Culture-free genome-wide locus sequence typing (GLST) provides new perspectives on Trypanosoma cruzi dispersal and infection complexity.

Analysis of genetic polymorphism is a powerful tool for epidemiological surveillance and research. Powerful inference from pathogen genetic variation, however, is often restrained by limited access to representative target DNA, especially in the study of obligate parasitic species for which ex vivo culture is resource-intensive or bias-prone. Modern sequence capture methods enable pathogen genetic variation to be analyzed directly from host/vector material but are often too complex and expensive for resource-poor settings where infectious diseases prevail. This study proposes a simple, cost-effective 'genome-wide locus sequence typing' (GLST) tool based on massive parallel amplification of information hotspots throughout the target pathogen genome. The multiplexed polymerase chain reaction amplifies hundreds of different, user-defined genetic targets in a single reaction tube, and subsequent agarose gel-based clean-up and barcoding completes library preparation at under 4 USD per sample. Our study generates a flexible GLST primer panel design workflow for Trypanosoma cruzi, the parasitic agent of Chagas disease. We successfully apply our 203-target GLST panel to direct, culture-free metagenomic extracts from triatomine vectors containing a minimum of 3.69 pg/µl T. cruzi DNA and further elaborate on method performance by sequencing GLST libraries from T. cruzi reference clones representing discrete typing units (DTUs) TcI, TcIII, TcIV, TcV and TcVI. The 780 SNP sites we identify in the sample set repeatably distinguish parasites infecting sympatric vectors and detect correlations between genetic and geographic distances at regional (< 150 km) as well as continental scales. The markers also clearly separate TcI, TcIII, TcIV and TcV + TcVI and appear to distinguish multiclonal infections within TcI. We discuss the advantages, limitations and prospects of our method across a spectrum of epidemiological research.

Estado nutricional, síndrome metabólico e inflamación en pacientes con enfermedad de Chagas / Nutritional condition, metabolic syndrome and inflammation in patients with Chagas disease

El propósito de este estudio fue describir la asociación entre el estado nutricional, la presencia de síndrome metabólico (SM), y el estado inflamatorio, en pacientes con Enfermedad de Chagas (ECh), atendidos en la consulta externa del Instituto de Medicina Tropical en Caracas. El estudio fue de tipo transversal y correlacional, en el cual se seleccionaron 34 pacientes a los cuales se les realizó un diagnóstico parasitológico, inmunológico y molecular de la ECh. Se evaluaron variables antropométricas, clínicas y bioquímicas, así como el SM el cual fue determinado por los criterios del III Panel estadounidense para el Tratamiento de Adultos del Programa Nacional de Educación sobre el Colesterol (ATP-III, por sus siglas en inglés). Se encontró que la mayoría de los pacientes presentaron sobrepeso u obesidad (73,5%), un porcentaje de grasa corporal (% GC) alto o muy alto (82,3%), y obesidad abdominal (61,8 %). La frecuencia de SM fue de 29,4% y más del 90% mostraron valores elevados de Proteína C Reactiva ultrasensible (PCRus). Valores más elevados del IMC se asociaron con un estadio más avanzado de la ECh. Los sujetos con presencia de ADN de Tripanosoma cruzi (T. cruzi) circulante en sangre, presentaron mayor % GC, y en su mayoría, fueron diagnosticados con SM. En conclusión, los pacientes evaluados mostraron un exceso de adiposidad, que puede favorecer el estado inflamatorio, el desarrollo de SM y la progresión de la ECh(AU)

The purpose of the study was to describe the association between nutritional and inflammatory status and the presence of metabolic syndrome (MS) on patients with Chagas disease (CD) treated at the Outpatient Services of the Tropical Medicine Institute in Caracas, Venezuela. The study was cross-sectional and correlational. Thirty-four (34) patients were selected and a molecular, immunological, and parasitological diagnostic test was ran for Chagas disease. Anthropometric, clinic, and biochemical variables were evaluated, and the MS was determined using National Cholesterol Education Program Expert/Adult Treatment Panel III (ATP-III) criteria. The results showed a high percentage of patients overweight or presenting obesity (73.5%), a high and very high percentage of body fat (82.3%), and abdominal obesity (61.8%). The prevalence of MS was 29,4% and more than 90% of patients showed elevated values of high sensitivity C-reactive protein (hsCRP). Higher body-mass index values were associated with advanced stages of the CD. Subjects in the presence of T. cruzi DNA in the blood showed a greater percentage of body fat and, most of them, were diagnosed with MS. In conclusion, the evaluated patients showed an excess of adiposity which may favor an inflammatory status, the development of the MS, and the progress of the CD(AU)

Genetic diversification of Panstrongylus geniculatus (Reduviidae: Triatominae) in northern South America.

