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Abdulrashid NI, Aminu S, Adamu RM, Tajuddeen N, Isah MB, Jatau ID, Aliyu AB, Simelane MBC, Onyike E, Ibrahim MA. Phloroglucinol as a Potential Candidate against Trypanosoma congolense Infection: Insights from In Vivo, In Vitro, Molecular Docking and Molecular Dynamic Simulation Analyses. Molecules 2022; 27:469. [PMID: 35056785 PMCID: PMC8781988 DOI: 10.3390/molecules27020469] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/06/2021] [Accepted: 12/21/2021] [Indexed: 11/30/2022] Open
Abstract
Sub-Saharan Africa is profoundly challenged with African Animal Trypanosomiasis and the available trypanocides are faced with drawbacks, necessitating the search for novel agents. Herein, the chemotherapeutic potential of phloroglucinol on T. congolense infection and its inhibitory effects on the partially purified T. congolense sialidase and phospholipase A2 (PLA2) were investigated. Treatment with phloroglucinol for 14 days significantly (p < 0.05) suppressed T. congolense proliferation, increased animal survival and ameliorated anemia induced by the parasite. Using biochemical and histopathological analyses, phloroglucinol was found to prevent renal damages and splenomegaly, besides its protection against T. congolense-associated increase in free serum sialic acids in infected animals. Moreover, the compound inhibited bloodstream T. congolense sialidase via mixed inhibition pattern with inhibition binding constant (Ki) of 0.181 µM, but a very low uncompetitive inhibitory effects against PLA2 (Ki > 9000 µM) was recorded. Molecular docking studies revealed binding energies of -4.9 and -5.3 kcal/mol between phloroglucinol with modeled sialidase and PLA2 respectively, while a 50 ns molecular dynamics simulation using GROMACS revealed the sialidase-phloroglucinol complex to be more compact and stable with higher free binding energy (-67.84 ± 0.50 kJ/mol) than PLA2-phloroglucinol complex (-77.17 ± 0.52 kJ/mol), based on MM-PBSA analysis. The sialidase-phloroglucinol complex had a single hydrogen bond interaction with Ser453 while none was observed for the PLA2-phloroglucinol complex. In conclusion, phloroglucinol showed moderate trypanostatic activity with great potential in ameliorating some of the parasite-induced pathologies and its anti-anemic effects might be linked to inhibition of sialidase rather than PLA2.
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Affiliation(s)
| | - Suleiman Aminu
- Department of Biochemistry, Ahmadu Bello University, Zaria 810241, Nigeria; (N.I.A.); (S.A.); (E.O.)
| | - Rahma Muhammad Adamu
- Department of Biotechnology, School of Engineering and Technology, Sharda University, Greater Noida 201310, India;
| | - Nasir Tajuddeen
- Department of Chemistry, Ahmadu Bello University, Zaria 810241, Nigeria; (N.T.); (A.B.A.)
| | - Murtala Bindawa Isah
- Department of Biochemistry, Umaru Musa Yar’adua University, Katsina 820241, Nigeria;
| | - Isa Danladi Jatau
- Department of Veterinary Parasitology and Entomology, Ahmadu Bello University, Zaria 810241, Nigeria;
| | - Abubakar Babando Aliyu
- Department of Chemistry, Ahmadu Bello University, Zaria 810241, Nigeria; (N.T.); (A.B.A.)
| | | | - Elewechi Onyike
- Department of Biochemistry, Ahmadu Bello University, Zaria 810241, Nigeria; (N.I.A.); (S.A.); (E.O.)
| | - Mohammed Auwal Ibrahim
- Department of Biochemistry, Ahmadu Bello University, Zaria 810241, Nigeria; (N.I.A.); (S.A.); (E.O.)
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Abstract
Interest in trypanosome lytic factors (TLFs) and apolipoprotein L1, the ion channel-forming protein component of TLFs, has increased tenfold since 2010. This is due to the association of African variants of APOL1 with kidney disease such that interest has reached circles beyond parasitology. We have extensive experience purifying and working with these proteins and protein complexes. Herein we describe our detailed purification protocols to aid the new burgeoning field by providing an opportunity for consistency in reagents used across laboratories. We emphasize that it is imperative to maintain APOL1 protein intact (~42 kDa) to analyze the active ion channel-forming component/protein.
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Affiliation(s)
- Joseph Verdi
- Hunter College, City University of New York, New York, NY, USA
- Ph.D. Program in Biology, The Graduate Center of the City University of New York, New York, NY, USA
| | - Charles Schaub
- Hunter College, City University of New York, New York, NY, USA
- Ph.D. Program in Biochemistry, The Graduate Center of the City University of New York, New York, NY, USA
| | - Russell Thomson
- Hunter College, City University of New York, New York, NY, USA
| | - Jayne Raper
- Hunter College, City University of New York, New York, NY, USA.
- Ph.D. Program in Biology, The Graduate Center of the City University of New York, New York, NY, USA.
- Ph.D. Program in Biochemistry, The Graduate Center of the City University of New York, New York, NY, USA.
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Sanches-Vaz M, Temporão A, Luis R, Nunes-Cabaço H, Mendes AM, Goellner S, Carvalho T, Figueiredo LM, Prudêncio M. Trypanosoma brucei infection protects mice against malaria. PLoS Pathog 2019; 15:e1008145. [PMID: 31703103 PMCID: PMC6867654 DOI: 10.1371/journal.ppat.1008145] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 11/20/2019] [Accepted: 10/11/2019] [Indexed: 12/22/2022] Open
Abstract
Sleeping sickness and malaria are parasitic diseases with overlapping geographical distributions in sub-Saharan Africa. We hypothesized that the immune response elicited by an infection with Trypanosoma brucei, the etiological agent of sleeping sickness, would inhibit a subsequent infection by Plasmodium, the malaria parasite, decreasing the severity of its associated pathology. To investigate this, we established a new co-infection model in which mice were initially infected with T. brucei, followed by administration of P. berghei sporozoites. We observed that a primary infection by T. brucei significantly attenuates a subsequent infection by the malaria parasite, protecting mice from experimental cerebral malaria and prolonging host survival. We further observed that an ongoing T. brucei infection leads to an accumulation of lymphocyte-derived IFN-γ in the liver, limiting the establishment of a subsequent hepatic infection by P. berghei sporozoites. Thus, we identified a novel host-mediated interaction between two parasitic infections, which may be epidemiologically relevant in regions of Trypanosoma/Plasmodium co-endemicity. Despite the geographical overlap between the parasites that cause sleeping sickness and malaria, the reciprocal impact of a co-infection by T. brucei and Plasmodium had hitherto not been assessed. We hypothesized that the strong immune response elicited by a T. brucei infection could potentially limit the ability of Plasmodium parasites to infect the same host. In this study, we showed that a primary infection by T. brucei significantly attenuates a subsequent infection by the malaria parasite. Importantly, a significant proportion of the co-infected mice do not develop Plasmodium parasitemia, and those few that do, do not display symptoms of severe malaria and survive longer than their singly infected counterparts. We further showed that the prevention or delay in appearance of malaria parasites in the blood results from a dramatic impairment of the preceding liver infection by Plasmodium, which is mediated by the strong immune response mounted against the primary T. brucei infection. Our study provides new insights for a novel inter-pathogen interaction that may bear great epidemiological significance in regions of Trypanosoma/Plasmodium co-endemicity.
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Affiliation(s)
- Margarida Sanches-Vaz
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Adriana Temporão
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Rafael Luis
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Helena Nunes-Cabaço
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - António M. Mendes
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Sarah Goellner
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Tânia Carvalho
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Luisa M. Figueiredo
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- * E-mail: (LMF); (MP)
| | - Miguel Prudêncio
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- * E-mail: (LMF); (MP)
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Kamoto K, Noyes H, Nambala P, Senga E, Musaya J, Kumwenda B, Bucheton B, Macleod A, Cooper A, Clucas C, Herz-Fowler C, Matove E, Chiwaya AM, Chisi JE. Association of APOL1 renal disease risk alleles with Trypanosoma brucei rhodesiense infection outcomes in the northern part of Malawi. PLoS Negl Trop Dis 2019; 13:e0007603. [PMID: 31412021 PMCID: PMC6750591 DOI: 10.1371/journal.pntd.0007603] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 09/18/2019] [Accepted: 07/04/2019] [Indexed: 12/19/2022] Open
Abstract
Trypanosoma brucei (T.b.) rhodesiense is the cause of the acute form of human African trypanosomiasis (HAT) in eastern and southern African countries. There is some evidence that there is diversity in the disease progression of T.b. rhodesiense in different countries. HAT in Malawi is associated with a chronic haemo-lymphatic stage infection compared to other countries, such as Uganda, where the disease is acute with more marked neurological impairment. This has raised the question of the role of host genetic factors in infection outcomes. A candidate gene association study was conducted in the northern region of Malawi. This was a case-control study involving 202 subjects, 70 cases and 132 controls. All individuals were from one area; born in the area and had been exposed to the risk of infection since birth. Ninety-six markers were genotyped from 17 genes: IL10, IL8, IL4, HLA-G, TNFA, IL6, IFNG, MIF, APOL, HLA-A, IL1B, IL4R, IL12B, IL12R, HP, HPR, and CFH. There was a strong significant association with APOL1 G2 allele (p = 0.0000105, OR = 0.14, CI95 = [0.05-0.41], BONF = 0.00068) indicating that carriers of the G2 allele were protected against T.b. rhodesiense HAT. SNP rs2069845 in IL6 had raw p < 0.05, but did not remain significant after Bonferroni correction. There were no associations found with the other 15 candidate genes. Our finding confirms results from other studies that the G2 variant of APOL1 is associated with protection against T.b. rhodesiense HAT.
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Affiliation(s)
- Kelita Kamoto
- University of Malawi, College of Medicine, Department of Basic Medical Sciences, Blantyre, Malawi
| | - Harry Noyes
- Centre for Genomic Research, University of Liverpool, United Kingdom
| | - Peter Nambala
- University of Malawi, College of Medicine, Department of Basic Medical Sciences, Blantyre, Malawi
| | - Edward Senga
- University of Malawi, College of Medicine, Department of Basic Medical Sciences, Blantyre, Malawi
| | - Janelisa Musaya
- University of Malawi, College of Medicine, Department of Basic Medical Sciences, Blantyre, Malawi
| | - Benjamin Kumwenda
- University of Malawi, College of Medicine, Department of Basic Medical Sciences, Blantyre, Malawi
| | - Bruno Bucheton
- Institut de Recherche pour le Développement (IRD), IRD-CIRAD 177, Montpellier, France
- Programme National de Lutte contre la Trypanosomose Humaine Africaine, Conakry, Guinea
| | - Annette Macleod
- Wellcome Trust Centre for Molecular Parasitology, University Place, Glasgow, United Kingdom
| | - Anneli Cooper
- Wellcome Trust Centre for Molecular Parasitology, University Place, Glasgow, United Kingdom
| | - Caroline Clucas
- Wellcome Trust Centre for Molecular Parasitology, University Place, Glasgow, United Kingdom
| | | | | | | | - John E. Chisi
- University of Malawi, College of Medicine, Department of Basic Medical Sciences, Blantyre, Malawi
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Batista JS, Araújo Júnior HND, Moura GHF, Góis RCDS, Paiva KARD, Silva JBD, Costa WP, Menezes MCD, Nunes FVA, Costa KMDFM, Medeiros GVDD. Cardiac involvement in trypanosomiasis in sheep experimentally infected by Trypanosoma vivax (Ziemman, 1905). Exp Parasitol 2019; 205:107714. [PMID: 31279927 DOI: 10.1016/j.exppara.2019.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 02/07/2018] [Revised: 04/13/2019] [Accepted: 05/27/2019] [Indexed: 11/15/2022]
Abstract
The objective of the present study was to evaluate the clinical signs, electrocardiographic signs and evolution of histopathological lesions in the heart of sheep experimentally infected by Trypanosoma vivax during the acute and chronic phases of infection as well as to investigate the presence of parasitic DNA in the heart using polymerase chain reaction (PCR). Twenty-two male sheep were divided into the following four groups: G1, which consisted of six sheep infected by T. vivax that were evaluated until 20 days post-infection (dpi; acute phase); G2, which consisted of six sheep infected by T. vivax that were evaluated until 90 dpi (chronic phase); and G3 and G4 groups, which each consisted of five uninfected sheep. At the end of the experimental period, electrocardiographic evaluations and necroscopic examinations were performed. Fragments of the heart were collected and stained by Hematoxylin-Eosin and Masson's trichrome, and the fragments were also evaluated by PCR for T. vivax. G2 animals presented clinical signs suggestive of heart failure and electrocardiogram alterations characterized by prolonged P, T and QRS complex durations as well as by a cardiac electrical axis shift to the left and increased heart rate. In these animals, mononuclear multifocal myocarditis and interstitial fibrosis were also observed. PCR revealed positivity for T. vivax in two G1 animals and in all G2 animals. Thus, these findings suggested that T. vivax is responsible for the occurrence of cardiac lesions, which are related to heart failure, electrocardiographic alterations and mortality of the infected animals.
