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1.
Med Mycol ; 62(6)2024 Jun 27.
Article in English | MEDLINE | ID: mdl-38935909

ABSTRACT

The World Health Organization, in response to the growing burden of fungal disease, established a process to develop a fungal pathogen priority list. This systematic review aimed to evaluate the epidemiology and impact of infections caused by Talaromyces marneffei, Coccidioides species, and Paracoccidioides species. PubMed and Web of Sciences databases were searched to identify studies published between 1 January 2011 and 23 February 2021 reporting on mortality, complications and sequelae, antifungal susceptibility, preventability, annual incidence, and trends. Overall, 25, 17, and 6 articles were included for T. marneffei, Coccidioides spp. and Paracoccidioides spp., respectively. Mortality rates were high in those with invasive talaromycosis and paracoccidioidomycosis (up to 21% and 22.7%, respectively). Hospitalization was frequent in those with coccidioidomycosis (up to 84%), and while the duration was short (mean/median 3-7 days), readmission was common (38%). Reduced susceptibility to fluconazole and echinocandins was observed for T. marneffei and Coccidioides spp., whereas >88% of T. marneffei isolates had minimum inhibitory concentration values ≤0.015 µg/ml for itraconazole, posaconazole, and voriconazole. Risk factors for mortality in those with talaromycosis included low CD4 counts (odds ratio 2.90 when CD4 count <200 cells/µl compared with 24.26 when CD4 count <50 cells/µl). Outbreaks of coccidioidomycosis and paracoccidioidomycosis were associated with construction work (relative risk 4.4-210.6 and 5.7-times increase, respectively). In the United States of America, cases of coccidioidomycosis increased between 2014 and 2017 (from 8232 to 14 364/year). National and global surveillance as well as more detailed studies to better define sequelae, risk factors, outcomes, global distribution, and trends are required.


Subject(s)
Antifungal Agents , Coccidioides , Paracoccidioides , Talaromyces , World Health Organization , Talaromyces/isolation & purification , Talaromyces/classification , Talaromyces/drug effects , Humans , Paracoccidioides/isolation & purification , Paracoccidioides/drug effects , Paracoccidioides/classification , Antifungal Agents/pharmacology , Antifungal Agents/therapeutic use , Coccidioides/isolation & purification , Coccidioides/classification , Coccidioides/drug effects , Mycoses/epidemiology , Mycoses/microbiology , Mycoses/mortality , Paracoccidioidomycosis/epidemiology , Paracoccidioidomycosis/microbiology , Paracoccidioidomycosis/drug therapy , Coccidioidomycosis/epidemiology , Coccidioidomycosis/microbiology , Microbial Sensitivity Tests
2.
Mycopathologia ; 188(1-2): 129-133, 2023 Apr.
Article in English | MEDLINE | ID: mdl-36633737

ABSTRACT

Paracoccidioidomycosis (PCM) defines a broad spectrum of human and animal diseases caused by Paracoccidioides species (Onygenales). In the twenty-first century, Paracoccidioides advanced from a monotypic taxon to a genus that harbors seven species, including P. brasiliensis sensu stricto, P. americana, P. restrepiensis, P. venezuelensis, P. lutzii, P. loboi, and P. cetii. Classic PCM, acquired upon inhalation of propagules from P. brasiliensis sensu stricto, P. americana, P. restrepiensis, P. venezuelensis, and P. lutzii, affects the human lungs and may progress to systemic granulomatous disease with tegumentary and visceral involvement. On the other hand, PCM loboi and PCM ceti caused by the unculturable P. loboi and P. cetii are subcutaneous mycoses, typically observed as keloid lesions in humans and dolphins. Such heterogeneity highlights the importance of recognizing species boundaries in Paracoccidioides to gain insights into the ecology, evolution, clinical features, and mitigation strategies to tackle the advance of PCM.


