非人类免疫缺陷病毒感染马尔尼菲青霉病9例临床特征分析及文献复习

为探讨和总结非人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者发生马尔尼菲青霉病的临床特点,回顾性研究复旦大学附属华山医院感染科2007年1月-2017年8月收治的9例及同期发表文献中的马尔尼菲青霉病病例,分析其临床表现、实验室检查、治疗及转归。9例马尔尼菲青霉病患者的HIV检测均为阴性,5例CD4^＋ T细胞计数正常。非HIV感染马尔尼菲青霉病的起病较缓,临床表现与经典马尔尼菲青霉病类似,真菌血症较少见,病理特点以肉芽肿改变及化脓性炎症为主,诊断方法仍以培养为主(8/9),1例通过病理及二代测序技术诊断。目前,非HIV感染马尔尼菲青霉病发病率有升高趋势,部分发生于免疫正常人群,需引起临床医师的重视。     

Analysis of the cysteine proteinases of Leishmania mexicana and Trypanosoma cruzi using specific antisera

Abstract Antisera raised against papain and cysteine proteinases (CPs) purified from Leishmania mexicana and Trypanosoma cruzi have been used to study the proteins in the two parasites. The antisera against the major CP of T. cruzi (cruzipain) not only cross-reacted with known CPs of L. mexicana but also detected stage-specific molecules that may represent previously unrecognised CPs. The binding of the same abtisera to extracts of different life cycle stages of T. cruzi suggested that the stages possess different isoforms of cruzipain. The lack of cross-reactivity of anti-papain antiserum against cruzipain suggests that the major immunogenic epitopes of these CPs are different, whereas the detection of the major CPs of L. mexicana with both heterologous antisera shows that the parasite's enzymes share epitopes with the other CPs.     

Trypanosoma cruzi ubiquitin as an antigen in the differential diagnosis of Chagas disease and leishmaniasis

In the present report we describe Trypanosoma cruzi ubiquitin as an antigen to be utilized in the differential diagnosis of Chagas disease and leishmaniasis. Initially, recombinant T. cruzi ubiquitin was evaluated against a panel of sera by phage dot immunoassay, showing a good performance against chagasic sera. However, the presence of a carboxy-terminal tail region encoding a ribosomal protein homologous to a related protein present in the genome of Leishmania sp. gave significant cross-reactivity with leishmanial sera. Therefore, ubiquitin was purified by a simple biochemical protocol and its immunoreactivity was studied by enzyme-linked immunosorbent assay. Analysis of 104 sera indicates that the response to ubiquitin is very sensitive towards chronic chagasic sera (98%) and, more important, highly species-specific, presenting better performance compared to the use of the recombinant protein or the total epimastigote extracts when tested against a panel of leishmanial sera, where out of a total of 70 sera tested, only five sera from the mucocutaneous form of the disease reacted with T. cruzi ubiquitin. On the other hand, Leishmania ubiquitin was not recognized by chagasic sera, but was recognized by sera from different forms of leishmaniasis. These results make ubiquitin an excellent candidate to be used in the differential diagnosis of these two parasitic diseases. The molecular basis for this highly species-specific response is discussed.     

Effect of the Antiphagocytic Agent Cytochalasin B on Macrophage Invasion by Leishmania mexicana Promastigotes and Trypanosoma cruzi Epimastigotes*

Unstimulated mouse peritoneal exudate cells were cultured on coverslips in Medium 199 containing 10% (v/v) calf serum. Cytochalasin B dissolved in dimethyl sulphoxide (DMSO) and diluted in Medium 199 was added to cultures to give final concentrations of 1, 5 and 10 μg/ml. Equal numbers of Leishmania mexicana promastigotes, Trypanosoma cruzi epimastigotes and sheep red cells were added to 24 hr cultures incubated at 37 C. The macrophage monolayers were fixed and stained at various time intervals. L. mexicana promastigotes and sheep red blood cells were found to attach to macrophages in the presence of the drug but did not enter the cells. When the medium containing the Cytochalasin was replaced with normal medium phagocytosis of the adherent parasites and red cells followed rapidly. T. cruzi epimastigotes were found inside macrophages in both drug-treated and drug-free cultures although the number found to be intracellular in the latter was significantly greater. This study suggests that L. mexicana promastigotes enter macrophages by being phagocytosed, whereas T. cruzi epimastigotes can actively penetrate these cells.     

