Periurbanização da leishmaniose visceral e emergência da coinfecção HIV/leishimania, no Rio Grande do Norte

Visceral leishmaniasis (VL) has undergone changes in terms of clinical and epidemiological presentation worldwide. Urbanization has been described in different regions of Brazil and the world, as well as in the state of Rio Grande do Norte. These changes have impacted in the clinical outcome of Leishmania infection. A new clinical entity called co-infection of HIV/Leishmania has been described as a consequence of overlapping areas of occurrence of VL and HIV / AIDS in different countries including Brazil. The aim of this study was to define the process of periurbanization of the LV and describe a case series of co-infection HIV / Leishmania in Rio Grande do Norte. A new demographic pattern of VL was detected, with an increase in the number VL adult male subjects. Analysis of spatial distribution of VL in the state of Rio Grande do Norte showed that in the past 20 years VL tends to occur in larger cities and therefore the highest risk disease is greater in the eastern and western regions. The first region included Natal, the state capital, where the process of suburbanization began in 1990, and more recently the city of Mossoró, the second largest state, where periurbanization began in the last five years. In 1990, the emergence of co-infection HIV/Leishmania in the state was observed. Case-control study revealed that the new clinical entity affects adult males, who acquired HIV through sexual intercourse, 40% of those with a preivous history of leishmania infection Relapse and death from LV is increased in HIV positive compared with HIV-negative patients matched by sex and age. This pattern is similar to the observed in Europe, except of the route of transmission, where in Europe occured concomitantly, by parenteral route in drug users. Analysis of spatial distribution identified overlapping new areas of occurrence of HIV / AIDS and LV potentially signaling to increased risk of this new clinical entity as described above. Therefore, epidemiological surveillance for co-infection HIV / Leishmania should be adopted in all areas of risk of VL. At the same time, it is necessary to evaluate drug resistance currently used in the treatment of VL, as well as parenteral transmission of L infantum/ chagasi in areas where drug dependence is a risk factor for HIV acquisition

Associação entre fatores nutricionais e a resposta frente à infecção por Leishmania chagasi

Leishmania chagasi infection presents a wide spectrum of clinical outcomes, ranging from asymptomatic self resolving infection to disease, visceral leishmaniasis (VL). The exact mechanisms that lead the evolution of infection to disease are not understood. It is believed that malnutrition is a risk factor associated with VL development, although there are few human studies in the area. We aimed to assess the nutritional factors associated with the response to L. chagasi infection in Rio Grande do Norte. The study was conducted from December 2006 to January 2008. 149 children were assessed: 20 active VL cases, 33 children with VL history, 40 DTH+ asymptomatic children and 56 DTH-. Nutritional status was assessed using z scores for Weight/Age, Weight/Height, Height/Age, Body Mass Index (BMI), and mid-upper arm circumference/height (MUAC/height). Vitamin A status was determined by serum retinol concentrations and the modified-relative-dose-esponse test (MRDR). Breastfeeding time and birth weight were also evaluated. VL children presented compromised nutritional status when compared to the other groups using BMI and MUAC/age, with means -1,53 ± 1,10 and -1,48 ± 1,28 z scores, respectively (ANOVA, p < 0,05). VL children also showed lower vitamin A levels: 43% presented serum retinol < 20 µg/dL and 15% MRDR > 0,060. Birth weight was inverserly associated with the risk to belong the VL group (β = -0,00; OR = 0,84; 95% CI 0,73 - 0,99; p = 0,047), whereas more breastfeeding time was directly associated with the risk to belong to the DTH+ group (β = 0,02; OD = 1,16; 95% CI 1,01 - 1,33; p = 0,036). The nutritional variables evaluated were associated with the response to the L. chagasi infection, with malnutrition and compromised vitamin A status as markers of children who present with VL. Higher birth weight was associated with protection to disease, and higher breastfeeding time was associated with increased likelihood of an asymptomatic infection. The results show that modifiable nutritional aspects in the study population are associated with the response to the L. chagasi infection

A novel A2 allele found in Leishmania (Leishmania) infantum chagasi

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Estudo comparativo dos métodos diagnósticos para Leishmaniose Visceral em cães oriundos de Ilha Solteira, SP

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Attraction of the cutaneous leishmaniasis vector Nyssomyia neivai (Diptera: Psychodidae) to host odour components in a wind tunnel

