New drug discovery strategies for the treatment of benznidazole-resistance in Trypanosoma cruzi, the causative agent of Chagas disease.

INTRODUCTION: Benznidazole, the drug of choice for treating Chagas Disease (CD), has significant limitations, such as poor cure efficacy, mainly in the chronic phase of CD, association with side effects, and parasite resistance. Understanding parasite resistance to benznidazole is crucial for developing new drugs to treat CD. AREAS COVERED: Here, the authors review the current understanding of the molecular basis of benznidazole resistance. Furthermore, they discuss the state-of-the-art methods and critical outcomes employed to evaluate the efficacy of potential drugs against T. cruzi, aiming to select better compounds likely to succeed in the clinic. Finally, the authors describe the different strategies employed to overcome resistance to benznidazole and find effective new treatments for CD. EXPERT OPINION: Resistance to benznidazole is a complex phenomenon that occurs naturally among T. cruzi strains. The combination of compounds that inhibit different metabolic pathways of the parasite is an important strategy for developing a new chemotherapeutic protocol.

Transcriptomic analysis of benznidazole-resistant and susceptible Trypanosoma cruzi populations.

BACKGROUND: Chagas disease (CD), caused by the parasite Trypanosoma cruzi, is a serious public health concern in Latin America. Nifurtimox and benznidazole (BZ), the only two drugs currently approved for the treatment of CD, have very low efficacies in the chronic phase of the disease and several toxic side effects. Trypanosoma cruzi strains that are naturally resistant to both drugs have been reported. We performed a comparative transcriptomic analysis of wild-type and BZ-resistant T. cruzi populations using high-throughput RNA sequencing to elucidate the metabolic pathways related to clinical drug resistance and identify promising molecular targets for the development of new drugs for treating CD. METHODS: All complementary DNA (cDNA) libraries were constructed from the epimastigote forms of each line, sequenced and analysed using the Prinseq and Trimmomatic tools for the quality analysis, STAR as the aligner for mapping the reads against the reference genome (T. cruzi Dm28c-2018), the Bioconductor package EdgeR for statistical analysis of differential expression and the Python-based library GOATools for the functional enrichment analysis. RESULTS: The analytical pipeline with an adjusted P-value of < 0.05 and fold-change > 1.5 identified 1819 transcripts that were differentially expressed (DE) between wild-type and BZ-resistant T. cruzi populations. Of these, 1522 (83.7%) presented functional annotations and 297 (16.2%) were assigned as hypothetical proteins. In total, 1067 transcripts were upregulated and 752 were downregulated in the BZ-resistant T. cruzi population. Functional enrichment analysis of the DE transcripts identified 10 and 111 functional categories enriched for the up- and downregulated transcripts, respectively. Through functional analysis we identified several biological processes potentially associated with the BZ-resistant phenotype: cellular amino acid metabolic processes, translation, proteolysis, protein phosphorylation, RNA modification, DNA repair, generation of precursor metabolites and energy, oxidation-reduction processes, protein folding, purine nucleotide metabolic processes and lipid biosynthetic processes. CONCLUSIONS: The transcriptomic profile of T. cruzi revealed a robust set of genes from different metabolic pathways associated with the BZ-resistant phenotype, proving that T. cruzi resistance mechanisms are multifactorial and complex. Biological processes associated with parasite drug resistance include antioxidant defenses and RNA processing. The identified transcripts, such as ascorbate peroxidase (APX) and iron superoxide dismutase (Fe-SOD), provide important information on the resistant phenotype. These DE transcripts can be further evaluated as molecular targets for new drugs against CD.

Comparative transcriptomic analysis of antimony resistant and susceptible Leishmania infantum lines.

