Prevalence and risk factors of anemia in the mother-child population from a region of the Colombian Caribbean.

BACKGROUND: Despite Colombia's robust well-child visits program, Colombian children and mothers still suffer from anemia, especially in populations of lower socioeconomic status. In this study, we aimed to quantify the prevalence and risk factors among mothers and their children attending their well-child visits in Apartadó, a municipality in the Urabá region of the Colombian Caribbean. METHODS: There were 100 mother-child pairs enrolled in this secondary data-analysis study from a health facility in the municipality of Apartadó, Urabá, Colombia, during well-child visits. Self-reported data included child illnesses in the past two weeks (diarrheal, fever, or respiratory symptoms), child feeding practices (breastfeeding, complementary feeding), child vaccinations, and demographic characteristics (mother's and child's age, mother's education, marital status, race, and child sex) and socioeconomic status. Mother and child anthropometry data were collected via standardized weight and height measurements. Mother or child anemia status was collected via a blood test. Chi-squared tests and multivariable logistic regression were used to assess associations between risk factors and anemia. RESULT: The anemia prevalence in children (74%) and mothers (47%) was higher than the Colombian national prevalence. Reported child comorbidities in the preceding two weeks were not significantly associated with child anemia and included respiratory illnesses (60%), fever (46%), and diarrhea (30%). Stunting (8%) was not significantly associated with anemia. Wasting (0%) was not observed in this study. Reported child breastfeeding and complementary feeding were also not significantly associated with child anemia. In adjusted models, the child's significant risk factors for anemia included the mother's "Mestiza" race (OR: 4.681; 95% CI: 1.258, 17.421) versus the Afro-Colombian race. Older children (25-60 months) were less likely to develop anemia than younger (6-24 months) children (OR: 0.073; 95% CI: 0.015, 0.360). CONCLUSIONS: The finding of high anemia prevalence in this study advances our understanding of child and maternal anemia in populations of low socioeconomic status where health care is regularly accessed through well-child programs.

High seropositivity against NDO-LID in a group of household contacts of leprosy patients. Are we close to leprosy elimination in Colombia?

INTRODUCTION: Leprosy is a chronic infectious disease caused by two mycobacteria (Mycobacterium leprae and Mycobacterium lepromatosis). The household contacts (HHC) of leprosy index cases are at higher risk of being infected with these mycobacteria. Therefore, serological testing in HHC would be an effective strategy to eliminate leprosy in Colombia. OBJECTIVE: To determine the seroprevalence and factors associated with the infection by M. leprae in HHC. METHODS: An observational study was conducted in 428 HHC located in the Colombian Caribbean, Andean, Pacific, and Amazonian regions. We evaluated the seropositivity and titrations of IgM, IgG, and protein A against NDO-LID. RESULTS: The evaluated HHC showed high seropositivity, precisely 36.9% anti-NDO-LID IgM, 28.3% anti-NDO-LID IgG, and 47.7% protein A. Furthermore, Protein A showed a greater capacity to detect infected individuals than other anti-NDO-LID conjugates (p < 0.0001). This study did not show differences in the seropositivity according to sex or age of the HHC (p > 0.05). Higher seropositivity for IgM was evidenced mainly in HHC located in the Colombian Pacific region (p 0.001). This research did not show differences in the seropositivity for these serological tests between HHC of PB or MB leprosy patients (p > 0.05). CONCLUSION: Leprosy transmission is still active between Colombian HHC. Consequently, controlling leprosy transmission in this population is fundamental to eradicating this disease.

Pilot study of the productivity and Salmonella seroprevalence in pigs administered organic acids.

