Phenotypical characterization and molecular identification of clinical isolates of Candida tropicalis.

BACKGROUND: Candida tropicalis is an increasingly important human pathogen which usually affects neutropenic oncology patients with common hematogenous seeding to peripheral organs and high mortality rates. Candida pathogenicity is facilitated by several virulence attributes, including secretion of hydrolytic enzymes; however, little is known regarding the C. tropicalis ability to secrete them and their role in the disease. AIMS: To confirm by molecular means the identification of 187 clinical isolates (127 from blood, 52 from urine, and 8 from diverse clinical origins) phenotypically identified as C. tropicalis, and to investigate their in vitro aspartyl proteinase, phospholipase, esterase, hemolysin, DNase and coagulase activities. METHODS: The molecular confirmation was performed by ITS sequencing, and the enzymatic determinations were conducted using plate assays with specific substrates, with the exception of coagulase, which was determined by the classical tube test. RESULTS: The majority of the strains exhibited a very strong or strong activity of aspartyl proteinase, phospholipase and esterase. A 4.7% of the bloodstream isolates were hemolysin producers, and all were negative for the coagulase and DNase assays. CONCLUSIONS: Very strong activities of aspartyl proteinase, phospholipase and esterase profiles were detected, and a statistical association between phospholipase production and blood and urine isolates was found.

Enzymatic and hemolytic activity in different Candida species.

BACKGROUND: Candida species, in conditions of microbiota imbalance or decreased immune defenses, may be one of the main human fungal pathogens. Virulence factors constitute the mechanisms used by the fungus to avoid host defenses. AIMS: This study aimed to investigate the in vitro production of virulence factors, such as hemolytic activity, and deoxyribonuclease (DNase), proteinase, and phospholipase activities in Candida spp. METHODS: Fifty clinical isolates were analyzed for virulence factors: Candida albicans (15), Candida tropicalis (15), Candida parapsilosis (10), Candida glabrata (5), and Candida krusei (5). Hemolytic activity was determined in Sabouraud dextrose agar plates containing 3% glucose and 7% sheep red cells. Culture media containing, respectively, agar-base DNA, egg yolk, and bovine albumin were used to determine DNase, phospholipase and proteinase activities, respectively. RESULTS: Forty-eight (96%) of 50 isolates showed hemolytic activity, with 10 (20%) positive for DNase, 19 (38%) for proteinase, and 16 (32%) for phospholipase. Statistically significant differences were observed between species for phospholipase (p<0.0001) and proteinase (p<0.05) production. CONCLUSIONS: It is concluded that all species had hemolytic activity. DNase activity was detected in all species except in C. glabrata; proteinase activity was detected in C. albicans, C. tropicalis, and C. parapsilosis; and phospholipase activity was observed in C. albicans and C. tropicalis.

Evaluación de un método de extracción y purificación de DNA a partir de tejido muscular fijado en formaldehido de cadáveres no identificados / Evaluation of a method of extracting and purifying DNA from muscle tissue fixed in formaldehyde unidentified bodies / Avaliação de um método de extracção e purificação de ADN a partir de tecido muscular fixado em formaldeído corpos não identificados

La obtención de DNA humano en buena cantidad y alta pureza a partir de tejido muscular fijado en Formaldehido no tamponado es de suma importancia en la amplificación por la Reacción en Cadena de la Polimerasa (PCR) para su aplicación en estudios de identificación y filiación genética. En este estudio se evaluó la eficiencia del Kit QIAampR DNA FFPE TISSUE y una modificación del mismo basado en lavados con PBS y el tiempo de digestión con proteinasa K, frente a la cantidad y calidad de este ácido nucléico. Las diferencias fueron significativas entre los tiempos de acción con la proteinasa K (PK) en relación a la cantidad y en la pureza producto de los lavados del tejido muscular previa extracción. Estos resultados proporcionan una pauta para el diseño de experimentos de acuerdo con el efecto de la fijación, optimizando recursos humanos e insumos.