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Affiliation(s)
- Jael Soares Batista
- Center for Agrarian Sciences, Federal Rural of the Semi-Arid University, Mossoro, 572 Av. Francisco Mota, Presidente Costa e Silva, RN, 59625-900, Brazil.
| | - Hélio Noberto de Araújo Júnior
- Center for Agrarian Sciences, Federal Rural of the Semi-Arid University, Mossoro, 572 Av. Francisco Mota, Presidente Costa e Silva, RN, 59625-900, Brazil.
| | - Gabriela Hémylin Ferreira Moura
- Center for Agrarian Sciences, Federal Rural of the Semi-Arid University, Mossoro, 572 Av. Francisco Mota, Presidente Costa e Silva, RN, 59625-900, Brazil
| | - Rayr Cezar de Souza Góis
- Center for Agrarian Sciences, Federal Rural of the Semi-Arid University, Mossoro, 572 Av. Francisco Mota, Presidente Costa e Silva, RN, 59625-900, Brazil
| | - Kaliane Alessandra Rodrigues de Paiva
- Center for Agrarian Sciences, Federal Rural of the Semi-Arid University, Mossoro, 572 Av. Francisco Mota, Presidente Costa e Silva, RN, 59625-900, Brazil
| | - Jardel Bezerra da Silva
- Center for Agrarian Sciences, Federal Rural of the Semi-Arid University, Mossoro, 572 Av. Francisco Mota, Presidente Costa e Silva, RN, 59625-900, Brazil
| | - Wirton Peixoto Costa
- Center for Agrarian Sciences, Federal Rural of the Semi-Arid University, Mossoro, 572 Av. Francisco Mota, Presidente Costa e Silva, RN, 59625-900, Brazil
| | - Manuela Costa de Menezes
- Center for Agrarian Sciences, Federal Rural of the Semi-Arid University, Mossoro, 572 Av. Francisco Mota, Presidente Costa e Silva, RN, 59625-900, Brazil
| | - Francisco Vitor Aires Nunes
- Center for Agrarian Sciences, Federal Rural of the Semi-Arid University, Mossoro, 572 Av. Francisco Mota, Presidente Costa e Silva, RN, 59625-900, Brazil
| | | | - Gerard Vicente Dantas de Medeiros
- Center for Agrarian Sciences, Federal Rural of the Semi-Arid University, Mossoro, 572 Av. Francisco Mota, Presidente Costa e Silva, RN, 59625-900, Brazil
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Laperchia C, Palomba M, Seke Etet PF, Rodgers J, Bradley B, Montague P, Grassi-Zucconi G, Kennedy PGE, Bentivoglio M. Trypanosoma brucei Invasion and T-Cell Infiltration of the Brain Parenchyma in Experimental Sleeping Sickness: Timing and Correlation with Functional Changes. PLoS Negl Trop Dis 2016; 10:e0005242. [PMID: 28002454 PMCID: PMC5217973 DOI: 10.1371/journal.pntd.0005242] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 01/06/2017] [Accepted: 12/07/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The timing of Trypanosoma brucei entry into the brain parenchyma to initiate the second, meningoencephalitic stage of human African trypanosomiasis or sleeping sickness is currently debated and even parasite invasion of the neuropil has been recently questioned. Furthermore, the relationship between neurological features and disease stage are unclear, despite the important diagnostic and therapeutic implications. METHODOLOGY Using a rat model of chronic Trypanosoma brucei brucei infection we determined the timing of parasite and T-cell neuropil infiltration and its correlation with functional changes. Parasite DNA was detected using trypanosome-specific PCR. Body weight and sleep structure alterations represented by sleep-onset rapid eye movement (SOREM) periods, reported in human and experimental African trypanosomiasis, were monitored. The presence of parasites, as well as CD4+ and CD8+ T-cells in the neuropil was assessed over time in the brain of the same animals by immunocytochemistry and quantitative analyses. PRINCIPAL FINDINGS Trypanosome DNA was present in the brain at day 6 post-infection and increased more than 15-fold by day 21. Parasites and T-cells were observed in the parenchyma from day 9 onwards. Parasites traversing blood vessel walls were observed in the hypothalamus and other brain regions. Body weight gain was reduced from day 7 onwards. SOREM episodes started in most cases early after infection, with an increase in number and duration after parasite neuroinvasion. CONCLUSION These findings demonstrate invasion of the neuropil over time, after an initial interval, by parasites and lymphocytes crossing the blood-brain barrier, and show that neurological features can precede this event. The data thus challenge the current clinical and cerebrospinal fluid criteria of disease staging.
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Affiliation(s)
- Claudia Laperchia
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Maria Palomba
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Paul F. Seke Etet
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Jean Rodgers
- Institute of Biodiversity Animal Health and Comparative Medicine, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Barbara Bradley
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Paul Montague
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Gigliola Grassi-Zucconi
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Peter G. E. Kennedy
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Marina Bentivoglio
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- National Institute of Neuroscience (INN), Verona Unit, Verona, Italy
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Ndilu LK, Ekila MB, Mayuma DF, Musaka A, Wumba R, Aloni MN. Characteristics, behaviors and association between Human African Trypanosomiasis and HIV seropositivity among volunteer blood donors in a semi-rural area: A survey from Kikwit, the Democratic Republic of Congo. Acta Parasitol 2016; 61:689-693. [PMID: 27787206 DOI: 10.1515/ap-2016-0096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 06/15/2016] [Indexed: 11/15/2022]
Abstract
Blood safety is a major element in the strategy to control the HIV epidemic. The aim of this study was to determine the prevalence and the associated factors of a positive HIV test among blood donors and its association between Human African Trypanosomiasis in Kikwit, the Democratic Republic of Congo. A cross-sectional study was conducted between November 2012 and May 2013. An anonymous questionnaire was designed to extract relevant data. The average mean age of participants was 30 years. The majority were man (67.8%). The overall prevalence of HIV, syphilis, hepatitis B, hepatitis C and human African trypanosomiasis was respectively 3.2%, 1.9%, 1.6%, 1.3% and 1.3%. Alcohol intake, casual unprotected sex, not using condoms during casual sex, sex after alcohol intake and seroprevalence of human African trypanosomiasis were significantly associated with a positive HIV test result ( p<0.05). In this study, sexual risk behaviors were the major risk factors associated with positive HIV tests in blood donors living in Kikwit. It is important to raise awareness about HIV and voluntary blood donation in response to some observations noted in this study such as the low educational level of the blood donors, the low level of knowledge of HIV prevention methods.
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Mbewe NJ, Namangala B, Sitali L, Vorster I, Michelo C. Prevalence of pathogenic trypanosomes in anaemic cattle from trypanosomosis challenged areas of Itezhi-tezhi district in central Zambia. Parasit Vectors 2015; 8:638. [PMID: 26669306 PMCID: PMC4681019 DOI: 10.1186/s13071-015-1260-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 12/10/2015] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The measure of anaemia status using packed cell volume (PCV) can be a reliable indicator of African trypanosomosis (AT) in the absence of other anaemia-causing conditions. However, studies that have estimated prevalence of anaemia in cattle from AT endemic areas have rarely reported the prevalence of the disease in the anaemic cattle. Therefore we investigated the prevalence of AT in anaemic cattle at sites that had recently reported the disease in Itezhi tezhi district of central Zambia. METHODS During a survey, blood samples were collected from 564 randomly selected cattle for anaemia determination from seven crush pens (Mutenda, Kapulwe, Banachoongo, Itumbi, Iyanda, New Ngoma and Shinampamba). At a PCV- value cut off of 26 %, all samples positive for anaemia were subjected to both parasitological examination on thick and thin blood smears and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) for detection of trypanosome DNA. Fisher's exact test and a mixed effect logistic regression analyses were used to determine and measures associations, respectively. RESULTS Of 564 cattle screened, 58 (10.3 %; 95 % CI: 7.8-12.8 %) had anaemia. PCR-RFLP results showed that 17 (29.3 %; 95 % CI; 17.2-41.4 %) anaemic cattle were positive for pathogenic trypanosomes compared to 1 (1.7 %; 95 % CI: 0.0-5.2 %) on parasitological examination using thick smears. The infections were caused by Trypanosoma congolense and Trypanosoma vivax. Fisher's exact test showed a strong association between PCV and pathogenic trypanosome infection (P = 0.004). A mixed effect multivariate logistic regression showed that a one unit increase in PCV reduced the likelihood of detecting AT with PCR-RFLP by 24.7 % (95 % CI: 4.6-40.6 %; P = 0.019) in anaemic cattle, taking into account their age and sex, with random effects for crush pen. CONCLUSION These results suggest that T. congolense and T. vivax could be important causes of anaemia in cattle reared in AT endemic areas of Itezhi tezhi in Central Zambia. This also suggests that even though pathogenic trypanosomal infection was strongly associated with PCV, it could only account for up to 41 % of the anaemia in cattle. Therefore further investigation to ascertain other factors responsible for anaemia in AT endemic areas of Itezhi tezhi in Central Zambia is needed.
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Affiliation(s)
- Njelembo J Mbewe
- Department of Public Health, School of Medicine, University of Zambia, P.O. Box 50110, Lusaka, Zambia.
- Tsetse and Trypanosomiasis Control Section, Department of Veterinary Services, P.O. Box 350001, Chilanga, Zambia.
| | - Boniface Namangala
- Department of Paraclinical Studies, School of Veterinary Medicine, University of Zambia, P.O. Box 32379, Lusaka, Zambia.
| | - Lungowe Sitali
- Department of Public Health, School of Medicine, University of Zambia, P.O. Box 50110, Lusaka, Zambia.
| | - Ilse Vorster
- Department of Veterinary Tropical Diseases, Faculty of Veterinary Science, University of Pretoria, Private Bag X04, Onderstepoort, 0110, South Africa.
| | - Charles Michelo
- Department of Public Health, School of Medicine, University of Zambia, P.O. Box 50110, Lusaka, Zambia.