Control of Salmonella in pig/pork production is important to protect public health because pork is one of the main sources of human infection. Moreover, antimicrobial use in pig farms should be kept low to minimize development and transmission of antimicrobial resistance. This pilot study evaluated the productivity and Salmonella seroprevalence in pigs administered organic acids (OA) compared to pigs given growth promoters in one farm in Antioquia, Colombia. Two groups each consisting of 60 pigs of 6-weeks of age were studied for 4 months. One group was provided feed and water with OA (Selko pH® and Selacid®), whereas the other group (control) received antimicrobial growth promoters according to routine feeding practices (tylosin and zinc bacitracin). Blood samples were taken three times (T1-T3) and pigs were weighted five times to calculate daily weight gain (DWG) and feed conversion ratio (FCR). Initially when the pigs were 6 weeks old (T1), the Salmonella seroprevalence was 1.7% in both groups. When the pigs were 11 weeks old (T2), the seroprevalence was significantly lower in pigs provided OA compared to the control group (19 vs. 47%, P < 0.001), whereas when the pigs were 23 weeks old (T3), the seroprevalence did not differ between the groups (62 vs. 77%; P = 0.075). The cumulative DWG was significantly higher in the intervention group than in the control group (713 vs. 667 g/day; P < 0.001). The cumulative FCR did not differ between groups (2.80 vs. 2.77; P = 0.144). The pilot study indicates that cleaning the water pipes and administrating OA improve productivity in pigs and delay exposure to Salmonella spp. when compared with growth promoters. Thus, OA could replace antimicrobial growth promoters and reduce antimicrobial use and resistance. However, the study should be repeated before firmer conclusions can be drawn.

Transcription Factor HES-1: How Is the Expression of This Transcriptional Factor in Paucibacillary Leprosy Patients?

INTRODUCTION: Leprosy is an ancient and chronic infectious disease caused by 2 mycobacteria (Mycobacterium leprae and Mycobacterium lepromatosis). Recently, our research group observed that HES-1, an innate cellular component of the Notch signaling pathway, is related to the pathogenesis of leprosy. Therefore, it could be helpful in its detection. OBJECTIVE: To determine the expression of HES-1 in the skin of patients with paucibacillary (PB) leprosy. METHODS: A cross-sectional, descriptive, observational study was conducted. Forty-five skin samples from patients with leprosy were evaluated (30 samples from MB leprosy and 15 from PB leprosy) using immunohistochemistry of HES-1 and S-100. RESULTS: PB leprosy biopsies revealed a reduction of HES-1 in 66.7% of the epidermis, 80% of the eccrine glands, and 62.5% of the hair follicles of these patients, with statistical differences in the control group (P < 0.0001). Besides, HES-1 showed similar utility to S-100 immunostaining in detecting the MB and PB leprosy. CONCLUSIONS: HES-1 is a transcriptional factor also reduced in PB patients' epidermis and skin appendages. Finally, our data show that HES-1 could be a biomarker in diagnosing PB and MB leprosy.

Transcriptional changes during metacyclogenesis of a Colombian Trypanosoma cruzi strain.

During its life cycle, Trypanosoma cruzi undergoes physiological modifications in order to adapt to insect vector and mammalian host conditions. Metacyclogenesis is essential, as the parasite acquires the ability to infect a variety of mammalian species, including humans, in which pathology is caused. In this work, the transcriptomes of metacyclic trypomastigotes and epimastigotes were analyzed in order to identify differentially expressed genes that may be involved in metacyclogenesis. Toward this end, in vitro induction of metacyclogenesis was performed and metacyclic trypomastigotes obtained. RNA-Seq was performed on triplicate samples of epimastigotes and metacyclic trypomastigotes. Differential gene expression analysis showed 513 genes, of which 221 were upregulated and 292 downregulated in metacyclic trypomastigotes. The analysis showed that these genes are related to biological processes relevant in metacyclogenesis. Within these processes, we found that most of the genes associated with infectivity and gene expression regulation were upregulated in metacyclic trypomastigotes, while genes involved in cell division, DNA replication, differentiation, cytoskeleton, and metabolism were mainly downregulated. The participation of some of these genes in T. cruzi metacyclogenesis is of interest, as they may be used as potential therapeutic targets in the design of new drugs for Chagas disease.

Neuropathic ulcers in leprosy: clinical features, diagnosis and treatment.

Leprosy is a neglected disease caused by Mycobacterium leprae and Mycobacterium lepromatosis, and is related to significant disabilities resulting from the neural damage generated by this mycobacteria. Neuropathic ulcers-lesions that can appear at the plantar and extra-plantar levels-are one such disability, and diagnosis requires an adequate dermatological, neurological and microbiological evaluation. The treatment of these lesions is based on a multidisciplinary approach that includes debridement of the necrotic tissue, controlling infections, reducing pressure areas, optimising blood flow, and nerve decompression. This review aims to describe the clinical features, diagnostic methods and treatment of neuropathic ulcers in leprosy. The diagnostic methods and medical management used in leprosy ulcers are based on those used for diabetic foot. This requires radical change as these diseases are immunologically and physiologically very different.

