Evaluation of a MPB70-ELISA to differentiate Mycobacterium bovis from M. avium-sensitized swine / Avaliação de um MPB70-ELISA para diferenciar entre suínos sensibilizados com Mycobacterium bovis ou M. avium

Swine are susceptible to different mycobacteria species, being Mycobacterium bovis an agent of tuberculosis, with most significant zoonotic risks, while M. avium determines a granulomatous lymphadenitis with low zoonotic risk. Currently performed intradermal tests present some important limitations, such as the lack of ability to detect anergic animals or to differentiate among mycobacterial species. In order to improve the TB diagnosis, serological assays have been developed, with encouraging results. The purpose of this study was to evaluate the performance of a MPB70-ELISA in 82 piglets divided into four groups: sensitized by inactivated M. bovis, M. avium, inoculated with oil adjuvant, or with saline solution. The test was able to discriminate between an animal sensitized by M. bovis and animals of the three other groups, including M. avium-sensitized animals; for this reason, we suggest that MPB70-ELISA could be used as a complementary tool for discriminating the agent of the mycobacteriosis, and therefore to diagnose tuberculosis in a swine herd.(AU)

Suínos são suscetíveis a diferentes espécies de micobactérias, sendo Mycobacterium bovis agente de tuberculose (TB), com claro risco zoonótico, enquanto M. avium determina uma linfadenite granulomatosa (LG) de baixo risco zoonótico. Os testes intradérmicos atualmente realizados apresentam algumas limitações importantes, como a falta de habilidade em detectar animais anérgicos ou de diferenciar entre as espécies micobacterianas. Com o intuito de melhorar o diagnóstico de TB, testes sorológicos têm sido desenvolvidos, com resultados encorajadores. O objetivo do presente estudo foi avaliar um MPB70-ELISA em 82 leitões divididos em quatro grupos: sensibilizados por M. bovis, por M. avium, inoculados com óleo adjuvante ou com solução salina. O teste foi capaz de discriminar entre os animais sensibilizados com M. bovis dos demais três grupos, incluindo aqueles que foram sensibilizados com M. avium; desta forma, sugere-se que o MPB70-ELISA poderia ser utilizado como ferramenta complementar para discriminar o agente da micobacteriose, e portanto diagnosticar TB em um plantel de suínos.(AU)

The Mycobacterium avium ssp. paratuberculosis specific mptD gene is required for maintenance of the metabolic homeostasis necessary for full virulence in mouse infections.

Mycobacterium avium subspecies paratuberculosis (MAP) causes Johne's disease, a chronic granulomatous enteritis in ruminants. Furthermore, infections of humans with MAP have been reported and a possible association with Crohn's disease and diabetes type I is currently discussed. MAP owns large sequence polymorphisms (LSPs) that were exclusively found in this mycobacteria species. The relevance of these LSPs in the pathobiology of MAP is still unclear. The mptD gene (MAP3733c) of MAP belongs to a small group of functionally uncharacterized genes, which are not present in any other sequenced mycobacteria species. mptD is part of a predicted operon (mptABCDEF), encoding a putative ATP binding cassette-transporter, located on the MAP-specific LSP14. In the present study, we generated an mptD knockout strain (MAPΔmptD) by specialized transduction. In order to investigate the potential role of mptD in the host, we performed infection experiments with macrophages. By this, we observed a significantly reduced cell number of MAPΔmptD early after infection, indicating that the mutant was hampered with respect to adaptation to the early macrophage environment. This important role of mptD was supported in mouse infection experiments where MAPΔmptD was significantly attenuated after peritoneal challenge. Metabolic profiling was performed to determine the cause for the reduced virulence and identified profound metabolic disorders especially in the lipid metabolism of MAPΔmptD. Overall our data revealed the mptD gene to be an important factor for the metabolic adaptation of MAP required for persistence in the host.

Detection of specific antibodies in cows after injection of PPD / Detecção de anticorpos específicos em vacas após a injeção de PPD

The diagnosis of bovine tuberculosis aims to identify the immune response against mycobacterial antigens. Although Single Intradermal Comparative Cervical Tuberculin test (SICCT) is broadly used for first identification of the disease, the performance of ELISAs has been investigated for diagnosis improvement. The present study expected to find out the influence of intradermal skin tests on the results of ELISAs using the recombinant proteins MPB70 and MPB83 as antigens on cows from a naturally infected herd. Results were analyzed by the F-test, Mann-Whitney and Friedman tests Although comparable to both proteins, results showed that positive animals presented a tendency of augment reactivity to MPB70, representing a tendency for a booster effect, but not to MPB83.

