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Ramos LG, de Souza KR, Barbosa JMC, Salomão K, Sales Junior PA, Pereira VRA, Murta SMF, Ferreira RS, Bernardes TCD, Wardell SMSV, Wardell JL, Boechat N, Carvalho SA. Synthesis and activity of benzimidazole N-Acylhydrazones against Trypanosoma cruzi, Leishmania amazonensis and Leishmania infantum. Bioorg Med Chem Lett 2024; 110:129876. [PMID: 38964519 DOI: 10.1016/j.bmcl.2024.129876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 06/14/2024] [Accepted: 07/01/2024] [Indexed: 07/06/2024]
Abstract
In this study, we present the design, synthesis, and cytotoxic evaluation of a series of benzimidazole N-acylhydrazones against strains of T. cruzi (Y and Tulahuen) and Leishmania species (L. amazonensis and L. infantum). Compound (E)-N'-((5-Nitrofuran-2-yl)methylene)-1H-benzo[d]imidazole-2-carbohydrazide demonstrated significant activity against both trypomastigote and amastigote forms (Tulahuen strain), with an IC50/120 h of 0.033 μM and a selectivity index (SI) of 7680. This represents a potency 46 times greater than that of benznidazole (IC50/120 h = 1.520 μM, SI = 1390). Another compound (E)-N'-(2-Hydroxybenzylidene)-1H-benzo[d]imidazole-2-carbohydrazide showed promising activity against both trypomastigote and amastigote forms (Tulahuen strain), with an IC50/120 h of 3.600 μM and an SI of 14.70. However, its efficacy against L. infantum and L. amazonensis was comparatively lower. These findings provide valuable insights for the development of more effective treatments against Trypanosoma cruzi.
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Affiliation(s)
- Laís G Ramos
- Laboratorio de Sintese de Farmacos-LASFAR, Instituto de Tecnologia em Farmacos - Farmanguinhos - Fundação Oswaldo Cruz, 21041-250 Rio de Janeiro, RJ, Brazil; Laboratório de Físico-Química de Materiais, Seção de Engenharia Química, Instituto Militar de Engenharia, Praça General Tibúrcio 80, 22290-270 Rio de Janeiro, Brazil
| | - Kátia R de Souza
- Laboratório de Físico-Química de Materiais, Seção de Engenharia Química, Instituto Militar de Engenharia, Praça General Tibúrcio 80, 22290-270 Rio de Janeiro, Brazil
| | - Juliana M C Barbosa
- Laboratório de Biologia Celular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, 21040-900 Rio de Janeiro, RJ, Brazil
| | - Kelly Salomão
- Laboratório de Biologia Celular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, 21040-900 Rio de Janeiro, RJ, Brazil
| | - Policarpo A Sales Junior
- Laboratório de Imunopatologia e Biologia Molecular, Departamento de Imunologia, Instituto Aggeu Magalhaes, Fundação Oswaldo Cruz, 50670-420 Recife, PE, Brazil
| | - Valéria R A Pereira
- Laboratório de Imunopatologia e Biologia Molecular, Departamento de Imunologia, Instituto Aggeu Magalhaes, Fundação Oswaldo Cruz, 50670-420 Recife, PE, Brazil
| | - Silvane M F Murta
- Grupo Genômica Funcional de Parasitos, Instituto René Rachou, Fiocruz Minas, 30190-002 Belo Horizonte, MG, Brazil
| | - Rafaela S Ferreira
- Laboratório de modelagem molecular e planejamento de fármacos, Departamento de Bioquímica e Imunologia, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627, Belo Horizonte, MG 31270-901, Brazil
| | - Talita C D Bernardes
- Laboratório de modelagem molecular e planejamento de fármacos, Departamento de Bioquímica e Imunologia, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627, Belo Horizonte, MG 31270-901, Brazil
| | | | - James L Wardell
- Department of Chemistry, University of Aberdeen, Old Aberdeen AB24 3UE, Scotland
| | - Nubia Boechat
- Laboratorio de Sintese de Farmacos-LASFAR, Instituto de Tecnologia em Farmacos - Farmanguinhos - Fundação Oswaldo Cruz, 21041-250 Rio de Janeiro, RJ, Brazil
| | - Samir A Carvalho
- Laboratorio de Sintese de Farmacos-LASFAR, Instituto de Tecnologia em Farmacos - Farmanguinhos - Fundação Oswaldo Cruz, 21041-250 Rio de Janeiro, RJ, Brazil.
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Alvarez ACPC, Dale C, Galvão C. Geometric morphometry of the Rhodniusprolixus complex (Hemiptera, Triatominae): patterns of intraspecific and interspecific allometry and their taxonomic implications. Zookeys 2024; 1202:213-228. [PMID: 38826493 PMCID: PMC11140263 DOI: 10.3897/zookeys.1202.108157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 11/07/2023] [Indexed: 06/04/2024] Open
Abstract
In the subfamily Triatominae, the genus Rhodnius is one of the most studied, not only because of its epidemiological importance, but also because of the difficulty in differentiating its species. Currently, one of the strategies to control Chagas disease, besides other initiatives such as the analysis of donated blood, is focused on fighting the vector. Correctly identifying triatomines is essential for the entomoepidemiological surveillance of Chagas disease. The objective of the present work was to compare the species of the R.prolixus complex using geometric morphometry of hemelytra and heads to evaluate the patterns of intraspecific and interspecific allometry and their taxonomic implications. This method can help in the diagnosis of close species, whose morphological characteristics are insufficient for correct identification. Specimens from five different collections were used, covering the species included in the R.prolixus complex (R.barretti, R.dalessandroi, R.domesticus, R.marabaensis, R.milesi, R.montenegrensis, R.nasutus, R.neglectus, R.neivai, R.prolixus and R.robustus). Morphometric analyses indicated that the hemelytra are not structures with good resolution for separating species and, for this reason, the use of the heads proved to be more adequate for this group (thus allowing differentiation of all species of the R.prolixus complex). The results suggest that R.milesi is a variant of R.neglectus and confirms that R.prolixus and R.robustus are distinct species. Furthermore, we propose the creation of the R.neivai complex comprising R.domesticus and R.neivai.