Intestinal parasitosis in children from a rural Caribbean area in Colombia / Parasitosis intestinal en niños de una zona rural del Caribe de Colombia

Abstract In Colombia, the prevalence of intestinal parasitosis varies throughout its regions, social classes, and living conditions. We performed a cohort study (2017-2018) on children from 1-10 years old in El Cedro, Ayapel, Colombia. We tested a convenience sampling of those who accepted and signed the consent form. The National Intestinal Parasite Survey was applied; feces and water source sampling were tested for coprological and microbiology analysis, respectively. Education and pharmacologic treatment to the minor and co-inhabitants were performed. After the recruiting, we followed up at 7 and 12 months. Statistical analysis was performed using IBM® SPSS22. Participants 47, 61,7% male, average age 5,7 years. The caretakers had a low educational background. The monthly income of 72,3% of households was < USD 87. The coprological test showed 61,7% with at least one type of parasite; 32,2% with two or more. Trichuris trichiura was the most frequent. Water sources were positive for Escherichia coli. The population tested showed a high frequency of parasitic infection. We did not find a reduction of intestinal parasitosis with educa tion and pharmacologic treatment at the end of the follow-up. It must be necessary to impact social determinants of public health to achieve intestinal parasitosis control.

Resumen En Colombia, la prevalencia de parasitosis intestinal varía por regiones, clases sociales, condiciones de vida. Realizamos estudio de cohorte (2017-2018) en niños de 1-10 años en El Cedro, Ayapel, Colombia. Muestra por conveniencia, se incluyeron aquellos que aceptaron y firmaron el consentimiento. Se aplicó la Encuesta Nacional de Parásitos Intestinales; se analizaron muestras de heces y fuentes de agua para análisis coprológico y microbiológico, respectivamente. Se realizó educación y tratamiento farmacológico al menor y cohabitantes. Después del reclutamiento, seguimiento a los 7 y 12 meses. El análisis estadístico se realizó con IBM® SPSS22. Participantes 47, 61,7% hombres, promedio de edad 5,7 años. Cuidadores con bajo nivel educativo, ingreso mensual del 72,3% de los hogares fue <USD 87. La población analizada mostró una alta frecuencia de infección parasitaria, un 61,7% con al menos un tipo de parásito; 32,2% con dos o más. Trichuris trichiura fue el más frecuente. Las fuentes de agua fueron positivas para Escherichia coli. Al final del seguimiento, no se redujo la frecuencia de la parasitosis intestinal a pesar de educación y tratamiento farmacológico. Se requiere incidir en los determinantes sociales y de salud pública para lograr el control de las parasitosis intestinales.

Mycobacterium lepromatosis as Cause of Leprosy, Colombia.

Leprosy is a granulomatous infection caused by infection with Mycobacterium leprae or M. lepromatosis. We evaluated skin biopsy and slit skin smear samples from 92 leprosy patients in Colombia by quantitative PCR. Five (5.4%) patients tested positive for M. lepromatosis, providing evidence of the presence of this pathogen in Colombia.

Biliary Tract Microbiota Similarities in Pancreatic Ductal Adenocarcinoma / Similitudes en la Microbiota de Tracto Biliar en Adenocarcinoma Ductal de Páncreas

Abstract Objective: to analyze microbiota profiles in the biliary tract, of pancreatic ductal adenocarcinoma (PDAC) patients and gallstones patients, in order to identify dif ferences, which may contribute to a better understanding of PDAC carcinogenesis. Methods: using microbiota analysis, a total of 25 samples from 14 patients were collected during surgery and compared. Samples were divided into three groups; one GS group (N = 3), and two PDAC groups; PDAC gallbladder group (N = 11) and PDAC brush group (N = 11). Results: upon comparison of bacterial communities' alpha and beta diversity indices and relative abundances by group (anatomic site) and condition (GS vs PDAC), we found no statistically significant results. However, we can highlight the high similarity of the compared parameters among the two different anatomic locations over the biliary tract in PDAC patients. Conclusion: to the best of our knowledge, this is the first study comparing two different anatomic locations over the biliary tract in PDAC patients. Among PDAC groups microbiota along the semi-closed duct system of the biliary tract showed substantial similarity, reflected in the alpha and beta diversity indices and relative abundances.