O diagnóstico da tuberculose bovina baseia-se na identificação da resposta imune do animal frente aos antígenos de Mycobacterium bovis. Embora o teste intradérmico comparativo cervical seja o mais empregado como primeiro teste diagnóstico, outras técnicas, como ELISA, tem sido investigadas para aumentar a detecção de animais infectados. O presente estudo analisou se os testes intradérmicos influenciariam os resultados de ELISAs que utilizaram as proteínas MPB70 e MPB83 como antígenos de captura em um rebanho naturalmente infectado. Os resultados foram analisados por meio de testes estatísticos de comparação e correlação de resultados: teste-F, Mann-Whitney e Friedman. O desempenho de ambos os ELISAs foi comparável; no entanto, os resultados demonstraram que entre os animais positivos, houve um aumento de reatividade ao MPB70, dado este que não foi observado junto ao ELISA-MPB83.

A multidisciplinary approach to diagnose naturally occurring bovine tuberculosis in Brazil / Uma abordagem multidisciplinar para o diagnóstico de tuberculose bovina em um rebanho naturalmente infectado no Brasil

A herd infected naturally with tuberculosis was investigated by different diagnostic methods. Ninety days after a screening test that identified 21 cows as skin test positive, a Comparative Intradermal Tuberculin Test (CITT) was performed in those 21 cows and in 29 other randomly selected skin test negative cows. Milk samples and nasal swabs were collected prior to the CITT for bacteriological culture and PCR, while blood samples were collected for IFN release and antibody responses to MPB70 and MPB83, at three time points post tuberculin injection. Animals positive by CITT were slaughtered and disease confirmation undertaken. Based on the Kappa test, IFN was comparable to the standard tests (culture, PCR and CITT) at all three sampling points. Results from both antibody ELISAs were similar but were not comparable to the standard tests. T-test analysis of the CITT, IFN and ELISAs demonstrated that their performances were not correlated. There is increasing recognition that individually, available diagnostic tests do not detect all infected cattle. Therefore, a comprehensive strategy for the diagnosis of bovine TB should include test results for the detection of both cellular and humoral immune responses where there may be animals at different stages of infection.

Um rebanho bovino naturalmente infectado por tuberculose foi analisado através de diferentes métodos diagnósticos. Um teste intradérmico simples (TIC) identificou 21 animais como positivos. Após 90 dias deste resultado, um teste intradérmico comparativo (TIC) foi aplicado nos 21 animais positivos ao TIS, além de outros 29 animais com resultados prévios negativos escolhidos aleatoriamente. De todos estes animais (50), foram coletadas amostras de leite e secreção nasal para isolamento e identificação de microrganismos por cultura e PCR; amostras de sangue de cada um dos animais foram coletadas para exames de ELISA: produção de Interferon-gama (IFN) e pesquisa de anticorpos frente aos antígenos MPB70 e MPB83. Tais amostras sanguíneas foram coletadas em três diferentes momentos: no dia da execução do TIC e nos dias dia 7 e dia 21 após a execução do TIC. Os animais que foram positivos a este teste foram abatidos; exames de identificação do agente, tais como cultivo e PCR foram realizados post-mortem para confirmação da doença. Baseado na análise Kappa, IFN apresentou resultados estatisticamente comparáveis aos resultados de isolamento e identificação bacteriana por cultura e PCR, além do TIC ao longo de todo o experimento. No entanto, TIC, ELISA e IFN não foram estatisticamente comparáveis. Tais resultados sugeriram que nenhum dos atuais métodos de diagnóstico para tuberculose possibilitou a identificação de todos os animais infectados. Por este motivo, uma estratégia mais abrangente deveria incluir métodos de diagnóstico que pudessem identificar a resposta imune celular e humoral, uma vez que animais de um mesmo rebanho poderiam se encontrar em diferentes estágios da infecção.