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Affiliation(s)
- Ana Carolina P. C. Alvarez
- Laboratório de Entomologia, Instituto Oswaldo Cruz, FIOCRUZ, Av. Brasil 4365, Pavilhão Mourisco, sala 214, Rio de Janeiro, RJ, 21040-360, BrazilInstituto Oswaldo CruzRio de JaneiroBrazil
| | - Carolina Dale
- Laboratório de Entomologia, Instituto Oswaldo Cruz, FIOCRUZ, Av. Brasil 4365, Pavilhão Mourisco, sala 214, Rio de Janeiro, RJ, 21040-360, BrazilInstituto Oswaldo CruzRio de JaneiroBrazil
| | - Cleber Galvão
- Laboratório de Entomologia, Instituto Oswaldo Cruz, FIOCRUZ, Av. Brasil 4365, Pavilhão Mourisco, sala 214, Rio de Janeiro, RJ, 21040-360, BrazilInstituto Oswaldo CruzRio de JaneiroBrazil
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Dumonteil E, Herrera C, Marx PA. Safety and preservation of cardiac function following therapeutic vaccination against Trypanosoma cruzi in rhesus macaques. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2023; 56:400-407. [PMID: 36210315 PMCID: PMC10131272 DOI: 10.1016/j.jmii.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/10/2022] [Accepted: 09/20/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Chronic Chagasic cardiomyopathy is responsible for a large disease burden in the Americas, and a therapeutic vaccine would be highly desirable. We tested the safety and efficacy of a therapeutic DNA vaccine encoding antigens TSA-1 and Tc24 for preventing cardiac alterations in experimentally infected macaques. A secondary objective was to evaluate the feasibility of detecting changes in cardiac alterations in these animals. METHODS Naïve rhesus macaques were infected with Trypanosoma cruzi and treated with three doses of DNA vaccines. RESULTS Blood cell counts and chemistry indicated that therapeutic vaccination was safe, as hepatic and renal function appeared unaffected by the vaccination and/or infection with T. cruzi. Electrocardiographic (ECG) recordings indicated that no marked arrhythmias developed up to 7 months post-infection. Univariate analysis of ECG parameters found no significant differences in any of these parameters between vaccinated and control macaques. However, linear discriminant analysis revealed that control macaques presented clear alterations in their ECG patterns at 7 months post-infection, indicative of the onset of conduction defects and cardiac alterations, and these changes were prevented in vaccine treated macaques. CONCLUSIONS This is the first evidence that therapeutic vaccination against T. cruzi can prevent cardiac alterations in non-human primates, strengthening the rationale for developing a human vaccine against Chagas disease.
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Affiliation(s)
- Eric Dumonteil
- Department of Tropical Medicine, School of Public Health and Tropical Medicine, Vector-Borne and Infectious Disease Research Center, Tulane University, New Orleans, LA, USA.
| | - Claudia Herrera
- Department of Tropical Medicine, School of Public Health and Tropical Medicine, Vector-Borne and Infectious Disease Research Center, Tulane University, New Orleans, LA, USA
| | - Preston A Marx
- Department of Tropical Medicine, School of Public Health and Tropical Medicine, Vector-Borne and Infectious Disease Research Center, Tulane University, New Orleans, LA, USA; Division of Microbiology, Tulane National Primate Research Center, Tulane University, Covington, LA, USA
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Matthews S, Tannis A, Puchner KP, Bottazzi ME, Cafferata ML, Comandé D, Buekens P. Estimation of the morbidity and mortality of congenital Chagas disease: A systematic review and meta-analysis. PLoS Negl Trop Dis 2022; 16:e0010376. [PMID: 36342961 PMCID: PMC9671465 DOI: 10.1371/journal.pntd.0010376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 11/17/2022] [Accepted: 10/21/2022] [Indexed: 11/09/2022] Open
Abstract
Chagas disease is caused by the parasite Trypanosoma cruzi which can be transmitted from mother to baby during pregnancy. There is no consensus on the proportion of infected infants with clinical signs of congenital Chagas disease (cCD). The objective of this systematic review is to determine the burden of cCD. Articles from journal inception to 2020 reporting morbidity and mortality associated with cCD were retrieved from academic search databases. Observational studies, randomized-control trials, and studies of babies diagnosed with cCD were included. Studies were excluded if they were case reports or series, without original data, case-control without cCD incidence estimates, and/or did not report number of participants. Two reviewers screened articles for inclusion. To determine pooled proportion of infants with cCD with clinical signs, individual clinical signs, and case-fatality, random effects meta-analysis was performed. We identified 4,531 records and reviewed 4,301, including 47 articles in the narrative summary and analysis. Twenty-eight percent of cCD infants showed clinical signs (95% confidence interval (CI) = 19.0%, 38.5%) and 2.2% of infants died (95% CI = 1.3%, 3.5%). The proportion of infected infants with hepatosplenomegaly was 12.5%, preterm birth 6.0%, low birth weight 5.8%, anemia 4.9%, and jaundice 4.7%. Although most studies did not include a comparison group of non-infected infants, the proportion of infants with cCD with clinical signs at birth are comparable to those with congenital toxoplasmosis (10.0%-30.0%) and congenital cytomegalovirus (10.0%-15.0%). We conclude that cCD burden appears significant, but more studies comparing infected mother-infant dyads to non-infected ones are needed to determine an association of this burden to cCD.
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Affiliation(s)
- Sarah Matthews
- Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America
| | - Ayzsa Tannis
- Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America
| | | | - Maria Elena Bottazzi
- National School of Tropical Medicine, Department of Pediatrics, Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, United States of America
- Texas Children’s Hospital Center for Vaccine Development, Houston, Texas, United States of America
| | - Maria Luisa Cafferata
- Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina
- Unidad de Investigación Clínica y Epidemiológica Montevideo (UNICEM), Montevideo, Uruguay
| | - Daniel Comandé
- Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina
| | - Pierre Buekens
- Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America
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Medina-Rivera M, Cárdenas WB, Erickson D, Mehta S. Gold Nanoshells-Based Lateral Flow Assay for the Detection of Chagas Disease at the Point-of-Care. Am J Trop Med Hyg 2022; 107:323-327. [PMID: 35895419 PMCID: PMC9393437 DOI: 10.4269/ajtmh.21-1119] [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: 10/25/2021] [Accepted: 04/11/2022] [Indexed: 08/03/2023] Open
Abstract
Chagas disease is a neglected parasitic infection and a major public health problem in the Americas. It remains underdiagnosed in the United States and internationally due to the lack of affordable testing and disparities in healthcare, particularly for those most at risk. We describe a proof-of-concept lateral flow immunoassay employing a recombinant Chagas multiantigen conjugated to gold nanoshells (AuNS) to detect circulating human anti-Chagas IgG antibodies. This is one of the first lateral flow immunoassays to capitalize on the larger surface area of AuNS compared with nanoparticles that can help amplify low-magnitude signals. Results were compared with 42 positive and negative Chagas serum samples, of which a subset of 27 samples was validated against an ELISA (Hemagen®). The sensitivity and specificity of our assay were 83% and 95%, respectively. These results suggest that an AuNS-based rapid testing for Chagas disease could facilitate in-field screening/diagnosis with a performance comparable to commercial methods.
