Mucosal Leishmaniasis caused by Leishmania (Viannia) braziliensis and Leishmania (Viannia) guyanensis in the Brazilian Amazon

Background

Leishmania (Viannia) braziliensis is a parasite recognized as the most important etiologic agent of mucosal leishmaniasis (ML) in the New World. In Amazonia, seven different species of Leishmania, etiologic agents of human Cutaneous Leishmaniasis, have been described. Isolated cases of ML have been described for several different species of Leishmania: L. (V.) panamensis, L. (V.) guyanensis and L. (L.) amazonensis.

Methodology

Leishmania species were characterized by polymerase chain reaction (PCR) of tissues taken from mucosal biopsies of Amazonian patients who were diagnosed with ML and treated at the Tropical Medicine Foundation of Amazonas (FMTAM) in Manaus, Amazonas state, Brazil. Samples were obtained retrospectively from the pathology laboratory and prospectively from patients attending the aforementioned tertiary care unit.

Results

This study reports 46 cases of ML along with their geographical origin, 30 cases caused by L. (V.) braziliensis and 16 cases by L. (V.) guyanensis. This is the first record of ML cases in 16 different municipalities in the state of Amazonas and of simultaneous detection of both species in 4 municipalities of this state. It is also the first record of ML caused by L. (V.) guyanensis in the states of Pará, Acre, and Rondônia and cases of ML caused by L. (V.) braziliensis in the state of Rondônia.

Conclusions/Significance

L. (V.) braziliensis is the predominant species that causes ML in the Amazon region. However, contrary to previous studies, L. (V.) guyanensis is also a significant causative agent of ML within the region. The clinical and epidemiological expression of ML in the Manaus region is similar to the rest of the country, although the majority of ML cases are found south of the Amazon River.

Author Summary

Leishmaniasis is considered a neglected disease with 1.5 million new cases of cutaneous leishmaniasis (CL) occurring each year. In the Amazon region and in the Americas in general, ML is caused by Leishmania (Viannia) braziliensis, though in rare cases it has been related to other species. ML, which is associated with inadequate treatment of CL, normally manifests itself years after the occurrence of CL. Clinical features evolve slowly and most often affect the nasal cavity, in some cases causing perforation, or even destruction, of the septum. Diagnosis is made using the Montenegro skin test, serology and histopathology of the patients'' mucosal tissues, or by isolation of the parasites. PCR is the best way to identify the species of leishmaniasis and is therefore the diagnostic method of choice. This paper describes 46 cases of ML and their geographical origin, 30 cases associated with L. (V.) braziliensis and 16 with L. (V.) guyanensis. The species of leishmaniasis was identified using mucosal biopsies taken from Amazonian patients who were diagnosed and treated for ML in the tertiary care unit, in Manaus, Amazonas state, Brazil. This is the highest number of ML cases caused by L. (V.) guyanensis that has ever been reported.     

Teaching the renal tubular reabsorption of glucose using two classic papers by Shannon et al

Most of the transport along the nephron uses membrane proteins and exhibits the three characteristics of mediated transport: saturation, specificity, and competition. Glucose reabsorption in the nephron is an excellent example of the consequences of saturation. Two classic papers by James A. Shannon and colleagues clearly show the ability of the kidney in transporting glucose and its saturation process, providing students with examples of the handling of glucose by the kidney. In addition, these articles demonstrate how stable and reproducible is the transport maximum of glucose in the proximal tubule under different experimental conditions. One key figure from each classic paper can be used to give students insight into how glucose transport becomes saturated, resulting in the excretion of glucose in urine, and will also give students a clear example of how careful experimentation and a clear interest in renal physiology led Shannon and colleagues to advance the field.     

