Superoxide-dependent and -independent pathways are involved in the transmission blocking of malaria.

Superoxide plays a crucial role in innate immunity to various pathogens. We examined the role of superoxides in the transmission of malaria using gp91phox knockout (X-CGD) mice that lack the ability to produce superoxide. Mosquitoes that fed on X-CGD mice infected intraperitoneally with Plasmodium berghei NK65 ANKA formed more oocysts than did those that fed on control mice at any day after infection. The number of oocysts peaked on day 5 post-infection in X-CGD and control mice and then decreased significantly after day 5 post-infection. However, on day 7 post-infection, the infectivity of gametocytes in X-CGD mice was significantly higher than that in control mice. These results show that two pathways, superoxide-dependent and -independent, are involved in the host systems regulating the transmission of malaria and inhibiting gametocyte development.

Chronic Chagas' heart disease in a Japanese-Brazilian traveler. A case report.

A 57-year-old Japanese-Brazilian man, visiting Japan for only 9 days, was admitted to our hospital due to syncope and frequent ventricular premature beats. He grew up in a rural area of Brazil and moved to Sao Paulo in 1959 when he was 20 years old. We suspected chronic Chagas' heart disease, i.e., dilated cardiomyopathy with apical ventricular aneurysm, right bundle branch block with left anterior fascicular block, and various arrhythmias including supraventricular premature beats, ventricular premature beats and non-sustained ventricular tachycardia because he showed typical echo- and electrocardiographic features of the disease. Coronary arteriograms were normal, and left ventriculogram confirmed the existence of apical ventricular aneurysm. A left ventricle biopsy specimen showed hypertrophic cardiac muscle with mild fibrosis. The diagnosis of chronic Chagas' disease was finally confirmed by the demonstration of Trypanosoma cruzi itself in the blood as well as Trypanosoma cruzi antibodies.

Characterisation of Trypanosoma cruzi populations by DNA polymorphism of the cruzipain gene detected by single-stranded DNA conformation polymorphism (SSCP) and direct sequencing.

Fifty fresh isolates of Trypanosoma cruzi from Triatoma dimidiata vectors and 31 from patients with Chagas' disease were analysed for DNA polymorphisms within the 432-bp core region of the cruzipain gene which encodes the active site of cathepsin L-like cystein proteinase. The cruzipain gene showed signs of polymorphism consisting of four different DNA sequences in Central and South American isolates of T. cruzi. The PCR fragments of Guatemalan isolates could be divided into three groups, Groups 1, 2 and 3, based on different patterns of single-stranded DNA conformation polymorphism. All of the strains isolated from Brazil, Chile, and Paraguay, except for the CL strain, showed a Group 4 pattern. Two to four isolates from each group were analysed by cloning and sequencing. A silent mutation occurred between Groups 1 and 2, and five nucleotides and two aa substitutions were detected between Groups 1 and 3. The DNA sequence of Group 4 contained five nucleotides and one aa substitution from Group 1. All of the DNA sequences corresponded well with the single-stranded DNA conformation polymorphism. The Group 1 isolates, the majority in the Guatemalan population (70/81, 86.4%), were isolated from both triatomines and humans, but Group 3 were isolated only from humans. Moreover, the Group 2 isolates were detected only in triatomine vectors (9/50; 18%), but never in humans (0/32, P<0.05) suggesting that this group has an independent life-cycle in sylvatic animals and is maintained by reservoir hosts other than humans.

Application of the polymerase chain reaction (PCR) in the epidemiology of Entamoeba histolytica and Entamoeba dispar infections.

In this paper, we briefly summarize the latest information on the polymerase chain reaction (PCR) as an epidemiologic tool for Entamoeba histolytica and Entamoeba dispar infections. This method which employs DNA template directly extracted from formalin fixed stool specimens offers a good promise for an accurate and reliable epidemiology of the two species. The assay is, sensitive enough to detect as few as five cysts in the stool sample, rapid and selectively differentiates E. histolytica from E. dispar DNA from stool specimens without the need for prior cultivation.

Short communication: cultivation of bloodstream forms of Trypanosoma brucei and T. evansi in a serum-free medium.