BACKGROUND: One of the major challenges to leishmaniasis treatment is the emergence of parasites resistant to antimony. To study differentially expressed genes associated with drug resistance, we performed a comparative transcriptomic analysis between wild-type and potassium antimonyl tartrate (SbIII)-resistant Leishmania infantum lines using high-throughput RNA sequencing. METHODS: All the cDNA libraries were constructed from promastigote forms of each line, sequenced and analyzed using STAR for mapping the reads against the reference genome (L. infantum JPCM5) and DESeq2 for differential expression statistical analyses. All the genes were functionally annotated using sequence similarity search. RESULTS: The analytical pipeline considering an adjusted p-value < 0.05 and fold change > 2.0 identified 933 transcripts differentially expressed (DE) between wild-type and SbIII-resistant L. infantum lines. Out of 933 DE transcripts, 504 presented functional annotation and 429 were assigned as hypothetical proteins. A total of 837 transcripts were upregulated and 96 were downregulated in the SbIII-resistant L. infantum line. Using this DE dataset, the proteins were further grouped in functional classes according to the gene ontology database. The functional enrichment analysis for biological processes showed that the upregulated transcripts in the SbIII-resistant line are associated with protein phosphorylation, microtubule-based movement, ubiquitination, host-parasite interaction, cellular process and other categories. The downregulated transcripts in the SbIII-resistant line are assigned in the GO categories: ribonucleoprotein complex, ribosome biogenesis, rRNA processing, nucleosome assembly and translation. CONCLUSIONS: The transcriptomic profile of L. infantum showed a robust set of genes from different metabolic pathways associated with the antimony resistance phenotype in this parasite. Our results address the complex and multifactorial antimony resistance mechanisms in Leishmania, identifying several candidate genes that may be further evaluated as molecular targets for chemotherapy of leishmaniasis.

Molecular characterization of Cyclophilin (TcCyP19) in Trypanosoma cruzi populations susceptible and resistant to benznidazole.

Cyclophilin (CyP), a peptidyl-prolyl cis/trans isomerase, is a key molecule with diverse biological functions that include roles in molecular chaperoning, stress response, immune modulation, and signal transduction. In this respect, CyP could serve as a potential drug target in disease-causing parasites. Previous studies employing proteomics techniques have shown that the TcCyP19 isoform was more abundant in a benznidazole (BZ)-resistant Trypanosoma cruzi population than in its susceptible counterpart. In this study, TcCyP19 has been characterized in BZ-susceptible and BZ-resistant T. cruzi populations. Phylogenetic analysis revealed a clear dichotomy between Cyphophilin A (CyPA) sequences from trypanosomatids and mammals. Sequencing analysis revealed that the amino acid sequences of TcCyP19 were identical among the T. cruzi samples analyzed. Southern blot analysis showed that TcCyP19 is a single-copy gene, located in chromosomal bands varying in size from 0.68 to 2.2 Mb, depending on the strain of T. cruzi. Northern blot and qPCR indicated that the levels of TcCyP19 mRNA were twofold higher in drug-resistant T. cruzi populations than in their drug-susceptible counterparts. Similarly, as determined by two-dimensional gel electrophoresis immunoblot, the expression of TcCyP19 protein was increased to the same degree in BZ-resistant T. cruzi populations. No differences in TcCyP19 mRNA and protein expression levels were observed between the susceptible and the naturally resistant T. cruzi strains analyzed. Taken together, these data indicate that cyclophilin TcCyP19 expression is up-regulated at both transcriptional and translational levels in T. cruzi populations that were in vitro-induced and in vivo-selected for resistance to BZ.

Desenvolvimento de uma PCR multiplex capaz de detectar e classificar cepas de Trypanosoma cruzi em amostras clínicas e de campo

