20 results on '"Rodeles, Luz"'
Search Results
2. IgG Autoantibodies Induced by T. cruzi During Pregnancy: Correlation with Gravidity Complications and Early Outcome Assessment of the Newborns
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Vicco, Miguel Hernan, Rodeles, Luz, Capovilla, Gabriela Soledad, Perrig, Melina, Choque, Ana Gabriela Herrera, Marcipar, Ivan, Bottasso, Oscar, Rodriguez, Celeste, and Cuña, Washington
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Autoantibodies -- Physiological aspects -- Research ,Birth weight -- Physiological aspects -- Genetic aspects -- Research ,Trypanosoma cruzi -- Physiological aspects -- Research ,Health care industry - Abstract
Objective The aim of the present research was to evaluate the correlation of vertically transmitted IgG antibodies induced by T. cruzi and newborn early outcome assessment, mainly birth weight and gestational age. Methods We performed a cross-sectional study with 183 pregnant women (64 with asymptomatic Chagas disease) and their newborns. Both were subjected to complete clinical examination. Peripheral parasitemia was assessed in mother and neonates by parasite detection through microscopic examination of the buffycoat from mother's peripheral and cord blood. Antibodies induced by T. cruzi, such as anti-FRA, anti-B13, anti-p2[beta] and anti-T. cruzi were assessed by immunoassay. Birth weight, general condition evaluation by APGAR Score and gestational age by Capurro Score, were determined in newborns. Results The rate of stillbirth background and pregnancy-induced hypertension were higher in patients with Chagas disease (p = 0.01 and p = 0.02, respectively). Parasitemia was detectable in 17 mothers and 4 newborns. The newborns of mothers with detectable parasitemia presented decreased gestational age (p = 0.006) and body weight (p = 0.04). Mostly all the mothers with Chagas disease and all their newborns have positive values of antibodies induced by T. cruzi; however, only anti-p2[beta] showed to be related to the presence of complication during pregnancy (OR 2.35, p = 0.036), and to low birth weight (OR 1.55, p = 0.02). Conclusions Low birth weight and decreased postnatal estimation of maturity were related to detectable parasitemia in the mother. Also, vertical transmission of T. cruzi-induced autoantibodies might have clinical implication in newborns given the negative association between anti-p2[beta] values and weight., Author(s): Miguel Hernan Vicco[sup.1] [sup.2] , Luz Rodeles[sup.1] [sup.2] , Gabriela Soledad Capovilla[sup.2] , Melina Perrig[sup.1] , Ana Gabriela Herrera Choque[sup.3] , Ivan Marcipar[sup.1] , Oscar Bottasso[sup.4] , Celeste Rodriguez[sup.3] [...]
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- 2016
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3. Assessment of Cross-reactive Host-pathogen Antibodies in Patients With Different Stages of Chronic Chagas Disease
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Vicco, Miguel H., Ferini, Franco, Rodeles, Luz, Cardona, Paula, Bontempi, Iván, Lioi, Susana, Beloscar, Juan, Nara, Takeshi, Marcipar, Iván, and Bottasso, Oscar A.
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- 2013
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4. Decreased level of antibodies and cardiac involvement in patients with chronic Chagas heart disease vaccinated with BCG
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Vicco, Miguel Hernán, Bontempi, Iván Alejandro, Rodeles, Luz, Yodice, Agustina, Marcipar, Iván Sergio, and Bottasso, Oscar
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- 2014
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5. Increased epicardial adipose tissue thickness associated with increased metabolic risk and the presence of heart failure in patients with Chronic Chagas disease.
