Publications by authors named "Jorge Enrique Gómez-Marín"

47 Publications

Ocular Toxocariasis in Parasitology Consultation in Quindío, Colombia: Description of Cases and Contact Studies.

J Trop Pediatr 2020 Dec 13. Epub 2020 Dec 13.

GEPAMOL Group, Universidad del Quindío, Armenia, Colombia 63004.

We report diagnosis, treatment and evolution of cases of ocular toxocariasis in specialized consultation in Quindío, Colombia. No cases were seen during the 2000-17 period, but five cases were confirmed from November 2017 to March 2019; two children resulted with definitive loss of vision on the affected eye. Studies in contacts found that 12 of 19 (63%) family members and 15 of 25 (60%) children <15 years of age living on the same street were positive for IgG Toxocara antibodies. Epidemiological studies are necessaries to establish the reasons for the increase in cases at this region.
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http://dx.doi.org/10.1093/tropej/fmaa096DOI Listing
December 2020

Clinical, Socio-economic and Environmental Factors Related with Recurrences in Ocular Toxoplasmosis in Quindío, Colombia.

Ophthalmic Epidemiol 2020 Oct 28:1-7. Epub 2020 Oct 28.

Group of Studies on Molecular Parasitology (GEPAMOL), Center of Biomedical Research, Faculty of Health Sciences, Universidad Del Quindío , Armenia, Colombia.

Purpose: To identify the sociodemographic, clinical, and environmental factors associated with recurrences in ocular toxoplasmosis (OT).

Methods: Retrospective analysis of clinical records of patients who consulted in the Health Centre at Universidad del Quindío between 2004 and 2017. Patients with retinochoroiditis due to infection and follow up >12 months were included. Comparisons were made with a recurrence index adjusted for months of follow up. For the statistical analysis, the Kruskal-Wallis test and analysis of variance (ANOVA) tests were performed in Epi Info 7.2 and SPSS 14.0. A statistical significance is shown if p ≤ 0.05.

Results: A total of 58 patients were included, with median age of 28 years (range 1-61) and 55.1% were women. The median of recurrences was 1.4 (range 0.6-16.6). High recurrence index was present in 43.1% of the patients. A higher size of lesions was observed in low socioeconomic groups ( = .016) and patients with congenital infection had more bilateral compromise ( = .002). Intake of boiled water was related to a lower recurrence index ( = .04).

Conclusions: Low socioeconomic level was associated with bigger lesions and congenital infection was related with higher frequency of bilateral OT. Finally, intake of boiled water is related to a lower recurrence index of OT.
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http://dx.doi.org/10.1080/09286586.2020.1839509DOI Listing
October 2020

Human peripheral blood mononuclear cells as an ex vivo model to study the host parasite interaction in Toxoplasma gondii.

Exp Parasitol 2020 Dec 12;219:108020. Epub 2020 Oct 12.

Grupo GEPAMOL, Centro de Investigaciones Biomédicas, Facultad de Ciencias de La Salud, Universidad Del Quindio, Colombia. Electronic address:

Toxoplasma gondii is a parasite that can invade any cell in the human body. Here, we implemented and described an ex vivo model with human peripheral blood mononuclear cells (PBMCs) without using culture supplements/antibiotics and without cryopreserved cells (EXMOWS) to study the interactions between T. gondii and human cells. To establish the EXMOWS, three independent tests were carried out. Firstly, blood samples from 5 individuals were included to assess the viability and adherence of PBMCs in plate culture. In a second trial, blood samples from three seropositive and two seronegative individuals for T. gondii were used to evaluate human PBMCs cells: parasites, multiplicity of infection (MOI) 1:1, 1:3 and 1:5 at different times post infection (1 h, 6 h and 24 h). The possible immunomodulatory effect of the infection for this EXMOWS were evaluated in a third trial where HFF cells were infected with T. gondii and co-cultured with PBMCs obtained from anti-Toxoplasma IgG positive and IgG negative individuals. One hour was enough time for T. gondii infection of human PBMCs and 2 h was the minimum incubation time to guarantee adherence before carrying out any infection assay. A minimum of 1:3 MOI was necessary to guarantee efficient infection in human PBMCs with T. gondii RH-GFP. All protocols, including PBMCs isolation and stimulation, should be conducted the same day. This EXMOWS can be adapted to study the early stages of interaction with other microorganisms of human interest, without need of using cryopreservation and supplements/antibiotics.
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http://dx.doi.org/10.1016/j.exppara.2020.108020DOI Listing
December 2020

Serotyping, host genes and cytokines response in human ocular toxoplasmosis.

Microb Pathog 2020 Nov 27;148:104465. Epub 2020 Aug 27.

GEPAMOL, Centro de Investigaciones Biomédicas, Facultad de Ciencias de la Salud, Universidad del Quindío, Armenia (Quindio), Colombia. Electronic address:

In human ocular toxoplasmosis, serotype is related with greater severity. We analyzed Toxoplasma GRA6 serotype in 23 patients with ocular toxoplasmosis (13 confirmed, two co-infections- and eight unconfirmed cases) and 20 individuals chronically infected with Toxoplasma but without ocular involvement. In patients with ocular toxoplasmosis, we also studied host gene polymorphisms related to immune response (IL-1β; IL-1α; IL-10; IFN-γ; TNF-α, IL-12), IL-17R, TLR-9, and P2RX7. Additionally, eight patients were studied for the production of TNFα, IL1-β, IFN-γ and IL-10 by their peripheral leukocytes after ex vivo stimulation with soluble Toxoplasma antigens. There were no differences in the distribution of serotypes (GRA6-I versus GRA6 non-I) between infected individuals with- or without ocular involvement. Seropositivity for GRA6-I was associated with higher number of retinal lesions and higher levels of IL-1β. Two polymorphisms were associated with specific clinical manifestations of ocular toxoplasmosis: IL-10 -819 C/T with bilateral lesions and IL-12 + 169,774 A/C with synechia. Higher levels of IL-10 were found in patients with the allele G/G at the polymorphic region IL-10 -1082. People with a GRA6 I serotype and possessing the allele G/G at the polymorphic region TNFα-857 suffered from an increased number of retinal lesions. We found a positive association between host cytokine genes polymorphisms and GRA6 serotypes correlated with specific clinical manifestations and immune response in ocular toxoplasmosis.
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http://dx.doi.org/10.1016/j.micpath.2020.104465DOI Listing
November 2020

First Detection of Toxoplasma gondii DNA in a Wild Bat from Colombia.

