1
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Dean DA, Roach J, Ulrich vonBargen R, Xiong Y, Kane SS, Klechka L, Wheeler K, Jimenez Sandoval M, Lesani M, Hossain E, Katemauswa M, Schaefer M, Harris M, Barron S, Liu Z, Pan C, McCall LI. Persistent Biofluid Small-Molecule Alterations Induced by Trypanosoma cruzi Infection Are Not Restored by Parasite Elimination. ACS Infect Dis 2023; 9:2173-2189. [PMID: 37883691 PMCID: PMC10842590 DOI: 10.1021/acsinfecdis.3c00261] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Chagas disease (CD), caused by Trypanosoma cruzi (T. cruzi) protozoa, is a complicated parasitic illness with inadequate medical measures for diagnosing infection and monitoring treatment success. To address this gap, we analyzed changes in the metabolome of T. cruzi-infected mice via liquid chromatography tandem mass spectrometry of clinically accessible biofluids: saliva, urine, and plasma. Urine was the most indicative of infection status across mouse and parasite genotypes. Metabolites perturbed by infection in urine include kynurenate, acylcarnitines, and threonylcarbamoyladenosine. Based on these results, we sought to implement urine as a tool for the assessment of CD treatment success. Strikingly, it was found that mice with parasite clearance following benznidazole antiparasitic treatment had an overall urine metabolome comparable to that of mice that failed to clear parasites. These results provide a complementary hypothesis to explain clinical trial data in which benznidazole treatment did not improve patient outcomes in late-stage disease, even in patients with successful parasite clearance. Overall, this study provides insights into new small-molecule-based CD diagnostic methods and a new approach to assess functional responses to treatment.
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Affiliation(s)
- Danya A. Dean
- Department of Chemistry and Biochemistry, University of Oklahoma, Norman, OK, 73019, USA
- Laboratories of Molecular Anthropology and Microbiome Research, University of Oklahoma, Norman, OK, 73019, USA
| | - Jarrod Roach
- Department of Chemistry and Biochemistry, University of Oklahoma, Norman, OK, 73019, USA
| | | | - Yi Xiong
- Department of Microbiology and Plant Biology, University of Oklahoma, Norman, OK, 73019, USA
| | - Shelley S. Kane
- Department of Chemistry and Biochemistry, University of Oklahoma, Norman, OK, 73019, USA
- Laboratories of Molecular Anthropology and Microbiome Research, University of Oklahoma, Norman, OK, 73019, USA
| | - London Klechka
- Department of Biology, University of Oklahoma, Norman, OK, 73019, USA
| | - Kate Wheeler
- Department of Biology, University of Oklahoma, Norman, OK, 73019, USA
| | | | - Mahbobeh Lesani
- Department of Microbiology and Plant Biology, University of Oklahoma, Norman, OK, 73019, USA
| | - Ekram Hossain
- Department of Chemistry and Biochemistry, University of Oklahoma, Norman, OK, 73019, USA
- Laboratories of Molecular Anthropology and Microbiome Research, University of Oklahoma, Norman, OK, 73019, USA
| | - Mitchelle Katemauswa
- Department of Chemistry and Biochemistry, University of Oklahoma, Norman, OK, 73019, USA
- Laboratories of Molecular Anthropology and Microbiome Research, University of Oklahoma, Norman, OK, 73019, USA
| | - Miranda Schaefer
- Department of Chemistry and Biochemistry, University of Oklahoma, Norman, OK, 73019, USA
| | - Morgan Harris
- Department of Chemistry and Biochemistry, University of Oklahoma, Norman, OK, 73019, USA
| | - Sayre Barron
- Department of Chemistry and Biochemistry, University of Oklahoma, Norman, OK, 73019, USA
| | - Zongyuan Liu
- Department of Chemistry and Biochemistry, University of Oklahoma, Norman, OK, 73019, USA
- Laboratories of Molecular Anthropology and Microbiome Research, University of Oklahoma, Norman, OK, 73019, USA
| | - Chongle Pan
- Department of Microbiology and Plant Biology, University of Oklahoma, Norman, OK, 73019, USA
| | - Laura-Isobel McCall
- Department of Chemistry and Biochemistry, University of Oklahoma, Norman, OK, 73019, USA
- Laboratories of Molecular Anthropology and Microbiome Research, University of Oklahoma, Norman, OK, 73019, USA
- Department of Microbiology and Plant Biology, University of Oklahoma, Norman, OK, 73019, USA
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2
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Dean DA, Roach J, vonBargen RU, Xiong Y, Kane SS, Klechka L, Wheeler K, Sandoval MJ, Lesani M, Hossain E, Katemauswa M, Schaefer M, Harris M, Barron S, Liu Z, Pan C, McCall LI. Persistent biofluid small molecule alterations induced by Trypanosoma cruzi infection are not restored by antiparasitic treatment. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.06.03.543565. [PMID: 37425694 PMCID: PMC10326868 DOI: 10.1101/2023.06.03.543565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Chagas Disease (CD), caused by Trypanosoma cruzi (T. cruzi) protozoa, is a complicated parasitic illness with inadequate medical measures for diagnosing infection and monitoring treatment success. To address this gap, we analyzed changes in the metabolome of T. cruzi-infected mice via liquid chromatography tandem mass spectrometry analysis of clinically-accessible biofluids: saliva, urine, and plasma. Urine was the most indicative of infection status, across mouse and parasite genotypes. Metabolites perturbed by infection in the urine include kynurenate, acylcarnitines, and threonylcarbamoyladenosine. Based on these results, we sought to implement urine as a tool for assessment of CD treatment success. Strikingly, it was found that mice with parasite clearance following benznidazole antiparasitic treatment had comparable overall urine metabolome to mice that failed to clear parasites. These results match with clinical trial data in which benznidazole treatment did not improve patient outcomes in late-stage disease. Overall, this study provides insights into new small molecule-based CD diagnostic methods and a new approach to assess functional treatment response.
