RESUMEN
AIMS: The aim of the present study was to assess serum cytokine and miRNA expression in visceral leishmaniasis-HIV (VL-HIV) co-infection and HIV mono-infection. METHODS AND RESULTS: We analysed 113 serum samples from HIV patients in areas endemic for leishmaniasis. The diagnosis of VL was confirmed in 65 of these 113 samples. The VL-HIV and HIV groups presented significant differences regarding haemoglobin level (P < .0001), lymphocyte count (P = .0444), white blood cell count (P = .0108), weight loss (P = .0310), HIV load (P < .0001) and CD4+ T-lymphocytes count (P = .0003). Levels of IL-6 and IL-10, IFN-γ and IL-6, IFN-γ and IL-10, TNF and IL-2 were positively correlated in VL-HIV co-infection, indicating higher serum levels of TNF and IL-4 (P < .0001). In addition, miR-182 expression was found to be significantly higher in HIV (P = .009), miR-210 exhibited no statistically significant difference between groups, and nonexpression of miR-122 was found in both groups. CONCLUSION: Together, TNF, IL-4 and miR-182 may represent circulatory biomarkers of VL-HIV co-infection.
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Infecciones por VIH/sangre , Leishmaniasis Visceral/sangre , MicroARNs/sangre , Adulto , Biomarcadores/sangre , Linfocitos T CD4-Positivos/inmunología , Coinfección , Citocinas/sangre , Femenino , Infecciones por VIH/complicaciones , Humanos , Interleucina-10/sangre , Interleucina-4/sangre , Leishmaniasis Visceral/complicaciones , Recuento de Leucocitos , MasculinoRESUMEN
Following the emergence of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), the number of visceral leishmaniasis-HIV (VL-HIV) coinfections has increased worldwide, mainly in Brazil. The development of clinical forms of VL can be influenced by nutritional status, age, and host genetic factors, which are important variables determining susceptibility to disease. There are no studies with a candidate gene approach assayed directly in the VL-HIV-coinfected population. Herein, we determined and analyzed the associations of SLC11A1, LECT2, CCL1, CCL16, and IL4 genetic polymorphisms with susceptibility to VL-HIV coinfection in Northeastern Brazil. We analyzed 309 DNA samples extracted from the peripheral blood of HIV patients, and clinical and hematological data were collected from medical records. The diagnosis of VL was confirmed in 110 out of 309 patients; genotyping was carried out by TaqMan assays afterwards. Our results confirmed the association between the SLC11A1 polymorphism (rs3731865) and VL-HIV coinfection (p = 0.0206, OR 1.8126, 95% CI 1.1050-2.9727). In addition, the SLC11A1 genotype GG (p = 0.0050, OR 3.0395, 95% CI 1.4065-6.5789) and CD4+ T lymphocyte count (p = 0.0030, OR 0.9980, 95% CI 0.9970-0.9990) were associated with VL-HIV coinfection in a multivariate model. The polymorphism of the SLC11A1 gene (rs3731865) was associated with VL-HIV coinfection, suggesting a possible genetic mechanism involved in the susceptibility to VL in HIV patients. This finding can suggest new therapeutic targets and genetic markers for the VL-HIV-coinfected population.
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Síndrome de Inmunodeficiencia Adquirida/epidemiología , Proteínas de Transporte de Catión/genética , Predisposición Genética a la Enfermedad/genética , Leishmaniasis Visceral/epidemiología , Adulto , Brasil/epidemiología , Linfocitos T CD4-Positivos/inmunología , Quimiocina CCL1/genética , Quimiocinas CC/genética , Coinfección/epidemiología , Coinfección/genética , Femenino , Genotipo , Humanos , Péptidos y Proteínas de Señalización Intercelular/genética , Interleucina-4/genética , Masculino , Persona de Mediana Edad , Polimorfismo Genético/genéticaRESUMEN
Several immune markers have been studied in controlling American tegumentary leishmaniosis based on mouse models. However, there is a lack of studies regarding human tegumentary leishmaniosis caused by Leishmania braziliensis. In this study, hypoxia-inducible factor-1α was found to be an important effector element in the localized control of human cutaneous and mucocutaneous lesions.
