The diagnosis and management of a case of leishmaniosis in a dog imported to Australia

This case study discusses in detail for the first time the diagnosis and management of a case of leishmaniosis in a dog imported to Australia. The dog presented with epistaxis and a non-regenerative anaemia five years after being imported from Europe. Protozoa were identified within macrophages in bone marrow and splenic cytology. A Leishmania indirect fluorescent antibody test was performed and was positive while an Ehrlichia canis antibody test was negative. Polymerase chain reaction of the ITS-1 and ITS-2 regions of skin, lymph node, spleen and bone marrow were all positive for Leishmania infantum. The dog was treated with amphotericin B with a strong clinical response. The importance of thorough diagnostics in non-endemic areas, particularly Australia, is discussed. Treatment with amphotericin B is discussed. Vigilance, disease reporting and response frameworks are recommended for non-endemic areas. © 2014 Elsevier B.V.

High levels of serum matrix metalloproteinases in dogs with natural visceral leishmaniosis: A preliminary report

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

Fungal pyogranulomatous encephalitis in a dog with leishmaniosis

É relatado um caso de encefalite piogranulomatosa em um cão fêmea de um ano de idade, da raça Fila Brasileiro. Ao exame macroscópico do cérebro, evidenciou-se área amolecida e hemorrágica no córtex frontal direito e na superfície de corte do hemisfério esquerdo, afetando a substância branca e áreas corticais profundas. O diagnóstico de encefalite piogranulomatosa micótica multifocal foi realizado através de exame histopatológico, que mostrou a presença de macrófagos, células gigantes, focos de hemorragia e hifas septadas de coloração marrom, com distribuição difusa e invadindo a luz de vasos. A identificação de formas amastigotas no imprint de linfonodo poplíteo confirmou o diagnóstico de leishmaniose. A infecção micótica no cérebro deste cão foi relacionada com a ocorrência concomitante de leishmaniose, uma doença imunossupressora.

Leishmania chagasi infection in cats with dermatologic lesions from an endemic area of visceral leishmaniosis in Brazil

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

Leishmania chagasi infection in cats with dermatologic lesions from an endemic area of visceral leishmaniosis in Brazil

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

Neutrophil dysfunction varies with the stage of canine visceral leishmaniosis

Canine visceral leishmaniosis (CVL) causes a dependent-stage alteration in neutrophil oxidative metabolism. When production of reactive oxygen species (ROS) exceeds the antioxidant capacity of neutrophils, apoptosis is triggered, impairing the viability and function of these cells, which can predispose dogs to infection. However, the uremic condition observed in late-stage CVL can also alter the viability and function of human neutrophils. To more clearly understand this relationship, the apoptosis rate and oxidative metabolism of neutrophils from control dogs (n= 20) were compared to dogs in moderate (n= 15) and very severe (n= 15) stage CVL, classified according to LeishVet Consensus. To assess neutrophil oxidative metabolism, superoxide production was measured using the nitroblue tetrazolium reduction test (NBT) in isolated neutrophils. The apoptosis rate of neutrophils was estimated using the morphological method. Moderate-stage dogs presented increased superoxide production, while dogs with very severe stage CVL presented decreased superoxide production and an increase neutrophil apoptosis rate. Leishmaniosis causes differential neutrophil dysfunction according to disease stage. In moderate stage CVL, increased superoxide production is observed with no change in neutrophil viability. However, in very severe stage CVL, decreased superoxide production and increased apoptosis occur associated with uremia. © 2013 Elsevier B.V.