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Rodeles, Luz María, Castro, Maximiliano, Zamora, María Ayelen Gaitán, Savarino, Roberto, Peverengo, Luz María, Prochetto, Estefanía Soledad, Marcipar, Iván, Arias, Pablo, and Vicco, Miguel Hernán
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ADIPOSE tissues ,HEART failure patients ,CHRONICALLY ill ,INSULIN resistance ,CARDIOVASCULAR diseases risk factors ,TYPE 2 diabetes - Abstract
Background It has been described that Trypanosoma cruzi is capable of promoting metabolic disturbances currently considered as cardiovascular risk factors. Moreover, it has been observed that the protozoa can remain in adipose tissue and alter its immune endocrine functions. The aim of this study was to characterize the thickness of epicardial adipose tissue (EAT) in patients with chronic Chagas disease (CCD) concerning their cardiovascular metabolic risk profile compared with those without CCD. Methods A cross-sectional study was performed including T. cruzi seropositive individuals categorized according to a standard CCD classification and a matched seronegative control group. Complete clinical examination, metabolic laboratory tests and transthoracic echocardiography to assess cardiac function and to quantify EAT were performed. Results Fifty-five individuals aged 46.7±11.9 y, 34 with CCD and 21 in the control group, were included. The CCD group presented higher EAT thickness in relation to controls (4.54±1.28 vs 3.22±0.99 mm; p=0.001), which was significantly associated with the presence of insulin resistance (OR=3, 95% CI 1.58 to 5.73; p<0.001). This group presented lower levels of plasmatic adiponectin than controls, especially in those patients with EAT ≥4.5 mm (p=0.005) who also presented with heart failure more frequently (p=0.01). Conclusion In patients with CCD, a higher EAT thickness is observed and is associated with an increased metabolic risk profile indicated mainly by insulin resistance. [ABSTRACT FROM AUTHOR]
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- 2021
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6. Seroprevalence of anti-SARS-CoV-2 IgG in asymptomatic and pauci-symptomatic people over a 5 month survey in Argentina.
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Rodeles, Luz María, Peverengo, Luz María, Benítez, Romina, Benzaquen, Nadia, Serravalle, Priscila, Long, Ana Karina, Ferreira, Virginia, Benitez, Agostina Daiana, Zunino, Luisina, Lizarraga, Camila, and Vicco, Miguel Hernán
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IMMUNOGLOBULIN G , *COVID-19 , *SEROPREVALENCE , *SEROCONVERSION , *INFECTION , *SYMPTOMS - Abstract
Objective. To evaluate the seroprevalence of COVID-19 infection in pauci-symptomatic and asymptomatic people, the associated epidemiological factors, and IgG antibody kinetic over a 5-month period to get a better knowledge of the disease transmissibility and the rate of susceptible persons that might be infected. Methods. Seroprevalence was evaluated by a cross-sectional study based on the general population of Santa Fe, Argentina (non-probabilistic sample) carried out between July and November 2020. A subgroup of 20 seropositive individuals was followed-up to analyze IgG persistence. For the IgG anti-SARS-CoV-2 antibodies detection, the COVID-AR IgG® ELISA kit was used. Results. 3 000 individuals were included conforming asymptomatic and pauci-symptomatic groups (n=1 500 each). From the total sample, only 8.83% (n=265) presented reactivity for IgG anti-SARS-CoV-2. A significant association was observed between positive anti-SARS-CoV-2 IgG and a history of contact with a confirmed case; the transmission rate within households was approximately 30%. In the pauci-symptomatic group, among the seropositive ones, anosmia and fever presented an OR of 16.8 (95% CI 9.5-29.8) and 2.7 (95% CI 1.6-4.6), respectively (p <0.001). In asymptomatic patients, IgG levels were lower compared to pauci-symptomatic patients, tending to decline after 4 months since the symptoms onset. Conclusion. We observed a low seroprevalence, suggestive of a large population susceptible to the infection. Anosmia and fever were independent significant predictors for seropositivity. Asymptomatic patients showed lower levels of antibodies during the 5-month follow-up. IgG antibodies tended to decrease over the end of this period regardless of symptoms. [ABSTRACT FROM AUTHOR]