Acta Parasitol 2020 Dec 20;65(4):969-973. Epub 2020 May 20.

Grupo de Estudio en Parasitología y Micología Molecular GEPAMOL, Universidad del Quindío, Armenia, Quindío, Colombia.

Introduction: Toxoplasma gondii infections have been reported for many warm-blooded animals around the world including chiropterans. However, in Colombia, the country that holds the highest taxonomic richness of this order of mammals in the Neotropics, up to date there are no reports of T. gondii in bats (Carollia brevicauda).

Purpose: The objective of the present study was to detect T. gondii DNA from internal bat organs from Quindío, Colombia.

Results: We report the first detection of T. gondii DNA from internal bat organs in the department of Quindio, Central Andes of Colombia. Out of three silky short tail bat (Carollia brevicauda) specimens collected at the natural reserve "La Montaña del Ocaso", organs were recovered (lungs, liver, heart, kidneys, small and large intestine) and tested for T. gondii through PCR for B1 sequence, with 1/3 (33.3%) positive result for the presence of T. gondii DNA in bat kidney tissues.

Conclusion: Taking into consideration the high diversity of bat species in Colombia, and the complexity of the ecological and functional relationships that these organisms establish in the ecosystems they inhabit, we discuss on the urgent need for more detailed research and surveys for Toxoplansma in bats and other mammalian wild species.
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http://dx.doi.org/10.2478/s11686-020-00222-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7238717PMC
December 2020

Detection and genotypes of Toxoplasma gondii DNA in feces of domestic cats in Colombia.

Parasite 2020 17;27:25. Epub 2020 Apr 17.

Grupo de Estudio en Parasitología y Micología Molecular (GEPAMOL), Centro de Investigaciones Biomédicas, Facultad Ciencias de la Salud, Universidad del Quindío, 630004 Armenia, Colombia.

The high prevalence of Toxoplasma gondii in the human population in Colombia has been linked to the existence of a high density of urban stray cats, exposing the whole population to a high density of oocysts. The goal of this study was to determine the DNA prevalence of T. gondii by conventional PCR and to phylogenetically analyze ROP18 sequences from positive samples in domestic cat (Felis catus) fecal samples in the city of Armenia, Quindío. Fecal samples from 140 cats were collected from 10 districts around the city. Samples were concentrated using Ritchie's method and analyzed through optical microscopy. Concentrates were used for DNA extraction followed by nested PCR amplification for T. gondii gene B1. PCR for ROP18 was performed on all B1 positive samples; the ROP18 sequences obtained were related to the Archetype I Brazilian and Chinese strains. No oocysts were detected by optical microscopy; however, 17.8% (25/140) B1 and 24% (6/25) ROP18 PCR-positive samples were detected. Phylogenetic analyses showed that isolates clustered into a single group. We assessed whether associations existed between T. gondii positive fecal samples and survey variables such as cat healthcare and socioeconomic characteristics of owners, but no statistically significant associations were found. The presence of T. gondii in cat feces is an important factor contributing to the high prevalence in the human population of this city.
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http://dx.doi.org/10.1051/parasite/2020023DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7164795PMC
December 2020

Severe acute multi-systemic failure with bilateral ocular toxoplasmosis in immunocompetent patients from urban settings in Colombia: Case reports.

Am J Ophthalmol Case Rep 2020 Jun 13;18:100661. Epub 2020 Mar 13.

Fundación Oftalmológica Nacional, Uveitis and Retina Services, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Cl. 50 #13 - 50, Bogotá, Colombia.

Propose: To report two cases of severe acute multi-systemic failure with bilateral ocular toxoplasmosis in immunocompetent patients from urban settings in Colombia.

Observations: We report two immunocompetent male patients aged 44- and 67-years-old who, despite not having visited the Amazonian region in Colombia, had severe bilateral posterior uveitis and extensive-bilateral macular lesions and multiple organ failure that required admission to an intensive care unit. was positive by PCR assay in vitreous humor samples. Patients were treated with intravitreal clindamycin and dexamethasone in addition to systemic treatment with trimethoprim-sulfamethoxazole. In both patients, infection by atypical strains was confirmed; in one case by serotyping and in another one by genotyping (ROP 18 virulent allele). After 2 and 4 months of treatment respectively, the patients showed improvement of the posterior uveitis and its systemic manifestations. However, there was no significant visual acuity improvement due to bilateral extensive macular involvement.

Conclusions And Importance: Clinicians should be aware that toxoplasmosis originating from South America could be associated with severe acute multisystemic and intraocular bilateral involvement, even in patients with no history of exposure to jungle environments.
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http://dx.doi.org/10.1016/j.ajoc.2020.100661DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7078491PMC
June 2020

Transfer Learning for Toxoplasma gondii Recognition.

mSystems 2020 Jan 28;5(1). Epub 2020 Jan 28.