Resumen Objetivo: analizar los perfiles de microbiota en el tracto biliar de pacientes con adenocarcinoma ductal pancreático (PDAC) y pacientes con cálculos biliares (GS), con el fin de identificar diferencias, lo que puede contribuir a una mejor comprensión de la carcinogénesis de PDAC. Métodos: mediante análisis de microbiota, se recolectaron durante la cirugía un total de 25 muestras de 14 pacientes y se compararon. Las muestras se dividieron en tres grupos; Grupo GS (N = 3) y dos grupos PDAC; Grupo de vesícula biliar PDAC (N = 11) y grupo de cepillado PDAC (N = 11). Resultados: al comparar los índices de diversidad alfa y beta de las comunidades bacterianas y las abundancias relativas por grupo (sitio anatómico) y condición (GS vs PDAC), no encontramos diferencias estadísticamente significativas. Sin embargo, podemos destacar la gran similitud de los parámetros comparados entre las dos ubicaciones anatómicas diferentes en el tracto biliar en pacientes con PDAC. Conclusión: hasta donde sabemos, este es el primer estudio que compara dos ubicaciones anatómicas diferentes sobre el tracto biliar en pacientes con PDAC. Entre los dos grupos de PDAC, la microbiota del sistema de conductos semicerrados del tracto biliar, se encontró una similitud sustancial, reflejada en los índices de diversidad alfa y beta y en abundancias.

Detection of Mycobacterium leprae infection in family clusters from six leprosy-endemic regions in Colombia.

BACKGROUND: Leprosy is a chronic infectious disease caused by Mycobacterium leprae, which continues to be endemic in tropical countries, making it necessary to implement strategies for its elimination. The objective of the current article was to detect M. leprae infection and associated factors through serological and epidemiological evaluation in family clusters of leprosy patients. METHODS: Mycobacterium leprae infection was determined in 50 family clusters of leprosy patients from the departments of Bolívar, Atlántico, Santander, Boyacá, Chocó and Antioquia through the detection of antibodies (protein A, IgM, IgG) against anti-natural octyl disacharide-leprosy IDRI diagnostic (NDO-LID). RESULTS: Higher seroconversion and elevated titers of these antibodies against NDO-LID were observed in the population of Chocó and Atlántico (p<0.05). Additionally, a higher frequency of infection was observed in large family groups that consumed armadillo meat and belonged to a low socioeconomic stratum (p<0.05). Multivariate analysis established that the main associated factors for a family cluster experiencing this infection were belonging to a vulnerable economic stratum and a large family group. CONCLUSIONS: This study found that the set of social and demographic variables (i.e. armadillo consumption, geographic area, low socioeconomic status and belonging to a large family cluster) are related to the promotion of seropositivity in family clusters.

Cholangiocyte derived carcinomas and local microbiota.

Trillions of bacteria are present in the gastrointestinal tract as part of the local microbiota. Bacteria have been associated with a wide range of gastrointestinal diseases including malignant neoplasms. The association of bacteria in gastrointestinal and biliary tract carcinogenesis is supported in the paradigm of Helicobacter pylori and intestinal-type gastric cancer. However, the association of bacterial species to a specific carcinoma, different from intestinal-type gastric cancer is unresolved. The relationship of bacteria to a specific malignant neoplasm can drive clinical interventions. We review the classic bacteria risk factors identified using cultures and PCR (polymerase chain reaction) with new research regarding a microbiota approach through 16S rRNA (16S ribosomal ribonucleic acid gene) or metagenomic analysis for selected carcinomas in the biliary tract.

