Canine visceral leishmaniasis as a systemic fibrotic disease.

We propose that canine visceral leishmaniasis (CVL) is a systemic fibrotic disease, as evidenced by the wide distribution of fibrosis that we have found in the dogs suffering from chronic condition. The inflammatory cells apparently direct fibrosis formation. Twenty-four cases (symptomatic dogs) were identified from a total of one hundred and five cases that had been naturally infected with Leishmania chagasi and had been documented during an epidemiological survey of CVL carried out by the metropolitan area of the municipality of Belo Horizonte, MG, Brazil. The histological criterion was intralobular liver fibrosis, as has been described previously in dogs with visceral leishmaniasis. In addition to the findings in the liver, here we describe and quantify conspicuous and systemic deposition of collagen in other organs, including spleen, cervical lymph nodes, lung and kidney of all the infected symptomatic dogs. Thus we report that there is a systematic fibrotic picture in these animals, where inflammatory cells appear to direct fibrosis in all organs that have been studied. Therefore we propose that CVL is a systemic fibrotic disease.

Histopathological and parasitological study of the gastrointestinal tract of dogs naturally infected with Leishmania infantum.

BACKGROUND: The aim of this study was to provide a systematic pathological and parasitological overview of the gastrointestinal tract (GIT), including the stomach, duodenum, jejunum, ileum, caecum and colon, of dogs naturally infected with Leishmania. METHODS: Twenty mongrel dogs naturally infected with Leishmania (Leishmania) infantum and obtained from the Control Zoonosis Center of the Municipality of Ribeirão das Neves, Belo Horizonte Metropolitan area, Minas Gerais (MG) state, Brazil, were analyzed. The dogs were divided into two groups: Group 1 comprised nine clinically normal dogs and group 2 comprised 11 clinically affected dogs. After necropsy, one sample was collected from each GIT segment, namely the stomach, duodenum, jejunum, ileum, caecum and colon. Furthermore, paraffin-embedded samples were used for histological and parasitological (immunohistochemistry) evaluation and a morphometrical study were carried out to determine the parasite load (immunolabeled amastigote forms of Leishmania). The Friedman and the Mann Whitney tests were used for statistical analysis. The Friedman test was used to analyze each segment of the GIT within each group of dogs and the Mann Whitney test was used to compare the GIT segments between clinically unaffected and affected dogs. RESULTS: The infected dogs had an increased number of macrophages, plasma cells and lymphocytes, but lesions were generally mild. Parasite distribution in the GIT was evident in all intestinal segments and layers of the intestinal wall (mucosal, muscular and submucosal) irrespective of the clinical status of the dogs. However, the parasite load was statistically higher in the caecum and colon than in other segments of the GIT. CONCLUSION: The high parasite burden evident throughout the GIT mucosa with only mild pathological alterations led us to consider whether Leishmania gains an advantage from the intestinal immunoregulatory response (immunological tolerance).

In vitro binding and survival assays of Leishmania parasites to peripherical blood monocytes and monocyte-derived macrophages isolated from dogs naturally and experimentally infected with Leishmania (Leishmania) chagasi.

BACKGROUND: There are a few works considering the characterization of canine monocyte-derived macrophages as well as a standardized procedure for isolation, culture, and infection of these cells with Leishmania. We have performed several modifications in order to improve the canine monocyte-derived macrophage cultures. In addition, we have done a comparative study between monocytes and monocyte-derived macrophages from dogs naturally and experimentally infected with L. chagasi. RESULTS: In the presence of exogenous serum, opsonized Leishmania promastigotes binds better to monocytes/macrophages than without serum. Otherwise, this binding occurs due to the strict correlation between the opsonized biologic particles with the third receptor of the complement (CR3-CD11b/CD18). In fact, our assays with CD11b confirmed the importance of this receptor for canine cells and the L. chagasi experimental system. Moreover, monocytes obtained from naturally infected dogs have shown a higher number of monocytes bounded to promastigotes. The experimental results regarding survival have shown that promastigote forms of opsonized L. chagasi were more infective, because we found higher numbers of promastigotes bound to the different cells. As a consequence, after forty-eight hours of binding, higher numbers of amastigotes appeared inside monocyte-macrophages. CONCLUSION: These studies have given support to continue comparative studies involving canine monocytes, monocyte-derived macrophages and peritoneal macrophages. Since we have standardized the canine cell culture, we are looking forward to determining the phenotypic properties of these cells before and after L. chagasi infection using flow cytometry.

Further genetic characterization of the two Trypanosoma cruzi Berenice strains (Be-62 and Be-78) isolated from the first human case of Chagas disease (Chagas, 1909).

