Parasite load and risk factors for poor outcome among children with visceral leishmaniasis. A cohort study in Belo Horizonte, Brazil, 2010-2011

Clinical and laboratory risk factors for death from visceral leishmaniasis (VL) are relatively known, but quantitative real-time polymerase chain reaction (qPCR) might assess the role of parasite load in determining clinical outcome. The aim of this study was to identify risk factors, including parasite load in peripheral blood, for VL poor outcome among children. This prospective cohort study evaluated children aged ≤ 12 years old with VL diagnosis at three times: pre-treatment (T0), during treatment (T1) and post-treatment (T2). Forty-eight patients were included and 16 (33.3%) met the criteria for poor outcome. Age ≤ 12 months [relative risk (RR) 3.51; 95% confidence interval (CI) 1.89-6.52], tachydyspnoea (RR 3.46; 95% CI 2.19-5.47), bacterial infection (RR 3.08; 95% CI 1.27-7.48), liver enlargement (RR 3.00; 95% CI 1.44-6.23) and low serum albumin (RR 7.00; 95% CI 1.80-27.24) were identified as risk factors. qPCR was positive in all patients at T0 and the parasite DNA was undetectable in 76.1% of them at T1 and in 90.7% at T2. There was no statistical association between parasite load at T0 and poor outcome.

Evaluation of four molecular methods for the diagnosis of tuberculosis in pulmonary and blood samples from immunocompromised patients

The present study analysed the concordance among four different molecular diagnostic methods for tuberculosis (TB) in pulmonary and blood samples from immunocompromised patients. A total of 165 blood and 194 sputum samples were collected from 181 human immunodeficiency virus (HIV)-infected patients with upper respiratory complaints, regardless of suspicious for TB. The samples were submitted for smear microscopy, culture and molecular tests: a laboratory-developed conventional polymerase chain reaction (PCR) and real-time quantitative PCR (qPCR) and the Gen-Probe and Detect-TB Ampligenix kits. The samples were handled blindly by all the technicians involved, from sample processing to results analysis. For sputum, the sensitivity and specificity were 100% and 96.7% for qPCR, 81.8% and 94.5% for Gen-Probe and 100% and 66.3% for Detect-TB, respectively. qPCR presented the best concordance with sputum culture [kappa (k) = 0.864)], followed by Gen-Probe (k = 0.682). For blood samples, qPCR showed 100% sensitivity and 92.3% specificity, with a substantial correlation with sputum culture (k = 0.754) and with the qPCR results obtained from sputum of the corresponding patient (k = 0.630). Conventional PCR demonstrated the worst results for sputa and blood, with a sensitivity of 100% vs. 88.9% and a specificity of 46.3% vs. 32%, respectively. Commercial or laboratory-developed molecular assays can overcome the difficulties in the diagnosis of TB in paucibacillary patients using conventional methods available in most laboratories.

Diagnostic challenges of single plaque-like lesion paucibacillary leprosy

The diagnosis of single-lesion paucibacillary leprosy remains a challenge. Reviews by expert dermatopathologists and quantitative polymerase chain reaction (qPCR) results obtained from 66 single-plaque biopsy samples were compared. Histological findings were graded as high (HP), medium (MP) or low (LP) probability of leprosy or other dermatopathy (OD). Mycobacterium leprae-specific genes were detected using qPCR. The biopsies of 47 out of 57 clinically diagnosed patients who received multidrug therapy were classified as HP/MP, eight of which were qPCR negative. In the LP/OD (n = 19), two out of eight untreated patients showed positive qPCR results. In the absence of typical histopathological features, qPCR may be utilised to aid in final patient diagnosis, thus reducing overtreatment and delay in diagnosis.

