Can domestic dogs be considered a good reservoir of Leishmania (L.) infantum chagasi in an endemic area of nonulcerated cutaneous leishmaniasis in Southern Honduras?

ABSTRACT Dogs are considered to be the main domestic reservoir associated with the transmission of Leishmania (L.) infantum chagasi to humans in endemic areas of visceral leishmaniasis in America. However, little is known about the role of canines as a source of infection in endemic areas of nonulcerated cutaneous leishmaniasis (NUCL). Therefore, the objective of the present study was to investigate the role of dogs as a possible reservoir of the parasite in Southern Honduras. Dogs (n = 107) living with individuals affected by NUCL were clinically examined and biological material was collected for parasitological and immunological diagnosis. Most animals showed a healthy appearance and a few presented slight weight loss (64%), alopecia (7%), onychogryphosis (5%) and skin lesions (1%). The overall seroprevalence of Leishmania infection based on the DDP ® quick test and/or in-house ELISA serological test was 41%. The presence of the parasite's DNA was confirmed in 94% of the dogs; however, the average parasite load in the buffy coat was low at 6.09 parasites/µL, ranging between 0.221 and 50.2. The skin of seropositive dogs examined by histopathology using paraffin sections stained by hematoxylin and immunohistochemistry did not show cutaneous lesions or parasite amastigotes. Based on the absence of parasites in the skin and the low parasite load detected in the buffy coat, it seems that the dog does not represent a good source of infection for the vector in the endemic area of NUCL transmission in Southern Honduras. Other domestic and/or wild animals should be investigated.

Reactivity of sera from dogs living in a leishmaniasis-endemic area to the COOH-terminal region of cysteine proteinase B

ABSTRACT Cysteine proteinases are well-known virulence factors of Leishmania spp. with demonstrated actions in both experimental mouse infection and human infection. However, studies on these enzymes in canine leishmaniasis are scarce. Here, we show, for the first time, the reactivity of sera from dogs living in an endemic area to a recombinant protein from the COOH-terminal region of cysteine B protease. In this work, enzyme-linked immunosorbent assays were performed using a 14 kDa rcyspep protein obtained through a pET28-a expression system in Escherichia coli. First, 96-well plates were coated with rcyspep (500 ng/well) and incubated with sera from dogs (1:100). Subsequently, IgG antibody detection was performed using rabbit anti-dog IgG antibodies conjugated with peroxidase. Sera from dogs (n = 114), including suspect (n = 30) and positive (n = 50) dogs from a leishmaniasis-endemic area and dogs from a nonendemic area, (n = 34), negative for leishmaniasis, were assessed. The results showed that sera from the suspect (42%) and positive (68%) groups responded differently to the antigen titers tested above the cut-off (Optical Density = 0.166). This finding suggests that the immune response detected against cyspep may be related to clinical disorders present in these animals. Collectively, the data gathered here suggest that cyspep can sensitize the immune systems of dogs from a leishmaniasis-endemic area to elicit a humoral response, an immunological parameter indicating the contribution of this protein in host-parasite interaction.

Performance of rapid tests for canine visceral leishmaniasis diagnosis in Argentina

To diagnose dogs infected by Leishmania infantum rK39 rapid diagnosis test is widely used in the Americas, while dual path platform (DPP) was recently adopted by Brazil. In this study we assessed the performance of rK39-RDT and DPP tests in recent urban transmission scenarios of Argentina. The sensitivity and specificity were evaluated with a sera panel and field samples, taken as true infected those from parasitological and/or PCR positive tests. Since none of these tests can be taken as a gold standard, the performance was also evaluated using Latent Class Analysis, a statistical modeling technique which allows to estimating sensitivity and specificity defining a latent class variable as the reference standard. The sensitivity of both tests in the panel was around 92% (symptomatic dogs 96%, asymptomatic 83%), while the sensitivity in field samples of rK39-RDT was 77%, and DPP 98% (mean in symptomatic dogs 89%, asymptomatic 82%). The specificity was similar for both tests and samples, around 98%. Therefore, these tests are acceptable for program dog population-based studies, as spatial stratification, focus intervention and follow up, and they could be used for individual screening and confirmation of clinical presumptive diagnosis in polysymptomatic dogs. The inability to discriminate between immunity and actual infectiousness suggest that a combination with other non-immunological based tests will be required for highly sensitive/specific diagnosis in order to targeting control measures in individual reservoirs from public health perspective, as for individual management from animal health perspective.

