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Zrein M, Granjon E, Gueyffier L, Caillaudeau J, Liehl P, Pottel H, Cardoso CS, Oliveira CDL, de Oliveira LC, Lee TH, Ferreira AM, Ribeiro ALP, Busch MP, Sabino EC. A novel antibody surrogate biomarker to monitor parasite persistence in Trypanosoma cruzi-infected patients. PLoS Negl Trop Dis 2018; 12:e0006226. [PMID: 29425201 PMCID: PMC5823467 DOI: 10.1371/journal.pntd.0006226] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [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: 08/30/2017] [Revised: 02/22/2018] [Accepted: 01/09/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Trypanosoma cruzi parasite, the causative agent of Chagas disease, infects about six million individuals in more than 20 countries. Monitoring parasite persistence in infected individuals is of utmost importance to develop and evaluate treatments to control the disease. Routine screening for infected human individuals is achieved by serological assays; PCR testing to monitor spontaneous or therapy-induced parasitological cure has limitations due to the low and fluctuating parasitic load in circulating blood. The aim of the present study is to evaluate a newly developed antibody profiling assay as an indirect method to assess parasite persistence based on waning of antibodies following spontaneous or therapy-induced clearance of the infection. METHODOLOGY/PRINCIPAL FINDINGS We designed a multiplex serology assay, an array of fifteen optimized T. cruzi antigens, to evaluate antibody diversity in 1654 serum samples from chronic Chagas patients. One specific antibody response (antibody 3, Ab3) showed a strong correlation with T. cruzi parasite persistence as determined by T. cruzi PCR positive results. High and sustained Ab3 signal was strongly associated with PCR positivity in untreated patients, whereas significant decline in Ab3 signals was observed in BZN-treated patients who cleared parasitemia based on blood PCR results. CONCLUSION/SIGNIFICANCE Ab3 is a new surrogate biomarker that strongly correlates with parasite persistence in chronic and benznidazole-treated Chagas patients. We hypothesize that Ab3 is induced and maintained by incessant stimulation of the immune system by tissue-based and shed parasites that are not consistently detectable by blood based PCR techniques. Hence, a simple immunoassay measurement of Ab3 could be beneficial for monitoring the infectious status of seropositive patients.
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Affiliation(s)
- Maan Zrein
- R&D, INFYNITY BIOMARKERS SAS, Lyon, France
| | | | | | | | | | - Hans Pottel
- Faculty of Medicine, University of Leuven (KULAK), Kortrijk, Belgium
| | - Clareci Silva Cardoso
- Federal University of São João del-Rey, Research Group in Epidemiology and New Technologies in Health-campus CCO, São João del-Rei, Brazil
| | - Claudia Di Lorenzo Oliveira
- Federal University of São João del-Rey, Research Group in Epidemiology and New Technologies in Health-campus CCO, São João del-Rei, Brazil
| | - Lea Campos de Oliveira
- Instituto de Medicina Tropical e Faculdade de Medicina (FMUSP) da Universidade de São Paulo, São Paulo, Brazil
- Laboratorio de Investigação Médica (LIM03), Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paolo, Brazil
| | - Tzong-Hae Lee
- Blood Systems Research Institute and University of California, San Francisco, California, United States of America
| | - Ariela Mota Ferreira
- Graduate Program in Health Sciences, State University of Montes Claros (Universidade Estadual de Montes Claros), Montes Claros, Minas Gerais, Brazil
| | - Antonio Luiz P. Ribeiro
- Hospital das Clínicas and School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Michael P. Busch
- Blood Systems Research Institute and University of California, San Francisco, California, United States of America
| | - Ester Cerdeira Sabino
- Instituto de Medicina Tropical e Faculdade de Medicina (FMUSP) da Universidade de São Paulo, São Paulo, Brazil
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Saba ES, Gueyffier L, Danjoy ML, Vanhems P, Pozzetto B, Sobh M, Pottel H, Michallet M, Zrein MA. Trypanosoma-Cruzi Cross-Reactive Antibodies Longitudinal Follow-Up: A Prospective Observational Study in Hematopoietic Stem Cell Transplantation. PLoS One 2015; 10:e0137240. [PMID: 26351849 PMCID: PMC4564178 DOI: 10.1371/journal.pone.0137240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 08/13/2015] [Indexed: 11/19/2022] Open
Abstract
Antibodies named TcCRA "Trypanosoma cruzi Cross Reactive Antibodies" were detected in 47% of blood donors from French population unexposed to the parasite. In order to evaluate the passive or active transmissibility of TcCRA and further characterize its role and etiology, we have conducted a study in a cohort of 47 patients who underwent allogeneic Hematopoietic Stem Cell Transplantations (allo-HSCT). Donors and recipients were tested for TcCRA prior to transplantation. Recipients were further tested during follow-up after transplantation. Demographical, clinical and biological data were collected. Our primary end-point was to assess the risk of TcCRA acquisition after transplantation. During this initial analysis, we observed no seroconversion in patients receiving cells from TcCRA negative donors (n = 23) but detected seroconversion in 4 out of 24 patients who received hematopoietic stem cells from positive donors. Here, we are discussing possible scenarios to explain TcCRA-immune status in recipient after transplantation.
