Trypanosomiasis in Venezuelan water buffaloes: association of packed-cell volumes with seroprevalence and current trypanosome infection.

The seroprevalence of trypanosomiasis and the prevalence of current trypanosome infection in water buffaloes from the most important livestock areas of Venezuela were evaluated by IFAT and the microhaematocrit centrifugation technique, respectively. The usefulness of a PCR-based assay for identifying the trypanosome species in the buffaloes was also evaluated. Of the 644 animals investigated, 40 (6.2%) were found infected with trypanosomes by blood centrifugation, and 196 (30.4%) were found positive for anti-trypanosome antibodies, by IFAT. The results of the PCR-based assay indicated that 92.5% of the animals with current infections were infected with Trypanosoma vivax and the rest with T. theileri (the first molecular confirmation of T. theileri in Venezuelan water buffaloes). The national programme to treat and prevent trypanosome infections in the buffaloes does not appear to be meeting with great success, even though it is focused on T. vivax. Although the level of parasitaemia was categorized as low for 28 (70%) of the infections detected (and packed-cell volumes appeared to be unassociated with IFAT result, and uncorrelated, in the infected animals, with level of parasitaemia), the 40 infected buffaloes had a significantly lower mean packed-cell volume than the uninfected animals (P<0.05). Farmers should therefore be made aware of the probability of trypanosome-attributable losses in buffalo productivity.

The detection and PCR-based characterization of the parasites causing trypanosomiasis in water-buffalo herds in Venezuela.

The usefulness of PCR-based assays for detecting trypanosomiasis in water buffaloes and other livestock was explored, under field conditions, in Venezuela. The sensitivity and specificity of the assays, which were based on established primer pairs (21-mer/22-mer and ILO1264/ILO1265), were evaluated, partly by comparison with the results of parasitological tests (stained bloodsmears and microhaematocrit centrifugation) and immunological assays (IFAT) run in parallel. The optimised PCR-based assays showed a sensitivity of 10 pg DNA. The use of the 21-mer/22-mer primer pair gave a test that was specific for species in the subgenus Trypanozoon (including Trypanosoma evansi), whereas use of ILO1264/ILO1265 produced a test that was specific for T. vivax. The results of a hybridization assay using T. evansi-DNA and T. vivax-DNA probes indicated no cross-hybridization between the T. evansi and T. vivax PCR products.The results of the bloodsmear examinations, microhaematocrit centrifugations (MHC) and IFAT indicated that 23 (6.7%), 39 (11.4%) and 135 (39.5%) of the 342 blood samples investigated (including 316 from water buffaloes) contained trypanosomes, respectively. The results of the PCR-based assays indicated that 68 (19.9%) of the same blood samples contained T. vivax (or at least T. vivax DNA), and that none contained T. evansi or any other member of the subgenus Trypanozoon. For the detection of trypanosomes, the assay therefore appeared almost twice as sensitive as the MHC. These results are the first on the molecular characterization of the trypanosomes infecting water buffaloes in Venezuela. When the results of the MHC (which is the most practical, and frequently used, alternative detection method) were used as the gold standard, the PCR-based assay for T. vivax was found to have 100% sensitivity, 90.4% specificity, a positive predictive value of 0.57, a positive likelihood ratio of 10.45, and a negative likelihood ratio of 0.00. The assay therefore appears a reasonable choice for detecting T. vivax in the mammalian livestock of Venezuela and elsewhere.

Nuclear DNA sequence specific to Leishmania (Viannia) subgenus: a molecular marker for species identification.

As shown by RFLP analysis, there is a high variability in the beta-tubulin gene region of Leishmania sp. Such variability has been used in the identification of these parasites, establishing differences between subgenera of New World Leishmania. We have found a region of 500 bp (beta500) upstream of the coding region of the beta-tubulin gene that is present in all strains tested belonging to the L. (Viannia) subgenus. This region apparently is a repetitive sequence and we have shown that it is specific to the Leishmania (Viannia) subgenus. This sequence has no homology with the genomic DNA isolated from either the species belonging to the L. (Leishmania) subgenus or other Kinetoplastida, such as Trypanosoma cruzi, T. brucei, Leptomonas samueli, or Crithidia fasciciulata. The beta500 sequence showed sufficient variation to be used as a molecular marker in the identification of parasites. We established inter- and intrasubgenus differentiation and were able to discriminate at the species level in the Vianna subgenus. A PCR assay confirmed the specificity of the beta500 sequence.

Experimental leishmaniasis: synergistic effect of ion channel blockers and interferon-gamma on the clearance of Leishmania major by macrophages.

