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Busselman RE, Meyers AC, Zecca IB, Auckland LD, Castro AH, Dowd RE, Curtis-Robles R, Hodo CL, Saunders AB, Hamer SA. High incidence of Trypanosoma cruzi infections in dogs directly detected through longitudinal tracking at 10 multi-dog kennels, Texas, USA. PLoS Negl Trop Dis 2021; 15:e0009935. [PMID: 34758049 PMCID: PMC8631682 DOI: 10.1371/journal.pntd.0009935] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 11/30/2021] [Accepted: 10/20/2021] [Indexed: 11/18/2022] Open
Abstract
Canine Chagas disease, caused by the protozoan parasite Trypanosoma cruzi, is increasingly recognized as a health concern for dogs in the USA, and infected dogs may signal geographic regions of risk for human disease. Dogs living in multi-dog kennel environments (kennels with more than one dog) where triatomine vectors are endemic may be at high risk for infection. We monitored a cohort of 64 T. cruzi-infected and uninfected dogs across 10 kennels in Texas, USA, to characterize changes in infection status over one year. We used robust diagnostic criteria in which reactivity on multiple independent platforms was required to be considered positive. Among the 30 dogs enrolled as serologically- and/or PCR-positive, all but one dog showed sustained positive T. cruzi diagnostic results over time. Among the 34 dogs enrolled as serologically- and PCR-negative, 10 new T. cruzi infections were recorded over a 12-month period. The resulting incidence rate for dogs initially enrolled as T. cruzi-negative was 30.7 T. cruzi infections per 100 dogs per year. This study highlights the risk of T. cruzi infection to dogs in kennel environments. To protect both dog and human health, there is an urgent need to develop more integrated vector control methods as well as prophylactic and curative antiparasitic treatment options for T. cruzi infection in dogs.
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Affiliation(s)
- Rachel E. Busselman
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, Texas, United States of America
| | - Alyssa C. Meyers
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, Texas, United States of America
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Italo B. Zecca
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, Texas, United States of America
| | - Lisa D. Auckland
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, Texas, United States of America
| | - Andres H. Castro
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, Texas, United States of America
| | - Rebecca E. Dowd
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, Texas, United States of America
| | - Rachel Curtis-Robles
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, Texas, United States of America
| | - Carolyn L. Hodo
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, Texas, United States of America
- The University of Texas MD Anderson Cancer Center, Michale E. Keeling Center for Comparative Medicine and Research, Bastrop, Texas, United States of America
| | - Ashley B. Saunders
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, United States of America
| | - Sarah A. Hamer
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, Texas, United States of America
- * E-mail:
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Martins-Melo FR, Castro MC, Werneck GL. Levels and trends in Chagas disease-related mortality in Brazil, 2000-2019. Acta Trop 2021; 220:105948. [PMID: 33971159 DOI: 10.1016/j.actatropica.2021.105948] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/06/2021] [Accepted: 04/29/2021] [Indexed: 10/21/2022]
Abstract
Chagas disease remains an important public health problem with high morbidity and mortality in several Latin American countries. This nationwide population-based ecological study analyzes the epidemiological characteristics and time trends of Chagas disease-related mortality in Brazil, 2000-2019. We included all deaths reported in Brazil in which Chagas disease was mentioned in the death certificate either as an underlying or associated cause of death (multiple causes of death). Crude and age-adjusted mortality rates (per 100,000 inhabitants) were calculated and time trends analysis was performed using joinpoint regression models. In the study period, a total of 22,663,092 deaths were recorded in Brazil. Chagas disease was identified in 122,291 deaths (0.54%), 94.788 (77.5%) as an underlying cause and 27,503 (22.5%) as an associated cause. Average annual age-adjusted mortality rate was 3.22 deaths/100,000 inhabitants (95% confidence interval [CI]: 3.14-3.30). Chronic Chagas disease with cardiac involvement was the predominant clinical presentation mentioned. The highest mortality rates were observed in males, age group ≥80 years, black race/skin color, schooling 1-3 years of study, and residents in the Central-West region. Age-adjusted mortality rates showed a significant declining trend at the national level in the period (Average Annual Percent Change: -3.1%; 95% CI: -3.3; -3.0), with different local patterns and a more pronounced reduction in important endemic areas in the past. The findings show that, despite a consistent decline in mortality rates in Brazil over the study period, Chagas disease remains an important and neglected cause of death in the country, showing a marked regional variation that has social and health care implications. In addition to the control measures for disease transmission, it is necessary to guarantee access, coverage, and quality of health care to Chagas disease patients, seeking to prevent the occurrence of severe forms and deaths from the disease.