Obtaining human DNA in large quantity and high purity from muscle tissue fixed in formaldehyde unbuffered is of utmost importance in amplification by Chain Reaction (PCR) for application in identification studies and genetic affiliation. In this study, the efficiency of DNA FFPE TISSUE QIAampR Kit and a modification thereof based washes with PBS and the time of digestion with proteinase K, compared to the amount and quality of the nucleic acid were evaluated. Differences were significant between the exposure times with proteinase K (PK) in relation to the quantity and purity of the product prior washings muscle tissue extraction. These results provide a guideline for the design of experiments according to the effect of fixing, optimizing human resources and inputs.

A obtenção de DNA humano em grande quantidade e de alta pureza a partir de tecido muscular fixado em formol não tamponado é de extrema importância para a amplificação por Reacção em Cadeia (PCR), para sua aplicação em estudos de identificação e filiação genética. Neste estudo, a eficácia do kit QIAampR DNA FFPE TISSUE e uma modificação do processo por lavagens com PBS e o tempo de digestão com proteinase K, em comparação com a quantidade e a qualidade do ácido nucléico desta base. As diferenças foram significativas entre os tempos de exposição com proteinase K em relação à quantidade e pureza produto das lavagens do tecido muscular extraída previamente. Estes resultados fornecem uma diretriz para o desenho de experimentos de acordo com o efeito de fixação, otimizando recursos humanos e insumos.

Normativas de diagnóstico y tratamiento del déficit de alfa-1 antitripsina / Guidelines on Diagnosis and Treatment of Alpha-1 Antitrypsin Deficiency

El déficit de alfa-1 antitripsina (AAT) es una condición hereditaria rara y raramente diagnosticada en todo el mundo, incluida Argentina. El infradiagnóstico es fundamentalmente debido a que muchos médicos desconocen su existencia, diagnóstico y tratamiento. Por ello, la Asociación Argentina de Medicina Respiratoria encomendó a un grupo de expertos la elaboración de la presente normativa. La AAT es una glicoproteína secretada por el hígado, muy abundante en sangre, tejidos y fluidos corporales, cuya función principal consiste en inhibir la elastasa del neutrófilo y otras serin proteasas, confiriendo al suero humano más del 90% de su capacidad antiproteasa. El déficit de AAT deriva de mutaciones del gen de la SERPINA1, y se manifiesta clínicamente por enfisema pulmonar, cirrosis hepática y, con menor frecuencia, por paniculitis, vasculitis sistémicas y posiblemente otras enfermedades. El déficit grave de AAT afecta mayoritariamente a individuos de raza caucasiana y tiene su máxima prevalencia (1:2.000-1:5.000 individuos) en el norte, oeste y centro de Europa. En EEUU y Canadá, la prevalencia es de 1: 5.000-10.000, y es 5 veces menor en países latinoamericanos, incluida Argentina, donde se estima que puede haber unos 18.000 individuos con genotipos deficientes graves SZ y ZZ, la inmensa mayoría sin diagnosticar. Sospechar la enfermedad resulta clave para medir la concentración sérica de AAT y completar el diagnóstico con la determinación del fenotipo o genotipo ante concentraciones bajas. La detección de casos permite la puesta en práctica del consejo genético, el chequeo de familiares consanguíneos y, en casos seleccionados, la aplicación de terapia sustitutiva.

The alpha-1 antitrypsin (AAT) deficiency is a rare hereditary condition which is rarely diagnosed in the world, including Argentina. Underdiagnosis is mainly due to lack of knowledge of its diagnosis and treatment by many physicians. For this reason, the Argentine Association of Respiratory Medicine convened a group of experts to develop the present guidelines. AAT is a glycoprotein secreted by the liver; it reaches high levels in blood, body tissues and fluids. Its main function is to inhibit the neutrophil elastase and other serum proteases providing 90% of human serine antiprotease activity. The AAT deficiency is produced by mutations of the SERPINA1 gene. Its clinical manifestations are pulmonary emphysema, liver cirrhosis, and less often panniculitis, systemic vasculitis and possibly other conditions. The severe AAT deficiency affects mainly Caucasian individuals. The highest prevalence, ranging from 1 in 2000 to 1 in 5000 population is observed in northern, western and central Europe. In the USA and Canada, the prevalence varies from 1 in 5000 to 1 in 10000 population. It is 5 times less frequent in Latin American countries. It is estimated that in Argentina there may be 18000 cases with severe deficiency of SZ y ZZ genotypes, most of them undiagnosed. It is crucial to suspect the disease in order to measure the serum AAT concentration, and, if the concentrations are low, to confirm the diagnosis with the phenotype or genotype determinations. Case detection allows genetic advice, control of blood-related relatives and in selected cases, replacement therapy.