Subject(s)
Paracoccidioides , Paracoccidioidomycosis , Animals , Humans , Dolphins/microbiology , Genomics , Paracoccidioides/classification , Paracoccidioides/genetics , Paracoccidioides/isolation & purification , Paracoccidioidomycosis/diagnosis , Paracoccidioidomycosis/epidemiology , Paracoccidioidomycosis/immunology , Paracoccidioidomycosis/microbiology , Phylogeny
3.
PLoS Negl Trop Dis ; 15(11): e0009956, 2021 11.
Article in English | MEDLINE | ID: mdl-34843484

ABSTRACT

INTRODUCTION: Paracoccidioidomycosis (PCM) is caused by several species of the Paracoccidioides genus which can be differentiated by interspecific genetic variations, morphology and geographic distribution. Intraspecific variability correlation with clinical and epidemiological aspects of these species still remains unclear. This study aimed to sequence the loci GP43, exon 2 and ARF of 23 clinical isolates of Paracoccidioides spp. from patients in the Southeast Region of Brazil. METHODOLOGY AND MAIN FINDINGS: GenBank was used to compare the present (23) with previous described sequences (151) that included ARF and GP43. It was identified a high polymorphism rate among the 23 isolates in comparison to the other 151. Among the isolates, 22 (95.66%) were S1/P. brasiliensis and 1 (4.34%) was identified as PS2/P. americana. A total of 45 haplotypes were found as follows: 19 from S1/P. brasiliensis (13 from the present study), 15 from P. lutzii, 6 from PS2/P. americana (1 from the present study), 3 from PS3/P. restrepiensis and 2 from PS4/P. venezuelensis. Moreover, exclusive haplotypes according to clinical origin and geographical area were found. S1/P. brasiliensis (HD = 0.655 and K = 4.613) and P. lutzii (HD = 0.649 and K = 2.906) presented the highest rate of polymorphism among all species, from which 12 isolates of the present study were clustered within S1b/P. brasiliensis. The GP43 locus showed a higher variability and was found to be the main reason for the species differentiation. CONCLUSIONS: The results herein decribed show a high intraspecific genetic variability among S1/P. brasiliensis isolates and confirm the predominance of this species in the Southeast region of Brazil. The finding of exclusive haplotypes according to clinical origin and geographical area would suggest correlation between the molecular profile with the clinical form and geographic origin of patients with PCM.


Subject(s)
Paracoccidioides/genetics , Paracoccidioidomycosis/microbiology , Adolescent , Adult , Brazil/epidemiology , Child , Child, Preschool , Female , Genetic Variation , Hospitals, Teaching/statistics & numerical data , Humans , Infant , Male , Middle Aged , Molecular Epidemiology , Paracoccidioides/classification , Paracoccidioides/isolation & purification , Paracoccidioidomycosis/epidemiology , Phylogeny , Young Adult
4.
PLoS Negl Trop Dis ; 15(4): e0009317, 2021 04.
Article in English | MEDLINE | ID: mdl-33826630

ABSTRACT

BACKGROUND: Paracoccidioidomycosis (PCM) is a systemic and endemic fungal infection in Latin American, mainly in Brazil. The majority of PCM cases occur in large areas in Brazil, comprising the South, Southeast and Midwest regions, with the latter demonstrating a higher incidence of the species Paracoccidioides lutzii. METHODOLOGY AND MAIN FINDINGS: This study presents clinical, molecular and serological data of thirteen new PCM cases during 2016 to 2019 from the state of Mato Grosso do Sul, located in the Midwest region, Brazil. From these thirteen cases, sixteen clinical isolates were obtained and their genomic DNAs were subjected to genotyping by tub1 -PCR-RFLP. Results showed Paracoccidioides brasiliensis sensu stricto (S1) (11/16; 68.8%), Paracoccidioides restrepiensis (PS3) (4/16; 25.0%) and P. lutzii (1/16; 6.2%) as Paracoccidiodes species. Therefore, in order to understand whether the type of phylogenetic species that are circulating in the state influence the reactivity profile of serological tests, we performed double agar gel immunodiffusion (DID), using exoantigens from genotyped strains found in this series of PCM cases. Overall, our DID tests have been false negative in about 30% of confirmed PCM cases. All patients were male, most with current or previous rural activity, with ages ranging from 17 to 59 years, with 11 patients (84.6%) over 40 years of age. No clinical or epidemiological differences were found between Paracoccidioides species. However, it is important to note that the only case of P. lutzii died as an outcome. CONCLUSIONS: This study suggests P. brasiliensis sensu stricto (S1) as the predominant species, showing its wide geographic distribution in Brazil. Furthermore, our findings revealed, for the first time, the occurrence of P. restrepiensis (PS3) in the state of Mato Grosso do Sul, Brazil. Despite our setbacks, it would be interesting to provide the complete sequencing of these clinical isolates to complement the molecular information presented.


