Trypanosoma cruzi: effect of phenothiazines on the parasite and its interaction with host cells

Phenothiazines were observed to have a direct effect on Trypanosoma cruzi and on its in vitro interaction with host cells. They caused lysis of trypomastigotes (50 uM/24 h) and,to a lesser extent, epimastigote proliferation. Treatment of infected peritoneal macrophages with 12.5 uM chlorpromazine or triflupromazine inhibited the infection; this effect was found to be partially reversible if the drugs were removed after 24 h of treatment. At 60 uM, the drugs caused damage to amastigotes interiorized in heart muscle cells. However, the narrow margin of toxity between anti-trypanossomal activity and damage to host cells mitigates against in vivo investigation at the present time. Possible hypothesis for the mechanism of action of phenothiazines are discussed.

Interaction between the Intermediate Host of Schistosomiasis in Brazil Biomphalaria glabrata (Planorbidae) and a Possible Competitor Melanoides tuberculata (Thiaridae): I. Laboratory Experiments

The biological control of Biomphalaria glabrata, intermediate host of Schistosoma mansoni, is one the accepted options to fight schistosomiasis. One of the most promising candidates to control B. glabrata is the snail Melanoides tuberculata, a potential competitor. However, the mechanisms of interaction between the two species are not clear. Our objective is to determine if M. tuberculata indeed compete with B. glabrata, using two laboratory experiments. In Experiment 1, we tested the effect of the presence of M. tuberculata on the fecundity and mortality rates of B. glabrata. In Experiment 2, we tested if there was a direct or indirect interaction between the two species. In Experiment 1, M. tuberculata was eliminated after the peak in reproductive activity of B. glabrata. In Experiment 2, B. glabrata produced more egg masses when raised with M. tuberculata. The conditions leading to this unexpected positive effect of M. tuberculata on the fecundity of B. glabrata need further clarification, but emphasize that detailed studies of the interaction between these species in the conditions of the local environment should be considered.