Triatomines are the vectors of Trypanosoma cruzi, the etiological agent of Chagas disease. Although Triatoma and Rhodnius are the most-studied vector genera, other triatomines, such as Panstrongylus, also transmit T. cruzi, creating new epidemiological scenarios. Panstrongylus has at least 13 reported species but there is limited information about its intraspecific genetic variation and patterns of diversification. Here, we begin to fill this gap by studying populations of P. geniculatus from Colombia and Venezuela and including other epidemiologically important species from the region. We examined the pattern of diversification of P. geniculatus in Colombia using mitochondrial and nuclear ribosomal data. Genetic diversity and differentiation were calculated within and among populations of P. geniculatus. Moreover, we constructed maximum likelihood and Bayesian inference phylogenies and haplotype networks using P. geniculatus and other species from the genus (P. megistus, P. lignarius, P. lutzi, P. tupynambai, P. chinai, P. rufotuberculatus and P. howardi). Using a coalescence framework, we also dated the P. geniculatus lineages. The total evidence tree showed that P. geniculatus is a monophyletic species, with four clades that are concordant with its geographic distribution and are partly explained by the Andes orogeny. However, other factors, including anthropogenic and eco-epidemiological effects must be investigated to explain the existence of recent geographic P. geniculatus lineages. The epidemiological dynamics in structured vector populations, such as those found here, warrant further investigation. Extending our knowledge of P. geniculatus is necessary for the accurate development of effective strategies for the control of Chagas disease vectors.

Venezuela's humanitarian crisis, resurgence of vector-borne diseases, and implications for spillover in the region.

In the past 5-10 years, Venezuela has faced a severe economic crisis, precipitated by political instability and declining oil revenue. Public health provision has been affected particularly. In this Review, we assess the impact of Venezuela's health-care crisis on vector-borne diseases, and the spillover into neighbouring countries. Between 2000 and 2015, Venezuela witnessed a 359% increase in malaria cases, followed by a 71% increase in 2017 (411 586 cases) compared with 2016 (240 613). Neighbouring countries, such as Brazil, have reported an escalating trend of imported malaria cases from Venezuela, from 1538 in 2014 to 3129 in 2017. In Venezuela, active Chagas disease transmission has been reported, with seroprevalence in children (<10 years), estimated to be as high as 12·5% in one community tested (n=64). Dengue incidence increased by more than four times between 1990 and 2016. The estimated incidence of chikungunya during its epidemic peak is 6975 cases per 100 000 people and that of Zika virus is 2057 cases per 100 000 people. The re-emergence of many vector-borne diseases represents a public health crisis in Venezuela and has the possibility of severely undermining regional disease elimination efforts. National, regional, and global authorities must take action to address these worsening epidemics and prevent their expansion beyond Venezuelan borders.

Panstrongylus geniculatus and four other species of triatomine bug involved in the Trypanosoma cruzi enzootic cycle: high risk factors for Chagas' disease transmission in the Metropolitan District of Caracas, Venezuela.

BACKGROUND: Chagas' disease is caused by the protozoan Trypanosoma cruzi and is autochthonous to the Americas. Its distribution depends on triatomine bugs that are responsible for the transmission of the disease. In 2005, we reported the presence of Panstrongylus geniculatus as a risk for Chagas' disease transmission in Caracas and neighboring areas. Three massive oral outbreaks occurred in the following years. Here we report the results of a 7-year study on triatomine species found in the Metropolitan District of Caracas (MDC), Venezuela. METHODS: Triatomine species collected by inhabitants of Caracas during 7 years were analyzed for parasite infection and blood meal. Triatomines were found in 31 of the 32 parishes surveyed. Traitomines were examined for the presence of blood and parasites in the digestive tract. Molecular techniques were used for the typing of parasites. RESULTS: A total of 3551 triatomines were captured from 31 of the 32 parishes surveyed. The vast majority of these were identified as P. geniculatus (98.96%), followed by Triatoma nigromaculata (0.59%), Triatoma maculata (0.39%) and Rhodnius prolixus (0.06%). Triatomines were always most abundant between April and June, and 2010 showed the highest number. We found that 54% of the specimens were females, 42.5% males and 3.5% nymphs. Overall, 75.2% of the insects were naturally infected with T. cruzi and 48.7% had fed on blood. Analysis of the adult forms showed that 60% of the females and 31.9 % of the males had blood in their stomachs, and 77.5% of the females and 73.3% of the males were naturally infected with T. cruzi. Nearly all, 99.6% of the T. cruzi isolates analyzed belonged to the TcI genotype. CONCLUSIONS: Blood-fed triatomine bugs infected with T. cruzi were distributed throughout Caracas. Four different species of triatomines were identified of which P. geniculatus was by far the most predominant. Our previous report of Eratyrus mucronatus raises the number of triatomine species in the MDC to 5. Dramatic modifications to the surrounding natural habitats have led to the establishment of a T. cruzi urban enzootic cycle, resulting in a high risk for Chagas' disease transmission in this capital city.