Subject(s)
Antigens, Fungal/immunology , Paracoccidioides/immunology , Paracoccidioidomycosis/immunology , Paracoccidioidomycosis/microbiology , Adolescent , Adult , Antibodies, Fungal/immunology , Brazil/epidemiology , Humans , Male , Middle Aged , Molecular Epidemiology , Paracoccidioides/classification , Paracoccidioides/isolation & purification , Paracoccidioidomycosis/diagnosis , Polymerase Chain Reaction , Polymorphism, Restriction Fragment Length , Serotyping , Young Adult
5.
J Med Microbiol ; 70(1)2021 Jan.
Article in English | MEDLINE | ID: mdl-33258768

ABSTRACT

Introduction. Paracoccidioidomycosis (PCM) is a systemic mycosis caused by Paracoccidioides spp. As the disease is known to affect mostly men over 40 years old who previously worked handling soil, some cities of agricultural economy in endemic regions may have more cases of paracoccidioidal infection.Gap statement. The true frequency of PCM cannot be established in Brazil because it is not a disease of mandatory reporting. The detection of paracoccidioidal infection may assist in the planning of health services, in order to provide early detection of the disease and to prevent its worsening or even progression to death. In addition, little is described about sera reactivity with antigens from different species of Paracoccidiodes, especially P. lutzii.Aim. Current research was conducted in an inland municipality of southern Brazil, in order to assess infection rate within this endemic region of PCM disease.Methodology. ELISA was employed to evaluate 359 sera from random volunteers from Guarapuava, Paraná, Brazil, to detect IgG against cell-free antigens (CFA) from P. restrepiensis B339, P. americana LDR3 and P. lutzii LDR2. Confirmatory ELISA employed gp43 from B339. Reduction of cross-reactions was sought by treatment with sodium metaperiodate (SMP-CFA, SMP-gp43). Immunoblot was performed with 37 selected sera among those reactive in ELISA. Epidemiological profile was assessed by questionnaire.Results. ELISA reactivity was: CFA/SMP-CFA in general 37.3/17.8 %, B339 25.3/14.5 %, LDR3 24.5/1.4 %, LDR2 8.3/5.8 %; gp43/SMP-gp43 7.2/4.7 %. There were sera reactive with multiple CFAs. In immunoblot, five sera showed the same reaction profile with P. lutzii's antigens as PCM disease sera. Rural residence and soil-related professions were risk factors for paracoccidioidal infection.Conclusion. The low prevalence is in accordance with previous reports of lower PCM disease endemicity in Guarapuava than in other areas of Paraná. Although P. brasiliensis seems to be the prevalent strain of the region, 21 sera from people who only lived in Guarapuava reacted with P. lutzii LDR2. CFA-ELISA with whole antigens seems a good option for serological screening in epidemiological surveys.


Subject(s)
Antibodies, Fungal/blood , Antigens, Fungal/blood , Carrier State/blood , Immunoglobulin G/blood , Paracoccidioides/immunology , Paracoccidioidomycosis/blood , Adult , Aged , Aged, 80 and over , Brazil/epidemiology , Carrier State/epidemiology , Carrier State/microbiology , Enzyme-Linked Immunosorbent Assay , Humans , Male , Middle Aged , Paracoccidioides/classification , Paracoccidioides/genetics , Paracoccidioides/isolation & purification , Paracoccidioidomycosis/epidemiology , Paracoccidioidomycosis/microbiology , Young Adult
6.
Article in English | MEDLINE | ID: mdl-33206863

ABSTRACT

Paracoccidioidomycosis caused by Paracoccidioides lutzii is endemic in the Midwest of Brazil and its clinical spectrum is still little known due to the recent identification of this fungal species. A patient resident in Southeast Brazil, but who had lived for many years in the Midwest region, presented with skin injuries, chronic cough and bilateral adrenal involvement. Paracoccidioides spp. was isolated in culture from a skin lesion biopsy. This isolate was later identified as P. lutzii using gene sequencing. A favorable initial response to treatment with itraconazole was observed, but a few weeks later, the patient developed respiratory failure and worsening of lung lesions. Evaluation by computed tomography and echocardiography were suggestive of pulmonary arterial hypertension, and a bronchoscopic biopsy showed peribronchial remodeling. The patient completed the antifungal treatment but maintained the respiratory dysfunction. The reported case shows that P. lutzii can be isolated from patients in a geographic area far from the place of infection acquisition and that, as P. brasiliensis , it can cause adrenal injury and cardio-respiratory complications as a consequence of excessive necrosis and fibrosis.