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Soares Cajaiba-Soares AM, Martinez-Silveira MS, Paim Miranda DL, de Cássia Pereira Fernandes R, Reis MG. Healthcare Workers' Knowledge about Chagas Disease: A Systematic Review. Am J Trop Med Hyg 2021; 104:1631-1638. [PMID: 33684063 PMCID: PMC8103490 DOI: 10.4269/ajtmh.20-1199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 12/17/2020] [Indexed: 11/07/2022] Open
Abstract
Transmission of Chagas disease (CD) has decreased in recent decades, but the disease remains an important problem in endemic areas. There was an increase in the proportion of nonvector transmission, mainly in non-endemic countries. The aim of this study was to gather evidence concerning healthcare professional's knowledge about CD. Searches were performed through Medline/PubMed, Lilacs, Web of Science databases, and Scielo archives, from which 13/97 articles were selected for a qualitative analysis after full-text reading. Most of the studies were from the United States, the oldest published in 2007 and the most recent in 2020, and most of them used surveys as the evaluation method. Each article used different methods, according to the epidemiological status of vector transmission. Two studies targeted specialty-related questions, and two used focus groups as methods for data gathering. Despite differences between the studies, all of them presented knowledge deficits among healthcare workers, regarding at least one of the evaluated aspects. In comparison with population surveys, healthcare professionals demonstrated higher results related to clinical aspects and awareness of the disease's importance. Most of the articles showed a low perception of CD's knowledge by the participants and a low probability of considering CD in the diagnosis of their patients. A previous contact with the subject was pointed by some studies as capable of improving knowledge of the participants. This study emphasizes the importance of continuing education to address deficits of healthcare professionals' knowledge.
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Affiliation(s)
| | | | | | | | - Mitermayer Galvão Reis
- Faculdade de Medicina da Bahia, Universidade Federal da Bahia (FAMEB-UFBA), Salvador, Brazil;,Instituto Gonçalo Muniz, Fundação Oswaldo Cruz (IGM-FIOCRUZ), Salvador, Brazil;,Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, Connecticut,Address correspondence to Mitermayer G. Reis, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Waldemar Falcão Street, 121, Salvador, 40296-710, Bahia, Brazil. E-mail:
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de Souza ALADAG, Mesquita CT. Chagas Disease - Past and Future. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2020. [DOI: 10.36660/ijcs.20200351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Acute Chagas disease in Brazil from 2001 to 2018: A nationwide spatiotemporal analysis. PLoS Negl Trop Dis 2020; 14:e0008445. [PMID: 32745113 PMCID: PMC7425982 DOI: 10.1371/journal.pntd.0008445] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 08/13/2020] [Accepted: 06/02/2020] [Indexed: 12/31/2022] Open
Abstract
Background In Brazil, acute Chagas disease (ACD) surveillance involves mandatory notification, which allows for population-based epidemiological studies. We conducted a nationwide population-based ecological analysis of the spatiotemporal patterns of ACD notifications in Brazil using secondary surveillance data obtained from the Notifiable Diseases Information System (SINAN) maintained by Brazilian Ministry of Health. Methodology/Principal findings In this nationwide population-based ecological all cases of ACD reported in Brazil between 2001 and 2018 were included. Epidemiological characteristics and time trends were analyzed through joinpoint regression models and spatial distribution using microregions as the unit of analysis. A total of 5,184 cases of ACD were recorded during the period under study. The annual incidence rate in Brazil was 0.16 per 100,000 inhabitants/year. Three statistically significant changes in time trends were identified: a rapid increase prior to 2005 (Period 1), a stable drop from 2005 to 2009 (Period 2), followed by another increasing trend after 2009 (Period 3). Higher frequencies were noted in males and females in the North (all three periods) and in females in Northeast (Periods 1 and 2) macroregions, as well as in individuals aged between 20–64 years in the Northeast, and children, adolescents and the elderly in the North macroregion. Vectorial transmission was the main route reported during Period 1, while oral