Promising application of the SsCBF ELISA test to monitor the therapeutic response of feline sporotrichosis caused by Sporothrix brasiliensis from Brazilian epidemics.

Sporotrichosis zoonotic transmission by cats has obtained hyperendemic magnitude in Rio de Janeiro, Brazil. Atypical cases, relapses, and reinfections as well as reduced diagnostic sensitivity of conventional methods have been reported. Previously, the anti-SsCBF enzyme-linked immunosorbent assay (ELISA) test was shown to be useful as a diagnostic tool for human sporotrichosis. Effective diagnosis and treatment are critical to interrupt the chain of transmission of this major pathogen in Brazilian Public Health. To evaluate its applicability for feline sporotrichosis diagnosis and/or therapeutic follow-up, 15 domestic cats from Rio de Janeiro were clinically and laboratory monitored by cytopathology, culture, Sporothrix genotyping, and anti-SsCBF IgG levels. Subsequently, animals were divided into satisfactory and non-satisfactory therapeutic responders. Averages of antibody serum levels obtained for diagnosis (first consultation) compared with the levels found after follow-up (last consultation) were significantly different in both groups (p = 0.0002 and p = 0.038, respectively). We conclude that the SsCBF ELISA test can predict feline sporotrichosis therapeutic responses even for animals with distinct clinical evolutions.

Domestic feline contribution in the transmission of Sporothrix in Rio de Janeiro State, Brazil: a comparison between infected and non-infected populations.

BACKGROUND: Sporotrichosis is a neglected zoonosis caused by pathogenic fungi belonging to the Sporothrix schenckii complex. In Rio de Janeiro state, this disease reached an epidemic status with over 4700 domestic felines and around 4000 humans affected since the mid-90s. The present study evaluated clinical and epidemiological aspects and also the frequency of colonization and infection by these fungi in healthy cats and among those with suspicious cutaneous lesions, inhabiting four Rio de Janeiro state distinct areas. RESULTS: Three hundred and seventy-one cats were included in two groups: 175 healthy cats [CRG] and 196 cats showing lesions suggesting sporotrichosis [SSG]. Mycological diagnosis allowed SSG animals to be divided in positive [104 cats; +SG] and negative [92 cats; -SG] groups. Nails, oral mucosa and lesions swabs were submitted to culture and potential colonies were subculture for micromorphologycal analysis, dimorphism and molecular tests. In the CRG, only one cat was colonized in the oral cavity [0.57%]; in the -SG group, four animals showed colonization of the nail and/or oral cavity [4.3%]; while the highest frequency of colonization [39.4%] was observed in the +SG. All molecularly typed isolates were identified as S. brasiliensis. CONCLUSION: The results obtained here indicate that healthy cats have a minor role in sporotrichosis transmission within the state of Rio de Janeiro. Conversely, a higher participation of diseased feline in sporotrichosis transmission was evidenced, especially by the colonization of their oral cavity. Sporothrix brasiliensis equally affects and colonizes animals from distinct Rio de Janeiro state areas. Thus, we hypothesize that sporotrichosis is a uniform endemic throughout the state, whose transmission depends mainly on the contact with cats with sporotrichosis. Since Rio de Janeiro displays a world unique epidemic model of the disease, not fully understood, data on the infected and non-infected animals can be of major importance for future strategies of sporotrichosis prevention and control. Finally, considering the importance of the current concept of "one health", the experience here observed can be helpful for distinct epizootias and/or zoonosis.

Cytokine gene polymorphisms are not associated with anti-PvDBP, anti-PvAMA-1 or anti-PvMSP-119 IgG antibody levels in a malaria-endemic area of the Brazilian Amazon.

BACKGROUND: The immune response against Plasmodium vivax immunogenic epitopes is regulated by pro- and anti-inflammatory cytokines that determine antibody levels and class switching. Cytokine gene polymorphisms may be responsible for changes in the humoral immune response against malaria. The aim of this study was to evaluate whether polymorphisms in the TNFA, IFNG and IL10 genes would alter the levels of anti-PvAMA1, PvDBP and -PvMSP-119 IgG antibodies in patients with vivax malaria. METHODS: Samples from 90 vivax malaria-infected and 51 uninfected subjects from an endemic area of the Brazilian Amazon were genotyped using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) to identify polymorphisms of the genes TNFA (-1031T > C, -308G > A, -238G > A), IFNG (+874T > A) and IL10 (-819C > T, -592C > A). The levels of total IgG against PvAMA1, PvDBP and PvMSP-119 were determined using an enzyme-linked immunosorbent assay (ELISA). Associations between the polymorphisms and the antibody response were assessed by means of logistic regression models. RESULTS: No significant differences were found in the levels of IgG antibodies against the PvAMA-1, PvDBP or PvMSP-119 proteins in relation to the studied polymorphisms. CONCLUSIONS: Although no associations were found among the evaluated genotypes and alleles and anti-merozoite IgG class P. vivax antibody levels, this study helps elucidate the immunogenic profile involved in the humoral immune response in malaria.