Seroprevalence of Trypanosoma cruzi and Leishmania mexicana in Free‐Ranging Howler Monkeys in Southeastern Mexico

Natural infection of wild mammals by protozoa parasites is quite common in nature. For Neotropical Primates different infections of parasites that are etiological agent of disease in human have been identified. In particular, infections by Trypanosoma cruzi and Leishmania sp., have been reported for some New World primate species, but there are no reports of infection with these parasites in any primate species in Mexico. A serological study was conducted on two howler monkey species (Alouatta pigra and A. palliata) from the Mexican states of Campeche and Tabasco. A total of 55 serum samples (20 samples from A. pigra, 20 samples from A. palliata, and 15 samples from semifree ranging A. palliata of Los Tuxtlas, Veracruz as negative controls) were analyzed for the detection of immunoglobulin G antibodies against T. cruzi and Leishmania mexicana through enzyme linked immunosorbent assay test, indirect immunofluorescence assay and Western blot. The overall prevalence of antibodies in howler monkeys was 17.5% for T. cruzi and 30% for L. mexicana. Our results also indicate that A. pigra is more susceptible to develop leishmaniasis than A. palliata. Finally, the finding of positive serology in these primates should be given serious consideration for public health, given the potential role of these primate species as wild reservoirs for these diseases and the increasing contact of monkeys with human populations due to habitat loss and fragmentation. Am. J. Primatol. 75:161‐169, 2013. © 2012 Wiley Periodicals, Inc.     

流行性出血热病毒对健康人外周淋巴细胞和大白鼠骨髓细胞染色体影响的研究

用流行性出血热病毒(EHFV)A9株,滴度为TCID_(50)10~(-5)/0.1ml,加入10名健康人外周血,作淋巴细胞姊妹染色单体互换(SCE)和染色体畸变的检测。每份血分对照组(不加病毒悬液)和A、B、C实验组(根据加不同病毒量而分)。其结果:一、SCE频率,实验组A(8.9±0.19)、实验组B(9.9±0.2)、实验组C(11.6±0.22)与对照组(6.57±0.15)比较,A、B、C、实验组均分别高于对照组,P<0.01,差异有高度显著性,A、B、C三个实验组比较,P<0.01,差异有高度显著性。二、染色体畸变,A、B、C三个实验组分别与对照组比较,P>0.05,差异均无显著性。用EHFV HA 108株,ID_(50)10~(-6)/0.02ml接种2—5日龄大白鼠脑内,15天后颈动脉放血处死,取骨髓细胞培养,另取幼大白鼠骨髓细胞培养作对照,检测SCE和染色体畸变。结果:一、SCE频率,实验组(9.8±0.35)高于对照组(5.4±0.19),P<0.01,差异有高度显著性。二、染色体畸变,实验组与对照组比较,P>0.05,差异无显著性。以上两个实验结果表明,EHFV作用于细胞,无论是在机体或试管内,都引起SCE频率增高,即EHFV促使DNA产生初级损伤,但不致染色体畸变。     

Oxygen-dependent microbicidal systems of phagocytes and host defense against intracellular protozoa

The role of oxygen-dependent microbicidal systems of leukocytes in the host defense against the major nonerythrocytic intracellular protozoa which infect man--Toxoplasma gondii, Trypanosoma cruzi, and the Leishmania species--is reviewed. The hydrogen peroxide-halide-peroxidase microbicidal system is uniformly cidal to these organisms in vitro. Peroxidase-independent oxygen product(s) toxicity is more variable. Studies to data indicate that phagocytes which contain granule peroxidase and which have the capacity to generate a vigorous respiratory burst; eg, neutrophils and monocytes, possess substantial activity against these protozoa. The absence of granule peroxidase together with the markedly attenuated respiratory burst of resident macrophages leaves these cells with a severe microbicidal defect. These protozoa can enter resident macrophages in the absence of antibody and survive and replicate within the intracellular environment. Enhancement of the antiparasite activity of resident macrophages can be accomplished either by activation of these cells by exposure to sensitized T-cell products, or by the introduction of exogenous peroxidase into the vacuole. Other factors influencing the ability of protozoa to survive intracellularly include the capacity of these organisms to avoid effective triggering of the macrophage respiratory burst and the levels of endogenous scavengers of oxygen products within the parasite.     