transmission was found to increase significantly in the North during the other periods. Spatiotemporal distribution was heterogeneous in Brazil over time. Despite regional differences, over time cases of ACD decreased significantly nationwide. An increasing trend was noted in the North (especially after 2007), and significant decreases occurred after 2008 among all microregions other than those in the North, especially those in the Northeast and Central-West macroregions. Conclusions/Significance In light of the newly identified epidemiological profile of CD transmission in Brazil, we emphasize the need for strategically integrated entomological and health surveillance actions. Chagas disease (CD) infection is a debilitating and neglected disease that occurs in 21 Latin America countries. CD has two distinct phases: acute and chronic. The generally asymptomatic acute phase begins shortly after infection and can last up to four months. When symptoms do appear, they are typically mild and unspecific. Following this phase, infected individuals evolve to a long-lasting chronic phase, which can be either symptomatic or asymptomatic. In Brazil, only acute cases are mandatorily notifiable in the Brazilian Notifiable Diseases Information System (Brazilian Ministry of Health). Most chronic cases are unknown and untreated. Considering that epidemiological data related to ACD is publicly available, we have analyzed the spatiotemporal distribution of notified cases of ACD and evaluated relevant epidemiological indicators throughout Brazil from 2001 to 2018. The data present here may contribute to surveillance actions designed at preventing new CD cases. We observed 5,184 cases of ACD during the period under study. The annual incidence rate in Brazil was 0.16 per 100,000 inhabitants/year. Three distinct epidemiological periods were identified: a rapid increase prior to 2005 (Period 1), a stable drop from 2005 to 2009 (Period 2), followed by another increasing trend after 2009 (Period 3). Vectorial transmission was the main route reported during Period 1, while oral transmission was found to increase significantly in the North during the other periods. Despite regional differences, over time cases of ACD decreased significantly nationwide. An increasing trend was noted in the North (especially after 2007). In light of the newly identified epidemiological profile of CD transmission in Brazil, we emphasize the need for strategically integrated entomological and health surveillance actions.
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Chagas disease: Historic perspective. Biochim Biophys Acta Mol Basis Dis 2020; 1866:165689. [DOI: 10.1016/j.bbadis.2020.165689] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 01/02/2020] [Accepted: 01/15/2020] [Indexed: 12/13/2022]
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Bellera CL, Alberca LN, Sbaraglini ML, Talevi A. In Silico Drug Repositioning for Chagas Disease. Curr Med Chem 2020; 27:662-675. [PMID: 31622200 DOI: 10.2174/0929867326666191016114839] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 09/12/2019] [Accepted: 09/23/2019] [Indexed: 12/18/2022]
Abstract
Chagas disease is an infectious tropical disease included within the group of neglected tropical diseases. Though historically endemic to Latin America, it has lately spread to high-income countries due to human migration. At present, there are only two available drugs, nifurtimox and benznidazole, approved for this treatment, both with considerable side-effects (which often result in treatment interruption) and limited efficacy in the chronic stage of the disease in adults. Drug repositioning involves finding novel therapeutic indications for known drugs, including approved, withdrawn, abandoned and investigational drugs. It is today a broadly applied approach to develop innovative medications, since indication shifts are built on existing safety, ADME and manufacturing information, thus greatly shortening development timeframes. Drug repositioning has been signaled as a particularly interesting strategy to search for new therapeutic solutions for neglected and rare conditions, which traditionally present limited commercial interest and are mostly covered by the public sector and not-for-profit initiatives and organizations. Here, we review the applications of computer-aided technologies as systematic approaches to drug repositioning in the field of Chagas disease. In silico screening represents the most explored approach, whereas other rational methods such as network-based and signature-based approximations have still not been applied.