Para diagnosticar perros infectados por Leishmania infantum, en las Américas se utiliza ampliamente la prueba rápida rK39, mientras que DPP fue adoptado recientemente por Brasil. En este estudio se evaluó el desempeño de las pruebas rK39-RDT y DPP en escenarios de transmisión urbana reciente en Argentina. La sensibilidad y especificidad se evaluaron con un panel de sueros y muestras de campo, considerando muestras infectadas verdaderas aquellas con pruebas parasitológicas y/o de PCR positivas. Como ninguna de estas pruebas puede considerarse estándar de oro, el desempeño también se evaluó mediante análisis de clases latentes, una técnica de modelado estadístico que permite estimar sensibilidad y especificidad definiendo una variable de clase latente como estándar. La sensibilidad de ambas pruebas en el panel fue de alrededor del 92% (perros sintomáticos 96%, asintomáticos 83%), mientras que la sensibilidad en muestras de campo fue rK39-RDT: 77%, y DPP 98% (media en perros sintomáticos 89%, asintomáticos 82%). La especificidad fue similar para ambas pruebas y muestras, cerca de 98%. Por lo tanto, estas pruebas son aceptables para estudios programáticos caninos de base-poblacional, como estratificación espacial, intervención de foco y seguimiento, y podrían utilizarse para el tamizaje individual y la confirmación del diagnóstico clínico presuntivo en perros poli-sintomáticos. La incapacidad de discriminar entre inmunidad e infectividad real sugiere que se requerirá una combinación con otras pruebas, de base no inmunológica, para un diagnóstico suficientemente sensible/específico que permita definir las medidas de control en reservorios individuales, tanto para salud pública, como para la gestión individual en salud animal.

Evaluation of the performance of three serological tests for diagnosis of Leishmania infantum infection in dogs using latent class analysis / Avaliação da realização de três testes sorológicos para diagnóstico de infecção por Leishmania infantum em cães utilizando análise de classe latente

Abstract Canine leishmaniasis (CanL) is a disease caused by Leishmania infantum. Serological methods are the most common diagnostic techniques used for the diagnosis of the CanL. The objective of our study was to estimate the sensitivity and specificity of one in-house ELISA kit (ELISA UNIZAR) and three commercially available serological tests (MEGACOR Diagnostik GmbH) including an immunochromatographic rapid test (FASTest LEISH®), an immunofluorescent antibody test (MegaFLUO LEISH®) and an enzyme-linked immunosorbent assay (MegaELISA LEISH®), using latent class models in a Bayesian analysis. Two hundred fifteen serum samples were included. The highest sensitivity was achieved for FASTest LEISH® (99.38%), ELISA UNIZAR (99.37%), MegaFLUO LEISH® (99.36%) followed by MegaELISA LEISH® (98.49%). The best specificity was obtained by FASTest LEISH® (98.43%), followed by ELISA UNIZAR (97.50%), whilst MegaFLUO LEISH® and MegaELISA LEISH® obtained the lower specificity (91.94% and 91.93%, respectively). The results of present study indicate that the immunochromatographic rapid test evaluated FASTest LEISH® show similar levels of sensitivity and specificity to the quantitative commercial tests. Among quantitative serological tests, sensitivity and specificity were similar considering ELISA or IFAT techniques.

Resumo A leishmaniose canina (Lcan) é uma causada pela Leishmania infantum. Os métodos sorológicos são as técnicas diagnósticas mais utilizadas para o diagnóstico da leishmaniose canina. O objetivo do nosso estudo foi estimar a sensibilidade e a especificidade de um kit ELISA interno (ELISA UNIZAR) e de três testes sorológicos disponíveis comercialmente, feitos pelo mesmo fabricante (MEGACOR Diagnostik GmbH), incluindo um teste rápido imunocromatográfico (FASTest LEISH®), um teste de anticorpos imunofluorescentes (Megafluo LEISH®) e um ensaio de imunoabsorção enzimática (Megaelisa LEISH®), utilizando-se modelos de classe latentes numa análise bayesiana. Foram incluídas duzentas e quinze amostras de soro. A maior sensibilidade foi alcançada para Fastest LEISH® (99,38%), ELISA UNIZAR (99,37%), Megafluo LEISH® (99,36%) seguida por Megaelisa LEISH® (98,49%). A melhor especificidade foi obtida por FASTest LEISH® (98,43%), seguida por ELISA UNIZAR (97,50%), enquanto Megafluo LEISH® e Megaelisa LEISH® obtiveram a menor especificidade (91,94% e 91,93%, respectivamente). Os resultados do presente estudo indicam que o teste rápido imunocromatográfico, avaliado por FASTest LEISH® mostra níveis similares de sensibilidade e especificidade aos testes comerciais quantitativos incluídos. Entre os testes sorológicos quantitativos, a sensibilidade e a especificidade foram semelhantes, considerando-se as técnicas de ELISA ou IFI.

