Use of heterologous antigens for the immunodiagnosis of abdominal angiostrongyliasis by an enzyme-linked immunosorbent assay

Angiostrongylus costaricensis has a broad geographic distribution spanning from North to South America and the infections of vertebrates with this nematode can result in abdominal complications. Human infections are diagnosed by histological or serological methods because the isolation of larvae from feces is not feasible, as most parasites become trapped in intestinal tissues due to intense eosinophilic inflammation. Because A. costaricensis is difficult to maintain in the laboratory, an immunodiagnostic IgG enzyme-linked immunosorbent assay (ELISA) using antigens from the congeneric Angiostrongylus cantonensis species was evaluated against a panel of serum samples from patients who were histologically diagnosed with A. costaricensis infections. Sera from uninfected individuals and individuals infected with other parasites were used as controls. The sensitivity and specificity of the assay were estimated at 88.4 percent and 78.7 percent, respectively. Because the use of purified or cloned antigens has not been established as a reliable diagnostic tool, the use of heterologous antigens may provide a viable alternative for the development of an ELISA-based immunodetection system for the diagnosis of abdominal angiostrongyliasis.

Individual serological follow-up of patients with suspected or confirmed abdominal angiostrongyliasis

Abdominal angiostrongyliasis (AA) is a zoonotic nematode infection caused by Angiostrongylus costaricensis, with widespread occurrence in the Americas. Although the human infection may be highly prevalent, morbidity is low in Southern Brazil. Confirmed diagnosis is based on finding parasitic structures in pathological examination of biopsies or surgical resections. Serology stands as an important diagnostic tool in the less severe courses of the infection. Our objective is to describe the follow up of humoral reactivity every 2-4 weeks up to one year, in six individuals with confirmed (C) and ten suspected (S) AA. Antibody (IgG) detection was performed by ELISA and resulted in gradually declining curves of reactivity in nine subjects (56 percent) (4C + 5S), that were consistently negative in only three of them (2C + 1S) after 221, 121 and 298 days. Three individuals (2C + 1S) presented with low persistent reacitivity, other two (1C + 1S) were serologically negative from the beginning, but also presenting a declining tendency. The study shows indications that abdominal angiostrongyliasis is usually not a persistent infection: although serological negativation may take many months, IgG reactivity is usually declining along time and serum samples pairing may add valuable information to the diagnostic workout.

Longitudinal clinical and serological survey of abdominal angiostrongyliasis in Guaporé, southern Brazil, from 1995 to 1999

Angiostrongilíase abdominal é uma zoonose causada pelo Angiostrongylus costaricensis, nematódeo que se localiza no interior de vasos mesentéricos. Nosso objetivo foi de abordar vários aspectos da história natural da parasitose, num estudo longitudinal clínico-sorológico. Um total de 179 indivíduos residentes em área rural no sul do Brasil, com transmissão ativa, foram seguidos por cinco anos. Neste período foram registradas prevalências de 28,2%, 4,2%, 10%, 20,2% e 2,8% e incidências de 0%, 5,9%, 8% e 1,5%. Tanto o sexo masculino quanto o feminino foram afetados com maiores frequências na faixa etária dos 30 aos 49 anos. Em 32 indivíduos, amostras de soro foram coletadas em todas as etapas e a reatividade de IgG detectada por ELISA foi variável e geralmente não persistindo mais do que um ano. Alguns padrões individuais foram sugestivos de re-infecção. Não houve associação com a ocorrência nem de dor abdominal nem com outras enteroparasitoses e não houve nenhum caso com diagnóstico confirmado (histopatológico) da infecção. Moluscos foram encontrados portando larvas infectantes de terceiro estadio, em algumas moradias, com uma prevalência geral de 16% e baixas cargas parasitárias. Em conclusão, a angiostrongilíase abdominal no sul do Brasil pode ser uma infecção frequente, porém com baixa morbidade e reatividade sorológica de gradual declínio.

Dogs may be a reservoir host for Angiostrongylus costaricensis

Angiostrongylus costaricensis is a parasitic nematode of wild rodents. Several other vertebrate species including man may become infected by ingestion of the third stage larvae produced by the intermediate hosts, usually slugs from the family Veronicellidae. There is a report of the diagnosis of abdominal angiostrongyliasis in Canis familiaris with lesions resembling those found in human disease. As a preliminar evaluation of the adequacy of a canine model for pathogenetic studies, a dog was inoculated with 75 L3 of A. costaricensis. Infection was established and fist stage larvae were found in feces up to 88 days post infection, sometimes in very large numbers (9.5 x 10(4) L1/g). No clinical manifestations or significant lesions were detected. These are indications that dog may play a role as a reservoir host for A. costaricensis

Detection of the acute phase of abdominal angiostrongyliasis with a parasite-specific IgG enzyme linked immunosorbent assay

Angiostrongylus costaricensis may cause intestinal lesions of varied severity when it accidentally infects man in Central and South America. First-stage larvae have never been detected in stools. Therefore, a parasite-specific IgG ELISA was evaluated for the determination of the acute phase of infection. The specificity and the sensitivity of the immunoassay was shown to be 76.2 percent and 91.1 percent, respectively. Eight serum samples taken from patients with histopathological diagnosis, at different time points (3 to 15 months) after surgical treatment, showed a sharp and early decline in antibody reactivity. The titration of anti-A. costaricensis antibodies has proved to be a useful method for the diagnosis of acute abdominal angiostrongyliasis