Genetic and Morphometric Variability of Triatoma sordida (Hemiptera: Reduviidae) from the Eastern and Western Regions of Paraguay.

Triatoma sordida is widely distributed throughout the Chaco and the Eastern Region of Paraguay. It is associated to palm trees and artificial ecotopes located in peridomestic environments. The aim of this work was to determine genetic and morphometric variability and feeding behavior among population of T. sordida captured in domicile and peridomicile areas of Paraguay. Feeding contents and levels of genetic and morphometric variation were determined in 124 T. sordida from domicile and peridomicile populations of San Pedro and Paraguarí departments of the Eastern Region and Boquerón and Presidente Hayes departments of the Western region using Double Diffusion Gel, random amplified polymorphic DNA (RAPD), and head and wings morphometry. Morphometric analysis revealed isolation of populations by geographic region and larger size in triatomine populations from the Western Region. RAPD showed no specific patterns for domicile and peridomicile populations. The estimator of diversity (F ST; 0.08) and high gene flow obtained (N m; 5.7) did not allow the establishment of genetic differentiation within the same region. The blood meal source showed that poultry feeding was 38% of host preferences, and human blood was the second feeding preference (24%) in the insects from the Eastern Region while poultry feeding was predominant in those from the Western Region (30%). This work showed homogeneity between T. sordida populations of the same region and between domicile and peridomicile. The genetic diversity was determined among T. sordida populations of both geographical regions suggesting differentiation associated to eco-geographical isolation by distance. It is important to notice that pattern feedings were different between the two regions. Further studies should be focused on how phenetic and genetic variations could be related to the adaptation capacity of these triatomine populations to domicile, increasing their vector potentiality in the transmission of Chagas disease.

Development of peptide-based lineage-specific serology for chronic Chagas disease: geographical and clinical distribution of epitope recognition.

BACKGROUND: Chagas disease, caused by infection with the protozoan Trypanosoma cruzi, remains a serious public health issue in Latin America. Genetically diverse, the species is sub-divided into six lineages, known as TcI-TcVI, which have disparate geographical and ecological distributions. TcII, TcV, and TcVI are associated with severe human disease in the Southern Cone countries, whereas TcI is associated with cardiomyopathy north of the Amazon. T. cruzi persists as a chronic infection, with cardiac and/or gastrointestinal symptoms developing years or decades after initial infection. Identifying an individual's history of T. cruzi lineage infection directly by genotyping of the parasite is complicated by the low parasitaemia and sequestration in the host tissues. METHODOLOGY/PRINCIPAL FINDINGS: We have applied here serology against lineage-specific epitopes of the T. cruzi surface antigen TSSA, as an indirect approach to allow identification of infecting lineage. Chagasic sera from chronic patients from a range of endemic countries were tested by ELISA against synthetic peptides representing lineage-specific TSSA epitopes bound to avidin-coated ELISA plates via a biotin labelled polyethylene glycol-glycine spacer to increase rotation and ensure each amino acid side chain could freely interact with their antibodies. 79/113 (70%) of samples from Brazil, Bolivia, and Argentina recognised the TSSA epitope common to lineages TcII/TcV/TcVI. Comparison with clinical information showed that a higher proportion of Brazilian TSSApep-II/V/VI responders had ECG abnormalities than non-responders (38% vs 17%; p<0.0001). Among northern chagasic sera 4/20 (20%) from Ecuador reacted with this peptide; 1/12 Venezuelan and 1/34 Colombian samples reacted with TSSApep-IV. In addition, a proposed TcI-specific epitope, described elsewhere, was demonstrated here to be highly conserved across lineages and therefore not applicable to lineage-specific serology. CONCLUSIONS/SIGNIFICANCE: These results demonstrate the considerable potential for synthetic peptide serology to investigate the infection history of individuals, geographical and clinical associations of T. cruzi lineages.

