1
|
Beatty NL, Arango-Ferreira C, Gual-Gonzalez L, Zuluaga S, Nolan MS, Cantillo-Barraza O. Oral Chagas Disease in Colombia-Confirmed and Suspected Routes of Transmission. Trop Med Infect Dis 2024; 9:14. [PMID: 38251211 PMCID: PMC10819552 DOI: 10.3390/tropicalmed9010014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/21/2023] [Accepted: 12/28/2023] [Indexed: 01/23/2024] Open
Abstract
Chagas disease (CD) remains endemic throughout many regions of Colombia despite implementing decades of vector control strategies in several departments. Some regions have had a significant decrease in vectorial transmission, but the oral ingestion of Trypanosoma cruzi through consumption of contaminated food and drink products is increasingly described. This form of transmission has important public health relevance in Colombia due to an increase in reported acute CD cases and clinical manifestations that often lead to significant morbidity and mortality. Oral CD in Colombia has been associated with the consumption of contaminated fruit juices, such as palm wine, sugar cane, or tangerine juice and water for consumption, or contaminated surfaces where food has been prepared. Another interesting route of oral transmission includes ingestion of unbeknownst infected armadillos' blood, which is related to a traditional medicine practice in Colombia. Some earlier reports have also implemented consumption of infected bush meat as a source, but this is still being debated. Within the Amazon Basin, oral transmission is now considered the principal cause of acute CD in these regions. Furthermore, new cases of acute CD are now being seen in departments where CD has not been documented, and triatomine vectors are not naturally found, thus raising suspicion for oral transmission. The oral CD could also be considered a food-borne zoonosis, and odoriferous didelphid secretions have been implemented in contaminating the human dwelling environment, increasing the risk of consumption of infectious metacyclic trypomastigotes. In this article, we will discuss the complex transmission dynamics of oral CD in Colombia and further examine the unique clinical manifestations of this route of infection. New insights into the oral transmission of Trypanosoma cruzi are being discovered in Colombia, which can help bring increased awareness and a better understanding of this neglected tropical disease to reduce the burden of CD throughout Latin America.
Collapse
Affiliation(s)
- Norman L. Beatty
- Division of Infectious Diseases and Global Medicine, Department of Medicine, University of Florida College of Medicine, Gainesville, FL 32610, USA;
- Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610, USA
| | - Catalina Arango-Ferreira
- Departamento de Pediatría, Hospital San Vicente Fundación, Medellín 050010, Colombia;
- Departamento de Pediatría, Facultad de Medicina, Universidad de Antioquia, Medellín 050010, Colombia
| | - Lídia Gual-Gonzalez
- Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (L.G.-G.); (M.S.N.)
| | - Sara Zuluaga
- Grupo Biología y Control de Enfermedades Infecciosas, Universidad de Antioquia, Medellín 050010, Colombia;
| | - Melissa S. Nolan
- Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (L.G.-G.); (M.S.N.)
| | - Omar Cantillo-Barraza
- Grupo Biología y Control de Enfermedades Infecciosas, Universidad de Antioquia, Medellín 050010, Colombia;
| |
Collapse
|
2
|
Ruiz-Guevara R, Alarcón de Noya B, Mendoza I, Rojas C, Machado I, Díaz-Bello Z, Muñoz-Calderón A, Castro J, Noya O. Ten years follow-up of the largest oral Chagas disease outbreak: Cardiological prospective cohort study. PLoS Negl Trop Dis 2023; 17:e0011643. [PMID: 37801449 PMCID: PMC10584157 DOI: 10.1371/journal.pntd.0011643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 10/18/2023] [Accepted: 09/06/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Chagas disease (ChD) is the most important endemy in Latin America. Some patients, develop chronic Chagasic cardiopathy (CCC) years after the acute phase. It is unknown if patients infected by the oral route have higher risk of developing early CCC. METHODS AND FINDINGS A prospective cohort study was conducted to assess morbidity and mortality during 10 years observation in 106 people simultaneously infected and treated in the largest known orally transmitted ChD outbreak in 2007. A preschooler died during the acute phase, but thereafter was no mortality associated to ChD. All acute phase findings improved in the first-year post-treatment. Each person was evaluated 8.7 times clinically, 6.4 by electrocardiogram (ECG)/Holter, and 1.7 by echocardiogram. Based on prevalence, the number of people who had any abnormalities (excluding repolarization abnormalities and atrial tachycardia which decreased) was higher than 2007, since they were found at least once between 2008-2017. However, when we evaluated incidence, except for clinical bradycardia and dizziness, it was observed that the number of new cases of all clinical and ECG findings decreased at the end of the follow-up. Between 2008-2017 there was not incidence of low voltage complex, 2nd degree AV block, long QT interval, left bundle branch block or left ventricular dysfunction that allowed the diagnosis of CCC. Total improvement prevailed over the persistence of all clinical and ECG/Holter findings, except for sinus bradycardia. Incomplete right bundle branch block, sinus bradycardia and/or T-wave inversion were diagnosed persistently in 9 children. The second treatment did not have significant influence on the incidence of clinical or ECG/Holter findings. CONCLUSIONS At the end of the 10-year follow-up, there were not clinical or ECG/Holter criteria for classifying patients with CCC. The incidence of arrhythmias and repolarization abnormalities decreased. However, special attention should be paid on findings that not revert as sinus bradycardia, or those diagnosed persistently in all ECG as sinus bradycardia, incomplete right bundle branch block or T-wave inversion. Early diagnosis and treatment may have contributed to the rapid improvement of these patients. In ChD follow-up studies prevalence overestimates the real dimension of abnormalities, the incidence looks as a better indicator.
Collapse
Affiliation(s)
- Raiza Ruiz-Guevara
- Cátedra de Parasitología, Escuela ¨Luís Razetti” Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela
| | - Belkisyolé Alarcón de Noya
- Instituto de Medicina Tropical, Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela
| | - Iván Mendoza
- Instituto de Medicina Tropical, Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela
| | - Cielo Rojas
- Departmento de Cardiología, Sección de Enfermedades Cardíacas Congénitas, Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela
| | - Iván Machado
- Departmento de Cardiología, Sección de Enfermedades Cardíacas Congénitas, Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela
| | - Zoraida Díaz-Bello
- Instituto de Medicina Tropical, Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela
| | - Arturo Muñoz-Calderón
- Instituto de Medicina Tropical, Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela
| | - Julio Castro
- Instituto de Medicina Tropical, Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela
| | - Oscar Noya
- Cátedra de Parasitología, Escuela ¨Luís Razetti” Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela
- Instituto de Medicina Tropical, Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela
- Centro para Estudios Sobre Malaria, Instituto de Altos Estudios “Dr. Arnoldo Gabaldón”, Ministerio del Poder Popular para la Salud (MPPS), Caracas, Venezuela
| |
Collapse
|
3
|
Marin-Neto JA, Rassi A, Oliveira GMM, Correia LCL, Ramos Júnior AN, Luquetti AO, Hasslocher-Moreno AM, Sousa ASD, Paola AAVD, Sousa ACS, Ribeiro ALP, Correia Filho D, Souza DDSMD, Cunha-Neto E, Ramires FJA, Bacal F, Nunes MDCP, Martinelli Filho M, Scanavacca MI, Saraiva RM, Oliveira Júnior WAD, Lorga-Filho AM, Guimarães ADJBDA, Braga ALL, Oliveira ASD, Sarabanda AVL, Pinto AYDN, Carmo AALD, Schmidt A, Costa ARD, Ianni BM, Markman Filho B, Rochitte CE, Macêdo CT, Mady C, Chevillard C, Virgens CMBD, Castro CND, Britto CFDPDC, Pisani C, Rassi DDC, Sobral Filho DC, Almeida DRD, Bocchi EA, Mesquita ET, Mendes FDSNS, Gondim FTP, Silva GMSD, Peixoto GDL, Lima GGD, Veloso HH, Moreira HT, Lopes HB, Pinto IMF, Ferreira JMBB, Nunes JPS, Barreto-Filho JAS, Saraiva JFK, Lannes-Vieira J, Oliveira JLM, Armaganijan LV, Martins LC, Sangenis LHC, Barbosa MPT, Almeida-Santos MA, Simões MV, Yasuda MAS, Moreira MDCV, Higuchi MDL, Monteiro MRDCC, Mediano MFF, Lima MM, Oliveira MTD, Romano MMD, Araujo NNSLD, Medeiros PDTJ, Alves RV, Teixeira RA, Pedrosa RC, Aras Junior R, Torres RM, Povoa RMDS, Rassi SG, Alves SMM, Tavares SBDN, Palmeira SL, Silva Júnior TLD, Rodrigues TDR, Madrini Junior V, Brant VMDC, Dutra WO, Dias JCP. SBC Guideline on the Diagnosis and Treatment of Patients with Cardiomyopathy of Chagas Disease - 2023. Arq Bras Cardiol 2023; 120:e20230269. [PMID: 37377258 PMCID: PMC10344417 DOI: 10.36660/abc.20230269] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023] Open
Affiliation(s)
- José Antonio Marin-Neto
- Universidade de São Paulo , Faculdade de Medicina de Ribeirão Preto , Ribeirão Preto , SP - Brasil
| | - Anis Rassi
- Hospital do Coração Anis Rassi , Goiânia , GO - Brasil
| | | | | | | | - Alejandro Ostermayer Luquetti
- Centro de Estudos da Doença de Chagas , Hospital das Clínicas da Universidade Federal de Goiás , Goiânia , GO - Brasil
| | | | - Andréa Silvestre de Sousa
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
| | | | - Antônio Carlos Sobral Sousa
- Universidade Federal de Sergipe , São Cristóvão , SE - Brasil
- Hospital São Lucas , Rede D`Or São Luiz , Aracaju , SE - Brasil
| | | | | | | | - Edecio Cunha-Neto
- Universidade de São Paulo , Faculdade de Medicina da Universidade, São Paulo , SP - Brasil
| | - Felix Jose Alvarez Ramires
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Fernando Bacal
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | - Martino Martinelli Filho
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Maurício Ibrahim Scanavacca
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Roberto Magalhães Saraiva
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
| | | | - Adalberto Menezes Lorga-Filho
- Instituto de Moléstias Cardiovasculares , São José do Rio Preto , SP - Brasil
- Hospital de Base de Rio Preto , São José do Rio Preto , SP - Brasil
| | | | | | - Adriana Sarmento de Oliveira
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | - Ana Yecê das Neves Pinto
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
| | | | - Andre Schmidt
- Universidade de São Paulo , Faculdade de Medicina de Ribeirão Preto , Ribeirão Preto , SP - Brasil
| | - Andréa Rodrigues da Costa
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
| | - Barbara Maria Ianni
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | - Carlos Eduardo Rochitte
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
- Hcor , Associação Beneficente Síria , São Paulo , SP - Brasil
| | | | - Charles Mady
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Christophe Chevillard
- Institut National de la Santé Et de la Recherche Médicale (INSERM), Marselha - França
| | | | | | | | - Cristiano Pisani
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | | | | | - Edimar Alcides Bocchi
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Evandro Tinoco Mesquita
- Hospital Universitário Antônio Pedro da Faculdade Federal Fluminense , Niterói , RJ - Brasil
| | | | | | | | | | | | - Henrique Horta Veloso
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
| | - Henrique Turin Moreira
- Hospital das Clínicas , Faculdade de Medicina de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto , SP - Brasil
| | | | | | | | - João Paulo Silva Nunes
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
- Fundação Zerbini, Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | | | | | | | | | - Luiz Cláudio Martins
- Universidade Estadual de Campinas , Faculdade de Ciências Médicas , Campinas , SP - Brasil
| | | | | | | | - Marcos Vinicius Simões
- Universidade de São Paulo , Faculdade de Medicina de Ribeirão Preto , Ribeirão Preto , SP - Brasil
| | | | | | - Maria de Lourdes Higuchi
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | - Mauro Felippe Felix Mediano
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
- Instituto Nacional de Cardiologia (INC), Rio de Janeiro, RJ - Brasil
| | - Mayara Maia Lima
- Secretaria de Vigilância em Saúde , Ministério da Saúde , Brasília , DF - Brasil
| | | | | | | | | | - Renato Vieira Alves
- Instituto René Rachou , Fundação Oswaldo Cruz , Belo Horizonte , MG - Brasil
| | - Ricardo Alkmim Teixeira
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | - Roberto Coury Pedrosa
- Hospital Universitário Clementino Fraga Filho , Instituto do Coração Edson Saad - Universidade Federal do Rio de Janeiro , RJ - Brasil
| | | | | | | | | | - Silvia Marinho Martins Alves
- Ambulatório de Doença de Chagas e Insuficiência Cardíaca do Pronto Socorro Cardiológico Universitário da Universidade de Pernambuco (PROCAPE/UPE), Recife , PE - Brasil
| | | | - Swamy Lima Palmeira
- Secretaria de Vigilância em Saúde , Ministério da Saúde , Brasília , DF - Brasil
| | | | | | - Vagner Madrini Junior
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP - Brasil
| | | | | | - João Carlos Pinto Dias
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz , Rio de Janeiro , RJ - Brasil
| |
Collapse
|
4
|
Gonçalves KR, Mazzeti AL, Nascimento AFDS, Castro-Lacerda In Memory JM, Nogueira-Paiva NC, Mathias FAS, Reis AB, Caldas S, Bahia MT. The entrance route: Oral, mucous, cutaneous, or systemic has a marked influence on the outcome of Trypanosoma cruzi experimental infection. Acta Trop 2022; 234:106581. [PMID: 35779591 DOI: 10.1016/j.actatropica.2022.106581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 06/27/2022] [Accepted: 06/28/2022] [Indexed: 11/25/2022]
Abstract
In recent decades, the oral infection of Trypanosoma cruzi has gathered increased attention due to frequent outbreaks that can lead to more severe clinical signs than those usually found in the areas of vector transmission. This study addresses the main routes of infection using metacyclic trypomastigotes (MT) and blood trypomastigotes (BT). Herein, BALB/c mice were infected with the Colombian (TcI) strain via intraperitoneal (IP), oral, intragastric (IG), ocular (OC) and cutaneous (CT) routes with 106 culture-derived MT or BT. Parasitemia was intermittent and low in animals inoculated with MT, in contrast, high parasitemia levels were found in BT-mice. A tropism for the muscles was observed in oral or IG infection with BT. Differently, the parasite was widely distributed in the tissues of mice infected with MT. However, the intensity of the inflammation infiltrating the tissues was higher in oral or IG infection with BT. Animals inoculated with BT via the IG route had similar serum levels of IFN-γ and smaller IL-10 compared to those infected with MT via the IG route. TNF-α levels were higher in the serum from BT-animals, which could explain the higher intensity of heart inflammation in these animals. Our results suggest that the infective form and the route of infection differentially modulated the outcome of Trypanosoma cruzi mice infection.
Collapse
Affiliation(s)
- Karolina Ribeiro Gonçalves
- Núcleo de Pesquisa em Ciências Biológicas, Universidade Federal de Ouro Preto, Campus Universitário, Morro do Cruzeiro - Ouro Preto, Minas Gerais, Brasil.
| | - Ana Lia Mazzeti
- Laboratório de Biologia Celular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Av. Brasil, 4365 Rio de Janeiro, Brasil; Laboratório de Parasitologia Aplicada, Universidade Estadual de Minas Gerais - Unidade Passos, Av. Juca Stockler, 1130 Passos, Minas Gerais, Brasil
| | - Alvaro Fernando da Silva Nascimento
- Núcleo de Pesquisa em Ciências Biológicas, Universidade Federal de Ouro Preto, Campus Universitário, Morro do Cruzeiro - Ouro Preto, Minas Gerais, Brasil
| | - Jéssica Mara Castro-Lacerda In Memory
- Núcleo de Pesquisa em Ciências Biológicas, Universidade Federal de Ouro Preto, Campus Universitário, Morro do Cruzeiro - Ouro Preto, Minas Gerais, Brasil
| | - Nívia Carolina Nogueira-Paiva
- Núcleo de Pesquisa em Ciências Biológicas, Universidade Federal de Ouro Preto, Campus Universitário, Morro do Cruzeiro - Ouro Preto, Minas Gerais, Brasil
| | - Fernando Augusto Siqueira Mathias
- Núcleo de Pesquisa em Ciências Biológicas, Universidade Federal de Ouro Preto, Campus Universitário, Morro do Cruzeiro - Ouro Preto, Minas Gerais, Brasil; Laboratório de Informática de Biossistemas e Genômica, Instituto René Rachou, Fundação Oswaldo Cruz, Av. Augusto de Lima, 1715 Belo Horizonte, Minas Gerais, Brasil
| | - Alexandre Barbosa Reis
- Núcleo de Pesquisa em Ciências Biológicas, Universidade Federal de Ouro Preto, Campus Universitário, Morro do Cruzeiro - Ouro Preto, Minas Gerais, Brasil
| | - Sérgio Caldas
- Núcleo de Pesquisa em Ciências Biológicas, Universidade Federal de Ouro Preto, Campus Universitário, Morro do Cruzeiro - Ouro Preto, Minas Gerais, Brasil; Serviço de Biotecnologia e Saúde, Diretoria de Pesquisa e Desenvolvimento, Fundação Ezequiel Dias, Rua Conde Pereira Carneiro, 80 - Belo Horizonte, Minas Gerais, Brasil
| | - Maria Terezinha Bahia
- Núcleo de Pesquisa em Ciências Biológicas, Universidade Federal de Ouro Preto, Campus Universitário, Morro do Cruzeiro - Ouro Preto, Minas Gerais, Brasil
| |
Collapse
|
5
|
Shikanai Yasuda MA. Emerging and reemerging forms of Trypanosoma cruzi transmission. Mem Inst Oswaldo Cruz 2022; 117:e210033. [PMID: 35584508 PMCID: PMC9113729 DOI: 10.1590/0074-02760210033] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 02/08/2021] [Indexed: 01/13/2023] Open
Abstract
This review aims to update and discuss the main challenges in controlling emergent and reemergent forms of Trypanosoma cruzi transmission through organ transplantation, blood products and vertical transmission in endemic and non-endemic areas as well as emergent forms of transmission in endemic countries through contaminated food, currently representing the major cause of acute illness in several countries. As a neglected tropical disease potentially controllable with a major impact on morbimortality and socioeconomic aspects, Chagas disease (CD) was approved at the WHO global plan to interrupt four transmission routes by 2030 (vector/blood transfusion/organ transplant/congenital). Implementation of universal or target screening for CD are highly recommended in blood banks of non-endemic regions; in organ transplants donors in endemic/non-endemic areas as well as in women at risk from endemic areas (reproductive age women/pregnant women-respective babies). Moreover, main challenges for surveillance are the application of molecular methods for identification of infected babies, donor transmitted infection and of live parasites in the food. In addition, the systematic recording of acute/non-acute cases and transmission sources is crucial to establish databases for control and surveillance purposes. Remarkably, antiparasitic treatment of infected reproductive age women and infected babies is essential for the elimination of congenital CD by 2030.