Alteration of sFAS and sFAS ligand expression during canine visceral leishmaniosis

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

Hypertension and its correlation with renal lesions in dogs with leishmaniosis

To evaluate the prevalence of hypertension and its correlation with the severity of renal injury and proteinuria in dogs with leishmaniosis, sixty-six dogs were divided into two groups. Group 1 (G1) was composed of 54 dogs included in stage 1 of chronic kidney disease (CKD), and group 2 (G2) of twelve dogs in stages 2 and 3 of CKD. Prevalence of hypertension was 28.8%, comprising 22.2% of the dogs from G1 and 58.3% from G2 (P=0.011). The mean arterial blood pressure (BP) of dogs from G1 (135.7 +/- 20.5) was lower than from G2 (170.0 +/- 26.3) (P <0.001). Urine proteincreatinine ratio (UP/C) revealed values above 0.5 in 75.7% of the dogs, with 34% presenting hypertension. All dogs with hypertension had histopathological and laboratory evidence of glomerular disease. Although there was no statistically significant correlation between elevated BP and the severity of glomerular lesions (P=0.408), there was a statistically significant correlation between elevated BP and increased UP/C in the studied population (P=0.002). Thus, dogs with leishmaniosis and renal disease must be screened for the presence of hypertension so that treatment may be instituted as early as possible, in countries where treatment is allowed, to prevent the progression of renal damage.

2,1,3-Bentsoksadiatsolirakenteiset molekyylit antibakteerisina ja antiparasiittisina yhdisteinä

Aikaisemman tutkimuksen perusteella tiedettiin tiettyjen 2,1,3-bentsoksadiatsolirakenteisten molekyylien olevan aktiivisia Chlamydia pneumoniae –bakteeria vastaan. Tutkimusta lähdettiin jatkamaan ja 2,1,3-bentsoksadiatsolimolekyylien rakenne-aktiivisuusuhteista haluttiin saada lisätietoa. Tarkoituksena oli kehittää 2,1,3-bentsoksadiatsolimolekyyleille ja sen avulla muodostaa molekyylikirjasto. Syntetisoidut molekyylit haluttiin testata sekä Chlamydia pneumoniae -bakteeria että Leishmania donovani –parasiittia vastaan. Chlamydia pneumoniae –bakteeri aiheuttaa akuutteja ylä- ja alahengitystieinfektiota, kuten keuhkoputkentulehdusta. Akuutissa tulehduksessa oireet vaihtelevat huomattavasti. Chlamydia pneumoniae –bakteerilla on myös taipumus aiheuttaa kroonisia tulehduksia. Nämä ovat useissa tutkimuksissa yhdistetty kansantaloudellisesti merkittäviin sairauksiin, kuten ateroskleroosiin ja astmaan. Leishmanioosi on toiseksi yleisin loissairaus ihmisellä malarian jälkeen. Leishmania donovani –parasiitti voi aiheuttaa tappavaa viskeraalista leishmanioosia. Vuodessa leishmanioosiin kuolee yli 50 000 ihmistä. Viime vuosina leishmanioosin lääkehoidossa on esiintynyt monenlaisia ongelmia. Osat lääkkeistä ovat menettäneet tehonsa ja osalla esiintyy vakavia haittavaikutuksia. 2,1,3-Bentsoksadiatsolirakenteisille yhdisteille saatiin kehitettyä toimiva synteesireitti. Lähtöaineena käytettiin 4-amino-2-nitrobentsoehappoa, josta saatiin hapettavalla renkaansulkeutumisreaktiolla 2,1,3-bentsoksadiatsoli-5-karboksyylihappoa. Karboksyylihaposta syntetisoitiin amidi-välituotteen kautta 2,1,3-bentsoksadiatsoli-5-karbonitriiliä. Hydroksyyliamiini hydrokloridin avulla 2,1,3-bentsoksadiatsoli-5-karbonitriilistä muodostettiin vastaavaa karboksimidamidia, joka oli synteesireitin yhteinen välituote kaikille molekyyleille. Viimeisessä vaiheessa N´-hydroksidi-2,1,3-bentsoksadiatsoli-5-karboksimidamidin annettiin reagoida joko fenyyli-isosyanaatin tai fenyyli-isotiosyanaatin kanssa, jolloin saatiin lopputuotetta. Synteesireitin kehittäminen osoittautui haastavaksi ja loppujen lopuksi saatiin ainoastaan kolme lopputuotetta syntetisoitua. Yksi lopputuotteista testattiin C. pneumoniae –bakteeria vastaan Åbo akademissa Turussa. Testattavaa yhdiste ei sisältänyt 2,1,3-bentsoksadiatsoliarengasta ja bioaktiivisuuskokeen tulos oli odotusten mukainen. Yhdiste ei ollut aktiivinen C. pneumoniae –bakteeria vastaan alhaisilla konsentraatioilla ja tuloksesta voitiin todeta 2,1,3-bentsoksadiatsolirengaan olevan tärkeä aktiivisuuden kannalta. Kaksi lopputuotetta saatiin testaukseen Leishamania donovani –parasiittia vastaan Israeliin. Ainoastaan toinen molekyyleistä sisälsi 2,1,3-bentsoksadiatsolirakenteen. Bioaktiivisuuskokeiden tulokset olivat erittäin rohkaisevia. Yhdisteet olivat aktiivisia parasiittia vastaan jo alhaisilla konsentraatioilla. Kuitenkin 2,1,3-bentsoksadiatsolirakenteinen molekyyli oli aktiivisempi, joten tämäkin aktiivisuuskokeen perusteella huomattiin rengasrakenteen olevan tärkeä aktiivisuuden kannalta.