Molecular epidemiologic source tracking of orally transmitted Chagas disease, Venezuela.

Oral outbreaks of Chagas disease are increasingly reported in Latin America. The transitory presence of Trypanosoma cruzi parasites within contaminated foods, and the rapid consumption of those foods, precludes precise identification of outbreak origin. We report source attribution for 2 peri-urban oral outbreaks of Chagas disease in Venezuela via high resolution microsatellite typing.

Trypanosoma cruzi III from armadillos (Dasypus novemcinctus novemcinctus) from Northeastern Venezuela and its biological behavior in murine model. Risk of emergency of Chagas' disease.

Trypanosoma cruzi, etiological agent of Chagas' disease, was isolated from armadillos (Dasypus novemcinctus novemcinctus) captured in rural communities Northeastern Venezuela from Nueva Esparta State (no endemic for Chagas' disease), Monagas and Anzoátegui States (endemics). The isolates, genetically typed by PCR-RFLP as belonging to the TcIII DTU, have demonstrated in murine model heterogenic parasitemia, mortality and histotropism with marked parasitism in cardiac, skeletal, and smooth myocytes that showed correlation with lymphobasophilic inflammatory infiltrates. Our finding of T. cruzi infected armadillos in Isla Margarita (Nueva Esparta State), together with reports of triatomine vectors in this region, the accentuated synanthropy of armadillos, intense economic activity, migration due to tourism and the lack of environmental education programs all of them represent risks that could cause the emergence of Chagas' disease in this area. This is the first report of the TcIII DTU in Northeastern Venezuela, thus widening the geographic distribution of this DTU.

Geographical distribution of Trypanosoma cruzi genotypes in Venezuela.

Chagas disease is an endemic zoonosis native to the Americas and is caused by the kinetoplastid protozoan parasite Trypanosoma cruzi. The parasite is also highly genetically diverse, with six discrete typing units (DTUs) reported TcI - TcVI. These DTUs broadly correlate with several epidemiogical, ecological and pathological features of Chagas disease. In this manuscript we report the most comprehensive evaluation to date of the genetic diversity of T. cruzi in Venezuela. The dataset includes 778 samples collected and genotyped over the last twelve years from multiple hosts and vectors, including nine wild and domestic mammalian host species, and seven species of triatomine bug, as well as from human sources. Most isolates (732) can be assigned to the TcI clade (94.1%); 24 to the TcIV group (3.1%) and 22 to TcIII (2.8%). Importantly, among the 95 isolates genotyped from human disease cases, 79% belonged to TcI - a DTU common in the Americas, however, 21% belonged to TcIV- a little known genotype previously thought to be rare in humans. Furthermore, were able to assign multiple oral Chagas diseases cases to TcI in the area around the capital, Caracas. We discuss our findings in the context of T. cruzi DTU distributions elsewhere in the Americas, and evaluate the impact they have on the future of Chagas disease control in Venezuela.

Multiple mitochondrial introgression events and heteroplasmy in trypanosoma cruzi revealed by maxicircle MLST and next generation sequencing.

BACKGROUND: Mitochondrial DNA is a valuable taxonomic marker due to its relatively fast rate of evolution. In Trypanosoma cruzi, the causative agent of Chagas disease, the mitochondrial genome has a unique structural organization consisting of 20-50 maxicircles (∼20 kb) and thousands of minicircles (0.5-10 kb). T. cruzi is an early diverging protist displaying remarkable genetic heterogeneity and is recognized as a complex of six discrete typing units (DTUs). The majority of infected humans are asymptomatic for life while 30-35% develop potentially fatal cardiac and/or digestive syndromes. However, the relationship between specific clinical outcomes and T. cruzi genotype remains elusive. The availability of whole genome sequences has driven advances in high resolution genotyping techniques and re-invigorated interest in exploring the diversity present within the various DTUs. METHODOLOGY/PRINCIPAL FINDINGS: To describe intra-DTU diversity, we developed a highly resolutive maxicircle multilocus sequence typing (mtMLST) scheme based on ten gene fragments. A panel of 32 TcI isolates was genotyped using the mtMLST scheme, GPI, mini-exon and 25 microsatellite loci. Comparison of nuclear and mitochondrial data revealed clearly incongruent phylogenetic histories among different geographical populations as well as major DTUs. In parallel, we exploited read depth data, generated by Illumina sequencing of the maxicircle genome from the TcI reference strain Sylvio X10/1, to provide the first evidence of mitochondrial heteroplasmy (heterogeneous mitochondrial genomes in an individual cell) in T. cruzi. CONCLUSIONS/SIGNIFICANCE: mtMLST provides a powerful approach to genotyping at the sub-DTU level. This strategy will facilitate attempts to resolve phenotypic variation in T. cruzi and to address epidemiologically important hypotheses in conjunction with intensive spatio-temporal sampling. The observations of both general and specific incidences of nuclear-mitochondrial phylogenetic incongruence indicate that genetic recombination is geographically widespread and continues to influence the natural population structure of TcI, a conclusion which challenges the traditional paradigm of clonality in T. cruzi.

