Standardization of the PCR Technique for the Detection of the Toxoplasma gondii B1 Gene in Meat and Water Samples and Cloning of the Product for Use as Control.

INTRODUCTION: Toxoplasmosis is caused by the parasite Toxoplasma gondii. The infection is generally asymptomatic and the most severe cases occur in immunosuppressed patients. The main route of transmission is the ingestion of water or food contaminated with cysts of the parasite. The objective of this work was the standardization of the PCR for the detection of the T. gondii B1 gene in meat and water samples and cloning of the product for use as a control. METHODS: The optimal reaction conditions of the different components of the PCR were determined and the technique was used to detect DNA from meat and water samples. Bands were purified and cloned into a pGEM-T-Easy vector and used as a control in the PCR. RESULTS: Optimal PCR conditions were; 100 µM dNTP, 0.4 µM primers, and 0.5 U Taq polymerase. The product obtained from the PCR was cloned with a simple cloning strategy with efficient results. With the standardized PCR and using the cloned DNA as a control, T. gondii DNA was detected in 90% of the positives samples of meat and water and there was no amplification in the negative samples. CONCLUSIONS: The PCR assay standardized in this study was demonstrated to be an effective technique to detect T. gondii DNA in meat and water samples. The cloning of PCR product and its application as a control in molecular diagnosis of toxoplasmosis might improve the reproducibility of this method and avoid the use of patient samples or cultures, which present several limitations.

Multiple-bead assay for the differential serodiagnosis of neglected human cestodiases: Neurocysticercosis and cystic echinococcosis.

BACKGROUND: Neurocysticercosis (NCC), and cystic echinococcosis (CE) are two neglected diseases caused by cestodes, co-endemic in many areas of the world. Imaging studies and serological tests are used in the diagnosis of both parasitic diseases, but cross-reactions may confound the results of the latter. The novel multiplex bead-based assay with recombinant antigens has been reported to increases the diagnostic accuracy of serological techniques. METHODOLOGY: We set-up an immunoassay based on the multiplex bead-based platform (MBA), using the rT24H (against Cysticercus cellulosae, causing cysticercosis) and r2B2t (against Echinococcus granulosus sensu lato, causing CE) recombinant antigens, for simultaneous and differential diagnosis of these infections. The antigens were tested on 356 sera from 151 patients with CE, 126 patients with NCC, and 79 individuals negative for both diseases. Specificity was calculated including sera from healthy donors, other neurological diseases and the respective NCC or CE sera counterpart. The diagnostic accuracy of this assay was compared with two commercial ELISA tests, Novalisa and Ridascreen, widely used in the routine diagnosis of cysticercosis and CE, respectively. MAIN FINDINGS: For the diagnosis of NCC, sensitivity ranged from 57.94-63.49% for the rT24H-MBA, and 40.48-46.03% for Novalisa ELISA depending on exclusion or inclusion of sera having equivocal results on ELISA from the analysis; specificities ranged from 90.87-91.30% and 70.43-76.96%, respectively. AUC values of the ROC curve were 0.783 (rT24H) and 0.619 (Novalisa) (p-value < 0.001). For the diagnosis of CE, the sensitivity of the r2B2t-MBA ranged from 68.87-69.77% and of Ridascreen ELISA from 50.00-57.62%; specificities from 92.47-92.68% and from 74.15-80.98%, respectively. AUC values were 0.717 and 0.760, respectively. CONCLUSIONS/SIGNIFICANCE: Overall, the recombinant antigens tested with the bead-based technology showed better diagnostic accuracy than the commercial assays, particularly for the diagnosis of NCC. The possibility of testing the same serum sample simultaneously for the presence of antibodies against both antigens is an added value particularly in seroprevalence studies for cysticercosis linked to control programs in endemic areas where these two parasites coexist.

Manifestaciones oculares de la toxocariasis en escolares del estado Anzoátegui en Venezuela / Ocular manifestations of toxocariasis in schoolchildren from the state from the Anzoátegui state in Venezuela

RESUMEN El objetivo de este estudio fue determinar manifestaciones oculares de la toxocariasis en escolares. Se realizó un estudio en dos escuelas del estado Anzoátegui en Venezuela en el 2019. Se empleó la prueba de ELISA para determinar los anticuerpos IgG contra Toxocara spp. Las familias completaron un cuestionario y los niños fueron evaluados clínicamente por pediatras y oftalmólogos. Participaron 118 niños, el 18,6% presentó anticuerpos anti-Toxocara spp. Las manifestaciones clínicas con asociación estadísticamente significativa fueron las reacciones alérgicas, epífora y disminución de la agudeza visual. En la evaluación oftalmológica se encontró queratitis, uveítis, iritis, granuloma retiniano, endoftalmitis, amaurosis, leucocoria, desprendimiento de retina y endotropía. Los hallazgos muestran una alta frecuencia de enfermedad ocular en niños con toxocariasis de un estado de Venezuela.

ABSTRACT The objective of this study was to determine ocular manifestations of toxocariasis in schoolchildren. A study was conducted in two schools in the Anzoátegui state in Venezuela in 2019. The ELISA test was used to determine IgG antibodies against Toxocara spp. The families completed a questionnaire, and the children were clinically evaluated by pediatricians and ophthalmologists. 118 children participated, 18.6% presented anti-Toxocara spp. The clinical manifestations with a statistically significant association were allergic reactions, epiphora, and decreased visual acuity. The ophthalmological evaluation found keratitis, uveitis, iritis, retinal granuloma, endophthalmitis, amaurosis, leukocoria, retinal detachment and endotropia. The findings show a high frequency of eye disease in children with toxocariasis from a state of Venezuela.

Empirical identification and validation of tumor-targeting T cell receptors from circulation using autologous pancreatic tumor organoids.