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Affiliation(s)
- Danya A. Dean
- Department of Chemistry and Biochemistry, University of Oklahoma, Norman, OK, 73019, USA
- Laboratories of Molecular Anthropology and Microbiome Research, University of Oklahoma, Norman, OK, 73019; USA
| | - Jarrod Roach
- Department of Chemistry and Biochemistry, University of Oklahoma, Norman, OK, 73019, USA
| | | | - Yi Xiong
- Department of Microbiology and Plant Biology, University of Oklahoma, Norman, OK, 73019, USA
| | - Shelley S. Kane
- Department of Chemistry and Biochemistry, University of Oklahoma, Norman, OK, 73019, USA
- Laboratories of Molecular Anthropology and Microbiome Research, University of Oklahoma, Norman, OK, 73019; USA
| | - London Klechka
- Department of Biology, University of Oklahoma, Norman, OK, 73019, USA
| | - Kate Wheeler
- Department of Biology, University of Oklahoma, Norman, OK, 73019, USA
| | | | - Mahbobeh Lesani
- Department of Microbiology and Plant Biology, University of Oklahoma, Norman, OK, 73019, USA
| | - Ekram Hossain
- Department of Chemistry and Biochemistry, University of Oklahoma, Norman, OK, 73019, USA
- Laboratories of Molecular Anthropology and Microbiome Research, University of Oklahoma, Norman, OK, 73019; USA
| | - Mitchelle Katemauswa
- Department of Chemistry and Biochemistry, University of Oklahoma, Norman, OK, 73019, USA
- Laboratories of Molecular Anthropology and Microbiome Research, University of Oklahoma, Norman, OK, 73019; USA
| | - Miranda Schaefer
- Department of Chemistry and Biochemistry, University of Oklahoma, Norman, OK, 73019, USA
| | - Morgan Harris
- Department of Chemistry and Biochemistry, University of Oklahoma, Norman, OK, 73019, USA
| | - Sayre Barron
- Department of Chemistry and Biochemistry, University of Oklahoma, Norman, OK, 73019, USA
| | - Zongyuan Liu
- Department of Chemistry and Biochemistry, University of Oklahoma, Norman, OK, 73019, USA
- Laboratories of Molecular Anthropology and Microbiome Research, University of Oklahoma, Norman, OK, 73019; USA
| | - Chongle Pan
- Department of Microbiology and Plant Biology, University of Oklahoma, Norman, OK, 73019, USA
| | - Laura-Isobel McCall
- Department of Chemistry and Biochemistry, University of Oklahoma, Norman, OK, 73019, USA
- Laboratories of Molecular Anthropology and Microbiome Research, University of Oklahoma, Norman, OK, 73019; USA
- Department of Microbiology and Plant Biology, University of Oklahoma, Norman, OK, 73019, USA
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Trypanosoma cruzi infection in puerperal women and their neonates at Barcelona, Anzoategui State, Venezuela. ACTA ACUST UNITED AC 2019; 39:769-784. [PMID: 31860187 PMCID: PMC7363338 DOI: 10.7705/biomedica.4606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Indexed: 11/21/2022]
Abstract
Introduction. Trypanosoma cruzi is mainly transmitted by vectors. Other pathways such as oral and congenital transmission have become increasingly relevant.
Objective. To evaluate T. cruzi infections in post-partum women and their newborns who attended the Hospital Universitario Dr. Luis Razetti (Barcelona, Anzoátegui state, Venezuela).
Materials and methods. A prospective cross-sectional study was undertaken from May, 2015, to August, 2016. ELISA, MABA and IFI assays were used to determine the infection in 1,200 post-partum women. The newborns of seropositive women were then examined for T. cruzi by PCR amplification and serological tests at nine months old. The prevalence of the parasitic infection in post-partum women and their newborns was then estimated. To establish the relationship between risk factors and infection, the chi-square test (c2) and the probability ratio (OR) was applied.
