Comparison of flow cytometry and indirect immunofluorescence assay in the diagnosis and cure criterion after therapy of American tegumentary leishmaniasis by anti-live Leishmania (Viannia) braziliensis immunoglobulin G

The aim of this study was to compare the techniques of indirect immunofluorescence assay (IFA) and flow cytometry to clinical and laboratorial evaluation of patients before and after clinical cure and to evaluate the applicability of flow cytometry in post-therapeutic monitoring of patients with American tegumentary leishmaniasis (ATL). Sera from 14 patients before treatment (BT), 13 patients 1 year after treatment (AT), 10 patients 2 and 5 years AT were evaluated. The results from flow cytometry were expressed as levels of IgG reactivity, based on the percentage of positive fluorescent parasites (PPFP). The 1:256 sample dilution allowed us to differentiate individuals BT and AT. Comparative analysis of IFA and flow cytometry by ROC (receiver operating characteristic curve) showed, respectively, AUC (area under curve) = 0.8 (95% CI = 0.64–0.89) and AUC = 0.90 (95% CI = 0.75–0.95), demonstrating that the flow cytometry had equivalent accuracy. Our data demonstrated that 20% was the best cut-off point identified by the ROC curve for the flow cytometry assay. This test showed a sensitivity of 86% and specificity of 77% while the IFA had a sensitivity of 78% and specificity of 85%. The after-treatment screening, through comparative analysis of the technique performance indexes, 1, 2 and 5 years AT, showed an equal performance of the flow cytometry compared with the IFA. However, flow cytometry shows to be a better diagnostic alternative when applied to the study of ATL in the cure criterion. The information obtained in this work opens perspectives to monitor cure after treatment of ATL.

Species-specific identification of Leishmania in naturally infected sand flies captured in Mato Grosso do Sul State, Brazil

An increase in cutaneous and visceral leishmaniasis cases has been reported in recent years in the state of Mato Grosso do Sul, Brazil, and little is known to date about their etiological agents. An investigation into natural Leishmania infection of sand flies captured in this state between December 2003 and August 2004 was carried out. Mini-exon sequences were used as targets to identify Leishmania, and an RFLP technique was employed for those identified as belonging to the Viannia subgenus. Calculation of the minimal infection rate (MR) revealed that 1.6% of sand flies captured in the forest, peridomicile and intradomicile were positive. Six species were found to be infected by Leishmania (V.) braziliensis. Interestingly, two of the six species. Lutzomyia longipalpis and Nyssomyia whitmani, were captured in anthropic environments. The findings of this study constitute a useful tool for planning control measures against this disease in the State of Mato Grosso do Sul. (C) 2010 Elsevier B.V. All rights reserved.

Leishmania spp. in Didelphis albiventris and Micoureus paraguayanus (Didelphimorphia: Didelphidae) of Brazil

Leishmaniasis is kept in nature by the participation of several animal species. This study evaluated the presence of Leishmania spp. in skin samples of free-ranging marsupials Micoureus paraguayanus (n = 95) and Didelphis albiventris (n = 191), captured in Morro do Diabo State Park and in sections of its surrounding forest, in the region of Pontal do Paranapanema, Sao Paulo State, Brazil. The samples were tested for the presence of kDNA of Leishmania spp. by polymerase chain reaction (PCR) and by real time PCR (qPCR). All samples from D. albiventris tested by PCR were negative for the presence of kDNA of Leishmania spp. However, when tested by qPCR, the positivity was 1.6%. A positivity of 7.4% by PCR and 11.6% by qPCR was observed for M. paraguayanus. Sixty-four per cent (9/14) of positive animals were limited to the same forest fragment. Presence of Leishmania (Leishmania) amazonensis and Leishmania (Viannia) braziliensis was detected in M. paraguayanus samples. While D. albiventris is the most studied marsupial species due to its urban habits, other marsupial species such as M. paraguayanus can be potential reservoirs of Leishmania spp. and should also be studied. (C) 2010 Elsevier B.V. All rights reserved.

Synthesis and in vitro activity of limonene derivatives against Leishmania and Trypanosoma

The synthesis and in vitro activity of R(+)-Limonene derivatives against Leishmania and Trypanosoma cruzi strains are reported. Seven compounds have shown better in vitro activity against Leishmania (V.)braziliensis than the standard drug pentamidine. Additionally, we have identified two promising new anti-T. cruzi limonene derivatives. (C) 2010 Elsevier Masson SAS. All rights reserved.