Multilocus sequence typing (MLST) for lineage assignment and high resolution diversity studies in Trypanosoma cruzi.

BACKGROUND: Multilocus sequence typing (MLST) is a powerful and highly discriminatory method for analysing pathogen population structure and epidemiology. Trypanosoma cruzi, the protozoan agent of American trypanosomiasis (Chagas disease), has remarkable genetic and ecological diversity. A standardised MLST protocol that is suitable for assignment of T. cruzi isolates to genetic lineage and for higher resolution diversity studies has not been developed. METHODOLOGY/PRINCIPAL FINDINGS: We have sequenced and diplotyped nine single copy housekeeping genes and assessed their value as part of a systematic MLST scheme for T. cruzi. A minimum panel of four MLST targets (Met-III, RB19, TcGPXII, and DHFR-TS) was shown to provide unambiguous assignment of isolates to the six known T. cruzi lineages (Discrete Typing Units, DTUs TcI-TcVI). In addition, we recommend six MLST targets (Met-II, Met-III, RB19, TcMPX, DHFR-TS, and TR) for more in depth diversity studies on the basis that diploid sequence typing (DST) with this expanded panel distinguished 38 out of 39 reference isolates. Phylogenetic analysis implies a subdivision between North and South American TcIV isolates. Single Nucleotide Polymorphism (SNP) data revealed high levels of heterozygosity among DTUs TcI, TcIII, TcIV and, for three targets, putative corresponding homozygous and heterozygous loci within DTUs TcI and TcIII. Furthermore, individual gene trees gave incongruent topologies at inter- and intra-DTU levels, inconsistent with a model of strict clonality. CONCLUSIONS/SIGNIFICANCE: We demonstrate the value of systematic MLST diplotyping for describing inter-DTU relationships and for higher resolution diversity studies of T. cruzi, including presence of recombination events. The high levels of heterozygosity will facilitate future population genetics analysis based on MLST haplotypes.

Infección por Trypanosoma cruzi y polimorfismo del Citocromo B del ADN mitocondrial en Triatoma maculata de Anzoategui y Portuguesa, Venezuela / Trypanosoma cruzi infection and cytochrome b polimorphism of mitochondrial dna in Triatoma maculata of Anzoátegui and Portuguesa states, Venezuela

Con el fin de entender la dinámica poblacional de Triatoma maculata, se analizó el polimorfismo genético y los índices de infección con Trypanosoma cruzi, utilizando triatominos provenientes de ecotopos y regiones geográficas diferentes. El índice de infección parasitaria para T. maculata, fue de 29.8% a través de la observación directa al microscopio y 40.3% utilizando el método de reacción en cadena de la polimerasa. Los niveles de infección encontrados incrementan la importancia de T. maculata como vector involucrado en el ciclo de transmisión de T. cruzi. El análisis del polimorfismo de longitud de fragmentos de restricción de una región del gen Cyt B, permitió establecer en forma preliminar, diferencias en los patrones de bandas de este gen, según el origen geográfico de cada población. Esto puede asociarse a cambios relacionados con procesos adaptativos involucrados en la colonización de nuevos hábitats. No se observó variación genética para vectores capturados en diferentes ecotopos de una misma localidad. Sin embargo es evidente la participación del vector en el ciclo de transmisión, mostrando que la presencia de T. maculata en las casas no puede ser ignorada

