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1.
Article in English | MEDLINE | ID: mdl-31658971

ABSTRACT

Understanding the mechanism(s) underpinning drug resistance could lead to novel treatments to reverse the increased tolerance of a pathogen. In this study, paromomycin (PMM) resistance (PMMr) was induced in three Nepalese clinical strains of Leishmania donovani with different inherent susceptibilities to antimony (Sb) drugs by stepwise exposure of promastigotes to PMM. Exposure to PMM resulted in the production of mixed populations of parasites, even though a single cloned population was used at the start of selection. PMM 50% inhibitory concentration (IC50) values for PMMr parasites varied between 104 and 481 µM at the promastigote stage and 32 and 195 µM at the intracellular amastigote stage. PMM resistance was associated with increased resistance to nitric oxide at the amastigote stage but not the promastigote stage (P < 0.05). This effect was most marked in the Sb-resistant (Sbr) PMMr clone, in which PMM resistance was associated with a significant upregulation of glutathione compared to that in its wild type (P < 0.05), although there was no change in the regulation of trypanothione (detected in its oxidized form). Interestingly, PMMr strains showed an increase in either the keto acid derivative of isoleucine (Sb intermediate PMMr) or the 2-hydroxy acids derived from arginine and tyrosine (Sb susceptible PMMr and Sbr PMMr). These results are consistent with the recent finding that the upregulation of the branched-chain amino acid aminotransferase and d-lactate dehydrogenase is linked to PMMr In addition, we found that PMMr is associated with a significant increase in aneuploidy during PMM selection in all the strains, which could allow the rapid selection of genetic changes that confer a survival advantage.


Subject(s)
Antiprotozoal Agents/pharmacology , Leishmania donovani/drug effects , Paromomycin/pharmacology , Animals , Drug Resistance/genetics , Female , Genomics , Humans , Leishmania donovani/genetics , Leishmania donovani/metabolism , Leishmaniasis, Visceral/drug therapy , Leishmaniasis, Visceral/parasitology , Lipidomics , Macrophages/parasitology , Metabolomics , Mice , Mice, Inbred BALB C , Nepal , Parasitic Sensitivity Tests , Polymorphism, Genetic
2.
mSphere ; 3(2)2018 04 25.
Article in English | MEDLINE | ID: mdl-29669889

ABSTRACT

Antimonials (Sb) were used for decades for chemotherapy of visceral leishmaniasis (VL). Now abandoned in the Indian subcontinent (ISC) because of Leishmania donovani resistance, this drug offers a unique model for understanding drug resistance dynamics. In a previous phylogenomic study, we found two distinct populations of L. donovani: the core group (CG) in the Gangetic plains and ISC1 in the Nepalese highlands. Sb resistance was only encountered within the CG, and a series of potential markers were identified. Here, we analyzed the development of resistance to trivalent antimonials (SbIII) upon experimental selection in ISC1 and CG strains. We observed that (i) baseline SbIII susceptibility of parasites was higher in ISC1 than in the CG, (ii) time to SbIII resistance was higher for ISC1 parasites than for CG strains, and (iii) untargeted genomic and metabolomic analyses revealed molecular changes along the selection process: these were more numerous in ISC1 than in the CG. Altogether these observations led to the hypothesis that CG parasites are preadapted to SbIII resistance. This hypothesis was experimentally confirmed by showing that only wild-type CG strains could survive a direct exposure to the maximal concentration of SbIII The main driver of this preadaptation was shown to be MRPA, a gene involved in SbIII sequestration and amplified in an intrachromosomal amplicon in all CG strains characterized so far. This amplicon emerged around 1850 in the CG, well before the implementation of antimonials for VL chemotherapy, and we discuss here several hypotheses of selective pressure that could have accompanied its emergence.IMPORTANCE The "antibiotic resistance crisis" is a major challenge for scientists and medical professionals. This steady rise in drug-resistant pathogens also extends to parasitic diseases, with antimony being the first anti-Leishmania drug that fell in the Indian subcontinent (ISC). Leishmaniasis is a major but neglected infectious disease with limited therapeutic options. Therefore, understanding how parasites became resistant to antimonials is of commanding importance. In this study, we experimentally characterized the dynamics of this resistance acquisition and show for the first time that some Leishmania populations of the ISC were preadapted to antimony resistance, likely driven by environmental factors or by drugs used in the 19th century.


