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Menezes CADS, de Oliveira ALG, Barbosa ICM, de Jesus ACP, Chaves AT, Rocha MODC. Galectin-3 (Gal-3) and the tissue inhibitor of matrix metalloproteinase (TIMP-2) as potential biomarkers for the clinical evolution of chronic Chagas cardiomyopathy. Acta Trop 2024; 252:107153. [PMID: 38373528 DOI: 10.1016/j.actatropica.2024.107153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND Chronic Chagas cardiomyopathy (CCC) is responsible for the highest morbidity and worst prognosis in Chagas disease patients. However, predicting factors that correlate with disease progression, morbidity, and mortality is challenging. It is necessary to have simple, quantitative, and economical risk biomarkers that add value to conventional methods and assist in the diagnosis and prognosis of patients with CCC or in evolution. OBJECTIVES We evaluated molecules related to cardiac remodeling and fibrosis, such as MMP-2, MMP-9, TIMP-2, TIMP-1, PICP, CTXI, and Gal-3, and correlated these biomarkers with echocardiographic variables (LVDD, LVEF, and E/e' ratio). METHODS Blood samples from Chagasic patients without apparent cardiopathy (WAC), CCC patients, and healthy individuals were used to perform plasma molecule dosages using Luminex or ELISA. RESULTS MMP-2 and TIMP-2 presented higher levels in CCC; in these patients, the inhibitory role of TIMP-2 over MMP-2 was reinforced. The ratio of MMP-2/TIMP-2 in WAC patients showed a bias in favor of the gelatinase pathway. MMP-9 and TIMP-1 showed higher levels in Chagas patients compared to healthy subjects. PICP and CTXI are not associated with cardiac deterioration in Chagas disease. Increased levels of Gal-3 are associated with worse cardiac function in CCC. Receiver operating characteristic (ROC) curve analysis identified Gal-3 and TIMP-2 as putative biomarkers to discriminate WAC from cardiac patients. CONCLUSIONS Among the molecules evaluated, Gal-3 and TIMP-2 have the potential to be used as biomarkers of cardiac remodeling and progressive myocardial fibrosis in Chagas disease.
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Affiliation(s)
- Cristiane Alves da Silva Menezes
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Belo Horizonte, Minas Gerais CEP 31270-901, Brazil.
| | - Ana Laura Grossi de Oliveira
- Faculdade de Medicina, Programa de Pós-graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Isabela Cristina Magalhães Barbosa
- Faculdade de Medicina, Programa de Pós-graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Augusto César Parreiras de Jesus
- Faculdade de Medicina, Programa de Pós-graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Ana Thereza Chaves
- Faculdade de Medicina, Programa de Pós-graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Manoel Otávio da Costa Rocha
- Faculdade de Medicina, Programa de Pós-graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
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Clímaco MDC, de Figueiredo LA, Lucas RC, Pinheiro GRG, Dias Magalhães LM, Oliveira ALGD, Almeida RM, Barbosa FS, Castanheira Bartholomeu D, Bueno LL, Mendes TA, Zhan B, Jones KM, Hotez P, Bottazzi ME, Oliveira FMS, Fujiwara RT. Development of chimeric protein as a multivalent vaccine for human Kinetoplastid infections: Chagas disease and leishmaniasis. Vaccine 2023; 41:5400-5411. [PMID: 37479612 DOI: 10.1016/j.vaccine.2023.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 06/23/2023] [Accepted: 07/10/2023] [Indexed: 07/23/2023]
Abstract
Leishmania spp. and Trypanosoma cruzi are parasitic kinetoplastids of great medical and epidemiological importance since they are responsible for thousands of deaths and disability-adjusted life-years annually, especially in low- and middle-income countries. Despite efforts to minimize their impact, current prevention measures have failed to fully control their spread. There are still no vaccines available. Taking into account the genetic similarity within the Class Kinetoplastida, we selected CD8+ T cell epitopes preserved among Leishmania spp. and T. cruzi to construct a multivalent and broad-spectrum chimeric polyprotein vaccine. In addition to inducing specific IgG production, immunization with the vaccine was able to significantly reduce parasite burden in the colon, liver and skin lesions from T. cruzi, L. infantum and L. mexicana challenged mice, respectively. These findings were supported by histopathological analysis, which revealed decreased inflammation in the colon, a reduced number of degenerated hepatocytes and an increased proliferation of connective tissue in the skin lesions of the corresponding T. cruzi, L. infantum and L. mexicana vaccinated and challenged mice. Collectively, our results support the protective effect of a polyprotein vaccine approach and further studies will elucidate the immune profile associated with this protection. Noteworthy, our results act as conceptual proof that a single multi-kinetoplastida vaccine can be used effectively to control different infectious etiologies, which in turn can have a profound impact on the development of a new generation of vaccines.