Normativas de diagnóstico y tratamiento del déficit de alfa-1 antitripsina

El déficit de alfa-1 antitripsina (AAT) es una condición hereditaria rara y raramente diagnosticada en todo el mundo, incluida Argentina. El infradiagnóstico es fundamentalmente debido a que muchos médicos desconocen su existencia, diagnóstico y tratamiento. Por ello, la Asociación Argentina de Medicina Respiratoria encomendó a un grupo de expertos la elaboración de la presente normativa. La AAT es una glicoproteína secretada por el hígado, muy abundante en sangre, tejidos y fluidos corporales, cuya función principal consiste en inhibir la elastasa del neutrófilo y otras serin proteasas, confiriendo al suero humano más del 90% de su capacidad antiproteasa. El déficit de AAT deriva de mutaciones del gen de la SERPINA1, y se manifiesta clínicamente por enfisema pulmonar, cirrosis hepática y, con menor frecuencia, por paniculitis, vasculitis sistémicas y posiblemente otras enfermedades. El déficit grave de AAT afecta mayoritariamente a individuos de raza caucasiana y tiene su máxima prevalencia (1:2.000-1:5.000 individuos) en el norte, oeste y centro de Europa. En EEUU y Canadá, la prevalencia es de 1: 5.000-10.000, y es 5 veces menor en países latinoamericanos, incluida Argentina, donde se estima que puede haber unos 18.000 individuos con genotipos deficientes graves SZ y ZZ, la inmensa mayoría sin diagnosticar. Sospechar la enfermedad resulta clave para medir la concentración sérica de AAT y completar el diagnóstico con la determinación del fenotipo o genotipo ante concentraciones bajas. La detección de casos permite la puesta en práctica del consejo genético, el chequeo de familiares consanguíneos y, en casos seleccionados, la aplicación de terapia sustitutiva.(AU)

The alpha-1 antitrypsin (AAT) deficiency is a rare hereditary condition which is rarely diagnosed in the world, including Argentina. Underdiagnosis is mainly due to lack of knowledge of its diagnosis and treatment by many physicians. For this reason, the Argentine Association of Respiratory Medicine convened a group of experts to develop the present guidelines. AAT is a glycoprotein secreted by the liver; it reaches high levels in blood, body tissues and fluids. Its main function is to inhibit the neutrophil elastase and other serum proteases providing 90% of human serine antiprotease activity. The AAT deficiency is produced by mutations of the SERPINA1 gene. Its clinical manifestations are pulmonary emphysema, liver cirrhosis, and less often panniculitis, systemic vasculitis and possibly other conditions. The severe AAT deficiency affects mainly Caucasian individuals. The highest prevalence, ranging from 1 in 2000 to 1 in 5000 population is observed in northern, western and central Europe. In the USA and Canada, the prevalence varies from 1 in 5000 to 1 in 10000 population. It is 5 times less frequent in Latin American countries. It is estimated that in Argentina there may be 18000 cases with severe deficiency of SZ y ZZ genotypes, most of them undiagnosed. It is crucial to suspect the disease in order to measure the serum AAT concentration, and, if the concentrations are low, to confirm the diagnosis with the phenotype or genotype determinations. Case detection allows genetic advice, control of blood-related relatives and in selected cases, replacement therapy.(AU)

[Proteinase activity in Candida albicans strains isolated from the oral cavity of immunocompromised patients, with oral candidiasis and in healthy subjects]. / Actividad de la proteinasa en cepas de Candida albicans aisladas de la cavidad oral de pacientes inmunodeprimidos, con candidiasis oral y sujetos sanos.