Pseudomicosis por oportunistas: desconocimiento y retos diagnósticos / Pseudomycosis due to opportunists: Lack of knowedge and diagnostic challenges

Resumen Se denominan pseudomicosis a las infecciones generadas por microorganismos que parecen hongos pero que no lo son. En esta revisión se abordan desde una perspectiva etiológica, epidemiológica y clínica algunas de las pseudomicosis por oportunistas más frecuentes: actinomicosis, botriomicosis, nocardiosis y prototecosis. Adicionalmente, se revisan las herramientas clínicas y paraclínicas para facilitar su diagnóstico y se actualizan las pautas de tratamiento.

Abstract Infections generated by microorganisms that look like fungi but are not fungal are called pseudomycosis. This review addresses pseudomycosis by more frequent opportunists: actinomicosis, botryomycosis, nocardiosis and prototechosis, from an etiological, epidemiological and clinical perspective. In addition, clinical and paraclinical tools are reviewed to facilitate diagnosis, and and treatment guides are updated.

Advances in the treatment of Chagas disease: Promising new drugs, plants and targets.

Chagas disease, caused by Trypanosoma cruzi, is treated with only two drugs; benznidazole and nifurtimox. These drugs have some disadvantages, including their efficacy only in the acute or early infection phases, adverse effects during their use, and the resistance that the parasite has developed to their activity. Therefore, it is necessary to identify new, safe and effective therapeutic alternatives to treat Chagas disease, though governments and the pharmaceutical industry have shown a lack of interest in contributing to this solution. Institutions and research groups on the other hand have worked on some strategies that can help to address the problem. Some of these include the modification of conventional drug dosages, drug repurposing, and combined therapy. Plants and derived compounds with antiparasitic effects have also been studied, taking advantage of traditional medicinal knowledge. Others have studied the parasite to identify essential genes that can be used as therapeutic targets to design new, targeted drugs. Some of these studies have generated promising results, but few reach clinical phase studies. Institutions and research groups should be encouraged to unify efforts and cover all aspects of drug development according to resources and knowledge availability. In the end, this exchange of knowledge would lead to the development of new therapeutic alternatives to treat Chagas disease and benefit the populations it affects.

Micobioma: diversidad fúngica en el cuerpo humano / Mycobiome: Fungal diversity in human body

Resumen Introducción: los hongos hacen parte de los microorganismos que se encuentran en el ser humano y que interactúan con bacterias, virus y archaeas. El equilibrio inter e intra-especies es importante para mantener la salud en los seres humanos. La mayoría de los estudios sobre el micobioma se han relacionado con estados de enfermedad causados por hongos, siendo de relevancia la exploración de las comunidades comensales en individuos sanos. Métodos: se realizó una búsqueda bibliográfica en PubMed, ScienceDirect, Scopus y Google Scholar, usando los términos mycobiome, intestinal fungi, skin mycobiome, vaginal mycobiome, fungal microbiome. Se incluyeron artículos desde 1996 hasta 2020, de revisión y de resultados de investigación en todos los idiomas. Resultados y discusión: existe variabilidad en las comunidades fúngicas en los sitios corporales según sus características intrínsecas y la relación con el medio ambiente. El estado de salud en los seres humanos puede estar influenciado por la densidad y diversidad fúngica, a diferencia de los individuos enfermos en quienes se evidencia una disminución en la diversidad y que se asocia con el oportunismo de agentes patógenos.

Abstract Introduction: Fungi are part of the microorganisms that are found in humans and interact with bacteria, viruses and archaeas. The balance inter and intra-species is important to maintain health in humans. Most studies on mycobiota have been related to disease states caused by fungi, the exploration of commensal communities in healthy individuals being relevant. Methods: literature search in PubMed, ScienceDirect, Scopus and Google Scholar, using the terms: mycobiome, intestinal fungi, skin mycobiome, vaginal mycobiome, fungal microbiome. Articles from 1996 to 2020, review and research results in all languages were included in this review. Results: Variability in fungal communities is determinated according to body site characteristics and the contact with the environment. Health status in humans can be influenced by fungal density and diversity, unlike sick individuals where there is evidence of a decrease in diversity and that is associated with the opportunism of pathogens.

Innate immune response: ally or enemy in cutaneous leishmaniasis?