Background: Laboratory studies of host-seeking olfactory behaviour in sandflies have largely been restricted to the American visceral leishmaniasis vector Lutzomyia longipalpis. In comparison, almost nothing is known about the chemical ecology of related species, which transmit American cutaneous leishmaniasis (ACL), due in part to difficulties in raising these insects in the laboratory. Understanding how ACL vectors locate their hosts will be essential to developing new vector control strategies to combat this debilitating disease.Methods: This study examined host-odour seeking behaviour of the ACL vector Nyssomyia neivai (Pinto) (=Lutzomyia neivai) using a wind tunnel olfactometer. The primary aim was to determine whether field-collected female N. neivai would respond to host odours in the laboratory, thereby eliminating the need to maintain colonies of these insects for behavioural experiments. Responses to two key host odour components, 1-octen-3-ol and lactic acid, and a commercially-available mosquito lure (BG-Lure (TM)) were assessed and compared relative to an air control. We also tested whether trials could be conducted outside of the normal evening activity period of N. neivai without impacting on fly behaviour, and whether the same flies could be used to assess baseline responses to air without affecting responses to octenol, thereby reducing the number of flies required for experiments.Results: Octenol was found to both activate host-seeking behaviour and attract female N. neivai in the wind tunnel, while lactic acid elicited weaker responses of activation and attractiveness under identical conditions. The BG-Lure did not activate or attract N. neivai under test conditions. Further experiments showed that sandfly behaviour in the wind tunnel was not affected by time of day, such that experiments need not be restricted to nocturnal hours. Moreover, using the same flies to measure both baseline responses to air and attraction to test compounds did not affect odour-seeking behaviour.Conclusions: The results of this study demonstrate that N. neivai taken from the field are suitable for use in laboratory olfactometer experiments. It is hoped this work will facilitate further research into chemical ecology of this species, and other ACL vectors.

Exames parasitológicos, imunoistoquímicos e histopatológicos para detecção de Leishmania chagasi em tecidos esplênicos de cães com leishmaniose visceral

O propósito do presente trabalho foi o estudo da Leishmaniose Visceral Canina - LVC por meio de métodos parasitológicos e imunoistoquímicos para a detecção de formas amastigotas de Leishmania (L.) chagasi em baço, além de descrever a histopatologia das lesões esplênicas em 34 cães, com diferentes manifestações clínicas da LVC, eutanasiados pelo Centro de Controle de Zoonoses de Ilha Solteira, SP. Esses animais foram examinados clinicamente antes da eutánásia e de acordo com os sinais clínicos da LVC, foram classificados em três grupos: assintomáticos (8 cães), oligossintomáticos (17 cães) e sintomáticos (9 cães). Após a realização desses exames, dos 34 cães, 22 (64,7%) estavam positivos e 12 (35,3%) negativos. Desses cães positivos, 1/22 (4,5%) era assintomático, 12/22 (54,5%) eram oligossintomáticos e 9/22 (40,1%) sintomáticos. Pela histopatologia, os cães, especialmente os sintomáticos apresentavam o baço com inflamação crônica e espessamento na região capsular e trabecular, além de extensa alteração morfológica na polpa vermelha e branca pela presença de grande quantidade de macrófagos repletos de amastigotas, pela reação granulomatosa inflamatória e pelas áreas hemorrágicas. Os exames histopatológicos e a detecção microscópica direta da L. (L.) chagasi revelaram que o baço é um órgão útil para auxiliar no diagnóstico da LVC. A coloração imunoistoquímica foi a que detectou o maior número de tecidos esplênicos positivos com amastigotas, além de elucidar os casos suspeitos pelos exames parasitológicos, principalmente, nos animais assintomáticos ou oligossintomáticos.

Caracterização e composição florística de uma comunidade savânica no Rio Grande do Norte, Brasil : subsídios para a conservação