In order to understand more about the populational dynamics of Triatoma maculata, the genetic polimorphism and the infection indexes of Trypanosoma cruzi were analysed, using triatomine obtained from different ecotopes and geographical regions. The parasitic infection index of T. maculata was 29.8% using the microscope direct observation, and 40.3% by the polymerase chain reaction method. Both methods were important for epidemiological screening of the vectors with low potential of infection. The amplification of one region the Cyt B gene of these organisms, followed by a restriction fragments length polymorphism analysis, allowed us to establish different patterns of bands according to the geographic origin of each population, which indicates the lack of migration between individuals of Portuguesa and Anzoátegui states. These genetic differences may be associated with changes in adaptative events involved in the colonization of new habitats. The lack of polymorphism among vectors collected in different habitats of the same region showed an important genetic flow which has epidemiological implications in the risk of transmission of the disease, showing that the presence of T. maculata in houses cannot be ignored

Efectos de la infección aguda por diferentes cepas de tripanosoma Cruzi en fetos de ratas / Effects of the Acute Infection by Different Trypanosoma cruzi Strains in Rats Fetuses

En el presente estudio se analizó el desarrollo intrauterino de los fetos de ratas Wistar, que recibieron una inyección por vía intraperitoneal de 2x10(5) tripomastigotes sanguícolas de las cepas Planalto (IP1) y ASM (IP2) de Trypanosoma cruzi. A los 12 días post-infección fueron apareadas; a los 20 días de preñez fueron sacrificadas y los fetos fueron extraídos de los sacos uterinos para ser evaluados. Ratas sanas preñadas (SP) y vírgenes (CI1, CI2) fueron usadas como controles. Los resultados indican que la parasitemia fue significativamente (P<0,05) mayor en las ratas preñadas en comparación con las ratas vírgenes CI1 y CI2 infectadas con diferentes cepas de T. cruzi. En las ratas IP1 se observaron 19 fetos con peso y longitud promedio de 2,86 ± 2,19 g y 2,63 ± 1,17; en una de las ratas se desarrolló un solo feto en el cuerno uterino izquierdo, en otra rata se observó inflamación del cuerno izquierdo, restos fetales, placentales y 6 fetos de aspecto normal en el cuerno derecho; en dos ratas se desarrollaron 8 y 4 fetos, respectivamente, de aspecto normal. En las ratas preñadas IP2, se desarrollaron 28 fetos con peso y longitud promedio de 2,77 ± 0,77 g y 3,31 ± 1,99 cm; en una rata los 4 fetos (57,14%) del cuerno uterino derecho presentaron malformaciones morfológicas sobre el lado dorsal del cuerpo, estrechamiento alrededor de la parte posterior y gran desarrollo de la base de la pata anterior derecha y en el cuerno izquierdo se observaron 3 fetos con aspecto normal; en otra rata se encontraron 2 fetos muertos y denso líquido amniótico en el cuerno uterino derecho y 5 fetos con aspecto normal en el cuerno izquierdo, y en dos ratas se observaron 8 y 6 fetos con aspecto normal, respectivamente. En las SP se desarrollaron 21 fetos con características físicas normales, con peso y longitud promedio de 6,16 ± 0,99 g y 2,88 ± 0,65 cm de longitud. La relación peso fetal/longitud fetal (g/cm) en los grupos de ratas preñadas IP1 e IP2 fue significantemente menor en comparación con los fetos de las ratas SP (P<0,00001). La comparación del peso fetal y diámetro de las placentas entre las ratas IP1, IP2 y SP resultó significativa (P<0,001). En conclusión, la infección por diferentes cepas de T. cruzi en las ratas preñadas produce restricción patológica del crecimiento fetal, anomalías morfológicas estructurales y funcionales en los fetos y muerte fetal. Los fetos de las ratas SP no mostraron ningun anomalía.