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Cnops J, De Trez C, Stijlemans B, Keirsse J, Kauffmann F, Barkhuizen M, Keeton R, Boon L, Brombacher F, Magez S. NK-, NKT- and CD8-Derived IFNγ Drives Myeloid Cell Activation and Erythrophagocytosis, Resulting in Trypanosomosis-Associated Acute Anemia. PLoS Pathog 2015; 11:e1004964. [PMID: 26070118 PMCID: PMC4466398 DOI: 10.1371/journal.ppat.1004964] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 05/20/2015] [Indexed: 01/17/2023] Open
Abstract
African trypanosomes are the causative agents of Human African Trypanosomosis (HAT/Sleeping Sickness) and Animal African Trypanosomosis (AAT/Nagana). A common hallmark of African trypanosome infections is inflammation. In murine trypanosomosis, the onset of inflammation occurs rapidly after infection and is manifested by an influx of myeloid cells in both liver and spleen, accompanied by a burst of serum pro-inflammatory cytokines. Within 48 hours after reaching peak parasitemia, acute anemia develops and the percentage of red blood cells drops by 50%. Using a newly developed in vivo erythrophagocytosis assay, we recently demonstrated that activated cells of the myeloid phagocytic system display enhanced erythrophagocytosis causing acute anemia. Here, we aimed to elucidate the mechanism and immune pathway behind this phenomenon in a murine model for trypanosomosis. Results indicate that IFNγ plays a crucial role in the recruitment and activation of erythrophagocytic myeloid cells, as mice lacking the IFNγ receptor were partially protected against trypanosomosis-associated inflammation and acute anemia. NK and NKT cells were the earliest source of IFNγ during T. b. brucei infection. Later in infection, CD8+ and to a lesser extent CD4+ T cells become the main IFNγ producers. Cell depletion and transfer experiments indicated that during infection the absence of NK, NKT and CD8+ T cells, but not CD4+ T cells, resulted in a reduced anemic phenotype similar to trypanosome infected IFNγR-/- mice. Collectively, this study shows that NK, NKT and CD8+ T cell-derived IFNγ is a critical mediator in trypanosomosis-associated pathology, driving enhanced erythrophagocytosis by myeloid phagocytic cells and the induction of acute inflammation-associated anemia. African trypanosomes are the causative agents of Human and Animal African Trypanosomosis, impairing economic development and causing death throughout the African continent. Anemia and inflammation are hallmark features of virtually every type of trypanosome infection. During experimental murine trypanosomosis, early inflammation causes enhanced red blood cell phagocytosis by cells of the myeloid phagocytic system, leading to severe anemia within 48 hours past peak parasitemia. Here, we identify the pro-inflammatory cytokine IFNγ as the main driver of the early inflammatory reaction and enhanced red blood cell phagocytosis. This IFNγ is derived consecutively by NK, NKT and CD8+ T cells, hence these cells all play a crucial role in the induction of inflammation and anemia.
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Affiliation(s)
- Jennifer Cnops
- Laboratory of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Structural Biology, Vlaams Instituut voor Biotechnologie (VIB), Brussels, Belgium
| | - Carl De Trez
- Laboratory of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Structural Biology, Vlaams Instituut voor Biotechnologie (VIB), Brussels, Belgium
| | - Benoit Stijlemans
- Laboratory of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Myeloid Cell Immunology, VIB, Brussels, Belgium
| | - Jiri Keirsse
- Laboratory of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Myeloid Cell Immunology, VIB, Brussels, Belgium
| | - Florence Kauffmann
- Laboratory of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Structural Biology, Vlaams Instituut voor Biotechnologie (VIB), Brussels, Belgium
| | - Mark Barkhuizen
- International Centre for Genetic Engineering and Biotechnology, Cape Town Component, Cape Town, South Africa
- Faculty of Health Sciences (IDM, Division Immunology), University of Cape Town, Cape Town, South Africa
| | - Roanne Keeton
- Faculty of Health Sciences (IDM, Division Immunology), University of Cape Town, Cape Town, South Africa
| | | | - Frank Brombacher
- International Centre for Genetic Engineering and Biotechnology, Cape Town Component, Cape Town, South Africa
- Faculty of Health Sciences (IDM, Division Immunology), University of Cape Town, Cape Town, South Africa
| | - Stefan Magez
- Laboratory of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Structural Biology, Vlaams Instituut voor Biotechnologie (VIB), Brussels, Belgium
- Faculty of Health Sciences (IDM, Division Immunology), University of Cape Town, Cape Town, South Africa
- * E-mail: (SM); (FB)
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Abstract
BACKGROUND Anaemia is an important complication of trypanosomiasis. The mechanisms through which trypanosomal infection leads to anaemia are poorly defined. A number of studies have implicated inflammatory cytokines, but these data are limited and inconsistent. In this article, we reviewed the published literature on cytokines associated with Trypanosoma brucei infections and their role in the immunopathology leading to anaemia. METHODOLOGY Articles were searched in PubMed through screening of titles and abstracts with no limitation on date of publishing and study design. Articles in English were searched using keywords "African trypanosomiasis", "sleeping sickness", "Trypanosoma brucei", in all possible combinations with "anaemia" and/or "cytokines". RESULTS Twelve articles examining cytokines and their role in trypanosomeinduced anaemia were identified out of 1095 originally retrieved from PubMed. None of the articles identified were from human-based studies. A total of eight cytokines were implicated, with four cytokines (IFN-γ, IL-10, TNF-α, IL-12) showing an association with anaemia. These articles reported that mice lacking TNF-α were able to control anaemia, and that IFN-γ was linked to severe anaemia given its capacity to suppress erythropoiesis, while IL-10 was shown to regulate IFN-γ and TNF-α, providing a balance that was associated with severity of anaemia. IFN-γ and TNF-α have also been reported to work in concert with other factors such as nitric oxide and iron in order to induce anaemia. CONCLUSION IFN-γ, IL-10, and TNF-α were the three major cytokines identified to be heavily involved in anaemia caused by Trypanosoma brucei infection. The anti-inflammatory cytokine, IL-10, was shown to counter the effects of proinflammatory cytokines in order to balance the severity of anaemia. The mechanism of anaemia is multifactorial and therefore requires further, more elaborate research. Data from human subjects would also shed more light.
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Affiliation(s)
- J Musaya
- Department of Pathology, Microbiology Unit, College of Medicine, University of Malawi, Blantyre, Malawi
| | - E Matovu
- Department of Biotechnical and Diagnostic Sciences, College of Veterinary Sciences, Animal Resource and Biosecurity, Makerere University, Kampala, Uganda
| | - M Nyirenda
- Department of Medicine, College of Medicine, University of Malawi & Malawi-Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi
| | - J Chisi
- Department of Basic Medical Sciences, Anatomy Unit, College of Medicine, University of Malawi, Blantyre, Malawi
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McCarroll CS, Rossor CL, Morrison LR, Morrison LJ, Loughrey CM. A Pre-clinical Animal Model of Trypanosoma brucei Infection Demonstrating Cardiac Dysfunction. PLoS Negl Trop Dis 2015; 9:e0003811. [PMID: 26023927 PMCID: PMC4449042 DOI: 10.1371/journal.pntd.0003811] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 05/04/2015] [Indexed: 11/19/2022] Open
Abstract
African trypanosomiasis (AT), caused by Trypanosoma brucei species, results in both neurological and cardiac dysfunction and can be fatal if untreated. Research on the pathogenesis and treatment of the disease has centred to date on the characteristic neurological symptoms, whereas cardiac dysfunction (e.g. ventricular arrhythmias) in AT remains largely unstudied. Animal models of AT demonstrating cardiac dysfunction similar to that described in field cases of AT are critically required to transform our understanding of AT-induced cardiac pathophysiology and identify future treatment strategies. We have previously shown that T. brucei can interact with heart muscle cells (cardiomyocytes) to induce ventricular arrhythmias in ex vivo adult rat hearts. However, it is unknown whether the arrhythmias observed ex vivo are also present during in vivo infection in experimental animal models. Here we show for the first time the characterisation of ventricular arrhythmias in vivo in two animal models of AT infection using electrocardiographic (ECG) monitoring. The first model utilised a commonly used monomorphic laboratory strain, Trypanosoma brucei brucei Lister 427, whilst the second model used a pleomorphic laboratory strain, T. b. brucei TREU 927, which demonstrates a similar chronic infection profile to clinical cases. The frequency of ventricular arrhythmias and heart rate (HR) was significantly increased at the endpoint of infection in the TREU 927 infection model, but not in the Lister 427 infection model. At the end of infection, hearts from both models were isolated and Langendorff perfused ex vivo with increasing concentrations of the β-adrenergic agonist isoproterenol (ISO). Interestingly, the increased frequency of arrhythmias observed in vivo in the TREU 927 infection model was lost upon isolation of the heart ex vivo, but re-emerged with the addition of ISO. Our results demonstrate that TREU 927 infection modifies the substrate of the myocardium in such a way as to increase the propensity for ventricular arrhythmias in response to a circulating factor in vivo or β-adrenergic stimulation ex vivo. The TREU 927 infection model provides a new opportunity to accelerate our understanding of AT-related cardiac pathophysiology and importantly has the required sensitivity to monitor adverse cardiac-related electrical dysfunction when testing new therapeutic treatments for AT.
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Affiliation(s)
- Charlotte S. McCarroll
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Charlotte L. Rossor
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Linda R. Morrison
- Easter Bush Pathology, Royal (Dick) School of Veterinary Studies and The Roslin Institute, Easter Bush Campus, University of Edinburgh, Midlothian, United Kingdom
| | - Liam J. Morrison
- Wellcome Trust Centre for Molecular Parasitology, Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
- Roslin Institute, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, Midlothian, United Kingdom
| | - Christopher M. Loughrey
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
- * E-mail:
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Elliott I, Patel T, Shah J, Venkatesan P. West-African trypanosomiasis in a returned traveller from Ghana: an unusual cause of progressive neurological decline. BMJ Case Rep 2014; 2014:bcr2014204451. [PMID: 25123570 PMCID: PMC4139564 DOI: 10.1136/bcr-2014-204451] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2014] [Indexed: 11/04/2022] Open
Abstract
West-African trypanosomiasis caused by Trypanosoma brucei gambiense is a rare imported infection presenting with somnolence, lymphadenopathy and wide-ranging neurological symptoms. A 67-year-old Caucasian man presented with a 10-month history of cognitive deterioration, ataxic gait, somnolence and urinary incontinence. His symptoms had progressed more rapidly over the course of a month prior to admission. Serological testing confirmed a diagnosis of West-African trypanosomiasis. The patient was successfully treated with eflornithine and made a good recovery. West-African trypanosomiasis should be considered in the differential diagnosis of unexplained cognitive decline in those with a relevant travel history. If left untreated, the condition is universally fatal.