College of Science, Harbin Institute of Technology, Shenzhen, China

, one of the world's most common parasites, can infect all types of warm-blooded animals, including one-third of the world's human population. Most current routine diagnostic methods are costly, time-consuming, and labor-intensive. Although can be directly observed under the microscope in tissue or spinal fluid samples, this form of identification is difficult and requires well-trained professionals. Nevertheless, the traditional identification of parasites under the microscope is still performed by a large number of laboratories. Novel, efficient, and reliable methods of identification are therefore needed, particularly in developing countries. To this end, we developed a novel transfer learning-based microscopic image recognition method for identification. This approach employs the fuzzy cycle generative adversarial network (FCGAN) with transfer learning utilizing knowledge gained by parasitologists that is banana or crescent shaped. Our approach aims to build connections between microscopic and macroscopic associated objects by embedding the fuzzy C-means cluster algorithm into the cycle generative adversarial network (Cycle GAN). Our approach achieves 93.1% and 94.0% detection accuracy for ×400 and ×1,000 microscopic images, respectively. We showed the high accuracy and effectiveness of our approach in newly collected unlabeled microscopic images, compared to other currently available deep learning methods. This novel method for microscopic image recognition will open a new window for developing cost-effective and scalable deep learning-based diagnostic solutions, potentially enabling broader clinical access in developing countries., one of the world's most common parasites, can infect all types of warm-blooded animals, including one-third of the world's human population. Artificial intelligence (AI) could provide accurate and rapid diagnosis in fighting So far, none of the previously reported deep learning methods have attempted to explore the advantages of transfer learning for detection. The knowledge from parasitologists is that the parasite is generally banana or crescent shaped. Based on this, we built connections between microscopic and macroscopic associated objects by embedding the fuzzy C-means cluster algorithm into the cycle generative adversarial network (Cycle GAN). Our approach achieves high accuracy and effectiveness in ×400 and ×1,000 microscopic images.
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http://dx.doi.org/10.1128/mSystems.00445-19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6989130PMC
January 2020

Influence of Two Major Virulence Factors (ROP16 and ROP18) on the Immune Response of Peripheral Blood Mononuclear Cells to Human Toxoplasmosis Infection.

Front Cell Infect Microbiol 2019 4;9:413. Epub 2019 Dec 4.

Grupo de Estudio en Parasitología Molecular (GEPAMOL), Facultad de Ciencias de la Salud, Centro de Investigaciones Biomédicas, Universidad del Quindío, Armenia, Colombia.

ROP16 and ROP18 proteins have been identified as important virulence factors for this parasite. Here, we describe the effect of ROP16 and ROP18 proteins on peripheral blood mononuclear cells (PBMCs) from individuals with different clinical status of infection. We evaluated IFN-γ, IL-10, and IL-1β levels in supernatants from PBMCs cultures infected with tachyzoites of the wild-type RH strain or with knock-out mutants of the and encoding genes (RHΔ and RHΔ). Cytokine secretion was compared between PBMCs obtained from seronegative individuals ( = 10), with those with chronic asymptomatic ( = 8), or ocular infection ( = 12). We also evaluated if polymorphisms in the genes encoding for -γ, β, Toll-like receptor 9 (), and purinoreceptor influenced the production of the encoded proteins after stimulation. In individuals with chronic asymptomatic infection, only a moderate effect on IL-10 levels was observed when PBMCs were infected with RHΔ, whereas a significant difference in the levels of inflammatory cytokines IFN-γ and IL-1β was observed in seronegative individuals, but this was also dependent on the host's cytokine gene polymorphisms. Infection with ROP16-deficient parasites had a significant effect on IFN-γ production in previously non-infected individuals, suggesting that ROP16 which is considered as a virulence factor plays a role during the primary infection in humans, but not in the secondary immune response.
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http://dx.doi.org/10.3389/fcimb.2019.00413DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6904310PMC
August 2020

Enzyme-Linked Aptamer Assay (ELAA) for Detection of ROP18 Protein in Human Serum.

Front Cell Infect Microbiol 2019 13;9:386. Epub 2019 Nov 13.

Centre for Biomedical Research CIBM, University of Quindío, Armenia, Colombia.

engenders the common parasitic disease toxoplasmosis in almost all warm-blooded animals. Being a critical secretory protein, ROP18 is a major virulence factor of . There are no reports about ROP18 detection in human serum samples with different clinical manifestations. New aptamers against ROP18 protein were developed through Systematic Evolution of Ligands by Exponential enrichment (SELEX). An Enzyme-Linked Aptamer Assay (ELAA) platform was developed using SELEX-derived aptamers, namely AP001 and AP002. The ELAA was used to evaluate total antigen from RH strain (RH Ag) and recombinant protein of ROP18 (rROP18). The results showed that the ELAA presented higher affinity and specificity to RH Ag and rROP18, compared to negative controls. Detection limit of rROP18 protein in serum samples was measured by standard addition method, achieving a lower concentration of 1.56 μg/mL. Moreover, 62 seropositive samples with different clinical manifestations of toxoplasmosis and 20 seronegative samples were tested. A significant association between ELAA test positive for human serum samples and severe congenital toxoplasmosis was found ( = 0.006). Development and testing of aptamers-based assays opens a window for low-cost and rapid tests looking for biomarkers and improves our understanding about the role of ROP18 protein on the pathogenesis of human toxoplasmosis.
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http://dx.doi.org/10.3389/fcimb.2019.00386DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6863806PMC
August 2020

Food safety assessment and risk for toxoplasmosis in school restaurants in Armenia, Colombia.

Parasitol Res 2019 Dec 28;118(12):3449-3457. Epub 2019 Oct 28.