In the present study was analyzed the intrauterine development of Wistar rats fetuses that received an injection of 2x10(5) bloodstream trypomastigotes of Planalto (IP1) and ASM (IP2) Trypanosoma cruzi strains. The rats with 12 days post-infection were mated; at day 20 the pregnat rats were sacrificed and its fetuses were extracted from the uterine horns in order to be evaluated. Healthy pregnant rats (HP) and virgin rats (CI1, CI2) were used as controls. The results showed that parasitemia was significanty (P<0.05) higher in pregnancy rats in comparison with the virgins rats CI1 and CI2 infected with different T. cruzi strains. The rats IP1, showed 19 fetuses with weight and measure average of 2.86 g ± 2.19 and 2.63 ± 1.17 cm of length. One rat showed 1 fetus in the left uterine horn, other rat showed the left uterine horn with inflammated aspect and with fetal and placental rests, and 6 fetuses of normal aspect into right uterine horn; in two rats were observed 8 and 4 fetuses of normal aspect. The pregnant rats IP2, developed 28 fetuses with weight and measure average of 2.77 ± 0.77 g and 3.31 ± 1.99 cm; in one rat, the 4 fetuses (57.14%) of right uterine horn presented morphological malformations on the dorsal side of the body, tightness around the body and development his anterior right footpad with big size and the left uterine horn of same rat was observed 3 fetuses with normal aspect; other rat showed 2 fetuses dead and dense amniotic liquid into right horn, and 5 fetuses with normal aspect in the left uterine horn, in two rats were developed 8 and 6 fetuses with normal aspect respectively. The HP development 21 fetuses with normal aspect of weight and measure average of 6.16 ± 0.99 g and 2.88 ± 0.65 cm of length. The relation weight/length fetal (g/cm) in infected pregnant rats groups IP1 and IP2 was significantly less in comparison with fetuses of HP rats (P<0.00001). The comparison of the fetal weight and placental diameters of IP1, IP2 and HP rats were significant (P<0.001). In conclusion, acute infection with different T. cruzi strains in pregnant rats, produces pathologic restriction of fetal growth, functional structural morphological anomalies in the fetuses and death of some fetuses. The fetuses of HP rats did not show any anomaly.

Analysis of molecular diversity of the Trypanosoma cruzi trypomastigote small surface antigen reveals novel epitopes, evidence of positive selection and potential implications for lineage-specific serology.

Chagas disease, marked by life-long chronic infection with Trypanosoma cruzi, remains a major parasitic disease in Latin America. Genetically heterogeneous, T. cruzi is divided into six discrete typing units (DTUs), most recently grouped as TcI-VI. The trypomastigote small surface antigen (TSSA) of T. cruzi has been described as the only known serological marker to identify infection by TcII-VI, as distinct from TcI. Here, by comparative analysis of a cohort of 25 reference strains representing all the known DTUs, we show that TSSA intra-specific diversity is greater than previously reported. Furthermore, TcIII and IV TSSA PCR products are, contrary to expectation, both digested by PvuII, revealing a more nuanced genotyping pattern. Amino acid sequence diversity reveals that the TSSA epitope considered to be serologically characteristic of TcII-VI is restricted to TcII, V and VI, but not of III or IV, and that the diagnostic peptide described as TcI-specific shares key features with TcIII and IV. Notably, TSSA sequences inferred greater phylogenetic affinities of TcIII and IV to TcI than to TcII, V or VI. A high ratio of non-synonymous to synonymous nucleotide substitutions (omega=1.233) indicates that the TSSA gene has been under positive selection pressure. The demonstration of lineage-specific epitopes within TcII-VI has implications for sero-epidemiological studies of Chagas disease based on this antigen.

Genotyping of Trypanosoma cruzi: systematic selection of assays allowing rapid and accurate discrimination of all known lineages.

Trypanosoma cruzi, the agent of Chagas disease, can be subdivided into six discrete typing units (DTUs), TcI, TcIIa, TcIIb, TcIIc, TcIId or TcIIe, each having distinct epidemiologically important features. Dozens of genetic markers are available to determine the DTU to which a T. cruzi isolate belongs, but there is no consensus on which should be used. We selected five assays: three polymerase chain reaction (PCR)-restriction fragment length polymorphisms based on single nucleotide polymorphisms (SNPs) in the HSP60, Histone H1, and GPI loci, and PCR product size polymorphism of the LSU rDNA and mini-exon loci. Each assay was tested for its capacity to differentiate between DTUs using a panel of 48 genetically diverse T. cruzi clones. Some markers allowed unequivocal identification of individual DTUs, however, only by using a combination of multiple markers could all six DTUs be resolved. Based upon the results we recommend a triple-assay comprising the LSU rDNA, HSP60 and GPI markers for reliable, rapid, low-cost DTU assignment.

Trypanosoma cruzi IIc: phylogenetic and phylogeographic insights from sequence and microsatellite analysis and potential impact on emergent Chagas disease.