The interaction of human pathogenic arena viruses with the host cell

SummaryResearch projects presented in this thesis aimed to investigate two major aspects of the arenaviruses life cycle in the host cell: viral entry and the biosynthesis of the viral envelope glycoprotein.Old World arenaviruses (OWAV), such as Lassa virus (LASV) and lymphocytic choriomeningitis virus (LCMV), attach to the cell by binding to their receptor, alpha-dystroglycan. Virions are then internalized by a largely unknown pathway of endocytosis and delivered to the late endosome/lysosome where fusion occurs at low pH. In the major project of my thesis, we sought to identify cellular factors involved in OWAV cell entry. Our work indicates that OWAV cell entry requires microtubular transport and a functional multivesicular body (MVB) compartment. Infection indeed depends on phosphatidyl inositol 3-kinase (PI3K) activity and lysobisphosphatidic acid (LBPA), a lipid found in membranes of intraluminal vesicles (ILVs) of the MVB. We further found a requirement of factors that are part of the endosomal sorting complex required for transport (ESCRT), involved in the formation of ILVs. This suggests an ESCRT-mediated sorting of virus- receptor complex during the entry process.During viral replication, biosynthesis of viral glycoprotein takes place in the endoplasmic reticulum (ER) of the host cell. When protein load exceeds the folding capacity of the ER, the accumulation of unfolded proteins is sensed by three ER resident proteins, activating transcription factor 6 (ATF6), inositol-requiring enzyme 1 (IRE1) and PKR-like ER kinase (PERK), whose signaling induces the cellular unfolded protein response (UPR). Our results indicate that acute LCMV infection transiently induces the activation of the ATF6 branch of the UPR, whereas the PERK, and IRE1 axis of UPR are neither triggered nor blocked during infection. Our data also demonstrate that activation of ATF6 pathway is required for optimal viral replication during acute infection.The formation of the mature, fusion-active form of arenaviruses glycoproteins requires proteolytic cleavage mediated by the cellular protease subtilisin kexin isozyme-1 (SKI-l)/site-l protease (SIP). We show that targeting the SKI-1/S1P enzymatic activity with specific inhibitors is a powerful strategy to block arenaviruses productive infection. Moreover, characterization of protease function highlights differences in processing between cellular and viral substrates, opening new possibilities in term of drug development against human pathogenic arenaviruses.RésuméLes projets de recherche présentés dans cette thèse visaient à étudier deux aspects du cycle de vie des arenavirus: l'entrée du virus dans la cellule hôte et la biosynthèse de la glycoprotéine durant la réplication virale.Les arenavirus du vieux monde (OWAV), tels que le virus de Lassa (LASV) et le virus de la chorioméningite lymphocytaire (LCMV) s'attachent à la cellule hôte en se liant à leur récepteur, l'alpha-dystroglycane. Les virions sont ensuite intemalisés par une voie d'endocytose inconnue et livrés à l'endosome tardif/lysosome, où le pH acide permet la fusion entre l'enveloppe virale et la membrane du compartiment. Le projet principal de ma thèse consistait à identifier les facteurs cellulaires impliqués dans l'entrée des OWAV dans la cellule hôte. Nos résultats indiquent que l'entrée des OWAV nécessite le transport microtubulaire et la présence d'un corps multivésiculaire (MVB) fonctionnel. L'infection dépend en effet de l'activité de phosphatidyl inositol 3-kinase (PI3K) et de lysobisphosphatidic acid (LBPA), un lipide présent dans les membranes des vésicules intraluminales (ILVs) du MVB. Nous avons également trouvé l'implication de facteurs constituant l'endosomal sorting complex required for sorting (ESCRT) qui joue un rôle dans la formation des ILVs. Ces donnés suggèrent l'incorporation du complexe virus-récepteur dans des ILVs durant le processus d'entrée.Lors de la réplication virale, la biosynthèse de la glycoprotéine virale a lieu dans le réticulum endoplasmique (ER) de la cellule hôte. Lorsque la charge de protéines nouvellement synthétisées excède la capacité de pliage des protéines dans le ER, l'accumulation de protéines mal pliées est détectée par trois facteurs: activating transcription factor 6 (ATF6), inositol-requiring enzyme 1 (IRE1) et PKR-like ER kinase (PERK). Leur signalisation constitue la réponse cellulaire face aux protéines mal pliées (UPR). Nos résultats montrent que l'infection aiguë avec LCMV induit transitoirement l'activation de la voie de signalisation ATF6 alors que les axes PERK et IRE1 de l'UPR ne sont ni induits ni bloqués pendant l'infection. Nos données prouvent également que l'activation de la voie ATF6 est nécessaire à une réplication virale optimale lors de l'infection aiguë avec LCMV.La maturation des glycoprotéines des arenavirus nécessite un clivage protéolytique par la protéase cellulaire subtilisin kexin isozyme-1 (SKI-l)/site-l protease (SIP). Nous avons démontré que le ciblage de l'activité enzymatique de SKI-1/SIΡ avec des inhibiteurs spécifiques est une stratégie prometteuse pour bloquer l'infection par les arenavirus. La caractérisation du mécanisme d'action de la protéase a, par ailleurs, révélé des différences au niveau du clivage entre les substrats cellulaires et viraux, ce qui ouvre de nouvelles perspectives en terme de développement de médicaments contre les arenavirus pathogènes pour l'homme.

The effect of Bulgarian propolis against Trypanosoma cruzi and during its interaction with host cells

Propolis has shown activity against pathogenic microorganisms that cause diseases in humans and animals. The ethanol (Et-Blg) and acetone (Ket-Blg) extracts from a Bulgarian propolis, with known chemical compositions, presented similar activity against tissue culture-derived amastigotes. The treatment of Trypanosoma cruzi-infected skeletal muscle cells with Et-Blg led to a decrease of infection and of the intracellular proliferation of amastigotes, while damage to the host cell was observed only at concentration 12.5 times higher than those affecting the parasite. Ultrastructural analysis of the effect of both extracts in epimastigotes revealed that the main targets were the mitochondrion and reservosomes. Et-Blg also affected the mitochondrion-kinetoplast complex in trypomastigotes, offering a potential target for chemotherapeutic agents.