We describe here an extension of a previous genetic characterization of Trypanosoma cruzi strains (Be-62 and Be-78) isolated from the patient Berenice, the first human case of Chagas disease [Chagas, C., 1909. Nova Tripanomíase humana. Estudos sobre morfologia e o ciclo evolutivo do Schizotrypanum cruzi, n. gen., n. sp., agente etiolójico da nova entidade morbida do homem. Mem. Inst. Oswaldo Cruz 1, 159-218]. We wanted to verify the composition of T. cruzi populations originated from these two isolates. In the present work, 22 enzymatic loci (MLEE), nine RAPD primers and 7 microsatellite loci were analyzed. Clones from both strains were also characterized to verify whether these strains are mono or polyclonal. Be-62 and Be-78 strains were different in 3 out of 22 enzymatic systems, in 3 out of 9 RAPD primers tested and in all microsatellite loci investigated. However, our data suggests that both strains are phylogenetically closely related, belonging to genetic group 32 from Tibayrenc and Ayala [Tibayrenc, M., Ayala, F.J., 1988. Isoenzime variability in Trypanosoma cruzi, the agent of Chagas' disease: genetical, taxonomical, and epidemiological significance. Evolution 42, 277-292], equivalent to zymodeme 2 and T. cruzi II major lineage which, in Brazil, comprises parasites from the domestic cycle of the disease. Microsatellite analyses showed differences between the parental strains but suggested that both populations are monoclonal since each strain and their respective clones showed the same amplification products.

Activity of the new triazole derivative albaconazole against Trypanosoma (Schizotrypanum) cruzi in dog hosts.

Albaconazole is an experimental triazole derivative with potent and broad-spectrum antifungal activity and a remarkably long half-life in dogs, monkeys, and humans. In the present work, we investigated the in vivo activity of this compound against two strains of the protozoan parasite Trypanosoma (Schizotrypanum) cruzi, the causative agent of Chagas' disease, using dogs as hosts. The T. cruzi strains used in the study were previously characterized (murine model) as susceptible (strain Berenice-78) and partially resistant (strain Y) to the drugs currently in clinical use, nifurtimox and benznidazole. Our results demonstrated that albaconazole is very effective in suppressing the proliferation of the parasite and preventing the death of infected animals. Furthermore, the parasitological, PCR, serological, and proliferative assay results indicated parasitological cure indices of 25 and 100% among animals inoculated with T. cruzi strain Y when they were treated with albaconazole at 1.5 mg/kg of body weight/day for 60 and 90 days, respectively. On the other hand, although albaconazole given at 1.5 mg/kg/day was very effective in suppressing the proliferation of the parasite in animals infected with the Berenice-78 T. cruzi strain, no parasitological cure was observed among them, even when a longer treatment period (150 doses) was used. In conclusion, our results demonstrate that albaconazole has trypanocidal activity in vivo and is capable of inducing radical parasitological cure, although natural resistance to this compound was also indicated. Furthermore, the compound can be used in long-term treatment schemes (60 to 150 days) with minimal toxicity and thus represents a potentially useful candidate for the treatment of human Chagas' disease.

Immunohistochemical studies in acute and chronic canine chagasic cardiomyopathy.

A major characteristic of Chagas' disease is a myocarditis constituted primarily of mononuclear cells, both during the acute and chronic phases of the disease. Using monoclonal antibodies and image analyses we have quantified canine CD8(+) T cells (caCD8(+) T cells), canine CD4(+) T cells (caCD4(+) T cells) and neutrophils in canine chagasic myocardiopathy induced by two strains isolated from the first human clinical case of Chagas' disease. We also evaluated the influence of tissue parasitism in the genesis of chronic myocarditis through immunohistochemistry. As in human myocarditis, there was a predominance of T lymphocytes in the inflammatory infiltrate in all animals studied. In the dogs inoculated with strain Berenice 78 (Be78) and necropsied during the acute phase of infection, we found 58% caCD8(+) and 42% caCD4(+) T cells. In chronically infected animals, 53% of T cells were represented by caCD8(+) and 47% were caCD4(+) T cells. Since normal canine lymphoid organs are constituted by 70-80% caCD4(+) T cells and 20-30% caCD8(+) T cells our results indicate a higher proliferation of caCD8(+) T cells in dogs inoculated with the Be78 strain. In chronic myocarditis induced by the Berenice 62 (Be62) strain, caCD8(+) cells constituted 33% of the T cells and 67% were caCD4(+) T cells, a proportion similar to that found in normal canine lymphoid organs. Since the Be78 strain induces greater loss of myocardiocytes than strain Be62, we believe that the caCD8(+) T cells, among other factors, can be important in the genesis of these lesions. Amastigote nests and immunohistochemically labelled Trypanosoma cruzi antigen were not found in dogs necropsied during the chronic phase. The absence of the parasite in the myocardium suggests the involvement of other mechanisms in the genesis of the inflammatory process.