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Affiliation(s)
- Melisa Medina-Rivera
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
- Institute for Nutritional Sciences, Global Health, and Technology (INSiGHT), Cornell University, Ithaca, New York
| | - Washington B. Cárdenas
- Laboratorio para Investigaciones Biomédicas, Escuela Superior Politécnica del Litoral, Guayaquil, Guayas, Ecuador
| | - David Erickson
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
- Institute for Nutritional Sciences, Global Health, and Technology (INSiGHT), Cornell University, Ithaca, New York
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, New York
| | - Saurabh Mehta
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
- Institute for Nutritional Sciences, Global Health, and Technology (INSiGHT), Cornell University, Ithaca, New York
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Dantas RO. Management of Esophageal Dysphagia in Chagas Disease. Dysphagia 2021; 36:517-522. [PMID: 33855597 DOI: 10.1007/s00455-021-10297-1] [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: 11/09/2020] [Accepted: 03/25/2021] [Indexed: 11/26/2022]
Abstract
Chagas disease, caused by the infection of the protozoan parasite Trypanosoma cruzi, has clinical consequences in the heart and digestive tract. The most important changes in the digestive tract occur in the esophagus (megaesophagus) and colon (megacolon). Esophageal dysfunction in Chagas disease results from damage of the esophageal myenteric plexus, with loss of esophageal peristalsis, partial or absent lower esophageal sphincter relaxation, and megaesophagus, which characterizes secondary esophageal achalasia. The treatment options for the disease are similar to those for idiopathic achalasia, consisting of diet and behavior changes, drugs, botulinum toxin, peroral endoscopic myotomy (POEM), pneumatic dilation of the lower esophageal sphincter, laparoscopic Heller myotomy, and esophagectomy. Chagas disease causes a life-threatening cardiopathy, and this should be considered when choosing the most appropriate treatment for the disease. While some options are palliative, for temporary relief of dysphagia (such as drugs, botulinum toxin, and pneumatic dilation), other therapies provide a long-term benefit. In this case, POEM stands out as a modern and successful strategy, with good results in more than 90% of the patients. Esophagectomy is the option in Chagas disease patients with advanced megaesophagus, despite the increased risk of complications. In these cases, peroral endoscopic myotomy may be an option, which needs further evaluation.
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Affiliation(s)
- Roberto Oliveira Dantas
- Department of Medicine, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900 - Campus da USP, Ribeirão Preto, SP, Brazil.
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Dumonteil E, Desale H, Tu W, Duhon B, Wolfson W, Balsamo G, Herrera C. Shelter cats host infections with multiple Trypanosoma cruzi discrete typing units in southern Louisiana. Vet Res 2021; 52:53. [PMID: 33823911 PMCID: PMC8025558 DOI: 10.1186/s13567-021-00923-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/12/2021] [Indexed: 11/15/2022] Open
Abstract
Trypanosoma cruzi is a zoonotic parasite endemic in the southern US and the Americas, which may frequently infect dogs, but limited information is available about infections in cats. We surveyed a convenience sample of 284 shelter cats from Southern Louisiana to evaluate T. cruzi infection using serological and PCR tests. Parasites from PCR positive cats were also genotyped by PCR and deep sequencing to assess their genetic diversity. We detected a seropositivity rate for T. cruzi of at least 7.3% (17/234), and 24.6% of cats (70/284) were PCR positive for the parasite. Seropositivity increased with cat age (R2 = 0.91, P = 0.011), corresponding to an incidence of 7.2% ± 1.3 per year, while PCR positivity decreased with age (R2 = 0.93, P = 0.007). Cats were predominantly infected with parasites from TcI and TcVI DTUs, and to a lesser extent from TcIV and TcV DTUs, in agreement with the circulation of these parasite DTUs in local transmission cycles. These results indicate that veterinarians should have a greater awareness of T. cruzi infection in pets and that it would be important to better evaluate the risk for spillover infections in humans.
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Affiliation(s)
- Eric Dumonteil
- Department of Tropical Medicine, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA. .,Vector-Borne and Infectious Disease Research Center, Tulane University, New Orleans, LA, USA.
| | - Hans Desale
- Department of Tropical Medicine, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.,Vector-Borne and Infectious Disease Research Center, Tulane University, New Orleans, LA, USA
| | - Weihong Tu
- Department of Tropical Medicine, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.,Vector-Borne and Infectious Disease Research Center, Tulane University, New Orleans, LA, USA
| | - Brandy Duhon
- School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA
| | - Wendy Wolfson
- School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA
| | - Gary Balsamo
- Infectious Disease Epidemiology Section, Office of Public Health, Department of Health, New Orleans, LA, USA
| | - Claudia Herrera
- Department of Tropical Medicine, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.,Vector-Borne and Infectious Disease Research Center, Tulane University, New Orleans, LA, USA
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Genetic diversity of Trypanosoma cruzi parasites infecting dogs in southern Louisiana sheds light on parasite transmission cycles and serological diagnostic performance. PLoS Negl Trop Dis 2020; 14:e0008932. [PMID: 33332357 PMCID: PMC7775123 DOI: 10.1371/journal.pntd.0008932] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 12/31/2020] [Accepted: 10/29/2020] [Indexed: 02/07/2023] Open
Abstract
Background Chagas disease is a neglected zoonosis of growing concern in the southern US, caused by the parasite Trypanosoma cruzi. We genotyped parasites in a large cohort of PCR positive dogs to shed light on parasite transmission cycles and assess potential relationships between parasite diversity and serological test performance. Methodology/principal findings We used a metabarcoding approach based on deep sequencing of T. cruzi mini-exon marker to assess parasite diversity. Phylogenetic analysis of 178 sequences from 40 dogs confirmed the presence of T. cruzi discrete typing unit (DTU) TcI and TcIV, as well as TcII, TcV and TcVI for the first time in US dogs. Infections with multiple DTUs occurred in 38% of the dogs. These data indicate a greater genetic diversity of T. cruzi than previously detected in the US. Comparison of T. cruzi sequence diversity indicated that highly similar T. cruzi strains from these DTUs circulate in hosts and vectors in Louisiana, indicating that they are involved in a shared T. cruzi parasite transmission cycle. However, TcIV and TcV were sampled more frequently in vectors, while TcII and TcVI were sampled more frequently in dogs. Conclusions/significance These observations point to ecological host-fitting being a dominant mechanism involved in the diversification of T. cruzi-host associations. Dogs with negative, discordant or confirmed positive T. cruzi serology harbored TcI parasites with different mini-exon sequences, which strongly supports the hypothesis that parasite genetic diversity is a key factor affecting serological test performance. Thus, the identification of conserved parasite antigens should be a high priority for the improvement of current serological tests. Chagas disease is a neglected zoonosis of growing concern in the southern US, caused by the parasite Trypanosoma cruzi. Here we analyzed the parasite genetic diversity in a large cohort of infected dogs to better understand parasite transmission cycles and assess potential relationships between parasite diversity and serological test performance. We used DNA sequencing of a well characterized T. cruzi genetic marker to assess parasite diversity. We confirmed the presence of T. cruzi lineages TcI and TcIV, and report TcII, TcV and TcVI for the first time in US dogs. Parasite lineages TcIV TcII and TcVI appeared more frequent in dogs compared to insect vectors. Dogs with negative, discordant or confirmed positive T. cruzi serology harbored genetically different TcI parasites, which shows that parasite genetic diversity is a key factor affecting serological test performance. Thus, the identification of parasite antigens conserved across strains and lineages should be a high priority for the improvement of current serological tests.