Evaluation of the trypanocidal and leishmanicidal in vitro activity of the crude hydroalcoholic extract of Pfaffia glomerata (Amarathanceae) roots

Three different concentrations (1, 10 and 50 μg/ml) of lyophilized hydroalcoholic crude extract of Pfaffia glomerata roots were assayed in vitro against strains of Trypanosoma cruzi (Y) and Leishmania braziliensis. It was observed that P. glomerata hydroalcoholic extract was relatively active within the tested concentrations for L. (V.) braziliensis, but inactive against T. cruzi. Despite the fact that both protozoans belong to the Trypanosomatidae family, we suggest that the difference observed for activity should be related to the biological differences between the two parasite species.     

On the production of glycerol and l-alanine during the aerobic fermentation of glucose by trypanosomatids

Abstract Glucose consumption and catabolite production by thick suspensions of Trypanosoma cruzi, Leishmania mexicana and Crithidia fasciculata were similar under aerobic and anaerobic conditions, indicating lack of Pasteur effect. Succinate was the main product for L. mexicana and C. fasciculata ; the latter also produced similar amounts of ethanol. T. cruzi produced succinate and l -alanine to a similar extent. l -Alanine was also a major product of L. mexicana , but was neither produced, nor consumed, by C. fasciculata . Small amounts of glycerol were produced by L. mexicana and C. fasciculata , but not by T. cruzi , which had no detectable NAD-dependent sn -glycerol-3-phosphate dehydrogenase activity.     

Density of Parasites in Various Organs and the Relation to Numbers of Trypomastigotes in the Blood during Acute Infections of Trypanosoma cruzi in Mice*

Quantitative methods were used to (a) determine the density of Trypanosoma cruzi in organs of CF₁ mice following intraperitoneal inoculation of 50,000 trypomastigotes of a Brazil strain of T. cruzi and (b) study the relation of the numbers of these intracellular stages to the numbers of trypomastigotes in the blood. Tissue stages (predominantly amastigotes) in heart, skeletal muscle (triceps), diaphragm, cerebrum, cerebellum, and musculature of stomach, duodenum, esophagus, jejunum, cecum, and rectum increased in numbers during the 1st 3 weeks of infection, reached maximum density 21–28 days after inoculation and subsequently declined in numbers until mice were histologically negative for intracellular parasites by 30–40 days. The density of tissue stages in the urinary bladder, uterine body, and ileum was similar with the exception that maximum numbers of parasites were observed slightly earlier at 15 days. The greatest density of intracellular stages was seen in heart, urinary bladder, diaphragm, and triceps muscle where mean counts of 44.6–60.0 × 10⁶ parasites/cc of muscle were recorded while maximum density of parasites in the uterine body, cerebrum, stomach, cerebellum, duodenum, esophagus, jejunum, ileum, cecum, and rectum was 13.0 × 10⁶/cc of muscle or less. Amastigotes were not observed in sections of lymph node, thymus, salivary glands, liver, spleen, or kidney and only a single pseudocyst containing 5 amastigotes was seen in lung. With the exception of the brain and lung, intracellular parasites were located exclusively in the musculature. Trypomastigotes in the blood increased during the 1st 3 weeks of infection, reached maximum numbers 21–28 days after initiation of infection, and subsequently decreased until by 30–40 days parasites were observed only rarely in the blood of a few animals. Thus generally close correlation was noted between the numbers of intracellular stages of T. cruzi in the organs and trypomastigotes in the blood throughout acute Chagas’ disease in mice as evidenced by the concomitant increase in numbers of both stages, the coincidence of days of maximum parasite levels, and the simultaneous decline in numbers of both stages. The mean number of parasites/pseudocyst section varied in the organs studied. Of the 15 positive organs studied, the pseudocyst sections in skeletal muscle contained the highest mean number of parasites (64.3 parasites/pseudocyst section) and those pseudocyst sections seen in the musculature of the small intestine contained the lowest mean number (5.5–6.8 parasites/pseudocyst section respectively in ileum and jejunum). Serial sections of skeletal muscle, heart, urinary bladder, and stomach revealed the largest pseudocysts in skeletal muscle while those in the musculature of the urinary bladder were the smallest.     