A infecção por Mycobacterium tuberculosis e micobactérias nãotuberculosas na infância: um desafio diagnóst / Childhood Mycobacterium tuberculosis and nontuberculous mycobacter: a challenge on the diagnosis

Objetivos: Avaliar a tuberculose e micobaterioses na infância por meio de uma revisão bibliográfica criteriosae crítica, com ênfase na epidemiologia, aspectos clínicos e ferramentas diagnósticas. Métodos: A pesquisa foirealizada nas bases de dados Lilacs, SciELO, PubMed, durante o período de 2000 a 2009. Quarenta e seis artigos foram considerados e onze diretrizes e manuais nacionais e internacionais. Os descritores utilizados foram: criança, infância, tuberculose, micobactérias atípicas, biologia molecular e diagnóstico. Resultados: As crianças portadoras da infecção pelo Mycobacterium tuberculosis são consideradas por diversos autorescomo “órfãos da tuberculose”. Várias características dificultam o estabelecimento do diagnóstico definitivoda tuberculose e micobacterioses na infância, entre elas as clínicas com lesões não extensivas, o caráterpaucibacilar, as formas latentes, a dificuldade de coleta de espécimes clínicos, as falhas das técnicas dabaciloscopia e cultura e a prática rotineira dos países em desenvolvimento de investigar a etiologia tuberculosa após falência terapêutica para patógenos habituais. Conclusões: A detecção da micobactéria permanece como confirmação diagnóstica e a oportunidade de investigação do perfil de sensibilidade, favorecendo o tratamento efetivo para qualquer faixa etária independente de seu papel na transmissão da doença. Nesse cenário, assumem maior importância, novas estratégias diagnósticas, entre elas as técnicas de biologia molecular com a promessa de melhor sensibilidade, especificidade e pronta detecção.

Objectives: To evaluate the tuberculosis and mycobacteriosis in childhood by a careful and critical literature review, with emphasis on epidemiology, clinical features and diagnostic devices. Methods: The study wasmade based on the following databases: LILACS, SciELO and PubMed, between the period of 2000 to 2009. Forty-six papers and eleven national and international guidelines/manuals were considered. The keywords used were: child, childhood, tuberculosis, atypical mycobacteria, molecular biology and diagnosis. Results: Children infected by Mycobacterium tuberculosis were considered by several authors as “orphans of tuberculosis”. To define final diagnosis of tuberculosis and mycobacterial infections is difficult in childhood because of several characteristics such as: the clinical with nonextensive lesions, the paucibacillary nature, the latent forms, the difficulty of collecting clinical specimens, the failures of the smear and culture techniques and routine practice of developing countries to investigate the etiology of tuberculosis after therapeutical failures for usual pathogens. Conclusions: The detection of mycobacteria remains usual to confirm the diagnosis and the opportunity to investigate the sensitivity profile. This promotes effective treatment for all age groups independent of their role in the disease transmission. In this environment, new diagnostic strategies including the interferon-gamma dosage and the molecular biology techniques can provide better sensitivity, specificity and ready detection.

Calicivirus and Giardia lamblia are associated with diarrhea in human immunodeficiency virus-seropositive patients from southeast Brazil.

To study enteropathogens, 100 fecal samples were collected from a Brazilian human immunodeficiency virus (HIV)-seropositive population, with or without diarrhea. Giardia lamblia and calicivirus were significantly associated with diarrhea as were severe immunosuppression and the presence of at least one enteropathogen. No sample was positive for rotavirus and only one asymptomatic individual carried the astrovirus. We concluded that there is a great diversity of pathogens and opportunistic infections in the studied population, with a high prevalence of mixed colonization/infection. Our findings pave the way for future molecular studies related to the expression of virulence factors and to the possibility of pathogen-pathogen interactions, especially between G. lamblia and calicivirus. These findings are relevant to the improvement of therapies and controlling diarrhea in the HIV-seropositive population.