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Gryschek RCB, Corral MA, Sitta RB, Gottardi M, Pierrotti LC, Costa SF, Abdala E, Chieffi PP, de Paula FM. Strongyloides infection screening in transplant candidates: What is the best strategy? Transpl Infect Dis 2023; 25:e14153. [PMID: 37750481 DOI: 10.1111/tid.14153] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/04/2023] [Accepted: 09/05/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND The potential that Strongyloides stercoralis infection has to cause major morbidity and high mortality when the disseminated form occurs in transplant patients is of particular concern. METHODS In this study, the objective was to observe S. stercoralis infection in patients who are candidates for transplantation by using parasitological, serological, and molecular techniques and to propose an algorithm for the detection of that infection in transplant candidates. RESULTS By parasitological techniques, 10% of fecal samples were positive. Anti-Strongyloides antibodies immunoglobulin G were detected in 19.3% and 20.7% of patients by immunofluorescence assay and enzyme-linked immunosorbent assay, respectively. S. stercoralis DNA was observed in 17.3% of samples by conventional polymerase chain reaction and 32.7% of samples by quantitative polymerase chain reaction (qPCR). CONCLUSION The set of results allows us to reinforce that a positive result by parasitological techniques and/or qPCR indicates that the specific treatment should be applied. However, the improvement of diagnostic techniques may suggest changes in the screening for strongyloidiasis in these patients.
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Affiliation(s)
- Ronaldo Cesar Borges Gryschek
- Laboratório de Investigação Médica (LIM/06), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - Marcelo Andreetta Corral
- Laboratório de Investigação Médica (LIM/06), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - Renata Barnabé Sitta
- Laboratório de Investigação Médica (LIM/06), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - Maiara Gottardi
- Laboratório de Investigação Médica (LIM/06), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - Ligia Camera Pierrotti
- Immunosuppressed Infection Group, Divisão de Moléstias Infecciosas e Parasitárias do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - Silvia Figueiredo Costa
- Immunosuppressed Infection Group, Divisão de Moléstias Infecciosas e Parasitárias do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - Edson Abdala
- Immunosuppressed Infection Group, Divisão de Moléstias Infecciosas e Parasitárias do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - Pedro Paulo Chieffi
- Faculdade de Ciências Médicas da Santa Casa de Misericórdia de São Paulo, Sao Paulo, Brazil
| | - Fabiana Martins de Paula
- Laboratório de Investigação Médica (LIM/06), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
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Corral MA, Gonçalves ALR, Costa IN, Abdala E, Pierrotti LC, Chieffi PP, Costa‐Cruz JM, Gryschek RCB, Martins de Paula F. Immune complexes as a tool for strongyloidiasis immunodiagnosis in kidney and liver transplant candidate. Parasite Immunol 2022; 44:e12920. [DOI: 10.1111/pim.12920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 04/07/2022] [Accepted: 04/11/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Marcelo A. Corral
- Laboratório de Investigação Médica (LIM‐06), Hospital das Clínicas da Faculdade de Medicina Universidade de São Paulo São Paulo Brazil
| | - Ana Lucia R. Gonçalves
- Laboratório de Diagnóstico de Parasitoses Universidade Federal de Uberlândia Uberlândia Minas Gerais Brazil
| | - Idessania N. Costa
- Departamento de Ciências Patológicas, Laboratório de Imunoparasitologia das Doenças Negligenciadas e Câncer Universidade Estadual de Londrina Paraná Brazil
| | - Edson Abdala
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo São Paulo Brazil
| | - Ligia C. Pierrotti
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo São Paulo Brazil
| | | | - Julia Maria Costa‐Cruz
- Laboratório de Diagnóstico de Parasitoses Universidade Federal de Uberlândia Uberlândia Minas Gerais Brazil
| | - Ronaldo Cesar B. Gryschek
- Laboratório de Investigação Médica (LIM‐06), Hospital das Clínicas da Faculdade de Medicina Universidade de São Paulo São Paulo Brazil
- Instituto de Medicina Tropical de São Paulo Universidade de São Paulo São Paulo Brazil
| | - Fabiana Martins de Paula
- Laboratório de Investigação Médica (LIM‐06), Hospital das Clínicas da Faculdade de Medicina Universidade de São Paulo São Paulo Brazil
- Instituto de Medicina Tropical de São Paulo Universidade de São Paulo São Paulo Brazil
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Costa IN, Bosqui LR, Corral MA, Costa-Cruz JM, Gryschek RCB, de Paula FM. Diagnosis of human strongyloidiasis: Application in clinical practice. Acta Trop 2021; 223:106081. [PMID: 34364894 DOI: 10.1016/j.actatropica.2021.106081] [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: 04/13/2021] [Revised: 07/08/2021] [Accepted: 07/26/2021] [Indexed: 12/28/2022]
Abstract
This review considers the advantages and disadvantages of parasitological techniques, methods of detecting antibodies and antigens, as well as molecular biology techniques in the diagnosis of human strongyloidiasis. In addition, it elucidates the potential of different techniques for rapid and effective detection of clinical cases, thus enabling early treatment and preventing fatal consequences of this helminthiasis.