Nesse trabalho, descrevemos a busca por marcadores moleculares que permitam simultaneamente o diagnóstico da doença de Chagas e a classificação das cepas segundo o fenótipo de susceptibilidade a drogas, zimodema e/ou grupos I e II do T. cruzi. [...], selecionamos seqüências repetitivas do DNA do T. cruzi e iniciadores descritos para o diagnóstico da doença de Chagas. Analisamos as seqüências do elemento repetitivo E13, kDNA e o DNA satélite (195 pb). Os resultados com o elemento repetitivo E13 e seqüências do kDNA, mostraram uma grandevariabilidade dessas seqüências, inviabilizando a busca de marcadores. Analisamos 160 seqüências do DNA satélite de 195 pb de 12 cepas do T. cruzi previamente caracterizadas segundo o fenótipo de susceptibilidade a drogas e zimodema. Estudos de filogenia mostraram a existência de dois grupos distintos, associados com os grupos I e II do T. cruzi. Observamos a presença de 8 polimorfismos exclusivos das cepas do grupo I do T. cruzi. [...] . Umsistema de PCR multiplex constituído pelos iniciadores TcSat 4 e Diaz 7 e 8 permitiram a classificação das cepas de T. cruzi nos grupos I e II. A sensibilidade foi de 10 fg, o que corresponde a 1/30 do DNA de um parasito. Amostras de DNA de outros tripanosomatídeos não produziram produto amplificado. Comparamos o perfil de amplificação do DNA satélite de 30 cepas de T. cruzi e 24 amostras de sangue de camundongos experimentalmente infectados com as cepas Colombiana (grupo I) e Y(grupo II) em papel de filtro. Em todas as amostras positivas foi possível a identificação dos grupos I e II. Para validarmos a técnica com amostras de campo, utilizamos 7 amostras de DNA do creme leucocitário de pacientes na fase aguda da doença deChagas e 15 amostras de fezes de Triatoma infestans em papel de filtro. As amostras de pacientes foram grupo II e as amostras de T. infestans grupo I. Esses resultadosestão de acordo com os dados descritos na literatura que mostram uma associação entre cepas do grupo I do T.

Desenvolvimento de uma PCR multiplex capaz de detectar e classificar cepas de Trypanosoma cruzi em amostras clínicas e de campo / Development of a PCR multiplex capable to detect and to classify cepas of Trypanosoma cruzi in clinical samples and field

Nesse trabalho, descrevemos a busca por marcadores moleculares que permitam simultaneamente o diagnóstico da doença de Chagas e a classificação das cepas segundo o fenótipo de susceptibilidade a drogas, zimodema e/ou grupos I e II do T. cruzi. [...], selecionamos seqüências repetitivas do DNA do T. cruzi e iniciadores descritos para o diagnóstico da doença de Chagas. Analisamos as seqüências do elemento repetitivo E13, kDNA e o DNA satélite (195 pb). Os resultados com o elemento repetitivo E13 e seqüências do kDNA, mostraram uma grandevariabilidade dessas seqüências, inviabilizando a busca de marcadores. Analisamos 160 seqüências do DNA satélite de 195 pb de 12 cepas do T. cruzi previamente caracterizadas segundo o fenótipo de susceptibilidade a drogas e zimodema. Estudos de filogenia mostraram a existência de dois grupos distintos, associados com os grupos I e II do T. cruzi. Observamos a presença de 8 polimorfismos exclusivos das cepas do grupo I do T. cruzi. [...] . Umsistema de PCR multiplex constituído pelos iniciadores TcSat 4 e Diaz 7 e 8 permitiram a classificação das cepas de T. cruzi nos grupos I e II. A sensibilidade foi de 10 fg, o que corresponde a 1/30 do DNA de um parasito. Amostras de DNA de outros tripanosomatídeos não produziram produto amplificado. Comparamos o perfil de amplificação do DNA satélite de 30 cepas de T. cruzi e 24 amostras de sangue de camundongos experimentalmente infectados com as cepas Colombiana (grupo I) e Y(grupo II) em papel de filtro. Em todas as amostras positivas foi possível a identificação dos grupos I e II. Para validarmos a técnica com amostras de campo, utilizamos 7 amostras de DNA do creme leucocitário de pacientes na fase aguda da doença deChagas e 15 amostras de fezes de Triatoma infestans em papel de filtro. As amostras de pacientes foram grupo II e as amostras de T. infestans grupo I. Esses resultadosestão de acordo com os dados descritos na literatura que mostram uma associação entre cepas do grupo I do T.