Diversity and composition of dengue virus type 2 in Venezuela.

Dengue is a mosquito-borne disease caused by four closely related dengue virus (genus Flavivirus)serotypes (DENV-1­4). The clinical outcomes vary from mild febrile illness to life-threatening haemorrhagic manifestations. DENVs are endemic in the tropics and subtropics globally and currently no specific treatment or vaccines are available. In Venezuela, the American-Asian genotype of DENV-2 is the most prevalent and has been associated with severe disease outcomes.We aimed to follow-up the molecular epidemiology of DENV-2 in Venezuela to investigate if the evolution of the virus has remained the same throughout time or if the same dynamics documented in Brazil (hyperendemic co-circulation) also occurred. The results show that whereas the epidemiology of DENV in several endemic areas is characterized by serotype replacements through time, in Venezuela the American-Asian genotype DENV-2 has evolved into several genetic lineages and has remained in hyperendemic co-circulation with the other serotypes.

A phylogenetic analysis using full-length viral genomes of South American dengue serotype 3 in consecutive Venezuelan outbreaks reveals a novel NS5 mutation.

Dengue virus currently causes 50-100 million infections annually. Comprehensive knowledge about the evolution of Dengue in response to selection pressure is currently unavailable, but would greatly enhance vaccine design efforts. In the current study, we sequenced 187 new dengue virus serotype 3 (DENV-3) genotype III whole genomes isolated from Asia and the Americas. We analyzed them together with previously-sequenced isolates to gain a more detailed understanding of the evolutionary adaptations existing in this prevalent American serotype. In order to analyze the phylogenetic dynamics of DENV-3 during outbreak periods; we incorporated datasets of 48 and 11 sequences spanning two major outbreaks in Venezuela during 2001 and 2007-2008, respectively. Our phylogenetic analysis of newly sequenced viruses shows that subsets of genomes cluster primarily by geographic location, and secondarily by time of virus isolation. DENV-3 genotype III sequences from Asia are significantly divergent from those from the Americas due to their geographical separation and subsequent speciation. We measured amino acid variation for the E protein by calculating the Shannon entropy at each position between Asian and American genomes. We found a cluster of seven amino acid substitutions having high variability within E protein domain III, which has previously been implicated in serotype-specific neutralization escape mutants. No novel mutations were found in the E protein of sequences isolated during either Venezuelan outbreak. Shannon entropy analysis of the NS5 polymerase mature protein revealed that a G374E mutation, in a region that contributes to interferon resistance in other flaviviruses by interfering with JAK-STAT signaling was present in both the Asian and American sequences from the 2007-2008 Venezuelan outbreak, but was absent in the sequences from the 2001 Venezuelan outbreak. In addition to E, several NS5 amino acid changes were unique to the 2007-2008 epidemic in Venezuela and may give additional insight into the adaptive response of DENV-3 at the population level.

Difference between the abilities of human Fcgamma receptor-expressing CV-1 cells to neutralize American and Asian genotypes of dengue virus 2.

Sera from patients involved in a Peruvian outbreak of dengue virus serotype 1 infection cross-neutralized the American genotype of dengue virus serotype 2 up to 100-fold more efficiently than they did the virulent Asian genotype of dengue virus serotype 2, as determined by a plaque reduction neutralization test (PRNT) with CV-1 fibroblasts modified to express human Fcgamma receptor CD32. The concordant preferential immune enhancement of the Asian genotype of dengue virus serotype 2 in human monocytes suggests that such a modification might strengthen the correlation between the PRNT titer and protection.

Molecular epidemiology of dengue virus type 3 in Venezuela.

