RESUMO
La enfermedad pulmonar obstructiva crónica (EPOC) es una enfermedad prevalente en la población colombiana, que característicamente tiene un deterioro progresivo y altera la calidad de vida de los pacientes. Solo del 15% al 20% de los pacientes con antecedente de tabaquismo desarrollan la enfermedad, por lo que factores ambientales y genéticos adicionales influyen en su progresión. De las causas infecciosas que han tomado importancia, el Pneumocystis jiroveái, un hongo ubicuo que entra en contacto con la vía aérea de los humanos desde la infancia, es causa de neumonía en pacientes inmunosuprimidos. Se han descrito tasas elevadas de colonización en pacientes con EPOC, que aumentan con la severidad de la enfermedad. EPOC e infección por P jiroveái parecen compartir una respuesta inmunológica similar; lo cual podría explicar el papel de la colonización por el hongo en su progresión y gravedad.
Chronic obstructive pulmonary disease (COPD) is a prevalent disease in our population, which characteristically has a Progressive deterioration and alters the quality of Iife of patients. Only 15-20% of patients with a history of smoking develop the disease, so there are additional environmental and genetic factors that influence the progression of the disease. Of the infectious causes that have taken importance is Pneumocystis jiroveái, this is a ubiquitous fungus that comes into contact with the airway of humans since childhood and is a cause of pneumonía in immunosuppressed patients. In addition, high rates of colonization have been reported in patients with COPD, which increase with the severity of the disease. COPD and P jiroveái infection appear to share a similar immune response, which may explain the role of fungal colonization in the progression and severity of the disease.
Assuntos
Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/imunologia , Pneumocystis carinii/classificaçãoRESUMO
The study described Pneumocystis jirovecii (P. jirovecii) multilocus typing in seven AIDS patients living in French Guiana (Cayenne Hospital) and seven immunosuppressed patients living in Brest, metropolitan France (Brest Hospital). Archival P. jirovecii specimens were examined at the dihydropteroate synthase (DHPS) locus using a PCR-RFLP technique, the internal transcribed spacer (ITS) 1 and ITS 2 and the mitochondrial large subunit rRNA (mtLSUrRNA) gene using PCR and sequencing. Analysis of typing results were combined with an analysis of the literature on P. jirovecii mtLSUrRNA types and ITS haplotypes. A wild DHPS type was identified in six Guianese patients and in seven patients from metropolitan France whereas a DHPS mutant was infected in the remaining Guianese patient. Typing of the two other loci pointed out a high diversity of ITS haplotypes and an average diversity of mtLSUrRNA types in French Guiana with a partial commonality of these haplotypes and types described in metropolitan France and around the world. Combining DHPS, ITS and mtLSU types, 12 different multilocus genotypes (MLGs) were identified, 4 MLGs in Guianese patients and 8 MLGs in Brest patients. MLG analysis allows to discriminate patients in 2 groups according to their geographical origin. Indeed, none of the MLGs identified in the Guianese patients were found in the Brest patients and none of the MLGs identified in the Brest patients were found in the Guianese patients. These results show that in French Guiana (i) PCP involving DHPS mutants occur, (ii) there is a diversity of ITS and mtLSUrRNA types and (iii) although partial type commonality in this territory and metropolitan France can be observed, MLG analysis suggests that P. jirovecii organisms from French Guiana may present specific characteristics.
Assuntos
Síndrome da Imunodeficiência Adquirida/virologia , Tipagem de Sequências Multilocus/métodos , Pneumocystis carinii/classificação , Pneumocystis carinii/genética , Pneumonia por Pneumocystis/virologia , Síndrome da Imunodeficiência Adquirida/complicações , Adulto , Idoso , Feminino , França , Guiana Francesa , Variação Genética , Genoma Viral , Haplótipos , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Pneumocystis carinii/isolamento & purificação , Estudos RetrospectivosRESUMO
Pneumocystis jirovecii is a leading cause of opportunistic infections among immunocompromised patients. The aim of this study was to determine the genetic diversity of P. jirovecii from colonized Cuban infants and toddlers by analysis of four genetic loci: mitochondrial large subunit (mtLSU) rRNA, cytochrome b (CYB), superoxide dismutase (SOD) and ß-tubulin (ß-tub). We determined the multilocus profiles based on concatenated genotype data (multilocus genotype; MLG) and nucleotide sequences (multilocus sequence analysis; MLSA) respectively, calculated the discriminatory power of each analysis, and investigated possible associations with demographic and clinical data. Sixteen of 51 PCR-positive nasopharyngeal swab specimens (years 2010-2013) with high P. jirovecii load were selected for downstream analysis. In mixed allelic profiles all genotypes/nucleotide sequence patterns were considered separately. All samples could be genotyped based on mtLSU, CYB and ß-tub locus. However, the SOD locus could be successfully amplified in only 7/16 (44%) specimens. Eight different P. jirovecii MLGs were identified among the 16 cases and eight samples presented identical MLG (MLG 1). Seventeen MLSA profiles were distinguished. No statistical association between genotypes or MLGs and demographic or clinical data could be identified. For MLSA the higher discriminatory power (S=0.976) was observed. The combination of mtLSU, CYB and ß-tub loci proved to be useful for molecular epidemiology studies of P. jirovecii. A total of 17 different MLSA profiles observed in 16 specimens indicated high genetic variability of P. jirovecii circulating in colonized Cuban infants and toddlers.