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Affiliation(s)
- Marianna de Carvalho Clímaco
- Department of Parasitology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Luiza Almeida de Figueiredo
- Department of Parasitology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Rayane Cristina Lucas
- Department of Parasitology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Luísa Mourão Dias Magalhães
- Department of Parasitology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ana Laura Grossi de Oliveira
- Department of Parasitology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Raquel Martins Almeida
- Department of Parasitology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Lilian Lacerda Bueno
- Department of Parasitology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Tiago Antonio Mendes
- Department of Biochemistry and Molecular Biology, Institute of Biotechnology Applied to Agropecuaria, Universidade Federal de Viçosa, Minas Gerais, Brazil
| | - Bin Zhan
- National School of Tropical Medicine, Departments of Pediatrics and Molecular Virology & Microbiology, Baylor College of Medicine, One Baylor Plaza, Houston, TX, USA; Texas Children's Hospital Center for Vaccine Development, Baylor College of Medicine, Houston, TX, USA
| | - Kathryn Marie Jones
- National School of Tropical Medicine, Departments of Pediatrics and Molecular Virology & Microbiology, Baylor College of Medicine, One Baylor Plaza, Houston, TX, USA; Texas Children's Hospital Center for Vaccine Development, Baylor College of Medicine, Houston, TX, USA
| | - Peter Hotez
- National School of Tropical Medicine, Departments of Pediatrics and Molecular Virology & Microbiology, Baylor College of Medicine, One Baylor Plaza, Houston, TX, USA; Texas Children's Hospital Center for Vaccine Development, Baylor College of Medicine, Houston, TX, USA
| | - Maria Elena Bottazzi
- National School of Tropical Medicine, Departments of Pediatrics and Molecular Virology & Microbiology, Baylor College of Medicine, One Baylor Plaza, Houston, TX, USA; Texas Children's Hospital Center for Vaccine Development, Baylor College of Medicine, Houston, TX, USA
| | - Fabrício Marcus Silva Oliveira
- Department of Parasitology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo Toshio Fujiwara
- Department of Parasitology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
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Chaves AT, Oliveira ALGD, Guimarães NS, Magalhães IC, Menezes CADS, Rocha MODC. Galectin-3 and fibrosis intensity in Chronic Chagas Cardiomyopathy: a systematic review. Rev Inst Med Trop Sao Paulo 2022; 64:e45. [PMID: 35749417 PMCID: PMC9236203 DOI: 10.1590/s1678-9946202264045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 05/15/2022] [Indexed: 11/24/2022] Open
Abstract
Chronic Chagas Cardiomyopathy (CCC) is the most prevalent type of myocarditis and the main clinical form of the Chagas disease, which has peculiarities such as focal inflammation, structural derangement, hypertrophy, dilation, and intense reparative fibrosis. Many cellular compounds contribute to CCC development. Galectin-3 is a partaker in inflammation and contributes to myocardial fibrosis formation. Some studies showed the connection between Galectin-3 and fibrosis in Chagas disease but are still inconclusive on the guidance for the early implementation of pharmacological therapy. This systematic review evaluated Galectin-3 as a biomarker for fibrosis intensity in CCC. Two independent reviewers have searched five databases (PubMed, EMBASE, Cochrane Library, Scopus, and Lilacs), using the following search terms: galectin-3, biomarkers, fibrosis, Chagas cardiomyopathy, and Chagas disease. Overall, seven studies met the inclusion criteria and made up this review. There were four trials conducted through animal model experiments and three trials with humans. Experimental data in mice indicate an association between Galectin-3 expression and fibrosis in CCC (75% of studies). Data from human studies showed no direct connection between myocardial fibrosis and Galectin-3 expression (80% of studies). Thus, human findings do not provide significant evidence indicating that Galectin-3 is related to fibrosis formation in Chagas disease. Based on the analyzed studies, it is suggested that Galectin-3 might not be a good fibrosis marker in CCC.