Results. A total of 78 women were identified as seropositive (6.50 %) (CI 95%: 5.10-7.89%), and parasitic DNA was detected in six of their newborns (9.09%). Nine months after birth eleven infants were examined, and all were found to be serologically negative. Risk factors detected were pregnancy duration (OR: 0,36; CI95%: 0,15-0,84), where the patients lived at present (OR: 0,34; CI95%: 0,24-0,62) or previously (OR: 2,50; CI95%: 1,38-4,52) and having relatives with Chagas disease (OR: 1,75; CI95%: 1,02-3,01).
Conclusions. Seroprevalence for T. cruzi infection in young post-partum women in rural areas was high. The detection of parasite DNA at birth was not indicative of congenital Chagas disease.
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Caballero E Z, Correa R, Nascimento MS, Villarreal A, Llanes A, Kesper N. High sensitivity and reproducibility of in-house ELISAs using different genotypes of Trypanosoma cruzi. Parasite Immunol 2019; 41:e12627. [PMID: 30908676 DOI: 10.1111/pim.12627] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 02/08/2019] [Accepted: 03/20/2019] [Indexed: 02/01/2023]
Abstract
The adequate choice of Trypanosoma cruzi strains as antigen source for the diagnosis of Chagas disease is still controversial due to differences in terms of accuracy reported between different diagnostic tests. In this study was determined if the genetic variability between different genotypes of T. cruzi (TcI, TcII and TcIV) affect the final diagnosis of Chagas disease. The sensitivity and specificity index of in-house ELISA tests prepared with different T. cruzi strains were evaluated with chagasic and non-chagasic control sera and using the TESA-blot as a reference test. The results of this study revealed that the sensitivity index did not vary, with percentages of 100% for all strains in both tests. However, the specificity index for ELISA tests showed differences between 92% and 98%, but were reduced to 78%-89% when Leishmania-positive sera were included. All ELISAs and TESA-blot prepared with different antigens and the recombinant Wiener test were challenged in an endemic community for Chagas disease in Panama. Both ELISAs and TESA-blot recognized the same positive sera, corroborating the sensitivity indexes (100%) found with the control sera. The TESA-blot maintained the specificity index of 100% and did not display false positives. However, the recombinant Wiener test decreased its sensitivity to 81.25%.
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Affiliation(s)
- Zuleima Caballero E
- Centro de Biología Celular y Molecular de Enfermedades, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología, Asociación de Interés Público (INDICASAT-AIP), Panamá, República of Panamá.,Sistema Nacional de Investigación - Secretaría Nacional de Ciencia, Tecnología e Innovación (SNI-SENACYT), Panamá, República de Panamá
| | - Ricardo Correa
- Centro de Biología Celular y Molecular de Enfermedades, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología, Asociación de Interés Público (INDICASAT-AIP), Panamá, República of Panamá.,Sistema Nacional de Investigación - Secretaría Nacional de Ciencia, Tecnología e Innovación (SNI-SENACYT), Panamá, República de Panamá
| | - Marilda S Nascimento
- Instituto de Medicina Tropical da Universidade de São Paulo (IMT-USP), São Paulo, Brasil
| | - Alcibiades Villarreal
- Sistema Nacional de Investigación - Secretaría Nacional de Ciencia, Tecnología e Innovación (SNI-SENACYT), Panamá, República de Panamá
| | - Alejandro Llanes
- Centro de Biología Celular y Molecular de Enfermedades, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología, Asociación de Interés Público (INDICASAT-AIP), Panamá, República of Panamá
| | - Norival Kesper
- Instituto de Medicina Tropical da Universidade de São Paulo (IMT-USP), São Paulo, Brasil
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Hematologic Aspects of Parasitic Diseases. Hematology 2018. [DOI: 10.1016/b978-0-323-35762-3.00158-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
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6
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García-Jordán N, Berrizbeitia M, Rodríguez J, Concepción JL, Cáceres A, Quiñones W. [Seroprevalence of Trypanosoma cruzi infection in the rural population of Sucre State, Venezuela]. CAD SAUDE PUBLICA 2017; 33:e00050216. [PMID: 29091170 DOI: 10.1590/0102-311x00050216] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Accepted: 01/06/2017] [Indexed: 11/21/2022] Open
Abstract
The current study aimed to determine the seroprevalence of Trypanosoma cruzi infection in Sucre State, Venezuela, and its association with epidemiological risk factors. The cluster sampling design allowed selecting 96 villages and 576 dwellings in the State's 15 municipalities. A total of 2,212 serum samples were analyzed by ELISA, HAI, and IFI. Seroprevalence in Sucre State was 3.12%. Risk factors associated with T. cruzi infection were: accumulated garbage, flooring and wall materials, type of dwelling, living in a house with wattle and daub walls and/or straw roofing, living in a house with risky walls and roofing, risky buildings and wattle and daub outbuildings, poultry inside the human dwelling, and presence of firewood. Infection was associated with individual age, and three seropositive cases were found in individuals less than 15 years of age. Sucre State has epidemiological factors that favor the risk of acquiring T. cruzi infection.