BACKGROUND: Candida albicans has a variety of virulence factors, including secreted aspartyl proteases, which are determinant factors in the pathogenesis of this yeast in immunocompromised patients. AIMS: Proteinase activity was identified in C. albicans strains isolated from the oral cavity of immunocompromised patients with cancer, diabetes and HIV+, with oral candidiasis and in healthy subjects. METHODS: Two hundred and fifty C. albicans strains were analyzed, distributed in 5 different groups: patients with cancer, diabetes, HIV+, with oral candidiasis and healthy subjects. RESULTS: Proteolytic activity was identified in 46% of the strains from cancer patients, 54% from HIV+ patients, 60% from diabetics, 70% from oral candidiasis patients, and 42% from healthy subjects. Activity was higher in strains from immunocompromised and oral candidiasis patients than in healthy subjects. Differences were observed between the candidiasis-healthy, candidiasis-HIV+, and diabetic-healthy groups. No differences were observed between the oral candidiasis, diabetes and cancer patients, between the diabetes and HIV+ patients, or between the cancer patients, HIV+ patients and healthy subjects. CONCLUSIONS: The present results suggest that although secreted aspartyl proteases are important in the pathogenesis of C. albicans, their activity depends on host conditions.

Occurrence and identification of yeasts in dogs external ear canal with and without otitis / Ocurrencia y detección de levaduras en el conducto auditivo de los perros con y sin otitis

Objective. To analyze the presence of yeast in the external ear canal of 116 dogs with and without a diagnosis of otitis from veterinary clinic in the Chapecó city, Santa Catarina, Brazil, and to examine the secretion of the proteinase in isolates. Materials and methods. Were collected cerumen of conduct hearing of dogs of 16 different races 71% with pendular ear type, 5% of semi-pendular and 24% of the erect type. All dogs were previously evaluated by otoscopy and grouped in dogs with and without otitis. Results. Yeasts were isolated in 44 samples (approximately 36%), where Malassezia pachydermatis was identified in 95% of samples where were observed growth of yeasts. On 20 samples the proteinase enzyme showed strong activity in 31% isolates, were 21% of the dogs with otitis tested showed high proteolytic activity. Conclusions. We observed a variation of strains of M. pachydermatis-producing enzymes. The variation in production of these enzymes is probably more associated with different response to the action of the immune system of the animal in the tissue injury.

Objetivo. Se investigó la presencia de levaduras en el canal externo del oído de 116 perros de la clínica veterinaria en la ciudad de Chapecó, Santa Catarina,Brasil, en perros sanos y perros con otitis y se examinó la secreción de la proteinasa en las muestra aisladas. Materiales y métodos. Se recogieron cerumen del oído de perros de 16 razas diferentes, dónde 71% fue de oído de tipo pendular, 5% de semi-pendular y 24% del tipo erecto. Todos los perros fueron evaluados previamente por otoscopia y agrupados en perros con y sin otitis externa. Resultados. Las levaduras se aislaron en 44 muestras (aproximadamente 36%), donde Malassezia pachydermatis se identificó en el 95% de las muestras donde se observó el crecimiento de las levaduras. El 20 muestras la secreción de proteinasa mostró fuerte actividad en el 31% de los aislados y en 21% de los perros con otitis mostró alta actividad proteolítica. Conclusiones. Hemos observado una variación de cepas de M. pachydermatis productoras de enzimas. La variación en la producción de estas enzimas es probablemente más asociados con la respuesta diferente a la acción del sistema inmunológico del animal en la lesión tisular.