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Affiliation(s)
- Ivo Elliott
- Department of Infectious Diseases, Nottingham University Hospitals City Campus, Nottingham, UK
| | | | - Jagrit Shah
- Department of Radiology, Nottingham University Hospitals, Nottingham, USA
| | - Pradhib Venkatesan
- Department of Infectious Diseases, Nottingham University Hospitals City Campus, Nottingham, UK
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Ibrahim MA, Musa AM, Aliyu AB, Mayaki HS, Gideon A, Islam MS. Phenolics-rich fraction of Khaya senegalensis stem bark: antitrypanosomal activity and amelioration of some parasite-induced pathological changes. Pharm Biol 2013; 51:906-913. [PMID: 23627467 DOI: 10.3109/13880209.2013.771191] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
CONTEXT The stem bark of Khaya senegalensis A. Juss (Meliaceae) is currently used for the treatment of trypanosomiasis by traditional practitioners in Nigeria. OBJECTIVES The present study investigated the anti-Trypanosoma brucei brucei activity of phenolics-rich fraction of K. senegalensis (pfks) and its ameliorative effects on trypanosome-induced pathological changes. MATERIALS AND METHODS The fraction was initially analyzed by gas chromatography-mass spectrometry (GC-MS). A 60 min time course experiment was conducted with various concentrations of the fraction using a 96-well microtiter plate technique and was further used to treat T. brucei infected rats at 100, 200 and 300 mg/kg body weight (BW). Indices of anemia as well as hepatic and renal functions were analyzed in all experimental animals at the end of the experiment. RESULTS The GC-MS analysis of the pfks revealed that the most abundant phytochemicals are phloroglucinol (40.56%) and 3,4-(dihydroxyphenyl) acetic acid (41.76%). The fraction showed a concentration dependent in vitro antitrypanosomal activity. Interestingly, the fraction completely eliminated the parasites from the bloodstream of infected rats without relapse during the experimental period at the dose of 300 mg/kg BW and also kept the parasites consistently lower at 100 and 200 mg/kg BW than that was recorded in the untreated infected rats. Furthermore, the severity of T. brucei-induced anemia and hepatic damage was significantly (p < 0.05) ameliorated in the 300 mg/kg BW treatment group whereas the parasite-induced renal damage was significantly (p < 0.05) ameliorated in all treatment groups. CONCLUSION Data from this study may suggest that phenolics play an important role in the antitrypanosomal activity of K. senegalensis.
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Kuriakose S, Muleme HM, Onyilagha C, Singh R, Jia P, Uzonna JE. Diminazene aceturate (Berenil) modulates the host cellular and inflammatory responses to Trypanosoma congolense infection. PLoS One 2012; 7:e48696. [PMID: 23144931 PMCID: PMC3492428 DOI: 10.1371/journal.pone.0048696] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Accepted: 09/27/2012] [Indexed: 11/18/2022] Open
Abstract
Background Trypanosoma congolense are extracellular and intravascular blood parasites that cause debilitating acute or chronic disease in cattle and other domestic animals. Diminazene aceturate (Berenil) has been widely used as a chemotherapeutic agent for trypanosomiasis in livestock since 1955. As in livestock, treatment of infected highly susceptible BALB/c mice with Berenil leads to rapid control of parasitemia and survival from an otherwise lethal infection. The molecular and biochemical mechanisms of action of Berenil are still not very well defined and its effect on the host immune system has remained relatively unstudied. Here, we investigated whether Berenil has, in addition to its trypanolytic effect, a modulatory effect on the host immune response to Trypanosoma congolense. Methodology/Principal Findings BALB/c and C57BL/6 mice were infected intraperitoneally with T. congolense, treated with Berenil and the expression of CD25 and FoxP3 on splenic cells was assessed directly ex vivo. In addition, serum levels and spontaneous and LPS-induced production of pro-inflammatory cytokines by splenic and hepatic CD11b+ cells were determined by ELISA. Berenil treatment significantly reduced the percentages of CD25+ cells, a concomitant reduction in the percentage of regulatory (CD4+Foxp3+) T cells and a striking reduction in serum levels of disease exacerbating pro-inflammatory cytokines including IL-6, IL-12, TNF and IFN-γ. Furthermore, Berenil treatment significantly suppressed spontaneous and LPS-induced production of inflammatory cytokines by splenic and liver macrophages and significantly ameliorated LPS-induced septic shock and the associated cytokine storm. Conclusions/Significance Collectively, these results provide evidence that in addition to its direct trypanolytic effect, Berenil also modulates the host immune response to the parasite in a manner that dampen excessive immune activation and production of pathology-promoting pro-inflammatory cytokines, suggesting that this drug may also be beneficial for treatment of disease conditions caused by excessive production of inflammatory cytokines.
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Affiliation(s)
- Shiby Kuriakose
- Department of Immunology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Helen M. Muleme
- Department of Immunology, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Rani Singh
- Department of Immunology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ping Jia
- Department of Immunology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jude E. Uzonna
- Department of Immunology, University of Manitoba, Winnipeg, Manitoba, Canada
- * E-mail:
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Kuepfer I, Schmid C, Allan M, Edielu A, Haary EP, Kakembo A, Kibona S, Blum J, Burri C. Safety and efficacy of the 10-day melarsoprol schedule for the treatment of second stage Rhodesiense sleeping sickness. PLoS Negl Trop Dis 2012; 6:e1695. [PMID: 22970329 PMCID: PMC3435133 DOI: 10.1371/journal.pntd.0001695] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2011] [Accepted: 05/01/2012] [Indexed: 11/19/2022] Open
Abstract
Objective Assessment of the safety and efficacy of a 10-day melarsoprol schedule in second stage T.b. rhodesiense patients and the effect of suramin-pretreatment on the incidence of encephalopathic syndrome (ES) during melarsoprol therapy. Design Sequential conduct of a proof-of-concept trial (n = 60) and a utilization study (n = 78) using historic controls as comparator. Setting Two trial centres in the T.b. rhodesiense endemic regions of Tanzania and Uganda. Participants: Consenting patients with confirmed second stage disease and a minimum age of 6 years were eligible for participation. Unconscious and pregnant patients were excluded. Main Outcome Measures The primary outcome measures were safety and efficacy at end of treatment. The secondary outcome measure was efficacy during follow-up after 3, 6 and 12 months. Results The incidence of ES in the trial population was 11.2% (CI 5–17%) and 13% (CI 9–17%) in the historic data. The respective case fatality rates were 8.4% (CI 3–13.8%) and 9.3% (CI 6–12.6%). All patients discharged alive were free of parasites at end of treatment. Twelve months after discharge, 96% of patients were clinically cured. The mean hospitalization time was reduced from 29 to 13 days (p<0.0001) per patient. Conclusions The 10-day melarsoprol schedule does not expose patients to a higher risk of ES or death than does treatment according to national schedules in current use. The efficacy of the 10-day melarsoprol schedule was highly satisfactory. No benefit could be attributed to the suramin pre-treatment. Trial Registration Current Controlled Trials ISRCTN40537886 Human African Trypanosomiasis (HAT) is a parasitic disease that occurs in a chronic form caused by T.b. gambiense in West and Central Africa and in an acute form caused by T.b. rhodesiense in East and South Africa. In the first stage of the disease parasites are detectable in blood and lymph. Once they enter the central nervous system, patients are in the so-called second stage, which is fatal if left untreated. Melarsoprol, an old and highly toxic drug, remains the only available treatment for second stage T.b. rhodesiense HAT. The empirically developed treatment regimens are a high burden to affected patients and health care providers due to very long hospitalization times and complicated dosing schemes. An improved 10-day melarsoprol treatment schedule was developed and tested in second stage T.b. gambiense patients from 1997–2004 and was approved for large-scale use by the International Scientific Committee for Trypanosomiasis Research and Control (ISCTRC) in 2003. To test its adequacy also in T.b. rhodesiense patients, a series of clinical trials were conducted from 2005–2009. Based on these results the ISCTRC has officially recommended the use of the 10-day melarsoprol schedule also for treatment of second stage Rhodesiense HAT in 2009.
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Affiliation(s)
- Irene Kuepfer
- Swiss Tropical and Public Heath Institute, Basel, Switzerland.
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Reid H, Kibona S, Rodney A, McPherson B, Sindato C, Malele I, Kinung'hi S, Jennaway M, Changalucha J, Blake B, Vallely A. Assessment of the burden of human African trypanosomiasis by rapid participatory appraisal in three high-risk villages in Urambo District, Northwest Tanzania. Afr Health Sci 2012; 12:104-13. [PMID: 23056014 DOI: 10.4314/ahs.v12i2.5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [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] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The public health and socio-economic burden of Human African Trypanosomiasis (HAT) in East Africa is not well documented. Understanding the epidemiology and impact of HAT in such settings is difficult due to a lack of robust surveillance and reporting systems, restricting evidence-based policy development and contributing to the continued neglect of this disease. OBJECTIVE To investigate the burden of HAT in Urambo District, Tanzania in order to inform future public health policy. METHODS A rapid participatory appraisal (RPA) using a combination of qualitative and quantitative methods was conducted, that included key informant interviews, hospital record analysis, and tools adapted from participatory learning and action. RESULTS Three villages adjacent to Ugala Game Reserve appeared to be the most affected. High levels of under-reporting were noted due to a lack of diagnostic tools at peripheral health care facilities and limited access to specialist services. Community stakeholders perceived the health and socio-economic burden of HAT to be similar to that of malaria. CONCLUSION The burden of HAT in remote rural communities is difficult to capture through routine surveillance systems alone. The RPA represents an efficient mechanism for engaging communities in public health action for trypanosomiasis control in northwest Tanzania.
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Affiliation(s)
- H Reid
- Australian Centre for International and Tropical Health, School of Population Health, University of Queensland, Herston, Brisbane, Australia
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Affiliation(s)
- Emily Wise
- Hospital for Tropical Diseases, University College London Hospitals NHS Trust, London.
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Corral-Corral I, Quereda Rodriguez-Navarro C. [Gustavo Pittaluga and the expedition to study sleeping sickness in the Spanish territories of the Gulf of Guinea (1909)]. Rev Neurol 2012; 54:49-58. [PMID: 22187212] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
INTRODUCTION Sleeping sickness, or human African trypanosomiasis, caused an important mortality at the beginnings of the twentieth century. For this reason the European colonial countries organized several scientific expeditions which contributed decisively to the knowledge of the disease. AIM To study the first investigation performed in Spain on African trypanosomiasis and in the field of tropical medicine, which was accomplished by a scientific expedition to the Spanish territories in the Gulf of Guinea organized by Cajal in 1909. DEVELOPMENT The parasitologist Gustavo Pittaluga, who became one of the most outstanding figures in Spanish medicine and public health during the first third of the twentieth century, commanded the expedition. Other members were Luis Rodriguez Illera and Jorge Ramon Fananas, Cajal's son. Along four months they travelled through the Spanish territories of Guinea, collecting clinical and epidemiological information on sleeping sickness and other diseases, and examining a great number of patients, who had hematological and parasitological studies performed. In the clinical description of the 14 cases of trypanosomiasis studied we have found the first description of the opsoclonus-myoclonus syndrome. A pathological study of the brain was performed in one case. In addition, important entomological studies and experimental investigations on trypanosomiasis were also performed. CONCLUSIONS This expedition took place in the context of the impulse of renovation of Spanish science headed by Cajal through the Junta de Ampliacion de Estudios, recently created. In the investigations performed in Guinea, Pittaluga demonstrated a high scientific standard in the fields of clinical medicine, hygiene, parasitology and entomology, comparable with other contemporary European studies.
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Affiliation(s)
- Iñigo Corral-Corral
- Servicio de Neurología, Hospital Universitario Ramon y Cajal, 28034 Madrid, España.