Antibacterial activity of extract, fractions and four compounds extracted from Piper solmsianum C. DC. VAR. solmsianum (Piperaceae)

Piper solmsianum C. DC. var. solmsianum (Piperaceae) is a shrub commonly found in areas with wet tropical soils. Other Piper species have been used in folk medicine as antitumoral and antiseptic agents. We studied the crude methanolic extract, some organic fractions and compounds isolated from this plant for possible antimicrobial activity against Gram-positive and Gram-negative bacteria. The bioautographic assays disclosed three inhibition zones. The minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) were determined showing excellent activity, particularly against the Gram-positive bacteria (Bacillus cereus, Staphylococcus aureus, Staphylococcus saprophyticus and Streptococcus agalactiae). It appears that the antimicrobial activity of Piper solmsianum is related mainly to the presence of conocarpan and eupomatenoid-5 (neolignans). However another, as yet unidentified, active compound could also be extracted from the plant.     

Gastroprotective activity of alkaloid extract and 2-phenylquinoline obtained from the bark of Galipea longiflora Krause (Rutaceae)

As part of our continuing search for bioactive natural products from plants, the present study was carried out in order to evaluate the gastroprotective properties of alkaloid extract and 2-phenylquinoline obtained from the bark of Galipea longiflora (Rutaceae). Anti-ulcer assays were performed using the following protocols in mice: nonsteroidal anti-inflammatory drug (NSAID)/bethanecol-induced ulcer, ethanol/HCl-induced ulcer, and stress-induced ulcer. The effects of the extract on gastric content volume, pH and total acidity were also evaluated, using the pylorus ligated model. Treatment using doses of 50, 125 and 250 mg/kg of G. longiflora alkaloid extract and positive controls (omeprazol or cimetidine) significantly diminished the lesion index, total lesion area, and percentage of lesion, in comparison with the negative control groups in all the models evaluated. Regarding the model of gastric secretion, a reduction in volume of gastric juice and total acidity was observed, as well as an increase in gastric pH. The main alkaloid of the plant, 2-phenylquinoline, was also evaluated in the ethanol-induced ulcer model. The results showed that at a dose of 50 mg/kg, it significantly inhibited ulcerative lesions. However, this effect was less than that of the alkaloid extract. All these results taken together show that G. longiflora displays gastroprotective activity, as evidenced by its significant inhibition of the formation of ulcers induced by different models. There are indications that mechanisms involved in anti-ulcer activity are related to a decrease in gastric secretion and an increase in gastric mucus content. Also, there is evidence of involvement of NO in the gastroprotector mechanisms. These effects may be attributed, at least in part, to the presence of some alkaloids, particularly 2-phenylquinoline.     

Integrating approaches towards the conservation of forest genetic resources: a case study of Araucaria angustifolia

In the past years the conservation of forest genetic resources has been widely recognized because of the risk of adverse effects associated with global changes in the environment. Since little effort has been made towards conservation of these resources, the assessment and the integration of information and knowledge so far generated are valuable tools in order to promote their conservation. In the present work the Brazilian conifer Araucaria angustifolia was used as a case study, integrating information, published between 1980 and 2007, about genetics, biotechnology, palaeobotany, and archeology. These studies were interpreted towards the conservation needs and strategies of the species germplasm. The main conclusions for the conservation of A. angustifolia genetic resources are: (1) despite the reduction of genetic diversity by unsustainable forest exploitation, the genetic system of A. angustifolia seems to be efficient to protect this species against rapid losses of its genetic diversity; (2) conservation measures starting now may be efficient, since the genetic structures of existing populations is more largely influenced by the past evolutionary process than by human disturbance occurred in the last century; (3) there are opportunities to save the genetic resources of the species, if simple measures are taken to safeguard the continued existence of the few remaining araucaria forests. Emerged as a general conclusion that the use of sound scientific arguments supported by different areas of the science could be a very powerful instrument in persuading decision-makers, also by governments, taking into account forest genetic resources as a primary issue for the future.     