Collapse
Affiliation(s)
- Maria Aparecida Shikanai Yasuda
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Moléstias Infecciosas e Ptarasitárias, São Paulo, SP, Brasil,Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Laboratório de Imunologia, São Paulo, SP, Brasil,WHO Technical Group IVb on Prevention and Control of Transmission and Case Management of Trypanosoma cruzi Infections, WHO, Geneva, Switzerland,+ Corresponding author:
| |
Collapse
|
6
|
Silva NSDL, Orikaza CM, de Santana FR, Dos Santos LA, Salu BR, Oliva MLV, Sinigaglia RDC, Mortara RA. Interleukin-9 in Immunopathology of Trypanosoma cruzi Experimental Infection. Front Cell Infect Microbiol 2021; 11:756521. [PMID: 34722343 PMCID: PMC8554238 DOI: 10.3389/fcimb.2021.756521] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 09/27/2021] [Indexed: 11/27/2022] Open
Abstract
Chagas’ disease is a parasitosis caused by Trypanosoma cruzi, which affects approximately 8 million people worldwide. The balance between pro- and anti-inflammatory cytokines produced during immunological responses contributes to disease prognosis and progression. Parasite tissue persistence can induce chronic inflammatory stimuli, which can cause long-term tissue injury and fibrosis. Chronic Chagas’ patients exhibit increased levels of interleukin (IL)-9, an important cytokine in the regulation of inflammatory and fibrogenic processes. Data on the role of IL-9 in other pathologies are sometimes contradictory, and few studies have explored this cytokine’s influence in Chagas’ disease pathology. Hence, the aim of this study was to evaluate the role of IL-9 in the progression of T. cruzi infection in vivo and in vitro. In vitro infection demonstrated that IL-9 reduced the number of infected cells and decreased the multiplication of intracellular amastigotes in both C2C12 myoblasts and bone marrow-derived macrophages. In myoblasts, the increased production of nitric oxide (NO) was essential for reduced parasite multiplication, whereas macrophage responses resulted in increased IL-6 and reduced TGF-β levels, indicating that parasite growth restriction mechanisms induced by IL-9 were cell-type specific. Experimental infection of BALB/c mice with T. cruzi trypomastigotes of the Y strain implicated a major role of IL-9 during the chronic phase, as increased Th9 and Tc9 cells were detected among splenocytes; higher levels of IL-9 in these cell populations and increased cardiac IL-9 levels were detected compared to those of uninfected mice. Moreover, rIL9 treatment decreased serum IL-12, IL-6, and IL-10 levels and cardiac TNF-α levels, possibly attempting to control the inflammatory response. IL-9 neutralization increased cardiac fibrosis, synthesis of collagens I and III, and mastocyte recruitment in BALB/c heart tissue during the chronic phase. In conclusion, our data showed that IL-9 reduced the invasion and multiplication of T. cruzi in vitro, in both myoblasts and macrophages, favoring disease control through cell-specific mechanisms. In vivo, IL-9 was elevated during experimental chronic infection in BALB/c mice, and this cytokine played a protective role in the immunopathological response during this phase by controlling cardiac fibrosis and proinflammatory cytokine production.
Collapse
Affiliation(s)
- Nadjania Saraiva de Lira Silva
- Microbiology, Immunology and Parasitology Department, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | - Cristina Mary Orikaza
- Microbiology, Immunology and Parasitology Department, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | - Fabiana Rodrigues de Santana
- Microbiology, Immunology and Parasitology Department, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | - Luana Aguiar Dos Santos
- Microbiology, Immunology and Parasitology Department, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | - Bruno Ramos Salu
- Biochemistry Department, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | - Maria Luiza Vilela Oliva
- Biochemistry Department, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | - Rita de Cássia Sinigaglia
- Electronic Microscopy Center, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | - Renato Arruda Mortara
- Microbiology, Immunology and Parasitology Department, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| |
Collapse
|
7
|
Towards global control of parasitic diseases in the Covid-19 era: One Health and the future of multisectoral global health governance. ADVANCES IN PARASITOLOGY 2021; 114:1-26. [PMID: 34696842 PMCID: PMC8503781 DOI: 10.1016/bs.apar.2021.08.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Human parasitic infections—including malaria, and many neglected tropical diseases (NTDs)—have long represented a Gordian knot in global public health: ancient, persistent, and exceedingly difficult to control. With the coronavirus disease (Covid-19) pandemic substantially interrupting control programmes worldwide, there are now mounting fears that decades of progress in controlling global parasitic infections will be undone. With Covid-19 moreover exposing deep vulnerabilities in the global health system, the current moment presents a watershed opportunity to plan future efforts to reduce the global morbidity and mortality associated with human parasitic infections. In this chapter, we first provide a brief epidemiologic overview of the progress that has been made towards the control of parasitic diseases between 1990 and 2019, contrasting these fragile gains with the anticipated losses as a result of Covid-19. We then argue that the complementary aspirations of the United Nations Sustainable Development Goals (SDGs) and the World Health Organization (WHO)’s 2030 targets for parasitic disease control may be achieved by aligning programme objectives within the One Health paradigm, recognizing the interdependence between humans, animals, and the environment. In so doing, we note that while the WHO remains the preeminent international institution to address some of these transdisciplinary concerns, its underlying challenges with funding, authority, and capacity are likely to reverberate if left unaddressed. To this end, we conclude by reimagining how models of multisectoral global health governance—combining the WHO's normative and technical leadership with greater support in allied policy-making areas—can help sustain future malaria and NTD elimination efforts.
Collapse
|
8
|
Valença-Barbosa C, Finamore-Araujo P, Moreira OC, Vergara-Meza JG, Alvarez MVN, Nascimento JR, Borges-Veloso A, Viana MC, Lilioso M, Miguel DC, Gadelha FR, Teixeira MMG, Almeida CE. Genotypic Trypanosoma cruzi distribution and parasite load differ ecotypically and according to parasite genotypes in Triatoma brasiliensis from endemic and outbreak areas in Northeastern Brazil. Acta Trop 2021; 222:106054. [PMID: 34273309 DOI: 10.1016/j.actatropica.2021.106054] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/09/2021] [Accepted: 07/10/2021] [Indexed: 12/13/2022]
Abstract
This study aimed to identify the Trypanosoma cruzi genotypes and their relationship with parasitic load in distinct geographic and ecotypic populations of Triatoma brasiliensis in two sites, including one where a Chagas disease (ChD) outbreak occurred in Rio Grande do Norte state, Brazil. Triatomine captures were performed in peridomestic and sylvatic ecotopes in two municipalities: Marcelino Vieira - affected by the outbreak; and Currais Novos - where high pressure of peridomestic triatomine infestation after insecticide spraying have been reported. The kDNA-PCR was used to select 124 T. cruzi positive triatomine samples, of which 117 were successfully genotyped by fluorescent fragment length barcoding (FFLB). Moreover, the T. cruzi load quantification was performed using a multiplex TaqMan qPCR. Our findings showed a clear ecotypic segregation between TcI and TcII harboured by T. brasiliensis (p<0.001). Although no genotypes were ecotypically exclusive, TcI was predominant in peridomestic ecotopes (86%). In general, T. brasiliensis from Rio Grande do Norte had a higher T. cruzi load varying from 3.94 to 7.66 x 106T. cruzi per insect. Additionally, TcII (median value=299,504 T. cruzi/intestine unit equivalents) had more than twice (p=0.1) the parasite load of TcI (median value=149,077 T. cruzi/intestine unit equivalents), which can be attributed to a more ancient co-evolution with T. brasiliensis. The higher prevalence of TcII in the sylvatic T. brasiliensis (70%) could be associated with a more diversified source of bloodmeals for wild insect populations. Either TcI or TcII may have been responsible for the ChD outbreak that occurred in the city of Marcelino Vieira. On the other hand, a smaller portion of T. brasiliensis was infected by TcIII (3%) in the peridomicile, in addition to T. rangeli genotype A (1%), often found in mixed infections. Our results highlight the need of understanding the patterns of T. cruzi genotype´s development and circulation in insect vectors and reservoirs as a mode of tracking situations of epidemiologic importance, as the ChD outbreak recently recorded for Northeastern Brazil.
Collapse
Affiliation(s)
- Carolina Valença-Barbosa
- Instituto de Biologia, Universidade de Campinas - UNICAMP, São Paulo, Brazil; Grupo Triatomíneos, Instituto René Rachou, Fundação Oswaldo Cruz - Fiocruz, Belo Horizonte, Minas Gerais, Brazil.
| | - Paula Finamore-Araujo
- Laboratório de Biologia Molecular e Doenças Endêmicas, Instituto Oswaldo Cruz/Fiocruz, Rio de Janeiro, Brazil
| | - Otacilio C Moreira
- Laboratório de Biologia Molecular e Doenças Endêmicas, Instituto Oswaldo Cruz/Fiocruz, Rio de Janeiro, Brazil
| | | | | | | | - André Borges-Veloso
- Instituto de Biologia, Universidade de Campinas - UNICAMP, São Paulo, Brazil; Grupo Triatomíneos, Instituto René Rachou, Fundação Oswaldo Cruz - Fiocruz, Belo Horizonte, Minas Gerais, Brazil
| | | | - Maurício Lilioso
- Instituto de Biologia, Universidade de Campinas - UNICAMP, São Paulo, Brazil
| | | | | | | | - Carlos Eduardo Almeida
- Instituto de Biologia, Universidade de Campinas - UNICAMP, São Paulo, Brazil; Instituto de Biologia, Universidade Federal da Bahia, Brazil
| |
Collapse
|
9
|
Vargas AL, Dias BDP, Moreira HT, Oliveira Filho ECD, Tanaka DM, Simões MV, Maciel BC, Schmidt A, Marin Neto JA, Romano MMD. Prospective study of ventricular function and myocardial deformation related to survival in acute Chagas disease: an experimental animal model. Rev Inst Med Trop Sao Paulo 2021; 63:e61. [PMID: 34378764 PMCID: PMC8357302 DOI: 10.1590/s1678-9946202163061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/23/2021] [Indexed: 11/22/2022] Open
Abstract
Chagas disease (CD) has been changing from an endemic Latino-American disease to a condition found outside endemic regions, due to migratory movements. Although often subclinical, its acute phase can be lethal. This study aimed to assess survival during the acute phase of CD and its relationship with ventricular function in an experimental model. To this end, 30 Syrian hamsters were inoculated with Trypanosoma cruzi (IG) and other 15 animals received saline solution (CG). Groups were monitored daily and submitted to echocardiography in two moments: before the challenge and 15 days post-infection. Left ventricular ejection fraction (LVEF) and global longitudinal myocardial strain (GLS) of the LV were measured. The IG was divided into groups of animals with and without clinical signs of disease. ANOVA for mixed models was used to compare ventricular function parameters. Survival analysis was studied using Kaplan-Meier curves and the log-rank test. The follow-up lasted 60 days. LVEF in IG was reduced through time (53.80 to 43.55%) compared to CG (57.86 to 59.73%) (p=0.002). There was also a reduction of GLS (-18.97% to -12.44%) in the IG compared to CG (p=0.012). Twelve animals from IG died compared to one animal from CG. Eleven out of the 12 animals from the IG group died before presenting with clinical signs of infection. Survival was reduced in the IG compared to CG over time (p=0.02). The reduced survival during the acute phase of this experimental model of Chagas disease was related to the significant reduction of LV function. The mortality rate in the IG was higher in the group presenting with clinical signs of infection.
Collapse
Affiliation(s)
- Arthur Lauand Vargas
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Centro de Cardiologia, Ribeirão Preto, São Paulo, Brazil
| | - Beatriz de Paula Dias
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Centro de Cardiologia, Ribeirão Preto, São Paulo, Brazil
| | - Henrique Turin Moreira
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Centro de Cardiologia, Ribeirão Preto, São Paulo, Brazil
| | - Edgard Camilo de Oliveira Filho
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Centro de Cardiologia, Ribeirão Preto, São Paulo, Brazil
| | - Denise Mayumi Tanaka
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Centro de Cardiologia, Ribeirão Preto, São Paulo, Brazil
| | - Marcus Vinicius Simões
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Centro de Cardiologia, Ribeirão Preto, São Paulo, Brazil
| | - Benedito Carlos Maciel
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Centro de Cardiologia, Ribeirão Preto, São Paulo, Brazil
| | - André Schmidt
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Centro de Cardiologia, Ribeirão Preto, São Paulo, Brazil
| | - José Antônio Marin Neto
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Centro de Cardiologia, Ribeirão Preto, São Paulo, Brazil
| | - Minna Moreira Dias Romano
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Centro de Cardiologia, Ribeirão Preto, São Paulo, Brazil
| |
Collapse
|
10
|
Rincón-Acevedo CY, Parada-García AS, Olivera MJ, Torres-Torres F, Zuleta-Dueñas LP, Hernández C, Ramírez JD. Clinical and Epidemiological Characterization of Acute Chagas Disease in Casanare, Eastern Colombia, 2012-2020. Front Med (Lausanne) 2021; 8:681635. [PMID: 34368188 PMCID: PMC8343227 DOI: 10.3389/fmed.2021.681635] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 06/29/2021] [Indexed: 12/29/2022] Open
Abstract
Background: Chagas disease (CD), caused by the protozoan Trypanosoma cruzi, is considered a public health problem in Latin America. In Colombia, it affects more than 437,000 inhabitants, mainly in Casanare, an endemic region with eco-epidemiological characteristics that favor its transmission. The objective of this study was to describe the clinical and epidemiological characteristics of the cases of acute CD in Casanare, eastern Colombia, in the period 2012–2020. Methods: In the present study, 103 medical records of confirmed cases of acute CD were reviewed. The departmental/national incidence and fatality were compared by year; the climatological data of mean temperature, relative humidity, and precipitation per year were reviewed and plotted at IDEAM (Colombian Meteorology Institute) concerning the number of cases of acute CD per month, and it was compared with the frequency of triatomines collected in infested houses by community surveillance. Univariate, bivariate, and multivariate analyses were performed, comparing symptoms and signs according to transmission routes, complications, and age groups. Results: The incidence was 3.16 cases per 100,000 inhabitants, and the fatality rate was 20% in the study period. The most frequent symptoms included: fever 98.1%, myalgia 62.1%, arthralgia 60.2%, and headache 49.5%. There were significant differences in the frequency of myalgia, abdominal pain, and periorbital edema in oral transmission. The main complications were pericardial effusion, myocarditis, and heart failure in the group over 18 years of age. In Casanare, TcI Discrete Typing Unit (DTU) has mainly been identified in humans, triatomines, and reservoirs such as opossums and dogs and TcBat in bats. An increase in the number of acute CD cases was evidenced in March, a period when precipitation increases due to the beginning of the rainy season. Conclusions: The results corroborate the symptomatic heterogeneity of the acute phase of CD, which delays treatment, triggering possible clinical complications. In endemic regions, clinical suspicion, diagnostic capacity, detection, and surveillance programs should be strengthened, including intersectoral public health policies for their prevention and control.