Assuntos
Pneumocystis carinii/genética , Pneumonia por Pneumocystis/microbiologia , Cuba/epidemiologia , DNA Fúngico/análise , DNA Fúngico/genética , Feminino , Variação Genética , Genótipo , Humanos , Lactente , Masculino , Pneumocystis carinii/classificação , Pneumocystis carinii/isolamento & purificação , Pneumonia por Pneumocystis/epidemiologiaRESUMO
This study describes the prevalence and genotype distribution of Pneumocystis jirovecii obtained from nasopharyngeal (NP) swabs from immunocompetent Cuban infants and toddlers with whooping cough (WC). A total of 163 NP swabs from 163 young Cuban children with WC who were admitted to the respiratory care units at two pediatric centers were studied. The prevalence of the organism was determined by a quantitative PCR (qPCR) assay targeting the P. jirovecii mitochondrial large subunit (mtLSU) rRNA gene. Genotypes were identified by direct sequencing of mtLSU ribosomal DNA (rDNA) and restriction fragment length polymorphism (RFLP) analysis of the dihydropteroate synthase (DHPS) gene amplicons. qPCR detected P. jirovecii DNA in 48/163 (29.4%) samples. mtLSU rDNA sequence analysis revealed the presence of three different genotypes in the population. Genotype 2 was most common (48%), followed in prevalence by genotypes 1 (23%) and 3 (19%); mixed-genotype infections were seen in 10% of the cases. RFLP analysis of DHPS PCR products revealed four genotypes, 18% of which were associated with resistance to sulfa drugs. Only contact with coughers (prevalence ratio [PR], 3.51 [95% confidence interval {CI}, 1.79 to 6.87]; P = 0.000) and exposure to tobacco smoke (PR, 1.82 [95% CI, 1.14 to 2.92]; P = 0.009) were statistically associated with being colonized by P. jirovecii. The prevalence of P. jirovecii in infants and toddlers with WC and the genotyping results provide evidence that this population represents a potential reservoir and transmission source of P. jirovecii.
Assuntos
Infecções por Pneumocystis/epidemiologia , Infecções por Pneumocystis/microbiologia , Pneumocystis carinii/classificação , Pneumocystis carinii/isolamento & purificação , Coqueluche/complicações , Criança , Pré-Escolar , Cuba/epidemiologia , DNA Fúngico/química , DNA Fúngico/genética , Feminino , Genótipo , Humanos , Lactente , Recém-Nascido , Masculino , Dados de Sequência Molecular , Nasofaringe/microbiologia , Pneumocystis carinii/genética , Polimorfismo de Fragmento de Restrição , Prevalência , Reação em Cadeia da Polimerase em Tempo Real , Análise de Sequência de DNA , Coqueluche/microbiologiaRESUMO
Genotypes of two different loci of the Pneumocystis jirovecii mitochondrial gene were studied in specimens from a total of 75 Pneumocystis pneumonia patients in Spain, France and Cuba. A new genotype of the mitochondrial small subunit rRNA gene of P. jirovecii (160A/196T) was identified, which was revealed to be the most common in these three countries, especially in Cuba where its proportion reached 93.8%. Our data imply that the new genotype might be circulating worldwide and also suggests that the distribution of P. jirovecii genotypes could be narrower in islands such as Cuba.