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- 2021
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7. In-hospital mortality risk factors in community acquired pneumonia: evaluation of immunocompetent adult patients without comorbidities
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Vicco, Miguel Hernan, Ferini, Franco, Rodeles, Luz, Scholtus, Patricia, Long, Ana Karina, and Musacchio, Héctor Mario
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variáveis de risco ,mortalidade intra-hospitalar ,pneumonia ,risk factors ,in-hospital mortality - Abstract
Summary Objective: several scores were developed in order to improve the determination of community acquired pneumonia (CAP) severity and its management, mainly CURB-65 and SACP score. However, none of them were evaluated for risk assessment of in-hospital mortality, particularly in individuals who were non-immunosuppressed and/or without any comorbidity. In this regard, the present study was carried out. Methods: we performed a cross-sectional study in 272 immunocompetent patients without comorbidities and with a diagnosis of CAP. Performance of CURB- 65 and SCAP scores in predicting in-hospital mortality was evaluated. Also, variables related to death were assessed. Furthermore, in order to design a model of in-hospital mortality prediction, sampled individuals were randomly divided in two groups. The association of the variables with mortality was weighed and, by multiple binary regression, a model was constructed in one of the subgroups. Then, it was validated in the other subgroup. Results: both scores yielded a fair strength of agreement, and CURB-65 showed a better performance in predicting in-hospital mortality. In our casuistry, age, white blood cell counts, serum urea and diastolic blood pressure were related to death. The model constructed with these variables showed a good performance in predicting in-hospital mortality; moreover, only one patient with fatal outcome was not correctly classified in the group where the model was constructed and in the group where it was validated. Conclusion: our findings suggest that a simple model that uses only 4 variables, which are easily accessible and interpretable, can identify seriously ill patients with CAP Resumo Objetivo: diversos escores de gravidade da pneumonia adquirida em comunidade (PAC) foram desenvolvidos com o intuito de melhorar o manejo clínico, em especial os escores CURB-65 e SCAP. Contudo, nenhum dos dois foi avaliado para determinar o risco de morte intra- hospitalar, principalmente em pacientes imunocompetentes e/ou sem comorbidades. Diante disso, propusemo- nos a analisar a utilidade dos escores para prever a mortalidade intra-hospitalar e estudar as variáveis associadas ao desfecho fatal. Métodos: desenvolvemos um trabalho transversal com 272 pacientes imunocompetentes, sem comorbidades e com diagnóstico de PAC. Foi avaliada a eficácia dos escores CURB-65 e SCAP em prever a mortalidade durante a internação. Foram estudadas as variáveis relacionadas a este desfecho. Por fim, a amostra foi dividida em dois subgrupos com o objetivo de desenvolver um modelo de avaliação do risco de morte em um subgrupo, validando-o no outro. Resultados: ambos os escores apresentaram pobre concordância de classificação da gravidade para PAC. O escore CURB-65 mostrou melhor desempenho na avaliação do risco de morte. Em nossa amostra, idade, contagem de glóbulos brancos, ureia sérica e pressão arterial diastólica foram as variáveis que se associaram à mortalidade. O modelo desenvolvido com essas variáveis mostrou eficácia muito boa para prever o desfecho fatal. Inclusive, somente um paciente no grupo de desenvolvimento do modelo e outro no grupo de validação foram classificados de modo incorreto. Conclusão: nossos resultados sugerem que com um modelo de quatro variáveis, de fácil acesso e interpretação, foi possível identificar pacientes gravemente enfermos com PAC.
