Sarcoptes scabiei mite affects many people worldwide and has been recently recognized by the WHO as a truly neglected tropical disease. Currently available treatments are insufficient to overcome this insidious disease and its co-morbidities for example impetigo, rheumatic heart disease and post-streptococcal glomerulonephritis. Treatment management is a major issue, as problems with compliance as well as mite resistance to current drugs are reported. Data have accumulated indicating that moxidectin could be a genuine new candidate drug for sustainable scabies control. To provide proof of concept, we utilized an experimental scabies pig model that closely resembles the human route of scabies infection. We demonstrated that a single moxidectin dose, when compared with the currently recommended two-doses ivermectin treatment routine, achieved a better and faster acaricidal efficacy. Importantly, the skin half-life of moxidectin is longer, potentially covering the entire mite life cycle. Our baseline data demonstrate in principle the potential and feasibility of moxidectin treatment for scabies, thereby enabling the move into larger high-powered efficacy and dose ranging studies in human populations. Moxidectin could indeed play a game-changing role in scabies control and has the potential to accelerate the steps towards elimination of this insidious disease.
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Affiliation(s)
- Charlotte Bernigaud
- Research Group Dynamyc, EA 7380, EnvA, Université Paris-Est (UPE), Maisons-Alfort & Créteil, France
- APHP, Hôpital Henri-Mondor, Department of Dermatology, UPEC, Créteil, France
- * E-mail:
| | - Fang Fang
- Research Group Dynamyc, EA 7380, EnvA, Université Paris-Est (UPE), Maisons-Alfort & Créteil, France
- Department of Parasitology, College of Animal Science and Technology, University of Guangxi, Nanning, China
| | - Katja Fischer
- Infections Diseases Department, Scabies Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Anne Lespine
- Toxalim, INRA, INP-ENVT, INP-EI-Purpan, Université de Toulouse III Paul Sabatier, Toulouse, France
| | - Ludwig Serge Aho
- Epidemiology and Infection Control Unit, University Hospital of Dijon, Dijon, France
| | | | - Andrew Kelly
- Department of Agriculture, Fisheries and Forestry, Queensland Animal Science Precinct, University of Queensland, Gatton Campus, Queensland, Australia
| | - Jean-François Sutra
- Toxalim, INRA, INP-ENVT, INP-EI-Purpan, Université de Toulouse III Paul Sabatier, Toulouse, France
| | - Francis Moreau
- Centre de Recherche BioMédicale (CRBM), EnvA, UPE, Maisons-Alfort, France
| | - Thomas Lilin
- Centre de Recherche BioMédicale (CRBM), EnvA, UPE, Maisons-Alfort, France
| | - Françoise Botterel
- Research Group Dynamyc, EA 7380, EnvA, Université Paris-Est (UPE), Maisons-Alfort & Créteil, France
- APHP, Hôpital Henri-Mondor, Parasitology and Mycology, Department of Microbiology, DHU VIC, UPEC, Créteil, France
| | - Jacques Guillot
- Research Group Dynamyc, EA 7380, EnvA, Université Paris-Est (UPE), Maisons-Alfort & Créteil, France
- Department of Parasitology and Mycology, Biopôle d'Alfort, Ecole nationale vétérinaire d'Alfort, UPE, Maisons-Alfort, France
| | - Olivier Chosidow
- APHP, Hôpital Henri-Mondor, Department of Dermatology, UPEC, Créteil, France
- EA EpiDermE (Epidémiologie en Dermatologie et Evaluation des Thérapeutiques) and INSERM, CIC 1430, UPE, Créteil, France
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Yates JE, Bleyer AJ, Yosipovitch G, Sangueza OP, Murea M. Enigmatic pruritus in a kidney transplant patient. Clin Kidney J 2015; 6:194-8. [PMID: 26019849 PMCID: PMC4432448 DOI: 10.1093/ckj/sft009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Accepted: 01/16/2013] [Indexed: 11/14/2022] Open
Abstract
Pruritus is a common problem following a kidney transplant and is usually attributable to new medications related to transplantation. We present an unusual case of pruritus that began several months after kidney transplantation. After changing several immunosuppressive medications, numerous clinical visits and consideration by the patient of stopping immunosuppression, scabies was diagnosed as the cause. Treatment with oral ivermectin and topical permethrin resulted in complete resolution of symptoms within 1 week. Transplant physicians should consider common causes of pruritus unrelated to transplantation; diagnostic skin lesions of scabies may be absent.
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Affiliation(s)
- John E Yates
- Department of Internal Medicine , Wake Forest School of Medicine , Winston-Salem, NC , USA
| | - Anthony J Bleyer
- Section on Nephrology , Department of Internal Medicine , Wake Forest School of Medicine , Winston-Salem, NC , USA
| | - Gil Yosipovitch
- Department of Dermatology , Wake Forest School of Medicine , Winston-Salem, NC , USA
| | - Omar P Sangueza
- Department of Pathology , Wake Forest School of Medicine , Winston-Salem, NC , USA
| | - Mariana Murea
- Section on Nephrology , Department of Internal Medicine , Wake Forest School of Medicine , Winston-Salem, NC , USA
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Mallo-García S, Taborga-Díaz E, Menéndez-Cuervo S, Santos-Juanes-Jiménez J. Staphylococcus aureus Sepsis as a Complication of Scabies. ACTAS DERMO-SIFILIOGRAFICAS 2008. [DOI: 10.1016/s1578-2190(08)70284-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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10
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Abstract
Parasitic agents determine some of the most common skin disorders. Although well known, they could present different manifestations or be modified by individual or external factors that make their diagnosis or treatment difficult. This review will discuss some of the most prevalent parasitic infections, scabies, and pediculosis and also mention reactions determined by contact with certain insects that, although rarely found, could induce important skin reactions.
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Affiliation(s)
- Tania Ferreira Cestari
- Department of Dermatology, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre RS, Brazil.
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Feldmeier H, Singh Chhatwal G, Guerra H. Pyoderma, group A streptococci and parasitic skin diseases -- a dangerous relationship. Trop Med Int Health 2005; 10:713-6. [PMID: 16045456 DOI: 10.1111/j.1365-3156.2005.01457.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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