Bloodstream forms of Trypanosoma brucei and T. evansi have been cultivated in an axenic culture system by using Iscove's modified DMEM-based HMI-9 medium supplemental with bathocuproinedisulphonic acid, L-cysteine, hypoxanthine, 2-mercaptoethanol, pyruvate, thymidine and 10% fetal bovine or adult horse serum. We developed a serum-free medium (HMI-244) in which serum in HMI-9 was replaced by fatty acid-free bovine serum albumin, bovine alpha 2-macroglobulin, bovine beta-lipoprotein, d-biotin, retinol, beta-alanine, L-anserine nitrate salt, L-ornithine hydrochloride, O-phosphorylethanolamine, sarcosine, taurine, adenosine-5'-triphosphate, 2'-deoxycytidine-5'-monophosphate, 2'-deoxyguanosine-5'-monophosphate, and 5-methyltetrahydrofolic acid. Maximum cell densities and population doubling times were 2.6 x 10(6) cells/ml; 10.6 hours and 2.2 x 10(6) cells/ml; 10.9 hours for T. brucei and T. evansi, respectively. Bloodstream forms continued to proliferate in the serum-free cultures for more than 90 days and the trypomastigotes retained their morphological characteristics and infectivity to mice. If validated, this serum-free medium may help reduce future interlaboratory variability in biochemical, immunological, molecular biological and drug sensitivity studies on these parasites.

Granulocyte-macrophage colony-stimulating factor production by T lymphocytes in Plasmodium berghei-infected mice.

The production of granulocyte-macrophage colony-stimulating factor (GM-CSF) by lymphocytes was examined in murine malaria. When spleen cells or lymph node cells from P. berghei-infected mice were cultured in vitro with malaria antigen, the GM-CSF production correlated with the incubation time up to 72 hours. When lymphocytes obtained at various days after infection were cultured with the antigen, GM-CSF became detectable as early as 2 days after infection, reached a peak at day 9 and then rapidly decreased. Production of GM-CSF was antigen-specific, and related to the dose of antigen. Treatment of lymphocytes with anti-Thy-1.2 antibody and complement resulted in almost complete loss of GM-CSF-producing activity, while treatment with either anti-CD4 or anti-CD8 antibody and complement resulted in partial loss of GM-CSF-producing activity, indicating that both CD4+ and CD8+ T cells are involved in GM-CSF production in malaria. GM-CSF exhibits glycoprotein nature, and has an apparent molecular weight of 36,000. The molecular properties of this T-cell derived GM-CSF were compared with those of known lymphokine GM-CSF.

Loss of tumor necrosis factor production by human monocytes in falciparum malaria after their maturation in vitro.

In Plasmodium-infected mammals, phagocytosis and production of tumor necrosis factor (TNF) by monocytes and macrophages are prominent features. The present work aimed at clarifying the relationship between the maturation of human monocytes to macrophages and their TNF productivity and phagocytic ability in the presence of Plasmodium falciparum-infected erythrocytes. Fresh monocytes produced a significantly higher quantity of TNF in the presence of schizont-infected erythrocytes than macrophages obtained by in vitro monocyte maturation on autologous serum, whereas phagocytic activity of macrophages was much higher than that of fresh monocytes. This indicated that the TNF-inducing factors from P. falciparum-infected erythrocytes could stimulate fresh monocytes, but not macrophages, to release TNF, regardless of their development of phagocytosis. Activation of macrophages by interferon-gamma could not recover their TNF productivity in the presence of P. falciparum-infected erythrocytes, but it enhanced their TNF productivity in the presence of lipopolysaccharide(s). The TNF-inducing factors were contained mainly in erythrocytes infected with mature schizonts but not in erythrocytes infected with the younger stages of the parasites. Fractionation of infected erythrocytes revealed that both soluble and insoluble components almost equally contained those factors.

Differentiation of Entamoeba histolytica and E. dispar DNA from cysts present in stool specimens by polymerase chain reaction: its field application in the Philippines.

It has been established that two distinct species exist within what was originally known as Entamoeba histolytica. These are E. dispar and E. histolytica, for the nonpathogenic and pathogenic forms, respectively. Differentiation of these two organisms is of great clinical importance since they are morphologically indistinguishable and both forms can infect the human intestinal cavity to different degrees. A simple and rapid DNA-extraction method that can be used directly on formalin-fixed stool specimens has been developed. The extracted DNA was used for the identification of the species existing in the stools by polymerase chain reaction (PCR). A total of 72 randomly collected stool samples from the Philippines were analyzed. In all, 19 samples reacted with E. dispar primers, resulting in the expected 101-bp PCR products; however, none reacted with E. histolytica primers. Furthermore, sensitivity assay suggests that genomic DNA from as few as five cysts can be used as a template for PCR. These observations imply that the use of genomic DNA directly extracted from formalin-fixed stool specimens for PCR amplification is a useful tool for obtaining a sensitive and accurate diagnosis that can be applied even in epidemiology studies.