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- 2015
8. In-hospital mortality risk factors in patients with ascites due to cirrhosis
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Vicco, Miguel Hernan, Rodeles, Luz, Ferini, Franco, Long, Ana Karina, and Musacchio, Héctor Mario
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hospital mortality ,ascites ,mortalidade hospitalar ,ascite ,cirrose hepática ,liver cirrhosis ,alcoólico ,alcoholic - Abstract
Introduction: ascites is one of the most common complications of cirrhosis associated with a high rate of mortality. Although several scores have been developed in order to assess the prognosis of the disease, they were designed for predicting liver transplantation requirements and mortality in the short term, but not while in hospital. The aim of this study was to weigh risk factors for in-hospital mortality in adult patients with ascites due to alcoholic cirrhosis. Material and methods: we performed a cross-sectional study in 180 adult patients with diagnosis of cirrhosis with portal hypertension associated with high alcohol intake. The diagnosis of cirrhosis was made by liver echography and portal hypertension was defined by clinical features plus serum-ascites albumin gradient. Sampled individuals were subjected to complete clinical examination. Child Pugh and the MELD scores were applied in all the patients. Results: nineteen patients died while in-hospital. Mortality was associated with increased levels of serum white blood cell, urea, creatinine, prolonged prothrombin time, aspartate aminotransferase and alanine aminotransferase. We conducted a multiple binary logistic to predict in-hospital mortality which yielded that serum urea, creatinine and prothrombin time made a significant contribution to prediction with an OR 14 (95% CI 12.8 - 16.7 p = 0.03), 2 (95% CI 0.5 - 3.47, p = 0.04), and 2 (95% CI 1.03 - 2.31, p = 0.01) linearly-related. Conclusions: our results suggest that acute renal failure and prolonged prothrombin time are predictors of in-hospital mortality in patients with portal hypertension due to alcoholic cirrhosis. Introdução: ascite é uma das complicações mais comuns de cirrose associadas a uma elevada taxa de mortalidade. Embora vários escores tenham sido desenvolvidos a fim de avaliar o prognóstico da doença, eles foram concebidos para prever requisitos de transplante de fígado e mortalidade a curto prazo, mas não durante a internação. O objetivo deste estudo foi o de pesar fatores de risco para a mortalidade intra-hospitalar em pacientes adultos com ascite decorrente de cirrose alcoólica. Material e métodos: foi realizado um estudo transversal em 180 pacientes adultos com diagnóstico de cirrose com hipertensão portal, associada à alta ingestão de álcool. O diagnóstico de cirrose foi feita por ecografia hepática e a hipertensão portal foi determinada por características clínicas e pelo gradiente de albumina soro-ascite. Indivíduos avaliados foram submetidos a exame clínico completo. A classificação de Child-Pugh e a escala MELD foram aplicadas em todos os pacientes. Resultados: dezenove pacientes morreram durante a internação. A mortalidade foi associada ao aumento dos níveis de glóbulos brancos, ureia, creatinina, aspartato aminotransferase, alanina aminotransferase e tempo de protrombina prolongado. Realizamos uma logística binária múltipla para prever a mortalidade intra-hospitalar, que confirmou que ureia, creatinina e tempo de protrombina contribuíram significativamente para a previsão, com uma OR = 14 (IC 95% 12,8-16,7 p = 0,03), 2 (IC 95% 0,5-3,47, p = 0,04), e 2 (IC 95% 1,03-2,31, p = 0,01), relacionada linearmente. Conclusões: nossos resultados sugerem que a insuficiência renal aguda e de tempo de protrombina prolongado são preditores de mortalidade intra-hospitalar em pacientes com hipertensão portal decorrente de cirrose alcoólica.
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- 2015
9. Trans-sialidase overcomes many antigens to be used as a vaccine candidate against Trypanosoma cruzi.
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Bontempi, Ivan, Fleitas, Pedro, Poato, Alexia, Vicco, Miguel, Rodeles, Luz, Prochetto, Estefania, Cabrera, Gabriel, Beluzzo, Bruno, Arias, Diego, Racca, Andrea, Guerrero, Sergio, and Marcipar, Iván
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- 2017
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10. Combined analysis of cross-reacting antibodies anti-β1AR and anti-B13 in advanced stages of Chagas heart disease.
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Rodeles, Luz M., Vicco, Miguel H., Bontempi, Iván A., Siano, Alvaro, Tonarelli, Georgina, Bottasso, Oscar A., Arias, Pablo, and Marcipar, Iván S.