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Dumonteil E, Herrera C, Tu W, Goff K, Fahlberg M, Haupt E, Kaur A, Marx PA, Ortega-Lopez J, Hotez PJ, Bottazzi ME. Safety and immunogenicity of a recombinant vaccine against Trypanosoma cruzi in Rhesus macaques. Vaccine 2020; 38:4584-4591. [PMID: 32417142 DOI: 10.1016/j.vaccine.2020.05.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 04/21/2020] [Accepted: 05/05/2020] [Indexed: 11/30/2022]
Abstract
Chagas disease, caused by the protozoan parasite Trypanosoma cruzi is one of the most important neglected parasitic diseases in the Americas. Vaccines represent an attractive complementary strategy for the control of T. cruzi infection and pre-clinical studies in mice demonstrated that trypomastigote surface antigen (TSA-1) and the flagellar calcium-binding (Tc24) parasite antigens are promising candidates for vaccine development. We performed here the first evaluation of the safety and immunogenicity of two recombinant vaccine antigens (named TSA1-C4 and Tc24-C4) in naïve non-human primates. Three rhesus macaques received 3 doses of each recombinant protein, formulated with E6020 (Eisai Co., Ltd.), a novel Toll-like receptor-4 agonist, in a stable emulsion. All parameters from blood chemistry and blood cell counts were stable over the course of the study and unaffected by the vaccine. A specific IgG response against both antigens was detectable after the first vaccine dose, and increased with the second dose. After three vaccine doses, stimulation of PBMCs with a peptide pool derived from TSA1-C4 resulted in the induction of TSA1-C4-specific TNFα-, IL-2- and IFNγ-producing CD4+ in one or two animals while stimulation with a peptide pool derived from Tc24-C4 only activated IFNγ-producing CD4+T cells in one animal. In two animals there was also activation of TSA1-C4-specific IL2-producing CD8+ T cells. This is the first report of the immunogenicity of T. cruzi-derived recombinant antigens formulated as an emulsion with a TLR4 agonist in a non-human primate model. Our results strongly support the need for further evaluation of the preventive efficacy of this type of vaccine in non-human primates and explore the effect of the vaccine in a therapeutic model of naturally-infected Chagasic non-human primates, which would strengthen the rationale for the clinical development as a human vaccine against Chagas disease.
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Affiliation(s)
- Eric Dumonteil
- Department of Tropical Medicine, School of Public Health and Tropical Medicine, and Vector-Borne and Infectious Disease Research Center, Tulane University, New Orleans, LA, USA.
| | - Claudia Herrera
- Department of Tropical Medicine, School of Public Health and Tropical Medicine, and Vector-Borne and Infectious Disease Research Center, Tulane University, New Orleans, LA, USA
| | - Weihong Tu
- Department of Tropical Medicine, School of Public Health and Tropical Medicine, and Vector-Borne and Infectious Disease Research Center, Tulane University, New Orleans, LA, USA
| | - Kelly Goff
- Division of Microbiology, Tulane National Primate Research Center, Tulane University, Covington, LA, USA
| | - Marissa Fahlberg
- Division of Immunology, Tulane National Primate Research Center, Tulane University, Covington, LA, USA
| | - Erin Haupt
- Division of Immunology, Tulane National Primate Research Center, Tulane University, Covington, LA, USA
| | - Amitinder Kaur
- Division of Immunology, Tulane National Primate Research Center, Tulane University, Covington, LA, USA
| | - Preston A Marx
- Department of Tropical Medicine, School of Public Health and Tropical Medicine, and Vector-Borne and Infectious Disease Research Center, Tulane University, New Orleans, LA, USA; Division of Microbiology, Tulane National Primate Research Center, Tulane University, Covington, LA, USA
| | - Jaime Ortega-Lopez
- Departmento de Biotecnología y Bioingeniería, CINVESTAV, Mexico, D.F., Mexico
| | - Peter J Hotez
- Texas Children's Hospital Center for Vaccine Development, Department of Pediatrics and National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Maria Elena Bottazzi
- Texas Children's Hospital Center for Vaccine Development, Department of Pediatrics and National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA
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Chagas disease: Historic perspective. Biochim Biophys Acta Mol Basis Dis 2020; 1866:165689. [DOI: 10.1016/j.bbadis.2020.165689] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 01/02/2020] [Accepted: 01/15/2020] [Indexed: 12/13/2022]
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Ruiz-Márvez E, Ramírez CA, Rodríguez ER, Flórez MM, Delgado G, Guzmán F, Gómez-Puertas P, Requena JM, Puerta CJ. Molecular Characterization of Tc964, A Novel Antigenic Protein from Trypanosoma cruzi. Int J Mol Sci 2020; 21:E2432. [PMID: 32244527 PMCID: PMC7177413 DOI: 10.3390/ijms21072432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/15/2020] [Accepted: 03/17/2020] [Indexed: 11/16/2022] Open
Abstract
The Tc964 protein was initially identified by its presence in the interactome associated with the LYT1 mRNAs, which code for a virulence factor of Trypanosoma cruzi. Tc964 is annotated in the T. cruzi genome as a hypothetical protein. According to phylogenetic analysis, the protein is conserved in the different genera of the Trypanosomatidae family; however, recognizable orthologues were not identified in other groups of organisms. Therefore, as a first step, an in-depth molecular characterization of the Tc946 protein was carried out. Based on structural predictions and molecular dynamics studies, the Tc964 protein would belong to a particular class of GTPases. Subcellular fractionation analysis indicated that Tc964 is a nucleocytoplasmic protein. Additionally, the protein was expressed as a recombinant protein in order to analyze its antigenicity with sera from Chagas disease (CD) patients. Tc964 was found to be antigenic, and B-cell epitopes were mapped by the use of synthetic peptides. In parallel, the Leishmania major homologue (Lm964) was also expressed as recombinant protein and used for a preliminary evaluation of antigen cross-reactivity in CD patients. Interestingly, Tc964 was recognized by sera from Chronic CD (CCD) patients at different stages of disease severity, but no reactivity against this protein was observed when sera from Colombian patients with cutaneous leishmaniasis were analyzed. Therefore, Tc964 would be adequate for CD diagnosis in areas where both infections (CD and leishmaniasis) coexist, even though additional assays using larger collections of sera are needed in order to confirm its usefulness for differential serodiagnosis.