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Affiliation(s)
- Ana Thereza Chaves
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Ciências da Saúde: Medicina Tropical e Doenças Infecciosas, Belo Horizonte, Minas Gerais, Brazil
| | - Ana Laura Grossi de Oliveira
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Ciências da Saúde: Medicina Tropical e Doenças Infecciosas, Belo Horizonte, Minas Gerais, Brazil
| | - Nathalia Sernizon Guimarães
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Ciências da Saúde: Medicina Tropical e Doenças Infecciosas, Belo Horizonte, Minas Gerais, Brazil
| | - Isabela Cristina Magalhães
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Ciências da Saúde: Medicina Tropical e Doenças Infecciosas, Belo Horizonte, Minas Gerais, Brazil
| | - Cristiane Alves da Silva Menezes
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Análises Clínicas e Toxicológicas, Belo Horizonte, Minas Gerais, Brazil
| | - Manoel Otávio da Costa Rocha
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Ciências da Saúde: Medicina Tropical e Doenças Infecciosas, Belo Horizonte, Minas Gerais, Brazil
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Alecrin ESD, Oliveira ALGD, Guimarães NS, Lyon S, Martins MAP, Rocha MODC. Factors associated with the development of leprosy in Brazilian contacts: a systematic review. Rev Inst Med Trop Sao Paulo 2022; 64:e55. [PMID: 36197417 PMCID: PMC9528391 DOI: 10.1590/s1678-9946202264055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 07/13/2022] [Indexed: 12/01/2022] Open
Abstract
People who interact with leprosy patients in their environment, neighborhood, family, or social relationships are at risk to develop the disease. This systematic review investigated the risk and protective factors associated with the development of leprosy in Brazilian contacts. The studies were found in Cochrane Library, PubMed (MEDLINE), Embase, Virtual Health Library, grey literature and hand search until July 2021. The study selection, data extraction and quality assessment were independently performed by two investigators. The quality assessment was performed using the Newcastle-Ottawa Scale (NOS). This review was registered in PROSPERO (CRD42020160680). Seventeen articles fulfilled the inclusion criteria (n=544). The immunological and molecular factors, such as Anti-phenolic Glycolipid Antibodies (Anti-PGL-1) seropositivity, negative Mitsuda test, absence of Bacillus Calmette-Guérin (BCG) scar, positive Polymerase Chain Reaction (PCR) in blood; age and race; conviviality, education, contact time and type of contact, as well as elements related to the index case (bacilloscopic index; genetic conditions, family relationships), and some combined factors were shown to be relevant risk factors associated with the development of the disease in Brazilian leprosy contacts. The protective factors reported were the presence of one or more BCG scars, positive Mitsuda test, and education level. All selected studies were considered of high quality according to NOS. The knowledge of disease-related risk and protective factors provides the scientific basis for decision-making in the management of the disease in leprosy contacts.