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Affiliation(s)
| | - Mariolga Berrizbeitia
- Postgrado en Biología Aplicada, Universidad de Oriente, Cumaná, Venezuela.,Instituto de Investigaciones en Biomedicina y Ciencias Aplicadas, Universidad de Oriente, Cumaná, Venezuela
| | - Jessicca Rodríguez
- Postgrado en Biología Aplicada, Universidad de Oriente, Cumaná, Venezuela
| | | | - Ana Cáceres
- Facultad de Ciencias, Universidad de Los Andes, Mérida, Venezuela
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Abstract
American trypanosomiasis, or Chagas disease, is the result of infection by the Trypanosoma cruzi parasite. Endemic in Latin America where it is the major cause of death from cardiomyopathy, the impact of the disease is reaching global proportions through migrating populations. New drugs that are safe, efficacious, low cost, and adapted to the field are critically needed. Over the past five years, there has been increased interest in the disease and a surge in activities within various organizations. However, recent clinical trials with azoles, specifically posaconazole and the ravuconazole prodrug E1224, were disappointing, with treatment failure in Chagas patients reaching 70% to 90%, as opposed to 6% to 30% failure for benznidazole-treated patients. The lack of translation from in vitro and in vivo models to the clinic observed for the azoles raises several questions. There is a scientific requirement to review and challenge whether we are indeed using the right tools and decision-making processes to progress compounds forward for the treatment of this disease. New developments in the Chagas field, including new technologies and tools now available, will be discussed, and a redesign of the current screening strategy during the discovery process is proposed.
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Affiliation(s)
- Eric Chatelain
- Drugs for Neglected Diseases initiative (DNDi), Geneva, Switzerland
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Santamaria C, Chatelain E, Jackson Y, Miao Q, Ward BJ, Chappuis F, Ndao M. Serum biomarkers predictive of cure in Chagas disease patients after nifurtimox treatment. BMC Infect Dis 2014; 14:302. [PMID: 24894358 PMCID: PMC4059459 DOI: 10.1186/1471-2334-14-302] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 05/28/2014] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Chagas disease (CD), caused by the protozoan Trypanosoma cruzi, remains an important public health issue in many Central and South American countries, as well as non-endemic areas with high rates of immigration from these countries. Existing treatment options for CD are limited and often unsatisfactory. Moreover the lack of post-treatment tests of cure limits the development of new drugs. To address this issue, we sought to identify serum biomarkers following nifurtimox (Nfx) treatment that could be used as an early test of cure and/or markers of a therapeutic response. METHODS Human sera from Chagas patients pre- and post-treatment with Nfx (n = 37) were compared to samples from healthy subjects (n = 37) using a range of proteomic and immunologic techniques. Biomarker peaks with the best discriminatory power were further characterized. RESULTS Using serum samples (n = 111), we validated the presence of five key biomarkers identified in our previous study, namely human apolipoprotein A-I (APOA1) and specific fragments thereof and one fragment of human fibronectin (FN1). In chagasic serum samples all biomarkers except full-length APOA1 were upregulated. These five biomarkers returned to normal in 43% (16/37) of the patients treated with Nfx at three years after treatment. CONCLUSIONS The normalization of biomarker patterns strongly associated with CD suggests that these markers can be used to identify patients in whom Nfx treatment is successful. We believe that these are the first biomarkers predictive of cure in CD patients.
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Affiliation(s)
| | | | | | | | | | | | - Momar Ndao
- National Reference Center for Parasitology, Research Institute of the McGill University Health Centre, Department of Medicine, Division of Infectious Diseases, Montreal General Hospital, 1650 Cedar Ave,, Room R3-137, Montreal, Quebec H3G 1A4, Canada.
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Pierimarchi P, Cerni L, Alarcón de Noya B, Nicotera G, Díaz-Bello Z, Angheben A, Scacciatelli D, Zonfrillo M, Recinelli G, Serafino A. Rapid Chagas diagnosis in clinical settings using a multiparametric assay. Diagn Microbiol Infect Dis 2013; 75:381-9. [DOI: 10.1016/j.diagmicrobio.2012.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Revised: 12/11/2012] [Accepted: 12/18/2012] [Indexed: 10/27/2022]
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Berrizbeitia M, Figueroa M, Ward BJ, Rodríguez J, Jorquera A, Figuera MA, Romero L, Ndao M. Development and Application of an ELISA Assay Using Excretion/Secretion Proteins from Epimastigote Forms of T. cruzi (ESEA Antigens) for the Diagnosis of Chagas Disease. J Trop Med 2012; 2012:875909. [PMID: 23049572 PMCID: PMC3463186 DOI: 10.1155/2012/875909] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2012] [Accepted: 08/14/2012] [Indexed: 11/18/2022] Open
Abstract
An indirect enzyme-linked immunoabsorbent assay (ELISA) for Trypanosoma cruzi was developed using epimastigote secretion/excretion proteins (ESEA antigens) obtained from axenic culture supernatants. A panel of 120 serum samples from subjects with confirmed Chagas disease (n = 50), healthy controls (n = 50), and patients with other parasitic diseases (n = 20) was used to evaluate the new ESEA-based ELISA (ELISA(ESEA)). This new test had excellent sensitivity (98%) and acceptable specificity (88%). Cross-reactivity was observed largely in sera from subjects with Leishmania and Ascaris infections. Using Western blotting and epimastigotes from two distinct T. cruzi isolates, several polypeptide bands with molecular masses ranging from 50 to 220 kDa were detected in pooled chagasic sera. However, the band pattern for each isolate was different. These data suggest that an inexpensive and technically simple ELISA based on ESEA antigens is a promising new tool for the diagnosis of Chagas disease.
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Affiliation(s)
- Mariolga Berrizbeitia
- Laboratorio de Diagnóstico Serológico en Enfermedades Infecciosas, Postgrado en Biología Aplicada, Universidad de Oriente, Núcleo de Sucre, Cumana 6101, Venezuela
- Instituto de Biomedicina y Ciencias Aplicadas, Universidad de Oriente, Núcleo de Sucre, Cumana 6101, Venezuela
| | - Milagros Figueroa
- Laboratorio de Diagnóstico Serológico en Enfermedades Infecciosas, Postgrado en Biología Aplicada, Universidad de Oriente, Núcleo de Sucre, Cumana 6101, Venezuela
| | - Brian J. Ward
- National Reference Centre for Parasitology, Research Institute of the McGill University Health Centre, Montreal General Hospital, 1650 Cedar Avenue R3-137, Montreal, QC, Canada H3G 1A4
| | - Jessicca Rodríguez
- Laboratorio de Diagnóstico Serológico en Enfermedades Infecciosas, Postgrado en Biología Aplicada, Universidad de Oriente, Núcleo de Sucre, Cumana 6101, Venezuela
| | - Alicia Jorquera
- Centro de Investigaciones en Ciencias de la Salud, de la Universidad de Oriente, Núcleo de Anzoátegui, Barcelona 6001, Venezuela
| | - Maria A. Figuera
- Departamento de Bioanálsis, Universidad de Oriente, Núcleo de Sucre, Cumana 6101, Venezuela
| | - Leomerys Romero
- Centro de Investigaciones en Ciencias de la Salud, de la Universidad de Oriente, Núcleo de Anzoátegui, Barcelona 6001, Venezuela
| | - Momar Ndao
- National Reference Centre for Parasitology, Research Institute of the McGill University Health Centre, Montreal General Hospital, 1650 Cedar Avenue R3-137, Montreal, QC, Canada H3G 1A4
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Trypanosoma cruzi Infection in an Indigenous Kariña Community in Eastern Venezuela. ACTA ACUST UNITED AC 2012. [DOI: 10.1155/2012/138259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We investigated the seroprevalence of Trypanosoma cruzi infection in an indigenous Kariña population in eastern Venezuela. A total of 175 serum samples were collected in the community of Piñantal during February 2009. Interviews targeting socioeconomic and environmental factors associated with the T. cruzi transmission were also conducted. Samples were evaluated using trypomastigote excreted/secreted antigens (TESAs) in an ELISA format. TESA-ELISA positive samples were confirmed by indirect haemagglutination (HAI) (Wiener). A nonsystematic collection of vectors was also undertaken. T. cruzi seroprevalence was 7.43% according to both assays, and the mean age of infected patients was 48.61±10.40 years (range 34 to 73 years). The vector infection rate was 20.00% (2/10). T. cruzi seropositivity was associated with a history of triatomine bites, the ability to recognize the vector and poor knowledge about Chagas disease, but no associations were found with gender, house type, knowledge of how the disease is transmitted, or the presence of vectors or animals inside dwellings. To our knowledge, this is the first study of the seroprevalence of T. cruzi in an indigenous population in eastern Venezuela. All of the epidemiological variables required for the establishment of active vectorial transmission of T. cruzi were present in this community.
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Characterization of an immunodominant antigenic epitope from Trypanosoma cruzi as a biomarker of chronic Chagas' disease pathology. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2011; 19:167-73. [PMID: 22155766 DOI: 10.1128/cvi.05566-11] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Nowadays, the techniques available for chronic Chagas' disease diagnosis are very sensitive; however, they do not allow discrimination of the patient's clinical stages of the disease. The present paper describes that three out of the five different repeats contained in the Trypanosoma cruzi TcCA-2 membrane protein (3972-FGQAAAGDKPPP, 6303-FGQAAAGDKPAP, and 3973-FGQAAAGDKPSL) are recognized with high sensitivity (>90%) by sera from chronic Chagas' disease patients and that they are not recognized by sera from patients in the acute phase of the disease. A total of 133 serum samples from chagasic patients and 50 serum samples from healthy donors were tested. In addition, sera from 15 patients with different autoimmune diseases, 43 serum samples from patients suffering an infectious disease other than Chagas' disease, and 38 serum samples from patients with nonchagasic cardiac disorders were also included in this study. The residue 3973 peptide shows a specificity of >98%, as it is not recognized by individuals with autoimmune and inflammatory processes or by patients with a nonchagasic cardiomyopathy. Remarkably, the levels of antibody against the 3973 epitope detected by the sera from Chagas' disease patients in the symptomatic chronic phase, involving cardiac or digestive alterations, are higher than those detected by the sera from Chagas' disease patients in the indeterminate phase of the disease. It is suggested that the diagnostic technique described could also be used to indicate the degree of pathology. The amino acids F, Q, and DKP located in the peptide at positions 1, 3, and 8 to 10, respectively, are essential to conform to the immunodominant antigenic epitope.
