Puzzling paracoccidioidomycosis: Factors associated with the severity of Paracoccidioides lutzii infections

Nery, Andréia Ferreira; Camargo, Zoilo Pires de; Rodrigues, Anderson Messias; Portela, Tiago Ferreira; Hoffmann-Santos, Hugo Dias; Pinheiro, Breno Gonçalves; Pôssa, Ana Paula; Cavalcante, Leticia Rossetto da Silva; Hagen, Ferry; Hahn, Rosane Christine

doi:10.1016/j.ijid.2021.05.002

Cited by 9 publications

(6 citation statements)

References 22 publications

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“…The second and significant group corresponds to the chronic form, found in 80 to 95 % of the total cases, and men between 30 and 50 years of age are the most affected patients ( Nery et al. 2021a , 2021b ). Brazil accounts for up to 80 % of cases of PCM in Latin America, with an incidence of 7.99 cases per 1 000 hospitalizations based on the overall hospital admissions notified to the Ministry of Health in the year 2011 ( Giacomazzi et al.…”

Section: Introductionmentioning

confidence: 99%

“…Phylogenetic species 2 (PS2) was found in Brazil, Venezuela, and Uruguay, while the remaining phylogenetic species PS3 and PS4 appear to be restricted to Colombia and Venezuela, respectively ( Theodoro et al 2012 ). Paracoccidioides lutzii (formerly Pb01-like) is prevalent in central-west Brazil, mainly in Mato Grosso state, with scattered cases outside this area ( Nery et al 2021b ).…”

Section: Introductionmentioning

confidence: 99%

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Trends in the molecular epidemiology and population genetics of emergingSporothrixspecies

Roberto¹,

Carvalho²,

Beale³

et al. 2021

Studies in Mycology

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Paracoccidioidomycosis (PCM) is a life-threatening systemic fungal infection acquired after inhalation of Paracoccidioides propagules from the environment. The main agents include members of the P. brasiliensis complex (phylogenetically-defined species S1, PS2, PS3, and PS4) and P. lutzii . DNA-sequencing of protein-coding loci (e.g., GP43 , ARF , and TUB1 ) is the reference method for recognizing Paracoccidioides species due to a lack of robust phenotypic markers. Thus, developing new molecular markers that are informative and cost-effective is key to providing quality information to explore genetic diversity within Paracoccidioides . We report using new amplified fragment length polymorphism (AFLP) markers and mating-type analysis for genotyping Paracoccidioides species. The bioinformatic analysis generated 144 in silico AFLP profiles, highlighting two discriminatory primer pairs combinations (#1 EcoRI-AC/MseI-CT and #2 EcoRI-AT/MseI-CT). The combinations #1 and #2 were used in vitro to genotype 165 Paracoccidioides isolates recovered from across a vast area of South America. Considering the overall scored AFLP markers in vitro (67–87 fragments), the values of polymorphism information content ( PIC = 0.3345–0.3456), marker index ( MI = 0.0018), effective multiplex ratio ( E = 44.6788–60.3818), resolving power ( Rp = 22.3152–34.3152), discriminating power ( D = 0.5183–0.5553), expected heterozygosity ( H = 0.4247–0.4443), and mean heterozygosity ( H avp = 0.00002–0.00004), demonstrated the utility of AFLP markers to speciate Paracoccidioides and to dissect both deep and fine-scale genetic structures. Analysis of molecular variance (AMOVA) revealed that the total genetic variance (65-66 %) was due to variability among P. brasiliensis complex and P. lutzii (PhiPT = 0.651–0.658, P < 0.0001), supporting a highly structured population. Heterothallism was the exclusive mating strategy, and the distributions of MAT1-1 or MAT1-2 idiomorphs were not significantly skewed (1:1 ratio) for P. brasiliensis s. str. (χ 2 = 1.025; P = 0.3113), P. venezuelensis (χ 2 = 0.692; P = 0.4054), and P. lutzii (χ 2 = 0.027; P = 0.8694), supporting random mating within each species. In contrast, skewed distributions were found ...