Sequence conservation in the C-terminal part of the precursor to the major merozoite surface proteins (MSP1) of Plasmodium falciparum from field isolates.

The C-terminal part of the precursor to the major merozoite surface proteins (MSP1) of Plasmodium falciparum contains potential protective epitopes and two cleavage sites for processing which take place prior to erythrocyte invasion by the merozoite. Since sequences available to date are limited and derived from cultured parasites, we have examined the extent of variations of this important part of the MSP1 gene from natural populations. Our sequence analyses of 1.6-1.7 kb from blocks 13-17 of the gene obtained from 19 Thai wild isolates have identified a deletion of a codon and 18 nucleotide substitutions, all of which are dimorphic substitutions and all but one create amino acid exchanges. However, residues at two cleavage sites for the C-terminus 42 kDa polypeptide and the 19-kDa polypeptide, a subfragment of the former, are conserved. Furthermore, all 12 cysteine residues at the C-terminal 19-kDa polypeptide are perfectly conserved, allowing the formation of 2 epidermal growth factor-like structures. These results indicate that in contrast to extensive variations at the N-terminal part of MSP1, limited variations occur at the C-terminal part.

New enzyme immunoassays for specific assay and general detection of Trypanosoma cruzi, epimastigotes.

A highly specific competitive enzyme-linked immunosorbent assay for the epimastigote of Tulahuen strain was developed by using the usual 3 immunological reagents, a rabbit antiserum specific for T. cruzi, epimastigote of Tulahuen strain, beta-D-galactosidase-labeled goat anti-rabbit immunoglobulin G and the solid-phase cell fragments of the epimastigote of Tulahuen strain. A new method, the selected antibody enzyme immunoassay (SAEIA) which generally detected all strains of the epimastigote tested with the same working range, was developed by changing only the solid-phase antigen to the epimastigote of Y strain among the 3 immunological reagents. Both assays permitted us to measure accurately as little as 1,000 parasites per assay tube. Scope of the SAEIA was limited to the epimastigote. Both life-cycle forms of T. cruzi which appear in mammals, amastigote and trypomastigote, and other kinetoplastids showed low cross-reaction values by the assay. The assay principle of the new method and a preliminary study to apply the SAEIA for finding the field T. cruzi-infected insect vectors were also reported.

[A basal cell carcinoma of the esophagus--a case report].

Reported is the case of a 58-year-old male who visited our hospital with the chief complaint of anorexia. Diagnosed as having an esophageal cancer, a subtotal esophagectomy was performed including the dissection of the tumor. According to the surgical findings, the tumor was not exposed to the tunica externa and no lymph node metastasis or infiltration to the pleura or a metastasis to the lung or liver was note. On histopathological examination a basal cell carcinoma of esophagus was determined but no squamous epithelium was seen. The carcinoma was the muscular propria, and neither infiltration into the epithelium nor invasion into the vessels was noted. The postoperative progress appeared good, however seven months later the patient died from multiple hepatic metastasis.

A Japanese survey on first attempts of percutaneous transluminal coronary angioplasty.

Experiences of the initial application of percutaneous transluminal coronary angioplasty (PTCA) in Japan performed during 1980-1981 at the multicenter level were analyzed. A survey in 72 cases which were collected from 12 centers showed an overall success rate of 64.7%, unimproved stenotic lesions in 8.1% and unpassable lesions in 24.3% of the cases. Complications were death of the patient in 2(2.8%), acute myocardial infarction in 6(8.3%) and dissection of the coronary artery in 3 cases (4.2%). Aortocoronary bypass graft surgery was performed in 8 cases (11.1%).

Comparative studies on trypomastigotes of Trypanosoma cruzi from infected mouse blood and infected fibroblast cell (L-cell) culture.

The resistance to phagocytosis by macrophages and the penetration into fibroblast cells of blood form trypomastigotes of Trypanosoma cruzi were compared with those of trypomastigotes grown in fibroblast cell culture. On incubation for 24 h, blood form trypomastigotes were almost completely resistant to phagocytosis, but about 40% of the trypomastigotes from cell culture were phagocytized. On longer incubation, the resistance of both forms of trypomastigotes decreased gradually. The penetrating ability of blood form trypomastigotes was much lower than that of trypomastigotes from cell culture. Infection of mice with blood form trypomastigotes resulted in less proliferation of parasites in the liver and spleen than that with trypomastigotes from cell culture. From these results, the existence of two functionally different forms of trypomastigotes in infected mice and in infected fibroblast cell culture, respectively, is discussed.