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Affiliation(s)
- Carolina L Bellera
- Laboratory of Bioactive Research and Development (LIDeB), Faculty of Exact Sciences, University of La Plata (UNLP), La Plata, Argentina
| | - Lucas N Alberca
- Laboratory of Bioactive Research and Development (LIDeB), Faculty of Exact Sciences, University of La Plata (UNLP), La Plata, Argentina
| | - María L Sbaraglini
- Laboratory of Bioactive Research and Development (LIDeB), Faculty of Exact Sciences, University of La Plata (UNLP), La Plata, Argentina
| | - Alan Talevi
- Laboratory of Bioactive Research and Development (LIDeB), Faculty of Exact Sciences, University of La Plata (UNLP), La Plata, Argentina
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Hagström L, Marques ALP, Nitz N, Hecht MM. The use of qPCR in human Chagas disease: a systematic review. Expert Rev Mol Diagn 2019; 19:875-894. [DOI: 10.1080/14737159.2019.1659729] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Luciana Hagström
- Laboratório Interdisciplinar de Biociências, Faculdade de Medicina, Universidade de Brasília, Campus Darcy Ribeiro, Brasília, Brazil
| | - Ana Luisa Pereira Marques
- Laboratório Interdisciplinar de Biociências, Faculdade de Medicina, Universidade de Brasília, Campus Darcy Ribeiro, Brasília, Brazil
| | - Nadjar Nitz
- Laboratório Interdisciplinar de Biociências, Faculdade de Medicina, Universidade de Brasília, Campus Darcy Ribeiro, Brasília, Brazil
| | - Mariana Machado Hecht
- Laboratório Interdisciplinar de Biociências, Faculdade de Medicina, Universidade de Brasília, Campus Darcy Ribeiro, Brasília, Brazil
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Gómez Marín JE, El Bissati K. Editorial: Innovative Therapeutic and Immunomodulatory Strategies for Protozoan Infections. Front Cell Infect Microbiol 2019; 9:293. [PMID: 31448246 PMCID: PMC6695569 DOI: 10.3389/fcimb.2019.00293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 07/30/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
- Jorge Enrique Gómez Marín
- Grupo GEPAMOL, Centro Investigaciones Biomédicas, Facultad de Ciencias de la Salud, Universidad del Quindío, Armenia, Colombia
| | - Kamal El Bissati
- Institute for Molecular Engineering, University of Chicago Medical Center, Chicago, IL, United States
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Villar JC, Herrera VM, Pérez Carreño JG, Váquiro Herrera E, Castellanos Domínguez YZ, Vásquez SM, Cucunubá ZM, Prado NG, Hernández Y. Nifurtimox versus benznidazole or placebo for asymptomatic Trypanosoma cruzi infection (Equivalence of Usual Interventions for Trypanosomiasis - EQUITY): study protocol for a randomised controlled trial. Trials 2019; 20:431. [PMID: 31307503 PMCID: PMC6631895 DOI: 10.1186/s13063-019-3423-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 05/10/2019] [Indexed: 12/05/2022] Open
Abstract
Background Either benznidazole (BZN) or nifurtimox (NFX) is recommended as equivalent to treat Trypanosoma cruzi infection. Nonetheless, supportive data from randomised trials is limited to individuals treated with BZN in southern cone countries of Latin America. Methods The goal of this randomised, concealed, blind, parallel-group trial is to inform the trypanocidal efficacy and safety of NFX and its equivalence to BZN among individuals with T. cruzi positive serology (TC+). Eligible individuals are TC+, 20–65 years old, with no apparent symptoms/signs or uncontrolled risk factors for cardiomyopathy and at negligible risk of re-infection. Consenting individuals (adherent to a 10-day placebo run-in phase) receive a 120-day BID blinded treatment with NFX, BZN or matching placebo (2:2:1 ratio). The four active medication arms include (1) a randomly allocated sequence of 60-day, conventional-dose (60CD) regimes (BZN 300 mg/day or NFX 480 mg/day, ratio 1:1), followed or preceded by a 60-day placebo treatment, or (2) 120-day half-dose (120HD) regimes (BZN 150 mg/day or NFX 240 mg/day, ratio 1:1). The primary efficacy outcome is the proportion of participants testing positive at least once for up to three polymerase chain reaction (PCR) assays (1 + PCR) 12–18 months after randomisation. A composite safety outcome includes moderate to severe adverse reactions, consistent blood marker abnormalities or treatment abandons. The trial outside Colombia (expected to recruit at least 60% of participants) is pragmatic; it may be open-label and not include all treatment groups, but it must adhere to the randomisation and data administration system and guarantee a blinded efficacy outcome evaluation. Our main comparisons include NFX groups with placebo (for superiority), NFX versus BZN groups and 60CD versus 120HD groups (for non-inferiority) and testing for the agent-dose and group-region interactions. Assuming a 1 + PCR ≥ 75% in the placebo group, up to 25% among BZN-treated and an absolute difference of up to ≥ 25% with NFX to claim its trypanocidal effect, 60–80 participants per group (at least 300 from Colombia) are needed to test our hypotheses (80–90% power; one-sided alpha level 1%). Discussion The EQUITY trial will inform the trypanocidal effect and equivalence of nitroderivative agents NFX and BZN, particularly outside southern cone countries. Its results may challenge current recommendations and inform choices for these agents. Trial registration ClinicalTrials.gov, NCT02369978. Registered on 24 February 2015. Electronic supplementary material The online version of this article (10.1186/s13063-019-3423-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Juan Carlos Villar
- Grupo de Cardiología Preventiva, Facultad de Ciencias de la Salud, Universidad Autónoma de Bucaramanga, Calle 157 No 19- 55, Campus el Bosque, Bucaramanga, Colombia. .,Departamento de Investigaciones, Fundación Cardioinfantil- Instituto de Cardiología, Bogotá, Colombia.