Species diversity of Leishmania (Viannia) parasites circulating in an endemic area for cutaneous leishmaniasis located in the Atlantic rainforest region of northeastern Brazil

OBJECTIVES To identify the aetiological agents of cutaneous leishmaniasis and to investigate the genetic polymorphism of Leishmania (Viannia) parasites circulating in an area with endemic cutaneous leishmaniasis (CL) in the Atlantic rainforest region of northeastern Brazil. METHODS Leishmania spp. isolates came from three sources: (i) patients diagnosed clinically and parasitologically with CL based on primary lesions, secondary lesions, clinical recidiva, mucocutaneous leishmaniasis and scars; (ii) sentinel hamsters, sylvatic or synanthropic small rodents; and (iii) the sand fly species Lutzomyia whitmani. Isolates were characterised using monoclonal antibodies, multilocus enzyme electrophoresis (MLEE) and polymerase chain reaction-restriction fragment length polymorphism of the internal transcribed spacer region rDNA locus. RESULTS Seventy-seven isolates were obtained and characterised. All isolates were identified as Leishmania (Viannia) braziliensis serodeme 1 based on reactivity to monoclonal antibodies. MLEE identified 10 zymodemes circulating in the study region. Most isolates were classified as zymodemes closely related to L. (V.) braziliensis, but five isolates were classified as Leishmania (Viannia) shawi. All but three of the identified zymodemes have so far been observed only in the study region. Enzootic transmission and multiclonal infection were observed. CONCLUSIONS Our results confirm that transmission cycle complexity and the co-existence of two or more species in the same area can affect the level of genetic polymorphism in a natural Leishmania population. Although it is not possible to make inferences as to the modes of genetic exchange, one can speculate that some of the zymodemes specific to the region are hybrids of L. (V.) braziliensis and L. (V.) shawi.

A real-time polymerase chain reaction assay for the identification and quantification of American Leishmania species on the basis of glucose-6-phosphate dehydrogenase

A real-time polymerase chain reaction (PCR) test was developed on the basis of the Leishmania glucose-6-phosphate dehydrogenase locus that enables identification and quantification of parasites. Using two independent pairs of primers in SYBR-Green assays, the test identified etiologic agents of cutaneous leishmaniasis belonging to both subgenera, Leishmania (Viannia) and Leishmania (Leishmania) in the Americas. Furthermore, use of TaqMan probes enables distinction between L. (V.) braziliensis or L. (V.) peruviania from the other L. (Viannia) species. All assays were negative with DNA of related trypanosomatids, humans, and mice. The parasite burden was estimated by normalizing the number of organisms per total amount of DNA in the sample or per host glyceraldehyde-3-phosphate dehydrogenase copies. The real-time PCR assay for L. (Leishmania) subgenus showed a good linear correlation with quantification on the basis of a limiting dilution assay in experimentally infected mice. The test successfully identifies and quantifies Leishmania in human biopsy specimens and represents a new tool to study leishmaniasis.

Leishmania spp. in Didelphis albiventris and Micoureus paraguayanus (Didelphimorphia: Didelphidae) of Brazil

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Análise morfológica das células de Langerhans purificadas da epiderme de camundongo Balb/c, após interação in vitro com Leishania (Viannia) brasiliensis e Leishamania (Leishmania) amazonensis

Células de Langerhans (CL) são células apresentadoras de antígenos, MHC classe II positivas, que constituem 2 a 3% de todas as células da epiderme, e que têm demonstrado serem estimuladoras de uma resposta vigorosa de linfócitos T contra Leishmania major. A leishmanionse cutânea do Novo Mundo é causada por diferentes espécies, apresentando formas clínicas diversas variando de leishmaniose cutânea difusa anérgica. Utilizando a técnica de "panning", CL da epiderme de comundongos BALB/c foram purificadas para em torno de 95% de pureza (pCL) em relação à outras células da epiderme. As CL recentemente isoladas apresentaram dentritos pequenos e delicados e os clássicos grânulos de Birbeck. Tem sido sugerido que os parasitos do subgênero Viannia e Leishmania, que são geneticamente bastante distintos, podem ter respostas espécie-específicas na resposta imune celular. Neste estudo, pCL e L. (V.) brasilienses ou L. (L.) amazonensis foram cultivadas e a morfologia das CL foi analizada após 12 ou 36 h de cultura. Utilizando a coloração de Giemsa e a microscopia eletrônica de varredura, alterações morfológicas diferentes foram detectadas nas CL após 12 h de cultivo nas duas culturas, CL e L. (V.) brasiliensis ou CL e L. (L.) amazonensis. Depois da interação com L. (V.) brasiliensis as CL tornaram-se mais dentríticas, que eram mais curtos quando comparados às CL cultivadas isoladamente. Em contraste, após a interação com L. (L.) amazonensis, as CL tornaram-se arredondadas com algumas células mostrando alguns dendritos. Além disto, verificou-se um contato íntimo entre o flagelo das prostigota com as CL, mas sem observar a fagocitose das leishmanias após 12 ou 36 h de cultivo, o que é diferente dos relatos da literatura com CL e L. major. Estes resultados sugerem que a resposta imune primária das CL contra as diferentes espécies de leishamania podem ser distintas de acordo com a espécie envolvida no processo de interação.