Angiostrongilose abdominal: patologia cirúrgica de importância regional / Abdominal angiostrongylosis: surgical pathology of reginal importance

Os autores revisaram 18.361 biópsias e peças cirúrgicas de patologia digestiva não-tumoral. Em 1.064 peças cirúrgicas do trato digestivo inferior foram observados 19 casos de angiostrongilose abdominal (AA). Relacionando estes casos com as intervenções cirúrgicas por complicações secundárias da doença de Crohn (DC), colite ulcerativa (CU) e tuberculose intestinal (TI), observou-se que a freqüência de AA em relação às patologias cirúrgicas citadas pode ser considerada como parasitose de importância cirúrgica regional

Abdominal agiostrongylosis in southern Brazil - prevalence and parasitic burden in mollusc intermediate hosts from eighteen endemic foci

Angistrongylus costaricencis is a parasitic nematode of rodents and molluscs are the intermediate hosts. Nocturnal collection of molluscs and search for infective third stage larvae of A.costaricensis was carried out in 18 endemic foci identified by the notification of a confirmed diagnosis in human biopsies or surgical specimens. Molluscs were digested in acidic solution and isolation of larvae eventually present was done in a Baermann funnel. Larvae identified by the presence of a delicate groove in the tail were counted to asses the individual parasitic burden. Four species were found infected, with ranges of prevalence in parenthesis: Phyllocaulis variegatus (7 per cent to 33.3 per cent); Brasybaena similaris (11.7 per cent to 24.1 per cent); Belocaulus angustipes (8.3 per cent) and Phyllocaulis soleiformis (3.3 per cent to 14.2 per cent). Parasitic burden varied from 1 to 75 with P.variegatus, 1 to 98 with B. similaris, 1 to 13 with B.angustipes and 1 larvae in each of two specimens of P.soleiformis. P.variegatus was present in all sites and was found infected with the highest prevalence figures and the highest individual parasitic burdens. These data strss the importance of veronicellid slugs as intermediate hosts for A.costaricensis in the endemic areas in Rio Grande do Sul, Brazil.

Biocompatibilidade entre implantes de titânio com e sem cobertura de hidroxiapatita / Biocompatibility of titanium implants with and without hydroxyapatite coating

O uso de implantes metálicos tem sido demonstrado por grande número de autores em estudos comparativos. No presente trabalho experimental, foram colocados implantes de titânio com e sem cobertura de hidroxiapatita (HA) no canal de ambos os fêmures, em ratos albinos, a de se analisarem aspectos histológicos e radiológicos da osteointegraçäo implante-osseo. As cobaias foram abatidas em quatro, doze e vinte e quatro semanas de evoluçäo, tendo sido retirados os seus fêmures, radiografados, fixados em formol 10 por cento, nos quais foram feitos cortes para estudo histológico. Evidenciou-se que implantes com cobertura de hidroxiapatita induzem à formaçäo óssea satisfatória e, em oposiçäo, em implantes sem cobertura (titânio jateado + ionizado, titânio jateado + ionizado + titânio oxidado), houve uma osteointegraçäo pobre, substituída por uma interface de tecido conjuntivo fibroso

Manifestaçöes de comprometimento hepático na angiostrongilíase abdominal e diagnóstico pelo encontro dos ovos do parasita / Clinical manifestations of hepatic involvement in abdominal angiostrongyliasis diagnosed by the finding of the parasite's eggs

Manifestaçöes clínicas de comprometimento hepático na angiostrongilíase abdominal e diagnóstico pelo encontro de ovos do parasita nos cortes histológicos, raramente säo referidos na literatura. Os autores descrevem um caso onde o quadro clínico inicial era sugestivo de lesäo tumoral na regiäo ileocecal. A presença de ovos do parasita nas lesöes anatômicas habituais desta parasitose auxiliou a estabelecer o diagnóstico. Este relato serve para alertar médicos e patologistas para apresentaçöes aparentemente pouco usuais da angiostrongilíase abdominal

On the diversity of mollusc intermediate hosts of Angiostrongylus costaricensis Morera & Cespedes, 1971 in southern Brazil

Veronicellid slugs are considered the most important intermediate hosts of Angiostrongylus costaricensis, an intra-arterial nematode of rodents. Studies undertaken in three localities in southern Brazil led to identification of molluscs other than veronicellid slugs as hosts of A. costaricensis: Limax maximus, Limax flavus and Bradybaena similaris. These data indicate a low host specificity of larval stages of A. costaricensis, as it has been reported to other congeneric species

Cystosarcoma phyllodes com retraçäo mamilar / Cystosarcoma phyllodes with nipple retraction

Um caso de "Cystosarcoma Phyllodes" é apresentado pelos autores. Os procedimentos para estabelecer o diagnóstico e tratamento säo discutidos. O aspecto mais importante enfatizado foi a retraçäo do mamilo