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AUTOANTIBODIES , *ADRENERGIC receptors , *CHAGAS' disease , *CROSS reactions (Immunology) , *DILATED cardiomyopathy , *HEART failure , *THERAPEUTICS , *CELL receptors , *MUSCLE proteins , *CARDIOMYOPATHIES , *PHARMACOKINETICS , *PROGNOSIS , *PROTOZOA , *TRYPANOSOMIASIS , *LOGISTIC regression analysis , *CROSS-sectional method , *SEVERITY of illness index , *DISEASE progression - Abstract
Objective: Autoantibodies cross-reacting with the β1 adrenergic receptor (anti-β1AR and anti-p2β) and cardiac myosin antigens (anti-B13) have been related to the pathogenesis of chronic Chagas heart disease (CCHD). Studies exploring their levels in different stages are scarce. We aimed to evaluate the relationship of these autoantibodies with the clinical profile of chronic patients, especially regarding their classificatory accuracy in severe presentation with heart failure.Methods and Results: We conducted a cross-sectional study of 155 T. cruzi-seropositive patients and 26 age- and gender-matched healthy controls. They were categorised in three stages of CCHD. Serum antibodies were measured by specific immunoassays. Symptomatic individuals showed increased levels of anti-β1AR and anti-B13, while anti-p2β antibodies were similar between groups. A composite logistic regression model including anti-B13, anti-β1AR antibody levels and age was able to predict systolic heart failure yielding an area under the curve of 83% (sensitivity of 67% and specificity of 89%).Conclusions: In our study, anti-β1AR and anti-B13 antibodies were higher in individuals with chronic Chagas heart disease stage III, mainly in those with dilated cardiomyopathy associated with systolic heart failure. Logistic regression analysis showed that both antibodies were good predictors of severe CCHD. As well as being involved in disease progression, anti-β1AR and anti-B13 antibodies may be used as a serum marker of poor prognosis in terms of heart compromise. [ABSTRACT FROM AUTHOR]- Published
- 2016
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11. Antibody profiles induced by Trypanosoma cruzi in chagasic patients with previous or current exposure to mycobacteria.
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Peverengo, Luz, Prochetto, Estefanía, Rodeles, Luz, Valenzuela, Ignacio, Marcipar, Iván Sergio, Bottasso, Oscar, and Vicco, Miguel Hernán
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TRYPANOSOMA cruzi ,MYCOBACTERIA ,ACTINOMYCETALES ,BCG vaccines ,TUBERCULOSIS diagnosis - Published
- 2016
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12. Development and assessment of an improved recombinant multiepitope antigen-based immunoassay to diagnose chronic Chagas disease.
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Peverengo, Luz María, Garcia, Valeria, Rodeles, Luz María, Mendicino, Diego, Vicco, Miguel, Lagier, Claudia, Gonzalez, Verónica, Gugliotta, Luis, and Marcipar, Iván
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DIAGNOSIS of Chagas' disease ,RECOMBINANT proteins ,IMMUNOASSAY ,ENZYME-linked immunosorbent assay ,EPITOPES - Abstract
The use of chimeric molecules fusing several antigenic determinants is a promising strategy for the development of low-cost, standardized and reliable kits to determine specific antibodies. In this study, we designed and assessed a novel recombinant chimera that complements the performance of our previously developed chimera, CP1 [FRA and SAPA antigens (Ags)], to diagnose chronic Chagas disease. The new chimeric protein, named CP3, is composed of MAP, TcD and TSSAII/V/VI antigenic determinants. We compared the performance of both chimeric Ags using a panel of 67 Trypanosoma cruzi -reactive sera and 67 non-reactive ones. The sensitivity of CP3 vs CP1 was 100 and 90.2%, and specificity was 92.5 and 100%, respectively. The mixture of CP1 + CP3 achieved 100% of sensitivity and specificity. More importantly, an additional subset of 17 sera from patients with discordant results of conventional serological methods was analysed; the CP1 + CP3 mixture allowed us to accurately classify 14 of them with respect to IIF, the usual technique used in most of the reference centres. These results show an improved performance of the CP1 + CP3 mixture in comparison with enzyme-linked immunosorbent assay and indirect haemagglutination commercial assays. [ABSTRACT FROM AUTHOR]
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- 2018
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13. Chagas disease, a risk factor for high blood pressure.