Canine visceral leishmaniasis in area with recent Leishmania transmission: prevalence, diagnosis, and molecular identification of the infecting species

Abstract INTRODUCTION: Canine visceral leishmaniasis (CVL) is an endemic disease in Brazil, and integrated control actions have been adopted by the Brazilian Ministry of Health to control its spread. However, the transmission profile is unknown in areas with recent CVL cases, including Itaúna, located in the Brazilian state of Minas Gerais, where the present study was carried out. METHODS: A total of 2,302 dogs from 12 neighborhoods were serologically tested for canine VL using the current diagnostic protocol adopted by the Brazilian Ministry of Health. Test positivity rate (TPR) and CVL prevalence were determined for each neighborhood. The presence of Leishmania was assessed in 60 seropositive dogs which had been recommended for euthanasia. Twenty-two of them (37%) were asymptomatic, and 38 (63%) were symptomatic for CVL. Parasitological (myeloculture and smear/imprint) and molecular (PCR) methods were employed for Leishmania detection in bone marrow, spleen, mesenteric lymph nodes, and ear skin. The infecting Leishmania species was identified by DNA sequencing. RESULTS: CVL prevalence (per 1,000 dogs) varied from 0.0-166.67, depending on the neighborhood, with a mean of 68.96 (SD 51.38). Leishmania DNA was detected in at least one tissue from all seropositive dogs, with comparable TPR among tissues. Leishmania parasites were identified in most (54/60) seropositive dogs, and the infecting parasite was identified as Leishmania infantum in all of these. CONCLUSIONS: Prevalence of CVL is a contributor to the spread of visceral leishmaniasis in Itaúna.

Genetic variability of Leishmania infantum in naturally infected dogs in the state of Bahia, Brazil / Variabilidade genética de Leishmania infantum em cães naturalmente infectados no estado da Bahia, Brasil

Abstract In Brazil, Leishmania infantum mainly affects humans and dogs. The state of Bahia presents many dogs that are positive for this parasite. Despite the importance of epidemiology in this region, there are still very few studies that have assessed the genetic characteristics of L. infantum. The aim of this study is to investigate the genetic variability of L. infantum isolated identified in naturally infected dogs, in order to verify occurrence of subpopulation of this parasite in the different biomes existing in the state of Bahia. Thirty-two samples of L. infantum were analyzed, which were obtained isolated in dogs from the Mata Atlântica (rainforest), Caatinga (semi-arid scrub forest), and Cerrado (a vast tropical savannah eco-region) Bahia municipalities' biomes. All animals presented with clinical changes suggestive of Leishmania spp. and they exhibited positive reactions to serological tests. kDNA analysis with RFLP markers revealed the presence of genetic variability and gene flow in subpopulations of L. infantum; samples from the Mata Atlântica areas were genetically more similar to those from the areas of Caatinga and they were less likely to resemble those of the Cerrado. This data may be used to investigate the dissemination of parasite in the canine population of state of Bahia.

Resumo No Brasil a Leishmania infantum afeta principalmente o homem e os cães. O estado da Bahia apresenta elevado número de cães positivos por este parasito. Apesar da importância epidemiologia para a região, ainda há poucos estudos que avaliam as características genéticas de L. infantum. Objetivou-se com este estudo investigar a variabilidade genética de cepas de L. infantum identificadas em cães naturalmente infectados, a fim de verificar a ocorrência de sobpopulações do parasito nos diferentes biomas existentes no estado da Bahia. Foram analisadas 32 amostras de L. infantum isoladas em cães de municípios baianos distribuídos nos biomas Mata Atlântica, Caatinga e Cerrado. Todos os animais apresentavam alterações clínicas sugestivas de Leishmania spp. e reação positiva em exames sorológicos. A análise do kDNA com marcadores RFLP revelaram a presença de variabilidade genética e fluxo gênico nas subpopulações de L. infantum sendo que as amostras das áreas de Mata Atlântica foram geneticamente mais semelhantes as das áreas de Caatinga e foram mais distantes daquelas oriundas do Cerrado. Estas informações podem auxiliar em investigações de dispersão do parasito na população canino do Estado da Bahia.