Collapse
Affiliation(s)
- Claudia Yaneth Rincón-Acevedo
- Centro de Investigaciones en Microbiología y Biotecnología-UR, Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia.,Maestría en Salud Pública, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | - Andrea Stella Parada-García
- Centro de Investigaciones en Microbiología y Biotecnología-UR, Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia.,Maestría en Salud Pública, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | | | | | | | - Carolina Hernández
- Centro de Investigaciones en Microbiología y Biotecnología-UR, Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Juan David Ramírez
- Centro de Investigaciones en Microbiología y Biotecnología-UR, Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| |
Collapse
|
11
|
Pinto GDC, Pimentel JHM, Barros MDNDDS, Medeiros CDA, Carrazzone CDFV, Matins SM, Oliveira WAD. ST-Elevation in a Patient with Acute Chagas Disease. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2021. [DOI: 10.36660/ijcs.20200396] [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
|
12
|
Rodriguez-Morales AJ, Paniz-Mondolfi AE, Faccini-Martínez ÁA, Henao-Martínez AF, Ruiz-Saenz J, Martinez-Gutierrez M, Alvarado-Arnez LE, Gomez-Marin JE, Bueno-Marí R, Carrero Y, Villamil-Gomez WE, Bonilla-Aldana DK, Haque U, Ramirez JD, Navarro JC, Lloveras S, Arteaga-Livias K, Casalone C, Maguiña JL, Escobedo AA, Hidalgo M, Bandeira AC, Mattar S, Cardona-Ospina JA, Suárez JA. The Constant Threat of Zoonotic and Vector-Borne Emerging Tropical Diseases: Living on the Edge. FRONTIERS IN TROPICAL DISEASES 2021; 2:676905. [PMID: 34010366 PMCID: PMC8132189 DOI: 10.3389/fitd.2021.676905] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 04/06/2021] [Indexed: 12/20/2022] Open
Affiliation(s)
- Alfonso J. Rodriguez-Morales
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundacion Universitaria Autonoma de las Americas, Pereira, Colombia
- Emerging Infectious Diseases and Tropical Medicine Research Group, Instituto para la Investigación en Ciencias Biomédicas - Sci-Help, Pereira, Colombia
- Coordinación Nacional de Investigación, Universidad Privada Franz Tamayo (UNIFRANZ), Cochabamba, Bolivia
- Master Program on Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru
| | - Alberto E. Paniz-Mondolfi
- Department of Pathology, Molecular and Cell-Based Medicine, Laboratory of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Instituto de Investigaciones Biomédicas IDB/Incubadora Venezolana de la Ciencia, Barquisimeto, Venezuela
| | | | - Andrés F. Henao-Martínez
- Department of Medicine, Division of Infectious Diseases, School of Medicine, University of Colorado Denver, Aurora, CO, United States
| | - Julian Ruiz-Saenz
- Grupo de Investigación en Ciencias Animales - GRICA, Facultad de Medicina Veterinaria y Zootecnia, Universidad Cooperativa de Colombia, Bucaramanga, Colombia
| | - Marlen Martinez-Gutierrez
- Grupo de Investigación en Ciencias Animales - GRICA, Facultad de Medicina Veterinaria y Zootecnia, Universidad Cooperativa de Colombia, Bucaramanga, Colombia
- Infettare, Facultad de Medicina, Universidad Cooperativa de Colombia, Medellín, Colombia
| | - Lucia E. Alvarado-Arnez
- Coordinación Nacional de Investigación, Universidad Privada Franz Tamayo (UNIFRANZ), Cochabamba, Bolivia
| | - Jorge E. Gomez-Marin
- Grupo de Estudio en Parasitologia Molecular (GEPAMOL) Group, Facultad de Ciencias de la Salud, Universidad del Quindío, Armenia, Colombia
| | - Ruben Bueno-Marí
- Departamento de Investigación y Desarrollo (I+D), Laboratorios Lokímica, Paterna, Spain
- Área de Parasitología, Departamento de Farmacia y Tecnología Farmaceútica y Parasitología, Universidad de Valencia, Burjasot, Spain
| | - Yenddy Carrero
- Facultad de Ciencias de la Salud, Carrera de Medicina, Universidad Técnica de Ambato, Ambato, Ecuador
| | - Wilmer E. Villamil-Gomez
- Infectious Diseases and Infection Control Research Group, Hospital Universitario de Sincelejo, Sincelejo, Colombia
- Programa Del Doctorado de Medicina Tropical, SUE Caribe, Universidad Del Atlántico, Barranquilla, Colombia
| | - D. Katterine Bonilla-Aldana
- Semillero de Investigación en Zoonosis (SIZOO), Grupo de Investigación BIOECOS, Fundacion Universitaria Autonoma de las Americas, Pereira, Colombia
| | - Ubydul Haque
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Juan D. Ramirez
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Juan-Carlos Navarro
- Research Group of Emerging Diseases, Ecoepidemiology and Biodiversity, Health Sciences Faculty, Universidad Internacional SEK, Quito, Ecuador
| | - Susana Lloveras
- Sección Zoopatología Médica, Hospital de Infecciosas FJ Muñiz, Buenos Aires, Argentina
| | - Kovy Arteaga-Livias
- Master Program on Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru
- Faculty of Medicine, Universidad Nacional Hermilio Valdizán, Huánuco, Peru
| | | | - Jorge L. Maguiña
- Master Program on Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru
| | - Angel A. Escobedo
- Department of Epidemiology, Institute of Gastroenterology, Havana, Cuba
| | - Marylin Hidalgo
- Infectious Diseases Group, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | - Salim Mattar
- Instituto de Investigaciones Biologicas del Tropico, Universidad de Cordoba, Monteria, Colombia
| | - Jaime A. Cardona-Ospina
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundacion Universitaria Autonoma de las Americas, Pereira, Colombia
- Emerging Infectious Diseases and Tropical Medicine Research Group, Instituto para la Investigación en Ciencias Biomédicas - Sci-Help, Pereira, Colombia
| | - Jose A. Suárez
- Investigador SNI Senacyt Panamá, Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama, Panama
| |
Collapse
|
13
|
Bruneto EG, Fernandes-Silva MM, Toledo-Cornell C, Martins S, Ferreira JMB, Corrêa VR, da Costa JM, Pinto AYDN, de Souza DDSM, Pinto MCG, Neto JADF, Ramos AN, Maguire JH, Silvestre OM. Case-fatality From Orally-transmitted Acute Chagas Disease: A Systematic Review and Meta-analysis. Clin Infect Dis 2021; 72:1084-1092. [PMID: 32772104 DOI: 10.1093/cid/ciaa1148] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Indexed: 11/13/2022] Open
Abstract
Orally-transmitted acute Chagas disease (CD) is emerging as an important public health problem. The prognosis of acute infection following oral transmission is unknown. The aim of this study was to analyze and summarize data on orally-transmitted acute CD. We searched for publications from 1968 to 31 January 2018. We included studies and unpublished data from government sources that reported patients with acute orally-transmitted CD. We identified 41 papers and we added 932 unpublished cases. In all, our study covered 2470 cases and occurrence of 97 deaths. Our meta-analysis estimated that the case-fatality rate was 1.0% (95% CI 0.0-4.0%). Lethality rates have declined over time (P = .02). In conclusion, orally-transmitted acute CD has considerable lethality in the first year after infection. The lethality in symptomatic cases is similar to that from other routes of infection. The lethality rate of orally-acquired disease has declined over the years.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - James H Maguire
- Division of Infectious Disease, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | |
Collapse
|
14
|
Torrecilhas AC, Soares RP, Schenkman S, Fernández-Prada C, Olivier M. Extracellular Vesicles in Trypanosomatids: Host Cell Communication. Front Cell Infect Microbiol 2020; 10:602502. [PMID: 33381465 PMCID: PMC7767885 DOI: 10.3389/fcimb.2020.602502] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 11/04/2020] [Indexed: 12/13/2022] Open
Abstract
Trypanosoma cruzi, Trypanosoma brucei and Leishmania (Trypanosomatidae: Kinetoplastida) are parasitic protozoan causing Chagas disease, African Trypanosomiasis and Leishmaniases worldwide. They are vector borne diseases transmitted by triatomine bugs, Tsetse fly, and sand flies, respectively. Those diseases cause enormous economic losses and morbidity affecting not only rural and poverty areas but are also spreading to urban areas. During the parasite-host interaction, those organisms release extracellular vesicles (EVs) that are crucial for the immunomodulatory events triggered by the parasites. EVs are involved in cell-cell communication and can act as important pro-inflammatory mediators. Therefore, interface between EVs and host immune responses are crucial for the immunopathological events that those diseases exhibit. Additionally, EVs from these organisms have a role in the invertebrate hosts digestive tracts prior to parasite transmission. This review summarizes the available data on how EVs from those medically important trypanosomatids affect their interaction with vertebrate and invertebrate hosts.
Collapse
Affiliation(s)
- Ana Claudia Torrecilhas
- Departamento de Ciências Farmacêuticas, Federal University of Sao Paulo (UNIFESP), Diadema, Brazil
| | | | - Sergio Schenkman
- Departamento de Microbiologia, Imunologia e Parasitologia, UNIFESP, São Paulo, Brazil
| | | | - Martin Olivier
- The Research Institute of the McGill University Health Centre, McGill University, Montréal, QC, Canada
| |
Collapse
|
15
|
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.
Collapse
|
16
|
Chadalawada S, Sillau S, Archuleta S, Mundo W, Bandali M, Parra-Henao G, Rodriguez-Morales AJ, Villamil-Gomez WE, Suárez JA, Shapiro L, Hotez PJ, Woc-Colburn L, DeSanto K, Rassi A, Franco-Paredes C, Henao-Martínez AF. Risk of Chronic Cardiomyopathy Among Patients With the Acute Phase or Indeterminate Form of Chagas Disease: A Systematic Review and Meta-analysis. JAMA Netw Open 2020; 3:e2015072. [PMID: 32865573 PMCID: PMC7489816 DOI: 10.1001/jamanetworkopen.2020.15072] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 06/16/2020] [Indexed: 11/24/2022] Open
Abstract
Importance Chagas cardiomyopathy is associated with substantial morbidity and mortality. Precise estimates of the risk of developing cardiomyopathy among patients with the acute or indeterminate chronic forms of Chagas disease are lacking. Objective To estimate the risk of developing chronic cardiomyopathy in patients with acute and indeterminate chronic forms of Chagas disease. Data Sources A systematic search in the Cochrane Library, Embase, Latin American and Caribbean Health Sciences Literature (LILACS), Medline, and Web of Science Core Collection databases was conducted from October 8 to October 24, 2018. Studies published between January 1, 1946, and October 24, 2018, that were written in the English, Spanish, and Portuguese languages were included. Search terms included Chagas disease; development of cardiomyopathy; latency duration; and determinants of the Chagas latency period. Study Selection Longitudinal observational studies of participants diagnosed with the acute phase of Chagas infection or the indeterminate chronic form of Chagas disease who were followed up until the development of cardiomyopathy were included. Studies were excluded if they did not provide sufficient outcome data. Of 10 761 records initially screened, 32 studies met the criteria for analysis. Data Extraction and Synthesis Critical appraisals of studies were performed using checklists from the Joanna Briggs Institute Reviewer's Manual, and data were collected from published studies. A random-effects meta-analysis was used to obtain pooled estimated annual rates. Data were analyzed from September 11 to December 4, 2019. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline for the registration of the protocol, data collection and integrity, assessment of bias, and sensitivity analyses. Main Outcomes and Measures Main outcomes were defined as the composite of the development of any new arrhythmias or changes in electrocardiogram results, dilated cardiomyopathy and segmental wall motion abnormalities in echocardiogram results, and mortality associated with Chagas disease. Results A total of 5005 records were screened for eligibility. Of those, 298 full-text articles were reviewed, and 178 of those articles were considered for inclusion in the quantitative synthesis. After exclusions, 32 studies that included longitudinal observational outcomes were selected for the analysis; 23 of those studies comprised patients with the indeterminate chronic form of Chagas disease, and 9 of those studies comprised patients in the acute phase of Chagas infection. The analysis indicated that the pooled estimated annual rate of cardiomyopathy development was 1.9% (95% CI, 1.3%-3.0%; I2 = 98.0%; τ2 [ln scale] = 0.9992) in patients with indeterminate chronic Chagas disease and 4.6% (95% CI, 2.7%-7.9%; I2 = 86.6%; τ2 [ln scale] = 0.4946) in patients with acute Chagas infection. Conclusions and Relevance Patients with the indeterminate chronic form of Chagas disease had a significant annual risk of developing cardiomyopathy. The annual risk was more than double among patients in the acute phase of Chagas infection.
Collapse
Affiliation(s)
| | - Stefan Sillau
- Department of Neurology, University of Colorado Denver, Denver
| | | | | | | | - Gabriel Parra-Henao
- National Institute of Health, Bogotá, Colombia
- Centro de Investigación en Salud para el Trópico (CIST), Universidad Cooperativa de Colombia, Santa Marta, Colombia
| | - Alfonso J. Rodriguez-Morales
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, Pereira, Risaralda, Colombia
| | | | - José Antonio Suárez
- Investigador Sistema Nacional de Investigación, Secretaría Nacional de Ciencia, Tecnología e Innovación, Clinical Research Department, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá City, Panamá
| | - Leland Shapiro
- Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado
- Division of Infectious Diseases, Department of Medicine, University of Colorado Denver, Denver
| | - Peter J. Hotez
- Texas Children’s Hospital Center for Vaccine Development, Texas Children’s Hospital, Houston, Texas
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
- Department of Molecular Virology and Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas
| | - Laila Woc-Colburn
- Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia
| | - Kristen DeSanto
- Health Sciences Library, University of Colorado Denver, Aurora
| | - Anis Rassi
- Division of Cardiology, Anis Rassi Hospital, Goiania, Goias, Brazil
| | - Carlos Franco-Paredes
- Division of Infectious Diseases, Department of Medicine, University of Colorado Denver, Denver
- Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | | |
Collapse
|
17
|
Velásquez-Ortiz N, Ramírez JD. Understanding the oral transmission of Trypanosoma cruzi as a veterinary and medical foodborne zoonosis. Res Vet Sci 2020; 132:448-461. [PMID: 32781335 DOI: 10.1016/j.rvsc.2020.07.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/21/2020] [Accepted: 07/29/2020] [Indexed: 02/07/2023]
Abstract
Chagas disease is a neglected tropical disease transmitted by the protozoan Trypanosoma cruzi that lately has been highlighted because several outbreaks attributed to oral transmission of the parasite have occurred. These outbreaks are characterized by high mortality rates and massive infections that cannot be related to other types of transmission such as the vectorial route. Oral transmission of Chagas disease has been reported in Brazil, Colombia, Venezuela, Bolivia, Ecuador, Argentina and French Guiana, most of them are massive oral outbreaks caused by the ingestion of beverages and food contaminated with triatomine feces or parasites' reservoirs secretions and considered since 2012 as a foodborne disease. In this review, we present the current status and all available data regarding oral transmission of Chagas disease, highlighting its relevance as a veterinary and medical foodborne zoonosis.
Collapse
Affiliation(s)
- Natalia Velásquez-Ortiz
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Departamento de Biología, Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Juan David Ramírez
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Departamento de Biología, Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia.
| |
Collapse
|
18
|
Martín-Escolano R, Martín-Escolano J, Ballesteros-Garrido R, Cirauqui N, Abarca B, Rosales MJ, Sánchez-Moreno M, Ballesteros R, Marín C. Repositioning of leishmanicidal [1,2,3]Triazolo[1,5-a]pyridinium salts for Chagas disease treatment: Trypanosoma cruzi cell death involving mitochondrial membrane depolarisation and Fe-SOD inhibition. Parasitol Res 2020; 119:2943-2954. [PMID: 32607710 DOI: 10.1007/s00436-020-06779-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 06/18/2020] [Indexed: 01/10/2023]
Abstract
Trypanosomatidae is a family of unicellular parasites belonging to the phylum Euglenozoa, which are causative agents in high impact human diseases such as Leishmaniasis, Chagas disease and African sleeping sickness. The impact on human health and local economies, together with a lack of satisfactory chemotherapeutic treatments and effective vaccines, justifies stringent research efforts to search for new disease therapies. Here, we present in vitro trypanocidal activity data and mode of action data, repositioning leishmanicidal [1,2,3]Triazolo[1,5-a]pyridinium salts against Trypanosoma cruzi, the aetiological agent of Chagas disease. This disease is one of the most neglected tropical diseases and is a major public health issue in Central and South America. The disease affects approximately 6-7 million people and is widespread due to increased migratory movements. We screened a suite of leishmanicidal [1,2,3]Triazolo[1,5-a]pyridinium salt compounds, of which compounds 13, 20 and 21 were identified as trypanocidal drugs. These compounds caused cell death in a mitochondrion-dependent manner through a bioenergetic collapse. Moreover, compounds 13 and 20 showed a remarkable inhibition of iron superoxide dismutase activity of T. cruzi, a key enzyme in the protection from the damage produced by oxidative stress.