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Vicco, Miguel Hernán, Rodeles, Luz, Yódice, Agustina, and Marcipar, Iván
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CHAGAS' disease , *HYPERTENSION , *TRYPANOSOMIASIS , *PROTOZOAN diseases , *BLOOD pressure - Abstract
Background. Chagas disease is a parasite infection caused by the protozoan Trypanosoma cruzi. Its most common complications is chronic Chagas heart disease but impairments of the systemic vasculature also has been observed. Although the different mechanisms that regulate blood pressure are disrupted, to our knowledge data on the association of hypertension and chronic Chagas disease are scarce. In this regard we evaluate whether Chagas disease constitutes a high blood pressure risk factor. Materials and methods. We recruited 200 individuals, half of them with positive serology for T. cruzi. They were subjected to a complete clinical examination. Results. The mean age of sampled individuals was 46.7 ± 12.3, and the mean of systolic and diastolic blood pressure were 124 ± 12 mmHg and 82 ± 10 mmHg, respectively. There were no between-group differences regarding age, sex distribution or body mass index. Chagas disease contributed significantly to high blood pressure (OR = 4, 95% CI 1.8323-7.0864, p = 0.0002). Conclusion. Our results reveal an important association between Chagas disease and high blood pressure, which should be contemplated by physicians in order to promote preventive cardiovascular actions in patients with Chagas disease. [ABSTRACT FROM AUTHOR]
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- 2014
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14. Functional Autoreactive Anti-β2 Adrenergic Antibodies May Contribute to Insulin Resistance Profile in Patients with Chronic Chagas Disease.
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Rodeles, Luz María, Vicco, Miguel Hernán, Siano, Álvaro, Fuchs, Leonardo Andrés, Peverengo, Luz María, Sanchez Puch, Silvia, Cymeryng, Cora Beatriz, Marcipar, Iván Sergio, Arias, Pablo, and Young, Lawrence S.
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INSULIN resistance ,ADRENERGIC receptors ,CHRONICALLY ill ,METABOLIC disorders ,GLUCOSE metabolism ,SLEEP interruptions ,IMMUNOGLOBULINS ,LIPID metabolism - Abstract
Potential activation of β2 adrenergic receptors (β2AR) by specific autoreactive antibodies (Abs) that arise during the host reaction to Trypanosoma cruzi, could contribute to the elevated prevalence of metabolic disturbances described in patients with chronic Chagas disease (CCD). This study aimed to determine the prevalence of anti-β2AR Abs in patients with CCD, as well as the correlation of these Abs with the presence of glucose and lipid metabolism disturbances, in order to explore their association with an insulin resistance profile. Additionally, we tested the functional effects of anti-β2AR Abs employing an in vitro bioassay with neuroendocrine cells expressing β2AR. A clinical and metabolic evaluation including an OGTT was performed in 80 CCD patients and 40 controls. Anti-β2AR Abs were measured by an in-house-developed ELISA, and the β2 adrenergic activity of affinity-purified IgG fractions from patient' sera were assayed in CRE-Luc and POMCLuc transfected AtT-20 cells. A higher proportion of dysglycemia (72.5% vs. 37.5%; p = 0.001) was observed in the CCD group, accompanied by increased HOMA2-IR (p = 0.019), especially in subjects with Abs (+). Anti-β2AR Abs reactivity (7.01 (2.39–20.5); p = 0.0004) and age >50 years (3.83 (1.30–11.25); p = 0.014) resulted as relevant for IR prediction (AUC: 0.786). Concordantly, Abs (+) CCD patients showed elevated metabolic risk scores and an increased prevalence of atherogenic dyslipidemia (p = 0.040), as compared to Abs (−) patients and controls. On functional bioassays, Abs exerted specific and dose-dependent β2-agonist effects. Our findings suggest that anti-β2AR Abs may induce the activation of β2AR in other tissues besides the heart; furthermore, we show that in patients with CCD these Abs are associated with an insulin resistance profile and atherogenic dyslipidemia, providing biological plausibility to the hypothesis that adrenergic activation by anti-β2AR Abs could contribute to the pathogenesis of metabolic disturbances described in CCD patients, increasing their cardiovascular risk. [ABSTRACT FROM AUTHOR]
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- 2021
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15. Congenital chagas disease: Development and assessment of a specific IgM capture-based assay for diagnosis of transmission.
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Peverengo, Luz María, Rodeles, Luz María, Maldonado, Camila, Ballering, