RESUMO
In this study, we tested the polymerase chain reaction (PCR)-method to diagnose cutaneous leishmaniasis (CL) by taking exudate materials from lesions with cotton swabs, using our previously tested (PCR) panel comprised of Leishmania (Viannia) panamensis, L. (V.) braziliensis, L. (V.) guyanensis, L. (Leishmania) mexicana and L. (L.) amazonensis. The objectives of the present study were to improve the sampling method convenient for the patients and to test the usefulness of samples taken with cotton swabs. Sixteen patients were clinically diagnosed to have CL including one case of diffuse cutaneous leishmaniasis (DCL) in Ecuador and the causative Leishmania parasites were identified by PCR. All the 12 samples from CL patients of La Mana, positive for Leishmania DNA, were identified as L. (V.) panamensis, while two from CL of Huigra and one from DCL of San Ignacio were L. (L.) mexicana. In the field condition, taking biopsy material is not only painful but sometimes causes iatrogenic bacterial infections. Considering the sensitivity of the test, and convenient sampling procedure, it may be suggested that collection of exudates using cotton swabs may be a better alternative to biopsy sample for PCR-diagnosis of CL.
Assuntos
Leishmania/isolamento & purificação , Leishmaniose Cutânea/diagnóstico , Reação em Cadeia da Polimerase/métodos , Adulto , Animais , Criança , Pré-Escolar , DNA de Protozoário/análise , Equador , Exsudatos e Transudatos/parasitologia , Feminino , Humanos , Lactente , Leishmania/genética , Masculino , Sensibilidade e Especificidade , Úlcera Cutânea/diagnóstico , Úlcera Cutânea/parasitologiaAssuntos
Leishmaniose Cutânea/diagnóstico , Reação em Cadeia da Polimerase/métodos , Adolescente , Adulto , Animais , Biópsia/métodos , Criança , Equador , Feminino , Humanos , Leishmania guyanensis/isolamento & purificação , Leishmania mexicana/isolamento & purificação , Leishmaniose Cutânea/parasitologia , MasculinoRESUMO
OBJECTIVE: To examine interrelationships among myositis subsets, autoantibodies, and major histocompatibility complex (MHC) class II alleles across ethnic lines, and to localize genetic susceptibility (presence of HLA-DR versus DQ) to myositis within the MHC class II region. METHODS: MHC class II alleles (HLA-DRB1, DQA1, and DQB1, detected by DNA oligotyping) and myositis-specific autoantibodies (MSA) were determined in 224 patients with various myositis syndromes, including 89 whites, 89 African-Americans, 25 Mexican-Americans, and 21 Japanese. RESULTS: Anti-Jo-1 (histidyl-transfer RNA [tRNA] synthetase) and other MSAs (anti-PL-12, anti-PL-7, anti-OJ, anti-EJ, anti-KJ, anti-tRNA, and anti-signal recognition particle) were equally distributed among the races, but occurred more often in patients with polymyositis (PM) than in those with dermatomyositis (DM) or other myositis syndromes. MSA frequencies were significantly positively associated with anti-Ro (SS-A) (P = 0.002), and significantly negatively associated with anti-U1 RNP (P = 0.003). Frequencies of the HLA-DRB1*0301 (DR3), DQA1*0501, and DQB1*0201 (DQ2) alleles (and haplotype) were each increased in white patients with myositis, especially those with PM, but most strikingly in those with MSAs. However, in the other ethnic groups, except the Japanese group, only frequencies of HLA-DQA1*0501 and the structurally similar DQA1*0401 alleles were significantly increased. The presence of HLA-DQA1*0501 or *0401 was most significantly associated with anti-Jo-1, anti-PL-12, and other MSAs, compared with myositis patients without MSAs (P = 0.0008, Pcorr = 0.01, odds ratio [OR] = 3.7), and with normal, ethnically matched controls (P = 3 x 10(-7), Pcorr = 1 x 10(-6), OR = 6.5). Among MSA-positive patients who were negative for HLA-DQA1*0501 and *0401, including Japanese patients, the HLA-DQA1*0102 and *0103 alleles predominated. In addition, there appeared to be a negative association of the HLA-DR2 alleles (DRB1*1501 and *1503) with PM (P = 0.007, Pcorr not significant, OR = 0.39), but not with DM or myositis overall. CONCLUSION: By transracial gene mapping, genetic susceptibility to anti-Jo-1 and other MSAs in patients with myositis can be localized within the MHC region to the HLA-DQA1 locus.