Collapse
Affiliation(s)
- Rubén Martín-Escolano
- Department of Parasitology, Instituto de Investigación Biosanitaria (ibs. Granada), Hospitales Universitarios de Granada/University of Granada, Severo Ochoa s/n, 18071, Granada, Spain
| | - Javier Martín-Escolano
- Department of Parasitology, Instituto de Investigación Biosanitaria (ibs. Granada), Hospitales Universitarios de Granada/University of Granada, Severo Ochoa s/n, 18071, Granada, Spain
| | - Rafael Ballesteros-Garrido
- Departamento de Química Orgánica, Facultad de Farmacia, Universidad de Valencia, Avda. Vicente Andrés Estellés s/n, 46100, Burjassot, Valencia, Spain
| | - Nuria Cirauqui
- Molecular Microbiology and Structural Biochemistry, Centre National de la Recherche Scientifique, Université Claude Bernard Lyon 1, 69367, Lyon Cedex 07, France
| | - Belén Abarca
- Departamento de Química Orgánica, Facultad de Farmacia, Universidad de Valencia, Avda. Vicente Andrés Estellés s/n, 46100, Burjassot, Valencia, Spain
| | - María José Rosales
- Department of Parasitology, Instituto de Investigación Biosanitaria (ibs. Granada), Hospitales Universitarios de Granada/University of Granada, Severo Ochoa s/n, 18071, Granada, Spain
| | - Manuel Sánchez-Moreno
- Department of Parasitology, Instituto de Investigación Biosanitaria (ibs. Granada), Hospitales Universitarios de Granada/University of Granada, Severo Ochoa s/n, 18071, Granada, Spain
| | - Rafael Ballesteros
- Departamento de Química Orgánica, Facultad de Farmacia, Universidad de Valencia, Avda. Vicente Andrés Estellés s/n, 46100, Burjassot, Valencia, Spain
| | - Clotilde Marín
- Department of Parasitology, Instituto de Investigación Biosanitaria (ibs. Granada), Hospitales Universitarios de Granada/University of Granada, Severo Ochoa s/n, 18071, Granada, Spain.
| |
Collapse
|
19
|
Martinez SJ, Romano PS, Engman DM. Precision Health for Chagas Disease: Integrating Parasite and Host Factors to Predict Outcome of Infection and Response to Therapy. Front Cell Infect Microbiol 2020; 10:210. [PMID: 32457849 PMCID: PMC7225773 DOI: 10.3389/fcimb.2020.00210] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 04/16/2020] [Indexed: 01/01/2023] Open
Abstract
Chagas disease, caused by the infection with the protozoan parasite Trypanosoma cruzi, is clinically manifested in approximately one-third of infected people by inflammatory heart disease (cardiomyopathy) and, to a minor degree, gastrointestinal tract disorders (megaesophagus or megacolon). Chagas disease is a zoonosis transmitted among animals and people through the contact with triatomine bugs, which are found in much of the western hemisphere, including most countries of North, Central and South America, between parallels 45° north (Minneapolis, USA) and south (Chubut Province, Argentina). Despite much research on drug discovery for T. cruzi, there remain only two related agents in widespread use. Likewise, treatment is not always indicated due to the serious side effects of these drugs. On the other hand, the epidemiology and pathogenesis of Chagas disease are both highly complex, and much is known about both. However, it is still impossible to predict what will happen in an individual person infected with T. cruzi, because of the highly variability of parasite virulence and human susceptibility to infection, with no definitive molecular predictors of outcome from either side of the host-parasite equation. In this Minireview we briefly discuss the current state of T. cruzi infection and prognosis and look forward to the day when it will be possible to employ precision health to predict disease outcome and determine whether and when treatment of infection may be necessary.
Collapse
Affiliation(s)
- Santiago J Martinez
- Laboratorio de Biología de Trypanosoma cruzi y la célula hospedadora-Instituto de Histología y Embriología "Dr. Mario H. Burgos," (IHEM-CONICET- Universidad Nacional de Cuyo), Mendoza, Argentina.,Department of Pathology and Laboratory Medicine, Cedars Sinai Medical Center, Los Angeles, CA, United States
| | - Patricia S Romano
- Laboratorio de Biología de Trypanosoma cruzi y la célula hospedadora-Instituto de Histología y Embriología "Dr. Mario H. Burgos," (IHEM-CONICET- Universidad Nacional de Cuyo), Mendoza, Argentina
| | - David M Engman
- Department of Pathology and Laboratory Medicine, Cedars Sinai Medical Center, Los Angeles, CA, United States.,Department of Pathology and Laboratory Medicine, University of California, Los Angeles, Los Angeles, CA, United States.,Departments of Pathology and Microbiology-Immunology, Northwestern University, Chicago, IL, United States
| |
Collapse
|
20
|
Cerbán FM, Stempin CC, Volpini X, Carrera Silva EA, Gea S, Motran CC. Signaling pathways that regulate Trypanosoma cruzi infection and immune response. Biochim Biophys Acta Mol Basis Dis 2020; 1866:165707. [DOI: 10.1016/j.bbadis.2020.165707] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 01/14/2020] [Accepted: 01/22/2020] [Indexed: 02/07/2023]
|
21
|
Ribeiro G, Dos Santos CGS, Lanza F, Reis J, Vaccarezza F, Diniz C, Miranda DLP, de Araújo RF, Cunha GM, de Carvalho CMM, Fonseca EOL, Dos Santos RF, de Sousa OMF, Reis RB, de Araújo WN, Gurgel-Gonçalves R, Dos Reis MG. Wide distribution of Trypanosoma cruzi-infected triatomines in the State of Bahia, Brazil. Parasit Vectors 2019; 12:604. [PMID: 31878960 PMCID: PMC6933904 DOI: 10.1186/s13071-019-3849-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 12/10/2019] [Indexed: 02/03/2023] Open
Abstract
Background The identification of Trypanosoma cruzi and blood-meal sources in synanthropic triatomines is important to assess the potential risk of Chagas disease transmission. We identified T. cruzi infection and blood-meal sources of triatomines caught in and around houses in the state of Bahia, northeastern Brazil, and mapped the occurrence of infected triatomines that fed on humans and domestic animals. Methods Triatominae bugs were manually captured by trained agents from the Epidemiologic Surveillance team of Bahia State Health Service between 2013 and 2014. We applied conventional PCR to detect T. cruzi and blood-meal sources (dog, cat, human and bird) in a randomized sample of triatomines. We mapped triatomine distribution and analyzed vector hotspots with kernel density spatial analysis. Results In total, 5906 triatomines comprising 15 species were collected from 127 out of 417 municipalities in Bahia. The molecular analyses of 695 triatomines revealed a ~10% T. cruzi infection rate, which was highest in the T. brasiliensis species complex. Most bugs were found to have fed on birds (74.2%), and other blood-meal sources included dogs (6%), cats (0.6%) and humans (1%). Trypanosoma cruzi-infected triatomines that fed on humans were detected inside houses. Spatial analysis showed a wide distribution of T. cruzi-infected triatomines throughout Bahia; triatomines that fed on dogs, humans, and cats were observed mainly in the northeast region. Conclusions Synanthropic triatomines have a wide distribution and maintain the potential risk of T. cruzi transmission to humans and domestic animals in Bahia. Ten species were recorded inside houses, mainly Triatoma sordida, T. pseudomaculata, and the T. brasiliensis species complex. Molecular and spatial analysis are useful to reveal T. cruzi infection and blood-meal sources in synanthropic triatomines, identifying areas with ongoing threat for parasite transmission and improving entomological surveillance strategies.
Collapse
Affiliation(s)
- Gilmar Ribeiro
- Instituto Gonçalo Moniz, Fiocruz-BA, Laboratório de Patologia e Biologia Molecular, Rua Waldemar Falcão, 121, Candeal-Salvador, BA, CEP: 40296-710, Brazil.,Faculdades Ruy Barbosa-Wyden, Rua Theodomiro Baptista, 422 - Rio Vermelho, Salvador, BA, 41940-320, Brazil
| | - Carlos G S Dos Santos
- Instituto Gonçalo Moniz, Fiocruz-BA, Laboratório de Patologia e Biologia Molecular, Rua Waldemar Falcão, 121, Candeal-Salvador, BA, CEP: 40296-710, Brazil.,SESAB/Diretoria de Vigilância Epidemiológica (DIVEP), Centro de Atenção à Saúde José Maria de Magalhães Netto., Av. Antônio Carlos Magalhães, s/nº, Parque Bela Vista, Salvador, BA, CEP 41.820-000, Brazil.,SESAB/Laboratório Central de Saúde Pública Prof, Gonçalo Moniz LACEN, Rua Waldemar Falcão, 12, Candeal, Salvador, BA, 40296-710, Brazil
| | - Fernanda Lanza
- Instituto Gonçalo Moniz, Fiocruz-BA, Laboratório de Patologia e Biologia Molecular, Rua Waldemar Falcão, 121, Candeal-Salvador, BA, CEP: 40296-710, Brazil
| | - Jamylle Reis
- Instituto Gonçalo Moniz, Fiocruz-BA, Laboratório de Patologia e Biologia Molecular, Rua Waldemar Falcão, 121, Candeal-Salvador, BA, CEP: 40296-710, Brazil
| | - Fernanda Vaccarezza
- Instituto Gonçalo Moniz, Fiocruz-BA, Laboratório de Patologia e Biologia Molecular, Rua Waldemar Falcão, 121, Candeal-Salvador, BA, CEP: 40296-710, Brazil
| | - Camila Diniz
- Instituto Gonçalo Moniz, Fiocruz-BA, Laboratório de Patologia e Biologia Molecular, Rua Waldemar Falcão, 121, Candeal-Salvador, BA, CEP: 40296-710, Brazil
| | - Diego Lopes Paim Miranda
- Instituto Gonçalo Moniz, Fiocruz-BA, Laboratório de Patologia e Biologia Molecular, Rua Waldemar Falcão, 121, Candeal-Salvador, BA, CEP: 40296-710, Brazil.,Faculdade de Medicina-UFBA, Rua Reitor Miguel Calmon, s/n Vale do Canela, Salvador, BA, 40110-100, Brazil
| | - Renato Freitas de Araújo
- SESAB/Diretoria de Vigilância Epidemiológica (DIVEP), Centro de Atenção à Saúde José Maria de Magalhães Netto., Av. Antônio Carlos Magalhães, s/nº, Parque Bela Vista, Salvador, BA, CEP 41.820-000, Brazil
| | - Gabriel Muricy Cunha
- SESAB/Diretoria de Vigilância Epidemiológica (DIVEP), Centro de Atenção à Saúde José Maria de Magalhães Netto., Av. Antônio Carlos Magalhães, s/nº, Parque Bela Vista, Salvador, BA, CEP 41.820-000, Brazil
| | - Cristiane Medeiros Moraes de Carvalho
- SESAB/Diretoria de Vigilância Epidemiológica (DIVEP), Centro de Atenção à Saúde José Maria de Magalhães Netto., Av. Antônio Carlos Magalhães, s/nº, Parque Bela Vista, Salvador, BA, CEP 41.820-000, Brazil
| | - Eduardo Oyama Lins Fonseca
- Instituto de Tecnologias da Saúde (CIMATEC ITS), Av. Orlando Gomes, 1845 Piatã, Salvador, BA, 41650-010, Brazil
| | - Roberto Fonseca Dos Santos
- SESAB/Laboratório Central de Saúde Pública Prof, Gonçalo Moniz LACEN, Rua Waldemar Falcão, 12, Candeal, Salvador, BA, 40296-710, Brazil
| | - Orlando Marcos Farias de Sousa
- Coordenação-Geral de Vigilância de Zoonoses e Doenças de Transmissão Vetorial, Secretaria de Vigilância em Saúde, Ministério da Saúde, SRTV 702, Via W 5 Norte, Brasília, DF, 70723-040, Brazil
| | | | - Wildo Navegantes de Araújo
- Núcleo de Medicina Tropical, Faculdade de Medicina, Universidade de Brasília, Campus Universitário Darcy Ribeiro, s/n, Asa Norte, Brasília, Distrito Federa, 70910-900, Brazil
| | - Rodrigo Gurgel-Gonçalves
- Laboratório de Parasitologia Médica e Biologia de Vetores Faculdade de Medicina, Universidade de Brasília, Campus, Universitário Darcy Ribeiro, Asa Norte, Brasília, Distrito Federal, 70910-900, Brazil
| | - Mitermayer G Dos Reis
- Instituto Gonçalo Moniz, Fiocruz-BA, Laboratório de Patologia e Biologia Molecular, Rua Waldemar Falcão, 121, Candeal-Salvador, BA, CEP: 40296-710, Brazil. .,Faculdade de Medicina-UFBA, Rua Reitor Miguel Calmon, s/n Vale do Canela, Salvador, BA, 40110-100, Brazil. .,Yale University, New Haven, CT, 06520, USA.
| |
Collapse
|
22
|
Alonso-Vega C, Losada-Galván I, Pinazo MJ, Sancho Mas J, Brustenga JG, Alonso-Padilla J. The senseless orphanage of Chagas disease. Expert Opin Orphan Drugs 2019. [DOI: 10.1080/21678707.2019.1701432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
| | | | | | - Javier Sancho Mas
- ISGlobal - Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | | | | |
Collapse
|
23
|
Henao-Martínez AF, Chadalawada S, Villamil-Gomez WE, DeSanto K, Rassi A, Franco-Paredes C. Duration and determinants of Chagas latency: an etiology and risk systematic review protocol. JBI DATABASE OF SYSTEMATIC REVIEWS AND IMPLEMENTATION REPORTS 2019; 17:2122-2128. [PMID: 31335560 DOI: 10.11124/jbisrir-d-18-00018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this systematic review is to explore and discuss the latency duration among asymptomatic people with chronic Chagas disease. INTRODUCTION Studies estimate the latency period of Chagas disease to be approximately 10-30 years. However, new findings may indicate that this latency period is shorter and depends on the presence of clinical factors. This systematic review protocol will explore the duration and factors affecting this latency period to inform treatment, with the potential of improving outcomes. INCLUSION CRITERIA Eligible studies will include asymptomatic people with indeterminate Chagas disease confirmed through positive serologic testing and the absence of structural cardiomyopathy with no heart failure symptoms and normal electrocardiography results. Studies that involve a longitudinal observation period of participants will be considered. This period must start from the acute acquisition of the infection or an already established indeterminate form of the disease until the development of a primary or secondary cardiac outcome. METHODS The following electronic databases will be searched: MEDLINE, Embase, Cochrane Library, Web of Science Core Collection and LILACS. The search will include the following concepts: Chagas disease, latency duration and determinants of the Chagas latency period. The languages will be restricted to English, Spanish and Portuguese. Two reviewers will review the selected studies for methodological quality using critical appraisal tools and conduct data extraction. Studies will, where possible, be pooled in a statistical meta-analysis. All data will be presented and synthesized through tables, summaries, figures and charts. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42019118019.
Collapse
Affiliation(s)
- Andrés F Henao-Martínez
- Division of Infectious Diseases, School of Medicine, University of Colorado Denver, Aurora, USA
| | | | | | - Kristen DeSanto
- Health Sciences Library, University of Colorado Denver, Aurora, USA
| | - Anis Rassi
- Division of Cardiology, Anis Rassi Hospital, Goiânia, Brazil
| | - Carlos Franco-Paredes
- Division of Infectious Diseases, School of Medicine, University of Colorado Denver, Aurora, USA
- Hospital Infantil de México - Federico Gómez, México City, México
| |
Collapse
|
24
|
Cunha ELA, Torchelsen FKVDS, Cunha LM, de Oliveira MT, Fonseca KDS, Vieira PMA, Carneiro CM, de Lana M. Benznidazole, itraconazole and their combination in the treatment of acute experimental chagas disease in dogs. Exp Parasitol 2019; 204:107711. [PMID: 31254494 DOI: 10.1016/j.exppara.2019.05.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 04/02/2019] [Accepted: 05/27/2019] [Indexed: 02/05/2023]
Abstract
Chagas disease (CD) is a serious public health problem in Latin America and its treatment remains neglected. Benznidazole (BZ), the only drug available in Brazil, presents serious side effects and low therapeutic efficacy, especially at the chronic phase. The last clinical trials demonstrated that the first generation of azole compounds were less successful than BZ in CD chemotherapy, which stimulated studies of these compounds associated to BZ and nifurtimox (NF). This study evaluated the therapeutic efficacy of BZ, itraconazole (ITZ) and their combination (BZ + ITZ) in dogs infected with the VL-10 T. cruzi strain in the acute phase of the disease. Twenty young mongrel dogs were inoculated with 2.0 × 103 blood trypomastigotes/kg and divided into four groups: treated with BZ, ITZ and BZ + ITZ for 60 days, and control group (INT). The parasitemia of the BZ + ITZ and BZ groups were similar and showed significant reduction compared to the INT group. The group treated with ITZ also showed significant parasitemia reduction compared to the INT group. The global analysis of hemoculture (HC), blood PCR, conventional serology (CS-ELISA), heart qPCR and histopathology techniques, used in the post-treatment evaluation, revealed that BZ + ITZ combination lead to a more reduction of parasitemia during the acute phase and heart qPCR positivity, less cardiac damage (inflammation and fibrosis in the left ventricle) and total survival. According to the classical cure criteria one animal treated with BZ + ITZ can be considered cured in its final evaluation and two other dogs, one of this group and one treated with ITZ were in process of cure. At least for BZ-resistant T. cruzi strains such as VL-10, BZ + ITZ was not effective to induce parasitological cure or a profound and sustained reduction of the parasite burden in blood and infected organs.
Collapse
Affiliation(s)
- Eleonora Lima Alves Cunha
- Programa de Pós-Graduação em Ciências Biológicas, Núcleo de Pesquisas em Ciências Biológicas (NUPEB), Universidade Federal de Ouro Preto (UFOP), Campus Universitário Morro do Cruzeiro, Bairro Bauxita, CEP: 35400-000, Ouro Preto, MG, Brazil
| | - Fernanda Karoline Vieira da Silva Torchelsen
- Programa de Pós-Graduação em Ciências Biológicas, Núcleo de Pesquisas em Ciências Biológicas (NUPEB), Universidade Federal de Ouro Preto (UFOP), Campus Universitário Morro do Cruzeiro, Bairro Bauxita, CEP: 35400-000, Ouro Preto, MG, Brazil; Departamento de Análises Clínicas, Escola de Farmácia, Universidade Federal de Ouro Preto (UFOP), Campus Universitário Morro do Cruzeiro, Bairro Bauxita, CEP: 35400-000, Ouro Preto, MG, UFOP, Brazil
| | - Lucas Maciel Cunha
- Programa de Pós-Graduação em Ciências Biológicas, Núcleo de Pesquisas em Ciências Biológicas (NUPEB), Universidade Federal de Ouro Preto (UFOP), Campus Universitário Morro do Cruzeiro, Bairro Bauxita, CEP: 35400-000, Ouro Preto, MG, Brazil
| | - Maykon Tavares de Oliveira
- Programa de Pós-Graduação em Ciências Biológicas, Núcleo de Pesquisas em Ciências Biológicas (NUPEB), Universidade Federal de Ouro Preto (UFOP), Campus Universitário Morro do Cruzeiro, Bairro Bauxita, CEP: 35400-000, Ouro Preto, MG, Brazil
| | - Kátia da Silva Fonseca
- Programa de Pós-Graduação em Ciências Biológicas, Núcleo de Pesquisas em Ciências Biológicas (NUPEB), Universidade Federal de Ouro Preto (UFOP), Campus Universitário Morro do Cruzeiro, Bairro Bauxita, CEP: 35400-000, Ouro Preto, MG, Brazil
| | - Paula Melo Abreu Vieira
- Programa de Pós-Graduação em Ciências Biológicas, Núcleo de Pesquisas em Ciências Biológicas (NUPEB), Universidade Federal de Ouro Preto (UFOP), Campus Universitário Morro do Cruzeiro, Bairro Bauxita, CEP: 35400-000, Ouro Preto, MG, Brazil
| | - Cláudia Martins Carneiro
- Programa de Pós-Graduação em Ciências Biológicas, Núcleo de Pesquisas em Ciências Biológicas (NUPEB), Universidade Federal de Ouro Preto (UFOP), Campus Universitário Morro do Cruzeiro, Bairro Bauxita, CEP: 35400-000, Ouro Preto, MG, Brazil; Departamento de Análises Clínicas, Escola de Farmácia, Universidade Federal de Ouro Preto (UFOP), Campus Universitário Morro do Cruzeiro, Bairro Bauxita, CEP: 35400-000, Ouro Preto, MG, UFOP, Brazil
| | - Marta de Lana
- Programa de Pós-Graduação em Ciências Biológicas, Núcleo de Pesquisas em Ciências Biológicas (NUPEB), Universidade Federal de Ouro Preto (UFOP), Campus Universitário Morro do Cruzeiro, Bairro Bauxita, CEP: 35400-000, Ouro Preto, MG, Brazil; Departamento de Análises Clínicas, Escola de Farmácia, Universidade Federal de Ouro Preto (UFOP), Campus Universitário Morro do Cruzeiro, Bairro Bauxita, CEP: 35400-000, Ouro Preto, MG, UFOP, Brazil.
| |
Collapse
|
25
|
Esper HR, Freitas VLTD, Assy JGPL, Shimoda EY, Berreta OCP, Lopes MH, França FOS. Fatal evolution of acute Chagas disease in a child from Northern Brazil: factors that determine poor prognosis. Rev Inst Med Trop Sao Paulo 2019; 61:e27. [PMID: 31066753 PMCID: PMC6502456 DOI: 10.1590/s1678-9946201961027] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 04/02/2019] [Indexed: 11/22/2022] Open
Abstract
Trypanosoma cruzi is the causative agent of Chagas disease. Nowadays, the transmission in Brazil occurs mainly by oral ingestion of contaminated food that has been associated with more severe clinical manifestations. We report a case of Acute Chagas disease caused by oral transmission in a child from Northern Brazil. In the hospital admission, physical examination showed tachycardia, hepatomegaly, bipalpebral edema and anasarca. Trypanosoma cruzi trypomastigotes were found in microscopy during blood cell count. Twenty-three days before hospitalization, the child had ingested the "bacaba palm fruit's wine". Even with the appropriate diagnosis and starting of treatment, she did not survive. Quantitative analysis of Trypanosoma cruzi DNA in a blood sample resulted in 54,053.42 parasite equivalents/mL and the DTU TcIV was identified. The outcome may have been determined by several factors, including the delay to seek a medical service beyond the high parasitemia, detected by qPCR. DTU TcIV could also have influenced the natural history of the disease.
Collapse
Affiliation(s)
- Helena Rangel Esper
- Hospital Municipal, Santarém, Pará, Brazil.,Universidade de São Paulo, Faculdade de Medicina, São Paulo, São Paulo, Brazil
| | | | | | - Erika Yoshie Shimoda
- Universidade de São Paulo, Hospital das Clínicas, Laboratório de Investigação Médica em Imunologia (LIM 48), São Paulo, São Paulo, Brazil
| | - Olivia Campos Pinheiro Berreta
- Hospital Municipal, Santarém, Pará, Brazil.,Universidade de São Paulo, Faculdade de Medicina, São Paulo, São Paulo, Brazil
| | - Marta Heloisa Lopes
- Universidade de São Paulo, Faculdade de Medicina, São Paulo, São Paulo, Brazil.,Universidade de São Paulo, Hospital das Clínicas, Laboratório de Investigação Médica em Imunologia (LIM 48), São Paulo, São Paulo, Brazil
| | - Francisco Oscar Siqueira França
- Universidade de São Paulo, Faculdade de Medicina, São Paulo, São Paulo, Brazil.,Universidade de São Paulo, Hospital das Clínicas, Laboratório de Investigação Médica em Imunologia (LIM 48), São Paulo, São Paulo, Brazil
| |
Collapse
|
26
|
Lewis MD, Francisco AF, Jayawardhana S, Langston H, Taylor MC, Kelly JM. Imaging the development of chronic Chagas disease after oral transmission. Sci Rep 2018; 8:11292. [PMID: 30050153 PMCID: PMC6062536 DOI: 10.1038/s41598-018-29564-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 07/10/2018] [Indexed: 12/26/2022] Open
Abstract
Chagas disease is a zoonosis caused by the protozoan parasite Trypanosoma cruzi. Transmission cycles are maintained by haematophagous triatomine bug vectors that carry infective T. cruzi in their faeces. Most human infections are acquired by contamination of mucosal membranes with triatomine faeces after being bitten, however, T. cruzi can be transmitted by several other routes. Oral transmission is an increasingly important aspect of Chagas disease epidemiology, typically involving food or drink products contaminated with triatomines. This has recently caused numerous outbreaks and been linked to unusually severe acute infections. The long-term impact of oral transmission on infection dynamics and disease pathogenesis is unclear. We used highly sensitive bioluminescence imaging and quantitative histopathology to study orally transmitted T. cruzi infections in mice. Both metacyclic and bloodform trypomastigotes were infectious via the oral cavity, but only metacyclics led to established infections by intra-gastric gavage. Mice displayed only mild acute symptoms but later developed significantly increased myocardial collagen content (p = 0.017), indicative of fibrosis. Gastrointestinal tissues and skin were the principal chronic infection reservoirs. Chronic phase parasite load profiles, tissue distribution and myocardial fibrosis severity were comparable to needle-injected controls. Thus, the oral route neither exacerbates nor ameliorates experimental Chagas disease.
Collapse
Affiliation(s)
- Michael D Lewis
- Department of Pathogen Molecular Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom.
| | - Amanda F Francisco
- Department of Pathogen Molecular Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom
| | - Shiromani Jayawardhana
- Department of Pathogen Molecular Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom
| | - Harry Langston
- Department of Pathogen Molecular Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom
| | - Martin C Taylor
- Department of Pathogen Molecular Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom
| | - John M Kelly
- Department of Pathogen Molecular Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom
| |
Collapse
|
27
|
Acquatella H, Asch FM, Barbosa MM, Barros M, Bern C, Cavalcante JL, Echeverria Correa LE, Lima J, Marcus R, Marin-Neto JA, Migliore R, Milei J, Morillo CA, Nunes MCP, Campos Vieira ML, Viotti R. Recommendations for Multimodality Cardiac Imaging in Patients with Chagas Disease: A Report from the American Society of Echocardiography in Collaboration With the InterAmerican Association of Echocardiography (ECOSIAC) and the Cardiovascular Imaging Department of the Brazilian Society of Cardiology (DIC-SBC). J Am Soc Echocardiogr 2018; 31:3-25. [DOI: 10.1016/j.echo.2017.10.019] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
|
28
|
de Souza Godoi PA, Piechnik CA, de Oliveira AC, Sfeir MZ, de Souza EM, Rogez H, Thomaz Soccol V. qPCR for the detection of foodborne Trypanosoma cruzi. Parasitol Int 2017; 66:563-566. [PMID: 28602861 DOI: 10.1016/j.parint.2017.06.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 01/30/2017] [Accepted: 06/03/2017] [Indexed: 11/19/2022]
Abstract
Here we presented a potential real-time PCR (qPCR) method with public health importance and relevance for detection of Trypanosoma cruzi in açai pulp. There is not a current process to identify T. cruzi in açai, that ensures innocuity of this food concerning oral transmission. First, six new primers were designed using the DNA sequences of T. cruzi y152 and Emerald strains obtained from GenBank. For primers evaluation and titration they were validated regarding the amplification and not with the fluorophore chosen 1ngμL-1 of the T. cruzi DNA as target. For determination of the ideal concentration the titration of the primers drawn in this study showed T. cruzi DNA amplification in five primer pairs at concentrations 100, 200 and 300nM and DNA fixed concentrations at 1ngμL-1. For standardization all reactions were performed in triplicate with 5.0μL and positives and negatives controls were included in every run. As positive control DNA from two genotypes TcI and TcII were used. As negative control the reaction product without DNA of the parasite was used. The best primer concentration, for the expected fragments, was 300nM. From six primers improved the Ep1F/Ep1R primer detected 1×10-4ngμL-1 for both genotype of the parasite. The Bp1F/Bp1R showed amplification for 1.70.10-7ngμL-1 for TcI and 4.31.10-8ngμL-1 for TcII, based on the standard curve. The last step we tested the selected primers in qPCR for monitoring T. cruzi in açai pulp experimentally contaminated. The recovery rate for the TcII was 71%, whereas in açai samples contaminated with TcI it was 76%.
Collapse
Affiliation(s)
- Poliana Alves de Souza Godoi
- Unidade Integrada Sesi Senai, Niquelândia, Goiás, Brazil; Universidade Federal do Paraná, Department of Bioprocess Engineering and Biotechnology, Molecular Biology Laboratory, Curitiba, Paraná, Brazil
| | - Claudio Adriano Piechnik
- Universidade Federal do Paraná, Department of Bioprocess Engineering and Biotechnology, Molecular Biology Laboratory, Curitiba, Paraná, Brazil
| | - Ana Caroline de Oliveira
- Universidade Federal do Pará, Centre for Valorisation of Amazonian Bioactive Compounds, Belém, Pará, Brazil
| | | | | | - Hervé Rogez
- Universidade Federal do Pará, Centre for Valorisation of Amazonian Bioactive Compounds, Belém, Pará, Brazil
| | - Vanete Thomaz Soccol
- Universidade Federal do Paraná, Department of Bioprocess Engineering and Biotechnology, Molecular Biology Laboratory, Curitiba, Paraná, Brazil.
| |
Collapse
|
29
|
[Possible oral transmission of Chagas disease among hydrocarbons sector workers in Casanare, Colombia, 2014]. BIOMEDICA 2017; 37:218-232. [PMID: 28527286 DOI: 10.7705/biomedica.v37i3.3153] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 08/19/2016] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Trypanosoma cruzi, the etiological agent for Chagas disease, can be transmitted by oral intake of contaminated food or drinks. During epidemiological week 14 of 2014, two cases of acute Chagas disease were notified among hydrocarbons sector workers in Paz de Ariporo, Casanare. OBJECTIVE To characterize the affected population, to establish control and prevention measures and to confirm the outbreak. MATERIALS AND METHODS We conducted an outbreak investigation that included the following components: a) Search for symptomatic people compatible with Chagas disease according to the case definition for their referral to medical services; b) entomological survey (192/197 houses); c) sanitary inspection and microbiological analysis of food samples; and d) study of reservoirs. Data management and analysis were done with Epi-Info 7.1.5 using descriptive statistics. We also calculated intradomicile and peridomicile triatomine infestation indexes. RESULTS We detected 552 exposed people; 40 had the disease (7.2%), of whom seven were women (17,5%) and 33, men (82.5%), i.e., a male-female ratio of 5:1. The mean age was 39.1 ± 10.8 years; the attack rate was 7.2% and lethality, 5% (2/40). Symptoms included fever (100% of cases), headache (80%), myalgia and arthralgia (65%), facial edema (55%), and abdominal pain (37.5%). The mean incubation time was 17 days (range: 3-21). Rhodnius prolixus domiciliary infestation index was 3.3 % and 2.2% in the peridomicile. In the five restaurants inspected sanitary conditions were deficient and food samples were microbiologically non-conforming. We found a dog and two opossums positive for IgG antibodies by ELISA. CONCLUSIONS Environmental, sanitary and epidemiological conditions at the place confirmed an outbreak of Chagas diseases related to occupational exposure, possibly by oral transmission, which may be the largest to date in Colombia.
Collapse
|
30
|
Silva-dos-Santos D, Barreto-de-Albuquerque J, Guerra B, Moreira OC, Berbert LR, Ramos MT, Mascarenhas BAS, Britto C, Morrot A, Serra Villa-Verde DM, Garzoni LR, Savino W, Cotta-de-Almeida V, de Meis J. Unraveling Chagas disease transmission through the oral route: Gateways to Trypanosoma cruzi infection and target tissues. PLoS Negl Trop Dis 2017; 11:e0005507. [PMID: 28379959 PMCID: PMC5397068 DOI: 10.1371/journal.pntd.0005507] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 04/19/2017] [Accepted: 03/20/2017] [Indexed: 02/02/2023] Open
Abstract
Oral transmission of Trypanosoma cruzi, the causative agent of Chagas disease, is the most important route of infection in Brazilian Amazon and Venezuela. Other South American countries have also reported outbreaks associated with food consumption. A recent study showed the importance of parasite contact with oral cavity to induce a highly severe acute disease in mice. However, it remains uncertain the primary site of parasite entry and multiplication due to an oral infection. Here, we evaluated the presence of T. cruzi Dm28c luciferase (Dm28c-luc) parasites in orally infected mice, by bioluminescence and quantitative real-time PCR. In vivo bioluminescent images indicated the nasomaxillary region as the site of parasite invasion in the host, becoming consistently infected throughout the acute phase. At later moments, 7 and 21 days post-infection (dpi), luminescent signal is denser in the thorax, abdomen and genital region, because of parasite dissemination in different tissues. Ex vivo analysis demonstrated that the nasomaxillary region, heart, mandibular lymph nodes, liver, spleen, brain, epididymal fat associated to male sex organs, salivary glands, cheek muscle, mesenteric fat and lymph nodes, stomach, esophagus, small and large intestine are target tissues at latter moments of infection. In the same line, amastigote nests of Dm28c GFP T. cruzi were detected in the nasal cavity of 6 dpi mice. Parasite quantification by real-time qPCR at 7 and 21 dpi showed predominant T. cruzi detection and expansion in mouse nasal cavity. Moreover, T. cruzi DNA was also observed in the mandibular lymph nodes, pituitary gland, heart, liver, small intestine and spleen at 7 dpi, and further, disseminated to other tissues, such as the brain, stomach, esophagus and large intestine at 21 dpi. Our results clearly demonstrated that oral cavity and adjacent compartments is the main target region in oral T. cruzi infection leading to parasite multiplication at the nasal cavity. Oral transmission of Trypanosoma cruzi associated with food/beverage consumption is presently an important route of infection in Brazil and Venezuela. Colombia, Bolivia, Argentina and Ecuador have also reported to have acute cases of Chagas disease transmission through the oral route. Significant studies about this form of T. cruzi infection are largely lacking. In addition to the classic cardiac involvement, orally-infected patient progress to a highly symptomatic disease and increased mortality rate (8–35%), surpassing the calculated mortality produced by the disease resulting from the biting of infected insect vectors (5–10%). Here, we explored by in vivo bioluminescent images, qPCR and fluorescence microscopy the primary site of parasite entry and multiplication in oral infection (OI). Our results clearly demonstrated that the oral cavity is the main T. cruzi target region in OI, leading to parasite multiplication at the nasal cavity and parasite dissemination to the brain and peripheral tissues. Interestingly, facial edema, paraesthesia of the tongue, gingivitis and dry cough were already described in affected patients. These findings might be associated to our present data, which describe for the first time the nasomaxillary region as the main target tissue following oral T. cruzi infection.
