Functional variations in MBL2 gene are associated with cutaneous leishmaniasis in the Amazonas state of Brazil.

Functional variations in the mannose-binding lectin (MBL2) gene causing low levels of serum MBL are associated with susceptibility to numerous infectious diseases. We investigated whether there is genetic association of MBL2 variant alleles with cutaneous leishmaniasis (CL) caused by Leishmania guyanensis. We used PCR-restriction fragment length polymorphism to genotype six MBL2 variants, three in the promoter region and three in the exon 1. An association was noted between the single nucleotide polymorphism -221X/Y of the MBL2 gene and CL (P=2.9 × 10(-6); odds ratio (OR)=1.9 (1.4-2.5) consistent with the hypothesis that the -221X allele confers high risk to development of CL among L. guyanensis-infected individuals. Furthermore, L. guyanensis-infected individuals bearing the codon 57 allele C had a higher risk of developing CL (P=5 × 10(-5); OR=1.9 (1.4-2.6)). The low MBL expressor haplotype LXPB was also associated to CL (P=6 × 10(-4)). This study raises the possibility that functional polymorphisms in MBL2 gene play a role in clinical outcome of Leishmania infection.

Identification of fungemia agents using the polymerase chain reaction and restriction fragment length polymorphism analysis

Prompt and specific identification of fungemia agents is important in order to define clinical treatment. However, in most cases conventional culture identification can be considered to be time-consuming and not without errors. The aim of the present study was to identify the following fungemia agents: Candida albicans, Candida parapsilosis, Candida tropicalis, Candida glabrata, Cryptococcus neoformans, Cryptococcus gattii, and Histoplasma capsulatum using the polymerase chain reaction and restriction fragment length polymorphism analysis (PCR/RFLP). More specifically: a) to evaluate 3 different amplification regions, b) to investigate 3 different restriction enzymes, and c) to use the best PCR/RFLP procedure to indentify 60 fungemia agents from a culture collection. All 3 pairs of primers (ITS1/ITS4, NL4/ITS5 and Primer1/Primer2) were able to amplify DNA from the reference strains. However, the size of these PCR products did not permit the identification of all the species studied. Three restriction enzymes were used to digest the PCR products: HaeIII, Ddel and Bfal. Among the combinations of pairs of primers and restriction enzymes, only one (primer pair NL4/ITS5 and restriction enzyme Ddel) produced a specific RFLP pattern for each microorganism studied. Sixty cultures of fungemia agents (selected from the culture collection of Fundação de Medicina Tropical do Amazonas - FMTAM) were correctly identified by PCR/RFLP using the prime pair NL4/ITS5 and Ddel. We conclude that the method proved to be both simple and reproducible, and may offer potential advantages over phenotyping methods.

Identification of fungemia agents using the polymerase chain reaction and restriction fragment length polymorphism analysis.

Prompt and specific identification of fungemia agents is important in order to define clinical treatment. However, in most cases conventional culture identification can be considered to be time-consuming and not without errors. The aim of the present study was to identify the following fungemia agents: Candida albicans, Candida parapsilosis, Candida tropicalis, Candida glabrata, Cryptococcus neoformans, Cryptococcus gattii, and Histoplasma capsulatum using the polymerase chain reaction and restriction fragment length polymorphism analysis (PCR/RFLP). More specifically: a) to evaluate 3 different amplification regions, b) to investigate 3 different restriction enzymes, and c) to use the best PCR/RFLP procedure to indentify 60 fungemia agents from a culture collection. All 3 pairs of primers (ITS1/ITS4, NL4/ITS5 and Primer1/Primer2) were able to amplify DNA from the reference strains. However, the size of these PCR products did not permit the identification of all the species studied. Three restriction enzymes were used to digest the PCR products: HaeIII, Ddel and Bfal. Among the combinations of pairs of primers and restriction enzymes, only one (primer pair NL4/ITS5 and restriction enzyme Ddel) produced a specific RFLP pattern for each microorganism studied. Sixty cultures of fungemia agents (selected from the culture collection of Fundação de Medicina Tropical do Amazonas--FMTAM) were correctly identified by PCR/RFLP using the prime pair NL4/ITS5 and Ddel. We conclude that the method proved to be both simple and reproducible, and may offer potential advantages over phenotyping methods.