Subject(s)
Antimony/pharmacology , Antiprotozoal Agents/pharmacology , Drug Resistance/genetics , Leishmania donovani/drug effects , Leishmania donovani/genetics , Antimony/therapeutic use , Antimony Potassium Tartrate/pharmacology , Antiprotozoal Agents/therapeutic use , Genetic Variation , Genomics , Humans , India/epidemiology , Leishmaniasis, Visceral/drug therapy , Leishmaniasis, Visceral/epidemiology , Metabolomics , Nepal/epidemiology , Protozoan Proteins/genetics
3.
mBio ; 8(3)2017 05 23.
Article in English | MEDLINE | ID: mdl-28536289

ABSTRACT

Aneuploidy is usually deleterious in multicellular organisms but appears to be tolerated and potentially beneficial in unicellular organisms, including pathogens. Leishmania, a major protozoan parasite, is emerging as a new model for aneuploidy, since in vitro-cultivated strains are highly aneuploid, with interstrain diversity and intrastrain mosaicism. The alternation of two life stages in different environments (extracellular promastigotes and intracellular amastigotes) offers a unique opportunity to study the impact of environment on aneuploidy and gene expression. We sequenced the whole genomes and transcriptomes of Leishmania donovani strains throughout their adaptation to in vivo conditions mimicking natural vertebrate and invertebrate host environments. The nucleotide sequences were almost unchanged within a strain, in contrast to highly variable aneuploidy. Although high in promastigotes in vitro, aneuploidy dropped significantly in hamster amastigotes, in a progressive and strain-specific manner, accompanied by the emergence of new polysomies. After a passage through a sand fly, smaller yet consistent karyotype changes were detected. Changes in chromosome copy numbers were correlated with the corresponding transcript levels, but additional aneuploidy-independent regulation of gene expression was observed. This affected stage-specific gene expression, downregulation of the entire chromosome 31, and upregulation of gene arrays on chromosomes 5 and 8. Aneuploidy changes in Leishmania are probably adaptive and exploited to modulate the dosage and expression of specific genes; they are well tolerated, but additional mechanisms may exist to regulate the transcript levels of other genes located on aneuploid chromosomes. Our model should allow studies of the impact of aneuploidy on molecular adaptations and cellular fitness.IMPORTANCE Aneuploidy is usually detrimental in multicellular organisms, but in several microorganisms, it can be tolerated and even beneficial. Leishmania-a protozoan parasite that kills more than 30,000 people each year-is emerging as a new model for aneuploidy studies, as unexpectedly high levels of aneuploidy are found in clinical isolates. Leishmania lacks classical regulation of transcription at initiation through promoters, so aneuploidy could represent a major adaptive strategy of this parasite to modulate gene dosage in response to stressful environments. For the first time, we document the dynamics of aneuploidy throughout the life cycle of the parasite, in vitro and in vivo We show its adaptive impact on transcription and its interaction with regulation. Besides offering a new model for aneuploidy studies, we show that further genomic studies should be done directly in clinical samples without parasite isolation and that adequate methods should be developed for this.


Subject(s)
Adaptation, Biological , Aneuploidy , Gene Expression , Leishmania donovani/genetics , Animals , Cricetinae , Environment , Gene Expression Profiling , Genome, Protozoan , Humans , Psychodidae , Sequence Analysis, DNA
4.
Parasite Immunol ; 38(5): 290-302, 2016 05.
Article in English | MEDLINE | ID: mdl-27012562

ABSTRACT

Leishmania donovani is a protozoan parasite causing the neglected tropical disease visceral leishmaniasis. One difficulty to study the immunopathology upon L. donovani infection is the limited adaptability of the strains to experimental mammalian hosts. Our knowledge about L. donovani infections relies on a restricted number of East African strains (LV9, 1S). Isolated from patients in the 1960s, these strains were described extensively in mice and Syrian hamsters and have consequently become 'reference' laboratory strains. L. donovani strains from the Indian continent display distinct clinical features compared to East African strains. Some reports describing the in vivo immunopathology of strains from the Indian continent exist. This study comprises a comprehensive immunopathological characterization upon infection with two additional strains, the Ethiopian L. donovani L82 strain and the Nepalese L. donovani BPK282 strain in both Syrian hamsters and C57BL/6 mice. Parameters that include parasitaemia levels, weight loss, hepatosplenomegaly and alterations in cellular composition of the spleen and liver, showed that the L82 strain generated an overall more virulent infection compared to the BPK282 strain. Altogether, both L. donovani strains are suitable and interesting for subsequent in vivo investigation of visceral leishmaniasis in the Syrian hamster and the C57BL/6 mouse model.