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Affiliation(s)
- Elizabeth Ruiz-Márvez
- Grupo de Investigación en Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Carrera 7 # 40- 62, Bogotá, Colombia; (E.R.-M.); (C.A.R.); (E.R.R.)
| | - César Augusto Ramírez
- Grupo de Investigación en Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Carrera 7 # 40- 62, Bogotá, Colombia; (E.R.-M.); (C.A.R.); (E.R.R.)
| | - Eliana Rocío Rodríguez
- Grupo de Investigación en Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Carrera 7 # 40- 62, Bogotá, Colombia; (E.R.-M.); (C.A.R.); (E.R.R.)
| | - Magda Mellisa Flórez
- Grupo de Investigación en Inmunotoxicología, Departamento de Farmacia, Facultad de Ciencias, Universidad Nacional de Colombia, Carrera 30 # 45-01, Bogota; Colombia; (M.M.F.); (G.D.)
| | - Gabriela Delgado
- Grupo de Investigación en Inmunotoxicología, Departamento de Farmacia, Facultad de Ciencias, Universidad Nacional de Colombia, Carrera 30 # 45-01, Bogota; Colombia; (M.M.F.); (G.D.)
| | - Fanny Guzmán
- Núcleo de Biotecnología Curauma (NBC), Pontificia Universidad Católica de Valparaiso, Avenida Universidad 2373223, Curauma, Valparaiso-Chile;
| | - Paulino Gómez-Puertas
- Grupo de Modelado Molecular del Centro de Biología Molecular Severo Ochoa, Microbes in Health and Welfare Department, Universidad Autónoma de Madrid (CBMSO, CSIC-UAM), 28049 Madrid, Spain;
| | - José María Requena
- Grupo Regulación de la Expresión Génica en Leishmania del Centro de Biología Molecular Severo Ochoa, Molecular Biology Department, Universidad Autónoma de Madrid (CBMSO, CSIC-UAM), 28049 Madrid, Spain;
| | - Concepción J. Puerta
- Grupo de Investigación en Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Carrera 7 # 40- 62, Bogotá, Colombia; (E.R.-M.); (C.A.R.); (E.R.R.)
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Capelini C, Câmara VRF, Villar JDF, Barbosa JMC, Salomão K, de Castro SL, Junior PAS, Murta SMF, Couto TB, Lourenço MCS, Wardell JL, Low JN, da Silva EF, Carvalho SA. Synthesis, Antitrypanosomal and Antimycobacterial Activities of Coumarin N-acylhydrazonic Derivatives. Med Chem 2020; 17:630-637. [PMID: 31965946 DOI: 10.2174/1573406416666200121105215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 12/10/2019] [Accepted: 12/10/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Near to 5-7 million people are infected with T. cruzi in the world, and about 10,000 people per year die of problems associated with this disease. METHODS Herein, the synthesis, antitrypanosomal and antimycobacterial activities of seventeen coumarinic N-acylhydrazonic derivatives have been reported. RESULTS These compounds were synthesized using methodology with reactions global yields ranging from 46%-70%. T. cruzi in vitro effects were evaluated against trypomastigote and amastigote, forming M. tuberculosis activity towards H37Rv sensitive strain and resistant strains. DISCUSSION Against T. cruzi, the more active compounds revealed only moderate activity IC50/96h~20 μM for both trypomastigotes and amastigotes intracellular forms. (E)-2-oxo-N'- (3,4,5-trimethoxybenzylidene)-2H-chromene-3-carbohydrazide showed meaningful activity in INH resistant/RIP resistant strain. CONCLUSION These compound acting as multitarget could be good leads for the development of new trypanocidal and bactericidal agents.
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Affiliation(s)
- Camila Capelini
- Instituto de Tecnologia em Farmacos - Farmanguinhos, Fundacao Oswaldo Cruz, 21041-250 Rio de Janeiro, RJ, Brazil
| | - Vitória R F Câmara
- Instituto de Tecnologia em Farmacos - Farmanguinhos, Fundacao Oswaldo Cruz, 21041-250 Rio de Janeiro, RJ, Brazil
| | - José D Figueroa Villar
- Grupo de Quimica Medicinal, Departamento de Quimica, Instituto Militar de Engenharia, Praca General Tiburcio 80, 22290-270 Rio de Janeiro, Brazil
| | - Juliana M C Barbosa
- Laboratório de Biologia Celular, Instituto Oswaldo Cruz, Fundacao Oswaldo Cruz, 21040-900, Rio de Janeiro, RJ, Brazil
| | - Kelly Salomão
- Laboratório de Biologia Celular, Instituto Oswaldo Cruz, Fundacao Oswaldo Cruz, 21040-900, Rio de Janeiro, RJ, Brazil
| | - Solange L de Castro
- Laboratório de Biologia Celular, Instituto Oswaldo Cruz, Fundacao Oswaldo Cruz, 21040-900, Rio de Janeiro, RJ, Brazil
| | - Policarpo A S Junior
- Instituto Rene Rachou - Fundacao Oswaldo Cruz, 30190002 - Belo Horizonte, MG, Brazil
| | - Silvane M F Murta
- Instituto Rene Rachou - Fundacao Oswaldo Cruz, 30190002 - Belo Horizonte, MG, Brazil
| | - Thais B Couto
- Instituto Nacional de Infectologia Evandro Chagas, Fundacao Oswaldo Cruz, 21045-900 Rio de Janeiro, RJ, Brazil
| | - Maria C S Lourenço
- Instituto Nacional de Infectologia Evandro Chagas, Fundacao Oswaldo Cruz, 21045-900 Rio de Janeiro, RJ, Brazil
| | - James L Wardell
- Instituto de Tecnologia em Farmacos - Farmanguinhos, Fundacao Oswaldo Cruz, 21041-250 Rio de Janeiro, RJ, Brazil
| | - John N Low
- Department of Chemistry, University of Aberdeen, Old Aberdeen, AB 24 3 UE, Scotland, United Kingdom
| | - Edson F da Silva
- Instituto de Tecnologia em Farmacos - Farmanguinhos, Fundacao Oswaldo Cruz, 21041-250 Rio de Janeiro, RJ, Brazil
| | - Samir A Carvalho
- Instituto de Tecnologia em Farmacos - Farmanguinhos, Fundacao Oswaldo Cruz, 21041-250 Rio de Janeiro, RJ, Brazil