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Salamanca-Gómez F. [The unexpected: chronic renal insufficiency, parasitism, and selective advantage]. GAC MED MEX 2010; 146:298-299. [PMID: 20964076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Affiliation(s)
- Fabio Salamanca-Gómez
- Coordinación de Investigación en Salud, Instituto Mexicano del Seguro Social, México DF, México
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Stijlemans B, Vankrunkelsven A, Brys L, Raes G, Magez S, De Baetselier P. Scrutinizing the mechanisms underlying the induction of anemia of inflammation through GPI-mediated modulation of macrophage activation in a model of African trypanosomiasis. Microbes Infect 2010; 12:389-99. [PMID: 20197106 DOI: 10.1016/j.micinf.2010.02.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [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: 11/20/2009] [Revised: 02/05/2010] [Accepted: 02/09/2010] [Indexed: 11/20/2022]
Abstract
In animal trypanosomiasis the severity of infection is reflected by the degree of anemia which resembles anemia of inflammation, involving a skewed iron homeostasis leading to iron accumulation within the reticuloendothelial system. Myeloid cells (M cells) have been implicated in the induction and maintenance of this type of anemia and modulation of M cells through the main trypanosome-derived glycosylphosphatidylinositol (GPI)-anchor could attenuate both anemia and trypano-susceptibility in Trypanosoma brucei-infected mice. Herein the GPI-based treatment, allowing a straightforward comparison between trypanotolerance and susceptibility in T. brucei-infected C57Bl/6 mice, was further adopted to scrutinize mechanisms/pathways underlying trypanosome-elicited anemia. Hereby, the following interlinkable observations were made in GPI-based treated (GBT) T. brucei-infected mice: (i) a reduced inflammatory cytokine production and increased IL-10 production associated with alleviation of anemia and restoration of serum iron levels, (ii) a shift in increased liver expression of iron storage towards iron export genes, (iii) increased erythropoiesis in the bone marrow and extramedullar sites (spleen) probably reflecting a normalized iron homeostasis and availability. Collectively, our results demonstrate that reprogramming macrophages towards an anti-inflammatory state alleviates anemia of inflammation by normalizing iron homeostasis and restoring erythropoiesis.
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Affiliation(s)
- Benoît Stijlemans
- Department of Molecular and Cellular Interactions, VIB, 1050 Brussel, Belgium.
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Kager PA, Schipper HG, Stam J, Majoie CBLM. Magnetic resonance imaging findings in human African trypanosomiasis: a four-year follow-up study in a patient and review of the literature. Am J Trop Med Hyg 2009; 80:947-952. [PMID: 19478256] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
Serial magnetic resonance imaging (MRI) was performed up to 4 years after treatment in a patient with Trypanosoma brucei gambiense infection. Four years after treatment and cure abnormalities were still present, although the patient led a normal social life, without physical and mental impairments. The literature on MRI in human African trypanosomiasis is reviewed. The MRI is useful to discriminate between encephalitis induced by trypanosomiasis and post-treatment reactive encephalopathy, a severe and often fatal complication of treatment, in particular of treatment with arsenicals. The MRI is not useful for diagnosis of human African trypanosomiasis (HAT).
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Affiliation(s)
- Piet A Kager
- Center for Infection and Immunity, Department of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
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Noyes HA, Alimohammadian MH, Agaba M, Brass A, Fuchs H, Gailus-Durner V, Hulme H, Iraqi F, Kemp S, Rathkolb B, Wolf E, de Angelis MH, Roshandel D, Naessens J. Mechanisms controlling anaemia in Trypanosoma congolense infected mice. PLoS One 2009; 4:e5170. [PMID: 19365556 PMCID: PMC2664899 DOI: 10.1371/journal.pone.0005170] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2008] [Accepted: 03/05/2009] [Indexed: 12/21/2022] Open
Abstract
Background Trypanosoma congolense are extracellular protozoan parasites of the blood stream of artiodactyls and are one of the main constraints on cattle production in Africa. In cattle, anaemia is the key feature of disease and persists after parasitaemia has declined to low or undetectable levels, but treatment to clear the parasites usually resolves the anaemia. Methodology/Principal Findings The progress of anaemia after Trypanosoma congolense infection was followed in three mouse strains. Anaemia developed rapidly in all three strains until the peak of the first wave of parasitaemia. This was followed by a second phase, characterized by slower progress to severe anaemia in C57BL/6, by slow recovery in surviving A/J and a rapid recovery in BALB/c. There was no association between parasitaemia and severity of anaemia. Furthermore, functional T lymphocytes are not required for the induction of anaemia, since suppression of T cell activity with Cyclosporin A had neither an effect on the course of infection nor on anaemia. Expression of genes involved in erythropoiesis and iron metabolism was followed in spleen, liver and kidney tissues in the three strains of mice using microarrays. There was no evidence for a response to erythropoietin, consistent with anaemia of chronic disease, which is erythropoietin insensitive. However, the expression of transcription factors and genes involved in erythropoiesis and haemolysis did correlate with the expression of the inflammatory cytokines Il6 and Ifng. Conclusions/Significance The innate immune response appears to be the major contributor to the inflammation associated with anaemia since suppression of T cells with CsA had no observable effect. Several transcription factors regulating haematopoiesis, Tal1, Gata1, Zfpm1 and Klf1 were expressed at consistently lower levels in C57BL/6 mice suggesting that these mice have a lower haematopoietic capacity and therefore less ability to recover from haemolysis induced anaemia after infection.
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Affiliation(s)
- Harry A. Noyes
- School of Biological Sciences, University of Liverpool, Liverpool, United Kingdom
| | | | - Morris Agaba
- International Livestock Research Institute, Nairobi, Kenya
| | - Andy Brass
- Faculty of Life Sciences, University of Manchester, Manchester, United Kingdom
- School of Computer Science, University of Manchester, Manchester, United Kingdom
| | - Helmut Fuchs
- GMC at the Helmholtz Zentrum München, Munich/Neuherberg, Germany
| | | | - Helen Hulme
- School of Computer Science, University of Manchester, Manchester, United Kingdom
| | - Fuad Iraqi
- International Livestock Research Institute, Nairobi, Kenya
| | - Stephen Kemp
- School of Biological Sciences, University of Liverpool, Liverpool, United Kingdom
- International Livestock Research Institute, Nairobi, Kenya
| | - Birgit Rathkolb
- GMC at the Helmholtz Zentrum München, Munich/Neuherberg, Germany
- Chair for Molecular Animal Breeding and Biotechnology, Gene Center, LMU Munich, Munich, Germany
| | - Eckard Wolf
- Chair for Molecular Animal Breeding and Biotechnology, Gene Center, LMU Munich, Munich, Germany
| | - Martin Hrabé de Angelis
- Chair for Molecular Animal Breeding and Biotechnology, Gene Center, LMU Munich, Munich, Germany
- Chair for Experimental Genetics, Center of Life and Food Science Weihenstephan, Technische Universität München, Freising, Germany
| | - Delnaz Roshandel
- School of Computer Science, University of Manchester, Manchester, United Kingdom
| | - Jan Naessens
- International Livestock Research Institute, Nairobi, Kenya
- * E-mail:
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Stijlemans B, Vankrunkelsven A, Brys L, Magez S, De Baetselier P. Role of iron homeostasis in trypanosomiasis-associated anemia. Immunobiology 2008; 213:823-35. [PMID: 18926297 DOI: 10.1016/j.imbio.2008.07.023] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2008] [Accepted: 07/23/2008] [Indexed: 12/21/2022]
Abstract
Anemia is a well-established infection-associated immunopathological feature of trypanosomiasis and the degree of the anemia is a reliable indicator of the severity of infection. Since infections with trypanosomes triggers a strong cytokine production and a type I immune response, the trypanosome-elicited anemia may be type I cytokine driven. This type of anemia termed anemia of chronic disease is characterized by an imbalance between erythrophagocytosis and erythropoiesis that is linked to a perturbed iron homeostasis including altered iron recycling by macrophages and iron sequestration. To further unravel the mechanisms underlying trypanosome-elicited anemia the expression profile of genes involved in erythrophagocytosis, uptake of iron-containing complexes and iron homeostasis was performed during the acute and chronic phase of experimental Trypanosoma brucei infections in a murine model. The results suggest that liver-associated erythrophagocytosis mediated by cytokine-activated macrophages (M1 cells) is the most likely main initiating event of aggressive anemia during the acute phase of infection. Persistence of strong type I cytokine production during the chronic phase of infection leads to hyper-activated M1 cells and a more progressive anemia. RT-PCR analysis of liver tissue demonstrates a strong increase of cell surface receptors involved in uptake of RBC and iron-containing compounds. For genes involved in iron processing we found an increase of ferroportin-1 (FPN-1), transferrin (Tf) and ceruloplasmin (CP) only in the acute phase, suggesting that export of iron is hampered in the chronic phase of infection. Our results suggest that in the chronic phase of trypanosomiasis, the iron-processing pathway is skewed towards iron sequestration, as evidenced by increased ferritin expression, while enhanced uptake of RBC/iron-containing compounds is maintained.
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Affiliation(s)
- Benoît Stijlemans
- Laboratory of Cellular and Molecular Immunology, VIB Department of Molecular and Cellular Interactions, Vrije Universiteit Brussel (VUB), Building E, Level 8, Pleinlaan 2, B-1050 Brussels, Belgium.
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Fèvre EM, Odiit M, Coleman PG, Woolhouse MEJ, Welburn SC. Estimating the burden of rhodesiense sleeping sickness during an outbreak in Serere, eastern Uganda. BMC Public Health 2008; 8:96. [PMID: 18366755 PMCID: PMC2322978 DOI: 10.1186/1471-2458-8-96] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2007] [Accepted: 03/26/2008] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Zoonotic sleeping sickness, or HAT (Human African Trypanosomiasis), caused by infection with Trypanosoma brucei rhodesiense, is an under-reported and neglected tropical disease. Previous assessments of the disease burden expressed as Disability-Adjusted Life Years (DALYs) for this infection have not distinguished T.b. rhodesiense from infection with the related, but clinically distinct Trypanosoma brucei gambiense form. T.b. rhodesiense occurs focally, and it is important to assess the burden at the scale at which resource-allocation decisions are made. METHODS The burden of T.b. rhodesiense was estimated during an outbreak of HAT in Serere, Uganda. We identified the unique characteristics affecting the burden of rhodesiense HAT such as age, severity, level of under-reporting and duration of hospitalisation, and use field data and empirical estimates of these to model the burden imposed by this and other important diseases in this study population. While we modelled DALYs using standard methods, we also modelled uncertainty of our parameter estimates through a simulation approach. We distinguish between early and late stage HAT morbidity, and used disability weightings appropriate for the T.b. rhodesiense form of HAT. We also use a model of under-reporting of HAT to estimate the contribution of un-reported mortality to the overall disease burden in this community, and estimate the cost-effectiveness of hospital-based HAT control. RESULTS Under-reporting accounts for 93% of the DALY estimate of rhodesiense HAT. The ratio of reported malaria cases to reported HAT cases in the same health unit was 133:1, however, the ratio of DALYs was 3:1. The age productive function curve had a close correspondence with the HAT case distribution, and HAT cases occupied more patient admission time in Serere during 1999 than all other infectious diseases other than malaria. The DALY estimate for HAT in Serere shows that the burden is much greater than might be expected from its relative incidence. Hospital based control in this setting appears to be highly cost-effective, highlighting the value of increasing coverage of therapy and reducing under-reporting. CONCLUSION We show the utility of calculating DALYs for neglected diseases at the local decision making level, and emphasise the importance of improved reporting systems for acquiring a better understanding of the burden of neglected zoonotic diseases.
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Affiliation(s)
- Eric M Fèvre
- Centre for Infectious Diseases, University of Edinburgh, Ashworth Laboratories, West Mains Road, Edinburgh, EH9 3JT, UK
| | - Martin Odiit
- Centre for Tropical Veterinary Medicine, College of Medicine and Veterinary Medicine, University of Edinburgh, Easter Bush, Roslin, Midlothian, EH25 9RG, UK
- Uganda AIDS Control Project, P.O. Box 25589, Kampala, Uganda; formerly Sleeping Sickness Programme, Livestock Health Research Institute, P. O. Box 96 Tororo, Uganda
| | - Paul G Coleman
- London School of Hygiene and Tropical Medicine, University of London, Keppel Street, WC1 7HT, UK
| | - Mark EJ Woolhouse
- Centre for Infectious Diseases, University of Edinburgh, Ashworth Laboratories, West Mains Road, Edinburgh, EH9 3JT, UK
| | - Susan C Welburn
- Centre for Tropical Veterinary Medicine, College of Medicine and Veterinary Medicine, University of Edinburgh, Easter Bush, Roslin, Midlothian, EH25 9RG, UK
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Ezzedine K, Darie H, Le Bras M, Malvy D. Skin features accompanying imported human African trypanosomiasis: hemolymphatic Trypanosoma gambiense infection among two French expatriates with dermatologic manifestations. J Travel Med 2007; 14:192-6. [PMID: 17437477 DOI: 10.1111/j.1708-8305.2007.00114.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Khaled Ezzedine
- Travel Clinics and Tropical Disease Unit, Department of Internal Medicine, Infectious Diseases and Tropical Medicine, University Hospital Center, Bordeaux, France.