| | - Víctor Mauricio Herrera
- Grupo de Cardiología Preventiva, Facultad de Ciencias de la Salud, Universidad Autónoma de Bucaramanga, Calle 157 No 19- 55, Campus el Bosque, Bucaramanga, Colombia
| | - Juan Guillermo Pérez Carreño
- Departamento de Investigaciones, Fundación Cardioinfantil- Instituto de Cardiología, Bogotá, Colombia.,Dirección de Investigación e Innovación, Universidad del Rosario, Bogotá, Colombia
| | - Eliana Váquiro Herrera
- Departamento de Investigaciones, Fundación Cardioinfantil- Instituto de Cardiología, Bogotá, Colombia
| | - Yeny Zulay Castellanos Domínguez
- Grupo de Cardiología Preventiva, Facultad de Ciencias de la Salud, Universidad Autónoma de Bucaramanga, Calle 157 No 19- 55, Campus el Bosque, Bucaramanga, Colombia
| | - Skarlet Marcell Vásquez
- Grupo de Cardiología Preventiva, Facultad de Ciencias de la Salud, Universidad Autónoma de Bucaramanga, Calle 157 No 19- 55, Campus el Bosque, Bucaramanga, Colombia
| | - Zulma Milena Cucunubá
- Grupo de Parasitología, Instituto Nacional de Salud, Bogotá,, Colombia.,MRC Centre for Global Infectious Disease Analysis (MRC GIDA), Department of Infection Disease Epidemiology, Imperial College London, London, UK
| | - Nilda Graciela Prado
- Departamento de Clínica, Patología y Tratamiento, Instituto Nacional de Parasitología Mario Fatala Chabén, Buenos Aires, Argentina
| | - Yolanda Hernández
- Departamento de Clínica, Patología y Tratamiento, Instituto Nacional de Parasitología Mario Fatala Chabén, Buenos Aires, Argentina
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Carvalho TB, Padovani CR, de Oliveira Júnior LR, Latini ACP, Kurokawa CS, Pereira PCM, Dos Santos RM. ACAT-1 gene rs1044925 SNP and its relation with different clinical forms of chronic Chagas disease. Parasitol Res 2019; 118:2343-2351. [PMID: 31236660 DOI: 10.1007/s00436-019-06377-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 06/10/2019] [Indexed: 02/06/2023]
Abstract
Chagas disease, caused by the protozoan Trypanosoma cruzi (T. cruzi), although discovered more than a century ago, is still a not very well-elucidated aspect. Individuals in the chronic phase of the disease may present asymptomatic clinical form or symptomatologies related to the cardiac, digestive systems, or both (mixed clinical form). SNPs (single nucleotide polymorphisms) have been identified as important markers because they constitute about 90% of the variation in the human genome. One of them is localized to the ACAT-1 gene (cholesterol acyltransferase 1) (rs1044925) and has been linked to lipid disorders. Some studies have suggested the interaction between T. cruzi and the lipid metabolism of the host. Therefore, the objective of the present study was to evaluate the association between the ACAT-1 gene rs1044925 SNP in relation to clinical manifestations in patients with chronic Chagas disease. A total of 135 individuals with chronic Chagas disease, 86 (63.7%) asymptomatic individuals and 49 (36.3%) symptomatic patients (22 with cardiac clinical form, 18 with digestive form and 9 with mixed form) participated in the study. To evaluate the polymorphism, the PCR-RFLP technique were used. There was a significant difference and a higher frequency of AA and AC genotypes (p = 0.047 and p = 0.016, respectively) of the ACAT-1 gene in asymptomatic chagasic individuals. The result suggests a protective character of the AA and AC genotypes of the rs1044925 SNP in relation to the presence of symptomatic clinical manifestations of the disease in chronic chagasic individuals.