Grupo Parasitología Molecular (GEPAMOL), Centro de Investigaciones Biomédicas, Facultad de Ciencias de la Salud, Universidad del Quindio, Avenida Bolivar 12N, Armenia, Quindio, Colombia.

We assessed the risk for toxoplasmosis in 10 school restaurants in Armenia (Quindio, Colombia). We analyzed the presence of Toxoplasma gondii DNA in the food, water, and living and inert surfaces of school restaurants, and we correlated these findings with the results of food safety inspection scores and with the prevalence of specific anti-T. gondii antibodies in children who ate at these restaurants. Of the 213 samples, 6.1% were positive using PCR to test for T. gondii DNA. Positive samples were found in meat, water, cucumber, guava juice, inert surfaces, and living surfaces. In 60% (6/10) of the public school restaurants, there was at least one PCR T. gondii-positive sample. In 311 serum samples from children who attended the restaurants, 101 (33%) were positive for IgG and 12 (3.9%) for IgM anti-T. gondii. The median of the compound score for the fulfillment of inspection for food safety conditions was of 60.7% (range 50-72). Higher T. gondii PCR positivity in surfaces, food, or water at each restaurant was correlated with lower inspection scores for water supply and water storage conditions. Lower scores in physical infrastructure and disinfection procedures and higher scores in furniture were correlated with a higher prevalence of IgG anti-T. gondii in children who ate at those restaurants. Inspection scores can identify restaurants with a higher risk for the presence of T. gondii.
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http://dx.doi.org/10.1007/s00436-019-06473-wDOI Listing
December 2019

Seroprevalence and molecular detection of Toxoplasma gondii among donors in a blood bank in Cúcuta, Colombia Introduction: Toxoplasma gondii infection

Biomedica 2019 08 1;39(Supl. 2):144-156. Epub 2019 Aug 1.

Grupo de investigación BIOGEN, Universidad de Santander, Cúcuta, Colombia.

Introduction: Toxoplasma gondii infection manifests differently in humans according to their immunity ranging from asymptomatic profiles to severe disease. There are multiple transmission mechanisms including blood transfusions, but little is known about the frequency of T. gondii infection in Colombia’s blood banks. Objective: To determine the prevalence of T. gondii infection in blood donors of a blood bank in the city of Cúcuta by serological and molecular diagnostic techniques. Materials and methods: We identified IgG and IgM antibodies against T. gondii by immunoassay in serum from 348 donors. The frequency of T. gondii DNA was determined by polymerase chain reaction (PCR) in whole blood from seropositive donors and relevant variables were analyzed based on the information obtained from surveys during blood donor selection. Results: Out of the 348 enrolled donors, 134 (38.5%) showed IgG antibodies against T. gondii; two of them (0.6%) had both IgG and IgM, and in two of them (1.5%), parasite DNA was detected in blood samples. A bivariate analysis indicated an association between seropositivity to T. gondii and being over 26 years of age (p=0.020). Conclusions: The prevalence of T. gondii infection found in the blood donors of this study suggests a significant exposure to the infectious agent that becomes relevant when parasitemia is detected.
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http://dx.doi.org/10.7705/biomedica.v39i4.4288DOI Listing
August 2019

Detection of with formalin/ether concentration in (cabbage) and (lettuce).

Heliyon 2019 Aug 28;5(8):e02377. Epub 2019 Aug 28.

Grupo Parasitología Molecular (GEPAMOL), Centro de Investigaciones Biomédicas, Facultad de Ciencias de la Salud, Universidad del Quindio, Armenia, Colombia.

Methods to detect protozoa are needed for food safety monitoring. We evaluated protocols to recover cysts in (cabbage) and (lettuce) and then detection was performed by concentrating with formalin/ether solutions and microscopy or immunofluorescence or DNA amplification via PCR. To evaluate this methodology, cysts were inoculated in triplicate (10 cysts) in 35-g samples of lettuce and cabbage. The method obtaining the highest percentage of recovery in cabbage was sulfamic acid solution plus stirring with stomacher (47.7% ± 7.5). For lettuce, the best method was glycine solution plus stirring with stomacher (46.6% ± 5.3). Inter-observer agreement was of 0.99. was detected by amplifying specific sequences for the DNA coding SSU rRNA. In 27 lettuce samples and 27 cabbage samples, obtained from supermarkets and street vendors, two lettuce samples (7.4%) and one cabbage sample (3.7%) were positive for via PCR assay and were sequenced, determining that they were two of assemblage B and one of lettuce to assemblage E. This method is proposed to detect in vegetables by PCR detection, enabling public health authorities to identify genotypes circulating in food, which will help to establish measures that reduce outbreaks of parasitic diseases associated with contaminated food.
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http://dx.doi.org/10.1016/j.heliyon.2019.e02377DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6728726PMC
August 2019

Editorial: Innovative Therapeutic and Immunomodulatory Strategies for Protozoan Infections.

Front Cell Infect Microbiol 2019 9;9:293. Epub 2019 Aug 9.

Institute for Molecular Engineering, University of Chicago Medical Center, Chicago, IL, United States.

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http://dx.doi.org/10.3389/fcimb.2019.00293DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6695569PMC
July 2020

Coinfections and differential diagnosis in immunocompetent patients with uveitis of infectious origin.

BMC Infect Dis 2019 Jan 25;19(1):91. Epub 2019 Jan 25.

GEPAMOL, Centro de Investigaciones Biomédicas, Facultad de Ciencias de la Salud, Universidad del Quindío, Armenia, Colombia.

Background: Making a definite diagnosis of infectious uveitis is a challenging task because many other infectious, and non-infectious uveitis, may have similar non-specific symptoms and overlapping clinical appearances. Co-infections in immunocompetent patients are not frequently proved with traditional serologic-diagnostic tools.