Cutaneous leishmaniasis (CL) is an infectious and neglected disease caused by parasites of the genus Leishmania, which produces a wide spectrum of cutaneous manifestations. CL research has shown that the innate immune activity of cells such as neutrophils, natural killers, macrophages, dendritic cells and the complement system are capable of controlling this infection. However, Leishmania can also modulate the immune activity of these cells to promote its own survival and proliferation at the intracellular level. This review discusses the role of the innate immune response in the control and spread of this infection.

Oct-6 transcriptional factor a possible biomarker for leprosy diagnosis.

Leprosy is an infectious disease caused by Mycobacterium leprae that affects the skin and nerves. The nerve damage in leprosy may be related to alterations in transcriptional factors, such as Krox-20, Oct-6, Sox-10. Thirty skin biopsies in leprosy patients and 15 non-leprosy skin biopsies were evaluated using RT-qPCR to assess Krox-20, Oct-6, and Sox-10 and these data was related with S-100 immunohistochemistry. Changes in gene expression were observed in the skin and dermal nerves of leprosy patients in Oct-6 and Sox-10. When comparing Oct-6 with S-100 IHC as diagnostic tests for leprosy, Oct-6 showed a sensitivity of 73.3%, and specificity of 100%, while S-100 IHC showed a sensitivity of 96.6% and specificity of 100%. Our data suggest Oct-6 could be an auxiliary biomarker specific to detecting changes in dermal nerves in leprosy and thus useful to health workers and pathologists with no expertise to observe nerve injuries in leprosy.

Primer caso confirmado de brucelosis humana por Brucella melitensis, una zoonosis presente en Colombia / First confirmed case of human brucellosis by Brucella melitensis, a zoonosis present in Colombia

Resumen La brucelosis, principal zoonosis a nivel mundial tiene alta prevalencia en varios países de Latinoamérica. Se asocia con la exposición a ganado infectado por distintas especies del género Brucella. B. melitensis la más virulenta para el humano, causa con frecuencia complicaciones de predominio osteoarticular. En Colombia se cree que la infección por B. melitensis es una entidad ausente, a pesar de su plausibilidad biológica en nuestro contexto; sin embargo, son escasos los estudios sobre su ocurrencia y mínimo el índice de sospecha de la enfermedad, por lo cual creemos está subdiagnosticada. Presentamos el primer caso confirmado de brucelosis por B. melitensis en Colombia en una joven embarazada, con diagnóstico incidental, en quien el análisis retrospectivo de su cuadro clínico alertó sobre puntos clave que pueden impactar en el diagnóstico y tratamiento oportuno de la enfermedad. Se plantean preguntas de prevalencia real de esta entidad en Colombia.

Summary Brucellosis, the principal zoonoses globally is highly prevalent in different countries of Latin America. It is associated with the exposition of livestock infected with different Brucella species, being B. melitensis the most virulent for humans, and frequently causing osteoarticular complications. In Colombia it is believed that B. melitensis infection is an absent entity, despite its biological plausibility in our context; however, there are few studies on its occurrence and a minimum index of suspicion of the disease, which is why we believe it is underdiagnosed. We present the first confirmed case of brucellosis by B. melitensis in Colombia diagnosed in a young pregnant patient, with an incidental diagnosis, in whom a retrospective analysis of her clinical outcome warned of key points that may impact on the diagnosis and timely treatment of the disease. We present several questions surrounding the real prevalence of this entity in Colombia.

Biliary Tract Carcinogenesis Model Based on Bile Metaproteomics.