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Affiliation(s)
- Edilamar Silva de Alecrin
- Universidade Federal de Minas Gerais, Brazil; Hospital Eduardo de Menezes, Ambulatório de Dermatologia, Brazil
| | | | | | - Sandra Lyon
- Universidade Federal de Minas Gerais, Brazil; Faculdade de Saúde e Ecologia Humana, Brazil
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Cisneros J, Ferreira JA, de Faria Grossi MA, de Filippis T, de Oliveira ALG, Lyon S, Fairley JK. Associations between occupation, leprosy disability and other sociodemographic factors in an endemic area of Brazil. PLOS Glob Public Health 2022; 2:e0000276. [PMID: 36962742 PMCID: PMC10021318 DOI: 10.1371/journal.pgph.0000276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 08/16/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND In Brazil, new leprosy cases with grade-2 disability (G2D) have been increasing. Physical disability has been associated with experienced stigmatization, psychological distress, and social restriction. OBJECTIVES To identify factors associated with leprosy disability in an endemic area of Brazil focusing on occupational and other sociodemographic factors. METHODS Between July and December 2015, adult patients with multibacillary leprosy who attended a clinic in Belo Horizonte, Brazil were enrolled. Social, clinical, and demographic factors were collected from an administered questionnaire and medical charts. Occupations were categorized as manual vs non-manual. Descriptive statistics and multivariable logistic regression were performed to study associated factors with disability (Grade 1 disability (G1D) and G2D combined). FINDINGS Seventy-three patients were enrolled with 48 (65.8%) presenting with either G1D or G2D at the time of enrollment. Twenty-nine (39.7%) had G2D. About half of the patients (n = 36, 49%) reported a manual labor occupation and reactions were common (n = 53, 73%). On univariate analyses, older age (p = 0.048) and low education (p = 0.007) were associated with disability. On multivariable analyses, only low education (primary or less) was associated with disability (OR = 6.34, 95% CI 1.37, 29.26). Greater distance from clinic, income, smoking, marital status, and occupation were not associated. MAIN CONCLUSIONS Low education was associated with leprosy disability, consistent with prior studies, and therefore should be a focus for disability reduction programs. While the sample size of this study may have limited detection of associations between disability and social determinants tested, half of the patients reported a manual job, highlighting the need for more extensive studies on associations between occupation, disability, and related injuries.
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Affiliation(s)
- Juan Cisneros
- Emory University, Atlanta, Georgia, United States of America
| | | | | | | | | | - Sandra Lyon
- Faculdade da Saúde e Ecologia Humana, Vespasiano, MG, Brazil
- Eduardo de Menezes / FHEMIG, Belo Horizonte, MG, Brazil
| | - Jessica K Fairley
- Emory University School of Medicine, Atlanta, Georgia, United States of America
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Parreiras de Jesus AC, Grossi de Oliveira AL, Sernizon Guimarães N, Mendoza L, Toshio Fujiwara R, Alves da Silva Menezes C, Rocha Vilela RV. Serological tests using Sporothrix species antigens for the accurate diagnosis of sporotrichosis: a meta-analysis. Diagn Microbiol Infect Dis 2020; 98:115131. [PMID: 32805583 DOI: 10.1016/j.diagmicrobio.2020.115131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/02/2020] [Accepted: 07/05/2020] [Indexed: 10/23/2022]
Abstract
Some species of the fungus Sporothrix cause a chronic granulomatous infection in humans and animals called sporotrichosis. In the last decades, some research into serological tests has been carried out by different groups for the rapid detection of this infection. We performed a systematic review of the literature with meta-analysis to evaluate studies using Sporothrix spp. antigens and to evaluate their accuracy for sporotrichosis diagnostic. We searched Scopus, MEDLINE, Web of Science, GALE, Technology Research Database, DOA, Elsevier, SciELO, and Google Scholar Databases. The united results of sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio with their corresponding 95% confidence intervals (CI) were assessed. A total of 15 assays from 8 studies using 7 different serological methods and 8 different antigens were analyzed. The studies were performed in the USA, Brazil, and Venezuela from 1973 until 2015 and presented good quality. A high heterogeneity for sensitivity [I2 = 90.7%; 87% CI = (84-89), P < 0.001] and specificity [I2 = 89.2%; 93% CI = (92-95), P < 0.001] was observed. The performance of diagnostic tests was 0.93. Enzyme-linked immunosorbent assay was the main tool used, and the ConA-binding fraction antigen of the strain 1099-18 appears as a promising diagnostic biomarker candidate.
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Affiliation(s)
- Augusto César Parreiras de Jesus
- Infectious Diseases and Tropical Medicine, Faculty of Medicine, Federal University of Minas Gerais, Av. Prof. Alfredo Balena, 190, Belo Horizonte, MG, Brazil, 30130-10.
| | - Ana Laura Grossi de Oliveira
- Infectious Diseases and Tropical Medicine, Faculty of Medicine, Federal University of Minas Gerais, Av. Prof. Alfredo Balena, 190, Belo Horizonte, MG, Brazil, 30130-10.