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Bates BR, Villacís AG, Mendez-Trivino A, Mendoza LE, Grijalva MJ. Determinants of intentions to prevent triatomine infestation based on the health belief model: An application in rural southern Ecuador. PLoS Negl Trop Dis 2020; 14:e0007987. [PMID: 31999721 PMCID: PMC6991950 DOI: 10.1371/journal.pntd.0007987] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 12/11/2019] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Control of triatomine infestation is a key strategy for the prevention of Chagas disease (CD). To promote this strategy, it is important to know which antecedents to behavioral change are the best to emphasize when promoting prevention. OBJECTIVE The aim of this study was to determine predictors for intention to prevent home infestation based on the Health Belief Model (HBM), a commonly used health intervention planning theory. MATERIALS & METHODS A cross-sectional study was conducted with 112 heads of household in six communities with endemic and high rates of triatomine infestation in Loja province, Ecuador. The data was collected by a questionnaire including perceived severity, susceptibility, benefits to action, barriers to action, and self-efficacy. These data were also used to predict actual infestation of homes. RESULTS Community members reported strong intentions to prevent home infestation. HBM constructs predicted about 14% of the observed variance in intentions. Perceived susceptibility and severity did not predict behavioral intention well; perceived barriers to small-scale action that reduce likelihood of infestation and self-efficacy in participating in surveillance systems did. Self-efficacy and perception of barriers were equally powerful predictors. The HBM constructs, however, did not predict well actual infestation. CONCLUSION The findings supported the HBM as a way to predict intentions to prevent infestation of the home by triatomine bugs. The findings highlight that messages emphasizing self-efficacy in participating in surveillance systems and overcoming barriers to small-scale action that reduce likelihood of infestation, rather than a focus on risk, should be central messages when designing and implementing educational interventions for CD. The gap between behavioral intention and actual infestation reveals the need to assess home practices and their actual efficacy to fully enact and apply the HBM.
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Affiliation(s)
- Benjamin R. Bates
- School of Communication Studies, Ohio University, Athens, OH, United States of America
- Infectious and Tropical Disease Institute, Biomedical Sciences Department, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, United States of America
- Center for International Studies, Ohio University, Athens, OH, United States of America
| | - Anita G. Villacís
- Infectious and Tropical Disease Institute, Biomedical Sciences Department, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, United States of America
- Centro de Investigación para la Salud en América Latina, Escuela de Ciencias Biológicas, Facultad de Ciencias Exactas y Naturales, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | - Angela Mendez-Trivino
- Infectious and Tropical Disease Institute, Biomedical Sciences Department, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, United States of America
- Center for International Studies, Ohio University, Athens, OH, United States of America
| | - Luis E. Mendoza
- Infectious and Tropical Disease Institute, Biomedical Sciences Department, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, United States of America
- Center for International Studies, Ohio University, Athens, OH, United States of America
| | - Mario J. Grijalva
- Infectious and Tropical Disease Institute, Biomedical Sciences Department, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, United States of America
- Center for International Studies, Ohio University, Athens, OH, United States of America
- Centro de Investigación para la Salud en América Latina, Escuela de Ciencias Biológicas, Facultad de Ciencias Exactas y Naturales, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
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Reed SL, McKerrow JH. Why Funding for Neglected Tropical Diseases Should Be a Global Priority. Clin Infect Dis 2019; 67:323-326. [PMID: 29688342 DOI: 10.1093/cid/ciy349] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 04/19/2018] [Indexed: 01/01/2023] Open
Abstract
Neglected tropical diseases affect >1 billion of the world's poorest persons. Control programs range from near-elimination (dracunculiasis) to increasing prevalence (dengue and cutaneous leishmaniasis). These are some of the most cost-effective public health interventions and should be a global priority.
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Affiliation(s)
- Sharon L Reed
- Departments of Pathology and Medicine, UC San Diego Health
| | - James H McKerrow
- Skaggs School of Pharmacy and Pharmaceutical Science, University of California, San Diego
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High prevalence of Trypanosoma cruzi infection in shelter dogs from southern Louisiana, USA. Parasit Vectors 2019; 12:322. [PMID: 31238941 PMCID: PMC6593594 DOI: 10.1186/s13071-019-3572-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 06/19/2019] [Indexed: 01/14/2023] Open
Abstract
Background Chagas disease is a zoonotic disease caused by the protozoan parasite Trypanosoma cruzi. The role of dogs as sentinels has been proposed in multiple regions, as they are a domestic reservoir for T. cruzi. Our objective was to determine the prevalence of T. cruzi infection in shelter dogs from southern Louisiana, and assess its magnitude and distribution. Results A total of 540 dogs were enrolled, from 20 animal shelters, and tested for T. cruzi infection by serological tests (rapid test, ELISA and western blot) and PCR. We documented a high prevalence of T. cruzi infection with at least 6.9% (95% CI: 5.0–9.3%) seropositive and 15.7% (95% CI: 12.9–19.1%) PCR-positive dogs. Serological tests showed limited agreement, and concordance between serology and PCR was higher when considering reactivity to single serological tests. Trypanosoma cruzi infection was distributed evenly among shelters. Infection was significantly correlated with age (R2 = 0.99), indicating an incidence of new cases of 2.27 ± 0.25% per year. Conclusion Trypanosoma cruzi infection is a significant and widespread veterinary problem in shelter dogs in the region, although it is mostly unnoticed by health professionals. This highlights the need for greater awareness of T. cruzi infection among the veterinary community and dog owners. Electronic supplementary material The online version of this article (10.1186/s13071-019-3572-y) contains supplementary material, which is available to authorized users.