During the past 40 years, dengue haemorrhagic fever and dengue shock syndrome (DHF/DSS) have emerged in humans, with approximately 3 million cases reported and over 58 000 deaths. Dengue virus serotypes 1, 2 and 4 (DENV-1, -2 and -4) have been co-circulating in Venezuela for at least the past 10 years, causing minor or major outbreaks of dengue fever (DF) and DHF/DSS. The first recorded outbreak due to DENV-3 in Venezuela dates to 1964 and the virus then seems to have disappeared. However, DENV-3 re-appeared recently (in July, 2000) in Venezuela after 32 years of absence and produced a prolonged major outbreak, which, by the end of 2001, involved 83 180 cases of dengue, mostly DF (92 %). Previous phylogenetic studies revealed that the DENV-3 circulating during the 1960s Latin American outbreak was a genotype V virus. To gain a better understanding of the nature of the current epidemic, the complete sequence was determined of the envelope (E) gene of 15 Venezuelan DENV-3 viruses isolated during 2000 and 2001 from patients presenting with different disease severity. Sequence data were used in phylogenetic comparisons with global samples of DENV-3. Analysis revealed that the strain circulating in Venezuela is closely related to isolates that were previously present in Panama and Nicaragua in 1994 and since then have spread through Central American countries and Mexico. This study also confirms previous reports showing that the DENV-3 strain currently circulating in the Americas is related to the strain that caused DHF epidemics in Sri Lanka and India in 1989-1991 (genotype III). Finally, no evidence of the re-emergence of the strain that circulated in Venezuela in the late 1960s and 1970s (genotype V) was found.

Molecular epidemiology of dengue type 2 virus in Venezuela: evidence for in situ virus evolution and recombination.

Epidemic outbreaks of dengue fever (DF) were first recorded in Venezuela in 1978 and were followed by the emergence of dengue haemorrhagic fever (DHF) outbreaks in 1989. To gain a better understanding of the nature of these epidemics, the complete envelope (E) gene sequence of 34 Venezuelan dengue type 2 (DEN-2) viruses, isolated between 1997 and 2000 was determined. Of these isolates, 16 were from patients with DF and 17 were from patients diagnosed with DHF. There were no diagnostic sequence differences between them, suggesting that the E gene alone does not determine disease severity. These sequence data were also used in phylogenetic comparisons with a global sample of DEN-2 viruses, including strains collected previously from Venezuela. This analysis revealed that the ancestors of the Venezuelan viruses were Asian in origin, implying that a DEN-2 virus strain from this region was introduced into Venezuela and the wider Caribbean region during the late 1970s or the early 1980s. The phylogenetic trees further indicate that evolution of DEN-2 virus in Venezuela has occurred in situ, with differentiation into a number of distinct but co-circulating lineages, rather than the repeated introduction of new strains from other localities. By incorporating additional sequence data from the virus capsid, premembrane and membrane genes, evidence is provided that a single Venezuelan strain sequenced previously, designated Mara4, is a recombinant virus, incorporating genome sequence from Venezuelan and Asian parental viruses.

Utilidad de la transcripción reversa-reacción en cadena de la polimerasa (RT-PCR) para la vigilancia proactiva y el diagnóstico clínico del dengue / Utility of everse-reaction transcrptions in chain of polimerase (RT-PCR) to the proactive surveillance and clinical diagnoses of dengue

Un sistema de vigilancia proactiva efectivo para dengue requiere de técnicas de laboratorio rápidas y confiable que puedan detectar tempranamente la transmisión viral para predecir las epidemias con suficiente anticipación. En este sentido, la técnica de reverso transcripción-reacción en cadena de la polimerasa (RT-PCR) es una alternativa que ha sido utilizada exitosamente en sistema de vigilancia proactiva de centro y Sur América. En este estudio comparamos las cualidades del diagnóstico confirmatorio temprano del dengue de las técnicas RT-PCR, aislamiento viral en células C6/36 y serotipificación con anticuerpos con monoclonales antidengue (AIV), ensayo inmunoenzimático de captura de IgM anti-dengue (MAC-ELISA) y la inhibición de la hemaglutinación (IHA). Para el estudio utilizamos 1.019 sueros de pacientes atendidos por el sistema de vigilancia proactiva del estado Aragua, Venezuela. Los resultados desmotraron que la RT_PCR tuvo: a)mayores tasas de positividad que el AIV, el MAC-ELISA y la IHA, b)Alta sensibilidad (100 por ciento) y aceptable especificidad (73,5 por ciento) respecto al AIV y c)buena eficacia y rapidez en obtener resultados en los cuatros días iniciales de la enfermedad. Estas cualidades la convierte en una poderosa herramienta para la vigilancia proactiva del dengue(au)

[Biological behavior of 3 strains of the dengue-2 virus in 2 cell lines of mosquitoes]. / Comportamiento biológico de 3 cepas del virus dengue-2 en 2 líneas celulares de mosquitos.