BACKGROUND: Tumor-specific cytotoxic T cells and T cell receptors are effective tools for cancer immunotherapy. Most efforts to identify them rely on known antigens or lymphocytes that have infiltrated into the tumor bed. Approaches to empirically identify tumor-targeting T cells and T cell receptors by exploiting all antigens expressed on tumor cell surfaces are not well developed for most carcinomas, including pancreatic cancer. METHODS: Autologous tumor organoids were stimulated with T cells from the patients' peripheral blood for 2 weeks to generate the organoid-primed T (opT) cells. opT cell phenotype was analyzed by monitoring changes in the expression levels of 28 cell surface and checkpoint proteins. Expression of ligands of the immune checkpoints was investigated by immunohistochemistry staining. T cells were labeled with carboxyfluorescein succinimidyl ester (CFSE) and assayed by flow cytometry to monitor tumor-induced T cell proliferation changes. opT cell-mediated killing of three-dimensional organoids was measured using an M30 ELISA kit. T cell receptors (TCRs) were identified by deep sequencing of gDNA isolated from T cells, and the TCR specificity was confirmed by transferring TCRs to the T cell line SKW-3 or donor T cells. RESULTS: The co-culture was effective in the generation of CD8 + or CD4+opT cells. The opT cells killed autologous tumors in a granzyme B or Fas-Fas ligand-dependent manner and expressed markers of tissue-resident memory phenotype. Each patient-derived opT cell culture displayed a unique complement of checkpoint proteins. Interestingly, only NKG2A blockade showed a potent increase in the interferon-γ production compared with blocking programmed cell death protein 1 (PD-1) or programmed cell death ligand 1 (PD-L1) or TIM3 or TIGIT or LAG3. Importantly, TCR sequencing demonstrated a dramatic clonal expansion of T cells with a restricted subset of TCRs. Cloning and transferring the TCRs to heterologous T cells was sufficient to confer tumor cell recognition and cytotoxic properties in a patient-specific manner. CONCLUSION: We report a platform for expanding tumor-targeting T cells from the peripheral blood of patients with pancreatic cancer. We identify the NKG2A-HLA-E axis as a potentially important checkpoint for CD8 +T cells for pancreatic cancer. Lastly, we demonstrate empirical identification of tumor-targeting TCRs that can be used for TCR-therapeutics.

[Ocular manifestations of toxocariasis in schoolchildren from the state from the Anzoátegui state in Venezuela]. / Manifestaciones oculares de la toxocariasis en escolares del estado Anzoátegui en Venezuela.

The objective of this study was to determine ocular manifestations of toxocariasis in schoolchildren. A study was conducted in two schools in the Anzoátegui state in Venezuela in 2019. The ELISA test was used to determine IgG antibodies against Toxocara spp. The families completed a questionnaire, and the children were clinically evaluated by pediatricians and ophthalmologists. 118 children participated, 18.6% presented anti-Toxocara spp. The clinical manifestations with a statistically significant association were allergic reactions, epiphora, and decreased visual acuity. The ophthalmological evaluation found keratitis, uveitis, iritis, retinal granuloma, endophthalmitis, amaurosis, leukocoria, retinal detachment and endotropia. The findings show a high frequency of eye disease in children with toxocariasis from a state of Venezuela.

El objetivo de este estudio fue determinar manifestaciones oculares de la toxocariasis en escolares. Se realizó un estudio en dos escuelas del estado Anzoátegui en Venezuela en el 2019. Se empleó la prueba de ELISA para determinar los anticuerpos IgG contra Toxocara spp. Las familias completaron un cuestionario y los niños fueron evaluados clínicamente por pediatras y oftalmólogos. Participaron 118 niños, el 18,6% presentó anticuerpos anti-Toxocara spp. Las manifestaciones clínicas con asociación estadísticamente significativa fueron las reacciones alérgicas, epífora y disminución de la agudeza visual. En la evaluación oftalmológica se encontró queratitis, uveítis, iritis, granuloma retiniano, endoftalmitis, amaurosis, leucocoria, desprendimiento de retina y endotropía. Los hallazgos muestran una alta frecuencia de enfermedad ocular en niños con toxocariasis de un estado de Venezuela.

Detection of Trypanosoma cruzi DNA in false negative samples of collected triatomines, xenodiagnosis material, and biopsies of experimentally infected animals.

Direct test over the gut material from triatomine vectors and xenodiagnosis over mammalian hosts are classical techniques for Trypanosoma cruzi parasitological diagnosis. Nevertheless, negative results can be a source of uncertainty. Experimental models have allowed evaluating the tissue invasion of different strains of T. cruzi, but conventional techniques for tissue biopsies involve time-consuming and elaborated procedures and have low sensitivity. Gut material of collected triatomines (microscopically negative) (n = 114), material of mammal xenodiagnoses (microscopically negative) (n = 138), and biopsy material (microscopically negative) from experimentally infected animals (n = 34) with isolates from endemic areas of Chagas' disease from Venezuela were used for DNA extraction and PCR for the amplification of kinetoplast DNA (kDNA) and satellite DNA (sDNA) of T. cruzi. Positive PCR was observed in 53.6% of collected triatomine material, 15.8% of parasitological negative xenodiagnosis material, and 70.6% in biopsies, revealing underestimation by the parasitological tests and the valour of this analysis with preserved material. Anzoátegui was the state with the highest percentage of infection, and the triatomine species Rhodnius prolixus and Panstrongylus geniculatus had the highest percentages of infection. Didelphis marsupialis and Canis familiaris were the most infected by T. cruzi revealed by PCR of xenodiagnosis material. In addition, the PCR technique allowed demonstrating the invasion of T. cruzi in all tissues analyzed, constituting a molecular marker of tissue invasion.

Characterization and evaluation of three new recombinant antigens of Taenia solium for the immunodiagnosis of cysticercosis.