Subject(s)
Paracoccidioides/isolation & purification , Paracoccidioidomycosis , Brazil , Humans , Itraconazole/therapeutic use , Paracoccidioides/classification , Paracoccidioidomycosis/complications , Paracoccidioidomycosis/diagnosis , Paracoccidioidomycosis/drug therapy , Pulmonary Arterial Hypertension
7.
Fungal Genet Biol ; 140: 103395, 2020 07.
Article in English | MEDLINE | ID: mdl-32325168

ABSTRACT

Paracoccidioidomycosis (PCM) is a life-threatening systemic mycosis widely reported in the Gran Chaco ecosystem. The disease is caused by different species from the genus Paracoccidioides, which are all endemic to South and Central America. Here, we sequenced and analyzed 31 isolates of Paracoccidioides across South America, with particular focus on isolates from Argentina and Paraguay. The de novo sequenced isolates were compared with publicly available genomes. Phylogenetics and population genomics revealed that PCM in Argentina and Paraguay is caused by three distinct Paracoccidioides genotypes, P. brasiliensis (S1a and S1b) and P. restrepiensis (PS3). P. brasiliensis S1a isolates from Argentina are frequently associated with chronic forms of the disease. Our results suggest the existence of extensive molecular polymorphism among Paracoccidioides species, and provide a framework to begin to dissect the connection between genotypic differences in the pathogen and the clinical outcomes of the disease.


Subject(s)
Genetic Variation/genetics , Genomics , Paracoccidioides/genetics , Paracoccidioidomycosis/genetics , Argentina/epidemiology , Ecosystem , Genetics, Population , Genome, Fungal/genetics , Genotype , Humans , Paracoccidioides/classification , Paracoccidioides/pathogenicity , Paracoccidioidomycosis/classification , Paracoccidioidomycosis/epidemiology , Paracoccidioidomycosis/microbiology , Paraguay/epidemiology , Phylogeny
8.
mBio ; 11(6)2020 12 22.
Article in English | MEDLINE | ID: mdl-33443110

ABSTRACT

The fungus Paracoccidioides is a prevalent human pathogen endemic to South America. The genus is composed of five species. In this report, we use 37 whole-genome sequences to study the allocation of genetic variation in Paracoccidioides We tested three genome-wide predictions of advanced speciation, namely, that all species should be reciprocally monophyletic, that species pairs should be highly differentiated along the whole genome, and that there should be low rates of interspecific gene exchange. We find support for these three hypotheses. Species pairs with older divergences show no evidence of gene exchange, while more recently diverged species pairs show evidence of modest rates of introgression. Our results indicate that as divergence progresses, species boundaries become less porous among Paracoccidioides species. Our results suggest that species in Paracoccidioides are at different stages along the divergence continuum.IMPORTANCEParacoccidioides is the causal agent of a systemic mycosis in Latin America. Most of the inference of the evolutionary history of Paracoccidioides has used only a few molecular markers. In this report, we evaluate the extent of genome divergence among Paracoccidioides species and study the possibility of interspecific gene exchange. We find that all species are highly differentiated. We also find that the amount of gene flow between species is low and in some cases is even completely absent in spite of geographic overlap. Our study constitutes a systematic effort to identify species boundaries in fungal pathogens and to determine the extent of gene exchange among fungal species.


Subject(s)
Gene Flow , Genome, Fungal , Paracoccidioides/classification , Paracoccidioides/genetics , Evolution, Molecular , Paracoccidioides/pathogenicity , Phylogeny , Sequence Analysis, DNA , Whole Genome Sequencing
10.
PLoS Negl Trop Dis ; 13(6): e0007437, 2019 06.
Article in English | MEDLINE | ID: mdl-31163028