Subject(s)
Leishmania donovani/classification , Leishmaniasis, Visceral/parasitology , Animals , Cricetinae , DNA, Kinetoplast/genetics , DNA, Protozoan/genetics , Humans , Leishmania donovani/genetics , Leishmania donovani/pathogenicity , Leishmaniasis, Visceral/pathology , Liver/parasitology , Liver/pathology , Mesocricetus , Mice , Mice, Inbred C57BL , Spleen/parasitology , Spleen/pathology , Virulence
5.
Mol Microbiol ; 99(6): 1134-48, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26713880

ABSTRACT

In this study, we followed the genomic, lipidomic and metabolomic changes associated with the selection of miltefosine (MIL) resistance in two clinically derived Leishmania donovani strains with different inherent resistance to antimonial drugs (antimony sensitive strain Sb-S; and antimony resistant Sb-R). MIL-R was easily induced in both strains using the promastigote-stage, but a significant increase in MIL-R in the intracellular amastigote compared to the corresponding wild-type did not occur until promastigotes had adapted to 12.2 µM MIL. A variety of common and strain-specific genetic changes were discovered in MIL-adapted parasites, including deletions at the LdMT transporter gene, single-base mutations and changes in somy. The most obvious lipid changes in MIL-R promastigotes occurred to phosphatidylcholines and lysophosphatidylcholines and results indicate that the Kennedy pathway is involved in MIL resistance. The inherent Sb resistance of the parasite had an impact on the changes that occurred in MIL-R parasites, with more genetic changes occurring in Sb-R compared with Sb-S parasites. Initial interpretation of the changes identified in this study does not support synergies with Sb-R in the mechanisms of MIL resistance, though this requires an enhanced understanding of the parasite's biochemical pathways and how they are genetically regulated to be verified fully.


Subject(s)
Antiprotozoal Agents/pharmacology , Leishmania donovani/drug effects , Leishmania donovani/metabolism , Phosphorylcholine/analogs & derivatives , Animals , Antimony/pharmacology , Drug Resistance , Female , Leishmania donovani/genetics , Leishmaniasis, Visceral/parasitology , Lipid Metabolism , Membrane Transport Proteins/genetics , Membrane Transport Proteins/metabolism , Mice , Mice, Inbred BALB C , Mutation , Nepal , Parasitic Sensitivity Tests , Phosphorylcholine/pharmacology
6.
J Antimicrob Chemother ; 70(11): 3023-6, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26253089

ABSTRACT

OBJECTIVES: Widespread antimony resistance in the Indian subcontinent has enforced a therapy shift in visceral leishmaniasis treatment primarily towards miltefosine and secondarily also towards paromomycin. In vitro selection of miltefosine resistance in Leishmania donovani turned out to be quite challenging. Although no increase in IC50 was detected in the standard intracellular amastigote susceptibility assay, promastigote back-transformation remained positive at high miltefosine concentrations, suggesting a more 'resistant' phenotype. This observation was explored in a large set of Nepalese clinical isolates from miltefosine cure and relapse patients to assess its predictive value for patient treatment outcome. METHODS: The predictive value of the promastigote back-transformation for treatment outcome of a set of Nepalese L. donovani field isolates (n = 17) derived from miltefosine cure and relapse patients was compared with the standard susceptibility assays on promastigotes and intracellular amastigotes. RESULTS: In-depth phenotypic analysis of the clinical isolates revealed no correlation between the different susceptibility assays, nor any clear link to the actual treatment outcome. In addition, the clinical isolates proved to be phenotypically heterogeneous, as reflected by the large variation in drug susceptibility among the established clones. CONCLUSIONS: This in vitro laboratory study shows that miltefosine treatment outcome is not necessarily exclusively linked with the susceptibility profile of pre-treatment isolates, as determined in standard susceptibility assays. The true nature of miltefosine treatment failures still remains ill defined.


Subject(s)
Antiprotozoal Agents/therapeutic use , Drug Resistance , Leishmania donovani/drug effects , Leishmania donovani/physiology , Leishmaniasis, Visceral/drug therapy , Leishmaniasis, Visceral/parasitology , Phosphorylcholine/analogs & derivatives , Antiprotozoal Agents/pharmacology , Humans , Nepal , Parasitic Sensitivity Tests , Phosphorylcholine/pharmacology , Phosphorylcholine/therapeutic use , Recurrence , Treatment Outcome
7.
Parasitol Res ; 113(5): 1875-81, 2014 May.
Article in English | MEDLINE | ID: mdl-24615359

ABSTRACT

Although widespread resistance of Leishmania donovani and L. infantum against miltefosine (MIL) and paromomycin (PMM) has not yet been demonstrated, both run the risk of resistance selection. Unraveling the dynamics and mechanisms of resistance development is key to preserve drug efficacy in the field. In this study, resistance against PMM and MIL was experimentally selected in vitro in intracellular amastigotes of several strains of both species with different antimony susceptibility background. To monitor amastigote susceptibility, microscopic determination of IC50-values and promastigote back-transformation assays were performed. Both techniques were also used to evaluate the susceptibility of field isolates from MIL-relapse patients. PMM-resistance could readily be selected in all species/strains, although promastigotes remained fully PMM-susceptible. Successful MIL-resistance selection was demonstrated only by promastigote back-transformation at increasing MIL-concentrations upon successive selection cycles. Important to note is that amastigotes with the MIL-resistant phenotype could not be visualized after Giemsa staining; hence, MIL-IC50-values showed no shift. The same phenomenon was observed in a set of recent clinical isolates from MIL-relapse patients. This study clearly endorses the need to use intracellular amastigotes for PMM- and MIL-susceptibility testing. When monitoring MIL-resistance, promastigote back-transformation should be used instead of the standard Giemsa staining. In-depth exploration of the mechanistic background of this finding is warranted.