Detección de anticuerpos contra los antígenos de diferenciación tumoral proteinasa 3 (PR3) y mieloperoxidasa (MPO) en la leucemia promielocítica / Detection of antibodies to antigens of proteinase 3 (PR3) tumor differentiations and myeloperoxidase (MPO) in cases of promyelocytic leukemia

La leucemia promielocítica (LPM) subtipo M3 representa del 5-15 por ciento en la clasificación FAB de las leucemias mieloides agudas (LMA). Está asociada con características genéticas únicas que incluyen la translocación recíproca t(15;17)(q22;q12). El mecanismo por el que ocurre la t(15;17) no se conoce. Las leucemias de estirpe mieloide expresan diversos antígenos de diferenciación tumoral como son la proteinasa 3 (PR 3) y la mieloperoxidasa (MPO) que se encuentran sobreexpresados en el promielocito. Se plantea que participan en la maduración y en la regulación de la división celular. Existe poca información acerca de la respuesta inmune de pacientes con LPM dirigida contra las células tumorales. En nuestro trabajo se detectó la presencia de anticuerpos contra los antígenos de diferenciación tumoral PR3 y MPO en diferentes fases del tratamiento de la enfermedad, mediante inmunofluorescencia indirecta. Los anticuerpos anti PR3 y anti MPO se detectaron en aquellos pacientes sin tratar y en fase de inducción, no así en la consolidación y mantenimiento, de ahí su posible utilidad como marcadores de diferenciación celular(AU)

ABSTRACT Promyelocytic leukemia (PML) subtype M3 represents the 5-15 percent in the FAB classification of acute myeloid leukemias (AML). It is associated with the unique genetic features including the reciprocal t-translocation (15;17) (q22;q12). The mechanism of t is unknown. The myeloid leukemias express different tumoral differentiation antigens such as the proteinase 3 (PR 3) and myeloperoxidase (MPO) which are over-expressed in promyelocyte. It is involved in maturation and regulation of cell division. There is scarce information on the immune response of patients with PLM against tumor cells. In our paper we detected presence of antibodies to RP3 and MPO tumor differentiation antigens in different phases of disease treatment by indirect immunofluorescence. Anti-MPO and anti-PR3 antibodies were detected in those patients without treatment and in induction phase but not in the consolidation and maintenance, thus its potential usefulness as cellular differentiation markers(AU)

Detección de anticuerpos contra los antígenos de diferenciación tumoral proteinasa 3 (PR3) y mieloperoxidasa (MPO) en la leucemia promielocítica / Detection of antibodies to antigens of proteinase 3 (PR3) tumor differentiations and myeloperoxidase (MPO) in cases of promyelocytic leukemia

La leucemia promielocítica (LPM) subtipo M3 representa del 5-15 por ciento en la clasificación FAB de las leucemias mieloides agudas (LMA). Está asociada con características genéticas únicas que incluyen la translocación recíproca t(15;17)(q22;q12). El mecanismo por el que ocurre la t(15;17) no se conoce. Las leucemias de estirpe mieloide expresan diversos antígenos de diferenciación tumoral como son la proteinasa 3 (PR 3) y la mieloperoxidasa (MPO) que se encuentran sobreexpresados en el promielocito. Se plantea que participan en la maduración y en la regulación de la división celular. Existe poca información acerca de la respuesta inmune de pacientes con LPM dirigida contra las células tumorales. En nuestro trabajo se detectó la presencia de anticuerpos contra los antígenos de diferenciación tumoral PR3 y MPO en diferentes fases del tratamiento de la enfermedad, mediante inmunofluorescencia indirecta. Los anticuerpos anti PR3 y anti MPO se detectaron en aquellos pacientes sin tratar y en fase de inducción, no así en la consolidación y mantenimiento, de ahí su posible utilidad como marcadores de diferenciación celular.

ABSTRACT Promyelocytic leukemia (PML) subtype M3 represents the 5-15 percent in the FAB classification of acute myeloid leukemias (AML). It is associated with the unique genetic features including the reciprocal t-translocation (15;17) (q22;q12). The mechanism of t is unknown. The myeloid leukemias express different tumoral differentiation antigens such as the proteinase 3 (PR 3) and myeloperoxidase (MPO) which are over-expressed in promyelocyte. It is involved in maturation and regulation of cell division. There is scarce information on the immune response of patients with PLM against tumor cells. In our paper we detected presence of antibodies to RP3 and MPO tumor differentiation antigens in different phases of disease treatment by indirect immunofluorescence. Anti-MPO and anti-PR3 antibodies were detected in those patients without treatment and in induction phase but not in the consolidation and maintenance, thus its potential usefulness as cellular differentiation markers.