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Arnal A, Waleckx E, Rico-Chávez O, Herrera C, Dumonteil E. Estimating the current burden of Chagas disease in Mexico: A systematic review and meta-analysis of epidemiological surveys from 2006 to 2017. PLoS Negl Trop Dis 2019; 13:e0006859. [PMID: 30964871 PMCID: PMC6474657 DOI: 10.1371/journal.pntd.0006859] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 04/19/2019] [Accepted: 03/15/2019] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND In Mexico, estimates of Chagas disease prevalence and burden vary widely. Updating surveillance data is therefore an important priority to ensure that Chagas disease does not remain a barrier to the development of Mexico's most vulnerable populations. METHODOLOGY/PRINCIPAL FINDINGS The aim of this systematic review and meta-analysis was to analyze the literature on epidemiological surveys to estimate Chagas disease prevalence and burden in Mexico, during the period 2006 to 2017. A total of 2,764 articles were screened and 36 were retained for the final analysis. Epidemiological surveys have been performed in most of Mexico, but with variable study scale and geographic coverage. Based on studies reporting confirmed cases (i.e. using at least 2 serological tests), and taking into account the differences in sample sizes, the national estimated seroprevalence of Trypanosoma cruzi infection was 3.38% [95%CI 2.59-4.16], suggesting that there are 4.06 million cases in Mexico. Studies focused on pregnant women, which may transmit the parasite to their newborn during pregnancy, reported an estimated seroprevalence of 2.21% [95%CI 1.46-2.96], suggesting that there are 50,675 births from T. cruzi infected pregnant women per year, and 3,193 cases of congenitally infected newborns per year. Children under 18 years had an estimated seropositivity rate of 1.51% [95%CI 0.77-2.25], which indicate ongoing transmission. Cases of T. cruzi infection in blood donors have also been reported in most states, with a national estimated seroprevalence of 0.55% [95%CI 0.43-0.66]. CONCLUSIONS/SIGNIFICANCE Our analysis suggests a disease burden for T. cruzi infection higher than previously recognized, highlighting the urgency of establishing Chagas disease surveillance and control as a key national public health priority in Mexico, to ensure that it does not remain a major barrier to the economic and social development of the country's most vulnerable populations.
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Affiliation(s)
- Audrey Arnal
- Departamento de Ecología de la Biodiversidad, Instituto de Ecología, Universidad Nacional Autónoma de México, Ciudad de México, México
- Centro de Investigaciones Regionales Dr Hideyo Noguchi, Universidad Autónoma de Yucatán, calle 96 s/n x av. Jacinto Canek y calle 47, Col. Paseo de las Fuentes, CP 97225, Mérida, Yucatán, México
| | - Etienne Waleckx
- Centro de Investigaciones Regionales Dr Hideyo Noguchi, Universidad Autónoma de Yucatán, calle 96 s/n x av. Jacinto Canek y calle 47, Col. Paseo de las Fuentes, CP 97225, Mérida, Yucatán, México
- Institut de Recherche pour le Développement, UMR INTERTRYP IRD, CIRAD, Université de Montpellier, Montpellier, France
| | - Oscar Rico-Chávez
- Departamento de Etología, Fauna Silvestre y Animales de Laboratorio, Facultad de Medicina Veterinaria Zootecnia, Universidad Nacional Autónoma de México, 04510 Ciudad de México, México
| | - Claudia Herrera
- Department of Tropical Medicine, School of Public Health and Tropical Medicine, and Vector-Borne and Infectious Disease Research Center, Tulane University, 1440 Canal St., New Orleans, LA 70112, United States of America
| | - Eric Dumonteil
- Department of Tropical Medicine, School of Public Health and Tropical Medicine, and Vector-Borne and Infectious Disease Research Center, Tulane University, 1440 Canal St., New Orleans, LA 70112, United States of America
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Dumonteil E, Herrera C, Buekens P. A therapeutic preconceptional vaccine against Chagas disease: A novel indication that could reduce congenital transmission and accelerate vaccine development. PLoS Negl Trop Dis 2019; 13:e0006985. [PMID: 30703092 PMCID: PMC6354953 DOI: 10.1371/journal.pntd.0006985] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- Eric Dumonteil
- Department of Tropical Medicine, School of Public Health and Tropical Medicine, and Vector Borne and Infectious Disease Research Center, Tulane University, New Orleans, Louisiana, United States of America
- * E-mail:
| | - Claudia Herrera
- Department of Tropical Medicine, School of Public Health and Tropical Medicine, and Vector Borne and Infectious Disease Research Center, Tulane University, New Orleans, Louisiana, United States of America
| | - Pierre Buekens
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, United States of America
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Borges Migliavaca C, Stein C, Colpani V, René Pinto de Sousa Miguel S, Nascimento Cruz L, Oliveira Dantas R, Falavigna M. Isosorbide and nifedipine for Chagas' megaesophagus: A systematic review and meta-analysis. PLoS Negl Trop Dis 2018; 12:e0006836. [PMID: 30265663 PMCID: PMC6179300 DOI: 10.1371/journal.pntd.0006836] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 10/10/2018] [Accepted: 09/11/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Chagas disease is a neglected tropical disease. About 6 to 8 million people are chronically infected and 10% to 15% develop irreversible gastrointestinal disorders, including megaesophagus. Treatment focuses on improving symptoms, and isosorbide and nifedipine may be used for this purpose. METHODOLOGY We conducted a systematic review to evaluate the effectiveness of pharmacological treatment for Chagas' megaesophagus. We searched MEDLINE, Embase and LILACS databases up to January 2018. We included both observational studies and RCTs evaluating the effects of isosorbide or nifedipine in adult patients with Chagas' megaesophagus. Two reviewers screened titles and abstracts, selected eligible studies and extracted data. We assessed the risk of bias using NIH 'Quality Assessment Tool for Before-After (Pre-Post) Studies with No Control Group' and RoB 2.0 tool. Overall quality of evidence was assessed using GRADE. PRINCIPAL FINDINGS We included eight studies (four crossover RCTs, four before-after studies). Three studies evaluated the effect of isosorbide on lower esophageal sphincter pressure (LESP), showing a significant reduction (mean difference -10.52mmHg, 95%CI -13.57 to-7.47, very low quality of evidence). Three studies reported the effect of isosorbide on esophageal emptying, showing a decrease in esophageal retention rates (mean difference -22.16%, 95%CI -29.94 to -14.38, low quality of evidence). In one study, patients on isosorbide reported improvement in the frequency and severity of dysphagia (moderate quality of evidence). Studies evaluating nifedipine observed a decrease in LESP but no effect on esophageal emptying (very low and low quality of evidence, respectively). Isosorbide had a higher incidence of headache as a side effect than nifedipine. CONCLUSIONS Although limited, available evidence shows that both isosorbide and nifedipine are effective in reducing esophageal symptoms. Isosorbide appears to be more effective, and its use is supported by a larger number of studies; nifedipine, however, appears to have a better tolerability profile. TRIAL REGISTRATION PROSPERO CRD42017055143. ClinicalTrials.gov CRD42017055143.