We have previously shown that cultured Leishmania promastigotes are sensitive to drugs blocking K+ and Na+ channels and Na+/H+ transport systems and that the percentage of parasite-infected macrophages decreases significantly in the presence of the drugs. In the present work, we analyzed whether this drug susceptibility of intracellular amastigotes was associated with the activation of macrophage microbicidal mechanisms. Pretreatment of the cells with glibenclamide (GLIB) increased their resistance to infection with Leishmania, an effect that may be mediated by calcium fluxes since it was reversed by ethylene glycol bis-(beta-aminoethyl ether)-N,N,N',N-tetraacetic acid (EGTA). It was noteworthy that in infected macrophages post-treated with the drugs the clearance of parasites was strongly enhanced when the cells were treated simultaneously with GLIB and interferon-gamma; this effect correlated with an increased production of reactive nitrogen intermediates. In conclusion, the data suggest that GLIB treatment increases the resistance of macrophages to infection with Leishmania and potentiates the interferon-gamma-stimulated clearance of parasites via the induction of nitric oxide.

Changes in the infectivity, pyruvate kinase activity, acid phosphatase activity and P-glycoprotein expression in glibenclamide-resistant Leishmania mexicana.

We previously demonstrated susceptibility of Leishmania sp. to glibenclamide, a K+ -ATP transport blocker which interacts with members of the superfamily of adenosine 5' triphosphate-binding cassette transporters. In order to characterize the molecular differences between a sensitive Leishmania strain, NR(Gs), and an experimentally selected glibenclamide-resistant strain, NR(Gr), specific biochemical and functional parameters have been evaluated both in the wild type and in the resistant strain. Most noteworthy, NR(Gr) exhibit an increased expression of P-glycoprotein and a decreased activity of functional key enzymes such as acid phosphatase, a prominent virulent factor of the parasite, and pyruvate kinase, a key control enzyme for both carbohydrate and protein metabolism. The specific biochemical, metabolic and functional changes observed in the resistant strain correlated with a reduced infectivity of stationary phase NR(Gr) in J774 macrophages and suggested a mechanism to overcome the effect of glibenclamide.

Malaria diagnosis by the polymerase chain reaction: a field study in south-eastern Venezuela.

A polymerase chain reaction (PCR) method that amplifies genus- and species-specific sequences present within the small subunit of ribosomal ribonucleic acid (ssRNA) genes of the human malaria parasites was used for the diagnosis of malaria in south-eastern Venezuela. One hundred blood samples were submitted to deoxyribonucleic acid extraction, PCR amplification and electrophoretic analysis of the PCR products, and the results were compared to those of routine microscopical diagnosis. The sensitivity of PCR for detection of Plasmodium vivax and P. falciparum malaria was 99% and 100%, respectively. However, 6 patients (6%) harboured parasites undetected by microscopy. The PCR assay detected a high proportion of mixed infections: 29% (17/59) of the infections microscopically diagnosed as P. vivax were shown to be mixed infections of P. vivax and P. falciparum. Forty per cent (7/17) of the individuals with a missed P. falciparum infection had received chloroquine in the previous 30 d. These results suggest that, in places where transmission of both P. vivax and P. falciparum occurs, PCR detection of malaria parasites can be a very useful complement to microscopical diagnosis in order to ascertain the true incidence of each species and for the follow-up of patients after specific treatment.

The genomic fingerprinting of the coding region of the beta-tubulin gene in Leishmania identification.

We have demonstrated the polymorphism of the beta-tubulin gene region in Leishmania and its value in the identification of the parasite. In this work we have shown that the coding region of the gene has sufficient variation to accurately discriminate these parasites at the subgenus level. Nevertheless, intrasubgenus diversity, for particular restriction enzymes, was found in New World Leishmania belonging to the Leishmania subgenus. For instance, differences were found between mexicana and amazonensis strains. A unique pattern at the species level was found in particular species of both subgenera, e.g. L. (L.) major strain P and L. (L.) tropica belonging to the Leishmania subgenus, and L. (V.) panamensis strain LS94 from the Viannia subgenus. Particular endonucleases are diagnostic in Leishmania species discrimination as in the case of PvuII for the mexicana and amazonensis. This variation evidenced in the beta-tubulin gene region of Leishmania also occurred in other Kinetoplastida e.g. Trypanosoma cruzi, Leptomonas spp. and Crithidia spp. Moreover, these organisms showed a different genomic fingerprinting for the beta-tubulin gene among them and also Leishmania. Thus, the polymorphism of the coding region of the beta-tubulin gene can be used as a molecular marker for the identification of Leishmania.

Leishmania sp.: growth and survival are impaired by ion channel blockers.