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13
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Fernández-Villegas A, Pinazo MJ, Marañón C, Thomas MC, Posada E, Carrilero B, Segovia M, Gascon J, López MC. Short-term follow-up of chagasic patients after benzonidazole treatment using multiple serological markers. BMC Infect Dis 2011; 11:206. [PMID: 21801456 PMCID: PMC3169482 DOI: 10.1186/1471-2334-11-206] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Accepted: 07/31/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Conventional serological tests, using total soluble proteins or a cocktail of recombinant proteins from T. cruzi as antigens, are highly sensitive for Chagas disease diagnosis. This type of tests, however, does not seem to be reliable tools for short- and medium-term monitoring of the evolution of patients after antiparasitic treatment. The aim of the present study was to search for immunological markers that could be altered in the sera from Chagas disease patients after benznidazole treatment, and therefore have a potential predictive diagnostic value. METHODS We analyzed the reactivity of sera from chagasic patients during different clinical phases of the disease against a series of immunodominant antigens, known as KMP11, PFR2, HSP70 and Tgp63. The reactivity of the sera from 46 adult Chronic Chagas disease patients living in a non-endemic country without vector transmission of T. cruzi (15 patients in the indeterminate stage, 16 in the cardiomiopathy stage and 16 in the digestive stage) and 22 control sera from non-infected subjects was analyzed. We also analyzed the response dynamics of sera from those patients who had been treated with benznidazole. RESULTS Regardless of the stage of the sickness, the sera from chagasic patients reacted against KMP11, HSP70, PFR2 and Tgp63 recombinant proteins with statistical significance relative to the reactivity against the same antigens by the sera from healthy donors, patients with autoimmune diseases or patients suffering from tuberculosis, leprosy or malaria. Shortly after benznidazole treatment, a statistically significant decrease in reactivity against KMP11, HSP70 and PFR2 was observed (six or nine month). It was also observed that, following benznidazole treatment, the differential reactivity against these antigens co-relates with the clinical status of the patients. CONCLUSIONS The recombinant antigens KMP11, PFR2, Tgp63 and HSP70 are recognized by Chagas disease patients' sera at any clinical stage of the disease. Shortly after benznidazole treatment, a drop in reactivity against three of these antigens is produced in an antigen-specific manner. Most likely, analysis of the reactivity against these recombinant antigens may be useful for monitoring the effectiveness of benznidazole treatment.
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Affiliation(s)
- Ana Fernández-Villegas
- Departamento de Biología Molecular, Instituto de Parasitología y Biomedicina López Neyra - Consejo Superior de Investigaciones Científicas, Parque Tecnológico de Ciencias de Salud - Avda, del Conocimiento s/n. 18100-Granada, Spain
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Ndao M, Rainczuk A, Rioux MC, Spithill TW, Ward BJ. Is SELDI-TOF a valid tool for diagnostic biomarkers? Trends Parasitol 2010; 26:561-7. [PMID: 20708969 DOI: 10.1016/j.pt.2010.07.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2010] [Revised: 07/15/2010] [Accepted: 07/19/2010] [Indexed: 01/25/2023]
Abstract
The genome revolution is providing fresh insights into host and parasite genomes, and new tools are becoming available for examining host-parasite interactions at the proteome level. Technologies such as surface-enhanced laser desorption/ionization time-of-flight (SELDI-TOF) mass spectrometry (MS) can be applied to discover biomarkers (alterations in both host and parasite proteomes) associated with parasitic diseases. Such biomarkers can represent host proteins, fragments of host proteins or parasite proteins that appear in body fluids or tissues following infection. Individual biomarkers or biomarker patterns not only have diagnostic utility (e.g. in active disease, prognosis, tests of cure) but can also provide unique insights into the mechanisms underlying host responses and pathogenesis.
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Affiliation(s)
- Momar Ndao
- National Reference Centre for Parasitology, Research Institute of the McGill University Health Centre, Montreal General Hospital, Montreal, Quebec, Canada.
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Wendel S. Transfusion transmitted Chagas disease: is it really under control? Acta Trop 2010; 115:28-34. [PMID: 20044970 DOI: 10.1016/j.actatropica.2009.12.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2009] [Revised: 12/12/2009] [Accepted: 12/22/2009] [Indexed: 12/13/2022]
Abstract
Transfusion transmitted Chagas disease was recognized as a medical problem more than 50 years ago. However, little attention was paid to it by Transfusion Medicine, medical authorities or regulatory agencies as a major problem and threat (especially after the advent of HIV/AIDS); perhaps because it was mainly restricted to tropical regions, usually in less developed countries. With the intense human migratory movement from developing to developed countries, it became more common and evident. The scope of this review is to cover the main transfusional aspects of American trypanosomiasis (Chagas disease), including the main strategies to prevent it through donor questionnaires, specific serological testing and alternative methods such as leukofiltration and pathogen reduction procedures, in order to increase the blood safety in both developing and developed countries.