| | - Nathalia Sernizon Guimarães
- Infectious Diseases and Tropical Medicine, Faculty of Medicine, Federal University of Minas Gerais, Av. Prof. Alfredo Balena, 190, Belo Horizonte, MG, Brazil, 30130-10.
| | - Leonel Mendoza
- Department of Microbiology and Molecular Genetics, 322 North Kedzie Hall, Michigan State University, East Lansing, MI, USA, 48824.
| | - Ricardo Toshio Fujiwara
- Infectious Diseases and Tropical Medicine, Faculty of Medicine, Federal University of Minas Gerais, Av. Prof. Alfredo Balena, 190, Belo Horizonte, MG, Brazil, 30130-10; Department of Parasitology, Biological Sciences Institute, Federal University of Minas Gerais, Av. Antônio Carlos, 6627 Pampulha, Belo Horizonte, MG, Brazil, 31270-901.
| | - Cristiane Alves da Silva Menezes
- Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Federal University of Minas Gerais, Av. Antônio Carlos, 6627 Pampulha, Belo Horizonte, MG, Brazil, 31270-901.
| | - Raquel Virginia Rocha Vilela
- Infectious Diseases and Tropical Medicine, Faculty of Medicine, Federal University of Minas Gerais, Av. Prof. Alfredo Balena, 190, Belo Horizonte, MG, Brazil, 30130-10; Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Federal University of Minas Gerais, Av. Antônio Carlos, 6627 Pampulha, Belo Horizonte, MG, Brazil, 31270-901.
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Grossi de Oliveira AL, Chaves AT, Santos Cardoso M, Gomide Pinheiro GR, Parreiras de Jesus AC, de Faria Grossi MA, Lyon S, Lacerda Bueno L, da Costa Rocha MO, Toshio Fujiwara R, Alves da Silva Menezes C. Hypovitaminosis D and reduced cathelicidin are strongly correlated during the multidrug therapy against leprosy. Microb Pathog 2020; 147:104373. [PMID: 32645421 DOI: 10.1016/j.micpath.2020.104373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/25/2020] [Accepted: 07/01/2020] [Indexed: 12/24/2022]
Abstract
Mycobacterium leprae infection depends on the competence of the host immune defense to induce effective protection against this intracellular pathogen. The present study investigated the serum levels of vitamin D and the antimicrobial peptide cathelicidin, to determine the statistical correlation between them in leprosy patients before and post-six months of multidrug therapy (MDT), household contacts, and healthy individuals. Previous studies associated these molecules with high risks to develop mycobacterial diseases, such as tuberculosis and leprosy. A total of 34 leprosy patients [paucibacillary (n = 14), multibacillary (n = 20)], and 25 household contacts were recruited. Eighteen healthy adults were selected as a control group. Serum concentrations of vitamin D (25(OH)VD3) and cathelicidin were measured using high-performance liquid chromatography (HPLC), and an enzyme-linked immunosorbent assay (ELISA) kit, respectively. There were no significant differences in serum levels of 25(OH)VD3 between all groups, and the overall prevalence rate of vitamin D deficiency was 67.1%. Cathelicidin levels were significantly lower in both untreated and treated patients when compared to controls and household contacts (p < 0.05). Strong correlations between hypovitaminosis D and reduced cathelicidin in untreated (r = 0.86) and post-six months of MDT (r = 0.79) leprosy patients were observed. These results suggest that vitamin D status and cathelicidin levels are strongly correlated during multidrug therapy for leprosy and nutritional supplementation from the beginning of treatment could strengthen the immune response against leprosy.