Estudo do microcultivo in vitro para o isolamento de Leishmania sp no estado do Pará

Os parasitas do gênero Leishmania apresentam uma variabilidade de espécies na região Amazônica e para sua correta identificação é necessário o isolamento dos mesmos. Atualmente para o isolamento do parasita e posterior diagnóstico da doença têm se utilizado a técnica de microcultivo in vitro. O objetivo de nosso trabalho foi otimizar a técnica de microcultivo in vitro para o isolamento de Leishmania sp. Para o isolamento, além do microcultivo, foi analisado a técnica de vácuo-aspiração adaptada e a viabilidade do parasita a temperaturas abaixo de 25ºC. No total foram utilizados 18 hamsters, infectados com amostras de casos clínicos de Leishmaniose tegumentar americana, sendo 3 de Leishmania.(Leishmania) amazonensis e 2 de Leishmania.(Viannia) braziliensis o qual foram realizados 56 cultivos por vácuo-aspiração em meio NNN, 12 em microtubos e 23 por microcapilares com RPMI suplementado, mantidos entre 25º e 31ºC. Para a segunda etapa, participaram 7 pacientes, totalizando 6 culturas por vácuo-aspiração e 42 por microcapilares. Conservou-se a baixa temperatura 7 tubos com NNN que foram mantidas a 5ºC. Foi observado que os isolamentos por vácuo-aspiração de amostras de L. (L.) amazonensis e L. (V.) braziliensis em hamsters foram sensíveis a adaptação da técnica, diferente das amostras de pacientes. A positividade variou entre 2 a 8 dias e 4 e 5 dias respectivamente. Os microtubos apresentaram positividade para as mesmas amostras de hamsters no período de 5 a 8 dias. Para as amostras dos pacientes, 2/12 tubos por vácuo-aspiração foram positivos e para isolamento em microcapilares 6/42, valores inferiores aos encontrados na literatura. A amostras conservadas a 5ºC apresentaram viabilidade até o 30º dia. Com estes resultados foi observado que o microcultivo é viável para uso dentro de nossa região, entretanto se mostrou limitado para o isolamento de amostras provenientes de pacientes. Devem-se utilizar outros meios de cultivo, de modo a observar o comportamento do parasito e também aperfeiçoar a coleta do material da lesão a fim de melhorar os resultados de isolamento.

In silico identification of conserved intercoding sequences in Leishmania genomes: Unraveling putative cis-regulatory elements

In silico analyses of Leishmania spp. genome data are a powerful resource to improve the understanding of these pathogens' biology. Trypanosomatids such as Leishmania spp. have their protein-coding genes grouped in long polycistronic units of functionally unrelated genes. The control of gene expression happens by a variety of posttranscriptional mechanisms. The high degree of synteny among Leishmania species is accompanied by highly conserved coding sequences (CDS) and poorly conserved intercoding untranslated sequences. To identify the elements involved in the control of gene expression, we conducted an in silico investigation to find conserved intercoding sequences (CICS) in the genomes of L major, L infantum, and L braziliensis. We used a combination of computational tools, such as Linux-Shell, PERL and R languages, BLAST, MSPcrunch, SSAKE, and Pred-A-Term algorithms to construct a pipeline which was able to: (i) search for conservation in target-regions, (ii) eliminate CICS redundancy and mask repeat elements, (iii) predict the mRNA's extremities, (iv) analyze the distribution of orthologous genes within the generated LeishCICS-clusters, (v) assign GO terms to the LeishCICS-clusters. and (vi) provide statistical support for the gene-enrichment annotation. We associated the LeishCICS-cluster data, generated at the end of the pipeline, with the expression profile oft. donovani genes during promastigote-amastigote differentiation, as previously evaluated by others (GEO accession: GSE21936). A Pearson's correlation coefficient greater than 0.5 was observed for 730 LeishCICS-clusters containing from 2 to 17 genes. The designed computational pipeline is a useful tool and its application identified potential regulatory cis elements and putative regulons in Leishmania. (C) 2012 Elsevier B.V. All rights reserved.