Estudo quantitativo e qualitativo dos plexos de Auerbach e Meissner do esôfago de cäes inoculados com o Trypanosoma cruzi / A quantitative and qualitative study of the Auerbach and Meissner plexus in dogs inoculated with Trypanosoma cruzi

A quantitative and qualitative study was conducted on the Auerbach and Meissner plexuses of the esophagus of four chagasic dogs sacrificed during the acute phase of infection. Ganglionitis and periganglionitis of the Auerbach plexus ranged from mild to moderate and induced significant neuronal lesions, especially in two animals. The ganglions of the Meissner plexus were observed in small number which did not permit any analysis. Mild or moderate myositis was observed mainly in the lower third of the esophagus and was rarely associated with amastigote nests. Ganglion and neuron counts did not demonstrate denervation. Although the formation of megaesophagus was not induced in any dog, lesions of the Auerbach plexus and myocells of the esophagus were observed during the acute phase of chagasic infection. To our knowledge, this is the first systematic quantitative and qualitative study of the Auerbach and Meissner plexuses of the esophagus in experimental trypanosomiasis cruzi.

Experimental Chagas' disease in dogs

This paper describes the development of experimental Chagas' disease in 64 out-bred young dogs. Twenty-nine animals were inoculated with the Be-62 and 35 with Be-78 Trypanosoma cruzi strains. Twenty-six were infected with blood trypomastigotes by different inoculation routes and 38 with metacyclic trypomastigotes from the vector via the conjunctival route. Twenty of the 26 dogs infected with blood trypomastigotes were autopsied during the acute phase. Eleven died spontaneously and nine were sacrificed. Six remained alive until they died suddenly (two) or were autopsied (four). Twelve of the 38 dogs infected with metacyclic trypomastigotes evolved naturally to the chronic phase and remained alive for 24-48 months. The parasitemia, clinical aspects and serology (IgM and IgG) as well as electrocardiogram, hemogram and heart anatomo-histopathologic patterns of acute and chronic cardiac forms of Chagas' disease as seen in human infections, were reproduced. The most important finding is the reproductibility of diffuse fibrosing chronic chagasic cardiopathy in all dogs infected with Be-78 T. cruzi strain autopsied between the 90th and 864th days of infection. Thus, the dog can be considered as a suitable experimental model to study Chagas' disease according to the requisites of the World Health Organization (1984). Futhermore the animal is easily obtained and easy to handle and maintain in experimental laboratory conditions

Fase crônica cardíaca fibrosante da tripanossomíase cruzi experimental no cäo / Fibrosing cardiac chronic phase in experimental Chagas' disease in dogs

Os autores documentan a cardiopatia difusa fibrosante, com todos os sintomas clínicos e dados de autópsia pertinente a insuficiência cardíaca congestiva, em um dos 21 cäes infectados com a cepa Colombiana (cinco morreram na fase aguda e quatro continuam vivos) e cinco, dos 13 infectados com a cepa Berenice-78 (oito morrerm na fase aguda), num período de oito anos de observaçäo. Em vista destes resultados, os autores sugerem que o cäo possa vir a ser um modelo experimental, adequado par o estudo da história da doença de Chagas, preenchendo os requisitos estabelecidos pelo Comitê Assessor de Doença de Chagas do Programa Especial de Pesquisa e Treinamento em Doenças Tropicais da Organizaçäo Mundial de Saúde

Envolvimento renal na associaçäo Salmonella-Schistosoma mansoni / Renal involvement in the association of Salmonelosis with Schistosoma mansoni

Vinte pacientes com a associaçäo Salmonella-S. mansoni (Grupo 1) e 20 com esquistossomose mansoni hepatesplênica (Grupo 2) foram selecionados para o estudo. Submeteram-se os pacientes dos Grupos 1 e 2 a exame clínico minucioso e a uma série de exames complementares, com destaque para as provas de funçäo renal. Em 10 pacientes do Grupo 1 e 20 do Grupo 2, realizou-se, ainda, estudo histológico do rim à microscopia óptica, de fluorescência e eletrônica. As alteraçöes renais foral mais freqüentes nos pacientes do Grupo 1. Após o tratamento dos pacientes do Grupo 1, com antibióticos e/ou esquistossomicidas, observou-se regressäo das alteraçöes renais sob o ponto de vista clínico, laboratorial e imunopatológico. Os autores concluem pela existência de duas nefropatias distintas: a nefropatia esquistossomótica e a encontrada em pacientes com a associaçäo Salmonella-S. mansoni

Alteraçöes quantitativas das células neuroendócrinas no megacólon chagásico / Quantitative changes in the neuroendocrine cells of chagasic megacolon

Utilizando-se técnicas histoquímicas pela prata (Masson-Fontana e Sevier-Munger) estudaram-se a distribuiçäo e o número de células enterocromafins (EC) e do conjunto EC mais células argirófilas (ARG) em peças cirúrgicas de megassigmóide chagásico. Observou-se que tanto nos "megas" (n = 16) como nos controles (n = 8), a posiçäo das células EC e ARG na mucosa foi predominantemente basal, com distribuiçäo irregular, principalmente das EC. A análise histológica revelou aparente aumento numérico das EC e do conjunto EC mais ARG. Todavia, contagens sistematizadas mostraram que somente o conjunto dessas células apresentou aumento estatisticamente significativo (P<0,01). Realizou-se tambéjm o estudo morfométrico da mucosa e das musculares que revelou espessamento significativo (P<0,01) dessas camadas em relaçäo aos casos controles