Pfatp6 molecular profile of Plasmodium falciparum isolates in the western Brazilian Amazon.

BACKGROUND: Anti-malarial drug resistance has emerged as one of the biggest challenges confronting the worldwide effort to control malaria. The appearance of chloroquine and multi-drug resistance had devastating effects on therapeutic efficacy of former first-line agents. Artemisinin has proven to be an excellent therapeutic alternative to fill the void in chemotherapeutic options left by resistance mechanisms. At the time of introduction, no resistance to artemisinins had been recorded, and artemisinins demonstrated excellent parasite reduction rates. In an attempt to protect artemisinin efficacy, the World Health Organization (WHO) made artemisinin-based combination therapy (ACT) its official first-line treatment recommendation for uncomplicated Plasmodium falciparum in 2006. In Brazil, artemether/lumefantrine became the Brazilian Malaria Control Programme's official treatment recommendation in 2007. The sarco/endoplasmic reticulum Ca2+ - ATPase ortholog of P. falciparum (pfatp6) has been suggested as one of the targets of artemisinins. Consequently, pfatp6 gene polymorphisms are being investigated as markers of artemisinin resistance elsewhere. The goal of this work was to describe the molecular profile of pfatp6 in P. falciparum isolates from different localities in the Amazonas State. METHODS: DNA polymorphisms of the pfatp6 gene in 80 P. falciparum isolates from 11 municipalities of the Amazonas State (Western Brazilian Amazon), before and after the introduction of ACT in the Brazilian anti-malarial guidelines, were analysed by automatic sequencing. Mutations in the pfatp6 gene were searched using Mutation Surveyor v3.25 software. RESULTS: The P. falciparum pfatp6 gene presented polymorphisms at codons 37, 630 and 898. The R37K mutation was found in 16% of the samples, A630S in 32% and I898I in 52%. No S769N mutation, however, was detected in the analysed samples. CONCLUSION: Despite the small number of samples, data presented here provide baseline information about polymorphisms of pfatp6 gene before and after exposure to ACT in a low transmission area, which will help to infer drug selection pressure in this area in the future.

Estudo comparativo de métodos complementares para o diagnóstico da tuberculose bovina em animais reagentes à tuberculinização / Comparative study of complementary diagnostic methods of bovine tuberculosis on skin-test reactive cattle

A tuberculose bovina é uma enfermidade infecciosa de ocorrência mundial. O teste intradérmico é o método padrão para seu diagnóstico da tuberculose, embora possa carecer de sensibilidade e especificidade. O presente estudo teve como objetivo avaliar diferentes métodos complementares para o diagnóstico da tuberculose bovina incluindo os exames macroscópicos de tecidos, histopatológico, bacteriológico e ELISA. Um total de 97 bovinos reagentes à prova de tuberculinização foi testado, e amostras de tecidos e soro foram colhidas no momento do abate. Do total de bovinos examinados, 70 (72,16 por cento) apresentaram lesão macroscópica sugestiva de tuberculose. Na avaliação histopatológica, 63 animais (64,95 por cento) apresentaram lesão granulomatosa característica. Assim, a histopatologia concordou com a avaliação macroscópica em 92,78 por cento das amostras. Em 47 (48,45 por cento) amostras foram visualizados Bacilos Álcool Ácido Resistentes (BAAR), todas positivas à histopatologia ou à avaliação macroscópica.(ACom relação à cultura bacteriológica, foram isolados Mycobacterium bovis em apenas 11 amostras (11,34 por cento). Quanto ao desempenho do teste de ELISA, 33 (34,02 por cento) soros foram reativos. O exame macroscópico detalhado associado ao exame histopatológico, devido à sua alta especificidade, são recomendados como ferramentas complementares e podem ser utilizados para confirmar os casos duvidosos no abatedouro.

