Microsporidia and acquired immunodeficiency syndrome

Infection by and genotype characteristics of Enterocytozoon bieneusi in HIV/AIDS patients from Guangxi Zhuang autonomous region, China

Background

Enterocytozoon bieneusi has been increasingly reported to infect humans and various mammals. Microsporidia cause diarrhea in HIV-infected patients worldwide. PCR amplification and sequencing based on the internal transcribed spacer region have been used to describe the genotypes of E. bieneusi and transmission of microsporidiosis.

Methods

In this study, we examined E. bieneusi infection and genotypes in HIV-positive patients in Guangxi, China. Stool specimens were collected from 285 HIV-positive patients and 303 HIV-negative individuals. E. bieneusi genotypes were characterized using nested PCR and sequencing.

Results

Thirty-three (11.58%) HIV-positive patients were infected with microsporidia, and no infection was found in the 303 healthy controls. Three new genotypes were identified and named as GX25, GX456, and GX458; four known genotypes, PigEBITS7, Type IV/K, D, and Ebpc, were also identified. Our data showed that the positive rate for microsporidia was significantly higher in the rural patients than in the other occupation groups. In addition, the positive rate for microsporidia was significantly higher in the patients who drink unboiled water than in those with other drinking water sources.

Conclusions

Our results will provide baseline data for preventing and controlling E. bieneusi infection in HIV/AIDS patients. Further studies are required to clarify the epidemiology and potential sources of microsporidia. Our study showed that microsporidium infection occurs in the HIV/AIDS patients in Guangxi, China.

Electronic supplementary material

The online version of this article (10.1186/s12879-017-2787-9) contains supplementary material, which is available to authorized users.

Ultrastructural and Molecular Characterisation of an Heterosporis-Like Microsporidian in Australian Sea Snakes (Hydrophiinae)

Four sea snakes (two Hydrophis major, one Hydrophis platurus, one Hydrophis elegans) were found washed ashore on different beaches in the Sunshine Coast region and Fraser Island in Queensland, Australia between 2007–2013. Each snake had multiple granulomas and locally extensive regions of pallor evident in the hypaxial and intercostal musculature along the body. Lesions in two individuals were also associated with vertebral and rib fractures. Histological examination revealed granulomas scattered throughout skeletal muscle, subcutaneous adipose tissue and fractured bone. These were composed of dense aggregates of microsporidian spores surrounded by a mantle of macrophages. Sequences (ssrRNA) were obtained from lesions in three sea snakes and all revealed 99% similarity with Heterosporis anguillarum from the Japanese eel (Anguillarum japonica). However, ultrastructural characteristics of the organism were not consistent with those of previous descriptions. Electron microscopic examination of skeletal muscle revealed large cysts (not xenomas) bound by walls of fibrillar material (Heterosporis-like sporophorocyst walls were not detected). The cysts contained numerous mature microsporidian spores arranged in small clusters, sometimes apparently within sporophorous vesicles. The microspores were monomorphic, oval and measured 2.5–3.0 μm by 1.6–1.8 μm. They contained isofilar polar filaments with 11 (infrequently 9–12) coils arranged in two ranks. This is the first published report of a microsporidian infection in hydrophiid sea snakes. This discovery shows microsporidia with molecular affinities to Heterosporis anguillarum but ultrastructural characters most consistent with the genus Pleistophora (but no hitherto described species). Further studies are required to determine whether the microsporidian presented here belongs to the genus Heterosporis, or to a polymorphic species group as suggested by the recognition of a robust Pleistophora/Heterosporis clade by molecular studies. The gross and histological pathology associated with these infections are described.

A study of microsporidiosis in corneal scrapings of keratitis patients referring to Farabi Eye Hospital, Tehran, Iran in 2013-14

Background and Purpose:

Microsporidiosis is one of the emerging and opportunistic infections, which causing various clinical symptoms in humans. The prevalence of this infection varies, depending on the infected organ, diagnostic methods, and geographical conditions. In the present study, we aimed to investigate microsporidial keratitis in patients referring to Farabi Eye Hospital Tehran, Iran in 2013-14.

Materials and Methods:

Two scraping samples were collected from 91 keratitis patients, five cases had prior history of receiving immune suppressive drugs. One of the two collected samples from each participant was used for Vero cell culture and the other was used for the preparation of Giemsa and Gram staining slides. After 30 days, the cells were scrapped and used for DNA extraction; afterwards, nested polymerase chain reaction (PCR) detection method was applied. Primer pairs of small-subunit ribosomal RNA gene were designed by CLC Genomics workbench software to amplify all major microsporidian pathogens, as well as E. bieneusi , which was used as the positive control in this study.

Results:

The nested PCR showed negative results regarding the presence of microsporidia in the samples. Similarly, Giemsa and Gram staining slides did not detect any spores.

Conclusion:

The prevalence of human microsporidiosis ranges between 0% and 50%, worldwide. Based on all the negative samples in the present study, we can conclude that the prevalence of this infection among Iranian patients falls in the lower quartile. By gathering further evidence, researchers can take a step forward in this area and open new doors for the assessment of AIDS patients and users of immunosuppressive drugs.

Toll-like receptor 2 recognition of the microsporidia Encephalitozoon spp. induces nuclear translocation of NF-kappaB and subsequent inflammatory responses

Microsporidia are obligate intracellular parasites that are ubiquitous in nature and have been recognized as causing an important emerging disease among immunocompromised individuals. Limited knowledge exists about the immune response against these organisms, and virtually nothing is known about the receptors involved in host recognition. Toll-like receptors (TLR) are pattern recognition receptors that bind to specific molecules found on pathogens and signal a variety of inflammatory responses. In this study, we show that both Encephalitozoon cuniculi and Encephalitozoon intestinalis are preferentially recognized by TLR2 and not by TLR4 in primary human macrophages. This is the first demonstration of host receptor recognition of any microsporidian species. TLR2 ligation is known to activate NF-kappaB, resulting in inflammatory cytokines, such as tumor necrosis factor alpha (TNF-alpha) and interleukin-8 (IL-8). We found that the infection of primary human macrophages leads to the nuclear translocation of NF-kappaB in as early as 1 h and the subsequent production of TNF-alpha and IL-8. To verify the direct role of TLR2 parasite recognition in the production of these cytokines, the receptor was knocked down in primary human macrophages using small interfering RNA. This knockdown resulted in decreases in both the nuclear translocation of NF-kappaB and the levels of TNF-alpha and IL-8 after challenge with spores. Taken together, these experiments directly link the initial inflammatory response induced by Encephalitozoon spp. to TLR2 stimulation in human macrophages.

Immunocompromised host: from the early events until the impact of acquired immunodeficiency syndrome

The concept that microorganisms can modulate the host resistance was historically reviewed in the present article. The importance of African trypanosomiasis in the development of the research on immunosuppression as well as the impact of human immunodeficiency virus infection are discussed. Each day new opportunistic organisms establish a constant challenge for the correct diagnosis of concomitant infections in acquired immunodeficiency syndrome. The importance of parasite infection in the balance of host resistance in the third world was emphasized. Finally, some aspects of Leishmania as opportunistic organisms were presented.