Subject(s)
Antiprotozoal Agents/pharmacology , Drug Resistance , Leishmania donovani/drug effects , Paromomycin/pharmacology , Phosphorylcholine/analogs & derivatives , Animals , Antimony/pharmacology , Female , Humans , Macrophages/parasitology , Mice , Parasitic Sensitivity Tests , Phosphorylcholine/pharmacology
8.
Euro Surveill ; 18(30): 20543, 2013 Jul 25.
Article in English | MEDLINE | ID: mdl-23929181

ABSTRACT

We describe Leishmania species determination on clinical samples on the basis of partial sequencing of the heat-shock protein 70 gene (hsp70), without the need for parasite isolation. The method is especially suited for use in non-endemic infectious disease clinics dealing with relatively few cases on an annual basis, for which no fast high throughput diagnostic tests are needed. We show that the results obtained from this gene are in nearly perfect agreement with those from multilocus enzyme electrophoresis, which is still considered by many clinicians and the World Health Organization (WHO) as the gold standard in Leishmania species typing. Currently, 203 sequences are available that cover the entire hsp70 gene region analysed here, originating from a total of 41 leishmaniasis endemic countries, and representing 15 species and sub-species causing human disease. We also provide a detailed laboratory protocol that includes a step-by-step procedure of the typing methodology, to facilitate implementation in diagnostic laboratories.


Subject(s)
HSP70 Heat-Shock Proteins/genetics , Leishmania/genetics , Leishmaniasis/parasitology , Polymerase Chain Reaction/methods , Protozoan Proteins/genetics , Sequence Analysis , Humans , Leishmania/classification , Leishmaniasis/diagnosis , Polymorphism, Restriction Fragment Length , Species Specificity , Tropical Medicine
9.
Eur J Clin Microbiol Infect Dis ; 31(7): 1453-61, 2012 Jul.
Article in English | MEDLINE | ID: mdl-22083340

ABSTRACT

The heat-shock protein 70 gene (hsp70) has been exploited for Leishmania species identification in the New and Old World, using PCR followed by restriction fragment length polymorphism (RFLP) analysis. Current PCR presents limitations in terms of sensitivity, which hampers its use for analyzing clinical and biological samples, and specificity, which makes it inappropriate to discriminate between Leishmania and other trypanosomatids. The aim of the study was to improve the sensitivity and specificity of a previously reported hsp70 PCR using alternative PCR primers and RFLPs. Following in silico analysis of available sequences, three new PCR primer sets and restriction digest schemes were tested on a globally representative panel of 114 Leishmania strains, various other infectious agents, and clinical samples. The largest new PCR fragment retained the discriminatory power from RFLP, while two smaller fragments discriminated less species. The detection limit of the new PCRs was between 0.05 and 0.5 parasite genomes, they amplified clinical samples more efficiently, and were Leishmania specific. We succeeded in significantly improving the specificity and sensitivity of the PCRs for hsp70 Leishmania species typing. The improved PCR-RFLP assays can impact diagnosis, treatment, and epidemiological studies of leishmaniasis in any setting worldwide.


Subject(s)
HSP70 Heat-Shock Proteins/genetics , Leishmania/genetics , Leishmania/isolation & purification , Leishmaniasis/diagnosis , Leishmaniasis/parasitology , Polymerase Chain Reaction/methods , Protozoan Proteins/genetics , DNA Primers/genetics , Humans , Leishmania/classification , Parasitology/methods , Polymorphism, Restriction Fragment Length , Sensitivity and Specificity
10.
Parasitology ; 138(11): 1392-9, 2011 Sep.
Article in English | MEDLINE | ID: mdl-21819638

ABSTRACT

Mathematical models predict that the future of epidemics of drug-resistant pathogens depends in part on the competitive fitness of drug-resistant strains. Considering metacyclogenesis (differentiation process essential for infectivity) as a major contributor to the fitness of Leishmania donovani, we tested its relationship with pentavalent antimony (SbV) resistance in clinical lines. Different methods for the assessment of metacyclogenesis were cross-validated: gene expression profiling (META1 and SHERP), morphometry (microscopy and FACS), in vitro infectivity to macrophages and resistance to complement lysis. This was done on a model constituted by 2 pairs of reference strains cloned from a SbV-resistant and -sensitive isolate. We selected the most adequate parameter and extended the analysis of metacyclogenesis diversity to a sample of 20 clinical lines with different in vitro susceptibility to the drug. The capacity of metacyclogenesis, as measured by the complement lysis test, was shown to be significantly higher in SbV-resistant clinical lines of L. donovani than in SbV-sensitive lines. Together with other lines of evidence, it is concluded that L. donovani constitutes a unique example and model of drug-resistant pathogens with traits of increased fitness. These findings raise a fundamental question about the potential risks of selecting more virulent pathogens through massive chemotherapeutic interventions.