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Affiliation(s)
- Esber S. Saba
- INFYNITY-Biomarkers, Lyon, France
- Laboratories of Bacteriology-Virology, GIMAP EA3064, Faculty of Medicine Jacques Lisfranc, Saint-Etienne, France
| | | | | | | | - Bruno Pozzetto
- Laboratories of Bacteriology-Virology, GIMAP EA3064, Faculty of Medicine Jacques Lisfranc, Saint-Etienne, France
| | | | - Hans Pottel
- Interdisciplinary Research Center, Catholic University Leuven, Kortrijk, Belgium
| | | | - Maan A. Zrein
- INFYNITY-Biomarkers, Lyon, France
- Hospices Civils de Lyon, Lyon, France
- * E-mail:
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Saba ES, Gueyffier L, Dichtel-Danjoy ML, Pozzetto B, Bourlet T, Gueyffier F, Mekki Y, Pottel H, Sabino EC, Vanhems P, Zrein MA. Anti-Trypanosoma cruzi cross-reactive antibodies detected at high rate in non-exposed individuals living in non-endemic regions: seroprevalence and association to other viral serologies. PLoS One 2013; 8:e74493. [PMID: 24069315 PMCID: PMC3775794 DOI: 10.1371/journal.pone.0074493] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [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: 06/28/2013] [Accepted: 07/22/2013] [Indexed: 01/03/2023] Open
Abstract
Cross-reactive antibodies are characterized by their recognition of antigens that are different from the trigger immunogen. This happens when the similarity between two different antigenic determinants becomes adequate enough to enable a specific binding with such cross-reactive antibodies. In the present manuscript, we report the presence, at an “abnormal” high frequency, of antibodies in blood samples from French human subjects cross-reacting with a synthetic-peptide antigen derived from a Trypanosoma cruzi (T. cruzi) protein sequence. As the vector of T. cruzi is virtually confined to South America, the parasite is unlikely to be the trigger immunogen of the cross-reactive antibodies detected in France. At present, the cross-reactive antibodies are measured by using an in-house ELISA method that employs the T. cruzi -peptide antigen. However, to underline their cross-reactive characteristics, we called these antibodies “Trypanosoma cruzi Cross Reactive Antibodies” or TcCRA. To validate their cross-reactive nature, these antibodies were affinity-purified from plasma of healthy blood donor and were then shown to specifically react with the T. cruzi parasite by immunofluorescence. Seroprevalence of TcCRA was estimated at 45% in serum samples of French blood donors while the same peptide-antigen reacts with about 96% of T. cruzi -infected Brazilian individuals. In addition, we compared the serology of TcCRA to other serologies such as HSV 1/2, EBV, HHV-6, CMV, VZV, adenovirus, parvovirus B19, mumps virus, rubella virus, respiratory syncytial virus, measles and enterovirus. No association was identified to any of the tested viruses. Furthermore, we tested sera from different age groups for TcCRA and found a progressive acquisition starting from early childhood. Our findings show a large seroprevalence of cross-reactive antibodies to a well-defined T. cruzi antigen and suggest they are induced by a widely spread immunogen, acquired from childhood. The etiology of TcCRA and their clinical relevance still need to be investigated.
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Affiliation(s)
- Esber S. Saba
- InfYnity-Biomarkers, Ecully, France
- Laboratory of Bacteriology-Virology, GIMAP EA3064, Faculty of Medicine Jacques Lisfranc, Saint-Etienne, France
| | | | | | - Bruno Pozzetto
- Laboratory of Bacteriology-Virology, GIMAP EA3064, Faculty of Medicine Jacques Lisfranc, Saint-Etienne, France
| | - Thomas Bourlet
- Laboratory of Bacteriology-Virology, GIMAP EA3064, Faculty of Medicine Jacques Lisfranc, Saint-Etienne, France
| | - François Gueyffier
- UCBL-Hospices Civils de Lyon, Faculty of Medicine Rockefeller, Lyon, France
| | - Yahia Mekki
- UCBL-Hospices Civils de Lyon, Faculty of Medicine Rockefeller, Lyon, France
| | - Hans Pottel
- Interdisciplinary Research Center, Catholic University Leuven, Campus Kortrijk, Kortrijk, Belgium
| | - Ester C. Sabino
- Faculdade de Medicina da USP, Dep de Molestias Infecciosas e Parasitárias, São Paulo, Brazil
| | - Philippe Vanhems
- UCBL-Hospices Civils de Lyon, Faculty of Medicine Rockefeller, Lyon, France
| | - Maan A. Zrein
- InfYnity-Biomarkers, Ecully, France
- UCBL-Hospices Civils de Lyon, Faculty of Medicine Rockefeller, Lyon, France
- * E-mail:
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