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Regulación de la Expresión Génica/fisiología , Subunidad alfa del Factor 1 Inducible por Hipoxia/metabolismo , Leishmania braziliensis/aislamiento & purificación , Leishmaniasis Cutánea/parasitología , Adulto , Humanos , Subunidad alfa del Factor 1 Inducible por Hipoxia/genéticaRESUMEN
BACKGROUND & OBJECTIVES: : Schistosomiasis is a rural endemic disease that has been expanding to urban and coastal areas in the state of Pernambuco, Brazil. The aim of this study was to characterize the distribution of breeding sites of the causative vector, Biomphalaria straminea in an endemic municipality for schistosomiasis and to present the predictive models for occurrences and dispersal of this vector snail to new areas. METHODS: : A malacological survey was conducted during January to December 2015 in the municipality of São Lourenço da Mata, Pernambuco, Brazil to identify the breeding sites of Biomphalaria. Faecal contamination was determined by means of the Colitag™ diagnostic kit. Rainfall data were collected, and correlated with snail distribution data. Kernel density estimation, kriging and maximum entropy (MaxEnt) modeling were used for spatial data analysis, by means of the spatial analysis software packages. RESULTS: : Out of the 130 demarcated collection points, 64 were classified as breeding sites for B. straminea. A total of 5,250 snails were collected from these sites. Among these 64 sites, four were considered as foci of schistosomiasis transmission and 54 as potential transmission foci. An inverse relationship between rainfall and snail density was observed. Kernel spatial analysis identified three areas at higher risk of snail occurrence, which were also the areas of highest faecal contamination and included two transmission foci. Kriging and MaxEnt modeling simulated the scenarios obtained through the kernel analyses. INTERPRETATION & CONCLUSION: : Use of geostatistical tools (Kriging and MaxEnt) is efficient for identifying areas at risk and for estimating the dispersal of Biomphalaria species across the study area. Occurrence of B. straminea in the study area is influenced by the rainy season, as it becomes more abundant during the period immediately after the rainy season, increasing the risk of dispersal and the appearance of new transmission foci.
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Distribución Animal , Biomphalaria/parasitología , Esquistosomiasis/epidemiología , Animales , Brasil/epidemiología , Cruzamiento , Vectores de Enfermedades , Enfermedades Endémicas , Heces/parasitología , Humanos , Modelos Teóricos , Lluvia , Medición de Riesgo , Esquistosomiasis/transmisión , Estaciones del Año , Análisis EspacialRESUMEN
Outbreaks of cutaneous leishmaniasis are relatively common among soldiers involved in nocturnal activities in tropical forests. We investigated the population dynamics of sand flies in a military training camp located in a remnant of Atlantic rainforest in northeastern Brazil, where outbreaks of cutaneous leishmaniasis have sporadically been described. From July 2012 to July 2014, light traps were monthly placed in 10 collection sites, being nine sites located near the forest edge and one near a sheep and goat stable. Light traps operated from 5:00 pm to 6:00 am, during four consecutive nights. Leishmania infection in sand flies was assessed using a fast real-time PCR assay. Cases of cutaneous leishmaniasis among soldiers were also investigated. In total, 24,606 sand flies belonging to 25 species were identified. Males (n = 12,683) predominated over females (n = 11,923). Sand flies were present during all months, being more numerous in March (n = 1,691) and April 2013 (n = 3,324). Lutzomyia choti (72.9%) was the most abundant species, followed by Lutzomyia longispina (13.8%), Lutzomyia complexa (5.3%), representing together >90% of the sand flies collected. Forty cases of cutaneous leishmaniasis were recorded among soldiers from January 2012 to December 2014. Leishmania isolates were obtained from eight patients and were all characterized as Leishmania braziliensis. Soldiers and anyone overnighting in Atlantic rainforest remnants should adopt preventative measures such as the use of repellents on bare skin or clothes and insecticide-treated tents.
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Leishmania braziliensis/aislamiento & purificación , Leishmaniasis Cutánea/epidemiología , Personal Militar , Dinámica Poblacional , Psychodidae/crecimiento & desarrollo , Psychodidae/parasitología , Animales , Brasil/epidemiología , Femenino , Bosques , Humanos , MasculinoRESUMEN
INTRODUCTION: Spinal cord schistosomiasis is a neglected, disabling neurological disease commonly identified in patients from northeast Brazil. The methods currently available for its diagnosis need improvement. PCR in feces and urine is a sensitive diagnostic tool for diagnosis of schistosomiasis, but its value in the cerebrospinal fluid (CSF) is still unknown. OBJECTIVE: The objective of this study was to detect Schistosoma mansoni DNA in CSF from patients with spinal cord schistosomiasis, using the nested PCR (NPCR) assay. METHODS: This was a cross-sectional study carried out from March 2013 to January 2014 at the Aggeu Magalhães Research Center/FIOCRUZ (Pernambuco state, Brazil). NPCR was used to detect Schistosoma mansoni DNA in CSF samples from 20 patients with spinal cord schistosomiasis and 30 controls. RESULTS: NPCR was positive in 16 patients with spinal cord schistosomiasis and none from the control group (sensitivity 80%; specificity 100%, positive predictive value 100%; negative predictive value 88.2%). CONCLUSION: The NPCR technique is highly sensitive and specific for diagnosis of spinal cord schistosomiasis and can be an important diagnostic tool, particularly in cases with negative CSF serology.