Methods: Descriptive transversal study, in a Uveitis Service of an Ophthalmology Reference Center, in Bogotá, Colombia, from July 2014 to February 2016. Aqueous humor (AH) and/or vitreous fluid, blood and serum samples were collected from consecutive patients suspected of having infectious uveitis. The diagnosis of ocular toxoplasmosis (OT) was confirmed by the Goldmann-Witmer coefficient (GWC) and by polymerase chain reaction (PCR). Differential diagnosis by PCR in AH was done for viral origin such as Cytomegalovirus (CMV), Herpes simplex virus type 1 (HSV1), Herpes simplex virus type 2 (HSV2), Varicella zoster virus (VZV), Epstein-Barr virus (EBV) and Mycobacterium tuberculosis.

Results: In 66 Colombian patients with uveitis of presumed infectious origin: 22 (33.3%) were confirmed as OT, 16 (24.2%) as undetermined OT, five (7.5%) as co-infections and 23 (34.8%) as other uveitis. Toxoplasma coinfection with M. tuberculosis was identified in one case by PCR and in four cases with HSV by GWC. The initial clinical diagnosis changed, after laboratory examination, in 21 cases (31.8%).

Conclusions: Clinical diagnosis can be changed by laboratory examination in a significant proportion of cases of uveitis. Diagnosis of OT should combine the use of PCR and GWC to reach the maximum of confirmation of cases. The use of multiple laboratory methods is necessary to identify co-infections and viral infections that can mimic OT in immunocompetent patients.
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http://dx.doi.org/10.1186/s12879-018-3613-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6347798PMC
January 2019

Global initiative for congenital toxoplasmosis: an observational and international comparative clinical analysis.

Emerg Microbes Infect 2018 Sep 27;7(1):165. Epub 2018 Sep 27.

Department of Ophthalmology and Visual Sciences, Department of Pediatrics (Infectious Diseases), Institute of Genomics, Genetics, and Systems Biology, Global Health Center, Toxoplasmosis Center, CHeSS, The College, University of Chicago, Chicago, IL, 60637, USA.

Globally, congenital toxoplasmosis remains a significant cause of morbidity and mortality, and outbreaks of infection with T. gondii represent a significant, emerging public health burden, especially in the developing world. This parasite is a threat to public health. Disease often is not recognized and is inadequately managed. Herein, we analyze the status of congenital toxoplasmosis in Morocco, Colombia, the United States, and France. We identify the unique challenges faced by each nation in the implementation of optimal approaches to congenital toxoplasmosis as a public health problem. We suggest that developed and developing countries use a multipronged approach, modeling their public health management protocols after those in France. We conclude that education, screening, appropriate treatment, and the development of novel modalities will be required to intervene successfully in caring for individuals with this infection. Gestational screening has been demonstrated to be cost-effective, morbidity-sparing, and life-saving. Recognition of the value and promise of public health interventions to prevent human suffering from this emerging infection will facilitate better patient and societal outcomes.
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http://dx.doi.org/10.1038/s41426-018-0164-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6160433PMC
September 2018

Polymerase chain reaction (PCR) in ocular and ganglionar toxoplasmosis and the effect of therapeutics for prevention of ocular involvement in South American setting.

Acta Trop 2018 Aug 31;184:83-87. Epub 2018 Jan 31.

Grupo de Estudio en Parasitología Molecular (GEPAMOL), Centro de Investigaciones Biomédicas, Universidad del Quindío, Armenia, Colombia; Grupo de Investigación en Neurociencias (NeURos), Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia. Electronic address:

Introduction: Cases of toxoplasmosis present in South America tend to be more severe than that found in other continents. Here, we present our clinical experience of ocular and ganglionar toxoplasmosis in the use of PCR, and of the treatment to prevent ocular involvement.

Methodology: Retrospective analysis of clinical charts of patients with ocular and lymphadenitic toxoplasmosis at the parasitology and tropical medicine consultation in the "Universidad del Quindio" in Colombia. In total, 91 records of cases with ocular toxoplasmosis and 17 with lymphadenitis that underwent PCR analysis for B1 repeated sequence in blood, were compared to the results of 104 people with chronic asymptomatic toxoplasmosis. In addition, 41 clinical records were included from patients with confirmed toxoplasmic lymphadenitis: 10 untreated, 6 that begun treatment after four months of symptoms, and 25 that were treated during the first four months of symptoms and had a follow-up during at least one year.

Results: Patients with ocular toxoplasmosis or lymphadenitis had a higher probability of PCR positivity in peripheral blood than chronic asymptomatic people. There were no cases of retinochoroiditis in 25 patients with toxoplasmic lymphadenitis treated before 4 months of symptoms and followed during at least 12 months. In four out of ten untreated cases, new lesions of retinochoroiditis presented after the symptoms of lymphadenitis.

Conclusions: Toxoplasmosisin South America exhibits different clinical behavior and this influences the laboratory results as well as the need for treatment in the case of lymphadenitis. Clinicians should be aware of the geographical origin of the infection in order to adopt different therapeutic and diagnostic approaches.
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http://dx.doi.org/10.1016/j.actatropica.2018.01.013DOI Listing
August 2018

Possibilities for Immunomodulation in Congenital Toxoplasmosis.

J Infect Dis 2016 08 29;214(4):656. Epub 2016 Jun 29.

Grupo de Estudio en Parasitología Molecular, Centro de Investigaciones Biomédicas, Universidad del Quindío, Armenia, Colombia.

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http://dx.doi.org/10.1093/infdis/jiw210DOI Listing
August 2016

Survey for Toxoplasma gondii by PCR detection in meat for human consumption in Colombia.