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Affiliation(s)
- Thaysa Buss Carvalho
- Department of Tropical Diseases, Botucatu Medical School, São Paulo State University (UNESP - Univ Estadual Paulista), Laboratório de Moléstias Infecciosas - UNIPEX - FMB UNESP, Rua Dr. Walter Mauricio Correa s/n, São Paulo, Brazil.
| | - Carlos Roberto Padovani
- Departament of Bioestatistics, Botucatu Biosciences Institute São Paulo State University (UNESP-Univ Estadual Paulista), São Paulo, Brazil
| | - Luiz Roberto de Oliveira Júnior
- Department of Tropical Diseases, Botucatu Medical School, São Paulo State University (UNESP - Univ Estadual Paulista), Laboratório de Moléstias Infecciosas - UNIPEX - FMB UNESP, Rua Dr. Walter Mauricio Correa s/n, São Paulo, Brazil
| | - Ana Carla Pereira Latini
- Department of Tropical Diseases, Botucatu Medical School, São Paulo State University (UNESP - Univ Estadual Paulista), Laboratório de Moléstias Infecciosas - UNIPEX - FMB UNESP, Rua Dr. Walter Mauricio Correa s/n, São Paulo, Brazil.,Departament of Molecular Biology, Lauro de Souza Lima Institute, São Paulo, Brazil
| | - Cilmery Suemi Kurokawa
- Department of Tropical Diseases, Botucatu Medical School, São Paulo State University (UNESP - Univ Estadual Paulista), Laboratório de Moléstias Infecciosas - UNIPEX - FMB UNESP, Rua Dr. Walter Mauricio Correa s/n, São Paulo, Brazil.,Departament of Pediatrics, Botucatu Medical School, São Paulo State University (UNESP-Univ Estadual Paulista), São Paulo, Brazil
| | - Paulo Câmara Marques Pereira
- Department of Tropical Diseases, Botucatu Medical School, São Paulo State University (UNESP - Univ Estadual Paulista), Laboratório de Moléstias Infecciosas - UNIPEX - FMB UNESP, Rua Dr. Walter Mauricio Correa s/n, São Paulo, Brazil
| | - Rodrigo Mattos Dos Santos
- Department of Tropical Diseases, Botucatu Medical School, São Paulo State University (UNESP - Univ Estadual Paulista), Laboratório de Moléstias Infecciosas - UNIPEX - FMB UNESP, Rua Dr. Walter Mauricio Correa s/n, São Paulo, Brazil
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Martins-Melo FR, Carneiro M, Ribeiro ALP, Bezerra JMT, Werneck GL. Burden of Chagas disease in Brazil, 1990–2016: findings from the Global Burden of Disease Study 2016. Int J Parasitol 2019; 49:301-310. [DOI: 10.1016/j.ijpara.2018.11.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 09/26/2018] [Accepted: 11/16/2018] [Indexed: 12/11/2022]
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Menezes Junior ADS, Lopes CC, Cavalcante PF, Martins E. Chronic Chagas Cardiomyopathy Patients and Resynchronization Therapy: a Survival Analysis. Braz J Cardiovasc Surg 2018; 33:82-88. [PMID: 29617506 PMCID: PMC5873775 DOI: 10.21470/1678-9741-2017-0134] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Accepted: 07/09/2017] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Chagas disease represents an important health problem with socioeconomic impacts in many Latin-American countries. It is estimated that 20% to 30% of the people infected by Trypanosoma cruzi will develop chronic Chagas cardiomyopathy (CCC), which is generally accompanied by heart failure (HF). Cardiac resynchronization therapy (CRT) may be indicated for patients with HF and electromechanical dysfunctions. OBJECTIVE The primary endpoint of this study was to analyze the response to CRT in patients with CCC, while the secondary endpoint was to estimate the survival rates of CRT responder patients. METHODS This is an observational, cross-sectional and retrospective study. The records of 50 patients with CRT pacing devices implanted between June 2009 and March 2017 were analyzed. For statistical analyses, Pearson's correlation was used along with Student's t-test, and survival was analyzed using the Kaplan-Meier method. A P value of <0.05 was considered significant. RESULTS Out of 50 patients, 56% were male, with a mean age of 63.4±13.3 years and an average CRT duration of 61.2±21.7 months. The mean QRS duration was 150.12±12.4 ms before and 116.04±2.2 ms after the therapy (P<0.001). The mean left ventricular ejection fractions (LVEF) were 29±7% and 39.1±12.2% before and after CRT, respectively (P<0.001). A total of 35 (70%) patients had a reduction of at least one New York Heart Association (NYHA) functional class after six months of therapy (P=0.014). The survival rate after 72 months was 45%. CONCLUSION This study showed clinical improvement and a nonsignificant survival rate in patients with CCC after the use of CRT.