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Affiliation(s)
- Celina Borges Migliavaca
- Institute for Education and Research, Hospital Moinhos de Vento, Porto Alegre, Brazil
- Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Cinara Stein
- Institute for Education and Research, Hospital Moinhos de Vento, Porto Alegre, Brazil
| | - Verônica Colpani
- Institute for Education and Research, Hospital Moinhos de Vento, Porto Alegre, Brazil
- Centro Universitário FADERGS, Porto Alegre, Brazil
- Faculdade Meridional–IMED, Passo Fundo, Brazil
| | - Sandro René Pinto de Sousa Miguel
- Institute for Education and Research, Hospital Moinhos de Vento, Porto Alegre, Brazil
- National Institute of Science and Technology for Health Technology Assessment, Post Graduate Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Luciane Nascimento Cruz
- Institute for Education and Research, Hospital Moinhos de Vento, Porto Alegre, Brazil
- National Institute of Science and Technology for Health Technology Assessment, Post Graduate Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Roberto Oliveira Dantas
- Department of Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Maicon Falavigna
- Institute for Education and Research, Hospital Moinhos de Vento, Porto Alegre, Brazil
- National Institute of Science and Technology for Health Technology Assessment, Post Graduate Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Department of Health Research Methods, Evidence and Impact, McMaster University Health Sciences Centre, Hamilton, Canada
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Berger BA, Bartlett AH, Jiménez-Hernández R, Trinidad Vázquez E, Galindo-Sevilla N. Physician Knowledge, Attitudes, and Practices Related to Chagas Disease in Tabasco, Mexico. Am J Trop Med Hyg 2018; 98:1743-1747. [PMID: 29692299 PMCID: PMC6086191 DOI: 10.4269/ajtmh.17-0495] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 03/11/2018] [Indexed: 12/27/2022] Open
Abstract
We designed and implemented a survey of physician knowledge, attitudes, and practices with respect to Chagas disease in the state of Tabasco, Mexico. Seventy-eight public sector physicians from across the state responded via Research Electronic Data Capture, an online survey capture tool. Improved performance on knowledge-based questions (P < 0.01) and an increase in decisions to screen (P = 0.04) were associated with previous training specific to this disease. Our results provide important descriptive information regarding knowledge, attitudes, and practices among a group of public sector Mexican doctors and highlight the importance of Chagas disease-specific physician training for identification and, ultimately, treatment of patients affected by this disease.
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Affiliation(s)
- Brandon A. Berger
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois
| | - Allison H. Bartlett
- Section of Infectious Disease, University of Chicago Comer Children’s Hospital, Chicago, Illinois
| | - Ricardo Jiménez-Hernández
- Dirección de Calidad y Educación en Salud, Secretaria de Salud de Tabasco, Villahermosa, Tabasco, Mexico
| | - Esmelin Trinidad Vázquez
- Dirección de Calidad y Educación en Salud, Secretaria de Salud de Tabasco, Villahermosa, Tabasco, Mexico
| | - Norma Galindo-Sevilla
- Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
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Franco J, Scarone L, Comini MA. Drugs and Drug Resistance in African and American Trypanosomiasis. ANNUAL REPORTS IN MEDICINAL CHEMISTRY 2018. [DOI: 10.1016/bs.armc.2018.08.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Keller JI, Ballif BA, St. Clair RM, Vincent JJ, Monroy MC, Stevens L. Chagas disease vector blood meal sources identified by protein mass spectrometry. PLoS One 2017; 12:e0189647. [PMID: 29232402 PMCID: PMC5726658 DOI: 10.1371/journal.pone.0189647] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 11/29/2017] [Indexed: 02/08/2023] Open
Abstract
Chagas disease is a complex vector borne parasitic disease involving blood feeding Triatominae (Hemiptera: Reduviidae) insects, also known as kissing bugs, and the vertebrates they feed on. This disease has tremendous impacts on millions of people and is a global health problem. The etiological agent of Chagas disease, Trypanosoma cruzi (Kinetoplastea: Trypanosomatida: Trypanosomatidae), is deposited on the mammalian host in the insect’s feces during a blood meal, and enters the host’s blood stream through mucous membranes or a break in the skin. Identifying the blood meal sources of triatomine vectors is critical in understanding Chagas disease transmission dynamics, can lead to identification of other vertebrates important in the transmission cycle, and aids management decisions. The latter is particularly important as there is little in the way of effective therapeutics for Chagas disease. Several techniques, mostly DNA-based, are available for blood meal identification. However, further methods are needed, particularly when sample conditions lead to low-quality DNA or to assess the risk of human cross-contamination. We demonstrate a proteomics-based approach, using liquid chromatography tandem mass spectrometry (LC-MS/MS) to identify host-specific hemoglobin peptides for blood meal identification in mouse blood control samples and apply LC-MS/MS for the first time to Triatoma dimidiata insect vectors, tracing blood sources to species. In contrast to most proteins, hemoglobin, stabilized by iron, is incredibly stable even being preserved through geologic time. We compared blood stored with and without an anticoagulant and examined field-collected insect specimens stored in suboptimal conditions such as at room temperature for long periods of time. To our knowledge, this is the first study using LC-MS/MS on field-collected arthropod disease vectors to identify blood meal composition, and where blood meal identification was confirmed with more traditional DNA-based methods. We also demonstrate the potential of synthetic peptide standards to estimate relative amounts of hemoglobin acquired when insects feed on multiple blood sources. These LC-MS/MS methods can contribute to developing Ecohealth control strategies for Chagas disease transmission and can be applied to other arthropod disease vectors.
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Affiliation(s)
- Judith I. Keller
- Department of Biology, University of Vermont, Burlington, Vermont, United States of America
| | - Bryan A. Ballif
- Department of Biology, University of Vermont, Burlington, Vermont, United States of America
- * E-mail: (LS); (BAB)
| | - Riley M. St. Clair
- Department of Biology, University of Vermont, Burlington, Vermont, United States of America
| | - James J. Vincent
- Department of Biology, University of Vermont, Burlington, Vermont, United States of America
| | - M. Carlota Monroy
- Department of Biology, University of Vermont, Burlington, Vermont, United States of America
- Laboratorio de Entomología Aplicada y Parasitología, Escuela de Biología, Facultad de Ciencias Químicas y Farmacia, Universidad de San Carlos de Guatemala, Ciudad de Guatemala, Guatemala
| | - Lori Stevens
- Department of Biology, University of Vermont, Burlington, Vermont, United States of America
- * E-mail: (LS); (BAB)
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Abstract
The nonischemic cardiomyopathies are a diverse group of cardiac disorders that frequently cause heart failure and death and are now recognized with increasing frequency. There has been substantial progress in the clinical recognition and understanding of the natural history of these conditions. Well-established and new techniques of cardiac imaging are also helpful in this regard. Basic scientists are elucidating the pathogenesis and pathobiology of individual cardiomyopathies. In this compendium, some of the most important advances in this field are reviewed. Scientific opportunities to enhance further collaborative research to accelerate progress are identified.
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Affiliation(s)
- Eugene Braunwald
- From the TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
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