Molecular diagnosis of strongyloidiasis in tropical areas: a comparison of conventional and real-time polymerase chain reaction with parasitological methods

This study aimed to evaluate the use of conventional polymerase chain reaction (cPCR) and real-time quantitative PCR (qPCR) in the diagnosis of human strongyloidiasis from stool samples in tropical areas. Stool samples were collected from individuals and were determined to be positive for Strongyloides stercoralis (group I), negative for S. stercoralis (group II) and positive for other enteroparasite species (group III). DNA specific to S. stercoralis was found in 76.7% of group I samples by cPCR and in 90% of group I samples by qPCR. The results show that molecular methods can be used as alternative tools for detecting S. stercoralis in human stool samples in tropical areas.

Optimisation of a quantitative polymerase chain reaction-based strategy for the detection and quantification of human herpesvirus 6 DNA in patients undergoing allogeneic haematopoietic stem cell transplantation

Human herpesvirus 6 (HHV-6) may cause severe complications after haematopoietic stem cell transplantation (HSCT). Monitoring this virus and providing precise, rapid and early diagnosis of related clinical diseases, constitute essential measures to improve outcomes. A prospective survey on the incidence and clinical features of HHV-6 infections after HSCT has not yet been conducted in Brazilian patients and the impact of this infection on HSCT outcome remains unclear. A rapid test based on real-time quantitative polymerase chain reaction (qPCR) has been optimised to screen and quantify clinical samples for HHV-6. The detection step was based on reaction with TaqMan® hydrolysis probes. A set of previously described primers and probes have been tested to evaluate efficiency, sensitivity and reproducibility. The target efficiency range was 91.4% with linearity ranging from 10-106 copies/reaction and a limit of detection of five copies/reaction or 250 copies/mL of plasma. The qPCR assay developed in the present study was simple, rapid and sensitive, allowing the detection of a wide range of HHV-6 loads. In conclusion, this test may be useful as a practical tool to help elucidate the clinical relevance of HHV-6 infection and reactivation in different scenarios and to determine the need for surveillance.

Identification of reference genes for expression analysis by real-time quantitative PCR in drought-stressed soybean

The objective of this work was to validate, by quantitative PCR in real time (RT-qPCR), genes to be used as reference in studies of gene expression in soybean in drought-stressed trials. Four genes commonly used in soybean were evaluated: Gmβ-actin, GmGAPDH, GmLectin and GmRNAr18S. Total RNA was extracted from six samples: three from roots in a hydroponic system with different drought intensities (0, 25, 50, 75 and 100 minutes of water stress), and three from leaves of plants grown in sand with different soil moistures (15, 5 and 2.5% gravimetric humidity). The raw cycle threshold (Ct) data were analyzed, and the efficiency of each primer was calculated for an overall analysis of the Ct range among the different samples. The GeNorm application was used to evaluate the best reference gene, according to its stability. The GmGAPDH was the least stable gene, with the highest mean values of expression stability (M), and the most stable genes, with the lowest M values, were the Gmβ-actin and GmRNAr18S, when both root and leaves samples were tested. These genes can be used in RT-qPCR as reference gene for expression analysis.

Expressão gênica induzida por estresses abióticos em nódulos de feijão-caupi

O objetivo deste trabalho foi avaliar o efeito isolado ou simultâneo dos estresses hídrico e térmico na expressão gênica em nódulos de feijão-caupi. A bactéria Bradyrhizobium japonicum (estirpe BR 3267) foi inoculada em sementes de feijão-caupi da cultivar IPA 206 e, 35 dias após a germinação, as plantas foram submetidas a diferentes regimes de disponibilidade hídrica e a estresse térmico, em casa de vegetação. Para a identificação dos genes diferencialmente expressos, foi utilizada a técnica de cDNA-AFLP, tendo-se isolado 67 fragmentos derivados de transcritos (FDTs) diferencialmente expressos. Após o sequenciamento dos FDTs e das análises de similaridade, com uso do programa Blastx, foram identificados 14 genes diferencialmente expressos envolvidos em diferentes processos metabólicos. O padrão de expressão de seis genes sob estresse abiótico foi confirmado por RT-qPCR, e observou-se indução de genes pertencentes a diferentes categorias funcionais, como biossíntese de ácido abscísico, sinalização celular, transportador de prolina e biossíntese de lipídeos de membranas. A expressão desses genes indica sua participação em processos relacionados à proteção dos nódulos ao estresse abiótico.