Strains A-15 (isolated in Cuba, 1981), Jamaica (isolated in Jamaica, 1981) and Nueva Guinea "C" (standard) from dengue-2 virus were compared according to the time of appearance of the cytopathic effect (CPE), to the time of appearance of specific fluorescence and to the kynetics of viral multiplication on being innoculated in the cell lines AP-61 (Aedes pseudoscutellaris) and C6/36 HT (Aedes albopictus). The results showed that the CPE of highest intensity and earliest appearance was for A-15, followed by Jamaica and Nueva Guinea "C" (NGC). AP-61 seems to favor the CPE of Jamaica with respect to that of the same strain in C6/36 HT. The fluorescence was earlier for Jamaica and A-15 and more intensive for the latter, whereas NGC manifested late. This behaviour was similar in the 2 cellular systems. The greatest titres during the kinetics of viral multiplication were obtained from A-15 in both lines, although in AP-61 they tend to be equal from the 4th day on. The strain A-15 showed a particular behaviour of these biological properties on comparing them with the other strains under study, which may be related to changes found in its neucleotide sequence.

[Ultrastructural identification of Ehrlichia sp in an experimentally infected dog in Venezuela]. / Identificación ultraestructural de Ehrlichia sp en un perro de Venezuela infectado experimentalmente.

This study is the first report made in Venezuela concerning the ultrastructural characteristics of Ehrlichia sp in mononuclear blood cells from an experimentally infected dog. The animal developed clinical manifestations characteristic of the infection, and typical intracitoplasmic inclusion bodies were clearly seen in blood smears stained with modified Giemsa examined by light microscopy. Microorganisms were visualized by transmission electron microscopy. The cytoplasmic inclusions, consisted of membrane-lined vacuole-containing elementary bodies. The organisms were extremely pleomorphic. Elementary bodies were surrounded by two distinct membranes and each was constituted by electro-dense granules. These findings corresponded to the described electron microscopy morphology which characterizes the Ehrlichia genus.

[Study of various biological properties of 3 strains of dengue 2 with differences in their nucleotide sequences]. / Estudio de algunas propiedades biológicas de 3 cepas de dengue 2 con diferencias en sus secuencias nucleotídicas.

Some biological properties of Dengue-2 strains such as A-15 (isolated in Cuba in 1981); Jamaica (isolated in Jamaica in 1981) and New Guinea "C" (NG"C") standard strain differing in their nucleotide sequences were studied. The results showed that the cytopathic effect in C6/36 HT cell line occurred earlier in A-15 strain and that fluorescence was first detected in Jamaica and A-15 strains. This seems to indicate that rapid detection of strains does not have any relation to neither their history of passage nor the original isolation system. A-15 and NG"C" strains exhibited an heterogeneous pattern formed by big and small plaques but average size of plaques in NG"C" was lower whereas Jamaica showed only small plaques. The most neurovirulent strain in mice was NG"G" followed by A-15 whereas Jamaica was not neurovirulent at all. These results indicate that A-15 has a different biological behaviour which is probably due to intrinsic differences. It should be taken into account that 7 amino acid changes were found in the envelope protein which may have affected the expression of some biological properties.

[The Dot immunoenzymatic assay on nitrocellulose (Dot-ELISA) in the diagnosis of Chagas disease. II. Seroepidemiologic study in 4 rural communities of Venezuela]. / El ensayo inmunoenzimático en microgotas sobre nitrocelulosa (Dot-ELISA) en el diagnóstico de la enfermedad de Chagas. II. Estudio seroepidemiológico en cuatro comunidades rurales de Venezuela.

A survey of human Trypanosoma cruzi infection in four rural communities of two Venezuelan states with different epidemiological Chagas' disease situations was carried out using the Dot-ELISA and conventional serology. In the two hamlets of Zulia state, no seropositives were found in the under-15 age group whereas seropositivity in the over-15 group was 15.6%. In Cojedes state, the two hamlets studied exhibited a seropositivity of 8.9% in the under-15 group and 51.6% in the over-15 group. Upon comparison with conventional methods, Dot-ELISA evidenced high co-positivity, co-negativity and efficiency indexes. In the samples taken from Zulia, the predictive value of the test was 66% and 60% for cytoplasmatic and integral antigens, respectively; with the Cojedes samples, 100% and 95%. The results suggest that Dot-ELISA could be a practical alternative for seroepidemiological Chagas' disease studies in underdeveloped regions.

Intracellular signaling transduction in the differentiation of Trypanosoma cruzi: role of cAMP.