Bovine tuberculosis is an infectious disease of world-wide occurrence. The intradermal tuberculin test is the standard test for its detection, but it can lack both sensitivity and specificity. The purpose of this study was to compare the efficiency of different complementary methods for the diagnosis of bovine tuberculosis such as macroscopic, histopathological, bacteriological analysis and Enzyme-linked immunosorbent assay (ELISA). A total of 97 skin-test reactive animals were studied, and tissues and serum samples were collected from all of them at the moment of the slaughter. Seventy animals (72.16 percent) showed macroscopic lesions suggestive of tuberculosis. At the histopathological exam, sixty three (64.95 percent) presented typical granulomatous lesions. Therefore, histopathology agreed with macroscopic inspection in 92.78 percent of the samples. Acid-fast bacilli were observed in tissues samples from 47 (48.45 percent) animals, all of them also positive either at macroscopic inspection or to histopathology. In reference to the bacterial culture, only 11 (11.34 percent) tissues samples yielded Mycobacterium bovis. Thirty three (34.02 percent) serum samples were reactive at ELISA. Detailed visual inspection as well as histopathology, due to its high specificity, are suggested as complementary tools and may be used for confirming doubtful cases of bovine tuberculosis at the slaughterhouse.

An alternative for the preadsorption step in the paratuberculosis serodiagnosis: Mycobacterium fortuitum / Mycobacterium fortuitum: uma alternativa para a etapa de pré-adsorção no sorodiagnóstico da paratuberculose

ELISAs for paratuberculosis employ a preadsorption step with Mycobacterium phlei to diminish unspecific reactions As M. fortuitum is one of the most frequent environmental mycobacteria, the purpose of this pilot study was to evaluate its use as an alternative for the preadsorption in ELISAs for paratuberculosis. Results suggest that M. fortuitum can be an alternative instead of or associated to M. phlei with comparable results (κ > 0.8) to conventional ELISAs using M. phlei as a preadsorption antigen.

Ensaios de sorodiagnóstico de paratuberculose (ELISA) utilizam Mycobacterium phlei na etapa de pré-adsorção para diminuir reações inespecíficas. Uma vez que M. fortuitum é uma das micobactérias atípicas mais isoladas no Brasil, o objetivo central deste estudo foi averiguar a possibilidade de sua utilização como antígeno da etapa de pré-adsorção destes testes. Os resultados sugerem que M. fortuitum apresentou resultados comparáveis (κ > 0.8) aos alcançados com M. phlei e que, portanto poderia ser uma alternativa ao invés ou associado a M. phlei na etapa de pré-adsorção de ELISAs para paratuberculose.

Interference of tuberculosis on the performance of ELISAs used in the diagnosis of paratuberculosis in cattle

Forty-four cows from five herds infected with tuberculosis (TB) and without paratuberculosis (PTB), and 21 cows from a herd without either infection were studied. The cattle presented concordant results in both the skin test and gamma-interferon assay for TB and two commercial ELISAs for PTB. Animals were divided according to TB test results into Group A with 28 TB-infected animals, Group B with 16 TB-negative animals from infected herds, and Group C with 21 TB-negative cows from a tuberculosis-free herd (which were used as controls). Twenty of 28 animals from Group A (71.4 percent), 6/16 from Group B (37.5 percent) and none from Group C were reactive to PTB ELISAs, suggesting that these commercial kits were unable to distinguish between PTB and TB. It is proposed that natural occurring TB strongly interferes in the diagnosis of PTB and that commercial ELISAs cannot be considered reliable tools in the diagnosis of paratuberculosis in tuberculosis-infected herds.

Quarenta e quatro animais provenientes de cinco rebanhos infectados com tuberculose e livres de paratuberculose, e 21 animais provenientes de rebanhos livres de ambas as infecções foram analisados. Todos os animais foram testados para tuberculose pelo teste intradérmico de PPD-bovino e pelo ensaio comercial de Interferon-gama (IFN-gama). Para o diagnóstico de paratuberculose, dois ELISAs comerciais foram usados neste estudo. Os animais foram divididos em três grupos, de acordo com os resultados obtidos pelos testes diagnósticos para tuberculose. O grupo A foi composto por 28 animais com resultados positivos para tuberculose; o grupo B foi formado por 16 animais provenientes de rebanhos infectados com tuberculose, porém com resultados negativos nos testes diagnósticos para esta infecção. O grupo C foi composto por 21 animais provenientes de propriedades livres de ambas as doenças e que foram utilizados como grupo controle deste estudo. Vinte dos 28 animais do grupo A (71,4 por cento), 6/16 do grupo B (37,5 por cento) e nenhum animal do grupo C foram reativos aos ELISAs para diagnóstico de paratuberculose, o que demonstrou que os kits comerciais utilizados não são capazes de diferenciar entre ambas as doenças. Os resultados aqui obtidos sugerem que a ocorrência natural de tuberculose pode interferir no diagnóstico da paratuberculose e os ELISAs comerciais disponíveis não são seguros para utilização em rebanhos onde há tuberculose.