ABSTRACT

BACKGROUND: The fungus Paracoccidioides lutzii was recently included as a new causative species of paracoccidioidomycosis (PCM) and most cases have been reported from Brazil. According to available epidemiological information, P. lutzii is concentrated in the Middle-West region in Brazil, mainly in the state of Mato Grosso. However, clinical and laboratorial data available on patients infected with P. lutzii remain extremely limited. METHODOLOGY/MAIN FINDINGS: This work describes the clinical manifestations of 34 patients suffering from PCM caused by P. lutzii, treated along 5 years (2011-2017) at a reference service center for systemic mycoses in Mato Grosso, Brazil. Adult rural workers (men), aged between 28 and 67 predominated. All patients had the chronic form of the disease, and the oral mucosa (n = 19; 55.9%), lymph nodes (n = 23; 67.7%), skin (n = 16; 47.1%) and lung (n = 28; 82.4%) were the most affected sites. Alcohol intake (n = 19; 55.9%) and smoking (n = 29; 85.3%) were frequent habits among the patients. No patient suffered from any other life-threatening disease, such as tuberculosis, cancer or other inflammatory or infectious parasitic diseases. The positivity in culture examination (97.1%) was higher than that found for the direct mycological examination (88.2%). Particularly, one patient presented fungemia at diagnosis, which lead to his death. The time elapsed between the initial symptoms and the initiation of treatment of PCM caused by P. lutzii was 19.7 (31.5) months, with most patients diagnosed 7 months after the symptoms' onset. CONCLUSIONS/SIGNIFICANCE: Compared with the classical clinical-epidemiological profile of PCM caused by P. brasiliensis, the results of this descriptive study did not show significant clinical or epidemiological differences that could be attributed to the species P. lutzii. Future studies may confirm or refute the existence of clinical differences between the two fungal species.


Subject(s)
Paracoccidioides/classification , Paracoccidioides/isolation & purification , Paracoccidioidomycosis/epidemiology , Paracoccidioidomycosis/pathology , Adult , Aged , Brazil , Chronic Disease/epidemiology , Female , Humans , Lung/pathology , Lymph Nodes/pathology , Male , Middle Aged , Mouth Mucosa/pathology , Paracoccidioidomycosis/microbiology
12.
PLoS Negl Trop Dis ; 13(4): e0007309, 2019 04.
Article in English | MEDLINE | ID: mdl-30986220

ABSTRACT

INTRODUCTION: The agents of paracoccidioidomycosis, historically identified as Paracoccidioides brasiliensis, are in fact different phylogenetic species. This study aims to evaluate associations between Paracoccidioides phylogenetic species and corresponding clinical data. METHODS: Paracoccidioides strains from INI/Fiocruz patients (1998-2016) were recovered. Socio-demographic, epidemiological, clinical, serological, therapeutic and prognostic data of the patients were collected to evaluate possible associations of these variables with the fungal species identified through partial sequencing of the ADP-ribosylation factor (arf) and the 43-kDa-glycoprotein (gp43) genes. RESULTS: Fifty-four fungal strains were recovered from 47 patients, most (72.3%) infected in Rio de Janeiro state, Brazil. Forty-one cases were caused by Paracoccidioides brasiliensis and six by Paracoccidioides americana (former PS2). P. brasiliensis was responsible for severe lymph abdominal forms, whereas patients infected with P. americana presented a high rate of adrenal involvement. However, no statistically significant associations were found for all variables studied. P. americana presented 100% reactivity to immunodiffusion, even when tested against antigens from other species, while negative results were observed in 9 (20%) cases caused by P. brasiliensis, despite being tested against a homologous antigen. CONCLUSIONS: P. brasiliensis and P. americana are sympatric and share similar clinical features and habitat, where they may compete for similar hosts.


Subject(s)
Genetic Background , Paracoccidioides/classification , Paracoccidioides/genetics , Paracoccidioidomycosis/microbiology , Paracoccidioidomycosis/pathology , Sympatry , ADP-Ribosylation Factors/genetics , Adult , Antigens, Fungal/genetics , Brazil , Female , Fungal Proteins/genetics , Glycoproteins/genetics , Humans , Male , Middle Aged , Paracoccidioides/isolation & purification , Sequence Analysis, DNA
14.
Article in English | MEDLINE | ID: mdl-30348661

ABSTRACT

Paracoccidioidomycosis (PCM), caused by Paracoccidioides, is a systemic mycosis with granulomatous character and a restricted therapeutic arsenal. The aim of this work was to search for new alternatives to treat largely neglected tropical mycosis, such as PCM. In this context, the enzymes of the shikimate pathway constitute excellent drug targets for conferring selective toxicity because this pathway is absent in humans but essential for the fungus. In this work, we have used a homology model of the chorismate synthase (EC 4.2.3.5) from Paracoccidioides brasiliensis (PbCS) and performed a combination of virtual screening and molecular dynamics testing to identify new potential inhibitors. The best hit, CP1, successfully adhered to pharmacological criteria (adsorption, distribution, metabolism, excretion, and toxicity) and was therefore used in in vitro experiments. Here we demonstrate that CP1 binds with a dissociation constant of 64 ± 1 µM to recombinant chorismate synthase from P. brasiliensis and inhibits enzymatic activity, with a 50% inhibitory concentration (IC50) of 47 ± 5 µM. As expected, CP1 showed no toxicity in three cell lines. On the other hand, CP1 reduced the fungal burden in lungs from treated mice, similar to itraconazole. In addition, histopathological analysis showed that animals treated with CP1 displayed less lung tissue infiltration, fewer yeast cells, and large areas with preserved architecture. Therefore, CP1 was able to control PCM in mice with a lower inflammatory response and is thus a promising candidate and lead structure for the development of drugs useful in PCM treatment.