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Biryomumaisho S, Katunguka-Rwakishaya E. The pathogenesis of anaemia in goats experimentally infected with Trypanosoma congolense or Trypanosoma brucei: Use of the myeloid:erythroid ratio. Vet Parasitol 2007; 143:354-7. [PMID: 16982150 DOI: 10.1016/j.vetpar.2006.08.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [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: 04/06/2006] [Revised: 08/10/2006] [Accepted: 08/17/2006] [Indexed: 10/24/2022]
Abstract
The present study examined the development of anaemia in Small East African goats experimentally infected with Trypanosoma congolense or Trypanosoma brucei. Experimental goats received a primary trypanosome challenge on day 0, treated with diminazene aceturate on day 49 and received a secondary trypanosome challenge on day 77 of the 136-day experiment. Both primary and secondary challenges were characterised by reduced peripheral erythrocyte counts, fall in packed cell volume (PCV), hypohaemoglobinaemia and reductions in the myeloid:erythroid ratios (M:E) compared with the uninfected goats. The progressive reduction in the M:E ratios denoted increased erythrogenesis in response to increased destruction of erythrocytes in blood by infecting trypanosomes or their products. The more rapid fall in M:E ratio in T. congolense infections shows that this parasite causes more severe clinical pathological effects in goats than T. brucei.
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Affiliation(s)
- S Biryomumaisho
- Department of Veterinary Medicine, Makerere University, P.O. Box 7062, Kampala, Uganda.
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Abstract
The socioeconomic implications of trypanosomosis in sub-Saharan Africa and the limitations of its current control regimes have stimulated research into alternative control methods. Considering the pro- and anti-inflammatory properties of transforming growth factor beta1 (TGF-beta1) and its potential to enhance immunity against protozoan parasites, we examined the effects of intraperitoneally delivered TGF-beta1 in C57BL/6 mice infected with Trypanosoma congolense, the hemoprotozoan parasite causing nagana in cattle. A triple dose of 10 ng TGF-beta1 significantly reduced the first parasitemic peak and delayed mortality of infected mice. Furthermore, exogenous TGF-beta1 significantly decreased the development of trypanosome-induced anemia and splenomegaly. The apparent TGF-beta1-induced antitrypanosome protection, occurring mainly during the early stage of infection, correlated with an enhanced parasite antigen-specific Th1 cell response characterized by a skewed type I cytokine response and a concomitant stronger antitrypanosome immunoglobulin G2a antibody response. Infected TGF-beta1-pretreated mice exhibited a significant reduction in the trypanosome-induced hyperexpansion of B cells. Furthermore, evidence is provided herein that exogenous TGF-beta1 activates macrophages that may contribute to parasite control. Collectively, these data indicate that exogenous TGF-beta1 is immunostimulative, inducing partial protection against T. congolense infection, possibly through mechanisms involving innate immune responses.
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Affiliation(s)
- Boniface Namangala
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Hokkaido 080-8555, Japan
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Howie S, Guy M, Fleming L, Bailey W, Noyes H, Faye JA, Pepin J, Greenwood B, Whittle H, Molyneux D, Corrah T. A Gambian infant with fever and an unexpected blood film. PLoS Med 2006; 3:e355. [PMID: 17002503 PMCID: PMC1576315 DOI: 10.1371/journal.pmed.0030355] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The authors describe the differential diagnosis, investigation, and management of a two-month-old infant with edema, malnutrition, and fever.
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Affiliation(s)
- Stephen Howie
- Medical Research Council Laboratories, Banjul, Gambia.
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Abstract
We report the case of a middle aged Tanzanian man who developed a spinal cord syndrome over 6 weeks, along with a mild encephalopathy. Investigations ruled out the usual major causes of such a syndrome in our setting in northern Tanzania. Examination of his cerebrospinal fluid revealed trypanosomes, and he made a slow but dramatic improvement after a full course of suramine and melarsoprol. We postulate that he had a transverse myelitis due to African trypanosomiasis, a rare and barely recognised cause.
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Affiliation(s)
- G S Kibiki
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre, Tumaini University, Moshi, Tanzania
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Naessens J. Bovine trypanotolerance: A natural ability to prevent severe anaemia and haemophagocytic syndrome? Int J Parasitol 2006; 36:521-8. [PMID: 16678182 DOI: 10.1016/j.ijpara.2006.02.012] [Citation(s) in RCA: 118] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2005] [Revised: 02/08/2006] [Accepted: 02/15/2006] [Indexed: 11/24/2022]
Abstract
Trypanotolerance is the capacity of certain West-African, taurine breeds of cattle to remain productive and gain weight after trypanosome infection. Laboratory studies, comparing Trypanosoma congolense infections in trypanotolerant N'Dama cattle (Bos taurus) and in more susceptible Boran cattle (Bos indicus), confirmed the field observations. Experiments using haemopoietic chimeric twins, composed of a tolerant and a susceptible co-twin, and T cell depletion studies suggested that trypanotolerance is composed of two independent traits. The first is a better capacity to control parasitaemia and is not mediated by haemopoietic cells, T lymphocytes or antibodies. The second is a better capacity to limit anaemia development and is mediated by haemopoietic cells, but not by T lymphocytes or antibodies. Weight gain was linked to the latter mechanism, implying that anaemia control is more important for survival and productivity than parasite control. Anemia is a marker for a more complex pathology which resembles human haemophagocytic syndrome: hepatosplenomegaly, pancytopenia and a large number of hyperactivated phagocytosing macrophages in bone marrow, liver and other tissues. Thus, mortality and morbidity in trypanosome-infected cattle are primarily due to self-inflicted damage by disproportionate immune and/or innate responses. These features of bovine trypanotolerance differ greatly from those in murine models. In mice, resistance is a matter of trypanosome control dependent on acquired immunity. However, a model of anaemia development can be established using C57BL/6J mice. As in cattle, the induction of anaemia was independent of T cells but its development differed with different trypanosome strains. Identification of the molecular pathways that lead to anaemia and haemophagocytosis should allow us to design new strategies to control disease.
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Affiliation(s)
- J Naessens
- International Livestock Research Institute, P.O. Box 30709, 00100 Nairobi, Kenya.
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Sternberg JM, Rodgers J, Bradley B, Maclean L, Murray M, Kennedy PGE. Meningoencephalitic African trypanosomiasis: Brain IL-10 and IL-6 are associated with protection from neuro-inflammatory pathology. J Neuroimmunol 2005; 167:81-9. [PMID: 16054238 DOI: 10.1016/j.jneuroim.2005.06.017] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2005] [Accepted: 06/20/2005] [Indexed: 12/27/2022]
Abstract
The relationship of neuropathology to CNS inflammatory and counter-inflammatory cytokine production in African trypanosome-infected mice was studied using an infection model with a defined disease progression. The initial phase of CNS infection by trypanosomes, where only mild neuropathology is evident, was characterised by high levels of IL-10 and IL-6. In the later phase of CNS infection and in a post-drug treatment model, moderate to severe neuropathology was associated with high levels of IFN-gamma and TNF-alpha. The relationship of these cytokines to neuropathological grade suggests that IL-10 and IL-6 protect the CNS from inflammatory pathology when parasites first enter the brain and the data reconcile previously contradictory clinical measurements of CSF cytokines in meningoencephalitic patients with post-mortem histopathology observations.
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Affiliation(s)
- Jeremy M Sternberg
- School of Biological Sciences, Zoology Building, University of Aberdeen, Aberdeen AB24 2TZ, UK.
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Abstract
OBJECTIVE To determine possible interaction between infections of Trypanosoma brucei rhodesiense sleeping sickness and HIV/AIDS in Western Kenya. DESIGN Random selection and testing for HIV infections of serum samples from HAT patients using an indirect single phase enzyme linked immunosorbent assay (EAI-Immunocomb II, oragenics). SETTING National Sleeping Sickness Referral Hospital-Alupe. RESULTS Four (16%) of the HAT serum samples (n = 25) were found to be seropositive for HIV type 1 and 2 infections, while an additional four (16%) were sero-positive to HIV type 2 infections alone. In contrast, the patients from the local STD clinic showed that 52% (n = 53) were seropositive for both HIV type 1 and 2 infections. No patient from the STD clinic was seropositive for HIV type 2 alone. Calculated Yates Chi square value of 17.31 (P > 0.001) indicated a significant increase in HIV type 2 antibodies in T. brucei rhodesiense sleeping sickness patients. RESULTS Sixteen percent of the HAT serum samples (n = 25) were found to be seropositive for HIV type 1 and 2 infections, while an additional 16% were sero-positive to HIV type 2 infections alone. In contrast, the patients from the local STD clinic showed that 52% (n = 53) were seropositive for both HIV type 1 and 2 infections. No patient from the STD clinic was seropositive for HIV type 2 alone. Calculated Yates Chi square value of 17.31 (P < 0.001) indicated a significant increase in HIV type 2 antibodies in T. brucei rhodesiense sleeping sickness patients. CONCLUSION T. brucei rhodesiense sleeping sickness is an immuno-suppressive disease whose patients have shown a higher affinity to HIV type 2 infections more common in central and western Africa. Such patients when treated, appear to recover from HAT but later succumb to full-blown AIDS. It is recommended that CD4+ T cell numbers and CD4/CD8 T cell ratios be assessed toinvestigate response to treatment in HIV positive HAT patients.
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Affiliation(s)
- G O Matete
- KARI Trypanosomiasis Research Centre, P.O. Box 362, Kikuyu, Kenya
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Abstract
OBJECTIVE To find out if indeed anaemia is a major sign in human trypanosomiasis caused by Trypanosoma brucei rhodensiense. DESIGN A one year cross-sectional study of all admitted and surveyed Trypanosoma brucei rhodensiense infected patients (June 2001-June 2002) SETTING Nkhotakota District Hospital-Central Region of Malawi. RESULTS After survey and investigations, 28 patients (16 males and 12 females) were admitted to Nkhotakota District Hospital with a parasite positive Trypanosoma brucei rhodensiense infection. Twenty four (85.7%) of them were anaemic. Their mean haemoglobin was 8.96 +/- 3.07 g/dl compared to controls that had a mean haemoglobin concentration of 12.17 +/- 1.35 g/dl (p < 0.000001, 95% CI -4.342 to -2.0785) (n = 45). None of the trypanosomiasis infected individuals had schistosomiasis or hookworms. Two patients had malaria. One of them was an 18-year-old pregnant woman with hepatosplenomegaly, who developed ante partum haemorrhage. She was jaundiced and had haemoglobin of 10 g/dl. She died after two weeks following the diagnosis and treatment. The other was a two-year-old girl who had haemoglobin of 8.4 g/dl. She also had hepatosplenomegaly. All the other patients looked well nourished with no other signs of chronic diseases. Hepatosplenomegaly was significantly related to the severity of illness (p = 0.011) but not to anaemia. CONCLUSION Though basic, this study has shown that anaemia is indeed a complication of human Africa trypanosomiasis caused by Trypanosoma brucei rhodesiense. There is need for further investigation to investigate the type of anaemia that is caused by this disease.
