Socio-economic and environmental factors associated with the occurrence of canine infection by Leishmania infantum in Teresina, Brazil.

American visceral leishmaniasis (AVL) is a zoonosis caused by protozoan parasites of the genus Leishmania. In Brazil, the disease is caused by Leishmania infantum and the main vector is the phlebotomine sandfly Lutzomyia longipalpis, found both in natural ecotopes and in the rural and urban environments, being very well adapted to the peridomestic environment. The domestic dog has been incriminated as the main reservoir of the parasite in the urban environment, but the control measures based on culling seropositive dogs have not shown to be effective to contain the spread of the disease throughout the country. Many studies evaluated risk factors for human visceral leishmaniasis but few focused on the socioeconomic and environmental factors associated with infection among dogs. Knowledge of these factors might help identify the conditions that contribute to the maintenance of transmission cycles in the urban environment and identify new targets for intervention. The objective of this study was to assess the association between socioeconomic and environmental factors and the occurrence of canine leishmaniasis at Teresina city, Brazil. This cross-sectional study was developed in ten districts of Teresina, involving 532 houses and 810 dogs. Peripheral blood samples were collected by vein punction using vacutainer tubes without anticoagulant for performing serological test (indirect immunofluorescence - IFI). Serum samples with IFI titers ≥1: 80 were considered positive. Owners of the selected dwellings were interviewed using a semi-structured questionnaire addressing socioeconomic and environment aspects. The association between variables and seropositivity was assessed through multilevel logistic regression models. Global seropositivity was 39%. There was no statistically significant difference between seropositivity and age and sex of animals, literacy of the household head, presence of other domestic animals or with household characteristic like water supply, inadequate sewage disposal system, type of floor and roof. Mixed-breed dogs and those living for a long time in houses with absence of masonry walls and presence of a kennel showed higher odds of seropositivity. These results suggest that some peridomestic characteristics, especially the absence of barriers that allow dogs to have free access to the street, in association with the presence of a kennel, might contribute to maintaining the infection cycle in urban areas. Intervention measures oriented to the management of the peridomestic environment and responsible dog possession could be useful tools for reducing disease burden in endemic area.

Improving the serodiagnosis of canine Leishmania infantum infection in geographical areas of Brazil with different disease prevalence.

Serodiagnosis of Leishmania infantum infection in dogs relies on the detection of antibodies against leishmanial crude extracts or parasitic defined antigens. The expansion of canine leishmaniasis from geographical areas of Brazil in which the infection is endemic to regions in which the disease is emerging is occurring. This fact makes necessary the analysis of the serodiagnostic capabilities of different leishmanial preparations in distinct geographical locations. In this article sera from dogs infected with Leishmania and showing the clinical form of the disease, were collected in three distinct Brazilian States and were tested against soluble leishmanial antigens or seven parasite individual antigens produced as recombinant proteins. We show that the recognition of soluble leishmanial antigens by sera from these animals was influenced by the geographical location of the infected dogs. Efficacy of the diagnosis based on this crude parasite preparation was higher in newly endemic regions when compared with areas of high disease endemicity. We also show that the use of three of the recombinant proteins, namely parasite surface kinetoplastid membrane protein of 11 kDa (KMP-11), and two members of the P protein family (P2a and P0), can improve the degree of sensitivity without adversely affecting the specificity of the diagnostic assays for canine leishmaniasis, independently of the geographical area of residence. In addition, sera from dogs clinically healthy but infected were also assayed with some of the antigen preparations. We demonstrate that the use of these proteins can help to the serodiagnosis of Leishmania infected animals with subclinical infections. Finally, we propose a diagnostic protocol using a combination of KMP-11, P2a y P0, together with total leishmanial extracts.

Novos adjuvantes vacinais: importante ferramenta para imunoterapia da leishmaniose visceral / New vaccine adjuvants: an important tool for immunotherapy of visceral leishmaniasis

Atualmente, muitas das vacinas em desenvolvimento são aquelas compostas de proteínas antigênicas individuais de parasitas ou uma combinação de vários antígenos individuais que são produzidos como produtos recombinantes obtidos por técnicas de biologia molecular. Dentre elas a Leish-111f e sua variação Leish-110f tem ganhado destaque na proteção contra a LV e LC e alcançaram estudos de fase II em seres humanos. A eficácia de uma vacina é otimizada pela adição de adjuvantes imunológicos. No entanto, embora os adjuvantes tenham sido usados por mais de um século, até o momento, apenas alguns adjuvantes são aprovados para o uso em humanos, a maioria destinada a melhorar a eficácia da vacina e a produção de anticorpos protetores específicos do antígeno. os mecanismos de ação dos adjuvantes imunológicos são diversos, dependendo da sua natureza química e molecular sendo capazes de ativar células imunes especificas que conduzem a respostas imunes inatas e adaptativas melhoradas. embora o mecanismo de ação molecular detalhado de muitos adjuvantes ainda seja desconhecido, a descoberta de receptores Toll-like (TLrs) forneceu informações críticas sobre o efeito imunoestimulador de numerosos componentes bacterianos que envolvem interação com receptores TLrs, mostrando que estes ligantes melhoram tanto a qualidade como a quantidade de respostas imunes adaptativas do hospedeiro quando utilizadas em formulações de vacinais direcionadas para doenças. o potencial desses adjuvantes de TLr em melhorar o design e os resultados de várias vacinas está em constante evolução, à medida que novos agonistas são descobertos e testados em modelos experimentais e estudos clínicos de vacinação. Nesta revisão, é apresentado um resumo do progresso recente no desenvolvimento de proteínas recombinantes de segunda geração e adjuvantes de TLr, sendo o foco principal nos TLr4 e suas melhorias.

many of the vaccines in development are currently composed of individual antigenic proteins from parasites or a combination of several individual antigens that are produced as recombinant products obtained by molecular biology techniques. Among them, Leish-111f and its Leish-110f variation have gained prominence in protection against LV and LC and already have Phase II clinical trials in humans. The efficacy of a vaccine is optimized by the addition of immunological adjuvants. However, although adjuvants have been used for more than a century, until present date, only a few adjuvants are approved for use in humans, most intended to improve vaccine efficacy, the production of antigen-specific protective antibodies and an appropriate cell-immune response. The mechanisms of action of immunological adjuvants are diverse depending on their chemical and molecular nature being able to activate specific immune cells leading to improved innate and adaptive immune responses. Although the molecular mechanism of action of many adjuvants is still unknown, the discovery of Toll-like receptors (TLrs) has provided critical information on the immunostimulatory effect of numerous bacterial components involving interaction with TLr showing that these ligands improve both the quality as the amount of host adaptive immune responses when used in vaccine formulations. The potential of these TLr adjuvants in improving the design and results of many vaccines is in constantly evolution as new molecules agonists are discovered and tested in experimental models and clinical trials as well. In this review, a summary of recent progress in the development of second generation recombinant proteinsand adjuvants of TLr is presented, being the main focus in TLr4 and its improvements.