Reaction of sweet orange cultivars expressing the attacin A gene to 'Candidatus Liberibacter asiaticus' infection

The objective of this work was to evaluate the reaction of four sweet orange cultivars expressing the attacin A gene to 'Candidatus Liberibacter asiaticus' (Las) infection, a bacterium associated to huanglongbing (HLB) disease. Transgenic sweet orange plants of Hamlin, Natal, Pêra, and Valência cultivars, as well as nontransgenic controls received inocula by grafting budwood sections of HLB-infected branches. Disease progression was evaluated through observations of leaf symptoms and by polymerase chain reaction (PCR) analysis, eight months after inoculation. A completely randomized design was used, with four experiments (one for each cultivar) performed simultaneously. Bacteria title was estimated by quantitative PCR (qPCR). HLB symptoms and Las titers were present in nontransgenic and transgenic plants expressing the attacin A gene of the four sweet orange cultivars, eight months after bacteria inoculation. Five transgenic lines (transformation events) of 'Pêra' sweet orange expressing the attacin A gene have significantly lower Las titers in comparison with nontransgenic plants of this cultivar.

Papel protetor do alelo G do polimorfismo no gene Interleucina 10 (-1082G/A) contra o desenvolvimento de pré-eclâmpsia

OBJETIVOS:Identificar a frequência do polimorfismo no gene IL-10, rs1800896 (-1082 A/G), em mulheres com pré-eclâmpsia (PE) e em mulheres do grupo controle e associar a presença deste polimorfismo com a proteção contra o desenvolvimento da PE.MÉTODOS:Estudo do tipo caso-controle, no qual foram selecionadas 54 mulheres com PE, classificadas de acordo com os critérios da National High Blood Pressure Education Program e 172 mulheres do grupo controle, com pelo menos duas gestações saudáveis. O polimorfismo proposto foi estudado utilizando-se a técnica de reação em cadeia da polimerase em tempo real (qPCR), com sondas de hidrólise. A análise estatística foi realizada utilizando-se o teste de associação do χ2. Odds ratio e seu intervalo de confiança de 95% foram usados para medir a força de associação entre o polimorfismo estudado e o desenvolvimento da PE.RESULTADOS:Foi observado aumento significativo da frequência do genótipo AG entre mulheres do grupo controle (85 versus 15% nas mulheres com PE). O alelo G é significativamente mais frequente entre as mulheres do grupo controle do que nas com PE (Teste χ2; p=0,01). Oodds ratio para as portadoras do alelo G foi de 2, 13, indicando que apresentam menor risco de desenvolver PE do que as não portadoras.CONCLUSÕES:Sugere-se associação entre a presença do alelo G do polimorfismo no geneIL-10, rs1800896 (-1082 A/G), e a proteção contra o desenvolvimento da PE. Mais estudos sobre a contribuição dessas variações e os mecanismos pelos quais afetam o risco de desenvolver PE ainda necessitam de ser realizadas.

A thymidine kinase-deleted bovine herpesvirus 5 establishes latent infection but reactivates poorly in a sheep model

The ability of thymidine kinase (tk)-deleted recombinant bovine herpesvirus 5 (BoHV-5tkΔ) to establish and reactivate latent infection was investigated in lambs. During acute infection, the recombinant virus replicated moderately in the nasal mucosa, yet to lower titers than the parental strain. At day 40 post-infection (pi), latent viral DNA was detected in trigeminal ganglia (TG) of all lambs in both groups. However, the amount of recombinant viral DNA in TGs was lower (9.7-fold less) than that of the parental virus as determined by quantitative real time PCR. Thus, tk deletion had no apparent effect on the frequency of latent infection but reduced colonization of TG. Upon dexamethasone (Dx) administration at day 40 pi, lambs inoculated with parental virus shed infectious virus in nasal secretions, contrasting with lack of infectivity in secretions of lambs inoculated with the recombinant virus. Nevertheless, some nasal swabs from the recombinant virus group were positive for viral DNA by PCR, indicating low levels of reactivation. Thus, BoHV-5 TK activity is not required for establishment of latency, but seems critical for efficient virus reactivation upon Dx treatment.