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Affiliation(s)
- J E Chisi
- College of Medicine, University of Malawi, Private Bag 360, Chichiri, Blantyre 3, Malawi
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Chiejina SN, Musongong GA, Fakae BB, Behnke JM, Ngongeh LA, Wakelin D. The modulatory influence of Trypanosoma brucei on challenge infection with Haemonchus contortus in Nigerian West African Dwarf goats segregated into weak and strong responders to the nematode. Vet Parasitol 2005; 128:29-40. [PMID: 15725530 DOI: 10.1016/j.vetpar.2004.11.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [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: 02/26/2004] [Revised: 08/20/2004] [Accepted: 11/04/2004] [Indexed: 11/27/2022]
Abstract
Although Nigerian West African Dwarf (WAD) goats are relatively resistant to infection with Haemonchus contortus and are also trypanotolerant, natural outbreaks of both infections are known to occur. Despite their relative resistance to H. contortus WAD goats nevertheless show variability in response phenotype and it was of interest to examine the effect of this variability on the outcome of concurrent trypanosome infection. Trypanosoma brucei infections were established in goats that were initially classified as good or poor responders to H. contortus. Thirty-nine goats were exposed to an escalating infection with H. contortus, and on the basis of their mean faecal egg counts (FEC) were allocated to high FEC (poor responders, 18 goats with the highest FEC) or low FEC (good responders, 18 goats with the lowest FEC) classes. Nine uninfected naive control goats were included to provide reference baseline values. Retrospective analysis of parasitological and pathological parameters after allocation into high/low FEC classes showed that FECs differed significantly, in both classes packed cell volume (PCV) values fell relative to naive controls, neither class lost weight and both generated marked IgG responses. All goats received anthelmintic on day 61, half of each group was infected with 50 million trypanosomes and on day 67, excepting the controls, all goats were challenged with 3000 L3 of H. contortus. Trypanosome parasitaemia was generally low, and marginally, but not significantly, higher in the low compared with high FEC class, peaking 12-16 days after exposure in both groups and then falling to below microscopically detectable levels (although still detectable by sub-inoculation into mice) by week 3. At autopsy (days 109/110), worm burdens were significantly higher in the trypanosome-infected goats from the high FEC class, relative to all other groups. Trypanosome infected goats showed a tendency (although not significant) towards higher FEC and, irrespective of their FEC class, had lower PCV values although body weight did not vary significantly. All goats challenged with H. contortus had higher antibody levels than naive controls, but neither trypanosome infection nor FEC class affected the magnitude of responses. These results confirm that WAD goats comprise a range of response phenotypes to initial H. contortus infection and that trypanotolerance is a key trait of this breed. Although immunity to nematode infection develops even in poor responders, these animals harbour higher nematode burdens during concurrent infection with T. brucei.
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Affiliation(s)
- S N Chiejina
- Department of Veterinary Parasitology and Entomology, University of Nigeria, Nsukka, Nigeria
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36
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Bourdon L, Buguet A. [Fundamentals of chronobiology: nyctohemeral rhythms]. J Fr Ophtalmol 2004; 27 Spec No 2:2S5-2S10. [PMID: 15314569] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Most biological activities fluctuate throughout the day and contribute to a better adaptation to the organism's daily activity. During the last 30 Years, chronobiology has aimed at studying these biological rhythms, explaining most of the biological mechanisms of i) the endogenous circadian rhythmicity, ii) the neurophysiological mechanisms of the photic system that allows its external resetting, and iii) the neuroendocrine mechanisms of internal rhythm synchronization. Moreover, the description of specific biological rhythm disorders and rhythm problems at the cellular and even the molecular level have prompted the emerging fields of chronopharmacology and chronotherapeutics.
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Affiliation(s)
- L Bourdon
- Département des facteurs humains, Centre de recherches du service de santé des armées Emile Pardé, BP 87, 38702 La Tronche Cedex, France.
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Hart W, Slee PH, Schipper HG, Koopmans RP, Kager PA. [Clinical reasoning and decision making in practice. A depressive foreign woman with symptoms of malaise]. Ned Tijdschr Geneeskd 2004; 148:771-6. [PMID: 15129565] [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] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
A 27-year-old woman was admitted to the hospital with a depression, anaemia and fatigue. She had come from Angola to the Netherlands as a refugee 2 years before this evaluation. As an explanation for her symptoms tropical infectious diseases of parasitic origin were considered, but no clues were found in this direction. The test for trypanosomiasis was considered to be suggestive for an infection in the past (persistent titre 1:200). She was discharged but readmitted 6 months later because of a deterioration of her clinical condition. Magnetic resonance imaging showed bilateral signal abnormalities within the white matter of the brain. On examination no neurological signs or abnormalities were found. Again, no definite diagnosis could be made and the patient was discharged. Because of a further deterioration of her clinical condition she was readmitted a short time later for the third time. On the MRI the white matter lesions had increased. The serum protein electrophoresis was markedly abnormal with an elevated IgM Level. Finally, at a repeated lumbar puncture mobile trypanosomes were found. The diagnosis of 'West African sleeping sickness' was made and the patient was treated with eflornithine. She recovered completely during the next 18 months.
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Affiliation(s)
- W Hart
- Sint Antonius Ziekenhuis, afd. Inwendige Ziekten, Nieuwegein
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Darsaud A, Bourdon L, Mercier S, Chapotot F, Bouteille B, Cespuglio R, Buguet A. Twenty-Four—Hour Disruption of the Sleep-Wake Cycle and Sleep-Onset REM-Like Episodes in a Rat Model of African Trypanosomiasis. Sleep 2004; 27:42-6. [PMID: 14998236 DOI: 10.1093/sleep/27.1.42] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES Patients with human African trypanosomiasis (sleeping sickness) due to the inoculation of Trypanosoma brucei gambiense or rhodesiense show a major disruption of the 24-hour sleep-wake distribution, accompanied by the occurrence of sleep-onset rapid-eye-movement (REM) sleep episodes, proportional to the severity of the illness. Although animal models of human African trypanosomiasis have been developed to understand the pathogenic mechanisms leading to immune alterations, the development of an animal model featuring the alterations of endogenous biologic rhythms remains a necessity. ANIMALS Sprague-Dawley rats (N = 10) entrained to a 12:12-hour dark-light regimen. INTERVENTIONS Rats were infected with Trypanosoma brucei brucei AnTat 1.1E and instrumented with electrocorticographic and electromyographic electrodes. Polysomnography was recorded continuously from 2 days before infection until the animal's death. MEASUREMENTS AND RESULTS The analysis of the spontaneous sleep-wake architecture revealed an increased proportion of slow-wave sleep (SWS) and a decreased amount of wakefulness 2 days before death. Considerable sleep fragmentation was observed in the infected rats, with numerous changes in sleep-wake stages and an increased number of episodes of wakefulness and SWS. Infected rats presented a fragmented pattern of SWS and a marked reduction in the mean paradoxical-sleep (PS) latency, resulting in a considerable disruption of the PS-SWS sequences. Abnormal transitions, particularly the appearance of sleep-onset REM episodes, marked the disruption of the internal sleep structure. The electrocorticogram traces were modified during SWS, with the occurrence of abnormal hypersynchronic slow waves and a disappearance of spindles. CONCLUSION The Trypanosoma brucei brucei-infected rat is a good model of the syndrome seen in human African trypanosomiasis, ie, the 24-hour disruption of the sleep-wake cycle and the occurrence of sleep-onset REM-like sleep episodes.
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Affiliation(s)
- Annabelle Darsaud
- Centre de recherches du Service de santé des armées, département des facteurs humains, B.P 87, F-38702 La Tronche cedex, France.
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Kennedy PGE, Rodgers J, Bradley B, Hunt SP, Gettinby G, Leeman SE, de Felipe C, Murray M. Clinical and neuroinflammatory responses to meningoencephalitis in substance P receptor knockout mice. Brain 2003; 126:1683-90. [PMID: 12805119 DOI: 10.1093/brain/awg160] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Human African trypanosomiasis, also known as sleeping sickness, affects the CNS at the late stage of the disease. Untreated the disease is invariably fatal, and melarsoprol, the only available and effective treatment for CNS disease, is associated in up to 10% of cases with a severe post-treatment reactive encephalopathy (PTRE), which can itself cause death. We used a reproducible mouse model of the PTRE to investigate the pathogenesis and treatment of this condition. Mice infected with Trypanosoma brucei brucei and treated subcuratively with diminazene aceturate develop a severe meningoencephalitis that closely resembles PTRE. We previously reported that substance P plays an important role in PTRE. We investigated the effect of disrupting the gene encoding for the NK1 receptor in mice on the clinical and neuroinflammatory response in this model. After induction of PTRE, NK1-/- mice showed a significant reduction in clinical impairment compared with NK1+/+ mice, but the severity of the neuroinflammatory response was significantly greater in NK1-/- mice. To explore the mechanisms of this dissociated phenotype, we treated infected NK1-/- mice with antagonists to NK2 and NK3 receptors, either singly or in combination. While none of these antagonist treatments altered the clinical score, combined treatment with the NK2 and NK3 antagonists significantly reduced the neuroinflammatory grading score in the NK1-/- mice. Thus, the clinical and neuroinflammatory responses to parasite invasion can be mediated by different pathways, and, importantly, the neuroinflammatory response is altered by alternative tachykinin receptor usage. These findings could be exploited to develop novel anti-inflammatory therapies in Human African trypanosomiasis by modulating the NK1 receptor as well as the parasite.
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MESH Headings
- Animals
- Diminazene
- Disease Models, Animal
- Hippocampus/pathology
- Meningoencephalitis/parasitology
- Meningoencephalitis/pathology
- Meningoencephalitis/physiopathology
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- Receptors, Neurokinin-1/genetics
- Receptors, Neurokinin-1/physiology
- Receptors, Neurokinin-2/antagonists & inhibitors
- Receptors, Neurokinin-2/physiology
- Receptors, Neurokinin-3/antagonists & inhibitors
- Receptors, Neurokinin-3/physiology
- Trypanosomiasis, African/complications
- Trypanosomiasis, African/pathology
- Trypanosomiasis, African/physiopathology
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Affiliation(s)
- Peter G E Kennedy
- Department of Neurology, Institute of Neurological Sciences, Southern General Hospital, Glasgow G51 4TF, UK.
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Chiejina S, Goyal P, Li C, Wakelin D. Concurrent infections with Trypanosoma brucei and Nippostrongylus brasiliensis in mice deficient in inducible nitric oxide. Parasitol Int 2003; 52:107-15. [PMID: 12798922 DOI: 10.1016/s1383-5769(02)00089-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Concurrent infection with Trypanosoma brucei (Tb) delays the normal protective responses of mice to the gastrointestinal parasite Nippostrongylus brasiliensis (Nb). The course of such infections was followed in mice genetically deficient in inducible nitric oxide synthase (INOS) to assess the role of nitric oxide (NO) in this effect. The time course of trypanosome infection in INOS deficient (INOS-/-) mice was similar to that in wild type (WT) and heterozygote (INOS+/-) mice but did not result in NO production. Although concurrent infection with Tb increased initial susceptibility to Nb in INOS-/- mice, the immune-mediated loss of N. brasiliensis and the associated decline in faecal egg output occurred more rapidly then in WT and INOS+/- littermates. Concurrent infection with trypanosomes markedly suppressed Concanavalin A (ConA)-induced in vitro proliferation of splenic lymphocytes in all groups, but had little effect on the responses of mesenteric node lymphocytes. Trypanosome infection was also associated with increased early release of interferon-gamma and reduced IL-5 from lymphocytes stimulated in vitro with ConA, but did not affect later release of IL-5. The overall similarity of proliferative and cytokine responses in WT, INOS+/- and INOS-/- mice suggest that the suppressive effects of T. brucei on N. brasiliensis infection do not simply reflect depressed lymphocyte responsiveness or altered cytokine profiles. NO appears to be involved in suppression only of the later phases of the host responses to Nb.