Collapse
Affiliation(s)
- Danielle Silva-dos-Santos
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Bárbara Guerra
- National Center of Structural Biology and Bio-imaging—CENABIO, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Otacilio C. Moreira
- Laboratory on Molecular Biology and Endemic Diseases, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Luiz Ricardo Berbert
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Mariana Tavares Ramos
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Constança Britto
- Laboratory on Molecular Biology and Endemic Diseases, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Alexandre Morrot
- Department of Immunology, Microbiology Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Déa M. Serra Villa-Verde
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Luciana Ribeiro Garzoni
- Laboratory for Innovations in Therapies, Education and Bioproducts, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Wilson Savino
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Vinícius Cotta-de-Almeida
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Juliana de Meis
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
- * E-mail:
| |
Collapse
|
31
|
Affiliation(s)
- Rodrigo Nogueira Angerami
- Epidemiological Surveillance Section, Division of Infectious Diseases, Hospital of Clinics; University of Campinas and Department of Public Health, School of Medical Sciences, University of Campinas; Campinas São Paulo Brazil
| | - Luiz Jacintho da Silva
- Division of Infectious Diseases, Department of Internal Medicine, School of Medical Sciences; University of Campinas; Campinas São Paulo Brazil
| | - Alfonso J. Rodriguez-Morales
- Public Health and Infection Research Group, Faculty of Health Sciences; Universidad Tecnologica de Pereira; Pereira Risaralda Colombia
- Infectious Diseases Research Group; Hospital Universitario de Sincelejo; Sucre Colombia
| |
Collapse
|
32
|
Nascimento CR, Andrade D, Carvalho-Pinto CE, Serra RR, Vellasco L, Brasil G, Ramos-Junior ES, da Mota JB, Almeida LN, Andrade MV, Correia Soeiro MDN, Juliano L, Alvarenga PH, Oliveira AC, Sicuro FL, de Carvalho ACC, Svensjö E, Scharfstein J. Mast Cell Coupling to the Kallikrein-Kinin System Fuels Intracardiac Parasitism and Worsens Heart Pathology in Experimental Chagas Disease. Front Immunol 2017; 8:840. [PMID: 28824610 PMCID: PMC5539176 DOI: 10.3389/fimmu.2017.00840] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 07/04/2017] [Indexed: 02/05/2023] Open
Abstract
During the course of Chagas disease, infectious forms of Trypanosoma cruzi are occasionally liberated from parasitized heart cells. Studies performed with tissue culture trypomastigotes (TCTs, Dm28c strain) demonstrated that these parasites evoke neutrophil/CXCR2-dependent microvascular leakage by activating innate sentinel cells via toll-like receptor 2 (TLR2). Upon plasma extravasation, proteolytically derived kinins and C5a stimulate immunoprotective Th1 responses via cross-talk between bradykinin B2 receptors (B2Rs) and C5aR. Awareness that TCTs invade cardiovascular cells in vitro via interdependent activation of B2R and endothelin receptors [endothelin A receptor (ETAR)/endothelin B receptor (ETBR)] led us to hypothesize that T. cruzi might reciprocally benefit from the formation of infection-associated edema via activation of kallikrein-kinin system (KKS). Using intravital microscopy, here we first examined the functional interplay between mast cells (MCs) and the KKS by topically exposing the hamster cheek pouch (HCP) tissues to dextran sulfate (DXS), a potent "contact" activator of the KKS. Surprisingly, although DXS was inert for at least 30 min, a subtle MC-driven leakage resulted in factor XII (FXII)-dependent activation of the KKS, which then amplified inflammation via generation of bradykinin (BK). Guided by this mechanistic insight, we next exposed TCTs to "leaky" HCP-forged by low dose histamine application-and found that the proinflammatory phenotype of TCTs was boosted by BK generated via the MC/KKS pathway. Measurements of footpad edema in MC-deficient mice linked TCT-evoked inflammation to MC degranulation (upstream) and FXII-mediated generation of BK (downstream). We then inoculated TCTs intracardiacally in mice and found a striking decrease of parasite DNA (quantitative polymerase chain reaction; 3 d.p.i.) in the heart of MC-deficient mutant mice. Moreover, the intracardiac parasite load was significantly reduced in WT mice pretreated with (i) cromoglycate (MC stabilizer) (ii) infestin-4, a specific inhibitor of FXIIa (iii) HOE-140 (specific antagonist of B2R), and (iv) bosentan, a non-selective antagonist of ETAR/ETBR. Notably, histopathology of heart tissues from mice pretreated with these G protein-coupled receptors blockers revealed that myocarditis and heart fibrosis (30 d.p.i.) was markedly and redundantly attenuated. Collectively, our study suggests that inflammatory edema propagated via activation of the MC/KKS pathway fuels intracardiac parasitism by generating infection-stimulatory peptides (BK and endothelins) in the edematous heart tissues.
Collapse
Affiliation(s)
- Clarissa R. Nascimento
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Daniele Andrade
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | | | - Rafaela Rangel Serra
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Lucas Vellasco
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Guilherme Brasil
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Erivan Schnaider Ramos-Junior
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- University of the Pacific, San Francisco, CA, United States
| | - Julia Barbalho da Mota
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Larissa Nogueira Almeida
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Marcus V. Andrade
- Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
- Departamento de Clinica Medica, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | | | - Luiz Juliano
- Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Patrícia Hessab Alvarenga
- Instituto de Bioquímica Médica Leopoldo de Meis (IBqM), Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ana Carolina Oliveira
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Fernando Lencastre Sicuro
- Universidade do Estado do Rio de Janeiro (UERJ), Centro Biomédico Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Erik Svensjö
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Julio Scharfstein
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- *Correspondence: Julio Scharfstein,
| |
Collapse
|
33
|
Assunção AN, Jerosch-Herold M, Melo RL, Mauricio AV, Rocha L, Torreão JA, Fernandes F, Ianni BM, Mady C, Ramires JAF, Kalil-Filho R, Rochitte CE. Chagas' heart disease: gender differences in myocardial damage assessed by cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2016; 18:88. [PMID: 27890014 PMCID: PMC5125033 DOI: 10.1186/s12968-016-0307-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 11/12/2016] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Since a male-related higher cardiovascular morbidity and mortality in patients with Chagas' heart disease has been reported, we aimed to investigate gender differences in myocardial damage assessed by cardiovascular magnetic resonance (CMR). METHODS AND RESULTS Retrospectively, 62 seropositive Chagas' heart disease patients referred to CMR (1.5 T) and with low probability of having significant coronary artery disease were included in this analysis. Amongst both sexes, there was a strong negative correlation between LV ejection fraction and myocardial fibrosis (male r = 0.64, female r = 0.73, both P < 0.001), with males showing significantly greater myocardial fibrosis (P = 0.002) and lower LV ejection fraction (P < 0.001) than females. After adjustment for potential confounders, gender remained associated with myocardial dysfunction, and 53% of the effect was mediated by myocardial fibrosis (P for mediation = 0.004). Also, the transmural pattern was more prevalent among male patients (23.7 vs. 9.9%, P < 0.001) as well as the myocardial heterogeneity or gray zone (2.2 vs. 1.3 g, P = 0.003). CONCLUSIONS We observed gender-related differences in myocardial damage assessed by CMR in patients with Chagas' heart disease. As myocardial fibrosis and myocardial dysfunction are associated to cardiovascular outcomes, our findings might help to understand the poorer prognosis observed in males in Chagas' disease.
Collapse
Affiliation(s)
- Antonildes N. Assunção
- Heart Institute, InCor, University of Sao Paulo Medical School, Cardiovascular Magnetic Resonance and Computed Tomography Sector, Av. Dr. Enéas de Carvalho Aguiar, 44, Andar AB, Cerqueira César, São Paulo, SP 05403-000 Brazil
| | | | - Rodrigo L. Melo
- Heart Institute, InCor, University of Sao Paulo Medical School, Cardiovascular Magnetic Resonance and Computed Tomography Sector, Av. Dr. Enéas de Carvalho Aguiar, 44, Andar AB, Cerqueira César, São Paulo, SP 05403-000 Brazil
| | - Alejandra V. Mauricio
- Heart Institute, InCor, University of Sao Paulo Medical School, Cardiovascular Magnetic Resonance and Computed Tomography Sector, Av. Dr. Enéas de Carvalho Aguiar, 44, Andar AB, Cerqueira César, São Paulo, SP 05403-000 Brazil
| | - Liliane Rocha
- Heart Institute, InCor, University of Sao Paulo Medical School, Cardiovascular Magnetic Resonance and Computed Tomography Sector, Av. Dr. Enéas de Carvalho Aguiar, 44, Andar AB, Cerqueira César, São Paulo, SP 05403-000 Brazil
| | - Jorge A. Torreão
- Heart Institute, InCor, University of Sao Paulo Medical School, Cardiovascular Magnetic Resonance and Computed Tomography Sector, Av. Dr. Enéas de Carvalho Aguiar, 44, Andar AB, Cerqueira César, São Paulo, SP 05403-000 Brazil
| | - Fabio Fernandes
- Heart Institute, InCor, University of Sao Paulo Medical School, Cardiovascular Magnetic Resonance and Computed Tomography Sector, Av. Dr. Enéas de Carvalho Aguiar, 44, Andar AB, Cerqueira César, São Paulo, SP 05403-000 Brazil
| | - Barbara M. Ianni
- Heart Institute, InCor, University of Sao Paulo Medical School, Cardiovascular Magnetic Resonance and Computed Tomography Sector, Av. Dr. Enéas de Carvalho Aguiar, 44, Andar AB, Cerqueira César, São Paulo, SP 05403-000 Brazil
| | - Charles Mady
- Heart Institute, InCor, University of Sao Paulo Medical School, Cardiovascular Magnetic Resonance and Computed Tomography Sector, Av. Dr. Enéas de Carvalho Aguiar, 44, Andar AB, Cerqueira César, São Paulo, SP 05403-000 Brazil
| | - José A. F. Ramires
- Heart Institute, InCor, University of Sao Paulo Medical School, Cardiovascular Magnetic Resonance and Computed Tomography Sector, Av. Dr. Enéas de Carvalho Aguiar, 44, Andar AB, Cerqueira César, São Paulo, SP 05403-000 Brazil
| | - Roberto Kalil-Filho
- Heart Institute, InCor, University of Sao Paulo Medical School, Cardiovascular Magnetic Resonance and Computed Tomography Sector, Av. Dr. Enéas de Carvalho Aguiar, 44, Andar AB, Cerqueira César, São Paulo, SP 05403-000 Brazil
| | - Carlos E. Rochitte
- Heart Institute, InCor, University of Sao Paulo Medical School, Cardiovascular Magnetic Resonance and Computed Tomography Sector, Av. Dr. Enéas de Carvalho Aguiar, 44, Andar AB, Cerqueira César, São Paulo, SP 05403-000 Brazil
| |
Collapse
|
34
|
Henao-Martínez AF, Colborn K, Parra-Henao G. Overcoming research barriers in Chagas disease-designing effective implementation science. Parasitol Res 2016; 116:35-44. [PMID: 27771804 DOI: 10.1007/s00436-016-5291-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 10/07/2016] [Indexed: 12/20/2022]
Abstract
Chagas disease is a complex tropical parasitic infection. It affects a significant portion of the population in Latin America, especially in areas of poverty and poor access to health care. It also affects immigrants in high-income countries who lack access to health care due to their legal status. Millions of people are at risk of contracting the disease, and approximately 30 % of chronically infected patients will develop cardiomyopathy. The cost of caring for patients that have been infected is substantial. Basic science research has introduced new concepts and knowledge for the parasite and vector biology as well as better understanding of the pathophysiology of the disease. These research findings nevertheless require effective and timely translation into clinical practice. Likewise, the design of new research projects should account for the multiple system-based barriers. Implementation science facilitates the applicability of research findings and identifies barriers to its execution. Creation of implementation science measures to reach and sustain research programs with greater potential to impact Chagas disease are lacking. This point of view proposes opportunities for implementation science in Chagas disease and strategies for researching effective interventions for preventing and treating the disease.
Collapse
Affiliation(s)
- Andrés F Henao-Martínez
- Division of Infectious Diseases, Department of Medicine, University of Colorado Denver, 12700 E. 19th Avenue, Mail Stop B168, Aurora, CO, 80045, USA.
| | - Kathryn Colborn
- Division of Health Care Policy and Research, Adult and Child Consortium for Health Outcomes Research and Delivery Science, School of Medicine, University of Colorado Denver, Aurora, CO, USA
| | - Gabriel Parra-Henao
- Red Chagas Colombia, Centro de Investigación en Salud para el Trópico (CIST), UCC, Santa Marta, Colombia
| |
Collapse
|
35
|
Gil-Jaramillo N, Motta FN, Favali CBF, Bastos IMD, Santana JM. Dendritic Cells: A Double-Edged Sword in Immune Responses during Chagas Disease. Front Microbiol 2016; 7:1076. [PMID: 27471496 PMCID: PMC4943928 DOI: 10.3389/fmicb.2016.01076] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 06/27/2016] [Indexed: 01/24/2023] Open
Abstract
Dendritic cells (DCs) are the most important member of the antigen presenting cells group due to their ability to recognize antigen at the infection site and their high specialized antigen internalization capacity. These cells have central role in connecting the innate and adaptive immune responses against Trypanosoma cruzi, the causative agent of Chagas disease. These first line defense cells modulate host immune response depending on type, maturation level, cytokine milieu and DC receptor involved in the interactions with T. cruzi, influencing the development of the disease clinic forms. Here, we present a review of DCs-T. cruzi interactions both in human and murine models, pointing out the parasite ability to manipulate DCs activity for the purpose of evading innate immune response and assuring its own survival and persistence.