A century of research: what have we learned about the interaction of Trypanosoma cruzi with host cells?

Since the discovery of Trypanosoma cruzi and the brilliant description of the then-referred to "new tripanosomiasis" by Carlos Chagas 100 years ago, a great deal of scientific effort and curiosity has been devoted to understanding how this parasite invades and colonises mammalian host cells. This is a key step in the survival of the parasite within the vertebrate host, and although much has been learned over this century, differences in strains or isolates used by different laboratories may have led to conclusions that are not as universal as originally interpreted. Molecular genotyping of the CL-Brener clone confirmed a genetic heterogeneity in the parasite that had been detected previously by other techniques, including zymodeme or schizodeme (kDNA) analysis. T. cruzi can be grouped into at least two major phylogenetic lineages: T. cruzi I, mostly associated with the sylvatic cycle and T. cruzi II, linked to human disease; however, a third lineage, T. cruziIII, has also been proposed. Hybrid isolates, such as the CL-Brener clone, which was chosen for sequencing the genome of the parasite (Elias et al. 2005, El Sayed et al. 2005a), have also been identified. The parasite must be able to invade cells in the mammalian host, and many studies have implicated the flagellated trypomastigotes as the main actor in this process. Several surface components of parasites and some of the host cell receptors with which they interact have been described. Herein, we have attempted to identify milestones in the history of understanding T. cruzi- host cell interactions. Different infective forms of T. cruzi have displayed unexpected requirements for the parasite to attach to the host cell, enter it, and translocate between the parasitophorous vacuole to its final cytoplasmic destination. It is noteworthy that some of the mechanisms originally proposed to be broad in function turned out not to be universal, and multiple interactions involving different repertoires of molecules seem to act in concert to give rise to a rather complex interplay of signalling cascades involving both parasite and cellular components.

Interaction between Paracoccidioides brasiliensis conidia and the coagulation system: involvement of fibrinogen

The infectious process starts with an initial contact between pathogen and host. We have previously demonstrated that Paracoccidioides brasiliensis conidia interact with plasma proteins including fibrinogen, which is considered the major component of the coagulation system. In this study, we evaluated the in vitro capacity of P. brasiliensis conidia to aggregate with plasma proteins and compounds involved in the coagulation system. We assessed the aggregation of P. brasiliensis conidia after incubation with human serum or plasma in the presence or absence of anticoagulants, extracellular matrix (ECM) proteins, metabolic and protein inhibitors, monosaccharides and other compounds. Additionally, prothrombin and partial thromboplastin times were determined after the interaction of P. brasiliensis conidia with human plasma. ECM proteins, monosaccharides and human plasma significantly induced P. brasiliensis conidial aggregation; however, anticoagulants and metabolic and protein inhibitors diminished the aggregation process. The extrinsic coagulation pathway was not affected by the interaction between P. brasiliensis conidia and plasma proteins, while the intrinsic pathway was markedly altered. These results indicate that P. brasiliensis conidia interact with proteins involved in the coagulation system. This interaction may play an important role in the initial inflammatory response, as well as fungal disease progression caused by P. brasiliensis dissemination.

Metabolomic insights into the intricate gut microbial-host interaction in the development of obesity and type 2 diabetes.

Gut microbiota has recently been proposed as a crucial environmental factor in the development of metabolic diseases such as obesity and type 2 diabetes, mainly due to its contribution in the modulation of several processes including host energy metabolism, gut epithelial permeability, gut peptide hormone secretion, and host inflammatory state. Since the symbiotic interaction between the gut microbiota and the host is essentially reflected in specific metabolic signatures, much expectation is placed on the application of metabolomic approaches to unveil the key mechanisms linking the gut microbiota composition and activity with disease development. The present review aims to summarize the gut microbial-host co-metabolites identified so far by targeted and untargeted metabolomic studies in humans, in association with impaired glucose homeostasis and/or obesity. An alteration of the co-metabolism of bile acids, branched fatty acids, choline, vitamins (i.e., niacin), purines, and phenolic compounds has been associated so far with the obese or diabese phenotype, in respect to healthy controls. Furthermore, anti-diabetic treatments such as metformin and sulfonylurea have been observed to modulate the gut microbiota or at least their metabolic profiles, thereby potentially affecting insulin resistance through indirect mechanisms still unknown. Despite the scarcity of the metabolomic studies currently available on the microbial-host crosstalk, the data-driven results largely confirmed findings independently obtained from in vitro and animal model studies, putting forward the mechanisms underlying the implication of a dysfunctional gut microbiota in the development of metabolic disorders.