Cysticerci of Taenia solium cause cysticercosis, with neurocysticercosis (NCC) as the major pathology. Sensible and specific recombinant antigens would be an source of antigen for immunodiagnosis. The objective of this work was the molecular characterization and evaluation, of three news recombinant antigens (TsF78, TsP43 and TsC28), obtained by screening of a Taenia solium cDNA library. The three cDNA were analysed by bioinformatic programs, subcloned and expresed. The purified proteins were evaluated in ELISA using cyst fluid as control. TsF78 is filamina, TsP43 a peroxidase and TsC28 collagen XV. The sensitivity and specificity of the recombinant proteins were; TsF78 93.8 % and 95.0 %, TsP62 91.7 % and 93.3 %, TsC28 85.4 % and 93.3 %, respectively, while the cyst fluid showed a sensitivity of 87.5 % and a specificity of 76.7 %. Given its high sensitivity and specificity, the recombinant proteins TsF78 and TsP62 could be used in the diagnosis of cysticercosis.

Diagnosis of Taeniosis in rural Venezuelan communities: Preliminary characterization of a Taenia solium specific monoclonal (VP-1) Coproantigen ELISA.

The objective of this study was to identify and treat carriers of adult Taenia solium present in two rural Venezuelan communities through examination of faecal samples by coproscopical analysis, and by the application of a polyclonal and a monoclonal (VP-1) coproantigen ELISA. Both the polyclonal and monoclonal ELISA's were negative when tested with soluble extracts of adults of Ascaris lumbricoides, Hymenolepis nana and Trichuris trichura. The polyclonal ELISA was positive for soluble extracts adults of T. solium and T. saginata, whereas the monoclonal ELISA, which recognizes a glycoprotein, was restricted to T. solium, and was also negative with faecal samples from five cases of T. saginata adult infections. In the first community studied, Potrero Largo (Total population: 300), of 248 faecal samples examined, 2 individuals were positive for Taenia spp eggs by coproscopical analysis and the VP-1 ELISA, and yielded T. solium adults upon purging. In contrast, when the polyclonal coproAg ELISA was applied to the same 248 faecal samples, there were a considerable number of positives. Indeed, seven patients highly positive in the polyclonal ELISA did not yield a Taenia spp upon purging and were negative in the VP-1 ELISA. In the second community studied La Yuca (Total population 560), none of the 333 individuals who donated faeces was positive for Taenia spp eggs. Many, however, were infected with a range of intestinal helminth and protozoan parasites. A total of 76 faecal samples with representative intestinal parasite were then tested in the polyclonal and VP-1 assays. Of these, many gave an unacceptable number of significant optical densities in the polyclonal coproAg ELISA. In contrast, all were negative in the VP-1 ELISA, thus providing evidence for the species specificity of the VP-1 ELISA in faecal samples. These results with the VP-1 coproAg ELISA, although preliminary, justify further validation through the testing of more faecal samples from T. solium and T. saginata adult infected individuals.

Infección natural por Trypanosoma cruzi en triatominos que habitan en la palma corozo ( Acrocomia aculeta ) en regiones del oriente de Venezuela / Triatominae in Palm Trees and Their Natural Infection by Trypanosoma cruzi in Regions of Eastern Venezuela

RESUMEN Objetivos Conocer la infestación natural por triatominos y su infección por Trypanosoma cruzi (T. cruzi) en Acrocomia aculeata (A. aculeata) o palma corozo en el estado Anzoátegui, Venezuela. Materiales y métodos Se estudió la infestación triatomínica y su infección por T. cruzi en A. aculeata desafectadas en campañas fitosanitarias. La presencia del parásito se determinó por microscopia y PCR-kDNA, y se realizó su caracterización mediante marcadores moleculares. Resultados Se encontraron 14 palmeras con infestación triatomínica, el 48,8 % de los ejemplares correspondieron a Rhodnius prolixus y el 48,2 % a Triatoma maculata, con desarrollo ontogénico hacia el adulto. Las pruebas parasitológicas y moleculares, su morfología típica y la infección en el modelo murino revelaron la presencia de T. cruzi en 54,8 % en promedio, para ambas especies de triatominos, con circulación del genotipo TcI de T. cruzi. Conclusiónes Se reportó para el estado Anzoátegui en Venezuela, la infestación de palma corozo con Rhodnius prolixus y Triatoma maculata y la presencia de subpoblaciones TcI de T. cruzi, siendo esta palma el hábitat peridomiciliar del binomio triatominos-T. cruzi y posible bioindicador de riesgo de infección para poblaciones humanas circunvecinas.

ABSTRACT Introduction To know the natural infestation by triatominae and their infection by Trypanosoma cruzi (T. cruzi) in Acrocomia Aculeata (A. aculeata) or coyol palm in the state of Anzoátegui, Venezuela. Materials and Methods Triatominic infestation and its infection by T. cruzi was studied in non-affected A. aculeata in phytosanitary campaigns. The presence of the parasite was determined by microscopy and PCR-kDNA, and its characterization was made by means of molecular markers. Results Fourteen palm trees with triatominic infestation were found; 48.8% of the individuals corresponded to Rhodnius prolixus and 48.2% to Maculata Triatoma, with ontogenetic development towards adult. The parasitology and molecular tests, their typical morphology and the infection in the murine model revealed the presence of T. cruzi in an average of 54,8%, for both species of triatominae, with circulation of the TcI genotype of T. cruzi. Conclusions The infestation of coyol palm trees with Rhodnius prolixus and Maculata Triatoma was reported for the state of Anzoátegui in Venezuela, as well as the presence of TcI sub-populations of T. cruzi, being this palm tree the peridomicilar habitat of the triatominae-T. cruzi binomial and possible bioindicador of risk of infection for surrounding human populations.