Subject(s)
Antifungal Agents/pharmacology , Drug Discovery/methods , Paracoccidioides/drug effects , Paracoccidioidomycosis/drug therapy , Phosphorus-Oxygen Lyases/antagonists & inhibitors , Quinolines/pharmacology , Amino Acid Sequence , Animals , Cell Line, Tumor , Disease Models, Animal , HeLa Cells , Human Umbilical Vein Endothelial Cells , Humans , Itraconazole/pharmacology , Male , Mice , Mice, Inbred BALB C , Microbial Sensitivity Tests , Microscopy, Electron, Scanning , Molecular Dynamics Simulation , Paracoccidioides/classification , Paracoccidioides/isolation & purification , Pulmonary Fibrosis/drug therapy , Pulmonary Fibrosis/microbiology , Sequence Analysis, Protein
15.
An. bras. dermatol ; 93(6): 902-904, Nov.-Dec. 2018. graf
Article in English | LILACS | ID: biblio-1038284

ABSTRACT

Abstract: Molecular studies have shown more than one species of the genus Paracoccidioides to be the causal agent of paracoccidioidomycosis. Efforts have been made to correlate the identified species with epidemiological and clinical data of patients, aiming to determine the real meaning and impact of new species. Bearing this objective in mind, the authors report a clinical case of paracoccidioidomycosis, from São Paulo state, Brazil, that manifested as uncommon sarcoid-like cutaneous lesions and was caused by Paracoccidioides brasiliensis sensu stricto (S1a). The patient was treated with itraconazole 200mg/day for 12 months, with complete clinical remission.


Subject(s)
Humans , Male , Middle Aged , Paracoccidioides/classification , Paracoccidioidomycosis/diagnosis , Paracoccidioidomycosis/microbiology , Sarcoidosis/diagnosis , Paracoccidioides/isolation & purification , Paracoccidioidomycosis/drug therapy , Itraconazole/therapeutic use , Diagnosis, Differential , Antifungal Agents/therapeutic use
16.
An Bras Dermatol ; 93(6): 902-904, 2018.
Article in English | MEDLINE | ID: mdl-30484542

ABSTRACT

Molecular studies have shown more than one species of the genus Paracoccidioides to be the causal agent of paracoccidioidomycosis. Efforts have been made to correlate the identified species with epidemiological and clinical data of patients, aiming to determine the real meaning and impact of new species. Bearing this objective in mind, the authors report a clinical case of paracoccidioidomycosis, from São Paulo state, Brazil, that manifested as uncommon sarcoid-like cutaneous lesions and was caused by Paracoccidioides brasiliensis sensu stricto (S1a). The patient was treated with itraconazole 200mg/day for 12 months, with complete clinical remission.


Subject(s)
Paracoccidioides/classification , Paracoccidioidomycosis/diagnosis , Paracoccidioidomycosis/microbiology , Sarcoidosis/diagnosis , Antifungal Agents/therapeutic use , Diagnosis, Differential , Humans , Itraconazole/therapeutic use , Male , Middle Aged , Paracoccidioides/isolation & purification , Paracoccidioidomycosis/drug therapy
17.
Mycoses ; 61(11): 826-832, 2018 Nov.
Article in English | MEDLINE | ID: mdl-29938841