Fatores associados à positividade da intradermorreação de Montenegro em Teresina, Piauí

A leishmaniose visceral americana (LVA) ou Calazar é um exemplo de doença infecciosa reemergente, cuja urbanização a uma das principais marcas da alteração de seu padrão epidemiológico de ocorrência. No Brasil, a infecção por L. chagasi tem se comportado de forma epidêmica em diversas regiões e as estratégias de controle não tem sido efetivas na contenção da propagação da doença. Para melhor compreensão deste processo, estudaram-se associações da imunidade tardia, medida por meio do teste de intradermorreação de Montenegro (IDRM), com fatores demográficos, sociais, econômicos e ambientais em área urbana com alta forca de transmissão. A análise dos dados foi feita tendo como base o modelo de regressão de Poisson ajustado pelo qui-quadrado, onde foram calculadas as razões de prevalência (RP) e seus respectivos intervalos de 95% de confiança (IC). Foi detectada maior prevalência da positividade a IDRM para o sexo masculino (RP = 1,32 IC: 1,11 1,56), com o aumento da idade (RP = 1,18 IC: 1,10 1,26), com a posse de cao por período de três anos ou mais (RP = 1,26 IC: 1,01 1,56) e com presença de fossa rudimentar no domicilio (RP = 1,33 IC: 0,99 1,77). Indivíduos com maior escolaridade (RP = 0,81 IC; 0,66 0,99), convivendo com três ou mais pessoas no domicilio (RP = 0,66 IC; 0,47 0,93), com história de Calazar no domicílio (RP = 0,40 IC: 0,16 0,99) e com parede com tijolo sem reboco (RP= 0,79 IC: 0,64 0,98) apresentaram prevalências mais baixas mostrando possível proteção infecção anterior. Os resultados obtidos podem contribuir para o melhor entendimento do dinamismo da doença em contexto urbano, permitindo melhor direcionamento das estratégias de intervenção.

Caractérisation moléculaire de la modulation spatio-temporelle des fonctions du phagosome