Parasitol Res 2016 Feb;115(2):691-5

The overall risk for toxoplasmosis in meat produced in Colombia is unknown. We analyzed by PCR assay meat samples for human consumption in two types of plants in Colombia: 120 samples from class I plants (60 samples from chicken, 30 from swine and 30 from beef) and 60 from class II plants (30 samples from beef and 30 from swine). Presence of Toxoplasma DNA was established by targeted B1 nested PCR assay. We detected 79 (43%) samples that were positive by B1 nested PCR (33 from chicken, 22 from beef, and 24 from pork). No differences were found by region or species. Eleven positive samples were confirmed by sequencing of the B1 repeated region. Some polymorphisms were detected without relation with clonal groups nor meat species. Food animals are highly exposed to Toxoplasma in Colombia. Detailed studies are needed to establish the reasons for differences in Toxoplasma prevalence between farms, regarding practices of animal food production.
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http://dx.doi.org/10.1007/s00436-015-4790-7DOI Listing
February 2016

Striking Divergence in Toxoplasma ROP16 Nucleotide Sequences From Human and Meat Samples.

J Infect Dis 2015 Jun 23;211(12):2006-13. Epub 2014 Dec 23.

Grupo de Estudio en Parasitología Molecular, Centro de Investigaciones Biomédicas, Facultad de Ciencias de la Salud, Universidad del Quindio, Armenia.

Background: ROP16 is a protein kinase of Toxoplasma gondii identified in the mouse model as a virulent marker, but it is unknown whether this finding is relevant in human toxoplasmosis.

Methods: We obtained the Toxoplasma ROP16 locus DNA sequence in samples from 12 patients with ocular toxoplasmosis, 1 sample from a patient with congenital toxoplasmosis, 22 samples from soldiers operating in the jungle, 2 samples from urban soldiers, and 10 samples from meat for human consumption. An enzyme-linked immunosorbent assay specific for antibodies against the ROP16 mouse-virulent peptide was performed in 46 serum specimens from patients with ocular toxoplasmosis and in 28 serum specimens from patients with chronic asymptomatic infection, of whom 19 had congenital infection and 11 had toxoplasmic lymphadenitis.

Results: We found a striking divergence of the ROP16 nucleotide sequences. Ten of 12 sequences (83.3%) from patients with ocular toxoplasmosis clustered with those of mouse-virulent strains, whereas 7 of 7 ROP16 sequences (100%) from meat were clustered with those of mouse-avirulent strains. Only 11 of 104 serum specimens (10.5%) had specific antibodies against the mouse-virulent peptide, and there was no association between clinical forms and positive results of serological assays.

Conclusions: The majority of ROP16 nucleotide sequences from Colombian patients with ocular toxoplasmosis belonged to the group of mouse-virulent strains.
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http://dx.doi.org/10.1093/infdis/jiu833DOI Listing
June 2015

[Gene polymorphisms in the dihydrofolate reductase ( dhfr ) and dihydropteroate synthase ( dhps ) genes and structural modelling of the dhps gene in Colombian isolates of Toxoplasma gondii].

Biomedica 2014 Oct-Dec;34(4):556-66

Grupo de Fisiología Molecular, Subdirección de Investigación Científica y Tecnológica, Instituto Nacional de Salud, Bogotá, D.C, Colombia.

Introduction: There are no reports describing polymorphisms in target genes of anti- Toxoplasma drugs in South American isolates.

Objective: This study sought to perform cloning and sequencing of the dihydrofolate reductase ( dhfr ) and dihydropteroate-synthase ( dhps ) genes of the reference Rh strain and two Colombian isolates of Toxoplasma gondii .

Materials And Methods: Two isolates were obtained from the cerebrospinal fluid of HIV-infected patients with cerebral toxoplasmosis. A DNA extraction technique and PCR assay for the dhfr and dhps genes were standardized, and the products of amplification were cloned into Escherichia coli and sequenced.

Results: One polymorphism (A « G) was found at position 235 of exon 2 in the dhps gene. In addition, two polymorphisms (G « C) at positions 259 and 260 and one polymorphism (T « G) at position 371 within exon 4 of the dhps gene were detected. In this last exon, a bioinformatic analysis revealed a non-synonymous polymorphism in the coding region that could lead to the substitution of Glu (CAA or CAG) for His (encoded by codons AAU or AAC). A structural model of the T. gondii DHPS protein was calculated, and the results revealed modifications in secondary structure due to mutations.

Conclusions: The methods described in this study can be used as a tool to search for polymorphisms in samples from patients with different clinical manifestations of toxoplasmosis and to examine their relationship with the therapeutic response.
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http://dx.doi.org/10.1590/S0120-41572014000400008DOI Listing
August 2015

An overview of seventy years of research (1944-2014) on toxoplasmosis in Colombia, South America.

Parasit Vectors 2014 Sep 4;7:427. Epub 2014 Sep 4.

Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, Av, Prof, Dr, Orlando Marques de Paiva 87 Cidade Universitária, São Paulo, SP, CEP 05508-270, Brasil.

This paper summarizes prevalence of Toxoplasma gondii in humans and animals and associated correlates of infection, clinical spectrum of disease in humans, and genetic diversity of T. gondii isolates from Colombia. Recent studies, especially in the states of Antioquia, Quindío and Cundinamarca, indicate that toxoplasmosis is a major public health problem. Approximately half of the women of child bearing age have T. gondii antibodies, and the clinical disease in congenitally infected children is more severe than in Europe. Limited studies indicate that the strains of T. gondii from Colombia are genetically and phenotypically different than in Europe and North America. However, epidemiological factors, such as the involvement of domestic and/or wild animals in transmission, the distribution of strain diversity by natural geographic regions, and the variation in risk factors between regions that are associated with human infection in Colombia, remain unknown. Areas of research for the future are outlined. This review should be of interest to biologists, veterinarians, physicians, and parasitologists.
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http://dx.doi.org/10.1186/1756-3305-7-427DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4262115PMC
September 2014

[Colombia need a modern national epidemiological surveillance system and to enlarge the use of molecular diagnosis in infectious diseases].