Assuntos
Alelos , Autoanticorpos/sangue , Antígenos HLA-DQ/genética , Antígenos HLA-DR/genética , Miosite/imunologia , Grupos Raciais , Adulto , África , Povo Asiático , População Negra/genética , Suscetibilidade a Doenças/imunologia , Feminino , Predisposição Genética para Doença , Cadeias alfa de HLA-DQ , Cadeias beta de HLA-DQ , Cadeias HLA-DRB1 , Humanos , Japão , Masculino , México , Miosite/classificação , Miosite/genética , América do Norte , População Branca/genéticaRESUMO
Eleven Paraguayan strains of Trypanosoma cruzi, from Chagas' disease patients and the bug vectors, were examined by restriction endonuclease analysis of kinetoplast DNA using Hae III, Msp I, Eco RI, HinfI, Taq I and Rsa I. Four schizodeme-profile groups were identified. Group 1 had much simpler profiles than groups 2, 3 and 4 and, although there were homogeneous profiles in the latter three groups, each group could be distinguished from the others. The profiles of group 1 could not be matched with any of the standard strains from Brazil, Chile and Columbia included in the schizodeme comparison. The profiles of groups 3 and 4 shared most features with those standards of the Brazilian Z2 zymodeme.
Assuntos
Doença de Chagas/parasitologia , Trypanosoma cruzi/classificação , Adolescente , Idoso , Animais , Criança , Pré-Escolar , Enzimas de Restrição do DNA , DNA Circular/análise , DNA de Cinetoplasto , DNA de Protozoário/análise , Eletroforese em Gel de Poliacrilamida , Feminino , Marcadores Genéticos , Humanos , Masculino , Pessoa de Meia-Idade , Paraguai , Trypanosoma cruzi/genéticaRESUMO
Between 1986 and 1988, epidemiologic studies were carried out in a small rural community in an Andean region of Ecuador, where cutaneous leishmaniasis is highly endemic. A total of 25 human cases, positive for Leishmania parasites by culture and/or smear, were examined. Fourteen of the cases were in infants less than one year of age, suggesting intradomiciliary transmission of the disease. Clinically, many of these cases were similar to descriptions of "uta," a form of cutaneous leishmaniasis which occurs in Andean regions of Peru and is reported caused by L. peruviana. Of the 11 positive cultures obtained from human cases in the present study, eight were identified by molecular characterization as L. mexicana and three were identified as L. major-like. Two additional isolates of L. mexicana were also made from an infected dog and from a sand fly, Lutzomyia ayacuchensis, living in the region, thus implicating the latter species as possible reservoir and vector, respectively, of L. mexicana in this highland community. The significance and validity of recent isolates of L. major-like parasites from the New World are also discussed.
Assuntos
Leishmania mexicana/isolamento & purificação , Leishmania tropica/isolamento & purificação , Leishmaniose/parasitologia , Animais , Anticorpos Monoclonais/imunologia , Criança , Pré-Escolar , DNA Circular/análise , DNA de Cinetoplasto , DNA de Protozoário/análise , Doenças do Cão/parasitologia , Cães , Equador/epidemiologia , Feminino , Humanos , Lactente , Insetos Vetores/parasitologia , Isoenzimas/análise , Leishmania mexicana/classificação , Leishmania mexicana/enzimologia , Leishmania tropica/classificação , Leishmania tropica/enzimologia , Leishmaniose/epidemiologia , Leishmaniose/veterinária , Masculino , Polimorfismo de Fragmento de Restrição , Psychodidae/parasitologiaRESUMO
Six strains of Leishmania isolated from wild mammals and humans on the Pacific Coast of Ecuador were identified by isoenzyme electrophoresis and by their reactivity patterns to a cross-panel of specific monoclonal antibodies using a radioimmune binding assay. Single isolates from Sciurus vulgaris, Potos flavus, and Tamandua tetradactyla were identified as Leishmania amazonensis. Three other strains, isolated from cutaneous lesions of humans, were identified as Leishmania panamensis.