Collapse
Affiliation(s)
- Natalia Gil-Jaramillo
- Laboratório de Interação Patógeno-Hospedeiro, Instituto de Biologia, Universidade de BrasíliaBrasília, Brazil
| | - Flávia N. Motta
- Laboratório de Interação Patógeno-Hospedeiro, Instituto de Biologia, Universidade de BrasíliaBrasília, Brazil
- Faculdade de Ceilândia, Universidade de BrasíliaBrasília, Brazil
| | - Cecília B. F. Favali
- Laboratório de Biologia do Gene, Instituto de Biologia, Universidade de BrasíliaBrasília, Brazil
| | - Izabela M. D. Bastos
- Laboratório de Interação Patógeno-Hospedeiro, Instituto de Biologia, Universidade de BrasíliaBrasília, Brazil
| | - Jaime M. Santana
- Laboratório de Interação Patógeno-Hospedeiro, Instituto de Biologia, Universidade de BrasíliaBrasília, Brazil
| |
Collapse
|
36
|
Robertson LJ, Devleesschauwer B, Alarcón de Noya B, Noya González O, Torgerson PR. Trypanosoma cruzi: Time for International Recognition as a Foodborne Parasite. PLoS Negl Trop Dis 2016; 10:e0004656. [PMID: 27253136 PMCID: PMC4890754 DOI: 10.1371/journal.pntd.0004656] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- Lucy J. Robertson
- Parasitology Lab, Section for Microbiology, Immunology, and Parasitology, Department of Food Safety and Infection Biology, Norwegian University of Life Sciences, Adamstuen-Campus, Oslo, Norway
- * E-mail:
| | - Brecht Devleesschauwer
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
- Emerging Pathogens Institute and Department of Animal Sciences, University of Florida, Gainesville, Florida, United States of America
| | - Belkisyolé Alarcón de Noya
- Immunology Section, Instituto de Medicina Tropical, Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela
| | - Oscar Noya González
- Biohelmintiasis Section, Instituto de Medicina Tropical, Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela
- Centro para Estudios Sobre Malaria, Instituto de Altos Estudios “Dr. Arnoldo Gabaldón”, Instituto Nacional de Higiene, MPPS, Caracas, Venezuela
| | - Paul R. Torgerson
- Section of Epidemiology, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland
| |
Collapse
|
37
|
Alarcón de Noya B, Colmenares C, Díaz-Bello Z, Ruiz-Guevara R, Medina K, Muñoz-Calderón A, Mauriello L, Cabrera E, Montiel L, Losada S, Martínez J, Espinosa R, Abate T. Orally-transmitted Chagas disease: Epidemiological, clinical, serological and molecular outcomes of a school microepidemic in Chichiriviche de la Costa, Venezuela. Parasite Epidemiol Control 2016; 1:188-198. [PMID: 29988179 PMCID: PMC5991850 DOI: 10.1016/j.parepi.2016.02.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 02/23/2016] [Accepted: 02/23/2016] [Indexed: 11/15/2022] Open
Abstract
Oral transmission of Trypanosoma cruzi is a frequent cause of acute Chagas disease (ChD). In the present cross-sectional study, we report the epidemiological, clinical, serological and molecular outcomes of the second largest outbreak of oral ChD described in the literature. It occurred in March 2009 in Chichiriviche de la Costa, a rural seashore community at the central littoral in Venezuela. The vehicle was an artisanal guava juice prepared at the local school and Panstrongylus geniculatus was the vector involved. TcI genotype was isolated from patients and vector; some showed a mixture of haplotypes. Using molecular markers, parasitic loads were high. Eighty-nine cases were diagnosed, the majority (87.5%) in school children 6-15 years of age. Frequency of symptomatic patients was high (89.9%) with long-standing fever in 87.5%; 82.3% had pericardial effusion detected by echocardiogram and 41% had EKG abnormalities. Three children, a pregnant woman and her stillborn child died (5.6% mortality). The community was addressed by simultaneous determination of specific IgG and IgM, confirmed with indirect hemagglutination and lytic antibodies. Determination of IgG and IgA in saliva had low sensitivity. No individual parasitological or serological technique diagnosed 100% of cases. Culture and PCR detected T. cruzi in 95.5% of examined individuals. Based on the increasing incidence of oral acute cases of ChD, it appears that food is becoming one of the most important modes of transmission in the Amazon, Caribbean and Andes regions of America.
Collapse
Affiliation(s)
- Belkisyolé Alarcón de Noya
- Sección de Inmunología Instituto de Medicina Tropical, Facultad de Medicina, Universidad Central de Venezuela, Venezuela
- Cátedra de Parasitología, Escuela de Medicina “Luis Razetti”, Universidad Central de Venezuela, Venezuela
| | - Cecilia Colmenares
- Sección de Inmunología Instituto de Medicina Tropical, Facultad de Medicina, Universidad Central de Venezuela, Venezuela
- Cátedra de Parasitología, Escuela de Medicina “Luis Razetti”, Universidad Central de Venezuela, Venezuela
| | - Zoraida Díaz-Bello
- Sección de Inmunología Instituto de Medicina Tropical, Facultad de Medicina, Universidad Central de Venezuela, Venezuela
| | - Raiza Ruiz-Guevara
- Cátedra de Parasitología, Escuela de Medicina “Luis Razetti”, Universidad Central de Venezuela, Venezuela
| | - Karen Medina
- Postgrado Nacional de Parasitología, Facultad de Medicina, Universidad Central de Venezuela, Venezuela
| | - Arturo Muñoz-Calderón
- Sección de Inmunología Instituto de Medicina Tropical, Facultad de Medicina, Universidad Central de Venezuela, Venezuela
| | - Luciano Mauriello
- Sección de Inmunología Instituto de Medicina Tropical, Facultad de Medicina, Universidad Central de Venezuela, Venezuela
| | - Elida Cabrera
- Servicio de Cardiología Infantil, Hospital Militar “Dr. Carlos Arvelo”, Venezuela
| | - Luís Montiel
- Dirección de Epidemiología, Ministerio del Poder Popular para la Salud, Venezuela
| | - Sandra Losada
- Sección de Biohelmintiasis, Instituto de Medicina Tropical, Facultad de Medicina, Universidad Central de Venezuela, Venezuela
| | - Jetzi Martínez
- Dirección de Epidemiología, Estado Vargas, Ministerio del Poder Popular para la Salud, Venezuela
| | - Raúl Espinosa
- Servicio de Cardiología, Hospital “Miguel Pérez Carreño”, Venezuela
| | - Teresa Abate
- Sección de Biología Molecular, Instituto de Medicina Tropical, Facultad de Medicina, Universidad Central de Venezuela, Venezuela
| |
Collapse
|
38
|
Rodrigues AA, Notário AFO, Teixeira TL, e Silva RT, Quintal APN, Alves RN, Brígido PC, Siqueira CS, Martins FA, Machado FC, Clemente TM, da Silva AA, Borges BC, Teixeira SC, dos Santos MA, da Silva CV. A high throughput analysis of cytokines and chemokines expression during the course of Trypanosoma cruzi experimental oral infection. Acta Trop 2016; 157:42-53. [PMID: 26827742 DOI: 10.1016/j.actatropica.2016.01.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 12/14/2015] [Accepted: 01/25/2016] [Indexed: 01/28/2023]
Abstract
Trypanosoma cruzi has high biological and biochemical diversity and variable tissue tropism. Here we aimed to verify the kinetics of cytokine and chemokine in situ secretion in animals infected with two distinct T. cruzi strains after oral inoculation. Also, we investigated parasite migration, residence and pathological damage in stomach, heart and spleen. Our results showed that host immune response against T. cruzi infection is an intricate phenomenon that depends on the parasite strain, on the infected organ and on the time point of the infection. We believe that a wide comprehension of host immune response will potentially provide basis for the development of immunotherapeutic strategies in order to clear parasitism and minimize tissue injury. In this context, we find that KC poses as a possible tool to be used.
Collapse
Affiliation(s)
- Adele A Rodrigues
- Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Ana Flávia O Notário
- Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Thaise L Teixeira
- Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Rebecca T e Silva
- Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Amanda P N Quintal
- Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Rosiane N Alves
- Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Paula C Brígido
- Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Carla S Siqueira
- Faculdade de Odontologia, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Flávia A Martins
- Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Fabrício C Machado
- Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil; Departamento de Microbiologia, Imunologia e Parasitologia, Universidade Federal de São Paulo, São Paulo, Brazil, Brazil
| | - Tatiana M Clemente
- Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil; Departamento de Microbiologia, Imunologia e Parasitologia, Universidade Federal de São Paulo, São Paulo, Brazil, Brazil
| | - Aline A da Silva
- Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Bruna C Borges
- Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Samuel C Teixeira
- Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Marlus A dos Santos
- Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Claudio V da Silva
- Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil.
| |
Collapse
|
39
|
Díaz ML, Leal S, Mantilla JC, Molina-Berríos A, López-Muñoz R, Solari A, Escobar P, González Rugeles CI. Acute Chagas outbreaks: molecular and biological features of Trypanosoma cruzi isolates, and clinical aspects of acute cases in Santander, Colombia. Parasit Vectors 2015; 8:608. [PMID: 26612724 PMCID: PMC4661967 DOI: 10.1186/s13071-015-1218-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 11/19/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Outbreaks of acute Chagas disease associated with oral transmission are easily detected nowadays with trained health personnel in areas of low endemicity, or in which the vector transmission has been interrupted. Given the biological and genetic diversity of Trypanosoma cruzi, the high morbidity, mortality, and the observed therapeutic failure, new characteristics of these outbreaks need to be addressed at different levels, both in Trypanosoma cruzi as in patient response. The aim of this work was to evaluate the patient's features involved in six outbreaks of acute Chagas disease which occurred in Santander, Colombia, and the characteristics of Trypanosoma cruzi clones isolated from these patients, to establish the potential relationship between the etiologic agent features with host behavior. METHODS The clinical, pathological and epidemiological aspects of outbreaks were analyzed. In addition, Trypanosoma cruzi clones were biologically characterized both in vitro and in vivo, and the susceptibility to the classical trypanocidal drugs nifurtimox and benznidazole was evaluated. Trypanosoma cruzi clones were genotyped by means of mini-exon intergenic spacer and cytochrome b genes sequencing. RESULTS All clones were DTU I, and based on the mini-exon intergenic spacer, belong to two genotypes: G2 related with sub-urban, and G11 with rural outbreaks. Girón outbreak clones with higher susceptibility to drugs presented G2 genotype and C/T transition in Cyt b. The outbreaks affected mainly young population (±25.9 years), and the mortality rate was 10 %. The cardiac tissue showed intense inflammatory infiltrate, myocardial necrosis and abundant amastigote nests. However, although the gastrointestinal tissue was congestive, no inflammation or parasites were observed. CONCLUSIONS Although all clones belong to DTU I, two intra-DTU genotypes were found with the sequencing of the mini-exon intergenic spacer, however there is no strict correlation between genetic groups, the cycles of the parasite or the clinical forms of the disease. Trypanosoma cruzi clones from Girón with higher sensitivity to nifurtimox presented a particular G2 genotype and C/T transition in Cyt b. When the diagnosis was early, the patients responded well to antichagasic treatment, which highlights the importance of diagnosis and treatment early to prevent fatal outcomes associated with these acute episodes.
Collapse
Affiliation(s)
- Martha Lucía Díaz
- Grupo de Inmunología y Epidemiología Molecular (GIEM), Facultad de Salud, Universidad Industrial de Santander, Bucaramanga, Colombia.
| | - Sandra Leal
- Grupo de Investigación en Enfermedades Tropicales (CINTROP), Departamento de Ciencias Básicas, Escuela de Medicina, Universidad Industrial de Santander, Bucaramanga, Colombia.
| | - Julio César Mantilla
- Grupo de Inmunología y Epidemiología Molecular (GIEM), Facultad de Salud, Universidad Industrial de Santander, Bucaramanga, Colombia.
| | - Alfredo Molina-Berríos
- Programa de Farmacología Molecular y Clínica, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile. .,Present address: Laboratorio de Farmacología y Farmacogenética, Instituto de Investigación en Ciencias Odontológicas (ICOD), Facultad de Odontología, Universidad de Chile, Santiago, Chile.
| | - Rodrigo López-Muñoz
- Programa de Farmacología Molecular y Clínica, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile. .,Present address: Instituto de Farmacología y Morfofisiología, Facultad de Ciencias Veterinarias, Universidad Austral de Chile, Valdivia, Chile.
| | - Aldo Solari
- Programa de Biología Celular y Molecular, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
| | - Patricia Escobar
- Grupo de Investigación en Enfermedades Tropicales (CINTROP), Departamento de Ciencias Básicas, Escuela de Medicina, Universidad Industrial de Santander, Bucaramanga, Colombia.
| | - Clara Isabel González Rugeles
- Grupo de Inmunología y Epidemiología Molecular (GIEM), Facultad de Salud, Universidad Industrial de Santander, Bucaramanga, Colombia. .,Escuela de Microbiología, Facultad de Salud, Carrera 32 #29-31, Oficina 419, Universidad Industrial de Santander, Bucaramanga, Colombia.
| |
Collapse
|
40
|
Molecular Characterization of a Novel Family of Trypanosoma cruzi Surface Membrane Proteins (TcSMP) Involved in Mammalian Host Cell Invasion. PLoS Negl Trop Dis 2015; 9:e0004216. [PMID: 26565791 PMCID: PMC4643927 DOI: 10.1371/journal.pntd.0004216] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 10/15/2015] [Indexed: 12/03/2022] Open
Abstract
Background The surface coat of Trypanosoma cruzi is predominantly composed of glycosylphosphatidylinositol-anchored proteins, which have been extensively characterized. However, very little is known about less abundant surface proteins and their role in host-parasite interactions. Methodology/ Principal Findings Here, we described a novel family of T. cruzi surface membrane proteins (TcSMP), which are conserved among different T. cruzi lineages and have orthologs in other Trypanosoma species. TcSMP genes are densely clustered within the genome, suggesting that they could have originated by tandem gene duplication. Several lines of evidence indicate that TcSMP is a membrane-spanning protein located at the cellular surface and is released into the extracellular milieu. TcSMP exhibited the key elements typical of surface proteins (N-terminal signal peptide or signal anchor) and a C-terminal hydrophobic sequence predicted to be a trans-membrane domain. Immunofluorescence of live parasites showed that anti-TcSMP antibodies clearly labeled the surface of all T. cruzi developmental forms. TcSMP peptides previously found in a membrane-enriched fraction were identified by proteomic analysis in membrane vesicles as well as in soluble forms in the T. cruzi secretome. TcSMP proteins were also located intracellularly likely associated with membrane-bound structures. We demonstrated that TcSMP proteins were capable of inhibiting metacyclic trypomastigote entry into host cells. TcSMP bound to mammalian cells and triggered Ca2+ signaling and lysosome exocytosis, events that are required for parasitophorous vacuole biogenesis. The effects of TcSMP were of lower magnitude compared to gp82, the major adhesion protein of metacyclic trypomastigotes, suggesting that TcSMP may play an auxiliary role in host cell invasion. Conclusion/Significance We hypothesized that the productive interaction of T. cruzi with host cells that effectively results in internalization may depend on diverse adhesion molecules. In the metacyclic forms, the signaling induced by TcSMP may be additive to that triggered by the major surface molecule gp82, further increasing the host cell responses required for infection. Trypanosoma cruzi is the etiologic agent of Chagas’ disease, which infects 6–7 million people worldwide, mostly in Latin America. Currently, there are no vaccines available, and the drugs used for treatment are toxic and are not fully effective. To infect mammalian hosts, T. cruzi relies on the ability to invade host cells, replicate intracellularly and spread the infection in different organs of the mammalian host. Knowledge of the structure and function of T. cruzi surface molecules is fundamental to understanding the mechanisms by which the parasite interacts with its host. T. cruzi infective forms engage a repertoire of surface and secreted molecules, some of which are involved in triggering signaling pathways both in the parasite and the host cell, leading to intracellular Ca2+ mobilization, a process essential for parasite internalization. Here, we described a novel family of T. cruzi surface membrane proteins (TcSMP), including their genomic distribution, expression and cellular localization. We studied the mechanism of action of TcSMP in host-cell invasion and proposed a triggering role for TcSMP in host-cell lysosome exocytosis during metacyclic internalization. TcSMP genes are conserved among different T. cruzi lineages and share orthologs in other Trypanosoma species. These results suggest that the diversification of TcSMP genes in mammalian trypanosomes occurred after continental drift. In T. cruzi this gene family expanded by gene duplication.
Collapse
|
41
|
de Noya BA, González ON. An ecological overview on the factors that drives to Trypanosoma cruzi oral transmission. Acta Trop 2015; 151:94-102. [PMID: 26066984 DOI: 10.1016/j.actatropica.2015.06.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 05/19/2015] [Accepted: 06/02/2015] [Indexed: 01/14/2023]
Abstract
American trypanosomiasis is one of the few native parasites of this continent. As a zoonosis, Trypanosoma cruzi infects about 180 species out of 25 families of mammals. Its regular transmission is through triatomines, which can easily transmit parasites either by the skin route (contamination of mammals skin with their feces) or by oral route (ingestion of food contaminated with complete triatomines or their feces) and additionally through haematogenous via (congenital and transfusional) and by tissues (transplants). The oral route, which seems to be the ancestral form of transmission to wild and domestic mammals, has recently become more important after the success achieved in the control of domicile vectors using residual pesticides. From its initial diagnosis in 1967, tens of oral outbreaks have been diagnosed mostly in the Brazilian Amazon and subsequently in other four countries in South America. Environmental imbalance caused by man through the invasion and deforestation of woodlands, results in reduction of biodiversity of mammals as food source for triatomines, affecting the "dilution effect" of T. cruzi in the nature increasing the risk of human infection. On the other hand, triatomines invade houses looking for new blood sources. One of the consequences of domiciliated triatomines is the food contamination spread, especially in home-made juices, which has been the source of infection of most oral outbreaks. Other biotic and abiotic factors help to explain the recent increase of oral transmission outbreaks of Chagas disease, distributed in nine eco-regions of America.