Trypanosoma cruzi, the etiological agent of Chagas disease, is highly genetically diverse. Numerous lines of evidence point to the existence of six stable genetic lineages or DTUs: TcI, TcIIa, TcIIb, TcIIc, TcIId, and TcIIe. Molecular dating suggests that T. cruzi is likely to have been an endemic infection of neotropical mammalian fauna for many millions of years. Here we have applied a panel of 49 polymorphic microsatellite markers developed from the online T. cruzi genome to document genetic diversity among 53 isolates belonging to TcIIc, a lineage so far recorded almost exclusively in silvatic transmission cycles but increasingly a potential source of human infection. These data are complemented by parallel analysis of sequence variation in a fragment of the glucose-6-phosphate isomerase gene. New isolates confirm that TcIIc is associated with terrestrial transmission cycles and armadillo reservoir hosts, and demonstrate that TcIIc is far more widespread than previously thought, with a distribution at least from Western Venezuela to the Argentine Chaco. We show that TcIIc is truly a discrete T. cruzi lineage, that it could have an ancient origin and that diversity occurs within the terrestrial niche independently of the host species. We also show that spatial structure among TcIIc isolates from its principal host, the armadillo Dasypus novemcinctus, is greater than that among TcI from Didelphis spp. opossums and link this observation to differences in ecology of their respective niches. Homozygosity in TcIIc populations and some linkage indices indicate the possibility of recombination but cannot yet be effectively discriminated from a high genome-wide frequency of gene conversion. Finally, we suggest that the derived TcIIc population genetic data have a vital role in determining the origin of the epidemiologically important hybrid lineages TcIId and TcIIe.

Genome-scale multilocus microsatellite typing of Trypanosoma cruzi discrete typing unit I reveals phylogeographic structure and specific genotypes linked to human infection.

Trypanosoma cruzi is the most important parasitic infection in Latin America and is also genetically highly diverse, with at least six discrete typing units (DTUs) reported: Tc I, IIa, IIb, IIc, IId, and IIe. However, the current six-genotype classification is likely to be a poor reflection of the total genetic diversity present in this undeniably ancient parasite. To determine whether epidemiologically important information is "hidden" at the sub-DTU level, we developed a 48-marker panel of polymorphic microsatellite loci to investigate population structure among 135 samples from across the geographic distribution of TcI. This DTU is the major cause of resurgent human disease in northern South America but also occurs in silvatic triatomine vectors and mammalian reservoir hosts throughout the continent. Based on a total dataset of 12,329 alleles, we demonstrate that silvatic TcI populations are extraordinarily genetically diverse, show spatial structuring on a continental scale, and have undergone recent biogeographic expansion into the southern United States of America. Conversely, the majority of human strains sampled are restricted to two distinct groups characterised by a considerable reduction in genetic diversity with respect to isolates from silvatic sources. In Venezuela, most human isolates showed little identity with known local silvatic strains, despite frequent invasion of the domestic setting by infected adult vectors. Multilocus linkage indices indicate predominantly clonal parasite propagation among all populations. However, excess homozygosity among silvatic strains and raised heterozygosity among domestic populations suggest that some level of genetic recombination cannot be ruled out. The epidemiological significance of these findings is discussed.

Flow cytometric analysis and microsatellite genotyping reveal extensive DNA content variation in Trypanosoma cruzi populations and expose contrasts between natural and experimental hybrids.

Trypanosoma cruzi exhibits remarkable genetic heterogeneity. This is evident at the nucleotide level but also structurally, in the form of karyotypic variation and DNA content differences between strains. Although natural populations of T. cruzi are predominantly clonal, hybrid lineages (TcIId and TcIIe) have been identified and hybridisation has been demonstrated in vitro, raising the possibility that genetic exchange may continue to shape the evolution of this pathogen. The mechanism of genetic exchange identified in the laboratory is unusual, apparently involving fusion of diploid parents followed by genome erosion. We investigated DNA content diversity in natural populations of T. cruzi in the context of its genetic subdivisions by using flow cytometric analysis and multilocus microsatellite genotyping to determine the relative DNA content and estimate the ploidy of 54 cloned isolates. The maximum difference observed was 47.5% between strain Tu18 cl2 (TcIIb) and strain C8 cl1 (TcI), which we estimated to be equivalent to approximately 73 Mb of DNA. Large DNA content differences were identified within and between discrete typing units (DTUs). In particular, the mean DNA content of TcI strains was significantly less than that for TcII strains (P<0.001). Comparisons of hybrid DTUs TcIId/IIe with corresponding parental DTUs TcIIb/IIc indicated that natural hybrids are predominantly diploid. We also measured the relative DNA content of six in vitro-generated TcI hybrid clones and their parents. In contrast to TcIId/IIe hybrid strains these experimental hybrids comprised populations of sub-tetraploid organisms with mean DNA contents 1.65-1.72 times higher than the parental organisms. The DNA contents of both parents and hybrids were shown to be relatively stable after passage through a mammalian host, heat shock or nutritional stress. The results are discussed in the context of hybridisation mechanisms in both natural and in vitro settings.