TCR-MHC class II interaction is required for peripheral expansion of CD4 cells in a T cell-deficient host.

It is well established that T cell-deficient nude and SCID mice can be reconstituted by i.v. injection of small numbers of purified peripheral CD4+ T cells; however, the requirements for expansion of the transferred T cells in such systems are not clear. We show here that blood and lymphoid organs of MHC class II-deficient mice (which selectively lack mature CD4+ T cells) cannot be reconstituted by transfer of purified splenic CD4+ T cells, whereas TCRalpha-deficient mice (which lack both CD4+ and CD8+ mature T cells) are readily reconstituted. The failure of CD4+ T cell reconstitution in MHC class II-deficient mice was not due to the presence of CD8+ T cells, since similar results were obtained in TCRalpha-MHC class II double-deficient mice. Consistent with most previous studies CD4+ T cells in reconstituted TCRalpha-deficient mice had a diverse TCR Vbeta repertoire and were predominantly of an activated/memory (CD44high) phenotype. Collectively our data demonstrate that the expansion of peripheral CD4+ T cells in a T cell-deficient host is dependent upon interactions of the TCR with MHC class II.

Interaction between Tephritidae (Insecta, Diptera) and plants of the family Asteraceae: new host and distribution records for the state of Rio Grande do Sul, Brazil

Twenty species of Tephritidae (Diptera) are recorded in association with capitula of plants in the family Asteraceae. The Tephritidae genus Tetreuarestais registered for Rio Grande do Sul for the first time. Five species of Tephritidae are newly recorded for Rio Grande do Sul, and new hosts are recorded for the following fly species: Dioxyna chilensis (Macquart), Plaumannimyia dolores (Hering), Plaumannimyia imitatrix (Hering), Plaumannimyia miseta(Hering), Plaumannimyia pallensHering, Tomoplagia incompleta (Williston), Tomoplagia matzenbacheriPrado, Norrbom & Lewinsohn, Tomoplagia reimoseriHendel, Xanthaciura biocellata(Thomson) and Xanthaciura chrysura(Thomson).

Genome sequencing of the plant pathogen Taphrina deformans, the causal agent of peach leaf curl.

Taphrina deformans is a fungus responsible for peach leaf curl, an important plant disease. It is phylogenetically assigned to the Taphrinomycotina subphylum, which includes the fission yeast and the mammalian pathogens of the genus Pneumocystis. We describe here the genome of T. deformans in the light of its dual plant-saprophytic/plant-parasitic lifestyle. The 13.3-Mb genome contains few identifiable repeated elements (ca. 1.5%) and a relatively high GC content (49.5%). A total of 5,735 protein-coding genes were identified, among which 83% share similarities with other fungi. Adaptation to the plant host seems reflected in the genome, since the genome carries genes involved in plant cell wall degradation (e.g., cellulases and cutinases), secondary metabolism, the hallmark glyoxylate cycle, detoxification, and sterol biosynthesis, as well as genes involved in the biosynthesis of plant hormones. Genes involved in lipid metabolism may play a role in its virulence. Several locus candidates for putative MAT cassettes and sex-related genes akin to those of Schizosaccharomyces pombe were identified. A mating-type-switching mechanism similar to that found in ascomycetous yeasts could be in effect. Taken together, the findings are consistent with the alternate saprophytic and parasitic-pathogenic lifestyles of T. deformans. IMPORTANCE: Peach leaf curl is an important plant disease which causes significant losses of fruit production. We report here the genome sequence of the causative agent of the disease, the fungus Taphrina deformans. The genome carries characteristic genes that are important for the plant infection process. These include (i) proteases that allow degradation of the plant tissues; (ii) secondary metabolites which are products favoring interaction of the fungus with the environment, including the host; (iii) hormones that are responsible for the symptom of severely distorted leaves on the host; and (iv) drug detoxification enzymes that confer resistance to fungicides. The availability of the genome allows the design of new drug targets as well as the elaboration of specific management strategies to fight the disease.