Comparison of an in-house and a commercial enzyme-linked immunosorbent assay (ELISA) for diagnosis of paratuberculosis

An in-house PPA-ELISA was compared to a commercial ELISA using a panel of 108 serum samples. In relation to commercial test, in-house assay presented 100 percent of sensitivity and 83.5 percent of specificity and a high concordance (kappa> 0.5), which demonstrates that the in-house assay is a valuable tool for use in developing countries.

Um teste ELISA in-house foi comparado a um teste comercial utilizando um painel de 108 soros. Em relação ao teste comercial, o ensaio in-house apresentou sensibilidade de 100 por cento, especificidade de 83,5 por cento e alta concordância (kapa>0,5), o que demonstra seu valor para uso em países em desenvolvimento.

Humoral response to HspX and GlcB to previous and recent infection by Mycobacterium tuberculosis.

BACKGROUND: Tuberculosis (TB) remains a major world health problem. Around 2 billions of people are infected by Mycobacterium tuberculosis, the causal agent of this disease. This fact accounts for a third of the total world population and it is expected that 9 million people will become infected each year. Only approximately 10% of the infected people will develop disease. However, health care workers (HCW) are continually exposed to the bacilli at endemic sites presenting increased chance of becoming sick. The objective of this work was to identify LTBI (latent tuberculosis infection) among all asymptomatic HCW of a Brazilian Central Hospital, in a three year follow up, and evaluate the humoral response among HCW with previous and recent LTBI to recombinant HspX and GlcB from M. tuberculosis. METHODS: Four hundred and thirty seven HCW were screened and classified into three different groups according to tuberculin skin test (TST) status: uninfected, previous LTBI and recent LTBI. ELISA test were performed to determine the humoral immune response to HspX and GlcB. RESULTS: The levels of IgG and IgM against the HspX and GlcB antigens were the same among HCW with recent and previous LTBI, as well as among non infected HCW. However, the IgM levels to HspX was significantly higher among HCW with recent LTBI (OD = 1.52 +/- 0.40) than among the uninfected (OD = 1.09 +/- 0.50) or subjects with previous LTBI (OD = 0.96 +/- 0.51) (p < 0.001). CONCLUSION: IgG and IgM humoral responses to GlcB antigens were similar amongst all studied groups; nevertheless IgM levels against HspX were higher among the recent LTBI/HCW.

Detection of Mycobacterium tuberculosis in sputum from Suruí Indian subjects, Brazilian Amazon

This investigation aimed at the detection of Mycobacterium tuberculosis (MTB) in the sputum of Suruí Indian subjects from Amazonia, Brazil. Polymerase chain reaction analyses were positive for12 samples, five of which were also culture-positive (N = 147). Four MTB genotypes were identified, one of which showed resistance to rifampicin and isoniazid. The study also highlighted one village complex as of particular importance, considering the relatively high number of tuberculosis cases reported and of MTB isolates obtained.

Improvement of an in-house ELISA for bovine paratuberculosis serology in Brazil

Paratuberculose (doenca de Johne) se caracteriza por uma enterite crônica de ruminantes, causada por Mycobacterium avium subesp. paratuberculosis (Map). O padrão ouro diagnóstico da infeccão é a cultura e isolamento do microrganismo a partir de tecidos ou fezes. No entanto, seu crescimento demora de três a cinco meses e a excrecão de Map em níveis detectáveis em cultura é irregular e não ocorre durante os primeiros estágios da infeccão, o que diminui seus níveis de sensibilidade. No Brasil, existem poucos relatos de seu isolamento. Os testes imunológicos mais comuns para a identificacão da infeccão são: Fixacão de complemento, imunodifusão em gel de agarose e ensaio imunoenzimático do tipo ELISA. No Brasil, kits comerciais ELISA de diagnóstico são importados e seu uso não está ainda aprovado. O objetivo deste estudo é melhorar um ensaio ELISA-PPA in-house previamente desenvolvido (10) e determinar sua sensibilidade e especificidade. Na primeira etapa deste estudo, as alteracões do protocolo original contribuíram para diminuir as variacões encontradas entre pocos na mesma placa e entre placas em experimentos diferentes, o que demonstrou uma maior estabilidade e reprodutibilidade do teste. Na segunda etapa, um painel de 106 amostras de soros foi testado pelo protocolo modificado do ELISA-PPA para estimar seus índices de sensibilidade e especificidade. O ensaio apresentou sensibilidade de 76,9 per center e especificidade de 70,0 per center. Nosso estudo demonstrou que este ensaio pode ser recomendado como uma valiosa ferramenta para diagnóstico e controle da paratuberculose no Brasil e em outros países em desenvolvimento.

