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Bandara M, Ananda M, Wickramage K, Berger E, Agampodi S. Globalization of leptospirosis through travel and migration. Global Health 2014; 10:61. [PMID: 25112368 PMCID: PMC4131158 DOI: 10.1186/s12992-014-0061-0] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Accepted: 07/23/2014] [Indexed: 11/10/2022] Open
Abstract
Leptospirosis remains the most widespread zoonotic disease in the world, commonly found in tropical or temperate climates. While previous studies have offered insight into intra-national and intra-regional transmission, few have analyzed transmission across international borders. Our review aimed at examining the impact of human travel and migration on the re-emergence of Leptospirosis. Results suggest that alongside regional environmental and occupational exposure, international travel now constitute a major independent risk factor for disease acquisition. Contribution of travel associated leptospirosis to total caseload is as high as 41.7% in some countries. In countries where longitudinal data is available, a clear increase of proportion of travel-associated leptospirosis over the time is noted. Reporting patterns is clearly showing a gross underestimation of this disease due to lack of diagnostic facilities. The rise in global travel and eco-tourism has led to dramatic changes in the epidemiology of Leptospirosis. We explore the obstacles to prevention, screening and diagnosis of Leptopirosis in health systems of endemic countries and of the returning migrant or traveler. We highlight the need for developing guidelines and preventive strategies of Leptospirosis related to travel and migration, including enhancing awareness of the disease among health professionals in high-income countries.
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Affiliation(s)
| | | | | | | | - Suneth Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka.
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Eshghi A, Cullen PA, Cowen L, Zuerner RL, Cameron CE. Global proteome analysis of Leptospira interrogans. J Proteome Res 2010; 8:4564-78. [PMID: 19663501 PMCID: PMC2757032 DOI: 10.1021/pr9004597] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
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Comparative global proteome analyses were performed on Leptospira interrogans serovar Copenhageni grown under conventional in vitro conditions and those mimicking in vivo conditions (iron limitation and serum presence). Proteomic analyses were conducted using iTRAQ and LC-ESI-tandem mass spectrometry complemented with two-dimensional gel electrophoresis and MALDI-TOF mass spectrometry. A total of 563 proteins were identified in this study. Altered expression of 65 proteins, including upregulation of the L. interrogans virulence factor Loa22 and 5 novel proteins with homology to virulence factors found in other pathogens, was observed between the comparative conditions. Immunoblot analyses confirmed upregulation of 5 of the known or putative virulence factors in L. interrogans exposed to the in vivo-like environmental conditions. Further, ELISA analyses using serum from patients with leptospirosis and immunofluorescence studies performed on liver sections derived from L. interrogans-infected hamsters verified expression of all but one of the identified proteins during infection. These studies, which represent the first documented comparative global proteome analysis of Leptospira, demonstrated proteome alterations under conditions that mimic in vivo infection and allowed for the identification of novel putative L. interrogans virulence factors. The L. interrogans proteome was analyzed using iTRAQ and 2DGE. These analyses identified 563 proteins and altered expression of 65 proteins upon growth of L. interrogans under in vivo-like conditions, including upregulation of the L. interrogans virulence factor Loa22, a putative lipoprotein with primary amino acid sequence similarity to the outer surface protein ErpY of B. burgdorferi, and 4 additional proteins with homology to virulence factors found in other pathogens.
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Affiliation(s)
- Azad Eshghi
- Department of Biochemistry and Microbiology, University of Victoria, Victoria, British Columbia, Canada
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Leptospirosis: an emerging disease in travellers. Travel Med Infect Dis 2010; 8:33-9. [PMID: 20188303 DOI: 10.1016/j.tmaid.2009.12.002] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2009] [Revised: 12/08/2009] [Accepted: 12/09/2009] [Indexed: 11/20/2022]
Abstract
A recent upsurge in leptospirosis in travellers has prompted the following review of the epidemiology of this infection in humans. The available data from the published literature as well as laboratory surveillance were examined to determine the possible causes of the apparent change in epidemiology.