Subject(s)
Antimony Sodium Gluconate/pharmacology , Leishmania donovani/drug effects , Leishmaniasis, Visceral/drug therapy , Life Cycle Stages/drug effects , Macrophages/drug effects , Animals , Antiprotozoal Agents/pharmacology , Drug Resistance/drug effects , Drug Resistance/genetics , Flow Cytometry , Gene Expression Profiling , Humans , Leishmania donovani/classification , Leishmania donovani/genetics , Leishmania donovani/growth & development , Leishmania donovani/isolation & purification , Leishmania donovani/pathogenicity , Leishmaniasis, Visceral/parasitology , Life Cycle Stages/genetics , Macrophages/parasitology , Molecular Typing , Protozoan Proteins/genetics , Protozoan Proteins/metabolism , Real-Time Polymerase Chain Reaction
11.
Eur J Clin Microbiol Infect Dis ; 30(2): 209-18, 2011 Feb.
Article in English | MEDLINE | ID: mdl-20936316

ABSTRACT

For the epidemiological monitoring and clinical case management of leishmaniasis, determination of the causative Leishmania species gains importance. Current assays for the Old World often suffer from drawbacks in terms of validation on a geographically representative sample set and the ability to recognize all species complexes. We want to contribute to standardized species typing for Old World leishmaniasis. We determined the ribosomal DNA internal transcribed spacer 1 sequence of 24 strains or isolates, and validated four species-specific polymerase chain reactions (PCRs) amplifying this target. They discriminate L. aethiopica, L. tropica, L. major, and the L. donovani complex, use the same cycling conditions, and include an internal amplification control. Our PCRs amplify 0.1 pg of Leishmania DNA, while being 100% specific for species identification on an extensive panel of geographically representative strains and isolates. Similar results were obtained in an endemic reference laboratory in Kenya. Species could also be identified in clinical specimens. The presented PCRs require only agarose gel detection, and have several other advantages over many existing assays. We outline potential problems, suggest concrete solutions for transferring the technique to other settings, and deliver the proof-of-principle for analyzing clinical samples.


Subject(s)
Leishmania/classification , Leishmania/isolation & purification , Leishmaniasis/diagnosis , Parasitology/methods , Polymerase Chain Reaction/methods , Animals , DNA Primers/genetics , DNA, Protozoan/genetics , DNA, Ribosomal Spacer/genetics , Dogs , Electrophoresis, Agar Gel , Humans , Leishmania/genetics , Leishmaniasis/parasitology , Sensitivity and Specificity
12.
Parasitology ; 138(2): 183-93, 2011 Feb.
Article in English | MEDLINE | ID: mdl-20678296

ABSTRACT

INTRODUCTION: Evaluation of Leishmania drug susceptibility depends on in vitro Sb(V) susceptibility assays, which are labour-intensive and may give a biased view of the true parasite resistance. Molecular markers are urgently needed to improve and simplify the monitoring of Sb(V)-resistance. We analysed here the gene expression profile of 21 L. braziliensis clinical isolates in vitro defined as Sb(V)-resistant and -sensitive, in order to identify potential resistance markers. METHODS: The differential expression of 13 genes involved in Sb(V) metabolism, oxidative stress or housekeeping functions was analysed during in vitro promastigote growth. RESULTS: Expression profiles were up-regulated for 5 genes only, each time affecting a different set of isolates (mosaic picture of gene expression). Two genes, ODC (ornithine decarboxylase) and TRYR (trypanothione reductase), showed a significantly higher expression rate in the group of Sb(V)-resistant compared to the group of Sb(V)-sensitive parasites (P<0.01). However, analysis of individual isolates showed both markers to explain only partially the drug resistance. DISCUSSION: Our results might be explained by (i) the occurrence of a pleiotropic molecular mechanism leading to the in vitro Sb(V) resistance and/or (ii) the existence of different epi-phenotypes not revealed by the in vitro Sb(V) susceptibility assays, but interfering with the gene expression patterns.