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Affiliation(s)
- Antônio da Silva Menezes Junior
- Escola de Ciências Médicas, Farmacêuticas e Biomédicas of the Pontifícia Universidade Católica de Goiás (PUC-GO), Goiânia, GO, Brazil
| | - Cynthia Caetano Lopes
- Escola de Ciências Médicas, Farmacêuticas e Biomédicas of the Pontifícia Universidade Católica de Goiás (PUC-GO), Goiânia, GO, Brazil
| | - Patrícia Freire Cavalcante
- Escola de Ciências Médicas, Farmacêuticas e Biomédicas of the Pontifícia Universidade Católica de Goiás (PUC-GO), Goiânia, GO, Brazil
| | - Edésio Martins
- Escola de Ciências Médicas, Farmacêuticas e Biomédicas of the Pontifícia Universidade Católica de Goiás (PUC-GO), Goiânia, GO, Brazil
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Gondim KC, Atella GC, Pontes EG, Majerowicz D. Lipid metabolism in insect disease vectors. INSECT BIOCHEMISTRY AND MOLECULAR BIOLOGY 2018; 101:108-123. [PMID: 30171905 DOI: 10.1016/j.ibmb.2018.08.005] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 08/17/2018] [Accepted: 08/26/2018] [Indexed: 06/08/2023]
Abstract
More than a third of the world population is at constant risk of contracting some insect-transmitted disease, such as Dengue fever, Zika virus disease, malaria, Chagas' disease, African trypanosomiasis, and others. Independent of the life cycle of the pathogen causing the disease, the insect vector hematophagous habit is a common and crucial trait for the transmission of all these diseases. This lifestyle is unique, as hematophagous insects feed on blood, a diet that is rich in protein but relatively poor in lipids and carbohydrates, in huge amounts and low frequency. Another unique feature of these insects is that blood meal triggers essential metabolic processes, as molting and oogenesis and, in this way, regulates the expression of various genes that are involved in these events. In this paper, we review current knowledge of the physiology and biochemistry of lipid metabolism in insect disease vectors, comparing with classical models whenever possible. We address lipid digestion and absorption, hemolymphatic transport, and lipid storage by the fat body and ovary. In this context, both de novo fatty acid and triacylglycerol synthesis are discussed, including the related fatty acid activation process and the intracellular lipid binding proteins. As lipids are stored in order to be mobilized later on, e.g. for flight activity or survivorship, lipolysis and β-oxidation are also considered. All these events need to be finely regulated, and the role of hormones in this control is summarized. Finally, we also review information about infection, when vector insect physiology is affected, and there is a crosstalk between its immune system and lipid metabolism. There is not abundant information about lipid metabolism in vector insects, and significant current gaps in the field are indicated, as well as questions to be answered in the future.
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Affiliation(s)
- Katia C Gondim
- Instituto de Bioquímica Médica Leopoldo de Meis, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | - Georgia C Atella
- Instituto de Bioquímica Médica Leopoldo de Meis, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Emerson G Pontes
- Departamento de Bioquímica, Instituto de Química, Universidade Federal Rural do Rio de Janeiro, Seropédica, RJ, Brazil
| | - David Majerowicz
- Departamento de Biotecnologia Farmacêutica, Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
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