Comparative Genomics Suggests that the Fungal Pathogen Pneumocystis Is an Obligate Parasite Scavenging Amino Acids from Its Host's Lungs.

Pneumocystis jirovecii is a fungus causing severe pneumonia in immuno-compromised patients. Progress in understanding its pathogenicity and epidemiology has been hampered by the lack of a long-term in vitro culture method. Obligate parasitism of this pathogen has been suggested on the basis of various features but remains controversial. We analysed the 7.0 Mb draft genome sequence of the closely related species Pneumocystis carinii infecting rats, which is a well established experimental model of the disease. We predicted 8'085 (redundant) peptides and 14.9% of them were mapped onto the KEGG biochemical pathways. The proteome of the closely related yeast Schizosaccharomyces pombe was used as a control for the annotation procedure (4'974 genes, 14.1% mapped). About two thirds of the mapped peptides of each organism (65.7% and 73.2%, respectively) corresponded to crucial enzymes for the basal metabolism and standard cellular processes. However, the proportion of P. carinii genes relative to those of S. pombe was significantly smaller for the "amino acid metabolism" category of pathways than for all other categories taken together (40 versus 114 against 278 versus 427, P<0.002). Importantly, we identified in P. carinii only 2 enzymes specifically dedicated to the synthesis of the 20 standard amino acids. By contrast all the 54 enzymes dedicated to this synthesis reported in the KEGG atlas for S. pombe were detected upon reannotation of S. pombe proteome (2 versus 54 against 278 versus 427, P<0.0001). This finding strongly suggests that species of the genus Pneumocystis are scavenging amino acids from their host's lung environment. Consequently, they would have no form able to live independently from another organism, and these parasites would be obligate in addition to being opportunistic. These findings have implications for the management of patients susceptible to P. jirovecii infection given that the only source of infection would be other humans.

Phenotypic plasticity in salmonid embryos : characterizing pathogen-induced stress effects on heritable variation in traits and reaction norms