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Trends in the molecular epidemiology and population genetics of emergingSporothrixspecies

Roberto¹,

Carvalho²,

Beale³

et al. 2021

Studies in Mycology

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“…O crescente desenvolvimento da biologia molecular trouxe novos testes para diagnóstico de PCM, que se baseiam principalmente em PCR e PCR-RFLP. Essas técnicas moleculares ainda estão em busca de melhores alvos que permitam a padronização e aplicação com parâmetros de precisão adequados (Nery, et al, 2021). Higuita-Gutiérrez, et al, (2019) implementação.…”

Section: Discussionunclassified

Avanços e desafios no diagnóstico de paracoccidioidomicose causada pelo complexo de espécies da paracoccidioides: revisão integrativa

Trindade¹,

Diniz²,

Alves³

et al. 2022

RSD

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O artigo a seguir apresenta o diagnóstico clássico e alguns avanços da paracoccidioidomicose, doença infecciosa com espectro de evolução aguda, subaguda ou crônica causada pelo fungo Paracoccidioides spp., a doença é contraída através da inalação de partículas fúngicas transportadas pelo ar, tendo como principais sintomas a tosse, falta de ar, emagrecimento e lesões na pele ou mucosas. Os sintomas clínicos dificultam um diagnóstico correto, em vista da semelhança com outras doenças, como, por exemplo, a tuberculose e a sarcoidose, além de que em algumas situações pode haver um extenso período de tempo entre a exposição do indivíduo ao fungo e a manifestação dos sintomas. Levando isso em consideração, o objetivo do trabalho é avaliar e discorrer dos métodos de diagnósticos, bem como, identificar os novos avanços realizados pelos métodos moleculares, sorológicos, micológicos e histopatológicos para essa micose. Para esta finalidade, foram realizados uma leitura sobre estudos de casos, ensaio experimental e uma revisão sistemática.

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“…P. venezuelensis is dominant in Venezuela and reported in Colombia as well. P. lutzii is prevalent in central-west Brazil, with scattered cases outside this area [ 14 , 15 , 16 , 17 , 18 ].…”

Section: Epidemiology Of Paracoccidioidomycosismentioning

confidence: 99%

“…Recent developments in genetic studies of Paracoccidioides’ different species and their epidemiology show that they co-exist in several regions of Latin America, with a clear overlapping distribution. Interestingly, when the magnitude of gene flow between species was analyzed, Mavengere et al [ 19 ] confirmed that Paracoccidioides species rarely exchange genes despite extensive geographic overlap [ 16 , 17 , 18 , 19 ].…”

Section: Epidemiology Of Paracoccidioidomycosismentioning

confidence: 99%

Paracoccidioidomycosis: What We Know and What Is New in Epidemiology, Diagnosis, and Treatment

Peçanha

Peçanha-Pietrobom

Velloso

et al. 2022

JoF

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Paracoccidioidomycosis (PCM) is a systemic mycosis endemic to Latin America caused by thermodimorphic fungi of the genus Paracoccidioides. In the last two decades, enhanced understanding of the phylogenetic species concept and molecular variations has led to changes in this genus’ taxonomic classification. Although the impact of the new species on clinical presentation and treatment remains unclear, they can influence diagnosis when serological methods are employed. Further, although the infection is usually acquired in rural areas, the symptoms may manifest years or decades later when the patient might be living in the city or even in another country outside the endemic region. Brazil accounts for 80% of PCM cases worldwide, and its incidence is rising in the northern part of the country (Amazon region), owing to new settlements and deforestation, whereas it is decreasing in the south, owing to agriculture mechanization and urbanization. Clusters of the acute/subacute form are also emerging in areas with major human intervention and climate change. Advances in diagnostic methods (molecular and immunological techniques and biomarkers) remain scarce, and even the reference center’s diagnostics are based mainly on direct microscopic examination. Classical imaging findings in the lungs include interstitial bilateral infiltrates, and eventually, enlargement or calcification of adrenals and intraparenchymal central nervous system lesions are also present. Besides itraconazole, cotrimoxazole, and amphotericin B, new azoles may be an alternative when the previous ones are not tolerated, although few studies have investigated their use in treating PCM.

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Puzzling paracoccidioidomycosis: Factors associated with the severity of Paracoccidioides lutzii infections

Cited by 9 publications

References 22 publications

Trends in the molecular epidemiology and population genetics of emergingSporothrixspecies

Trends in the molecular epidemiology and population genetics of emergingSporothrixspecies

Avanços e desafios no diagnóstico de paracoccidioidomicose causada pelo complexo de espécies da paracoccidioides: revisão integrativa

Paracoccidioidomycosis: What We Know and What Is New in Epidemiology, Diagnosis, and Treatment

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