ABSTRACT
This work compared the time at which negative seroconversion was detected by conventional serology (CS) and by the ELISA-F29 test on a cohort of chronic chagasic patients treated with nifurtimox or benznidazole. A retrospective study was performed using preserved serum from 66 asymptomatic chagasic adults under clinical supervision, and bi-annual serological examinations over a mean follow-up of 23 years. Twenty nine patients received trypanocide treatment and 37 remained untreated. The ELISA-F29 test used a recombinant antigen which was obtained by expressing the Trypanosoma cruzi flagellar calcium-binding protein gene in Escherichia coli. Among the untreated patients, 36 maintained CS titers. One patient showed a doubtful serology in some check-ups. ELISA-F29 showed constant reactivity in 35 out of 37 patients and was negative for the patient with fluctuating CS. The treated patients were divided into three groups according to the CS titers: in 13 they became negative; in 12 they decreased and in four they remained unchanged. ELISA-F29 was negative for the first two groups. The time at which negativization was detected was significantly lower for the ELISA-F29 test than for CS, 14.5 ± 5.7 and 22 ± 4.9 years respectively. Negative seroconversion was observed in treated patients only. The results obtained confirm that the ELISA-F29 test is useful as an early indicator of negative seroconversion in treated chronic patients.
Este trabalho comparou os tempos de soroconversão negativos obtidos pela sorologia convencional (CS) e teste ELISA-F29 em uma coorte de pacientes chagásicos crônicos tratados com nifurtimox ou benznidazol. Um estudo retrospectivo foi realizado com soro preservado de 66 adultos chagásicos assintomáticos com acompanhamento clínico e sorológico semestral ao longo de um seguimento médio de 23 anos. 29 pacientes receberam tratamento tripanossomicida e 37 outras permaneceram sem tratamento. O teste ELISA-F29 usou um antígeno recombinante obtido por expressão do gene de uma proteína flagelar de Trypanosoma cruzi de ligação de cálcio em Escherichia coli. Entre os pacientes não tratados, 36 mantiveram os títulos da CS. Um paciente apresentou sorologia duvidosa em alguns controles. ELISA-F29 apresentou reatividade constante em 35/37 e foi negativo no paciente com CS flutuante. Os pacientes tratados foram agrupados de acordo com os títulos da CS, em três grupos: 13 tornaram-se negativos, 12 diminuíram e quatro permaneceram inalterados. ELISA-F29 foi negativo nos dois primeiros grupos. O tempo de negativização foi significativamente menor para o teste ELISA-F29 do que para CS (14,5 ± 5,7 e 22 ± 4,9 anos, respectivamente). A soroconversão negativa foi observada somente nos pacientes tratados. Os resultados obtidos confirmam que o teste ELISA-F29 é útil como um indicador precoce de soronegativação em pacientes crônicos tratados.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Chagas Disease/drug therapy , Enzyme-Linked Immunosorbent Assay/methods , Nifurtimox/therapeutic use , Nitroimidazoles/therapeutic use , Trypanocidal Agents/therapeutic use , Trypanosoma cruzi/immunology , Antibodies, Protozoan/blood , Antigens, Protozoan/immunology , Case-Control Studies , Chronic Disease , Cohort Studies , Chagas Disease/parasitology , Retrospective Studies , Time Factors , Treatment OutcomeABSTRACT
En este trabajo se describe la realización de un mapeo del genoma del parásito causal de la enfermedad de Chagas, el Trypanosoma cruzi, hibridando una genoteca construída en cósmidos y grillada en filtros de alta densidad, utilizando como sondas clones de AND copia provenientes de una genoteca de expresión en epimastigotes. Se muestra además la correlación de secuencias superpuestas de cósmidos (contigs) con bandas cromosomales del parásito. Utilizando estas mismas genotecas generadas por el Proyecto Genoma de T. cruzi, se caracterizó un nuevo miembro de la familia Tc 13 de la superfamilia de antígenos de superficie de tripomastigotes. A partir de un clon de la cepa Tulahuén stock. Tul2, con homología con estos antígenos, se secuenció y caracterizó el gen completo en la cepa de referencia CL clon CL Brener, encontrándose además homología con diferentes ESTs, lo cual posibilitaria conocer en su totalidad a esta familia de antígenos.
Subject(s)
Animals , Antigens, Protozoan/genetics , Antigens, Surface/genetics , Genome , Trypanosoma cruzi/genetics , Base Sequence , Chromosome Mapping , DNA Probes , KaryotypingABSTRACT
SKF525A, an inhibitor and inducer of cytochrome P450, was tested on different developmental stages of Trypanosoma cruzi. Growth, motility and structure of epimastigotes, motility and infectivity of trypomastigotes, and infectivity of trypomastigotes to Vero cells in culture were abolished by the drug at 10-100 muM concentration. When blood from infected mice was treated with the drug, and used to infect 8 day-old-mice, no parasites were observed at 0.6-1 mM, and all animals survived. Blood cell morphology was well preserved, and the sleeping time of pentobarbital-treated mice inoculated with the same amount of drug was not increased. The present results suggest that SKF525A or other related inhibitors of cytochrome P450 coned be tested as an additive for blood sterilization in blood banks.