Epidemiological, clinical and laboratory features of toxocariasis in school children from Aragua State, Venezuela.

Background: Toxocariasis is a widespread zoonosis caused by canine and feline Toxocara spp. In Venezuela, seroepidemiological studies in Aragua State have been carried out only in preschool children. The objective of this study was to determine the prevalence of anti-Toxocara spp. antibodies and identify clinical symptoms and risk factors of Toxocara spp. infection in school children in two municipalities of Aragua State of Venezuela. Methods: A cross-sectional field study with 259 children between 6 and 12 y of age was conducted in six schools in Aragua State. Immunoglobulin G antibodies against Toxocara spp. by enzyme-linked immunosorbent assay, haematology and eosinophil counts were detected in blood. Participating families filled in a questionnaire and studied children were clinically evaluated by paediatricians. Results: Anti-Toxocara spp. antibodies were detected in 14.3% of children. The seroprevalence in the schools studied ranged from 4.4% to 24.1%. Statistical associations with eosinophilia, decreased visual acuity, eyestrain, headache and paleness were found. Significant risk factors were contact with dogs, playing with dogs and playing with soil. Conclusions: The identification of risk factors and their association with infection suggest that the infection is a problem in the municipalities studied, so screening for toxocariasis in school children should be recommended.

Molecular typing reveals the co-existence of two transmission cycles of American cutaneous leishmaniasis in the Andean Region of Venezuela with Lutzomyia migonei as the vector

BACKGROUND The transmission routes for American cutaneous leishmaniasis (ACL) are in flux, so studies examining its transmission in humans, mammalian hosts, and sand fly vectors are urgently needed. OBJECTIVES The aim of this work was understand the epidemiological cycles of Leishmania spp., which causes ACL in the Andean Region of Venezuela, by identifying the Leishmania and the sand fly species involved in human and dog infections. METHODS Thirty-one biopsies from patients in Mérida and Táchira states with suspected ACL were studied by both parasitological tests (cultures and hamster inoculation) and a molecular test [Internal transcribed spacer 1 (ITS1) nested polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP)]. We also conducted a survey to detect Leishmania infection in dogs (Immunifluorescence antibody test and ITS1 nested PCR-RFLP) and sand flies (ITS1 nested PCR-RFLP) from El Carrizal, a highly endemic focus of ACL in Venezuela. FINDINGS Three different Leishmania species were identified in the clinical samples from humans (Leishmania braziliensis, L. guyanensis, and L. mexicana) and dogs (L. guyanensis and L. mexicana). The predominant sand fly species found were those from the Verrucarum group (infected with L. mexicana) and Lutzomyia migonei (infected with L. guyanensis and L. mexicana). MAIN CONCLUSIONS We show that Lu. migonei may be the putative vector in two ACL epidemiological cycles, involving L. guyanensis and L. mexicana. We also report for the first time the presence of L. guyanensis in domestic animals.

[Seroprevalence and risk factors of cysticercosis in two rural communities in Anzoátegui state, Venezuela].

INTRODUCTION: Cysticercosis is caused by Taenia solium cysticerci, which are located mainly in the central nervous system causing neurocysticercosis. In Venezuela, few epidemiological studies on this disease have been conducted. OBJECTIVE: To determine the seroprevalence and risk factors for cysticercosis in two rural communities in Anzoátegui state. MATERIAL AND METHODS: We conducted a survey to collect data on possible risk factors and signs and symptoms of the disease, and we took 182 samples in two communities, Boquerón and Punto Lindo. Detection of IgG antibodies against T. solium cysticerci was performed by ELISA. RESULTS: Seroprevalence in Boquerón was 3.3%; due to the low number of seropositives the statistical analysis was not possible. However, the three seropositive persons had knowledge of the disease, and a history of consumption of undercooked pork meat, and presence of headache. In Punto Lindo, seroprevalence was 28.9%. There were no significant differences by sex or age; however, we found more seropositives among individuals younger than 20 years. With regard to risk factors and signs and symptoms, significant associations were found with consumption of undercooked pork (OR=18; 95% CI: 5.78 to 55.9), headaches (OR=3.6; 95% CI: 1.15 to 11.4), seizures (OR=18.9; 95% CI: 2.15 to 166.5) and visual problems (OR=5.7; 95% CI: 2.13 to 15.34). CONCLUSIONS: The results showed low transmission of cysticercosis in Boquerón, and high in Punto Lindo, where the high prevalence in children suggests recent transmission.

Seroprevalencia y factores de riesgo de cisticercosis en dos comunidades rurales del norte del estado Anzoátegui, Venezuela / Seroprevalence and risk factors of cysticercosis in two rural communities in Anzoátegui state, Venezuela

Resumen Introducción. La cisticercosis es causada por las larvas de Taenia solium, las cuales se localizan principalmente en el sistema nervioso central y causan neurocisticercosis. En Venezuela se han hecho pocos estudios epidemiológicos de esta enfermedad. Objetivo. Determinar la seroprevalencia y los factores de riesgo de la cisticercosis en dos comunidades rurales del estado Anzoátegui, Venezuela. Materiales y métodos. Se hizo una encuesta para recolectar datos sobre los posibles factores de riesgo y los signos y síntomas de la enfermedad, y se tomaron 182 muestras de los habitantes de las comunidades de Boquerón y Punto Lindo. Se determinaron los anticuerpos IgG contra cisticercos de T. solium mediante ensayo inmunoenzimático (ELISA). Resultados. En Boquerón, se presentó una seroprevalencia de 3,3 %; debido al bajo número de muestras positivas no se pudo hacer el análisis estadístico. Sin embargo, las tres personas positivas tenían conocimiento de la enfermedad, antecedentes de tenencia de cerdos no confinados, consumo de carne de cerdo semicruda y cefalea frecuente. En Punto Lindo, la seroprevalencia fue de 28,9 %. No hubo diferencias estadísticamente significativas en cuanto al sexo y la edad, sin embargo, se encontró mayor frecuencia en menores de 20 años. Con respecto a los factores de riesgo y los signos y síntomas, se encontró asociación significativa con el consumo de carne de cerdo semicruda (odds ratio, OR=18; IC95% 5,78-55,9), cefalea frecuente (OR=3,6; IC95% 1,15-11,4), convulsiones (OR=18,9; IC95% 2,15-166,5) y problemas de visión (OR=5,7; IC95% 2,13-15,34). Conclusión. Los resultados demostraron que había poca transmisión de cisticercosis en Boquerón, pero mucha en Punto Lindo, sobre todo en niños, lo cual sugeriría que se trata de transmisión reciente.

Abstract Introduction: Cysticercosis is caused by Taenia solium cysticerci, which are located mainly in the central nervous system causing neurocysticercosis. In Venezuela, few epidemiological studies on this disease have been conducted. Objective: To determine the seroprevalence and risk factors for cysticercosis in two rural communities in Anzoátegui state. Material and methods: We conducted a survey to collect data on possible risk factors and signs and symptoms of the disease, and we took 182 samples in two communities, Boquerón and Punto Lindo. Detection of IgG antibodies against T. solium cysticerci was performed by ELISA. Results: Seroprevalence in Boquerón was 3.3%; due to the low number of seropositives the statistical analysis was not possible. However, the three seropositive persons had knowledge of the disease, and a history of consumption of undercooked pork meat, and presence of headache. In Punto Lindo, seroprevalence was 28.9%. There were no significant differences by sex or age; however, we found more seropositives among individuals younger than 20 years. With regard to risk factors and signs and symptoms, significant associations were found with consumption of undercooked pork (OR=18; 95% CI: 5.78 to 55.9), headaches (OR=3.6; 95% CI: 1.15 to 11.4), seizures (OR=18.9; 95% CI: 2.15 to 166.5) and visual problems (OR=5.7; 95% CI: 2.13 to 15.34). Conclusions: The results showed low transmission of cysticercosis in Boquerón, and high in Punto Lindo, where the high prevalence in children suggests recent transmission.

Molecular diagnosis of dengue virus infections in samples collected on filter paper / Diagnóstico molecular de infecciones por virus Dengue en muestras colectadas en papel de filtro

Dengue virus infections (DENV) are a severe public health problem due to the high rates of morbidity and mortality involved, and the fact that no clinical treatment or vaccines are available. In order to strengthen the laboratory diagnosis for surveillance systems in tropical countries with low resources, we report an optimized method using filter paper for blood spotting and subsequent molecular diagnosis of DENV serotypes. Control strains of all serotypes, as well as 35 whole blood patient samples dispensed on filter paper, were stored at room temperature for as long as 36 months. RT-PCR of 5’UTR-C fragment was amplified through adapted protocols to diagnose all dengue serotypes. Results showed amplification for all four viral serotypes, including control viral strains and 88.6 % of the samples. These results allowed determining the utility of filter paper for the preservation of samples regularly obtained from patients with clinical suspicion of dengue in settings where low resources do not permit an immediate analysis of the samples. Likewise, this study evidence the possibility of molecular diagnosis of DENV from multiple areas of the world where there are no laboratories with the capacity to confirm DENV cases.

Las infecciones por virus Dengue (DENV) representan un grave problema de salud pública debido a las altas tasas de morbilidad y mortalidad que causan, además no cuentan con tratamiento clínico específico, ni vacuna. Con el fin de reforzar el diagnóstico de laboratorio para los sistemas de vigilancia epidemiológica en países tropicales con recursos económicos limitados, se optimizó una metodología utilizando papel de filtro para la recolección de muestras y el subsiguiente diagnóstico molecular de los serotipos de DENV. Se emplearon cepas controles correspondientes a todos los serotipos virales, así como 35 muestras de sangre total dispensadas en papel de filtro que fueron mantenidas a temperatura ambiente por 36 meses. Las muestras fueron analizadas mediante RT-PCR para la amplificación de la región del genoma correspondiente a 5´UTR-C de los DENV. Los resultados mostraron la amplificación de los mencionados fragmentos en 88,6% de las muestras analizadas, así como de las cepas controles. Estos resultados evidenciaron la utilidad del papel de filtro para conservación de muestras obtenidas de pacientes con sospecha clínica de dengue ubicados en zonas donde no es posible realizar análisis de laboratorio de forma inmediata, así como su uso para el diagnóstico molecular. De este modo se reforzaría la vigilancia en áreas, donde no hay laboratorios con capacidad para confirmar casos de DENV.

Clonación de secuencias de alfavirus y flavivirus para su uso como controles positivos en el diagnóstico molecular / Cloning alphavirus and flavivirus sequences for use as positive controls in molecular diagnostics

RESUMEN El objetivo de la investigación fue obtener controles positivos para la validación de técnicas moleculares (RT-PCR) utilizadas en diagnóstico e investigación de infecciones virales. A partir de cepas de CHIKV, Zika, DENV-1, DENV-2, DENV-3 y DENV-4, se extrajeron ARN virales para obtener por RT-PCR los ADN complementarios (ADNc) de las secuencias nsP4 (CHIKV), NS5 (virus Zika), C/prM-M y 5´UTR-C (DENV-1, DENV-2, DENV-3, DENV-4) que fueron clonados en pGEM®-T Easy. La clonación se confirmó mediante PCR de colonias, de las cuales se extrajo el ADN plasmídico para la verificación de la clonación de los fragmentos. Se logró la clonación de ADNc correspondientes a nsP4, NS5, C/prM-M y 5´UTR-C de los distintos agentes virales. En conclusión se obtuvieron los plásmidos recombinantes con cada una de las secuencias especificadas para su posterior valoración como controles positivos en técnicas moleculares, evitando el uso de cultivos celulares que pueden resultar costosos, laboriosos y potencialmente peligrosos.