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Ndao M, Spithill TW, Caffrey R, Li H, Podust VN, Perichon R, Santamaria C, Ache A, Duncan M, Powell MR, Ward BJ. Identification of novel diagnostic serum biomarkers for Chagas' disease in asymptomatic subjects by mass spectrometric profiling. J Clin Microbiol 2010; 48:1139-49. [PMID: 20071547 PMCID: PMC2849606 DOI: 10.1128/jcm.02207-09] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2009] [Revised: 12/26/2009] [Accepted: 01/07/2010] [Indexed: 01/10/2023] Open
Abstract
More than 10 million people are thought to be infected with Trypanosoma cruzi, primarily in the Americas. The clinical manifestations of Chagas' disease (CD) are variable, but most subjects remain asymptomatic for decades. Only 15 to 30% eventually develop terminal complications. All current diagnostic tests have limitations. New approaches are needed for blood bank screening as well as for improved diagnosis and prognosis. Sera from subjects with asymptomatic CD (n = 131) were compared to those from uninfected controls (n = 164) and subjects with other parasitic diseases (n = 140), using protein array mass spectrometry. To identify biomarkers associated with CD, sera were fractionated by anion-exchange chromatography and bound to two commercial ProteinChip array chemistries: WCX2 and IMAC3. Multiple candidate biomarkers were found in CD sera (3 to 75.4 kDa). Algorithms employing 3 to 5 of these biomarkers achieved up to 100% sensitivity and 98% specificity for CD. The biomarkers most useful for diagnosis were identified and validated. These included MIP1 alpha, C3a anaphylatoxin, and unusually truncated forms of fibronectin, apolipoprotein A1 (ApoA1), and C3. An antipeptide antiserum against the 28.9-kDa C terminus of the fibronectin fragment achieved good specificity (90%) for CD in a Western blot format. We identified full-length ApoA1 (28.1 kDa), the major structural and functional protein component of high-density lipoprotein (HDL), as an important negative biomarker for CD, and relatively little full-length ApoA1 was detected in CD sera. This work provides proof of principle that both platform-dependent (i.e., mass spectrometry-based) and platform-independent (i.e., Western blot) tests can be generated using high-throughput mass profiling.
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Affiliation(s)
- Momar Ndao
- National Reference Centre for Parasitology, Research Institute of the McGill University Health Center, Montreal, Quebec, Canada.
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Berrizbeitia M, Ward BJ, Bubis J, Gottschalk M, Aché A, Perdomo D, Medina R, Medina M, Spencer L, Ndao M. 85-kDa protein of Trypanosoma cruzi purified by affinity chromatography used in the multiple antigen binding assay (MABA) for the diagnosis of T. cruzi infection in a Venezuelan rural community. Parasitol Res 2010; 106:1127-34. [DOI: 10.1007/s00436-010-1773-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2009] [Accepted: 01/17/2010] [Indexed: 11/29/2022]
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Remesar MC, Gamba C, Colaianni IF, Puppo M, Sartor PA, Murphy EL, Neilands TB, Ridolfi MA, Leguizamón MS, Kuperman S, Del Pozo AE. Estimation of sensitivity and specificity of several Trypanosoma cruzi antibody assays in blood donors in Argentina. Transfusion 2009; 49:2352-8. [PMID: 19903291 PMCID: PMC2841448 DOI: 10.1111/j.1537-2995.2009.02301.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The absence of a gold standard test for Trypanosoma cruzi antibodies represents a problem not only for the evaluation of screening tests, but also for appropriate blood donor counseling. The aim of this study was to estimate the sensitivity and specificity of multiple blood donor screening tests for T. cruzi antibodies in Argentina. STUDY DESIGN AND METHODS From June 2006 to March 2007 a sample of 1455 blood donors was recruited from two blood banks in Chaco province, an area of Argentina with highly endemic T. cruzi infection. Samples were tested by three epimastigote lysate enzyme immunoassays (EIAs), one recombinant antigen EIA, two indirect hemagglutination assay (IHA) tests, a particle agglutination assay (PA), and a research trans-sialidase inhibition assay (TIA). Sensitivity and specificity were estimated using latent class analysis (LCA). RESULTS LCA estimated the consensus prevalence of T. cruzi infection at 24.5%. Interassay correlation was higher among the four EIA tests and TIA compared to IHA tests. Assay sensitivities varied from 96 to 99.7 for different EIAs, 91% for TIA, 84% for PA, and 66 to 74% for IHA tests. Relative to the LCA, assay specificities were from 96% to almost 100%. CONCLUSION Based on the comparison of several tests in a large population from an endemic area for T. cruzi infection, our data showed an adequate sensitivity for EIA tests in contrast to PA and IHA assays. The latter tests should no longer be used for blood donor screening.