Tissue requirements for establishing long-term CD4+ T cell-mediated immunity following Leishmania donovani infection

Organ-specific immunity is a feature of many infectious diseases, including visceral leishmaniasis caused by Leishmania donovani. Experimental visceral leishmaniasis in genetically susceptible mice is characterized by an acute, resolving infection in the liver and chronic infection in the spleen. CD4+ T cell responses are critical for the establishment and maintenance of hepatic immunity in this disease model, but their role in chronically infected spleens remains unclear. In this study, we show that dendritic cells are critical for CD4+ T cell activation and expansion in all tissue sites examined. We found that FTY720-mediated blockade of T cell trafficking early in infection prevented Ag-specific CD4+ T cells from appearing in lymph nodes, but not the spleen and liver, suggesting that early CD4+ T cell priming does not occur in liver-draining lymph nodes. Extended treatment with FTY720 over the first month of infection increased parasite burdens, although this associated with blockade of lymphocyte egress from secondary lymphoid tissue, as well as with more generalized splenic lymphopenia. Importantly, we demonstrate that CD4+ T cells are required for the establishment and maintenance of antiparasitic immunity in the liver, as well as for immune surveillance and suppression of parasite outgrowth in chronically infected spleens. Finally, although early CD4+ T cell priming appeared to occur most effectively in the spleen, we unexpectedly revealed that protective CD4+ T cell-mediated hepatic immunity could be generated in the complete absence of all secondary lymphoid tissues.

Identification and Characterization of a Novel Deoxyhypusine Synthase in Leishmania donovani

Deoxyhypusine synthase, an NAD(+)-dependent enzyme, catalyzes the first step in the post-translational synthesis of an unusual amino acid, hypusine (N-epsilon-(4-amino-2-hydroxybutyl)lysine), in the eukaryotic initiation factor 5A precursor protein. Two putative deoxyhypusine synthase (DHS) sequences have been identified in the Leishmania donovani genome, which are present on chromosomes 20: DHSL20 (DHS-like gene from chromosome 20) and DHS34 (DHS from chromosome 34). Although both sequences exhibit an overall conservation of key residues, DHSL20 protein lacks a critical lysine residue, and the recombinant protein showed no DHS activity in vitro. However, DHS34 contains the critical lysine residue, and the recombinant DHS34 effectively catalyzed deoxyhypusine synthesis. Furthermore, in vivo labeling confirmed that hypusination of eukaryotic initiation factor 5A occurs in intact Leishmania parasites. Interestingly, the DHS34 is much longer, with 601 amino acids, compared with the human DHS enzyme (369 amino acids) and contains several unique insertions. To study the physiological role of DHS34 in Leishmania, gene deletion mutations were attempted via targeted gene replacement. However, chromosomal null mutants of DHS34 could only be obtained in the presence of a DHS34-containing episome. The present data provide evidence that DHS34 is essential for L. donovani and that structural differences in the human and leishmanial DHS enzyme may be exploited for designing selective inhibitors against the parasite.

Rihmamatolääkkeiden vaikutuskohteita. Betuliinin johdannaisia mahdollisiksi uusiksi yhdisteiksi