ABSTRACT The purpose of the study was to obtain a positive control to validate molecular techniques (reverse transcription- polymerase chain reaction [RT-PCR]) used in the diagnosis and research of viral infections. From strains of Chikungunya virus (CHIKV), Zika virus, and Dengue virus (DENV-1, DENV-2, DENV- 3, and DENV-4) viral RNAs were extracted to obtain complementary DNA using RT-PCR from the nsP4 (CHIKV), NS5 (Zika virus), C/prM-M, and 5′UTR-C (DENV-1, DENV-2, DENV-3, DENV-4) sequences, which were cloned into pGEM®-T Easy. Cloning was confirmed through colony PCR, from which plasmid DNA was extracted for fragment cloning verification. Cloning of cDNA corresponding to nsP4, NS5, C/prM-M, and 5′UTR-C of the different viral agents was achieved. In conclusion, recombinant plasmids were obtained with each of the sequences specified for further assessment as positive controls in molecular techniques in an effort to avoid the use of cell cultures, which can be costly, time-consuming, and potentially dangerous.

Análisis de secuencias de moléculas de Taenia solium procesadas post-transcripcionalmente mediante trans splicing / Sequences analysis of molecules of Taenia solium post-transcriptionally processed by trans-splicing

La neurocisticercosis es una enfermedad neurológica causada por la presencia de cisticercos de Taenia solium en el sistema nervioso central. La clonación de genes del parásito es importante para la identificación y estudio de moléculas claves en la biología del parásito, en diagnóstico, protección y en las relaciones parásito-hospedador. En T. solium, ocurre un mecanismo alternativo en el procesamiento de algunos ARNm, denominado trans-splicing, en el cual una pequeña molécula de ARN (Spliced Leader, SL) es añadida al extremo 5´ de una molécula de pre-ARNm, formando diferentes ARNm maduros que contienen un extremo 5´ común. El objetivo de este trabajó fue realizar el análisis de las secuencias de algunas moléculas que utilizan este procesamiento, para conocer mejor este mecanismo en T. solium. Para ello, se realizó un cribado mediante PCR de genotecas de expresión de cisticerco de T. solium utilizando como cebador directo SL y como reverso ZAP-3´UP, oligonucleótido que hibrida con la secuencia del vector. Se obtuvieron diferentes ADN complementarios (ADNc), que fueron clonados en el plásmido pGEM-T-easy, secuenciados y comparados con las bases de datos (GenBank). Un total de 14 moléculas diferentes fueron obtenidas, las cuales muestran similitud principalmente con proteínas de T. solium, Echinococcus sp. e Hymenolepis sp. Se obtuvieron transcriptos completos que codifican una variedad de proteínas que forman parte de la biología propia de organismos vivos, tales como; enzimas, transportadores, proteínas estructurales, entre otras. Aunque no fue posible determinar si existen grupos específicos de ADNc (con funciones comunes), escogidos para llevar a cabo esta modificación post-transcripcional, se pudo observar que el proceso de trans-splicing ocurre en una gran variedad de ARN que codifican diferentes proteínas de importancia biológica para T. solium.

Neurocysticercosis is a neurological disease caused by the presence of Taenia solium cysticerci in the central nervous system. T. solium uses an alternative mechanism for processing some mRNAs, known as trans-splicing, in which a small RNA molecule (Spliced Leader, SL) is added to the 5' end, of one pre-mRNA molecule, leading to the formation of different mature mRNAs that all contain a common 5' end. The aim of this study was to analyze the sequences of some of the molecules that undergo this type of post-transcriptional processing in order to learn more about this mechanism in T. solium. Expression libraries of T. solium cysticerci were screened using PCR with SL as the forward primer and ZAP 3' UP, an oligonucleotide that hybridizes to the vector sequence, as the reverse primer. Different cDNAs were obtained which were cloned in the pGEM-T-easy plasmid, sequenced and then compared with sequences in databases (GenBank). A total of 14 different molecules showing similarities to T. solium, Echinococcus sp. and Hymenolepis sp. proteins were obtained. Complete transcripts encoding a variety of proteins that are part of the biology of living organisms, such as enzymes, transporters and structural proteins, were also identified. Although we could not determine whether specific cDNA groups (with common functions) are selected to carry out this post-transcriptional modification, we were able to observe that the process of trans-splicing occurs in a variety of RNAs that code for several proteins biologically important for T. solium.

Estandarización de la técnica de PCR para la detección de ADN de Leishmanía sp. en muestras de sangre de caninos / Standardization of the PCR technique for detection of Leishmania sp. DNA in canine blood samples

La leishmaniasis es una enfermedad con diversidad clínica y epidemiológica, producida por varias especies de protozoarios parásitos del género Leishmania. Estos parásitos infectan una amplia variedad de hospedadores mamíferos y son transmitidos por insectos del género Lutzomyia, en nuestro país. Los caninos han sido implicados como posibles reservorios del parásito. Para el diagnóstico de leishmaniasis se utilizan técnicas parasitológicas que generalmente tienen baja sensibilidad e inmunológicas, con pobre especificidad. Debido a las limitaciones en el diagnóstico, y lo difícil de la obtención, transporte y almacenamiento de las muestras, en este trabajo se planteó estandarizar de una técnica de PCR anidada (Leishmania nested PCR, Ln-PCR) para la detección de ADN de Leishmania sp. en muestras de sangre de caninos colectadas en papel de filtro. Para ello se titularon las concentraciones de reactivos de la PCR para la amplificación del ADN del parásito y se determinó la sensibilidad analítica y la especificidad de la técnica. Se evaluaron 36 muestras de sangre de caninos (6 infectados y 30 no infectados). Las condiciones óptimas de reacción fueron 0,2 mM de dNTPs, 0,4 µM de cada cebador y 1 U de Taq polimerasa. La sensibilidad analítica de Ln-PCR fue de 10 fg y la especificidad fue de 100% en la detección de ADN de Leishmania sp., ya que no se observó amplificación con ADN de otros parásitos, ni con ADN humano, ni de perro. De las muestras de caninos evaluadas los seis controles infectados todos amplificaron por la PCR, mientras que los 30 no infectados, en ninguno se observó amplificación. La extracción de ADN de muestras de sangre colectadas en papel de filtro fue eficiente para la amplificación por la PCR, técnica que puede ser muy útil para el diagnóstico de leishmaniasis en animales y su implicación como posibles reservorios.