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ADN de Helmintos/análisis , Reacción en Cadena de la Polimerasa/métodos , Schistosoma mansoni/genética , Esquistosomiasis mansoni/líquido cefalorraquídeo , Enfermedades de la Médula Espinal/líquido cefalorraquídeo , Enfermedad Aguda , Adolescente , Adulto , Anciano , Animales , Brasil , Estudios Transversales , Diagnóstico Diferencial , Ensayo de Inmunoadsorción Enzimática , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Esquistosomiasis mansoni/tratamiento farmacológico , Sensibilidad y Especificidad , Enfermedades de la Médula Espinal/tratamiento farmacológico , Adulto JovenRESUMEN
BACKGROUND: The occurrence of multifocal skeletal involvement in immunocompetent patients is rare, even in countries where tuberculosis is endemic. Multifocal skeletal lesions may occur as a result of hematogenous dissemination from another primary focus such as cervical lymph nodes, lungs, tonsils or gastrointestinal tract. CASE PRESENTATION: We present a 59 year-old man with a history of intermittent and disabling pain in his left knee for 2 years. The patient in this case presented with lung infection with bilateral skeletal dissemination in the knees and femurs. Immunological examination for the HIV was negative. CONCLUSIONS: Diagnosis of this condition is not always easy because of the disease's insidious character, and it can be confused with other diseases such as osteoarthritis, especially in middle-aged individuals.
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Rodilla/microbiología , Tuberculosis/diagnóstico , Antibacterianos/uso terapéutico , Artroscopía/efectos adversos , ADN Bacteriano/análisis , Fístula , Humanos , Huésped Inmunocomprometido , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Mycobacterium tuberculosis/genética , Mycobacterium tuberculosis/aislamiento & purificación , Osteoartritis/terapia , Osteomielitis/etiología , Osteomielitis/microbiología , Reacción en Cadena de la Polimerasa , Tuberculosis/tratamiento farmacológico , Tuberculosis/microbiologíaRESUMEN
Conventional nested PCR is a very sensitive and specific method for the diagnosis of visceral leishmaniasis. However, this type of PCR is notorious for contamination problems related to the processing of the product between the first and the second PCR steps. In order to have a PCR method that is just as efficient but without the risk of contamination, we attempted the optimization of a single-tube nested PCR (STNPCR) method. During the first and the second PCR steps, we used the small subunit of ribosomal RNA (ssu rRNA) and the ribosomal internal transcribed spacer (ITS) as targets, respectively. The performances of STNPCR and nested PCR in detecting the DNA of Leishmania chagasi were compared. In the case of STNPCR, the inner primers were immobilized on the interior of the tube cap by means of adsorption microtubes and then were solubilized before the second reaction. This procedure eliminated the need to open the microtube, which could have led to false-positive results through cross-contamination. The detection limit for the purified L. chagasi DNA was 1 fg by using nested PCR and 10 fg by using STNPCR. We also tested the specificity of the system against other parasites, and observed that Trypanosoma cruzi DNA was amplified with a detection limit of up to 1 pg. This study not only presents a promising tool for the diagnosis of visceral leishmaniasis, but also provides a new tool for the diagnosis of Chagas disease, either in mono-infection by T. cruzi or in co-infection with Leishmania spp.
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ADN Protozoario/análisis , ADN Ribosómico/análisis , Leishmania infantum/aislamiento & purificación , Leishmaniasis Visceral/diagnóstico , Reacción en Cadena de la Polimerasa/métodos , ADN Espaciador Ribosómico/genética , Leishmania braziliensis/genética , Leishmania braziliensis/aislamiento & purificación , Leishmania infantum/genética , Leishmania major/genética , Leishmania major/aislamiento & purificación , Leishmania mexicana/genética , Leishmania mexicana/aislamiento & purificación , Reacción en Cadena de la Polimerasa/normas , ARN Ribosómico/genética , Sensibilidad y Especificidad , Especificidad de la Especie , Trypanosoma cruzi/genética , Trypanosoma cruzi/aislamiento & purificaciónRESUMEN
This study was performed with the objective to identify the prevalence of colonization by Staphylococcus aureus in nursing professionals from a teaching hospital in Pernambuco, and evaluate the resistance profile of these isolates. To do this, we performed a cross-sectional study where biological samples were collected from the hands and nasal cavities of the subjects. S. aureus was identified using agar (blood agar and mannitol salt) via catalase and coagulase tests. The sensitivity profile was determined by Kirby Bauer technique and determination of methicillin resistance was performed with oxacillin screening with sodium chloride (NaCl) addition. Of the 151 professionals evaluated, 39 were colonized which showed a prevalence of 25.8%. Among the variables studied, age and use of PPE were associated with colonization by the organism. Of all the isolates, only five were resistant to methicillin.