Subject(s)
Antimony/pharmacology , Drug Resistance/genetics , Leishmania braziliensis/drug effects , Leishmania braziliensis/genetics , Leishmaniasis, Cutaneous/drug therapy , Leishmaniasis, Cutaneous/genetics , Animals , Antimony/therapeutic use , Cell Culture Techniques , Gene Expression Profiling , Genetic Pleiotropy , Genetic Variation , Humans , Leishmania braziliensis/classification , Leishmaniasis, Cutaneous/parasitology , NADH, NADPH Oxidoreductases/genetics , NADH, NADPH Oxidoreductases/metabolism , Ornithine Decarboxylase/genetics , Ornithine Decarboxylase/metabolism , Parasitic Sensitivity Tests
13.
Parasitology ; 137(8): 1159-68, 2010 Jul.
Article in English | MEDLINE | ID: mdl-20441679

ABSTRACT

INTRODUCTION: Species typing in leishmaniasis gains importance in diagnostics, epidemiology, and clinical studies. A restriction fragment length polymorphism (RFLP) assay of PCR amplicons from a partial heat-shock protein 70 gene (hsp70) had been described for the New World, allowing identification of some species. METHODS: Based on an initial in silico analysis of 51 hsp70 sequences, most of which we recently determined in the frame of a phylogenetic study, species-specific restriction sites were identified. These were tested by PCR-RFLP on 139 strains from 14 species, thereby documenting both inter- and intra-species variability. RESULTS: Our assay could identify Leishmania infantum, L. donovani, L. tropica, L. aethiopica, L. major, L. lainsoni, L. naiffi, L. braziliensis, L. peruviana, L. guyanensis, and L. panamensis by applying 2 subsequent digests. L. mexicana, L. amazonensis, and L. garnhami did not generate species-specific restriction fragment patterns. CONCLUSION: Currently no assay is available for global Leishmania species discrimination. We present a universal PCR-RFLP method allowing identification of most medically relevant Old and New World Leishmania species on the basis of a single PCR, obviating the need to perform separate PCRs. The technique is simple to perform and can be implemented in all settings where PCR is available.


Subject(s)
HSP70 Heat-Shock Proteins/genetics , Leishmania/classification , Leishmaniasis/diagnosis , Leishmaniasis/parasitology , Polymerase Chain Reaction/methods , Polymorphism, Restriction Fragment Length , Animals , Humans , Leishmania/genetics , Leishmania/isolation & purification , Leishmaniasis, Cutaneous/diagnosis , Leishmaniasis, Cutaneous/parasitology , Polymorphism, Single Nucleotide , Species Specificity
14.
Parasitology ; 137(6): 947-57, 2010 May.
Article in English | MEDLINE | ID: mdl-20109247

ABSTRACT

INTRODUCTION: Leishmania donovani, the causative agent of visceral leishmaniasis in the Indian subcontinent, has been reported to be genetically homogeneous. In order to support ongoing initiatives to eliminate the disease, highly discriminative tools are required for documenting the parasite population and dynamics. METHODS: Thirty-four clinical isolates of L. donovani from Nepal were analysed on the basis of size and restriction endonuclease polymorphisms of PCR amplicons from kinetoplast minicircle DNA, 5 nuclear microsatellites, and nuclear loci encoding glycoprotein 63, cysteine proteinase B, and hydrophilic acylated surface protein B. We present and validate a procedure allowing standardized analysis of kDNA fingerprint patterns. RESULTS: Our results show that parasites are best discriminated on the basis of kinetoplast minicircle DNA (14 genotypes) and 1 microsatellite defining 7 genotypes, while the remaining markers discriminated 2 groups or were monomorphic. Combination of all nuclear markers revealed 8 genotypes, while extension with kDNA data yielded 18 genotypes. CONCLUSION: We present tools that allow discrimination of closely related L. donovani strains circulating in the Terai region of Nepal. These can be used to study the micro-epidemiology of parasite populations, determine the geographical origin of infections, distinguish relapses from re-infection, and monitor the spread of particular variants.


Subject(s)
Leishmania donovani/classification , Leishmania donovani/genetics , Leishmaniasis/epidemiology , Leishmaniasis/parasitology , Polymerase Chain Reaction/methods , Animals , DNA, Kinetoplast/genetics , Genotype , Humans , Nepal/epidemiology , Phylogeny
15.
Trans R Soc Trop Med Hyg ; 104(3): 225-9, 2010 Mar.
Article in English | MEDLINE | ID: mdl-19726065