Purpose: To analyze human and bacteria proteomic profiles in bile, exposed to a tumor vs. non-tumor microenvironment, in order to identify differences between these conditions, which may contribute to a better understanding of pancreatic carcinogenesis. Patients and Methods: Using liquid chromatography and mass spectrometry, human and bacterial proteomic profiles of a total of 20 bile samples (7 from gallstone (GS) patients, and 13 from pancreatic head ductal adenocarcinoma (PDAC) patients) that were collected during surgery and taken directly from the gallbladder, were compared. g:Profiler and KEGG (Kyoto Encyclopedia of Genes and Genomes) Mapper Reconstruct Pathway were used as the main comparative platform focusing on over-represented biological pathways among human proteins and interaction pathways among bacterial proteins. Results: Three bacterial infection pathways were over-represented in the human PDAC group of proteins. IL-8 is the only human protein that coincides in the three pathways and this protein is only present in the PDAC group. Quantitative and qualitative differences in bacterial proteins suggest a dysbiotic microenvironment in the PDAC group, supported by significant participation of antibiotic biosynthesis enzymes. Prokaryotes interaction signaling pathways highlight the presence of zeatin in the GS group and surfactin in the PDAC group, the former in the metabolism of terpenoids and polyketides, and the latter in both metabolisms of terpenoids, polyketides and quorum sensing. Based on our findings, we propose a bacterial-induced carcinogenesis model for the biliary tract. Conclusion: To the best of our knowledge this is the first study with the aim of comparing human and bacterial bile proteins in a tumor vs. non-tumor microenvironment. We proposed a new carcinogenesis model for the biliary tract based on bile metaproteomic findings. Our results suggest that bacteria may be key players in biliary tract carcinogenesis, in a long-lasting dysbiotic and epithelially harmful microenvironment, in which specific bacterial species' biofilm formation is of utmost importance. Our finding should be further explored in future using in vitro and in vivo investigations.

Notch Signaling Pathway Expression in the Skin of Leprosy Patients: Association With Skin and Neural Damage.

Introduction: Leprosy is an infectious disease caused by Mycobacterium leprae, a debilitating disease that affects the skin and peripheral nerves. It is possible that tissue changes during infection with leprosy are related to alterations in the activity of the Notch signaling pathway, an innate signaling pathway in the physiology of the skin and peripheral nerves. Methods: This is a descriptive observational study. Thirty skin biopsies from leprosy patients and 15 from individuals with no history of this disease were evaluated. In these samples, gene expressions of cellular components associated with the Notch signaling pathway, Hes-1, Hey-1, Runx-1 Jagged-1, Notch-1, and Numb, were evaluated using q-PCR, and protein expression was evaluated using immunohistochemistry of Runx-1 and Hes-1. Results: Changes were observed in the transcription of Notch signaling pathway components; Hes-1 was downregulated and Runx-1 upregulated in the skin of infected patients. These results were confirmed by immunohistochemistry, where reduction of Hes-1 expression was found in the epidermis, eccrine glands, and hair follicles. Increased expression of Runx-1 was found in inflammatory cells in the dermis of infected patients; however, it is not related to tissue changes. With these results, a multivariate analysis was performed to determine the causes of transcription factor Hes-1 reduction. It was concluded that tissue inflammation was the main cause. Conclusions: The tissue changes found in the skin of infected patients could be associated with a reduction in the expression of Hes-1, a situation that would promote the survival and proliferation of M. leprae in this tissue.

Social and environmental conditions related to Mycobacterium leprae infection in children and adolescents from three leprosy endemic regions of Colombia.

BACKGROUND: Leprosy is is still considered a public health issue and in Colombia 7-10% of new cases are found in children, indicating both active transmission and social inequality. We hypothesized that circulating antibodies against Natural Octyl Disaccharide-Leprosy IDRI Diagnostic (NDO-LID) (a combination of Mycobacterium leprae antigens) could reveal the social and environmental aspects associated with higher frequencies of M. leprae infection among children and adolescents in Colombia. METHODS: An observational cross-sectional study was conducted involving sampling from 82 children and adolescents (younger than 18 years of age) who had household contact with index leprosy patients diagnosed in the last 5 years. Data were analyzed through bivariate analysis made by applying a Pearson x2 test for qualitative variables, while quantitative variables, depending on their distribution, were analyzed using either a Student's t-test or Mann-Whitney U test. Multivariate analysis was performed using a multiple regression and binomial logistic approach. RESULTS: A bivariate analysis demonstrated that antibody titers against NDO-LID were significantly greater in children and adolescents with a low socioeconomic status that had: lived in vulnerable areas of the UAChR shared region; eaten armadillo meat; exposure of over 10 years to an index case and; not received BCG immunization. Moreover, a multivariate analysis showed that residing in the UAChR region has a strong association with a greater possibility of M. leprae infection. CONCLUSIONS: M. leprae transmission persists among young Colombians, and this is associated with social and environmental conditions. An intensification of efforts to identify new leprosy cases in vulnerable and forgotten populations where M. leprae transmission continues therefore appears necessary.