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Molecular basis of the substrate specificity and the catalytic mechanism of citramalate synthase from Leptospira interrogans. Biochem J 2008; 415:45-56. [DOI: 10.1042/bj20080242] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Leptospira interrogans is the causative agent for leptospirosis, a zoonotic disease of global importance. In contrast with most other micro-organisms, L. interrogans employs a pyruvate pathway to synthesize isoleucine and LiCMS (L. interrogans citramalate synthase) catalyses the first reaction of the pathway which converts pyruvate and acetyl-CoA into citramalate, thus making it an attractive target for the development of antibacterial agents. We report here the crystal structures of the catalytic domain of LiCMS and its complexes with substrates, and kinetic and mutagenesis studies of LiCMS, which together reveal the molecular basis of the high substrate specificity and the catalytic mechanism of LiCMS. The catalytic domain consists of a TIM barrel flanked by an extended C-terminal region. It forms a homodimer in the crystal structure, and the active site is located at the centre of the TIM barrel near the C-terminal ends of the β-strands and is composed of conserved residues of the β-strands of one subunit and the C-terminal region of the other. The substrate specificity of LiCMS towards pyruvate against other α-oxo acids is dictated primarily by residues Leu81, Leu104 and Tyr144, which form a hydrophobic pocket to accommodate the C2-methyl group of pyruvate. The catalysis follows the typical aldol condensation reaction, in which Glu146 functions as a catalytic base to activate the methyl group of acetyl-CoA to form an enolated acetyl-CoA intermediate and Arg16 as a general acid to stabilize the intermediate.
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Clark IA, Alleva LM, Mills AC, Cowden WB. Pathogenesis of malaria and clinically similar conditions. Clin Microbiol Rev 2004; 17:509-39, table of contents. [PMID: 15258091 PMCID: PMC452556 DOI: 10.1128/cmr.17.3.509-539.2004] [Citation(s) in RCA: 136] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
There is now wide acceptance of the concept that the similarity between many acute infectious diseases, be they viral, bacterial, or parasitic in origin, is caused by the overproduction of inflammatory cytokines initiated when the organism interacts with the innate immune system. This is also true of certain noninfectious states, such as the tissue injury syndromes. This review discusses the historical origins of these ideas, which began with tumor necrosis factor (TNF) and spread from their origins in malaria research to other fields. As well the more established proinflammatory mediators, such as TNF, interleukin-1, and lymphotoxin, the roles of nitric oxide and carbon monoxide, which are chiefly inhibitory, are discussed. The established and potential roles of two more recently recognized contributors, overactivity of the enzyme poly(ADP-ribose) polymerase 1 (PARP-1) and the escape of high-mobility-group box 1 (HMGB1) protein from its normal location into the circulation, are also put in context. The pathogenesis of the disease caused by falciparum malaria is then considered in the light of what has been learned about the roles of these mediators in these other diseases, as well as in malaria itself.
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Affiliation(s)
- Ian A Clark
- School of Biochemistry and Molecular Biology, Australian National University, Canberra, ACT 0200, Australia.
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Bharti AR, Nally JE, Ricaldi JN, Matthias MA, Diaz MM, Lovett MA, Levett PN, Gilman RH, Willig MR, Gotuzzo E, Vinetz JM. Leptospirosis: a zoonotic disease of global importance. THE LANCET. INFECTIOUS DISEASES 2004; 3:757-71. [PMID: 14652202 DOI: 10.1016/s1473-3099(03)00830-2] [Citation(s) in RCA: 1359] [Impact Index Per Article: 68.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
In the past decade, leptospirosis has emerged as a globally important infectious disease. It occurs in urban environments of industrialised and developing countries, as well as in rural regions worldwide. Mortality remains significant, related both to delays in diagnosis due to lack of infrastructure and adequate clinical suspicion, and to other poorly understood reasons that may include inherent pathogenicity of some leptospiral strains or genetically determined host immunopathological responses. Pulmonary haemorrhage is recognised increasingly as a major, often lethal, manifestation of leptospirosis, the pathogenesis of which remains unclear. The completion of the genome sequence of Leptospira interrogans serovar lai, and other continuing leptospiral genome sequencing projects, promise to guide future work on the disease. Mainstays of treatment are still tetracyclines and beta-lactam/cephalosporins. No vaccine is available. Prevention is largely dependent on sanitation measures that may be difficult to implement, especially in developing countries.