La phagocytose est un processus par lequel des cellules spécialisées du système immunitaire comme les macrophages ingèrent des microorganismes envahisseurs afin de les détruire. Les microbes phagocytés se retrouvent dans un compartiment intracellulaire nommé le phagosome, qui acquiert graduellement de nombreuses molécules lui permettant de se transformer en phagolysosome possédant la capacité de tuer et dégrader son contenu. L’utilisation de la protéomique a permis de mettre en évidence la présence de microdomaines (aussi nommés radeaux lipidiques ou radeaux membranaires) sur les phagosomes des macrophages. Notre équipe a démontré que ces radeaux exercent des fonctions cruciales au niveau de la membrane du phagosome. D’abord nous avons observé que la survie du parasite intracellulaire L. donovani est possible dans un phagosome dépourvu de radeaux lipidiques. Parallèlement nous avons constaté qu’un mutant de L. donovani n’exprimant pas de LPG à sa surface(LPG-) est rapidement tué dans un phagosome arborant des radeaux membranaires. Pour comprendre le mécanisme de perturbation des microdomaines du phagosome par la molécule LPG, nous avons provoqué la phagocytose de mutants LPG- du parasite et comparé par microscopie les différences avec le parasite de type sauvage. Nous avons ainsi démontré que le LPG de L. donovani est nécessaire et suffisant au parasite pour empêcher la maturation normale du phagosome. Nous avons également découvert que la molécule LPG permet d’empêcher la formation des radeaux lipidiques sur le phagosome et peut aussi désorganiser les radeaux lipidiques préexistants. Enfin, nous avons montré que l’action de LPG est proportionnelle au nombre d’unités répétitives de sucres (Gal(β1,4)-Manα1-PO4) qui composent cette molécule. Nos travaux ont démontré pour la première fois le rôle important de ces sous-domaines membranaires dans la maturation du phagosome. De plus, nos conclusions seront des pistes à suivre au cours des études cliniques ayant pour but d’enrayer la leishmaniose. Le second objectif de ce travail consistait à effectuer la caractérisation des radeaux lipidiques par une analyse protéomique et lipidomique à l’aide de la spectrométrie de masse. Nous avons ainsi entrepris l’identification systématique des protéines présentes dans les radeaux membranaires des phagosomes et ce, à trois moments clés de leurmaturation. Le traitement des phagosomes purifiés avec un détergent nous a permis d’isoler les «Detergent Resistent Membranes» (DRMs) des phagosomes, qui sont l’équivalent biochimique des radeaux membranaires. Nous avons ainsi établi une liste de 921 protéines associées au phagosome, dont 352 sont présentes dans les DRMs. Les protéines du phagosome sont partagées presque également entre trois tendances cinétiques (augmentation, diminution et présence transitoire). Cependant, une analyse plus spécifique des protéines des DRMs démontre qu’une majorité d’entre elles augmentent en fonction de la maturation. Cette observation ainsi que certains de nos résultats montrent que les radeaux lipidiques des phagosomes précoces sont soit très peu nombreux, soit pauvres en protéines, et qu’ils sont recrutés au cours de la maturation du phagosome. Nous avons aussi analysé les phospholipides du phagosome et constaté que la proportion entre chaque classe varie lors de la maturation. De plus, en regardant spécifiquement les différentes espèces de phospholipides nous avons constaté que ce ne sont pas uniquement les espèces majoritaires de la cellule qui dominent la composition de la membrane du phagosome. L’ensemble de nos résultats a permis de mettre en évidence plusieurs fonctions potentielles des radeaux lipidiques, lesquelles sont essentielles à la biogenèse des phagolysosomes (signalisation, fusion membranaire, action microbicide, transport transmembranaire, remodelage de l’actine). De plus, la cinétique d’acquisition des protéines de radeaux lipidiques indique que ceux-ci exerceraient leurs fonctions principalement au niveau des phagosomes ayant atteint un certain niveau de maturation. L’augmentation du nombre de protéines des radeaux membranaires qui s’effectue durant la maturation du phagosome s’accompagne d’une modulation des phospholipides, ce qui laisse penser que les radeaux membranaires se forment graduellement sur le phagosome et que ce ne sont pas seulement les protéines qui sont importées.

Avaliação de dois clones de Escherichia coli recombinante quanto ao crescimento e expressão de antígenos de Leishmania chagasi (kmp11 e P36)