Infectio 2014 Jul-Sep;18(3):77-78. Epub 2014 Jul 16.

Centro de Investigaciones Biomédicas, Universidad del Quindío, Norte Armenia, Quindío, Colombia.

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http://dx.doi.org/10.1016/j.infect.2014.06.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7133574PMC
July 2014

[Blastocystis sp. frequency and sources among children from 0 to 5 years of age attending public day care centers in Calarcá, Colombia].

Biomedica 2014 Apr-Jun;34(2):218-27

Grupo GEPAMOL, Centro de Investigaciones Biomédicas, Facultad de Ciencias de la Salud, Universidad del Quindío.

Introduction: There are no reports of the potential sources of Blastocystis sp . in Colombia.

Objectives: To estimate the frequency of Blastocystis sp . and explore possible associations among infection, clinical manifestations and environmental sources.

Materials And Methods: A descriptive study was conducted; a representative sample was calculated from a population of 1,993 children less than 5 years old of the lowest socioeconomic levels (1 and 2) attending day care centers in Calarcá, Colombia. The calculated sample size was 275 children, who were selected randomly in 10 % of the centers. Stool testing, questionnaires and sampling to identify the parasite in feces, nails, pets and environmental sources, were performed. Fresh preparations were made with 1% iodine solution, and a concentration technique with formalin-ether was used. Prevalence and odd ratios were estimated; the chi-square test was utilized for qualitative variables, and Student's t for the quantitative ones.

Results: The prevalence of infection in children was of 57.5%. A statistically significant association was found between the Blastocystis sp . positive stool tests and the presence of the parasite in containers of sugar cane beverage (OR=1.70; 95% CI: 1.05-2.79), wood or ground floors (OR=3.43; 95% CI: 1.12-10.48) and in foods other than bottled milk (OR=3.23; 95% CI: 1.41-4.41). A non-significant high prevalence was found in nails (OR=1.62; 95% CI: 0.99-2.67), as well as a significantly higher prevalence of diarrhea (OR=1.95; 95% CI: 0.99-2.77) in children with Blastocystis sp . (45%) as compared with those without the parasite (33%; p<0.05).

Conclusions: Blastocystis sp . showed a significant association with diarrhea symptoms in children 0 to 5 years old and was widely distributed in the environment and in water. It is necessary to determine if there are specific hosts with pathogenic potential through molecular techniques.
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http://dx.doi.org/10.1590/S0120-41572014000200008DOI Listing
April 2015

Th1 and Th2 immune response to P30 and ROP18 peptides in human toxoplasmosis.

Med Microbiol Immunol 2014 Oct 11;203(5):315-22. Epub 2014 May 11.

Grupo de Estudio en Parasitología Molecular (GEPAMOL), Facultad de Ciencias de la Salud, Centro de Investigaciones Biomédicas, Universidad del Quindio, Av. Bolivar 12 N, Armenia, Quindio, Colombia, South America.

We determined the specific lymphocyte proliferative response and cytokine profile production regarding Toxoplasma P30 (2017 from virulent and non-virulent strain) and ROP18 protein-derived peptides (from clonal lineages I, II and III) in 19 patients having ocular toxoplasmosis, five suffering chronic asymptomatic infection, nine with congenital toxoplasmosis and eight Toxoplasma negative people. A Beckman Coulter FC500 flow cytometer was used for determining antigen-specific T cells (CD3+ CD4+ or CD3+ CD8+ cells) in peripheral blood culture. IFN γ and IL10 levels were determined in culture supernatants. Specific CD4+ and CD8+ T cell response to total antigen and P30- and ROP18-derived peptides was observed in infected people. Ocular toxoplasmosis patients had a preferential Th2 response after antigenic stimulation. Non-virulent peptide 2017 was able to shift response toward Th1 in congenitally infected children and virulent peptide 2017 induced a Th2 response in chronically infected, asymptomatic people. An immune response in human toxoplasmosis after ex vivo antigenic stimulation was Th1- or Th2-skewed, depending on a patient's clinical condition. Colombian ocular toxoplasmosis patients' immune response was Th2-skewed, regardless of the nature of antigen stimulus.
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http://dx.doi.org/10.1007/s00430-014-0339-0DOI Listing
October 2014

Characterization of ROP18 alleles in human toxoplasmosis.

Parasitol Int 2014 Apr 29;63(2):463-9. Epub 2013 Oct 29.

Grupo de Estudio en Parasitología Molecular (GEPAMOL), Centro de Investigaciones Biomédicas, Facultad de Ciencias de la Salud, Universidad del Quindio, Armenia (Q), Colombia. Electronic address:

The role of the virulent gene ROP18 polymorphisms is not known in human toxoplasmosis. A total of 320 clinical samples were analyzed. In samples positive for ROP18 gene, we determined by an allele specific PCR, if patients got the upstream insertion positive ROP18 sequence Toxoplasma strain (mouse avirulent strain) or the upstream insertion negative ROP18 sequence Toxoplasma strain (mouse virulent strain). We designed an ELISA assay for antibodies against ROP18 derived peptides from the three major clonal lineages of Toxoplasma. 20 clinical samples were of quality for ROP18 allele analysis. In patients with ocular toxoplasmosis, a higher inflammatory reaction on eye was associated to a PCR negative result for the upstream region of ROP18. 23.3%, 33% and 16.6% of serums from individuals with ocular toxoplasmosis were positive for type I, type II and type III ROP18 derived peptides, respectively but this assay was affected by cross reaction. The absence of Toxoplasma ROP18 promoter insertion sequence in ocular toxoplasmosis was correlated with severe ocular inflammatory response. Determination of antibodies against ROP18 protein was not useful for serotyping in human toxoplasmosis.
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http://dx.doi.org/10.1016/j.parint.2013.10.012DOI Listing
April 2014

Evaluation of IgG anti-toxoplasma avidity and polymerase chain reaction in the postnatal diagnosis of congenital toxoplasmosis.