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Affiliation(s)
- Ajay R Bharti
- Division of Infectious Diseases, Department of Medicine, University of California San Diego School of Medicine, La Jolla, CA 92093, USA
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Smythe LD, Smith IL, Smith GA, Dohnt MF, Symonds ML, Barnett LJ, McKay DB. A quantitative PCR (TaqMan) assay for pathogenic Leptospira spp. BMC Infect Dis 2002; 2:13. [PMID: 12100734 PMCID: PMC117785 DOI: 10.1186/1471-2334-2-13] [Citation(s) in RCA: 201] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2002] [Accepted: 07/08/2002] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Leptospirosis is an emerging infectious disease. The differential diagnosis of leptospirosis is difficult due to the varied and often "flu like" symptoms which may result in a missed or delayed diagnosis. There are over 230 known serovars in the genus Leptospira. Confirmatory serological diagnosis of leptospirosis is usually made using the microscopic agglutination test (MAT) which relies on the use of live cultures as the source of antigen, often performed using a panel of antigens representative of local serovars. Other techniques, such as the enzyme linked immunosorbent assay (ELISA) and slide agglutination test (SAT), can detect different classes of antibody but may be subject to false positive reactions and require confirmation of these results by the MAT. METHODS The polymerase chain reaction (PCR) has been used to detect a large number of microorganisms, including those of clinical significance. The sensitivity of PCR often precludes the need for isolation and culture, thus making it ideal for the rapid detection of organisms involved in acute infections. We employed real-time (quantitative) PCR using TaqMan chemistry to detect leptospires in clinical and environmental samples. RESULTS AND CONCLUSIONS The PCR assay can be applied to either blood or urine samples and does not rely on the isolation and culture of the organism. Capability exists for automation and high throughput testing in a clinical laboratory. It is specific for Leptospira and may discriminate pathogenic and non-pathogenic species. The limit of detection is as low as two cells.
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Affiliation(s)
- Lee D Smythe
- WHO/FAO/OIE Collaborating Centre for Reference & Research on Leptospirosis, Centre for Public Health Sciences, Queensland Health Scientific Services, Brisbane, Australia
| | - Ina L Smith
- Public Health Virology, Centre for Public Health Sciences, Queensland Health Scientific Services, Brisbane, Australia
| | - Greg A Smith
- Public Health Virology, Centre for Public Health Sciences, Queensland Health Scientific Services, Brisbane, Australia
| | - Michael F Dohnt
- WHO/FAO/OIE Collaborating Centre for Reference & Research on Leptospirosis, Centre for Public Health Sciences, Queensland Health Scientific Services, Brisbane, Australia
| | - Meegan L Symonds
- WHO/FAO/OIE Collaborating Centre for Reference & Research on Leptospirosis, Centre for Public Health Sciences, Queensland Health Scientific Services, Brisbane, Australia
| | - Leonie J Barnett
- WHO/FAO/OIE Collaborating Centre for Reference & Research on Leptospirosis, Centre for Public Health Sciences, Queensland Health Scientific Services, Brisbane, Australia
| | - David B McKay
- Sippy Downs Drive, University of the Sunshine Coast, Maroochydore, 4558 Queensland, Australia
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Abstract
Leptospirosis is a worldwide zoonotic infection with a much greater incidence in tropical regions and has now been identified as one of the emerging infectious diseases. The epidemiology of leptospirosis has been modified by changes in animal husbandry, climate, and human behavior. Resurgent interest in leptospirosis has resulted from large outbreaks that have received significant publicity. The development of simpler, rapid assays for diagnosis has been based largely on the recognition that early initiation of antibiotic therapy is important in acute disease but also on the need for assays which can be used more widely. In this review, the complex taxonomy of leptospires, previously based on serology and recently modified by a genotypic classification, is discussed, and the clinical and epidemiological value of molecular diagnosis and typing is also evaluated.
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Affiliation(s)
- P N Levett
- University of the West Indies, School of Clinical Medicine & Research, and Leptospira Laboratory, Ministry of Health, Barbados.
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Plank R, Dean D. Overview of the epidemiology, microbiology, and pathogenesis of Leptospira spp. in humans. Microbes Infect 2000; 2:1265-76. [PMID: 11008116 DOI: 10.1016/s1286-4579(00)01280-6] [Citation(s) in RCA: 191] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Leptospirosis is probably the world's most widespread zoonosis. It remains underdiagnosed largely due to the broad spectrum of signs and symptoms attributable to this spirochetal pathogen. Leptospira spp. cause a diversity of diseases from flu-like illness to Weil's syndrome with multi-organ failure. Recent epidemics may herald a change in virulence or an alteration in the balance between humans and their interactions with other host species and the environment.
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Affiliation(s)
- R Plank
- Division of Infectious Disease, University of California at San Francisco School of Medicine, Box 0811, CA 94143, USA
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