Les pressions écologiques peuvent varier tant en nature qu'en intensité dans le temps et l'espace. C'est pourquoi, un phénotype unique ne peut pas forcément conférer la meilleure valeur sélective. La plasticité phénotypique peut être un moyen de s'accommoder de cette situation, en augmentant globalement la tolérance aux changements environnementaux. Comme pour tout trait de caractère, une variation génétique doit persister pour qu'évoluent les traits plastiques dans une population donnée. Cependant, les pressions extérieures peuvent affecter l'héritabilité, et la direction de ces changements peut dépendre du caractère en question, de l'espèce mais aussi du type de stress. Dans la présente thèse, nous avons cherché à élucider les effets des pressions pathogéniques sur les phénotypes et la génétique quantitative de plusieurs traits plastiques chez les embryons de deux salmonidés, la palée (Coregonus palaea), et la truite de rivière (Salmo trutta). Les salmonidés se prêtent à de telles études du fait de leur extraordinaire variabilité morphologique, comportementale et des traits d'histoire de vie. Par ailleurs, avec le déclin des salmonidés dans le monde, il est important de savoir combien la variabilité génétique persiste dans les normes de réaction afin d'aider à prédire leur capacité à répondre aux changements de leur milieu. Nous avons observé qu'une augmentation de la croissance des communautés microbiennes symbiotiques entraînait une mortalité accrue et une éclosion précoce chez la palée, et dévoilait la variance génétique additive pour ces deux caractères (Chapitres 1-2). Bien qu'aucune variation génétique n'ait été trouvée pour les normes de réaction, nous avons observé une variabilité de la plasticité d'éclosion. Néanmoins, on a trouvé que les temps d'éclosion étaient corrélés entre les environnements, ce qui pourrait limiter l'évolution de la norme de réaction. Le temps d'éclosion des embryons est lié à la taille des géniteurs mâles, ce qui indique des effets pléiotropiques. Dans le Chapitre 3, nous avons montré qu'une interaction triple entre la souche bactérienne {Pseudomonas fluorescens}, l'état de dévelopement de l'hôte ainsi que ses gènes ont une influence sur la mortalité, le temps d'éclosion et la taille des alevins de la palée. Nous avons démontré qu'une variation génétique subsistait généralement dans les normes de réaction des temps d'éclosion, mais rarement pour la taille des alevins, et jamais pour la mortalité. Dans le même temps, nous avons exhibé que des corrélations entre environnements dépendaient des caractères phénotypiques, mais contrairement au Chapitre 2, nous n'avons pas trouvé de preuve de corrélations transgénérationnelles. Le Chapitre 4 complète le chapitre précédent, en se plaçant du point de vue moléculaire, et décrit comment le traitement d'embryons avec P. fluorescens s'est traduit par une régulation négative d'expression du CMH-I indépendemment de la souche bactérienne. Nous avons non seulement trouvé une variation génétique des caractères phénotypiques moyens, mais aussi de la plasticité. Les deux derniers chapitres traitent de l'investigation, chez la truite de rivière, des différences spécifiques entre populations pour des normes de réaction induites par les pathogènes. Dans le Chapitre 5, nous avons illustré que le métissage entre des populations génétiquement distinctes n'affectait en rien la hauteur ou la forme des normes de réaction d'un trait précoce d'histoire de vie suite au traitement pathogénique. De surcroît, en dépit de l'éclosion tardive et de la réduction de la taille des alevins, le traitement n'a pas modifié la variation héritable des traits de caractère. D'autre part, dans le Chapitre 6, nous avons démontré que le traitement d'embryons avec des stimuli contenus dans l'eau de conspécifiques infectés a entraîné des réponses propre à chaque population en terme de temps d'éclosion ; néanmoins, nous avons observé peu de variabilité génétique des normes de réaction pour ce temps d'éclosion au sein des populations. - Ecological stressors can vary in type and intensity over space and time, and as such, a single phenotype may not confer the highest fitness. Phenotypic plasticity can act as a means to accommodate this situation, increasing overall tolerance to environmental change. As with any trait, for plastic traits to evolve in a population, genetic variation must persist. However, environmental stress can alter trait heritability, and the direction of this shift can be trait, species, and stressor-dependent. In this thesis, we sought to understand the effects of pathogen stressors on the phenotypes and genetic architecture of several plastic traits in the embryos of two salmonids, the whitefish (Coregonus palaea), and the brown trout (Salmo trutta). Salmonids lend themselves to such studies because their extraordinary variability in morphological, behavioral, and life-history traits. Also, with declines in salmonids worldwide, knowing how much genetic variability persists in reaction norms may help predict their ability to respond to environmental change. We found that increasing growth of symbiotic microbial communities increased mortality and induced hatching in whitefish, and released additive genetic variance for both traits (Chapters 1-2). While no genetic variation was found for survival reaction norms, we did find variability in hatching plasticity. Nevertheless, hatching time was correlated across environments, which could constrain evolution of the reaction norm. Hatching time in the induced environment was also correlated to sire size, indicating pleiotropic effects. In Chapter 3 we report that a three-way interaction between bacterial strain (Pseudomonas fluorescens), host developmental stage, and host genetics impacted mortality, hatching time, and hatchling size in whitefish. We also showed that genetic variation generally persisted in hatching age reaction norms, but rarely for hatchling length, and never for mortality. At the same time, we demonstrated that cross-environmental correlations were trait-dependent, and unlike Chapter 2, we found no evidence of cross-generational correlations. Chapter 4 expands on the previous chapter, moving to the molecular level, and describes how treatment of embryos with P. fluorescens resulted in strain-independent downregulation of MHC class I. Genetic variation was evident not only in trait means, but also in plasticity. In the last two chapters, we investigated population level differences in pathogen- induced reaction norms in brown trout. In Chapter 5, we found that interbreeding between genetically distinct populations did not affect the elevation or shapes of the reaction norms of early life-history traits after pathogen challenge. Moreover, despite delaying hatching and reducing larval length, treatment produced no discernable shifts in heritable variation in traits. On the other hand, in Chapter 6, we found that treatment of embryos with water-borne cues from infected conspecifics elicited population-specific responses in terms of hatching time; however, we found little evidence of genetic variability in hatching reaction norms within populations. We have made considerable progress in understanding how pathogen stressors affect various early life-history traits in salmonid embryos. We have demonstrated that the effect of a particular stressor on heritable variation in these traits can vary according to the trait and species under consideration, in addition to the developmental stage of the host. Moreover, we found evidence of genetic variability in some, but not all reaction norms in whitefish and brown trout.