Jokisokeus eli onkosersiaasi on ihmisen loismatotauti, jota aiheuttaa Onchocerca volvulus -rihmamato. Tautia esiintyy trooppisilla alueilla Afrikassa ja Latinalaisessa Amerikassa. Tartunnan saaneita on noin 37 miljoonaa. Jokisokeus ilmenee iho- ja silmäoireina. Oireet johtuvat loisen nuorimmista muodoista eli mikrofilarioista. Jokisokeutta vastaan on käyty jakamalla lähinnä mikrofilarioihin tehoavaa ivermektiiniä. Tarvetta olisi lääkkeelle, joka tappaisi aikuiset madot tai steriloisi naaraat. Rokote olisi vielä parempi vaihtoehto. Antibiootit on uusi hoitokeino, sillä O. volvuluksella on elintärkeänä symbionttina Wolbachia-bakteeri. Doksisykliini tappaa vähintään 60 prosenttia aikuisista madoista ja steriloi naaraita, mutta kuuri kestää viikkoja. Yksi lupaava yhdiste on emodepsidi, jolla on loismatolääkkeille uusi vaikutusmekanismi. Rihmamatolääkkeiksi on testattu lukuisia yhdisteitä. Jotkut niistä inhiboivat entsyymejä, joilla madot kiertävät ihmisen immuunipuolustusta. Toiset häiritsevät neljä kertaa tapahtuvaa nahanvaihtoa. Hyvä lääkkeiden vaikutuskohde on loiselle välttämätön mutta puuttuu nisäkkäiltä. Betuliini on triterpeeni, jota on runsaasti koivun tuohessa. Betuliini ja monet sen johdannaiset ovat farmakologisesti aktiivisia yhdisteitä, joita tutkitaan etenkin syöpä- ja HIV-lääkkeiksi. Helsingin yliopiston lääkekemian ryhmä on syntetisoinut ja tutkinut lukuisia johdoksia. Jotkin niistä ovat lupaavia esimerkiksi Leishmania-alkueläimiin, Chlamydia pneumoniae -bakteeriin ja alfaviruksiin. Siksi yhdisteitä kannattaisi tutkia muihinkin taudinaiheuttajiin, kuten rihmamatoihin. Sekä Wolbachialla että C. pneumoniaella on sama lipidisynteesireitti, joka on kummallekin elintärkeä. Betuliinista syntetisoitiin johdoksia, joissa betuliinin alkoholeja on hapetettu karbonyyleiksi ja joihin on liitetty typpiheterorengas. Sekä Leishmania donovani että L. braziliensis -tutkimuksissa tehokkain oli formyylibetuliinin heterosykli. Vaikka valmistettuja yhdisteitä ei ole tutkittu rihmamatotesteissä, jatkossa voisi syntetisoida johdannaisia, joissa karbonyylien tilalla on typpirakenteita, koska C. pneumoniaehen hyvin tehonneessa yhdisteessä betuliinin OH-ryhmien tilalla on oksiimi.

A Unique Modification of the Eukaryotic Initiation Factor 5A Shows the Presence of the Complete Hypusine Pathway in Leishmania donovani

Deoxyhypusine hydroxylase (DOHH) catalyzes the final step in the post-translational synthesis of an unusual amino acid hypusine (N-(sic)-(4-amino-2-hydroxybutyl) lysine), which is present on only one cellular protein, eukaryotic initiation factor 5A (eIF5A). We present here the molecular and structural basis of the function of DOHH from the protozoan parasite, Leishmania donovani, which causes visceral leishmaniasis. The L. donovani DOHH gene is 981 bp and encodes a putative polypeptide of 326 amino acids. DOHH is a HEAT-repeat protein with eight tandem repeats of alpha-helical pairs. Four conserved histidine-glutamate sequences have been identified that may act as metal coordination sites. A similar to 42 kDa recombinant protein with a His-tag was obtained by heterologous expression of DOHH in Escherichia coli. Purified recombinant DOHH effectively catalyzed the hydroxylation of the intermediate, eIF5A-deoxyhypusine (eIF5A-Dhp), in vitro. L. donovani DOHH (LdDOHH) showed similar to 40.6% sequence identity with its human homolog. The alignment of L. donovani DOHH with the human homolog shows that there are two significant insertions in the former, corresponding to the alignment positions 159-162 (four amino acid residues) and 174-183 (ten amino acid residues) which are present in the variable loop connecting the N- and C-terminal halves of the protein, the latter being present near the substrate binding site. Deletion of the ten-amino-acid-long insertion decreased LdDOHH activity to 14% of the wild type recombinant LdDOHH. Metal chelators like ciclopirox olamine (CPX) and mimosine significantly inhibited the growth of L. donovani and DOHH activity in vitro. These inhibitors were more effective against the parasite enzyme than the human enzyme. This report, for the first time, confirms the presence of a complete hypusine pathway in a kinetoplastid unlike eubacteria and archaea. The structural differences between the L. donovani DOHH and the human homolog may be exploited for structure based design of selective inhibitors against the parasite.

Theoretical and in vitro studies of a C-terminal peptide from PGKC of Leishmania mexicana mexicana

Trypanosomatids cause deadly diseases in humans. Of the various biochemical pathways in trypanosomatids, glycolysis, has received special attention because of being sequestered in peroxisome like organelles critical for the survival of the parasites. This study focuses on phosphoglycerate kinase (PGK) from Leishmania spp. which, exists in two isoforms, the cytoplasmic PGKB and glycosomal PGKC differing in their biochemical properties. Computational analysis predicted the likelihood of a transmembrane helix only in the glycosomal isoform PGKC, of approximate length 20 residues in the 62-residue extension, ending at, arginine residues R471 and R472. From experimental studies using circular dichroism and NMR with deuterated sodium dodecyl sulfate, we find that the transmembrane helix spans residues 448 +/- 2 to 476 in Leishmania mexicana PGKC. The significance of this observation is discussed in the context of glycosomal transport and substrate tunneling. (C) 2012 Elsevier B.V. All rights reserved.