ABSTRACT

Since the new species Paracoccidioides lutzii emerged in 2009, much has been researched on strains previously considered atypical. Still, there is no consensus about recognition of antigens from P. lutzii by antibodies directed to other Paracoccidioides species, which can have great impact on Paracoccidioidomycosis (PCM) diagnosis. Current research investigated soluble protein/carbohydrate epitopes from P. lutzii LDR2, Paracoccidioides restrepiensis B339 and Paracoccidioides americana LDR3 recognised by IgG directed to Paracoccidioides brasiliensis. Cell free antigens (CFA) were analysed by: (a)silver and periodic acid-Schiff staining of SDS-PAGE; (b)immunoblot (IB) with rabbit IgG anti-P. brasiliensis Pb18; (c)IB and ELISA with a pool of PCM patients' sera before and after treatment with sodium metaperiodate (SMP) to oxidise carbohydrate epitopes. Both rabbit and human immune sera recognised several antigens of P. lutzii LDR2, P. restrepiensis B339 and P. americana LDR3. P. lutzii's gp43 was not observed in IB or silver/PAS staining. SMP treatment affected reactions with all 3 CFAs, but more intensely with antigens from P. lutzii LDR2. In conclusion, antibodies directed to P. brasiliensis recognised antigens from P. lutzii LDR2. The use of any of the recognised antigens in a broad spectrum diagnostic model for Paracoccidioides species complex needs to be further investigated.


Subject(s)
Antibodies, Fungal/immunology , Antigens, Fungal/immunology , Paracoccidioides/isolation & purification , Paracoccidioidomycosis/microbiology , Animals , Antibodies, Fungal/analysis , Antigens, Fungal/analysis , Enzyme-Linked Immunosorbent Assay , Female , Humans , Immunoblotting , Male , Paracoccidioides/classification , Paracoccidioides/genetics , Paracoccidioides/immunology , Paracoccidioidomycosis/diagnosis , Rabbits
18.
Medicina (B Aires) ; 78(3): 180-184, 2018.
Article in Spanish | MEDLINE | ID: mdl-29940544

ABSTRACT

Paracoccidioidomycosis (PCM) is among the systemic mycoses which are endemic only in Latin America. In Argentina, the vast majority of the cases are reported at north of latitude 34.5° S. The disease is produced by thermodimorphic fungi of the genus Paracoccidoides: P. brasiliensis (S1), P. americana (PS2), P. restrepiensis (PS3), P. venezuelensis (PS4) y P. lutzii. The natural habitat of members of this genus is the soil, where they produce infectious conidia. Little is known, however, about their specific ecologic niche(s), and this knowledge gap hampers the design of measures to control the infection. Rural male workers are the group most at risk of developing PCM. Infection occurs by inhalation of aerosolized conidia and may either be asymptomatic or cause mild respiratory symptoms. In turn, this primary infection may be self-limited or progress to severe pulmonary or disseminated disease. The disease has two clinical presentations: (i) acute or subacute (juvenile), frequent in children, adolescents and people with immunodeficiencies; and (ii) chronic progressive, in adults. Active lesions often resolve into fibrotic scars which can cause dysphagia, dysphonia, adrenal insufficiency, and intestinal obstruction. Although efficient tools are available for diagnosis and treatment, the nonspecific nature of PCM clinical manifestations frequently delay the diagnosis. In addition, the poor adherence to long antifungal treatments allows the advance of the disease and the development of extensive fibrosis compromising severely and permanently respiratory and adrenal functions, thus altering the patient"s quality of life and even causing his/her death.


Subject(s)
Neglected Diseases , Paracoccidioides/classification , Paracoccidioidomycosis , Humans , Paracoccidioidomycosis/diagnosis , Paracoccidioidomycosis/parasitology , Paracoccidioidomycosis/therapy
19.
Medicina (B.Aires) ; 78(3): 180-184, jun. 2018. ilus
Article in Spanish | LILACS | ID: biblio-954974

ABSTRACT

La paracoccidioidomicosis (PCM) es una de las micosis sistémicas que son endémicas exclusivamente en América Latina. Está causada por hongos termodimorfos del género Paracoccidoides: P. brasiliensis (S1), P. americana (PS2), P. restrepiensis (PS3), P. venezuelensis (PS4) y P. lutzii. Paracoccidioides habita y produce conidios infecciosos en suelos de zonas subtropicales húmedas. En Argentina está presente al norte del paralelo 34.5° S. Poco se sabe sobre su nicho ecológico específico, lo que dificulta el diseño de medidas de control de la PCM. La infección ocurre en hospederos susceptibles cuando inhalan conidios aerosolizados. Los trabajadores rurales varones son el grupo más expuesto a contraer PCM. La primoinfección puede ser asintomática o causar un cuadro respiratorio leve; este, a su vez, puede autolimitarse o progresar a enfermedad, ya sea pulmonar o diseminada. Existen dos formas de presentación: (i) aguda/subaguda, en niños, adolescentes y personas con sistemas inmunes comprometidos; y (ii) crónica progresiva, en adultos. La cicatrización de las lesiones resulta en secuelas fibróticas que pueden causar disfagia, disfonía, insuficiencia suprarrenal y obstrucción intestinal. Aunque existen herramientas para su diagnóstico, la PCM es rara vez sospechada precozmente porque sus manifestaciones clínicas iniciales son inespecíficas. Sumados, el diagnóstico tardío y la baja adherencia a los efectivos pero largos tratamientos antimicóticos permiten el avance de la enfermedad y el desarrollo de fibrosis tisular extensa, lo que compromete gravemente la función respiratoria y suprarrenal, altera permanentemente la calidad de vida del paciente y puede causar su muerte.