Prevalência sorológica e molecular de Babesia bovis e Babesia bigemina em búfalos (Bubalus bubalis) na Ilha de Marajó, Pará

O objetivo do estudo foi testar a prevalência sorológica e molecular de Babesia bovis e Babesia bigemina em búfalos da Ilha de Marajó, Pará. Foi utilizado ensaio de imunoadsorção enzimático indireto (iELISA) com antígeno total contendo proteínas de superfície externa e reação em cadeia da polimerase (qPCR), envolvendo o uso de SYBR Green com base na amplificação de um pequeno fragmento de gene do citocromo b. A prevalência de animais positivos no ELISA para B. bovis, B. bigemina e para infecção mista foi de 24.87% (199/800), 20.75% (166/800) e 18.75% (150/800), respectivamente. Na PCR foi detectado a presença de B. bovis em 15% (18/199) e de B. bigemina em 16% (19/199) dos animais, sendo que destes, 58% (11/19) apresentavam-se co-infectados pelos dois agentes. Os resultados mostram uma baixa prevalência de anticorpos anti-B. bovis e anti-B. bigemina em búfalos da Ilha do Marajó. Porém, observou-se que os agentes da babesiose bovina circulam em búfalos, podendo estes atuar como reservatórios.

Freund's adjuvant-induced inflammation: clinical findings and its effect on hepcidin mRNA expression in horses

Hypoferremia observed during systemic inflammatory disorders is regulated by hepcidin. Hepcidin up-regulation is particularly important during acute inflammation, as it restricts the availability of iron, which is necessary for pathogenic microorganism growth before adaptive immunity occurs. The aim of this study was to evaluate the clinical findings and hepatic hepcidin mRNA expression in horses using a Freund's complete adjuvant (FCA) model of inflammation. The expression of hepcidin mRNA in the liver was determined in healthy horses following two intramuscular injections of FCA at 0 h and 12 h. Plasma iron and fibrinogen concentrations were measured at multiple time points between 0 h and 240 h post-FCA injection (PI). Hepcidin mRNA expression was determined by RT-qPCR using liver biopsy samples performed at 0 h (control), 6 h and 18 h PI. The mean plasma fibrinogen level was significantly different from the control values only between 120 and 216 h PI. The mean plasma iron level was significantly lower than the control between 16 and 72 h PI, reaching the lowest levels at 30 h PI (33 % of the initial value), and returned to the reference value from 96 h PI to the end of the experiment. Hepcidin mRNA expression increased at 6 h PI and remained high at 18 h PI. The iron plasma concentration was an earlier indicator of inflammatory processes in horses when compared with fibrinogen and might be useful for the early detection of inflammation in the horse. FCA administration caused the rapid onset of hypoferremia, and this effect was likely the result of up-regulated hepatic hepcidin gene expression. This study emphasizes the importance of hepcidin and iron metabolism during inflammation in horses.