Effects of intradermal gamma-interferon in cutaneous leishmaniasis.

The clinical and immunological evolution of lesions in cutaneous leishmaniasis was assessed after treatment with human recombinant gamma interferon (rIFN-gamma). 3 weeks after rIFN-gamma treatment of lesions due to Leishmania braziliensis guyanensis, 12/13 had become smaller compared with 6/13 control lesions; only 4 treated lesions were free of parasites. 9 of 13 L tropica lesions treated with rIFN-gamma resolved completely within 4-8 weeks of treatment. An acute inflammatory reaction around treated lesions was more common in lesions due to L tropica. There were no other local or systemic adverse reactions. Histological and immunohistochemical studies indicate that local application of rIFN-gamma enhances cell-mediated immune responses and thus promotes healing of cutaneous leishmaniasis.

Deep mycoses in Amazon region.

Patients with deep mycoses diagnosed in dermatologic clinics of Manaus (state of Amazonas, Brazil) were studied from November 1973 to December 1983. They came from the Brazilian states of Amazonas, Pará, Acre, and Rondônia and the Federal Territory of Roraima. All of these regions, with the exception of Pará, are situated in the western part of the Amazon Basin. The climatic conditions in this region are almost the same: tropical forest, high rainfall, and mean annual temperature of 26C. The deep mycoses diagnosed, in order of frequency, were Jorge Lobo's disease, paracoccidioidomycosis, chromomycosis, sporotrichosis, mycetoma, cryptococcosis, zygomycosis, and histoplasmosis.

[Jorge Lobo's disease. Second Peruvian case]. / Enfermedad de Jorge Lobo. Segundo caso Peruano.

A case of Jorge Lobo's disease is described. According to the references consulted the case presented is the second in Peru. The patient is a native of the Peruvian jungle (River Madre de Dios, State Madre de Dios). The disease was restricted to the left ear. Clinical and histopathological aspects were typical of Lobo's disease.

[Epidemiologic survey on Hansen's disease and other dermatoses in school children, Manaus, Estado do Amazonas, Brasil]. / Inquérito epidemiológico sobre hanseníase e outras dermatoses em escolares, Manaus, Estado do Amazonas, Brasil.

During the period from April 1978 to May 1980 some 10,178 school children in the city of Manaus, State of Amazonas, Brazil, were examined. 22 cases of Hansen's disease were discovered, 16 presented with the tuberculoid form of the disease, 5 lepromatous and 1 indeterminate case were found. The most frequent dermatological conditions were dermatozoonosis, superficial mycosis, disorders of keratinization, naevus and bacterial infections.

Hanseniase no Estado do Amazonas: historico e desativacao do leprosario. / Hanseniasis in the State of Amazonas: historical aspects and disactivation of the leprosarium

Sao estudados os principais aspectos da evolucao da hanseniase no Estado do Amazonas, desde os primeiros casos registrados, sua provavel procedencia, a criacao dos primeiros isolamentos e a desativacao do leprosario em 1979. Ate dezembro de 1979 estavam registrados 10.800 doentes; desse total, 4.142 eram da forma virchowiana e/ou dimorfa, 4.523 da forma tuberculoide e 2.135 do tipo indeterminado. Os doentes da antiga colonia estao sob controle no posto de saude do atual Bairro do Aleixo ou no asilo, tambem area da antiga colonia

Hanseniase no Estado do Amazonas: historico e desativacao do leprosario / Hansen's disease in the State of Amazonas: historical aspects and disactivation of the leprosarium

Sao estudados os principais aspectos da evolucao da hanseniase no Estado do Amazonas, desde os primeiros casos registrados, sua provavel procedencia, a criacao dos primeiros isolamentos e a desativacao do leprosario em 1979. Ate dezembro de 1979 estavam registrados 10.800 doentes; desse total, 4.142 eram da forma virchowiana e/ou dimorfa, 4.523 da forma tuberculoide e 2.135 do tipo indeterminado. Os doentes da antiga colonia estao sob controle no posto de saude do atual Bairro do Aleixo ou no asilo, tambem area da antiga colonia