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Affiliation(s)
| | - Ana Thereza Chaves
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Mariana Santos Cardoso
- Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | | | | | - Sandra Lyon
- Hospital Eduardo de Menezes, Fundação Hospitalar do Estado de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Lilian Lacerda Bueno
- Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Ricardo Toshio Fujiwara
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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de Oliveira ALG, Fraga VG, Sernizon-Guimarães N, Cardoso MS, Viana AG, Bueno LL, Bartholomeu DC, da Silva Menezes CA, Fujiwara RT. Diagnostic accuracy of tests using recombinant protein antigens of Mycobacterium leprae for leprosy: A systematic review. J Infect Public Health 2020; 13:1078-1088. [PMID: 32299687 DOI: 10.1016/j.jiph.2019.12.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 12/13/2019] [Accepted: 12/15/2019] [Indexed: 01/24/2023] Open
Abstract
The aim of this systematic review was to investigate the studies that evaluated the sensitivity and specificity of serologic tests using recombinant protein antigens from Mycobacterium leprae for leprosy diagnosis. We included 13 studies that were available in PubMed, Brazilian Virtual Library of Health, Web of Science, ScienceDirect and Scopus. From these studies, we found that the recombinant serine-rich 45-kDa protein of M. leprae (ML0411) demonstrated high performance for multibacillary (MB) also to paucibacillary (PB) patients, although this study was tested only for Indian population. Despite that, studies using the ND-O-LID antigen have been able to more accurately identify new cases of leprosy among people living in endemic or non-endemic areas and household contacts in Brazil, Colombia, and the Philippines, especially when combined with other biomarkers. Finally, low sensitivity values for PB patients' antibodies response remain challenging for tests intended to diagnose clinical forms that comprise this classification in leprosy.
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Affiliation(s)
- Ana Laura Grossi de Oliveira
- Post-Graduate Program in Health Sciences: Infectious Diseases and Tropical Medicine, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil.
| | - Vanêssa Gomes Fraga
- Department of Parasitology, Institute of Biological Sciences (ICB), UFMG, Brazil.
| | | | | | | | - Lilian Lacerda Bueno
- Department of Parasitology, Institute of Biological Sciences (ICB), UFMG, Brazil.
| | | | - Cristiane Alves da Silva Menezes
- Department of Clinical and Toxicological Analyses, School of Pharmacy, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil.
| | - Ricardo Toshio Fujiwara
- Post-Graduate Program in Health Sciences: Infectious Diseases and Tropical Medicine, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil; Department of Parasitology, Institute of Biological Sciences (ICB), UFMG, Brazil.
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Fairley JK, Ferreira JA, de Oliveira ALG, de Filippis T, de Faria Grossi MA, Chaves LP, Caldeira LN, Dos Santos PS, Costa RR, Diniz MC, Duarte CS, Bomjardim Pôrto LA, Suchdev PS, Negrão-Corrêa DA, do Carmo Magalhães F, Peixoto Moreira JM, de Melo Freire Júnior A, Cerqueira MC, Kitron U, Lyon S. The Burden of Helminth Coinfections and Micronutrient Deficiencies in Patients with and without Leprosy Reactions: A Pilot Study in Minas Gerais, Brazil. Am J Trop Med Hyg 2020; 101:1058-1065. [PMID: 31549606 DOI: 10.4269/ajtmh.18-0502] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Leprosy reactions are immune-mediated complications occurring in up to 50% of patients. The immune consequences of helminth infections and micronutrient deficiencies suggest a potential role in type 1 reactions (T1R) or type 2 reactions (T2R). We conducted a case-control study in Minas Gerais, Brazil, to evaluate whether comorbidities and other factors are associated with reactions in patients with multibacillary leprosy. Stool and serum were tested for helminth infections. Deficiencies of vitamin A, D, and iron were measured using serum retinol, 25-hydroxyvitamin D, and ferritin, respectively. Logistic regression models identified associations between reactions and helminth infections, micronutrient deficiencies, and other variables. Seventy-three patients were enrolled, 24 (33%) with T1R, 21 (29%) with T2R, 8 (15%) with mixed T1R/T2R, and 20 (27%) without reactions. Evidence of helminth infections were found in 11 participants (15%) and included IgG4 reactivity against Schistosoma mansoni, Strongyloides, and Ascaris antigens. Thirty-eight (52%) had vitamin D deficiency, eight (11%) had vitamin A insufficiency, 21 (29%) had anemia, and one (1.4%) had iron deficiency. Multivariable logistic regression showed no statistically significant associations between helminth coinfections and total reactions (adjusted odds ratios [aOR]: 1.36, 95% CI: 0.22, 8.33), T1R (aOR: 0.85, 95% CI: 0.17, 4.17), or T2R (aOR: 2.41, 95% CI: 0.29, 20.0). Vitamin D deficiency and vitamin A insufficiency were also not statistically associated with reactions. However, vitamin deficiencies and helminth infections were prevalent in these patients, suggesting a potential role for additional treatment interventions. Studying reactions prospectively may further clarify the role of comorbidities in the clinical presentation of leprosy.
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Affiliation(s)
- Jessica K Fairley
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Jose A Ferreira
- Faculdade Saúde e Ecologia Humana (FASEH), Vespasiano, Brazil
| | | | | | | | | | | | | | | | | | | | | | - Parminder S Suchdev
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | | | | | | | | | | | - Uriel Kitron
- Department of Environmental Sciences, Emory University, Atlanta, Georgia
| | - Sandra Lyon
- Faculdade Saúde e Ecologia Humana (FASEH), Vespasiano, Brazil
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Pereira FB, Dutra WO, Gollob KJ, Reis EA, Oliveira ALGD, Rocha MODC, Menezes CADS. Vasoactive intestinal peptide degradation might influence Interleukin-17 expression in cardiac chagasic patients. Rev Inst Med Trop Sao Paulo 2018; 60:e57. [PMID: 30365640 PMCID: PMC6199123 DOI: 10.1590/s1678-9946201860057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 08/14/2018] [Indexed: 12/03/2022] Open
Abstract
The vasoactive intestinal peptide (VIP) expression is lower in cardiac chagasic patients and is related to worse cardiac function. The reduction of VIP in patients with Chagas disease may be a result of its enhanced degradation. To test this hypothesis, the tryptase and chymase expression was evaluated. We also related VIP levels with interleukin-17 (IL-17) expression since VIP may modulate IL-17 production. Plasma levels of chymase were higher in chagasic patients. Conversely, VIP/chymase and VIP/tryptase ratios were lower in chagasic patients when compared to non-infected individuals. Besides, the VIP/chymase ratio was lower in chagasic cardiac patients in comparison with the indeterminate group. A positive correlation between tryptase and chymase levels was observed in chagasic cardiac patients. In relation to IL-17, we observed a higher expression of this cytokine in the cardiac form of the disease than in the indeterminate form. IL-17/VIP ratio was higher in the cardiac form in comparison with non-infected or indeterminate form. These results suggest that the low levels of VIP observed in chagasic patients could be due to an increased production of chymase and/or to the additive effect of the interaction between chymase and tryptase in the cardiac form. Moreover, the decreased VIP expression may contribute to the increase of IL-17 in chagasic cardiac patients.
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Affiliation(s)
| | - Walderez O. Dutra
- Universidade Federal de Minas Gerais, Brazil; Instituto Nacional de Ciência e Tecnologia de Doenças Tropicais, Brazil
| | - Kenneth J. Gollob
- Instituto Nacional de Ciência e Tecnologia de Doenças Tropicais, Brazil; A.C. Camargo Cancer Center, Brazil
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Oliveira ALGD, Chaves AT, Menezes CAS, Guimarães NS, Bueno LL, Fujiwara RT, Rocha MODC. Vitamin D receptor expression and hepcidin levels in the protection or severity of leprosy: a systematic review. Microbes Infect 2017; 19:311-322. [PMID: 28323068 DOI: 10.1016/j.micinf.2017.03.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 02/06/2017] [Accepted: 03/03/2017] [Indexed: 12/20/2022]
Abstract
Leprosy is a chronic infectious disease whose disequilibrium in the host's genetic, immunological and clinical mechanisms leads to distinct manifestations defining the type of immunological response. This review focuses its attention on the influence of the Vitamin D Receptor and hepcidin expressions that can suggest the protection or severity of leprosy.
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Affiliation(s)
- Ana Laura Grossi de Oliveira
- Post-graduate Program in Health Sciences: Infectious Diseases and Tropical Medicine, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil.
| | - Ana Thereza Chaves
- Post-graduate Program in Health Sciences: Infectious Diseases and Tropical Medicine, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | | | - Nathalia Sernizon Guimarães
- Post-graduate Program in Health Sciences: Infectious Diseases and Tropical Medicine, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | | | - Ricardo Toshio Fujiwara
- Post-graduate Program in Health Sciences: Infectious Diseases and Tropical Medicine, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Manoel Otávio da Costa Rocha
- Post-graduate Program in Health Sciences: Infectious Diseases and Tropical Medicine, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
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