Visceral leishmaniosis caused by Leishmania chagasi, also known as calazar, presented, in the period from 1990 to 2005, tax of incidence in Brazil varying between 1 and 3 cases for 100 000 inhabitants. The Northeast region that up to the year of 2000 contributed with almost 90% of the registered cases is reducing his participation in the current decade, reaching 56% in 2005. Conventional leishmaniasis treatment is costly and it shows high toxicity, demanding more research for alternative treatments, with special interest in development of vaccines and diagnosis kits which include production of recombinant antigens by host cells. Escherichia coli has been the microorganism most studied and used as a host for recombinant protein production. Therefore, the aim of this work was to study the influence of induction on cellular growth and to verify the type of Leishmania chagasi antigens expression (intra or extracellular) during two recombinant E. coli clones (kmp11 and P36) cultivation in rotary incubator (shaker) using three different media (2xTY, TB, FASS+EL). For that, tests were carried out using conditions established in the literature for E. coli (37°C and 200 rpm) and media supplemented with antibiotics to guarantee that only competent cells grows. First, tests were carried out without induction in order to verify the two microorganisms kinetic behavior (growth and substrate consumption) in different media. Next, the induction was carried out through the addition of IPTG (1mM as final concentration), at the first hour of cultivation. It was observed that protein expression were intracellular for all clones and media tested, however the highest level of expression was clearly observed by the electrophoresis band density (intensity) for 2xTY medium and kmp11 protein. Although it contains the lowest substrate concentration, consequently, a reduced cellular concentration when compared to other media, it appeared that this medium and clone combination is the most indicated for recombinant protein production. Therefore, the objective of this work was achieved, since the interested proteins were produced. Consequently, this result motivates new studies for production optimization using different cultivation strategies

IL-6 and TNF-alpha production during active canine visceral leishmaniasis

We investigated the production of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) during canine visceral leishmaniasis (VL) to gain a better understanding of the role of such multi-functional cytokines in parasite resistance. IL-6 and TNF-alpha levels were measured by capture ELISA in sera from 8 healthy dogs from a non-endemic area (control group) and in sera from 16 dogs from Aracatuba, SP, Brazil, an area endemic for leishmaniosis. The dogs from the endemic area were selected by positive ELISA serology against total Leishmania chagasi antigen, positive spleen imprints for Leishmania, and the presence of at least three clinical signs associated with active visceral leishmaniasis (fever, dermatitis, lymphoadenopathy, onychogryphosis, weight loss, cachexia, locomotory difficulty, conjunctivitis, epistaxis, hepatosplenomegaly, edema, and apathy).Enhanced systemic IL-6 production was found in sera from dogs with the active disease compared to healthy dogs (t-test, P < 0.05). In contrast, TNF-alpha did not differ between the two groups studied. There was no correlation between IL-6 production and anti-leishmanial antibody titers in the sera. Our findings suggest that IL-6 is a good marker of active disease during leishmaniasis, and that other cytokines may be involved in the hypergammaglobulinemia characteristic of canine visceral leishmaniasis. (c) 2006 Published by Elsevier B.V.

Evaluation of transformation growth factor beta(1), interleukin-10, and interferon-gamma in male symptomatic and asymptomatic dogs naturally infected by Leishmania (Leishmania) chagasi

The aims of this study were to evaluate the immunomodulatory role of TGF-beta(1), 1L-10, and INF-gamma in spleen and liver extracts and supernatant cultures of white spleen cells from male symptomatic and asymptomatic dogs, naturally infected by Leishmania (Leishmania) chagasi. Thirty dogs from Aracatuba, São Paulo, Brazil, an endemic leishmaniosis area, were selected by positive ELISA serological reaction for Leishmania sp. and divided into two groups: asymptomatic (n=15) and symptomatic (n=15) consisting of animals with at least three characteristic signs (fever, dermatitis, lymphoadenopathy, onychogryphosis, weight loss, cachex a, locomotion problems, conjunctivitis, epistaxis, hepatosplenomegaly, edema, and apathy). After euthanasia, spleen and liver fragments were collected for ex vivo quantification of TGF-beta(1), IL-10, and INF-gamma. Naturally active in vitro produced TGF-beta(1) was also evaluated in spleen cell culture supernatant. Spleen and liver extract of asymptomatic dogs had higher mean TGF-beta(1) levels than symptomatic dogs. High concentrations of IL-10 were found in spleen, and mainly in liver extract of both groups. Higher INF-gamma concentrations were found in spleen extracts of symptomatic dogs, and in liver extracts of asymptomatic dogs. Extract of this cytokire was lower in spleen extract. Although INF-gamma is being produced in canine infection, mean levels of TGF-beta(1) and IL-10 from spleen and liver extracts were quantitatively much higher; suggesting that immune response in both asymptomatic and symptomatic dogs A as predominantly type Th2. (c) 2006 Elsevier B.V. All rights reserved.