ABSTRACT

Drug-related factors and parasite resistance have been implicated in the failure of pentavalent antimonials (Sb(v)) in the Indian subcontinent; however, little information is available on host-related factors. Parasitologically confirmed kala-azar patients, treatment naïve to Sb(v), were prospectively recruited at a referral hospital in Nepal and were treated under supervision with 30 doses of quality-assured sodium stibogluconate (SSG) 20mg/kg/day and followed for 12 months to assess cure. Analysis of risk factors for treatment failure was assessed in those receiving >or=25 doses and completing 12 months of follow-up. One hundred and ninety-eight cases were treated with SSG and the overall cure rate was 77.3% (153/198). Of the 181 cases who received >or=25 doses, 12-month follow-up data were obtained in 169, comprising 153 patients (90.5%) with definite cure and 16 (9.5%) treatment failures. In the final logistic regression model, increased failure to SSG was significantly associated with fever for >or=12 weeks [odds ratio (OR)=7.4], living in districts bordering the high SSG resistance zone in Bihar (OR=6.1), interruption of treatment (OR=4.3) and ambulatory treatment (OR=10.2). Early diagnosis and supervised treatment is of paramount importance to prevent treatment failures within the control programme.


Subject(s)
Antimony Sodium Gluconate/administration & dosage , Antiprotozoal Agents/administration & dosage , Leishmaniasis, Visceral/drug therapy , Adolescent , Adult , Child , Epidemiologic Methods , Female , Humans , Leishmaniasis, Visceral/parasitology , Male , Nepal , Treatment Failure , Young Adult
16.
Parasitology ; 135(10): 1157-64, 2008 Sep.
Article in English | MEDLINE | ID: mdl-18700995

ABSTRACT

Trypanosoma cruzi, the agent of Chagas disease is associated with a very high clinical and epidemiological pleomorphism. This might be better understood through studies on the evolutionary history of the parasite. We explored here the value of antigen genes for the understanding of the evolution within T. cruzi. We selected 11 genes and 12 loci associated with different functions and considered to be involved in host-parasite interaction (cell adhesion, infection, molecular mimicry). The polymorphism of the respective genes in a sample representative of the diversity of T. cruzi was screened by PCR-RFLP and evolutionary relationships were inferred by phenetic analysis. Our results support the classification of T. cruzi in 2 major lineages and 6 discrete typing units (DTUs). The topology of the PCR-RFLP tree was the one that better fitted with the epidemiological features of the different DTUs: (i) lineage I, being encountered in sylvatic as well as domestic transmission cycles, (ii) IIa/c being associated with a sylvatic transmission cycle and (iii) IIb/d/e being associated with a domestic transmission cycle. Our study also supported the hypothesis that the evolutionary history of T. cruzi has been shaped by a series of hybridization events in the framework of a predominant clonal evolution pattern.


Subject(s)
Antigens, Protozoan/genetics , Trypanosoma cruzi/genetics , Animals , Genes, Protozoan/genetics , Phylogeny , Polymerase Chain Reaction , Polymorphism, Genetic/genetics , Polymorphism, Restriction Fragment Length/genetics
17.
Parasitology ; 135(2): 183-94, 2008 Feb.
Article in English | MEDLINE | ID: mdl-17931458

ABSTRACT

Gene expression profiling is increasingly used in the field of infectious diseases for characterization of host, pathogen and the nature of their interaction. The purpose of this study was to develop a robust, standardized method for comparative expression profiling and molecular characterization of Leishmania donovani clinical isolates. The limitations and possibilities associated with expression profiling in intracellular amastigotes and promastigotes were assessed through a series of comparative experiments in which technical and biological parameters were scrutinized. On a technical level, our results show that it is essential to use parasite harvesting procedures that involve minimal disturbance of the parasite's environment in order to 'freeze' gene expression levels instantly; this is particularly a delicate task for intracellular amastigotes and for specific 'sensory' genes. On the biological level, we demonstrate that gene expression levels fluctuate during in vitro development of both intracellular amastigotes and promastigotes. We chose to use expression-curves rather than single, specific, time-point measurements to capture this biological variation. Intracellular amastigote protocols need further refinement, but we describe a first generation tool for high-throughput comparative molecular characterization of patients' isolates, based on the changing expression profiles of promastigotes during in vitro differentiation.


Subject(s)
Gene Expression Profiling/methods , Gene Expression Regulation, Developmental , Leishmania donovani/physiology , Leishmaniasis, Visceral/parasitology , Life Cycle Stages/physiology , Animals , DNA Primers/chemistry , Genes, Protozoan/physiology , Humans , Leishmania donovani/genetics , Leishmania donovani/growth & development , Polymerase Chain Reaction/methods , Time Factors
18.
Parasitology ; 135(3): 319-26, 2008 Mar.
Article in English | MEDLINE | ID: mdl-17961284