Studies on Brazilian biodiversity are still very few and can observe the difference of knowledge between the different regions of the country. This affirmation can be verified in the investigation to identify the rare species in Brazil and the key biodiversity areas (ACBs). In that study were identified for Brasil 2.256 rare species and 752 ACBs. The Rio Grande do Norte (RN) was the only Brazilian state that has not been identified any rare species and no ACBs, possibly due to the lack of floristic studies in this state. A particular area was selected for this study: an area of ecological tension with savanna physiognomy in Rio do Fogo, RN. This savanna community is represented in RN in a fragment and immersed in restinga and caatinga and was identified and described only through of radar imagens there are no studies to date in loco . We have prepared the following questions about this community savanna: 1) The region delimited and described by through of radar images by the RADAMBRASIL, 1976, can be associated of the Cerrado, in terms of floristic ?; 2) What is the floristic composition of this area? This area includes rare species, endemic or endangered? 3) What is the geographical and phytogeographical distribution of plant species registered in this area? 4) Those plant species registered are endemic or have affinity with other areas phytoecological Brazilian? To answer these questions we performed a floristic inventory of the August 2007 to September/2009. The results are presented in two chapters (manuscripts). The first chapter, titled "The Savannah Rio Grande do Norte: floristic links with other plant formations in the Northeast and Center-West Brazil" was submitted to the Revista Brasileira de Botância. Chapter 1 discusses the phytogeographical distribution of the species, by comparing floristic studies conducted in the Cerrado, Caatinga and Restinga in the Northeast and Cerrado of the Central Brazil. The analysis of data of this study and compilation with other studies indicated that: i) the record of 94 plant species; ii) of total species, about 64% are associated with the Cerrado, the second specialized bibliography, and about 78% as the List of Species of Flora of Brazil. However, about 73% of total species (94) are also distributed in the Caatinga, the Atlantic forest 64%, the Amazon forest 64%, the Pantanal 15% and the Pampa 12%. Floristically the data show that the community studied is influenced by other floras, has a structure where grasses dominate and also because of his appearance the same savanna then be classified as a Savana gramíneo-lenhosa do tabuleiro . Chapter 2, titled "Considerations on the flora of a savanna community in Rio Grande do Norte, northeastern Brazil: Subsidy key area for conservation" was submitted to the Revista Natureza e Conservação. This has the objective of improve the knowledge of flora of Rio Grande do Norte and to identify possible rare species and consequently increase the key areas of biodiversity in Brazil. The data indicated that: i) of 94 species registered in the study area, 40 were new records for the Rio Grande do Norte state; ii) These citations to unpublished state, Stylosanthes montevidensis Vogel (Fabaceae) and Aristida laevis (Nees) Kunth (Poaceae) are indicated for the first time to the Northeast of Brazil; iii) are registered in the area 24 species endemic to Brazil and 63 non-endemic; iv) Aspilia procumbens Baker (Asteraceae) registered in the area is considered a restricted species and micro endemic Rio Grande do Norte, ie rare species; v) Aspilia procumbens is also cited in the category of critically endangered species and Stilpnopappus cearensis Hubber (Asteraceae) a species vulnerable to extinction. This study shows a new area phytoecological in Rio Grande do Norte and indicates the area's potential to contribute with the sites of global significance for biodiversity conservation, either locally, regionally and nationally. This will certainly contribute to respond some targets set by the Global Strategy for Plant Conservation and the Convention on Biological Diversity such as the inventory of vegetal diversity in a region with little collection, which will provide data that contributes to questions and themes related to biodiversity.

DNA damage and nitric oxide production in mice following infection with L. chagasi

Leishmania chagasi, which causes visceral leishmaniasis in South America, is an obligate intracellular protozoan. Production of nitric oxide by macrophages during the inflammatory response is one of the main microbicidal mechanisms against this parasite. The goal of this study was to evaluate whether L. chagasi infection causes DNA damage in peripheral blood and spleen cells of Balb/c mice and whether such damage may be related to NO production. Balb/c mice were either infected with L chagasi or maintained as controls. The single-cell gel electrophoresis (comet) assay was used to measure DNA damage in peripheral blood and spleen cells, and the Griess reaction was used to measure NO production in the spleen. L chagasi infection induced DNA damage in peripheral blood and spleen cells of infected mice. Macrophages from the control group, challenged with L. chagasi, showed significantly (p < 0.05) greater NO production, compared to non-challenged cells. Treatment of spleen cells with N(G)-monomethyl-L-arginine (LNMMA) caused a significant reduction of NO production and DNA damage (p < 0.05). Our results indicate that L. chagasi induces DNA damage in the peripheral blood and spleen cells and that NO not only causes killing of the parasite but also induces DNA damage in adjacent cells. (C) 2011 Elsevier B.V. All rights reserved.

Imunomarcação de células CD3+ e CD79a+ nas lesões descamativas e ulcerativas de cães com leishmaniose

Canine visceral leishmaniasis is an endemic infectious disease in some regions from São Paulo state and even though it is a systemic disease, in the dog, the main clinical sign is dermatological. Thirty dogs with positive results in serology (IFI) and parasitological exams (fine needle aspiration) for leishmaniasis from Aracatuba city were evaluated. They only showed dermatological signs and were divided in two groups, one with exfoliative (n=15) and other with ulcerative (n=15) lesions. There was significant statistical difference between CD3 and CD79a population in the same dermatological pattern, and with CD79a population between exfoliative and ulcerative patterns (p<0,05).