Pathology of dogs in Campo Grande, MS, Brazil naturally co-infected with Leishmania infantum and Ehrlichia canis / Patologia de cães naturalmente coinfectados por Leishmania infantum e Ehrlichia canis em Campo Grande, MS, Brasil

Different parasites that commonly occur concomitantly can influence one another, sometimes with unpredictable effects. We evaluated pathological aspects of dogs naturally co-infected with Leishmania infantum and Ehrlichia canis. The health status of the dogs was investigated based on histopathological, hematological and biochemical analyses of 21 animals infected solely with L. infantum and 22 dogs co- infected with L. infantum and E. canis. The skin of both groups showed chronic, predominantly lymphohistioplasmacytic inflammatory reaction. The plasmacytosis in the lymphoid tissues was likely related with the hypergammaglobulinemia detected in all the dogs. The disorganization of extracellular matrix found in the reticular dermis of the inguinal region and ear, characterized by the substitution of thick collagen fibers for thin fibers, was attributed to the degree of inflammatory reaction, irrespective of the presence of parasites. In addition, the histopathological analysis revealed that twice as many dogs in the co-infected group presented Leishmania amastigotes in the ear skin than those infected solely with Leishmania, increasing the possibility of becoming infected through sand fly vectors. Our findings highlight the fact that the health of dogs infected concomitantly with L. infantum and E. canis is severely compromised due to their high levels of total plasma protein, globulins, alkaline phosphatase and creatine kinase, and severe anemia.

A infecção simultânea por parasitas de diferentes espécies pode resultar em alterações imprevisíveis. O presente estudo avaliou a patologia de cães naturalmente coinfectados por Leishmania infantum e Ehrlichia canis. A saúde dos cães foi investigada pelas análises histopatológicas, hematológicas e bioquímicas de 21 cães infectados somente por L. infantum e 22 cães coinfectados por L. infantum e E. canis. Observou-se uma reação inflamatória crônica, predominantemente linfohistioplasmocítica, na pele dos dois grupos. A plasmocitose, encontrada nos tecidos linfóides, provavelmente estava relacionada com a hipergamaglobulinemia observada em todos os cães amostrados. A desorganização da matriz extracelular da derme da região inguinal e da orelha, demonstrada pela substituição das fibras de colágeno espessas por fibras finas, foi relacionada com o grau de reação inflamatória, independente da presença de parasitas. Ainda, observamos duas vezes mais animais do grupo coinfectado apresentando formas amastigotas na pele de orelha pela histopatologia comparado ao número de cães infectados apenas por Leishmania, tornando-os desta forma mais infectivos aos vetores. Nossos resultados ressaltam que a saúde de cães coinfectados estava severamente comprometida devido aos altos níveis de proteína plasmática total, globulinas, fosfatase alcalina, creatina quinase e anemia acentuada.

Isotipos de anticorpos anti-leishmania no soro e expressão de citocinas no baço de cães naturalmente infectados com Leishmania infantum / Isotypes of anti-leishmania antibodies in serum and cytokine expression in the spleen of dogs naturally infected with Leishmania infantum

Neste estudo foi analisada a distribuição de isotipos de imunoglobulinas IgG1, IgG2 e IgE envolvidas na resposta a Leishmania no soro e a expressão de mRNA para IFN-g e IL-4 in situ no baço de cães naturalmente infectados com L.infantum com diferentes perfis de susceptibilidade ou resistência à doença. A atividade sérica de anticorpos do isotipo IgG1 contra Leishmania tendeu a ser maior nos animais com teste cutêneo da Leishmanina negativo e com parasitismo esplênico (grupo infectado potencialmente susceptível, 0,424±0,401) que nos outros grupos: com teste cutêneo da Leishmanina positivo e ausência de parasitismo esplênico (grupo infectado potencialmente resistente, 0,226±0,114), ou com ambos teste cutêneo da Leishmanina e cultura esplênica positivos (grupo em fase indeterminada da doença, 0,234±0,125) ou com ambos os parâmetros negativos (grupo potencialmente não infectado, 0,159±0,044). Essa diferença não foi, contudo estatisticamente significante (ANOVA, P=0,1450). IgG2 específica anti-Leishmania foi maior (ANOVA P=0,0001)...

We analyzed the distribution immunoglobulin isotypes IgG1, IgG2 and IgE involved in the response to Leishmania and the mRNA expression for IFN-g and IL-4 in situ in the spleen of dogs naturally infected with IgG1 antibody anti-Leishmania serum activity was higher in animals with negative Leishmanin skin test and splenic parasitism (infected and potencially susceptible to VL group, 0,424±0,401) than in other groups: positive Leishmanin skin test and negative splenic parasitism (infected and potentially resistant to VL group, 0,226±0,114), or both positive Leishmanin skin test and slpenic parasitism (infected with undefined susceptibility status group, 0234±0,125) or both negative parameters (non-infected group, 0159±0,044). This difference however was not statistically significant (ANOVA, P=0145)...