Experimental American leishmaniasis and Chagas'' disease in the Brazilian squirrel monkey: cross immunity and electrocardiographic studies of monkeys infected with Leishmania braziliensis and Trypanosoma cruzi

, and 1988. Experimental American leishmaniasis and Chagas' disease in the Brazilian squirrel monkey: cross immunity and electrocardiographic studies of monkeys infected with Leishmania braziliensis and Trypanosoma cruzi. International Journal for Parasitology 18: 1053–1059. Adult, laboratory-bred squirrel monkeys (Saimiri sciureus) previously infected with either Leishmania braziliensis braziliensis or L. b. panamensis were challenge infected with blood-form trypomastigotes of Trypanosoma cruzi (Brazil strain). Monkeys previously infected with T. cruzi were challenged with stationary phase promastigote forms of L. b. braziliensis. Monkeys were examined during the course of challenge for evidence of infection, electrocardiographic alterations and parasite-specific antibody responses. T. cruzi epimastigotes were cultured from the blood of monkeys up to 3 months after challenge with this parasite. Unulcerated cutaneous lesions appeared and persisted in monkeys challenged with L. b. braziliensis. The formation of satellite lesions was observed in one monkey. Increased QRS intervals were not observed in T. cruzi challenged monkeys without prior cardiac irregularities and QRS left axis shifts were observed in only two of these monkeys. Elevated titers of parasite binding IgM and IgG specific for both T. cruzi and L. braziliensis were observed in all monkeys following challenge. These results indicate that prior infection with T. cruzi or L. braziliensis does not protect against heterologous challenge infection with these organisms. However, prior infection with Leishmania parasites may provide some protection against chagasic cardiopathies.     

Incidence and significance of opportunistic fungi in leukemia patients in India

Twenty-four patients with acute leukemia were investigated for the incidence of opportunistic fungi. Culture isolations of the sputum and urine samples revealed significant levels of Candida in 14 patients; Candida albicans, C. tropicalis and C. pseudotropicalis were the predominant ones isolated. Aspergillus flavus was isolated from blood in two cases and C. albicans and a black yeast from the blood of another two. Serological studies showed fungal antibodies in seven patients; precipitins against Candida were detected in five and Aspergillus in two. Both of the Aspergillus positive cases and two patients who had rising antibodies against Candida died during the course of investigation. In this study 13 of 24 patients developed oral candidiasis.     

人骨髓基质细胞的长期培养及其对病毒的敏感性

为了长期培养骨髓基质细胞和研究其对病毒的敏感性,我们采用静置贴壁培养法,体外长期培养了胎儿、儿童和成人骨髓基质细胞,并将传至５代以上的肌样骨髓基质细胞采用微量细胞病变（ＣＰＥ）法,开展了对５种病毒的敏感性试验。结果表明,人骨髓基质肌样细胞对滤泡性口腔炎病毒,脊髓灰质炎病毒、Ⅰ型和Ⅱ型单纯疱疹病毒均敏感,能产生明显的ＣＰＥ,其效价（ＴＣＩＤ５０）可达１０＾－３～１０＾－４,其中胎儿骨髓基质肌样细胞对     

Characterization and hepatogenic differentiation of mesenchymal stem cells from human amniotic fluid and human bone marrow: a comparative study

Since stem cells can differentiate into hepatocyte, stem cell-based therapy becomes a potential alternative treatment for terminal liver diseases. However, an appropriate source of human mesenchymal stem cells (hMSCs) for hepatocytes has not yet been clearly elucidated. The aim of the present study was to investigate the in vitro biological characterization and hepatic differentiation potential of human amniotic fluid-derived mesenchymal stem cells (AF-hMSCs) and human bone marrow-derived mesenchymal stem cells (BM-hMSCs). Our results show that AF-hMSCs possess higher proliferation and self-renewal capacity than BM-hMSCs. Cytogenetic studies indicate that AF-hMSCs are as genetically stabile as BM-hMSCs. Following incubation with specific hepatogenic agents, AF-hMSCs showed a higher hepatic differentiation potential than BM-hMSCs. Expression of several liver-specific markers was significantly greater in AF-hMSCs than in BM-hMSCs, as shown by real time RT-PCR and immunofluorescence (IF). In conclusion, AF-hMSCs possess superior potential for hepatic differentiation, making them more suitable for diverse terminal liver diseases.     