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Paula FMD, Malta FM, Corral MA, Marques PD, Gottardi M, Meisel DMCL, Yamashiro J, Pinho JRR, Castilho VLP, Gonçalves EMDN, Gryschek RCB, Chieffi PP. DIAGNOSIS OF Strongyloides stercoralis INFECTION IN IMMUNOCOMPROMISED PATIENTS BY SEROLOGICAL AND MOLECULAR METHODS. Rev Inst Med Trop Sao Paulo 2016; 58:63. [PMID: 27680168 PMCID: PMC5048634 DOI: 10.1590/s1678-9946201658063] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 03/23/2016] [Indexed: 11/22/2022] Open
Abstract
Strongyloidiasis is a potentially serious infection in immunocompromised patients.
Thus, the availability of sensitive and specific diagnostic methods is desirable,
especially in the context of immunosuppressed patients in whom the diagnosis and
treatment of strongyloidiasis is of utmost importance. In this study, serological and
molecular tools were used to diagnose Strongyloides stercoralis
infections in immunosuppressed patients. Serum and stool samples were obtained from
52 patients. Stool samples were first analyzed by Lutz, Rugai, and Agar plate culture
methods, and then by a quantitative real time polymerase chain reaction (qPCR). Serum
samples were evaluated by an enzyme-linked immunosorbent assay (ELISA) using a
soluble (AS) or a membrane fractions antigen (AM) obtained from alkaline solutions of
the filariform larvae of Strongyloides venezuelensis. Of the 52
immunosuppressed patients, three (5.8%) were positive for S.
stercoralis by parasitological methods, compared to two patients (3.8%)
and one patient (1.9%) who were detected by ELISA using the AS and the AM antigens,
respectively. S. stercoralis DNA was amplified in seven (13.5%)
stool samples by qPCR. These results suggest the utility of qPCR as an alternative
diagnostic tool for the diagnosis of S. stercoralis infection in
immunocompromised patients, considering the possible severity of this helminthiasis
in this group of patients.
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Affiliation(s)
- Fabiana Martins de Paula
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo. São Paulo, SP, Brazil. E-mails: ; ; ; ; .,Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Laboratório de Investigação Médica. São Paulo, SP, Brazil. E-mails: ; ; ; ; ;
| | - Fernanda Mello Malta
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo. São Paulo, SP, Brazil. E-mails: ; ; ; ; .,Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina Laboratório de Gastroenterologia e Hepatologia Tropical. São Paulo, SP, Brazil. E-mail: ;
| | - Marcelo Andreetta Corral
- Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Laboratório de Investigação Médica. São Paulo, SP, Brazil. E-mails: ; ; ; ; ;
| | - Priscilla Duarte Marques
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo. São Paulo, SP, Brazil. E-mails: ; ; ; ; .,Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Laboratório de Investigação Médica. São Paulo, SP, Brazil. E-mails: ; ; ; ; ;
| | - Maiara Gottardi
- Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Laboratório de Investigação Médica. São Paulo, SP, Brazil. E-mails: ; ; ; ; ;
| | - Dirce Mary Correia Lima Meisel
- Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Laboratório de Investigação Médica. São Paulo, SP, Brazil. E-mails: ; ; ; ; ;
| | - Juliana Yamashiro
- Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Laboratório de Investigação Médica. São Paulo, SP, Brazil. E-mails: ; ; ; ; ;
| | - João Renato Rebello Pinho
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo. São Paulo, SP, Brazil. E-mails: ; ; ; ; .,Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina Laboratório de Gastroenterologia e Hepatologia Tropical. São Paulo, SP, Brazil. E-mail: ;
| | - Vera Lucia Pagliusi Castilho
- Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Seção de Parasitologia, Divisão de Laboratório Central. São Paulo, SP, Brazil. E-mails: ;
| | - Elenice Messias do Nascimento Gonçalves
- Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Seção de Parasitologia, Divisão de Laboratório Central. São Paulo, SP, Brazil. E-mails: ;
| | - Ronaldo César Borges Gryschek
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo. São Paulo, SP, Brazil. E-mails: ; ; ; ; .,Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Laboratório de Investigação Médica. São Paulo, SP, Brazil. E-mails: ; ; ; ; ;