We have studied the cell differentiation of Trypanosoma cruzi in an vitro system that allows the transformation of epimastigotes into metacyclic trypomastigotes. Intracellular cAMP levels of epimastigotes increased 3 fold prior to their differentiation into metacyclics where cAMP remained elevated 3.7 fold with respect to epimastigotes. We also observed a 3 fold increase in the specific activity of cAMP-binding of metacyclics crude homogenates. This activity resided in a cAMP-binding receptor protein (CARPT) which was different from the typical cAMP-binding subunits (RI and RII) of cAMP-dependent protein kinases, as shown by the use of polyclonal antibodies prepared against these two types of proteins. Anti-RI antibodies did not react with CARPT, and anti-RII antibodies gave a cross reaction with CARPT which was at least 1,000 fold less sensitive than the one shown by the homologous antigen. On Western blots CARPT displayed a major band with Mr = 87,000 instead of Mr = 56,000 for RII. These studies implicate that cAMP may act as a mediator of the cell differentiation of T. cruzi by a mechanism involving a novel type of cAMP-binding receptor.

Cyclic AMP as an inducer of the cell differentiation of Trypanosoma cruzi.

The addition to epimastigotes cultures of T. cruzi, of either cAMP, monobutyryl-cAMP, dibutyryl-cAMP, 8-Br-cAMP (at 2 mM each), or the cAMP-phosphodiesterase inhibitor, papaverine (0.2 mM), promoted the in vitro differentiation of these parasite forms into metacyclics. This effect of cAMP may also be exerted in vivo in the insect vector, since cAMP was detected in the urine and in the Malpighi secretion fluids of Rodnius prolixus.

[Immunoenzyme assay using micro Dot on nitrocellulose (Dot-ELISA) in the diagnosis of Chagas' disease. I. Comparative study of 2 antigenic preparations of Trypanosoma cruzi]. / El ensayo inmunoenzimático en microgotas sobre nitrocelulosa (Dot-ELISA) en el diagnóstico de la enfermedad de Chagas. I. Estudio comparativo de dos preparaciones antigénicas de Trypanosoma cruzi.

Using the Dot-ELISA technique, two antigenic preparations of Trypanosoma cruzi epimastigote forms have been compared for the diagnosis of Chagas' disease: (1) The cytoplasmic fraction (cytoplasmic antigen) and (2) whole formalin fixed epimastigotes (integral antigen). There was been used sera from 95 chagasic patients with chronic cardiomyopathy, positive conventional serology and either positive or negative xenodiagnosis; 74 subjects with negative conventional serology, and either clinically normal or presenting cardiomyopathy; 74 patients with different diseases including syphilis, toxoplasmosis, leishmaniasis or autoantibodies such as rheumatoid factor and antinuclear antibodies. By defining the diagnostic titers (cut off): 1:512 for cytoplasmic antigen and 1:128 for the integral antigen, a sensitivity of 100% has been obtained with both antigenic preparations, being the specificity of 96% for the former and 100% for the latter when leishmaniasis sera were not included. A comparative study with conventional serology was carried out using 147 sera from a Laboratory of Chagas' diagnosis; Dot-ELISA with cytoplasmic antigen showed co-positivity index of 1.0, co-negativity 0.989 and efficiency of 0.993, and Dot-ELISA with integral antigen 1.0, 0.979 and 0.986 respectively. According to this evaluation, Dot-ELISA using whole formalin fixed epimastigotes might be a practical alternative for the serological diagnosis of Chagas' disease.

Trypanosoma cruzi: polypeptide markers of epimastigotes and trypomastigotes.

We compared the major polypeptides of epimastigotes and trypomastigotes of T. cruzi, by submitting total parasite lysates to electrophoresis in polyacrylamide gels (SDS-PAGE), protein staining with Coomassie brilliant blue, laser densitometry, or immunoblotting with sera derived from infected individuals (Chagas' disease). Epimastigotes and trypomastigotes displayed extensive homology, the differences being quantitative, except for a trypomastigote-specific band of Mr 75,000 which reacted with chagasic sera. Immunoblotting with chagasic sera confirmed the electrophoretic homology of epimastigotes and trypomastigotes. Upon antigenic dilution, a cluster of antigenic bands in the range of Mr 150,000 to 75,000 prevailed in the trypomastigotes, whereas the epimastigotes displayed more abundance of antigenic bands in the range of Mr 72,000 to 36,000.