Leishmaniasis is a disease with clinical and epidemiological diversity, caused by several species of protozoan parasites of the genus Leishmania. These parasites infect a wide variety of mammalian hosts, and are transmitted by insects of the genus Lutzomyia in our country. Canines have been implicated as potential reservoirs of the parasite. For the diagnosis of leishmaniasis, parasitological techniques generally with low sensitivity and immunological techniques, with poor specificity, are used. Because of limitations in the diagnosis, and the difficulty to obtain, transport, and store samples, the aim of this research was to standardize a Leishmania nested PCR test (Ln-PCR), for the detection of Leishmania sp. DNA in blood samples from dogs collected in filter paper. For that purpose, concentrations of the PCR reagent for DNA parasite amplification were titrated and the analytical sensitivity and specificity of the technique were determined. A total of 36 canine blood samples (6 infected and 30 uninfected) were evaluated.  The optimal reaction conditions were: 0.2 mM dNTPs; 0.4 µM of each primer; and 1 U of Taq polymerase. The analytical sensitivity of the Ln-PCR was 10 fg and the specificity was 100% in detecting Leishmania sp. DNA, since no amplification was observed with DNA from other parasites, human DNA or canine DNA. The six samples from infected canines evaluated amplified Leishmania sp. DNA by PCR, whereas in none of the 30 samples from uninfected canines the amplification was observed. The DNA extraction from blood samples collected in filter paper was efficient for the PCR amplification, a technique that can be very useful for the diagnosis of leishmaniasis in animals and their involvement as potential reservoirs.

Leishmaniasis.

dogs.

diagnosis.

PCR.

Aproximación a la problemática de la coendemicidad enfermedad de Chagas-Leishmaniasis desde un enfoque de Ecosalud / Approximation to the problem of coendemicity chagas-Leishmaniasis diseases from and Ecohealth approach

Chagas disease and leishmaniasis belong to the group of Neglected Tropical Diseases are zoonosis considered as a public health problem in Venezuela, present in rural, suburban and urban areas. The transmission of both is given by complex processes, which modifies the environment favoring infection with these two groups of protozoa have a common susceptible host, human, many of their geographical foci coincide and can also exist, practices and attitudes linked to ignorance of the modes of transmission of these diseases could encourage contact and infection /coinfection. To study these the Ecohealth approach, which allows to identify interactions between social and ecological systems, which connects to the complex thought, with a view from its fundamental principles proposed: 1) systems thinking, 2) transdisciplinary research 3) social participation, 4) social and environmental sustainability 5) gender equality and social, and 6) the approach of the gap between knowledge and action, which could provide important information of great help to propose public health policies, to strengthen the control programs for these diseases.

La enfermedad de Chagas y leishmaniasis pertenecen al grupo de las Enfermedades Tropicales Desatendidas, son zoonosis consideradas problemas de salud pública en Venezuela, presentes en zonas rurales, suburbanas y urbanas. La transmisión de ambas se da por procesos complejos, en los cuales se modifica el medio ambiente favoreciendo la infección con estos dos grupos de protozoarios, tienen un hospedador susceptible común, el humano, muchos de sus focos geográficos coinciden y pueden existir además, prácticas y actitudes que unidas al desconocimiento de las formas de transmisión de estas enfermedades, pudiesen favorecer el encuentro y la infección/coinfección. Para el estudio de estas se propone el enfoque de Ecosalud, el cual permite identificar interacciones entre los sistemas sociales y ecológicos, que se conecta con el pensamiento complejo, con una mirada desde sus principios fundamentales: 1) pensamiento sistémico, 2) investigación transdisciplinaria 3) participación social, 4) sostenibilidad social y ambiental, 5) equidad de género y social, y 6) el acercamiento de la brecha entre conocimiento y acción, los cuales podrían aportar datos importantes de gran ayuda para proponer políticas públicas de salud, que fortalezcan los programas de control para estas enfermedades.

Comparación de dos protocolos de extracción de ADN de Trypanosoma cruzi cultivados en medio axénico / Comparing two protocols of DNA extraction of Trypanosoma cruzi cultured in axenic medium

Objetivos. Comparar dos protocolos de extracción de ADN de Trypanosoma cruzi para su uso en la amplificación de ADN de minicírculos de kinetoplasto (ADNk) mediante la técnica de Reacción en Cadena de Polimerasa (PCR). Materiales y métodos. Se cultivaron epimastigotas de T. cruzi en condiciones exénicas obteniéndose masas entre 1,5 hasta 100 x 10(6) parásitos. A partir de estas se procedió a la extracción de ADN mediante dos protocolos: extracción con solventes orgánicos (fenol/cloroformo), y empleo de resina (Chelex®100), a partir de los diferentes sedimentos parasitarios. La concentración y pureza del ADN se determinó por espectrofotometría y la integridad se evaluó mediante electroforesis en geles de agarosa. Se realizó el análisis de varianza y comparaciones de medias mediante la prueba de Tukey, utilizando el software Statistix 8.0. Resultados. Se realizaron diez extracciones de ADN de cada una de las diferentes cantidades de parásitos sedimentados. En la extracción de ADN con la resina Chelex®100 se obtuvo mayor rendimiento, pero menor pureza e integridad respecto a la extracción con solventes orgánicos. Sin embargo, permitió la amplificación del producto de 330 pb de ADNk de T. cruzi. Conclusiones. Aun cuando la técnica de Chelex®100 proporcionó menor pureza e integridad del ADN, permitió la amplificación con éxito de ADNk por PCR, evitando el uso de técnicas laboriosas y solventes orgánicos tóxicos.