Paracoccidioidomycosis (PCM) is among the systemic mycoses which are endemic only in Latin America. In Argentina, the vast majority of the cases are reported at north of latitude 34.5° S. The disease is produced by thermodimorphic fungi of the genus Paracoccidoides: P. brasiliensis (S1), P. americana (PS2), P. restrepiensis (PS3), P. venezuelensis (PS4) y P. lutzii. The natural habitat of members of this genus is the soil, where they produce infectious conidia. Little is known, however, about their specific ecologic niche(s), and this knowledge gap hampers the design of measures to control the infection. Rural male workers are the group most at risk of developing PCM. Infection occurs by inhalation of aerosolized conidia and may either be asymptomatic or cause mild respiratory symptoms. In turn, this primary infection may be self-limited or progress to severe pulmonary or disseminated disease. The disease has two clinical presentations: (i) acute or subacute (juvenile), frequent in children, adolescents and people with immunodeficiencies; and (ii) chronic progressive, in adults. Active lesions often resolve into fibrotic scars which can cause dysphagia, dysphonia, adrenal insufficiency, and intestinal obstruction. Although efficient tools are available for diagnosis and treatment, the nonspecific nature of PCM clinical manifestations frequently delay the diagnosis. In addition, the poor adherence to long antifungal treatments allows the advance of the disease and the development of extensive fibrosis compromising severely and permanently respiratory and adrenal functions, thus altering the patient´s quality of life and even causing his/her death.


Subject(s)
Humans , Paracoccidioides/classification , Paracoccidioidomycosis/diagnosis , Paracoccidioidomycosis/parasitology , Paracoccidioidomycosis/therapy , Neglected Diseases
20.
Med Mycol ; 56(8): 950-962, 2018 Nov 01.
Article in English | MEDLINE | ID: mdl-29325170

ABSTRACT

Paracoccidioides brasiliensis and the related species P. americana, P. restrepiensis, P. venezuelensis, and P. lutzii (Ascomycota, Ajellomycetaceae) are the etiological agents of paracoccidoidoimycosis (PCM), one of the most important systemic mycoses in Latin America. They are dimorphic fungi, with a mycelial life cycle in soil and a yeast phase associated with tissues of mammalian hosts. This study aimed to detect Paracoccidioides spp. in armadillo tissues and associated soil samples in three well-defined geographic areas, including the Alta Floresta, an area not only endemic for PCM in the central region of Brazil but also of probable P. lutzii occurrence, whose ecology and geographic distribution are poorly elucidated. The isolates were genotyped by sequencing ITS-rDNA and the gp43-exon-2 region, and by PCR-RFLP of alpha tubulin (tub1) gene; mycological aspects such as yeast-to-mycelial transition, growth and conidial production in soil extract agar were also evaluated. We confirmed that while armadillos are highly infected by P. brasiliensis, including multiple infections by distinct genotypes or species (P. brasiliensis and P. americana) in the same animal, the same does not hold true for P. lutzii, which in turn seems to present less capacity for mycelial growth and conidial production, when developing in a soil-related condition.


Subject(s)
Armadillos/microbiology , Genetic Variation , Paracoccidioides/isolation & purification , Paracoccidioidomycosis/veterinary , Soil Microbiology , Animals , Antigens, Fungal/genetics , Brazil , Cluster Analysis , DNA, Fungal/chemistry , DNA, Fungal/genetics , DNA, Ribosomal Spacer/chemistry , DNA, Ribosomal Spacer/genetics , Female , Fungal Proteins/genetics , Genotype , Glycoproteins/genetics , Male , Microbiological Techniques , Paracoccidioides/classification , Paracoccidioides/genetics , Paracoccidioides/physiology , Paracoccidioidomycosis/microbiology , Phylogeny , Sequence Analysis, DNA , Tubulin/genetics
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