Diagnosis of Enterocytozoon bieneusi by the polymerase chain reaction in archival fixed duodenal tissue.

This study involved ninety five formalin-fixed paraffin-embedded duodenal biopsy specimens retrieved from hospital files that were microscopically observed for the presence of microsporidia. Eleven samples that revealed compatible organisms were analyzed by the polymerase chain reaction (PCR) with four different protocols for the detection of Enterocytozoon bieneusi. Amplicons of the right size were obtained by at least one method for nine samples, remaining two negative ones. We report a PCR methodology that allows the use of archival specimens obtained for traditional pathology.

Comparison of serological methods for the diagnostic of Caprine arthritis-encephalitis (CAE) in Rio de Janeiro, Brazil

Soros de 562 caprinos foram submetidos à pesquisa de Artrite-encefalite caprina através dos testes de imunodifusão em gel de agarose (AGID) de teste imunoenzimático (ELISA). Das amostras testadas, 79 (14,1 per center) foram reativas em ambos os testes, mas 141 (25,1 per center) foram positivos apenas no ELISA. Assim, a sensibilidade do ELISA em relação ao AGID foi de 100 per center e a especificidade de 70,8 per center.

Sensitivity of amplicor mtb on direct detection of Mycobacterium tuberculosis in smear-negative specimens from outpatients in Rio de Janeiro

We evaluated the performance of the AMPLICOR MTB assay for detection of M. tuberculosis in clinical specimens obtained from 98 smear-negative tuberculous patients (43 with positive and 55 with negative culture results). The sensitivity of the AMPLICOR MTB was 44.9(per cent) (44/98) and that of culture was 43.8(per cent) (43/98). No significant difference was observed between the results obtained by AMPLICOR MTB and by culture. We conclude that amplification assays could be used for testing smear-negative specimens because a rapid diagnosis will benefit those patients.

Diagnostic detection of human immunodeficiency virus type 1 antibodies in urine: a brazilian study.

We evaluated, for the first time in Latin America, the performance of a commercial enzyme immunoassay (EIA) (Calypte Biomedical Corporation, Berkeley, Calif.) that detects human immunodeficiency virus type 1 (HIV-1)-specific antibodies in urine in comparison to standard serological assays (two commercial EIAs and a commercial Western blot [WB] assay). Paired serum and urine specimens were collected from two different groups of Brazilian patients: 225 drug users with unknown HIV status who attended drug treatment centers in Rio de Janeiro, Brazil, and 135 subjects with known HIV status. Patients showing positive results in the serum EIAs and/or in the urine EIA were serologically confirmed by WB assay. For 135 individuals with known HIV status, the urine EIA showed 100% sensitivity (74 positive samples) and 95.1% specificity (58 of 61 negative specimens). For 225 drug users, the test showed 100% sensitivity (2 positive samples) and 98.7% specificity (220 of 223 negative samples) compared to WB-confirmed serological EIA results. Thus, in a total of 360 samples, the urine EIA correctly identified all 76 HIV-positive samples and 278 of 284 negative samples (100% sensitivity and 97.9% specificity). Detailed analysis of the urine EIA results indicates that an increase of the recommended cutoff value might raise the specificity of the assay without affecting its sensitivity. Our results suggest that the HIV-1 urine EIA is a good screening test suitable for developing countries like Brazil. However, as for all other HIV screening tests on the market, it is not specific enough to be used as a one-step test and therefore requires confirmation.