Collapse
|
42
|
Domingues CS, Hardoim DJ, Souza CSF, Cardoso FO, Mendes VG, Previtalli-Silva H, Abreu-Silva AL, Pelajo-Machado M, Gonçalves da Costa SC, Calabrese KS. Oral Outbreak of Chagas Disease in Santa Catarina, Brazil: Experimental Evaluation of a Patient's Strain. PLoS One 2015; 10:e0122566. [PMID: 26469517 PMCID: PMC4607495 DOI: 10.1371/journal.pone.0122566] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 02/22/2015] [Indexed: 11/18/2022] Open
Abstract
Chagas disease is a worldwide public health problem. Although the vectorial transmission of Chagas disease has been controlled in Brazil there are other ways of transmission, such as the ingestion of T. cruzi contaminated food, which ensures the continuation of this zoonosis. Here, we demonstrate the influence of the inoculation route on the establishment and development of the SC2005 T. cruzi strain infection in mice. Groups of Swiss mice were infected intragastrically (IG) or intraperitoneally (IP) with the T. cruzi SC2005 strain derived from an outbreak of oral Chagas disease. The results revealed that 100% of IP infected mice showed parasitemia, while just 36% of IG infected showed the presence of the parasite in blood. The parasitemia peaks were later and less intense in the IG infected mice. Mortality of the IP infected animals was more intense and earlier when compared to the IG infected mice. In the IP infected mice leucopenia occurred in the early infection followed by leucocytosis, correlating positively with the increase of the parasites. However, in the IG infected mice only an increase in monocytes was observed, which was positively correlated with the increase of the parasites. Histopathological analyses revealed a myotropic pattern of the SC2005 strain with the presence of inflammatory infiltrates and parasites in different organs of the animals infected by both routes as well as fibrosis foci and collagen redistribution. The flow cytometric analysis demonstrated a fluctuation of the T lymphocyte population in the blood, spleen and mesenteric lymph nodes of the infected animals. T. cruzi DNA associated with the presence of inflammatory infiltrates was detected by PCR in the esophagus, stomach and intestine of all infected mice. These findings are important for the understanding of the pathogenesis of T. cruzi infection by both inoculation routes.
Collapse
Affiliation(s)
- Carolina S. Domingues
- Laboratório de Imunomodulação e Protozoologia, Instituto Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brasil
| | - Daiana J. Hardoim
- Laboratório de Imunomodulação e Protozoologia, Instituto Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brasil
| | - Celeste S. F. Souza
- Laboratório de Imunomodulação e Protozoologia, Instituto Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brasil
| | - Flávia O. Cardoso
- Laboratório de Imunomodulação e Protozoologia, Instituto Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brasil
| | - Verônica G. Mendes
- Centro de Desenvolvimento Tecnológico em Saúde (CDTS)/Instituto Nacional de Ciência e Tecnologia em Doenças Negligenciadas/FIOCRUZ, Rio de Janeiro, Rio de Janeiro, Brasil
| | - Henrique Previtalli-Silva
- Laboratório de Imunomodulação e Protozoologia, Instituto Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brasil
| | - Ana L. Abreu-Silva
- Departamento de Patologia, Universidade Estadual do Maranhão, São Luiz, Maranhão, Brasil
| | - Marcelo Pelajo-Machado
- Laboratório de Patologia, Instituto Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brasil
| | | | - Kátia S. Calabrese
- Laboratório de Imunomodulação e Protozoologia, Instituto Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brasil
- * E-mail:
| |
Collapse
|
43
|
Messenger LA, Miles MA, Bern C. Between a bug and a hard place: Trypanosoma cruzi genetic diversity and the clinical outcomes of Chagas disease. Expert Rev Anti Infect Ther 2015; 13:995-1029. [PMID: 26162928 PMCID: PMC4784490 DOI: 10.1586/14787210.2015.1056158] [Citation(s) in RCA: 127] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Over the last 30 years, concomitant with successful transnational disease control programs across Latin America, Chagas disease has expanded from a neglected, endemic parasitic infection of the rural poor to an urbanized chronic disease, and now a potentially emergent global health problem. Trypanosoma cruzi infection has a highly variable clinical course, ranging from complete absence of symptoms to severe and often fatal cardiovascular and/or gastrointestinal manifestations. To date, few correlates of clinical disease progression have been identified. Elucidating a putative role for T. cruzi strain diversity in Chagas disease pathogenesis is complicated by the scarcity of parasites in clinical specimens and the limitations of our contemporary genotyping techniques. This article systematically reviews the historical literature, given our current understanding of parasite genetic diversity, to evaluate the evidence for any association between T. cruzi genotype and chronic clinical outcome, risk of congenital transmission or reactivation and orally transmitted outbreaks.
Collapse
Affiliation(s)
- Louisa A Messenger
- Department of Pathogen Molecular Biology, Faculty of Infectious Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Michael A Miles
- Department of Pathogen Molecular Biology, Faculty of Infectious Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Caryn Bern
- Global Health Sciences, Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, San Francisco, CA, USA
| |
Collapse
|
44
|
Bonney KM, Engman DM. Autoimmune pathogenesis of Chagas heart disease: looking back, looking ahead. THE AMERICAN JOURNAL OF PATHOLOGY 2015; 185:1537-47. [PMID: 25857229 DOI: 10.1016/j.ajpath.2014.12.023] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 12/21/2014] [Accepted: 12/23/2014] [Indexed: 01/14/2023]
Abstract
Chagas heart disease is an inflammatory cardiomyopathy that develops in approximately one-third of individuals infected with the protozoan parasite Trypanosoma cruzi. Since the discovery of T. cruzi by Carlos Chagas >100 years ago, much has been learned about Chagas disease pathogenesis; however, the outcome of T. cruzi infection is highly variable and difficult to predict. Many mechanisms have been proposed to promote tissue inflammation, but the determinants and the relative importance of each have yet to be fully elucidated. The notion that some factor other than the parasite significantly contributes to the development of myocarditis was hypothesized by the first physician-scientists who noted the conspicuous absence of parasites in the hearts of those who succumbed to Chagas disease. One of these factors-autoimmunity-has been extensively studied for more than half a century. Although questions regarding the functional role of autoimmunity in the pathogenesis of Chagas disease remain unanswered, the development of autoimmune responses during infection clearly occurs in some individuals, and the implications that this autoimmunity may be pathogenic are significant. In this review, we summarize what is known about the pathogenesis of Chagas heart disease and conclude with a view of the future of Chagas disease diagnosis, pathogenesis, therapy, and prevention, emphasizing recent advances in these areas that aid in the management of Chagas disease.
Collapse
Affiliation(s)
- Kevin M Bonney
- Department of Pathology, Northwestern University, Chicago, Illinois; Department of Microbiology-Immunology, Northwestern University, Chicago, Illinois
| | - David M Engman
- Department of Pathology, Northwestern University, Chicago, Illinois; Department of Microbiology-Immunology, Northwestern University, Chicago, Illinois; Department of Feinberg Cardiovascular Research Institute, Northwestern University, Chicago, Illinois.
| |
Collapse
|
45
|
Mantilla BS, Paes LS, Pral EMF, Martil DE, Thiemann OH, Fernández-Silva P, Bastos EL, Silber AM. Role of Δ1-pyrroline-5-carboxylate dehydrogenase supports mitochondrial metabolism and host-cell invasion of Trypanosoma cruzi. J Biol Chem 2015; 290:7767-90. [PMID: 25623067 PMCID: PMC4367278 DOI: 10.1074/jbc.m114.574525] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 12/30/2014] [Indexed: 01/03/2023] Open
Abstract
Proline is crucial for energizing critical events throughout the life cycle of Trypanosoma cruzi, the etiological agent of Chagas disease. The proline breakdown pathway consists of two oxidation steps, both of which produce reducing equivalents as follows: the conversion of proline to Δ(1)-pyrroline-5-carboxylate (P5C), and the subsequent conversion of P5C to glutamate. We have identified and characterized the Δ(1)-pyrroline-5-carboxylate dehydrogenase from T. cruzi (TcP5CDH) and report here on how this enzyme contributes to a central metabolic pathway in this parasite. Size-exclusion chromatography, two-dimensional gel electrophoresis, and small angle x-ray scattering analysis of TcP5CDH revealed an oligomeric state composed of two subunits of six protomers. TcP5CDH was found to complement a yeast strain deficient in PUT2 activity, confirming the enzyme's functional role; and the biochemical parameters (Km, kcat, and kcat/Km) of the recombinant TcP5CDH were determined, exhibiting values comparable with those from T. cruzi lysates. In addition, TcP5CDH exhibited mitochondrial staining during the main stages of the T. cruzi life cycle. mRNA and enzymatic activity levels indicated the up-regulation (6-fold change) of TcP5CDH during the infective stages of the parasite. The participation of P5C as an energy source was also demonstrated. Overall, we propose that this enzymatic step is crucial for the viability of both replicative and infective forms of T. cruzi.
Collapse
Affiliation(s)
- Brian S Mantilla
- From the Instituto de Ciências Biomédicas, Departamento de Parasitologia, Universidade de São Paulo, 05508-000 São Paulo, Brazil
| | - Lisvane S Paes
- From the Instituto de Ciências Biomédicas, Departamento de Parasitologia, Universidade de São Paulo, 05508-000 São Paulo, Brazil
| | - Elizabeth M F Pral
- From the Instituto de Ciências Biomédicas, Departamento de Parasitologia, Universidade de São Paulo, 05508-000 São Paulo, Brazil
| | - Daiana E Martil
- the Laboratório de Biologia Estrutural, Instituto de Física de São Carlos, and
| | - Otavio H Thiemann
- the Laboratório de Biologia Estrutural, Instituto de Física de São Carlos, and
| | - Patricio Fernández-Silva
- the Departamento de Bioquímica, Biología Molecular y Celular, Universidad de Zaragoza, 50013 Zaragoza Spain
| | - Erick L Bastos
- Instituto de Química, Departamento de Química Fundamental, Universidade de São Paulo, 13560-590 São Paulo, Brazil, and
| | - Ariel M Silber
- From the Instituto de Ciências Biomédicas, Departamento de Parasitologia, Universidade de São Paulo, 05508-000 São Paulo, Brazil,
| |
Collapse
|
46
|
Lima MM, Carvalho-Costa FA, Toma HK, Borges-Pereira J, de Oliveira TG, Sarquis O. Chagas disease and housing improvement in northeastern Brazil: a cross-sectional survey. Parasitol Res 2015; 114:1687-92. [PMID: 25673077 DOI: 10.1007/s00436-015-4350-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 01/22/2015] [Indexed: 11/29/2022]
Abstract
Chagas disease was investigated in two new settlements of landless rural workers inhabiting prefabricated, triatomine-proof houses and in four neighboring older communities where mud huts were still well suitable for vectors. Through a cross-sectional survey and entomological assessment, we surveyed 148 houses/families in the two new settlements and in 47 houses/families in the four older localities. We determined seroprevalence of Chagas disease through IFI and Elisa (eluates) assays and searched for vectors in the domestic and peridomestic environments. Seroprevalence reached 0.6% (3/466) in the new settlements and 0.8% (1/115) in the older communities. Triatomines were not found in the new settlements, while 7 Triatoma brasiliensis, 4 T. pseudomaculata, 1 Panstrongylus lutzi, and 145 Rhodnius nasutus were collected in the older localities. In addition, a colony of T. brasiliensis (n = 55) was encountered inside a school attended by children of the region. Parasite strains isolated from the insects were characterized as T. cruzi I. Despite the low prevalence of Chagas disease in both scenarios, entomological surveillance must be strengthened and housing improvement reinforced in order to control vector transmission. The risk of infection by the vectors was lower in the settlements of improved homes, where conditions for colonization of the peridomestic environment by transmitting insects were not observed.
Collapse
Affiliation(s)
- Marli M Lima
- Laboratório de Ecoepidemiologia da Doença de Chagas, Instituto Oswaldo Cruz, Fiocruz, Avenida Brasil, 4365, Rio de Janeiro, RJ, CEP 21045-900, Brazil,
| | | | | | | | | | | |
Collapse
|
47
|
Sánchez-Valdéz FJ, Pérez Brandán C, Ferreira A, Basombrío MÁ. Gene-deleted live-attenuated Trypanosoma cruzi parasites as vaccines to protect against Chagas disease. Expert Rev Vaccines 2014; 14:681-97. [PMID: 25496192 DOI: 10.1586/14760584.2015.989989] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Chagas disease is a neglected tropical disease caused by the protozoan parasite Trypanosoma cruzi. This illness is now becoming global, mainly due to congenital transmission, and so far, there are no prophylactic or therapeutic vaccines available to either prevent or treat Chagas disease. Therefore, different approaches aimed at identifying new protective immunogens are urgently needed. Live vaccines are likely to be more efficient in inducing protection, but safety issues linked with their use have been raised. The development of improved protozoan genetic manipulation tools and genomic and biological information has helped to increase the safety of live vaccines. These advances have generated a renewed interest in the use of genetically attenuated parasites as vaccines against Chagas disease. This review discusses the protective capacity of genetically attenuated parasite vaccines and the challenges and perspectives for the development of an effective whole-parasite Chagas disease vaccine.
Collapse
|
48
|
Gironès N, Carbajosa S, Guerrero NA, Poveda C, Chillón-Marinas C, Fresno M. Global metabolomic profiling of acute myocarditis caused by Trypanosoma cruzi infection. PLoS Negl Trop Dis 2014; 8:e3337. [PMID: 25412247 PMCID: PMC4239010 DOI: 10.1371/journal.pntd.0003337] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 10/12/2014] [Indexed: 12/25/2022] Open
Abstract
Chagas disease is caused by Trypanosoma cruzi infection, being cardiomyopathy the more frequent manifestation. New chemotherapeutic drugs are needed but there are no good biomarkers for monitoring treatment efficacy. There is growing evidence linking immune response and metabolism in inflammatory processes and specifically in Chagas disease. Thus, some metabolites are able to enhance and/or inhibit the immune response. Metabolite levels found in the host during an ongoing infection could provide valuable information on the pathogenesis and/or identify deregulated metabolic pathway that can be potential candidates for treatment and being potential specific biomarkers of the disease. To gain more insight into those aspects in Chagas disease, we performed an unprecedented metabolomic analysis in heart and plasma of mice infected with T. cruzi. Many metabolic pathways were profoundly affected by T. cruzi infection, such as glucose uptake, sorbitol pathway, fatty acid and phospholipid synthesis that were increased in heart tissue but decreased in plasma. Tricarboxylic acid cycle was decreased in heart tissue and plasma whereas reactive oxygen species production and uric acid formation were also deeply increased in infected hearts suggesting a stressful condition in the heart. While specific metabolites allantoin, kynurenine and p-cresol sulfate, resulting from nucleotide, tryptophan and phenylalanine/tyrosine metabolism, respectively, were increased in heart tissue and also in plasma. These results provide new valuable information on the pathogenesis of acute Chagas disease, unravel several new metabolic pathways susceptible of clinical management and identify metabolites useful as potential specific biomarkers for monitoring treatment and clinical severity in patients.
Collapse
Affiliation(s)
- Núria Gironès
- Centro de Biología Molecular Severo Ochoa, CSIC-UAM, Madrid, Spain
- Instituto de Investigación Sanitaria de la Princesa, Madrid, Spain
- * E-mail:
| | - Sofía Carbajosa
- Centro de Biología Molecular Severo Ochoa, CSIC-UAM, Madrid, Spain
| | | | - Cristina Poveda
- Centro de Biología Molecular Severo Ochoa, CSIC-UAM, Madrid, Spain
| | | | - Manuel Fresno
- Centro de Biología Molecular Severo Ochoa, CSIC-UAM, Madrid, Spain
- Instituto de Investigación Sanitaria de la Princesa, Madrid, Spain
| |
Collapse
|
49
|
Clanton L, Sandhu A, Krantz MJ. Seizures and ST-segment elevation: Chagas disease. Am J Med 2014; 127:714-6. [PMID: 24736244 DOI: 10.1016/j.amjmed.2014.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 04/03/2014] [Accepted: 04/04/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Leigh Clanton
- Department of Medicine, University of Colorado Health Sciences Center, Denver, CO
| | - Amneet Sandhu
- Department of Medicine, University of Colorado Health Sciences Center, Denver, CO; Division of Cardiology, Department of Medicine, Denver Health Medical Center, Denver, CO
| | - Mori J Krantz
- Department of Medicine, University of Colorado Health Sciences Center, Denver, CO; Division of Cardiology, Department of Medicine, Denver Health Medical Center, Denver, CO.
| |
Collapse
|
50
|
Anti-Trypanosoma cruzi activity of 10 medicinal plants used in northeast Mexico. Acta Trop 2014; 136:14-8. [PMID: 24742906 DOI: 10.1016/j.actatropica.2014.04.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 04/03/2014] [Accepted: 04/05/2014] [Indexed: 12/15/2022]
Abstract
The aim of this study was to screen the trypanocidal activity of plants used in traditional Mexican medicine for the treatment of various diseases related to parasitic infections. Cultured Trypanosoma cruzi epimastigotes were incubated for 96h with different concentrations of methanolic extracts obtained from Artemisia mexicana, Castela texana, Cymbopogon citratus, Eryngium heterophyllum, Haematoxylum brasiletto, Lippia graveolens, Marrubium vulgare, Persea americana, Ruta chalepensis and Schinus molle. The inhibitory concentration (IC50) was determined for each extract via a colorimetric method. Among the evaluated species, the methanolic extracts of E. heterophyllum, H. brasiletto, M. vulgare and S. molle exhibited the highest trypanocidal activity, showing percentages of growth inhibition between 88 and 100% at a concentration of 150μg/ml. These medicinal plants may represent a valuable source of new bioactive compounds for the therapeutic treatment of trypanosomiasis.
Collapse
|