Assuntos
DNA Mitocondrial/genética , Variação Genética , Técnicas de Tipagem Micológica , Pneumocystis carinii/classificação , Pneumocystis carinii/genética , Pneumonia por Pneumocystis/epidemiologia , Pneumonia por Pneumocystis/microbiologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Cuba/epidemiologia , Feminino , França/epidemiologia , Genes de RNAr , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Epidemiologia Molecular , Tipagem Molecular , Pneumocystis carinii/isolamento & purificação , Espanha/epidemiologia , Adulto JovemAssuntos
Tipagem Molecular , Técnicas de Tipagem Micológica , Pneumocystis carinii/classificação , Pneumocystis carinii/isolamento & purificação , Pneumonia por Pneumocystis/diagnóstico , Pneumonia por Pneumocystis/microbiologia , Líquido da Lavagem Broncoalveolar/microbiologia , DNA Fúngico/genética , DNA Espaçador Ribossômico/genética , Guiana Francesa , Humanos , Masculino , Pessoa de Meia-Idade , Pneumocystis carinii/genéticaRESUMO
Introducción: Pneumocystis jirovecii es uno de los patógenos oportunistas más importantes que afectan a individuos con síndrome de inmunodeficiencia adquirida y pacientes inmunodeprimidos por otras causas. A pesar de haber sido observado por primera vez hace más de 100 años, se desconocen aún muchos aspectos importantes de su biología y de la morbilidad que produce. Objetivo: en este trabajo se pretende presentar una actualización sobre los principales aspectos de la historia, la epidemiología y la biología de P. jirovecii, así como de la enfermedad que produce. Conclusiones: se han publicado varios artículos de revisión desde su descubrimiento que brindan detalles y elementos novedosos del microorganismo, sin embargo, pocos son los manuscritos encontrados en la literatura de habla hispana que aborden esta problemática.
Introduction: Pneumocystis jirovecii is one of the most important opportunistic pathogens affecting AIDS individuals and immunodepressive patients. In spite of the fact that it was observed one hundred years ago for the first time, many fundamental aspects of its biology and the morbidity it causes are still unknown. Objective: this paper was aimed at presenting updating on the main aspects of the history, the epidemiology and the biology of P. jirovecii and the disease it causes. Conclusions: a number of review articles have been published since the discovery, all of which provide details and novel elements of the microorganism. However, few original papers dealing with this problem have been found in the Spanish literature.
Assuntos
História do Século XIX , História do Século XX , Pneumocystis carinii , Incidência , Prevalência , Infecções por Pneumocystis/diagnóstico , Infecções por Pneumocystis/epidemiologia , Infecções por Pneumocystis/história , Pneumocystis carinii/classificação , Pneumocystis carinii/fisiologiaRESUMO
INTRODUCTION: Pneumocystis jirovecii is one of the most important opportunistic pathogens affecting AIDS individuals and immunodepressive patients. In spite of the fact that it was observed one hundred years ago for the first time, many fundamental aspects of its biology and the morbidity it causes are still unknown. OBJECTIVE: this paper was aimed at presenting updating on the main aspects of the history, the epidemiology and the biology of P. jirovecii and the disease it causes. CONCLUSIONS: a number of review articles have been published since the discovery, all of which provide details and novel elements of the microorganism. However, few original papers dealing with this problem have been found in the Spanish literature.
Assuntos
Pneumocystis carinii , História do Século XIX , História do Século XX , Incidência , Infecções por Pneumocystis/diagnóstico , Infecções por Pneumocystis/epidemiologia , Infecções por Pneumocystis/história , Pneumocystis carinii/classificação , Pneumocystis carinii/fisiologia , PrevalênciaRESUMO
Previous studies have provided histological evidence of an association between primary Pneumocystis infection and sudden infant death syndrome (SIDS). The aim of this work was to determine the species of clustered Pneumocystis organisms found in formalin-fixed paraffin-embedded (FFPE) lung tissue sections from Chilean sudden infant death (SID) victims. This approach needed first to optimize a DNA extraction method from such histological sections. For that purpose, the QIAamp DNA Isolation from Paraffin-Embedded Tissue method (Qiagen) was first tested on FFPE lung tissue sections of immunosuppressed Wistar rats inoculated with rat-derived PNEUMOCYSTIS: Successful DNA extraction was assessed by the amplification of a 346 bp fragment of the mitochondrial large subunit rRNA gene of the Pneumocystis species using a previously described PCR assay. PCR products were analysed by direct sequencing and sequences corresponding to Pneumocystis carinii were found in all the samples. This method was then applied to FFPE lung tissue sections from Chilean SID victims. Pneumocystis jirovecii was successfully identified in the three tested samples. In conclusion, an efficient protocol for isolating PCR-ready DNA from FFPE lung tissue sections was developed. It established that the Pneumocystis species found in the lungs of Chilean SID victims was P. jirovecii.