小鼠脑组织腺苷A2A受体缺失模型的建立与评价

制备了脑组织腺苷A2A受体基因缺失的小鼠模型并对该模型进行评价。在采用2次6.2 Gy X线间隔照射对敲除A2A受体基因的雌性C57BL/6小鼠进行清髓处理后, 将野生型雄性C57BL/6小鼠骨髓细胞移植到其体内, 使其脑组织的A2A受体仍保持缺失型。然后对移植效果进行鉴定, 并对模型的生理指标进行观察和评价。结果发现: 骨髓移植6周后, 受体小鼠的白细胞性染色体基因由雌性变为雄性; 骨髓中A2A受体阳性细胞率为94.85%, 而脑内A2A受体mRNA与A2A受体基因敲除小鼠比较, 无显著差异。模型小鼠除心率略低于野生型小鼠外, 在呼吸频率、脑含水量以及脑内谷氨酸含量等生理指标上均与野生型小鼠和A2A基因敲除小鼠无显著差异。     

小鼠脑组织腺苷A2A受体缺失模型的建立与评价

制备了脑组织腺苷A2A受体基因缺失的小鼠模型并对该模型进行评价。在采用2次6.2 Gy X线间隔照射对敲除A2A受体基因的雌性C57BL/6小鼠进行清髓处理后, 将野生型雄性C57BL/6小鼠骨髓细胞移植到其体内, 使其脑组织的A2A受体仍保持缺失型。然后对移植效果进行鉴定, 并对模型的生理指标进行观察和评价。结果发现: 骨髓移植6周后, 受体小鼠的白细胞性染色体基因由雌性变为雄性; 骨髓中A2A受体阳性细胞率为94.85%, 而脑内A2A受体mRNA与A2A受体基因敲除小鼠比较, 无显著差异。模型小鼠除心率略低于野生型小鼠外, 在呼吸频率、脑含水量以及脑内谷氨酸含量等生理指标上均与野生型小鼠和A2A基因敲除小鼠无显著差异。     

广西人类免疫缺陷病毒感染者/艾滋病患者合并马尔尼菲篮状菌感染的特征及Mp1p抗原快速筛检的研究

为调查广西人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者/艾滋病(acquired immunodeficiency syndrome,AIDS)患者合并马尔尼菲篮状菌(Talaromyces marneffei,TM)感染的特征并评价TM Mp1p(一种甘露糖蛋白)抗原试剂...     

Comparative study of the chondrogenic potential of human bone marrow stromal cells, neonatal chondrocytes and adult chondrocytes

Cartilage tissue engineering is still a major clinical challenge with optimisation of a suitable source of cells for cartilage repair/regeneration not yet fully addressed. The aims of this study were to compare and contrast the differences in chondrogenic behaviour between human bone marrow stromal cells (HBMSCs), human neonatal and adult chondrocytes to further our understanding of chondroinduction relative to cell maturity and to identify factors that promote chondrogenesis and maintain functional homoeostasis. Cells were cultured in monolayer in either chondrogenic or basal medium, recapitulating procedures used in existing clinical procedures for cell-based therapies. Cell doubling time, morphology and alkaline phosphatase specific activity (ALPSA) were determined at different time points. Expression of chondrogenic markers (SOX9, ACAN and COL2A1) was compared via real time polymerase chain reaction. Amongst the three cell types studied, HBMSCs had the highest ALPSA in basal culture and lowest ALPSA in chondrogenic media. Neonatal chondrocytes were the most proliferative and adult chondrocytes had the lowest ALPSA in basal media. Gene expression analysis revealed a difference in the temporal expression of chondrogenic markers which were up regulated in chondrogenic medium compared to levels in basal medium. Of the three cell types studied, adult chondrocytes offer a more promising cell source for cartilage tissue engineering. This comparative study revealed differences between the microenvironment of all three cell types and provides useful information to inform cell-based therapies for cartilage regeneration.