ABSTRACT

Leishmania (Viannia) braziliensis and L. (V.) peruviana are two parasite species characterized by a very different pathogenicity in humans despite a high genetic similarity. We hypothesized previously that L. (V.) peruviana would descend from L. (V.) braziliensis and would have acquired its 'peruviana' character during the southward colonization and adaptation of the transmission cycle in the Peruvian Andes. In order to have a first appreciation of the differences in virulence between both species, we evaluated an in vitro and in vivo model for experimental infection. A procedure was adapted to enrich culture forms in infective stages and the purified metacyclics were used to infect macrophage cell lines and golden hamsters. The models were tested with 2 representative strains of L. (V.) braziliensis from cutaneous and mucosal origin respectively and 2 representative strains of L. (V.) peruviana from Northern and Southern Peru respectively. Our models were reproducible and sensitive enough to detect phenotypic differences among strains. We showed in vitro as well as in vivo that the L. (V.) braziliensis was more infective than L. (V.) peruviana. Furthermore, we found that in vitro infectivity patterns of the 4 strains analysed, were in agreement with the geographical structuring of parasite populations demonstrated in our previous studies. Further work is needed to confirm our results with more strains of different geographical origin and their specific clinical outcome. However, our data open new perspectives for understanding the process of speciation in Leishmania and its implications in terms of pathogenicity.


Subject(s)
Disease Models, Animal , Leishmania braziliensis/pathogenicity , Leishmaniasis, Cutaneous/parasitology , Macrophages/parasitology , Mesocricetus , Adaptation, Biological , Animals , Cell Line , Cricetinae , Hydrogen-Ion Concentration , Leishmania braziliensis/genetics , Male , Mice , Peru , Phenotype , Random Allocation , Species Specificity , Time Factors , Virulence
19.
Parasitology ; 134(Pt 12): 1689-98, 2007 Nov.
Article in English | MEDLINE | ID: mdl-17897481

ABSTRACT

Gene expression is known to vary significantly during the Leishmania life-cycle. Its monitoring might allow identification of molecular changes associated with the infective stages (metacyclics and amastigotes) and contribute to the understanding of the complex host-parasite relationships. So far, very few studies have been done on Leishmania (Viannia) braziliensis, one of the most pathogenic species. Such studies require, first of all, reference molecular markers. In the present work, we applied differential display analysis (DD analysis) in order to identify transcripts that might be (i) candidate markers of metacyclics and intracellular amastigotes of L. (V.) braziliensis or (ii) potential controls, i.e. constitutively expressed. In total, 48 DNA fragments gave reliable sequencing data, 29 of them being potential markers of infective stages and 12 potential controls. Eight sequences could be identified with reported genes. Validation of the results of DD analysis was done for 4 genes (2 differentially expressed and 2 controls) by quantitative real-time PCR. The infective insect stage-specific protein (meta 1) was more expressed in metacyclic-enriched preparations. The oligopeptidase b showed a higher expression in amastigotes. Two genes, glucose-6-phosphate dehydrogenase and a serine/threonine protein kinase, were found to be similarly expressed in the different biological samples.


Subject(s)
Gene Expression Regulation , Genes, Protozoan/genetics , Leishmania braziliensis/genetics , Leishmania braziliensis/metabolism , Leishmaniasis, Cutaneous/parasitology , Animals , Base Sequence , Biomarkers/metabolism , Gene Expression Profiling , Humans , Molecular Sequence Data , Reproducibility of Results , Reverse Transcriptase Polymerase Chain Reaction
20.
Parasitology ; 134(Pt 1): 33-9, 2007 Jan.
Article in English | MEDLINE | ID: mdl-16978449

ABSTRACT

In the present work we studied the karyotype stability during long-term in vitro maintenance in 3 cloned strains of Leishmania (Viannia) peruviana, Leishmania (Viannia) braziliensis and a hybrid between both species. Only the L. (V.) peruviana strain showed an unstable karyotype, even after subcloning. Four chromosomes were studied in detail, each of them characterized by homologous chromosomes of different size (heteromorphy). Variations in chromosome patterns during in vitro maintenance were rapid and discrete, involving loss of heteromorphy or appearance of additional chromosome size variants. The resulting pattern was not the same according to experimental conditions (subinoculation rate or incubation temperature), and interestingly, this was associated with differences in growth behaviour of the respective parasites. No change in total ploidy of the cells was observed by flow cytometry. We discuss several mechanisms that might account for this variation of chromosome patterns, but we favour the occurrence of aneuploidy, caused by aberrant chromosome segregation during mitosis. Our results provide insight into the generation of karyotype diversity in natural conditions and highlight the relativity of the clone concept in parasitology.


Subject(s)
Chromosomes/ultrastructure , Genome, Protozoan , Leishmania braziliensis/genetics , Leishmania/genetics , Animals , Clone Cells , Culture Techniques , Karyotyping , Leishmania/chemistry , Leishmania/cytology , Leishmania/growth & development , Leishmania braziliensis/cytology , Leishmania braziliensis/growth & development , Life Cycle Stages , Models, Biological , Ploidies
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