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Affiliation(s)
- Samuel Chiejina
- School of Life and Environmental Sciences, University of Nottingham, Nottingham NG7 2RD, UK
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Abstract
The release of Sialic acid (SA) into the serum by Trypanosoma congolense infected BalbC mice was investigated. A progressive increase in the level of serum SA corresponding to anemia and parasitemia was observed. At maximum parasitemia, the level of total SA from the red blood cells (RBC) dropped by about 45%. Solved polynomials revealed an association between free serum SA and RBC-SA. Positive roots of quadratics were used to predict complete cleavage of RBC-SA on day 7.01 and maximum accumulation of free serum SA on day 6.6. A steady rise in the level of serum sialidase (SD) activity and a low packed cell volume (PCV) with an increase in parasitemia were observed. Mice infused with galactose, methyl-beta-gal, lactose, mannose, or L-arabinose and challenged by intraperitoneal inoculation with Trypanosoma congolense neither developed anemia nor secreted free SA above the control level even though there was detectable SD activity. Bloodstream Trypanosoma congolense parasites were isolated using DEAE cellulose from heparinized blood of experimentally infected BalbC mice. The parasites were lysed with 0.2% Triton-CF 54 to release membrane bound SD. The activity of the SD was proportional to the number of parasites. The enzyme was partially purified on Q-Sepharose and Fetuin agarose columns successively. The final active fraction from the latter column was used as the partially purified SD. The enzyme had an optimum pH of 6 and was maximally active at 37 degrees C with a requirement for the divalent ions Ca(2+) and Mg(2+). The enzyme was highly specific for NeuAc5alpha2,3 lac and Methylumbelliferyl-Neu5Ac (4-MU-Neu5Ac) with K(M) values of 0.34 and 0.025 mM, respectively. It was inhibited competitively by 2,3-didehydroneuraminic acid (Neu5Ac2en) and para-nitro-phenyloxamic acid (pNPO) with inhibition binding constants K(i) of 65 and 215 micro M, respectively. In deviation from the procyclic trypanosomal SD, it lacked trans-sialidase (TS) activity. The possible role of a secreted bloodstream Trypanosoma congolense SD and the development of anemia in the pathogensesis of trypanosomiasis are discussed.
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Affiliation(s)
- Andrew J Nok
- Department of Biochemistry, Ahmadu Bello University Zaria, Nigeria.
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Nok AJ. Arsenicals (melarsoprol), pentamidine and suramin in the treatment of human African trypanosomiasis. Parasitol Res 2003; 90:71-9. [PMID: 12743807 DOI: 10.1007/s00436-002-0799-9] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.7] [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: 10/23/2002] [Accepted: 10/31/2002] [Indexed: 10/25/2022]
Abstract
Human African trypanosomiasis (HAT), otherwise known as sleeping sickness, has remained a disease with no effective treatment. Recent progress in HAT research suggests that a vaccine against the disease is far from being successful. Also the emergence of drug-resistant trypanosomes makes further work in this area imperative. So far the treatment for the early stage of HAT involves the drugs pentamidine and suramin which have been very successful. In the second stage of the disease, during which the trypanosomes reside in the cerebrospinal fluid (CSF), treatment is dependent exclusively on the arsenical compound melarsoprol. This is largely due to the inability to find compounds that can cross the blood brain barrier and kill the CSF-residing trypanosomes. This review summarises our current understanding on the treatment of HAT.
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Lejon V, Reiber H, Legros D, Djé N, Magnus E, Wouters I, Sindic CJM, Büscher P. Intrathecal immune response pattern for improved diagnosis of central nervous system involvement in trypanosomiasis. J Infect Dis 2003; 187:1475-83. [PMID: 12717630 DOI: 10.1086/374645] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.7] [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: 09/26/2002] [Accepted: 12/17/2002] [Indexed: 11/04/2022] Open
Abstract
Diagnosis of central nervous system (CNS) involvement in human African trypanosomiasis is crucial in determination of therapy. Cerebrospinal fluid (CSF) and serum immunoglobulin concentrations, blood-CSF barrier dysfunction, pattern of intrathecal immunoglobulin synthesis, trypanosome-specific antibody synthesis, and CSF lactate concentrations were analyzed in 272 patients with Trypanosoma brucei gambiense infection. As part of the 2- or 3-class immune response, the predominant intrathecal IgM synthesis was the most sensitive (95%) marker for inflammation of the brain. We propose to replace the World Health Organization (WHO) criteria (white blood cell count >5 cells/microL and presence of trypanosomes in CSF) with a new approach for stage determination in trypanosomiasis: CNS involvement is diagnosed only in patients with >20 cells/microL or with intrathecal IgM synthesis, independent of the presence of trypanosomes in CSF. Compared with the use of these new criteria, the WHO criteria incorrectly classified 49 of 234 patients in the meningoencephalitic stage and 7 of 38 patients in the hemolymphatic disease stage. We also show that trypanosomiasis-related immunoglobulin patterns are of value in differential diagnosis.
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Affiliation(s)
- Veerle Lejon
- Department of Parasitology, Institute of Tropical Medicine, Antwerp, Belgium.
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Castellani A. Researches on the etiology of sleeping sickness. 1903. Parassitologia 2003; 45:51-60. [PMID: 15272468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
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Abstract
We present the case of a patient who presented with hypertrophic cardiomyopathy, generalized lymphadenopathy and serological evidence of African sleeping sickness (Trypanosoma gambiense). He made a full recovery after intravenous administration of eflornithine, a drug that is no longer distributed for antiparasitic indications for pharmacoeconomic reasons.
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Affiliation(s)
- Christoph Stephan
- Zentrum der Inneren Medizin, Klinikum der Johann Wolfgang Goethe Universität, Frankfurt, Germany.
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Affiliation(s)
- Demetrios J Sahlas
- Department of Medicine, Sunnybrook and Women's College Hospital, Toronto, Canada
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Abstract
African trypanosomes cross the blood-brain barrier, but how they do so remains an area of speculation. We propose that proteases, such as the trypanopains and oligopeptidases that are released by trypanosomes, could mediate in this process. The trypanosomes also possess cell-surface-associated acid phosphatases that could play a role in invasion similar to that in advancing cancer cells. Such enzymes, perhaps acting in concert, have the potential to cause tissue degradation and ease the passage of the trypanosomes through various tissues in the host, including the blood-brain barrier.
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Affiliation(s)
- John D Lonsdale-Eccles
- Center for Biophysical Sciences and Engineering, University of Alabama, Birmingham, AL 35294, USA
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Blum J, Nkunku S, Burri C. Clinical description of encephalopathic syndromes and risk factors for their occurrence and outcome during melarsoprol treatment of human African trypanosomiasis. Trop Med Int Health 2001; 6:390-400. [PMID: 11348533 DOI: 10.1046/j.1365-3156.2001.00710.x] [Citation(s) in RCA: 101] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Encephalopathies are the most feared complications of sleeping sickness treatment with melarsoprol. To investigate the existence of risk factors, the incidence of encephalopathic syndromes and the relationship between the development of different types of encephalopathies and the clinical outcome was studied in a clinical trial with 588 patients under treatment with melarsoprol. The 38 encephalopathy cases were classified into three types according to the leading clinical picture: coma type, convulsion type and psychotic reactions. Nine patients were attributed to the convulsion type, defined as a transient event of short duration with convulsions followed by a post-ictal phase, without signs of a generalized disease. None of these patients died from the reaction. Febrile reactions in the 48 h preceding the reaction were generally not observed in this group. Twenty-five patients were attributed to the coma type, which is a progredient coma lasting several days. Those patients often had signs of a generalized disease such as fever (84%), headache (72%) or bullous skin (8%) reactions. The risk of mortality was high in this group (52%). About 14/16 patients with encephalopathic syndrome of the coma type were infected with malaria. Patients with psychotic reactions or abnormal psychiatric behaviour (3/38) and one patient who died after alcohol intake were excluded from the analysis. The overall rate of encephalopathic syndromes in the cases analysed (n=34) was 5.8%, of which 38.2% died. We did not find any parameters of predictive value for the risk of developing an encephalopathic syndrome based on the symptoms and signs before treatment initiation. The appearance during treatment of febrile reactions (RR 11.5), headache (RR 2.5), bullous eruptions (RR 4.5) and systolic hypotension (RR 2.6) were associated with an increased risk for the occurrence of encephalopathic syndromes especially of the coma type.
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Affiliation(s)
- J Blum
- Swiss Tropical Institute, Basel, Switzerland.
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Billiard M, Ondzé B. [Disorders of awakening. Second part: secondary disorders]. Rev Neurol (Paris) 2001; 157:480-96. [PMID: 11438768] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Secondary disorders of awakening should be distinguished from primary disorders, narcolepsy, idiopathic hypersomnia, recurrent hypersomnia, the causes of which are still unknown despite regular progress in the knowledge of the pathophysiology of narcolepsy. By definition secondary disorders of awakening are due to clearly identified causes of various origins. Two main types of secondary disorders of awakening have been distinguished: those depending on more or less voluntary sleep curtailment or on psychotropic or non psychotropic medications and those consecutive to different disorders, respiratory, neurologic, traumatic, psychotropic, infectious, metabolic, endocrinologic, and insomnia. Some of these disorders, frequent or very frequent, are polysomnographically investigated, night and day, enabling to assess in each case the type and severity of sleepiness. Others are only clinically evaluated. Disorders of awakening secondary to neurologic conditions and to a lesser extent to infectious conditions offer a special opportunity to study the anatomical basis of these disorders. They are granted more space.
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Affiliation(s)
- M Billiard
- Service de Neurologie B, Hôpital Gui de Chauliac, 34295 Montpellier Cedex 5.
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Abstract
Anaemia is the most prominent clinical sign of trypanosomosis in domestic animals but little is known about its pathogenesis. This work investigated erythrophagocytosis as the possible cause of anaemia. Pathogenic Trypanosoma congolense (IL3000) was intravenously inoculated into six goats at 3x10(6) trypanosomes per goat. Six other goats were maintained as controls. The infection was studied for 10 weeks and parasitaemia, packed cell volume (PCV) and serum protein levels were determined. The amount of erythrophagocytosis was determined from the amount of 51Cr-labelled red blood cells (RBCs) phagocytosed by self mononuclear cells (MNCs) in vitro and by microscopically counting phagocytosed RBCs on Giemsa stained smears of incubated mixtures of RBCs and self MNCs. The infection resulted in trypanosomosis with rapid progressive anaemia and mean peaks of parasitaemia of about 3x10(3)ml(-1). In infected goats, a significant (P<0.05) mean reduction in PCV (of 37-22%) was observed starting from about 20 days up to 56 days post-infection. Within this same phase, significant (P<0.05) differences in mean radioactivity counts of (51)Cr incorporated into MNCs were observed with infected goats' samples having counts 50% higher than the control goats' samples. Microscopically, the mean number of phagocytosed RBCs in infected goats' MNCs was noted to be 80% higher (P<0.05) than that of control goats. Appreciable increases (P<0.05) in mean serum globulin levels, from 3.5 to 4.7g/dl, were observed within 3 weeks of infection. The study showed that erythrophagocytosis is an important mechanism leading to anaemia in the pathophysiology of T. congolense infection in Zambian goats.
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Affiliation(s)
- W H Witola
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Zambia, PO Box 32379, 10101, Lusaka, Zambia.
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