Objectives. To compare two extraction protocols of Trypanosoma cruzi DNA for use in DNA amplification of kinetoplast minicircles (kDNA) through the technique of Polymerase Chain Reaction (PCR). Materials and methods. Epimastigotes of T. cruzi were cultured in axenic conditions and masses from 1.5 to 100 x 106 parasites were obtained. DNA extraction was performed using two protocols: extraction with organic solvents (phenol/chloroform), and with resin (Chelex®100), from different parasitic sediments. Concentration and purity of DNA was determined by spectrophotometry, and integrity was assessed by agarose gel electrophoresis. Analysis of variance and comparisons of means were performed through Tukey’s test, using the Statistix 8.0 software. Results. Ten DNA extractions were done of each one of the different amounts of parasitic sediments. In the DNA extraction with Chelex®100 resin, a higher performance was obtained but a lower purity and integrity compared to the extraction with organic solvents. However, it allowed a product amplification of 330 bp of T. cruzi kDNA. Conclusions. Although the technique of Chelex®100 provided less purity and integrity of DNA, it allowed a successful amplification of kDNA by PCR, avoiding the use of laborious techniques and toxic organic solvents.

Estandarización de la técnica de aglutinación directa para el inmunodiagnóstico de la enfermedad de Chagas / Standardization of a direct agglutination test for the immunodiagnosis of Chagas disease

Introducción. La enfermedad de Chagas es causada por el parásito Trypanosoma cruzi y su diagnóstico inmunológico se basa principalmente en la detección de anticuerpos contra T. cruzi mediante pruebas tales como ELISA, inmunofluorescencia indirecta (IFI) y hemaglutinación indirecta (HAI). Esta última tiene el inconveniente de requerir la preparación de eritrocitos de carnero, difíciles de obtener y de poca duración. Sin embargo, existen pruebas alternativas, como la técnica de aglutinación directa. Objetivo. Estandarizar la técnica de aglutinación directa para el diagnóstico de la enfermedad de Chagas. Materiales y métodos. Se prepararon parásitos epimastigotes de T. cruzi mediante dos protocolos, con tratamiento con tripsina y sin él. Los parásitos se colorearon, y se determinaron las condiciones óptimas de concentración parasitaria y diluciones de suero. Se utilizaron sueros de pacientes con enfermedad de Chagas, de individuos sanos y con otras parasitosis. Resultados. La concentración parasitaria óptima fue de 500 x10 6 parásitos/ml, utilizando parásitos coloreados y sin tratamiento con tripsina. Las diluciones de suero óptimas fueron de 1/25, 1/50 y1/100, y el punto de corte, la dilución de 1/50. La técnica estandarizada mostró índices diagnósticos de sensibilidad de 94,3 % (IC 95% 79,5-99,0) y de especificidad de 96,3 % (IC 95% 88,8-99,0); se encontró reacción cruzada en tres sueros de individuos con leishmaniasis visceral, con valores pronósticos positivo y negativo de 91,7 % (IC 95% 76,4-97,8) y de 97,5 % (IC 95% 90,4-99,6), respectivamente. Se compararon los resultados con los obtenidos por HAI, ELISA e IFI y la concordancia fue de 96 % con un índice kappa de 0,90 (IC 95% 0,81-0,99). Conclusión. La técnica de aglutinación directa estandarizada podría ser útil para el inmunodiagnóstico de la enfermedad de Chagas.

Introduction: Chagas´ disease is caused by the parasite Trypanosoma cruzi and its immunological diagnosis is mainly based on the detection of antibodies against T. cruzi using tests such as the ELISA, the indirect fluorescence antibody test (IFAT) and the indirect hemagglutination test (IHAT). The main disadvantage of the IHAT is the need to prepare sheep erythrocytes, whose availability is limited and they have a short duration once prepared. However, there are alternative tests, such as the direct agglutination test (DAT). Objective: To standardize the direct agglutination test for the diagnosis of Chagas disease. Materials and methods: Trypanosoma cruzi epimastigotes were prepared using two protocols, with and without trypsin treatment. The parasites were stained and optimal conditions for parasitic concentration and serum dilutions were determined. We evaluated the technique using sera from patients with Chagas disease, from healthy individuals and from individuals with other parasitic diseases. Results: The optimal parasitic concentration was 500 x 10 6 parasites/ml using stained parasites without trypsin treatment. The optimal serum dilutions were 1/25, 1/50 y 1/100 and the cut-off point was the 1/50 dilution. The diagnostic indices for the standardized technique were as follows: Sensitivity, 94.3% (95% CI: 79.5-99.0) and specificity, 96.3% (95% CI: 88.8-99.0), with positive and negative predictive values ?? of 91.7% (95% CI: 76.4-97.8) and 97.5% (95% CI: 90.4-99.6), respectively. Cross-reaction was observed only in three sera from individuals with visceral leishmaniasis. The results were compared with those obtained by IHA, ELISA, and IFA, and the concordance rate was 96% and the kappa index, 0.90 (95% CI: 0.81-0.99). Conclusion: The standardized direct agglutination test could be useful for immunodiagnosis of Chagas disease.