Pediatr Infect Dis J 2013 Jun;32(6):693-5

Grupo de Estudio en Parasitología Molecular, Centro de Investigaciones Biomédicas, Universidad del Quindio, Armenia (Q), Colombia.

Confirmatory tests for congenital toxoplasmosis were evaluated in 23 infected and 31 uninfected newborns. Conventional polymerase chain reaction was better than real-time polymerase chain reaction, but did not identify additional cases. Avidity tests added 2 new cases that were not identified by other criteria. Overall sensitivity was 82.6%. Avidity assay, but not polymerase chain reaction, increased the sensitivity of confirmatory assays in congenital toxoplasmosis.
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http://dx.doi.org/10.1097/INF.0b013e31828807a4DOI Listing
June 2013

Toxoplasmosis in military personnel involved in jungle operations.

Acta Trop 2012 Apr 9;122(1):46-51. Epub 2011 Dec 9.

Grupo Parasitologia Molecular, Centro de Investigaciones Biomedicas, Facultad de Ciencias de la Salud, Universidad del Quindio, Armenia, Colombia.

Tropical diseases, mainly leishmaniasis and malaria, increased among Colombian military personnel due to intensive operations in the jungle in the last ten years; as a result the Colombian army developed important preventive strategies for malaria and leishmaniasis. However, no knowledge exists about toxoplasmosis, an emergent disease in military personnel. We compared the prevalence of IgG anti-Toxoplasma antibodies by ELISA and of parasitaemia by a real time PCR assay, in 500 professional soldiers that operated in the jungle with a group of 501 soldiers working in an urban zone (Bogotá). We found that the prevalence was significantly different between both groups of soldiers (80% in soldiers operating in jungle vs. 45% in urban soldiers, adjusted OR 11.4; CI 95%: 3.8-34; p<0.0001). All soldiers operating in the jungle drink unboiled and chlorine untreated lake or river water. In urban soldiers, these risk factors along with eating wild animal meat or eating tigrillo (little spotted cat) were significantly associated with a higher prevalence. Characteristic toxoplasmic choriorretinal lesions were found in 4 soldiers that operated in the jungle (0.8%) and in one urban soldier (0.19%). All soldiers before being deployed in jungle operations should be tested for Toxoplasma antibodies and to receive adequate health information about the routine use of personnel filters to purify their water for consumption.
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http://dx.doi.org/10.1016/j.actatropica.2011.11.019DOI Listing
April 2012

Serum levels of dehydroepiandrosterone sulfate (DHEAS) in ocular toxoplasmosis.

J Microbiol Immunol Infect 2012 Feb 6;45(1):65-8. Epub 2011 Dec 6.

Grupo de Estudio en Parasitología Molecular, Universidad del Quindío, Armenia, Colombia.

There are no previous study about ocular toxoplasmosis and serum levels of dehydroepiandrosterone sulphated hormone (DHEAS). We use the chemoluminiscence automatized Immulite assay to determine the levels of DHEAS. Four groups were studied: (1) Individuals with chronic asymptomatic infection with a positive test for IgG anti-Toxoplasma and without ocular lesions (n = 16); (2) Chronic asymptomatic patients with retinal scars of retinochoroiditis by Toxoplasma (n = 19); (3) Acute symptomatic patients with active retinochoroiditis by Toxoplasma (n = 26); (4) Individuals with negative assays for IgG anti-Toxoplasma (n = 21). Comparison of DHEAS levels between groups were adjusted by age and sex and non-parametric Kruskall Wallis statistical tests were applied. No significant differences in serum levels of DHEAS were found between groups when age and sex were controlled. DHEAS levels were not significantly different in active ocular toxoplasmosis related to non active or non infected persons.
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http://dx.doi.org/10.1016/j.jmii.2011.09.003DOI Listing
February 2012

Quality of life assessment in ocular toxoplasmosis in a Colombian population.

Ocul Immunol Inflamm 2011 Aug;19(4):262-6

Grupo de Estudio en Parasitología Molecular (GEPAMOL), Centro de Investigaciones Biomédicas, Universidad del Quindío, Armenia, Colombia.

Objective: To assess the quality of life in patients with ocular toxoplasmosis.

Methods: The participants were 29 otherwise healthy patients with retinochoroidal lesions consistent with Toxoplasma infection. The controls were 29 gender and age-matched people with normal visual function who came from the same socioeconomic and educational background as the participants. The authors used the version of the National Eye Institute 25-item visual function questionnaire (NEI VFQ25).

Results: Patients with ocular toxoplasmosis had statistically significant lower scores than controls for all the subscales, except for color vision. Patients with bilateral lesions were more affected in the mental health, difficulties role, and specific vision subscales. The median of the compound score for the participants was 79 (range 35-99) and for the controls was 95 (range 72-98).

Conclusions: People with ocular toxoplasmosis have worse vision-related quality of life than people without the condition, especially if they have bilateral lesions and more recurrences.
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http://dx.doi.org/10.3109/09273948.2011.582220DOI Listing
August 2011