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Affiliation(s)
- Mirta C Remesar
- Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina.
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Campos Y, Briceño L, Reina K, Figarella K, Pérez JL, Mosca W. Serological diagnosis of Chagas disease: evaluation and characterisation of a low cost antigen with high sensitivity and specificity. Mem Inst Oswaldo Cruz 2009; 104:914-7. [DOI: 10.1590/s0074-02762009000600016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2009] [Accepted: 08/20/2009] [Indexed: 11/21/2022] Open
Affiliation(s)
| | | | - Kate Reina
- Universidad Central de Venezuela, Venezuela
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20
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de Moraes MH, Guarneri AA, Girardi FP, Rodrigues JB, Eger I, Tyler KM, Steindel M, Grisard EC. Different serological cross-reactivity of Trypanosoma rangeli forms in Trypanosoma cruzi-infected patients sera. Parasit Vectors 2008; 1:20. [PMID: 18611261 PMCID: PMC2475519 DOI: 10.1186/1756-3305-1-20] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2008] [Accepted: 07/08/2008] [Indexed: 11/20/2022] Open
Abstract
UNLABELLED BACKGROUND American Trypanosomiasis or Chagas disease is caused by Trypanosoma cruzi which currently infects approximately 16 million people in the Americas causing high morbidity and mortality. Diagnosis of American trypanosomiasis relies on serology, primarily using indirect immunofluorescence assay (IFA) with T. cruzi epimastigote forms. The closely related but nonpathogenic Trypanosoma rangeli has a sympatric distribution with T. cruzi and is carried by the same vectors. As a result false positives are frequently generated. This confounding factor leads to increased diagnostic test costs and where false positives are not caught, endangers human health due to the toxicity of the drugs used to treat Chagas disease. RESULTS In the present study, serologic cross-reactivity between the two species was compared for the currently used epimastigote form and the more pathologically relevant trypomastigote form, using IFA and immunoblotting (IB) assays. Our results reveal an important decrease in cross reactivity when T. rangeli culture-derived trypomastigotes are used in IFA based diagnosis of Chagas disease. Western blot results using sera from both acute and chronic chagasic patients presenting with cardiac, indeterminate or digestive disease revealed similar, but not identical, antigenic profiles. CONCLUSION This is the first study addressing the serological cross-reactivity between distinct forms and strains of T. rangeli and T. cruzi using sera from distinct phases of the Chagasic infection. Several T. rangeli-specific proteins were detected, which may have potential as diagnostic tools.
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Affiliation(s)
- Milene H de Moraes
- Departamento de Microbiologia e Parasitologia, Universidade Federal de Santa Catarina, 88040-900, Florianópolis, Santa Catarina, Brazil
| | - Alessandra A Guarneri
- Departamento de Microbiologia e Parasitologia, Universidade Federal de Santa Catarina, 88040-900, Florianópolis, Santa Catarina, Brazil
- Instituto René Rachou, Fiocruz, Belo Horizonte, Minas Gerais, Brazil
| | - Fabiana P Girardi
- Departamento de Microbiologia e Parasitologia, Universidade Federal de Santa Catarina, 88040-900, Florianópolis, Santa Catarina, Brazil
| | - Juliana B Rodrigues
- Departamento de Microbiologia e Parasitologia, Universidade Federal de Santa Catarina, 88040-900, Florianópolis, Santa Catarina, Brazil
| | - Iriane Eger
- Departamento de Microbiologia e Parasitologia, Universidade Federal de Santa Catarina, 88040-900, Florianópolis, Santa Catarina, Brazil
- Universidade do Vale do Itajaí, Itajaí, Santa Catarina, Brazil
| | - Kevin M Tyler
- Biomedical Research Centre, School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, Norfolk, UK
| | - Mário Steindel
- Departamento de Microbiologia e Parasitologia, Universidade Federal de Santa Catarina, 88040-900, Florianópolis, Santa Catarina, Brazil
| | - Edmundo C Grisard
- Departamento de Microbiologia e Parasitologia, Universidade Federal de Santa Catarina, 88040-900, Florianópolis, Santa Catarina, Brazil
- Biomedical Research Centre, School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, Norfolk, UK
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Garraud O, Pelletier B, Aznar C. Pourquoi ajourner au don de sang des candidats au motif d’un risque de maladie de Chagas ? Transfus Clin Biol 2008; 15:123-8. [DOI: 10.1016/j.tracli.2008.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2007] [Accepted: 05/05/2008] [Indexed: 10/21/2022]
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Gorlin J, Rossmann S, Robertson G, Stallone F, Hirschler N, Nguyen KA, Gilcher R, Fernandes H, Alvey S, Ajongwen P, Contestable P, Warren H. Evaluation of a new Trypanosoma cruzi antibody assay for blood donor screening. Transfusion 2008; 48:531-40. [DOI: 10.1111/j.1537-2995.2007.01566.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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