Pneumococcal penumonia presenting with septic shock: host-ant pathogen-related factors and outcomes

BACKGROUND: Host- and pathogen-related factors associated with septic shock in pneumococcal pneumonia are not well defined. The aim of this study was to identify risk factors for septic shock and to ascertain patient outcomes. Serotypes, genotypes and antibiotic resistance of isolated strains were also analysed. METHODS: Observational analysis of a prospective cohort of non-severely immunosuppressed hospitalised adults with pneumococcal pneumonia. Septic shock was defined as a systolic blood pressure of <90 mm Hg and peripheral hypoperfusion with the need for vasopressors for >4 h after fluid replacement. RESULTS: 1041 patients with pneumococcal pneumonia diagnosed by Gram stain and culture of appropriate samples and/or urine antigen test were documented, of whom 114 (10.9%) had septic shock at admission. After adjustment, independent risk factors for shock were current tobacco smoking (OR, 2.11; 95% CI, 1.02 to 4.34; p = 0.044), chronic corticosteroid treatment (OR, 4.45; 95% CI, 1.75 to 11.32; p = 0.002) and serotype 3 (OR, 2.24; 95% CI, 1.12 to 4.475; p = 0.022). No significant differences were found in genotypes and rates of antibiotic resistance. Compared with the remaining patients, patients with septic shock required mechanical ventilation more frequently (37% vs 4%; p<0.001) and had longer length of stay (11 vs 8 days; p<0.001). The early (10% vs 1%; p<0.001) and overall case fatality rates (25% vs 5%; p<0.001) were higher in patients with shock. CONCLUSIONS: Septic shock is a frequent complication of pneumococcal pneumonia and causes high morbidity and mortality. Current tobacco smoking, chronic corticosteroid treatment and infection caused by serotype 3 are independent risk factors for this complication.

Adhesion of the human pathogen Sporothrix schenckii to several extracellular matrix proteins

The pathogenic fungus Sporothrix schenckii is the causative agent of sporotrichosis. This subcutaneous mycosis may disseminate in immunocompromised individuals and also affect several internal organs and tissues, most commonly the bone, joints and lung. Since adhesion is the first step involved with the dissemination of pathogens in the host, we have studied the interaction between S. schenckii and several extracellular matrix (ECM) proteins. The binding of two morphological phases of S. schenckii, yeast cells and conidia, to immobilized type II collagen, laminin, fibronectin, fibrinogen and thrombospondin was investigated. Poly (2-hydroxyethyl methacrylate) (poly-HEMA) was used as the negative control. Cell adhesion was assessed by ELISA with a rabbit anti-S. schenckii antiserum. The results indicate that both morphological phases of this fungus can bind significantly to type II collagen, fibronectin and laminin in comparison to the binding observed with BSA (used as blocking agent). The adhesion rate observed with the ECM proteins (type II collagen, fibronectin and laminin) was statistically significant (P<0.05) when compared to the adhesion obtained with BSA. No significant binding of conidia was observed to either fibrinogen or thrombospondin, but yeast cells did bind to the fibrinogen. Our results indicate that S. schenckii can bind to fibronectin, laminin and type II collagen and also show differences in binding capacity according to the morphological form of the fungus.