Complement activation-related pseudoallergy in dogs following intravenous administration of a liposomal formulation of meglumine antimoniate / Pseudoalergia relacionada à ativação do complemento em cães após administração intravenosa de uma formulação lipossomal de antimoniato de meglumina

The increasing use of nanotechnologies in advanced therapies has allowed the observation of specific adverse reactions related to nanostructures. The toxicity of a novel liposome formulation of meglumine antimoniate in dogs with visceral leishmaniasis after single dose has been investigated. Groups of 12 animals received by the intravenous route a single dose of liposomal meglumine antimoniate (group I [GI], 6.5 mg Sb/kg), empty liposomes (GII) or isotonic saline (GIII). Evaluation of hematological and biochemical parameters showed no significant changes 4 days after administration. No undesired effects were registered in the GIII. However, adverse reactions were observed in 67.7% of dogs from both groups that received liposomal formulations. The side effects began moments after bolus administration and disappeared during the first 15 minutes after treatment. Prostation, sialorrhea and defecation were the most frequent clinical signs, registered in 33.3% and 41.6 % of animals from the groups GI and GII, respectively. Tachypnea, mydriasis, miosis, vomiting and cyanosis were also registered in both groups. The adverse reactions observed in this study were attributed to the activation of the complement system by lipid vesicles in a phenomenon known as Complement Activation-Related Pseudoallergy (CARPA). The influence of the physical-chemical characteristics of liposomal formulation in the triggering of CARPA is discussed.

O crescente uso das nanotecnologias nas terapias avançadas tem permitido a observação de reações adversas específicas relacionadas às nanoestruturas. A toxicidade de uma nova formulação lipossomal de antimoniato de meglumina após dose única foi avaliada em cães com leishmaniose visceral. Grupos de 12 animais receberam por via intravenosa uma dose única de antimoniato de meglumina lipossomal (grupo I [GI], 6,5 mg Sb/kg), lipossomas vazios (GII) ou solução salina isotônica (GIII). A avaliação de parâmetros hematológicos e bioquímicos não revelou alterações significativas quatro dias após a administração. Nenhum efeito indesejável foi registrado no GIII. No entanto, reações adversas foram observadas em 67,7% dos cães de ambos os grupos que receberam formulações lipossomais. Os efeitos colaterais iniciaram momentos após a administração em "bolus" e desapareceram no decurso dos primeiros 15 minutos após o tratamento. Prostração, sialorréia e defecação foram os sinais clínicos mais frequentes, registrados em 33,3% e 41,6% dos animais dos grupos GI e GII, respectivamente. Taquipnéia, midríase, miose, vômitos e cianose também foram registrados em ambos os grupos. As reações adversas observadas neste trabalho foram atribuídas à ativação do sistema complemento pelas vesículas lipídicas em fenômeno conhecido como Pseudoalergia Relacionada à Ativação do Complemento (PARAC). A influência das características físico-químicas da formulação lipossomal no desencadeamento de PARAC é abordada.

Canine leishmaniasis in México: the detection of a new focus of canine leishmaniasis in the state of Guerrero correlates with an increase of human cases

Background. In Mexico, a steady increase of patients with visceral leishmaniasis has been reported, especially in the states of Chiapas and Guerrero, yet only limited information exists on canine leishmaniasis in areas of visceral leishmaniasis in Mexico. A veterinary report of dogs with nonhealing cutaneous lesions in Pungarabato, Guerrero led us to investigate the possible presence of Leishmania infection in an area where Lutzomyia longipalpis and Lutzomyia evansi, both vectors of Leishmania infantum, have been described. Methods. We analyzed skin lesions of 25 dogs by immunohistochemistry and PCR. Results. We found a 60% prevalence of Leishmania-infected dogs, the infection rate being higher in males than females. Thus, we established a new focus of canine leishmaniasis, and although to date no patients have been reported in this municipality, it is close to and shares the same ecological characteristics of dry tropical forests as regions where visceral leishmaniasis has been reported in Mexico. We also include updated information of localities of visceral leishmaniasis in Mexico as well as the distribution of possible sand fly vectors. Conclusions. Our data show the need to ascertain the magnitude of this new focus in view of the current data on human visceral leishmaniasis, a disease that is surging in Mexico.