Diagnóstico de paratuberculose por biópsia retal em búfalos

Resumo: Foram realizadas biópsias retais de 140 búfalos, machos e fêmeas, das raças Murrah e mestiços de Murrah com Mediterrâneo, com idade acima de três anos, em uma propriedade no município de São Mateus, Maranhão, Brasil. Adicionalmente foram realizadas necropsias de 11 búfalos, para realizar um estudo comparativo entre os achados das biópsias retais e de tecidos de íleo e linfonodo mesentérico. A propriedade apresentava histórico de animais com emagrecimento progressivo e diarreia não responsiva a antimicrobianos. Os búfalos apresentavam sinais clínicos caracterizados por diarreia, estado nutricional regular a ruim, desidratação e edema submandibular. Nas biópsias retais seis búfalos apresentaram lesões sugestivas da paratuberculose na Hematoxilina-Eosina (HE), sendo estas caracterizadas por inflamação granulomatosa multifocal moderada na lâmina própria com macrófagos epitelioides. Em quatro animais foram observadas adicionalmente células gigantes do tipo Langhans. Em 15 búfalos foi observado infiltrado linfocitário multifocal leve na lâmina própria. Pela coloração de Ziehl-Neelsen (ZN), 4,3% (6/140) apresentaram bacilos álcool-ácido resistentes (BAAR) e na PCR em tempo real (qPCR), 5,71% (7/140) tiveram amplificação do material genético. Foram necropsiados 11 búfalos, à necropsia foram observados aumento de linfonodos mesentéricos com áreas esbranquiçadas na superfície de corte; intestino delgado e grosso com dobras transversais evidentes, mucosa espessada e irregular, de aspecto reticulado, placas de Peyer evidentes e conteúdo líquido e marrom. Ainda se viam áreas espessadas em torno da válvula ileocecal e vasos linfáticos evidentes. As lesões histológicas localizadas no intestino delgado e linfonodos mesentéricos de quatro búfalos foram compatíveis com lesões já descritas na literatura, e apresentaram BAAR e amplificação de material genético na qPCR. A concordância entre a biópsia retal e a análise dos tecidos de íleo e linfonodo mesentérico, segundo o teste Kappa (K=0,792), foi alta. A biópsia retal realizada demonstrou ser promissora e pode ser empregada, juntamente com outras técnicas, para auxiliar no diagnóstico ante mortem em búfalos de rebanhos com suspeita de paratuberculose; pela mesma foi possível detectar animais positivos através da coloração de ZN e qPCR. Os resultados obtidos podem ser utilizados no controle da enfermidade para selecionar e eliminar animais positivos do rebanho, diminuindo gradualmente, a disseminação do agente no ambiente, e a consequente contaminação de outros animais.

Infecção transplacentária e intrauterina por Brucella abortus em búfalos (Bubalus bubalis)

RESUMO: O objetivo deste trabalho foi verificar a presença de Brucella abortus e as lesões causadas por esse agente nos anexos fetais e nos fetos de búfalas. Para isso, 20 búfalas em diversos meses de gestação, sorologicamente positivas para brucelose, foram submetidas ao abate sanitário. A idade fetal foi determinada através de exames ultrassonográficos associados à mensuração dos fetos durante a necropsia. Do útero fechado desses animais foram coletadas amostras para histopatologia e qPCR. A partir do segundo mês de gestação foi possível detectar a presença de DNA de B. abortus em líquido amniótico, líquido alantoide e em útero e, a partir do quinto mês, na placenta, coração, baço, rim, pulmão, intestino, fígado e linfonodos dos fetos. Os principais achados anatomopatológicos foram placentite fibrinopurulenta necrótica e endometrite supurativa crônica.

Detecção de Brucella abortus em linfonodos de búfalas (Bubalus bubalis) em diferentes fases da gestação

Resumo: O objetivo do presente trabalho foi verificar a presença do DNA de Brucella abortus e caracterizar as lesões causadas por esse agente em linfonodos de búfalas. Foram utilizadas 19 búfalas em diversos estágios de gestação, sorologicamente positivas para brucelose, submetidas ao abate sanitário, das quais se coletou fragmentos de diversos linfonodos. A idade fetal foi determinada através de exames ultrassonográficos associados à mensuração dos fetos durante a necropsia. Amostras foram coletadas e submetidas à qPCR e histopatologia. A detecção de DNA de B. abortus nos linfonodos das búfalas avaliadas foi verificada a partir do quarto mês de gestação em sete búfalas e em uma búfala pós-parição. Os achados histológicos foram linfadenite aguda a crônica. A presença de DNA de B. abortus foi detectada em todos os grupos de linfonodos avaliados, sendo que os linfonodos mais acometidos foram os mamários.