Impact of leishmaniasis on public health

Leishmaniasis is a parasitic zoonosis caused by protozoans of the genus Leishmania transmitted by insects known as phlebotomines, which are found in wild or urban environments. It affects domestic and wild animals and transmission to man happens by accident. The disease occurs in tropical and sub-tropical areas, mainly in Asia, Europe, Africa, and the Americas. There are two forms that affect man: American cutaneous leishmaniasis (ACL) and American visceral leishmaniasis (AVL). The latter is caused by three species of Leishmania: Leishmania (Leishmania) donovani, Leishmania (Leishmania) infantum, and Leishmania (Leishmania) chagasi, which are grouped in the Leishmania (Leishmania) donovani complex. Wild reservoir hosts of L. chagasi known so far are foxes and marsupials. In domestic environment, dogs are the most important reservoir hosts and sources of infection to the vectors Lutzomyia longipalpis. Leishmaniasis is difficult to control, causing epidemic outbreaks, thus being an important public health problem. Due to lesions caused by the mucocutaneous type and the severity of those caused by the visceral type in humans, visceral leishmaniasis is one of the main public health concerns. This paper is part of the monograph presented at the end of the residency program in the field of Zoonosis and Public Health at the School of Veterinary Sciences and Animal Husbandry, São Paulo State University, UNESP, Botucatu, São Paulo State, Brazil, in 2005.

Diagnóstico da Leishmaniose Visceral Canina pelas técnicas de imunoistoquímica e PCR em tecidos cutâneos em associação com a RIFI e ELISA-teste

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Avaliação da leishmaniose visceral canina em Poxoréo, Estado do Mato Grosso, Brazil

O cão doméstico desempenha importante papel como reservatório na transmissão da leishmaniose visceral ao homem, zoonose de grande importância em saúde pública. Realizou-se avaliação epidemiológica da leishmaniose visceral em 1.112 cães domiciliados no município de Poxoréo, estado do Mato Grosso e observou-se prevalência de 7,8%. Observou-se ainda associação estatisticamente significativa entre a prevalência de leishmaniose visceral canina e as variáveis faixa etária, presença de sinais clínicos e presença de outra espécie animal co-habitando com os cães avaliados, tendo sido as galinhas mais freqüentemente observadas entre os animais soropositivos. O sexo, a coleta de lixo domiciliar bem como a renda familiar não apresentaram associação estatisticamente significativa com a prevalência da leishmaniose visceral canina. A análise dos resultados sugere que cães com idade superior a sete anos e a , presença de outra espécie animal co-habitando com os cães podem ser fatores de risco para a leishmaniose visceral canina.

Padrões histopatológicos das lesões descamativas e ulcerativas da pele em cães com leishmaniose

Canine visceral leishmaniasis is an endemic infectious disease in some São Paulo state regions and even though it is a systemic disease, in the dog, the main clinical sign is dermatological. Thirty dogs with positive results in serology and parasitological exams for leishmaniasis from Aracatuba city were evaluated. They just showed dermatological signs and were divided in two groups, one with exfoliative(n = 15) and other with ulcerative (n = 15) lesions. Histopathological. patterns in the group of exfoliative lesions were: periadnexial dermatitis (5115, 33,3%), superficial perivascular dermatitis (1/5, 6,6%), nodular dermatitis (1115, 6,6%) and mixed dermatitis (8/15, 53,3%), including intersticial/periadnexial dermatitis (1/8, 12,5%). lichenoid/perivascular superficial and deep dermatitis (1/8, 12,5%), perivascular superficial and deep/periadnexial dermatitis (1/8, 12,5%) and superficial perivascular/perianexial dermatitis (5/8, 62,5%). In the group of ulcerative lesions, the histopathological patterns were: perivascular superficial and deep dermatitis (5115, 33,3%), diffuse dermatitis (3/15. 20%), periadnexial dermatitis (2/15, 13,3%), nodular dermatitis (1/15, 6,6%) and mixed dermatitis (4/15, 26,6%), including intersticial/perivascular superficial and deep dermatitis (1/4, 25%), nodular/periadnexial dermatitis (1/4, 25%), fibrosing/perianexial dermatitis (1/4. 25%) and perivascular superficial and deep/periadnexial dermatitis(1/4, 25%). Parasites were found in eight dogs (8/15, 53,3%) with exfoliative dematitis and seven (7/15, 46,6%) with ulcerative dermatitis.

Phlebotomine (Diptera: Psychodidae) survey and some considerations about epidemiological aspects of canine leishmaniasis in Rio Claro city, São Paulo, Brazil.

Between 2000 and 2004, 170 sand flies were captured in urban or peri-urban areas of the Rio Claro city, SP, Brazil. Nyssomyia neivai, the main LTA vector species in São Paulo territory, corresponded to 124 specimens (72,94%) of the total number of captured insects. Incidence of American Cutaneous (LTA) and Visceral leishmaniasis (LVA) is increasing in human and dogs in São Paulo State. Rio Claro city is located in the center-east region of the State. During 2001 and 2003, two cases of alochtonus canine LVA and an autochthonous case of canine LTA were locally diagnosed. Results indicate the risk of LVA establishment in this region. Possible role of alternative vectors in leishmaniasis transmission is discussed.

Apoptosis in T lymphocytes from spleen tissue and peripheral blood of L. (L.) chagasi naturally infected dogs

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)