Avanços no conhecimento da imunopatogênese da leptospirose e a aplicação do método do imprint como ferramenta qualitativa e quantitativa de leptospiras / Advances in understanding the immunopathogenesis of leptospirosis and application of the imprint method as a qualitative and quantitative tool leptospires

A leptospirose é uma zoonose causada por espiroquetas patogênicas pertencentes ao gênero Leptospira. O modelo da doença em camundongos tem vantagens devido à ampla gama de ferramentas genéticas e imunológicas disponíveis para pesquisas básicas. A maior limitação na conduta clínica e na pesquisa experimental da leptospirose é o fraco desempenho dos métodos disponíveis para detecção direta e para quantificação de leptospiras. Foi incluído nesta tese um conjunto de três manuscritos que visam investigar o desfecho da infecção pela cepa virulenta de Leptospira interrogans nas linhagens de camundongos selvagens (A, CBA, BALB/c e C57BL/6)...

Leptospirosis is a zoonosis caused by pathogenic spirochaetes belonging to the genus Leptospira. The mouse disease model is advantagous due to the broad array of immunological and genetic tools available for basic research. A major limitation in the clinical management and experimental research of leptospirosis is the poor performance of the available methods in the direct detection and quantification of leptospires. This thesis includes three manuscripts that investigate the outcome of infection by a virulent strain of Leptospira interrogans in wildtype mice strains: A, CBA, BALB/c and C57BL/6; in iNOS knockout (KO) mice, recombination activating gene 1 (RAG1) KO mice and CB17 severe combined immunodeficiency (SCID) mice. To investigate whether the imprint method (IM) of quantification was reliable we compared it with against real time PCR (qPCR) for the detection and quantification of leptospires in kidney samples from rats and hamsters. As expected, none of the wildtype mice were susceptible to lethal leptospirosis. The A and C57BL/6 strains exhibited high leptospiral loads in the kidney samples and the CBA and C57BL/6...

Ionic imbalance and lack of effect of adjuvant treatment with methylene blue in the hamster model of leptospirosis

Leptospirosis in humans usually involves hypokalaemia and hypomagnesaemia and the putative mechanism underlying such ionic imbalances may be related to nitric oxide (NO) production. We previously demonstrated the correlation between serum levels of NO and the severity of renal disease in patients with severe leptospirosis. Methylene blue inhibits soluble guanylyl cyclase (downstream of the action of any NO synthase isoforms) and was recently reported to have beneficial effects on clinical and experimental sepsis. We investigated the occurrence of serum ionic changes in experimental leptospirosis at various time points (4, 8, 16 and 28 days) in a hamster model. We also determined the effect of methylene blue treatment when administered as an adjuvant therapy, combined with late initiation of standard antibiotic (ampicillin) treatment. Hypokalaemia was not reproduced in this model: all of the groups developed increased levels of serum potassium (K). Furthermore, hypermagnesaemia, rather than magnesium (Mg) depletion, was observed in this hamster model of acute infection. These findings may be associated with an accelerated progression to acute renal failure. Adjuvant treatment with methylene blue had no effect on survival or serum Mg and K levels during acute-phase leptospirosis in hamsters. .

O imprint como método para detecção de leptospita SSP / The imprint as a method to detect leptospita SSP

Na determinação da eficácia de novas candidatas à vacina para leptospirose, o marcador primário considerado é a mortalidade, e um marcador secundário importante é a indução de uma imunidade estéril. Entretanto, a avaliação da imunidade estéril é dificultada pelo tempo demandado e pela complexidade de métodos como o isolamento pela cultura. Neste estudo, foi avaliado o uso do método do imprint (ou touch preparation) na detecção da presença de leptospiras em tecidos de hamsters infectados com L interrogans sorovar Copenhageni. Comparado com a cultura, o imprint demonstrou igualou melhor detecção de leptospiras em amostras de rim, fígado, pulmão e sangue coletadas após a infecção obtendo uma concordância geral boa (K = 0.61). Além disso, na avaliação de hamsters imunizados com uma proteína recombinante de Leptospira candidata à vacina e subsequente desafio com leptospiras patogênicas, a concordância entre a cultura e o imprint foi alta (K = 0.84). Estes achados indicam que o imprint é um método rápido para a observação direta de Leptospira spp. e que pode ser facilmente aplicado na avaliação de animais infectados experimentalmente com leptospiras e na determinação de imunidade esterilizante durante avaliações de potenciais candidatas à vacina.

In determining the efficacy of new vaccine candidates for leptospirosis the primaryendpoint is death and an important secondary endpoint is sterilizing immunity.However, evaluation of this endpoint is often hampered by the time consumingdemands and complexity of methods such as culture isolation (CI). In this study, weevaluated the use of an imprint (or touch preparation) method (IM) in detecting thepresence of leptospires in tissues of hamsters infected with L. interrogans serovar Copenhageni. Compared to CI, the IM exhibited equal or improved detection of leptospires in kidney, liver, lung and blood samples collected post-infection and the overall concordance was good (ê = 0.61). Furthermore, in an evaluation of hamsters immunized with a recombinant Leptospira protein-based vaccine candidate and subsequently challenged with leptospires, the agreement between the CI and IM wasvery good (ê = 0.84). These finding indicate that the IM is a rapid method for the direct observation of Leptospira spp. that can be readily applied to evaluatingLeptospira infection in experimental animals and determining sterilizing immunity when screening potential vaccine candidates.