In the present work we examined the effect of ion transport blockers on the growth and viability of Leishmania sp. and on the infection of macrophages by the parasite. 4-aminopyridine and glibenclamide block voltage-dependent and K+ ATP channels, respectively; amiloride is used to detect Na+ channels and Na+/H+ antiporters; and anthracene-9-carboxylic acid affects chloride channels. The EC50 for promastigote cultures of three strains of the Leishmania subgenus, namely, Leishmania (Leishmania) NR, Leishmania (Leishmania) amazonensis LTB0016, and Leishmania (Leishmania) major, at their stationary phase of growth, were, respectively, 39, 46, and 464 microM for 4-aminopyridine; 7, 0.8, and 10 microM for glibenclamide and 66, 170, and 10 microM for anthracene-9-carboxylic acid. The amiloride EC50 for NR was 264 microM and 10 microM for L. (L.) major, but was never reached for LTB0016. Higher concentrations of the drugs impaired the exponential growth of Leishmania promastigotes. These results suggest the susceptibility of Leishmania sp. to blockers associated with K+ and Cl- and to Na+ or Na+/H+ transport systems. Blockade of such systems might have impaired the survival of the parasites as promastigotes. In addition, it affected the persistence of parasites in host cells. Although the infection of the macrophage cell line J774 and peritoneal-exudate macrophages was not significantly decreased by concentrations of the drugs around the promastigotes' EC50, the survival of intracellular parasites decreased significantly in the presence of these drugs without affecting the viability of the macrophages. Some blockers consistently gave small EC50 and significantly decreased the infection process as well as the survival of intracellular parasites. Thus, elucidation of their mechanism of action in Leishmania is relevant, since they could represent a potential subject for the development of leishmanicidal drugs.

Sensitivity of Leishmania spp. to glibenclamide and 4-aminopyridine: a tool for the study of drug resistance development.

We have demonstrated that Leishmania spp. grown as promastigotes, are sensitive to the K+ channel inhibitors 4-aminopyridine and glibenclamide. Their host cells, the macrophages, are not affected by similar concentrations of the drugs. We have also initiated the molecular characterization of the mechanisms involved in the development of drug resistance to glibenclamide by the parasite. Therefore, we have selected experimentally and begun to characterize the Venezuelan Leishmania (Leishmania) strain, NR resistant to glibenclamide [NR(Gr)]. The analysis of genomic DNA evidenced the existence of a fragment which apparently is amplified in NR(Gr). The fragment recognized by the pgpA probe, related to the Leishmania P-glycoprotein family and which was originally isolated from L. tarentolae, showed a size polymorfism between the sensitive and the resistant strain. These results suggest that the development of resistance to glibenclamide in the strain NR(Gr) might be associated with the amplification of the ltpgpA or related gene(s).

The RFLP analysis of the beta-tubulin gene region in New World Leishmania.

We have examined the similarities and differences in the organization of tubulin genes in New World Leishmania by restriction endonuclease digestion of genomic DNA and Southern blot analysis, using heterologous and homologous tubulin gene probes. As judged by the hybridization pattern and the restriction fragment length polymorphism (RFLP), there were large differences in both the restriction and hybridization patterns of the beta-tubulin sequences between stocks of the mexicana and braziliensis complexes. There were similarities in the hybridization patterns of different species of the mexicana complex. In contrast, a high heterogeneity was found between species of the braziliensis complex which includes intraspecific variation. The results suggest that this polymorphism may be associated with random mutations. The same analysis gave evidence of large differences in the beta-tubulin gene restriction pattern between New and Old World Leishmania. This variation in the beta-tubulin gene region was sufficient to distinguish between New and Old World Leishmania groups and between stocks of the mexicana and braziliensis complexes.

A small chromosome of Leishmania (Viannia) braziliensis contains multicopy sequences which are complex specific.

Orthogonal Field Alternating Gel Electrophoresis (OFAGE) has been used to show a band of approximately 260 kb which is stained intensely with ethidium bromide in Leishmania (V.) braziliensis stock M2903. This small chromosome (sc-2903), as well as a 50 kb and a 200 kb chromosome seen in L. (L.) mexicana and L. (L.) amazonensis, respectively, are stably maintained and linear. When used as a hybridisation probe, sc-2903 showed homology to large chromosomal DNA bands and to a multiplicity of genomic fragments in all braziliensis stocks tested, indicating either different sequences, different copy numbers or both but no hybridisation to mexicana stocks. It is possible that these sequences are present in all members of the braziliensis complex and are not related to LD1 or any other previously published small chromosome sequences. However, at least one clone isolated from a sc-2903 library recognised genomic DNA of stocks belonging to the braziliensis, mexicana and donovani complexes. Our results suggest that the clone carries sequence(s) that are repeated and shared between stocks of different complexes but with a variable genomic distribution.