High prevalence of drug-resistant tuberculosis and other mycobacteria among HIV-infected patients in Brazil: a systematic review

There is a little-noticed trend involving human immunodeficiency virus (HIV)-infected patients suspected of having tuberculosis: the triple-treatment regimen recommended in Brazil for years has been potentially ineffective in over 30% of the cases. This proportion may be attributable to drug resistance (to at least 1 drug) and/or to infection with non-tuberculous mycobacteria. This evidence was not disclosed in official statistics, but arose from a systematic review of a few regional studies in which the diagnosis was reliably confirmed by mycobacterial culture. This paper clarifies that there has long been ample evidence for the potential benefits of a four-drug regimen for co-infected patients in Brazil and it reinforces the need for determining the species and drug susceptibility in all positive cultures from HIV-positive patients.     

Modeling dichromatic and trichromatic sensitivity to the color properties of fruits eaten by squirrel monkeys (Saimiri sciureus)

Most platyrrhines have a visual polymorphism that is characterized by the presence of multiple alleles of the M/LWS gene on the X chromosome. This polymorphism is probably maintained by selection. There are two possible mechanisms by which this can be explained: First, heterozygous females may have perceptual advantages over dichromats, such that trichromacy would be favored via the existence of different visual pigments. This is known as selection by heterosis. Second, dichromacy may be advantageous in some situations, with polymorphism being maintained by frequency-dependent selection. In this study the reflectance spectra of fruits and flowers eaten by a troop of squirrel monkeys (Saimiri sciureus) in Eastern Amazon were measured using a spectrophotometer. S. sciureus have an SWS cone with a spectral tuning of approximately 430 nm, and three M/LWS alleles with spectral tunings of 535 nm, 550 nm, and 562 nm. Based on the spectral tunings of the different phenotypes and the spectral data obtained from the food items, the responses of the different visual systems to the measured objects were modeled and then compared. The model predicted that trichromatic phenotypes would have an advantage over dichromats in detecting fruits and flowers from background foliage, which suggests that heterosis is the mechanism for maintaining polymorphism in S. sciureus. On the other hand, a large proportion of fruits could not be detected by any of the phenotypes. Additional studies are necessary to determine whether other important aspects of the primates' visual world, such as prey, predator, and conspecific detection, favor tri- or dichromacy.     

Biocontrol of tomato late blight with the combination of epiphytic antagonists and rhizobacteria

Control of tomato late blight (LB) in Brazil is heavily based on chemicals. However, reduction in fungicide usage is required in both conventional and organic production systems. Assuming that biological control is an alternative for LB management, 208 epiphytic microorganisms and 23 rhizobacteria (RB) were isolated from conventional and organically grown tomato plants and tested for antagonistic activity against Phytophthora infestans. Based on in vitro inhibition of sporangia germination and detached leaflet bioassays, four EP microorganisms (Aspergillus sp., Cellulomonas flavigena, Candida sp., and Cryptococcus sp.) were selected. These microorganisms were applied either singly or combined on tomato plants treated or not with the RB Bacillus cereus. On control plants, LB progress rate (r), area under disease progress curve, and final disease severity were high. Lowest values of final severity were recorded on plants colonized by B. cereus and treated with C. flavigena, Candida sp. and Cryptococcus sp. There was no reduction on disease severity in plants treated only with RB. Biological control of LB resulted in low values of r and final severity. Integration of biological control with fungicides, cultural practices, and other measures can contribute to manage LB on tomato production systems.     

N-Phenyl and N-phenylalkyl-maleimides acting against Candida spp.: time-to-kill, stability, interaction with maleamic acids

N-Phenyl and N-phenylalkyl maleimides (alkyl chain=(CH(2))n; n=0-4) and their respective open derivatives (maleamic acids) were evaluated against Candida spp. with the microbroth dilution method following the guidelines of CLSI (formely NCCLS). MIC values of maleimides without pre-incubation and submitted to different pre-incubation times into the growth media, time-to-kill studies as well as a time-dependent UV-spectroscopy study of the maleimides in water, led to determine that maleimides display antifungal activities with their intact maleimide ring, being in addition their activities not dependent on the length of the alkyl chain. They are not only fungistatic but fungicidal with very low MICs and MFCs, displaying strong fungicide activities not only against standardized but also clinical isolates of Candida albicans and non-albicans Candida spp.