Assuntos
Animais Selvagens/parasitologia , Isoenzimas/análise , Leishmania/classificação , Animais , Anticorpos Monoclonais , Equador , Eletroforese/métodos , Humanos , Leishmania/enzimologia , Leishmania/isolamento & purificação , RadioimunoensaioRESUMO
The relationship was examined between the severity of ulcerated lesions and immune responses in 19 Ecuadorian patients in the early stages of New World cutaneous leishmaniasis. As an immunological assay, the humoral immune response was assessed by enzyme-linked immunosorbent assay (ELISA) and the cell-mediated response by delayed type skin test for leishmanial antigen (leishmanin test). There was a statistically significant correlation (r = 0.61, P less than 0.01) between the total area of ulcerated lesions and the reciprocal titre of ELISA in identical subjects. However, no significant difference was observed in the ELISA titre between patients with a single lesion and those with multiple lesions (chi 2 = 7.06, df = 5, P greater than 0.2). A correlation (r = 0.48, P less than 0.05) was observed between the area of lesions and the intensity of leishmanin test; further, the ELISA titre also correlated to the intensity of leishmanin test in the identical subjects (r = 0.71, P less than 0.01). These results suggest that the severity of ulcerated lesions relates to the activation of both the humoral and cell-mediated immune systems in the early stage of New World cutaneous leishmaniasis.
Assuntos
Leishmaniose/imunologia , Úlcera Cutânea/patologia , Pele/patologia , Adolescente , Adulto , Animais , Anticorpos Antiprotozoários/biossíntese , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Imunidade Celular , Leishmania/imunologia , Leishmaniose/complicações , Leishmaniose/patologia , Masculino , Testes Cutâneos , Úlcera Cutânea/etiologiaRESUMO
In highland Ecuador (province of El Oro), electrocardiograms (ECGs) were taken and analysed from 340 subjects, of whom 154 were seropositive to Trypanosoma cruzi by indirect haemagglutination test. Abnormal ECGs were present in 40.3% of seropositive individuals and 8.1% of seronegatives, and were slightly more common in seropositive males than in seropositive females. In seropositive individuals, the prevalence of abnormal ECG progressively increased with age and reached its peak level of 64.0% in the age group over 60 years, implying that Chagas disease in Ecuador produces little mortality among seropositive individuals. The most common ECG alterations were ventricular conduction defects: 26 of 117 seropositive individuals in the age group over 40 years had complete right bundle branch block. The frequency of atrioventricular block and arrhythmias was also associated with seropositivity to T. cruzi. A further ECG examination in lowland (province of Guayas) showed that the prevalence of abnormal ECGs there was significantly lower than that in highlands. These results suggest possible differences between T. cruzi strains in the two geographical areas of Ecuador.
Assuntos
Cardiomiopatia Chagásica/fisiopatologia , Adolescente , Adulto , Fatores Etários , Anticorpos Antiprotozoários/análise , Arritmias Cardíacas/diagnóstico , Criança , Equador , Eletrocardiografia , Feminino , Bloqueio Cardíaco/diagnóstico , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The biting patterns of Lutzomyia trapidoi and Lu. hartmanni, vectors of leishmaniasis, were studied using a human bait in an endemic area on the Pacific slope of the Andes in Ecuador. The results suggest that Lu. trapidoi is primarily an early biter at dusk, with the first peak at 20.00-21.00 hours and the second at 03.00-04.00 hours; and that Lu. hartmanni bites more constantly throughout the night, with a pronounced peak between 23.00 and 24.00 hours. The biting activity, however, shows a marked variation at each site and between different collections at the same site. The activity and the biting places on man are discussed in relation to human infection with leishmaniasis in the area and the location of lesions on patients.