| | - Pedro Paulo Chieffi
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo. São Paulo, SP, Brazil. E-mails: ; ; ; ; .,Faculdade de Ciências Médicas, Santa Casa. São Paulo, SP, Brazil. E-mail:
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Corral MA, Paula FMD, Gottardi M, Meisel DMCL, Castilho VLP, Gonçalves EMDN, Chieffi PP, Gryschek RCB. IMMUNODIAGNOSIS OF HUMAN STRONGYLOIDIASIS: USE OF SIX DIFFERENT ANTIGENIC FRACTIONS FROM Strongyloides venezuelensis PARASITIC FEMALES. Rev Inst Med Trop Sao Paulo 2016; 57:427-30. [PMID: 26603231 PMCID: PMC4660453 DOI: 10.1590/s0036-46652015000500010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 06/19/2015] [Indexed: 11/23/2022] Open
Abstract
The aim of this study was to evaluate six different antigenic fractions from Strongyloides venezuelensis parasitic females for the immunodiagnosis of human strongyloidiasis. Soluble and membrane fractions from S. venezuelensis parasitic females were prepared in phosphate-buffered saline (SSF and SMF, respectively), Tris-HCl (TSF and TMF, respectively), and an alkaline buffer (ASF and AMF, respectively). Serum samples obtained from patients with strongyloidiasis or, other parasitic diseases, and healthy individuals were analyzed by enzyme-linked immunosorbent assay (ELISA). Soluble fractions SSF, TSF, and ASF showed 85.0%, 75.0%, and 80.0% sensitivity and 93.1%, 93.1%, and 87.5% specificity, respectively. Membrane fractions SMF, TMF, and AMF showed 80.0%, 75.0%, and 85.0% sensitivity, and 95.8%, 90.3%, and 91.7% specificity, respectively. In conclusion, the present results suggest that the fractions obtained from parasitic females, especially the SSF and SMF, could be used as alternative antigen sources in the serodiagnosis of human strongyloidiasis.
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Affiliation(s)
| | | | - Maiara Gottardi
- Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, SP, Brasil
| | | | | | | | - Pedro Paulo Chieffi
- Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, SP, Brasil
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Corral MA, Paula FM, Gottardi M, Meisel DMCL, Chieffi PP, Gryschek RCB. Membrane fractions from Strongyloides venezuelensis in the immunodiagnosis of human strongyloidiasis. Rev Inst Med Trop Sao Paulo 2015; 57:77-80. [PMID: 25651330 PMCID: PMC4325527 DOI: 10.1590/s0036-46652015000100011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 08/06/2014] [Indexed: 11/22/2022] Open
Abstract
Strongyloides venezuelensis is a parasitic nematode of rodents
frequently used to obtain heterologous antigens for the immunological diagnosis of
human strongyloidiasis. The aim of this study was to evaluate membrane fractions from
S. venezuelensis for human strongyloidiasis immunodiagnosis.
Soluble and membrane fractions were obtained in phosphate saline (SS and SM) and
Tris-HCl (TS and TM) from filariform larvae of S. venezuelensis.
Ninety-two serum samples (n = 92) were obtained from 20 strongyloidiasis patients
(Group I), 32 from patients with other parasitic diseases (Group II), and 40 from
healthy individuals (Group III), and were analyzed by enzyme-linked immunosorbent
assay (ELISA). Soluble fractions (SS and TS) showed 90.0% sensitivity and 88.9%
specificity, whereas the membrane fractions (SM and TM) showed 95.0% sensitivity and
94.4% specificity. The present results suggest the possible use of membrane fractions
of S. venezuelensis as an alternative antigen for human
strongyloidiasis immunodiagnosis.
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Affiliation(s)
| | - Fabiana Martins Paula
- Laboratório de Investigação Médica (LIM-06), Hospital das Clínicas da Faculdade de Medicina, São Paulo, SP, Brazil
| | - Maiara Gottardi
- Instituto de Medicina Tropical de São Paulo, São Paulo, SP, Brazil
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Gottardi M, Paula FM, Corral MA, Meisel DMC, Costa SF, Abdala E, Pierrotti LC, Yamashiro J, Chieffi PP, Gryschek RCB. Immunofluorescence assay for diagnosis of strongyloidiasis in immunocompromised patients. Infect Dis (Lond) 2015; 47:550-4. [DOI: 10.3109/23744235.2015.1028096] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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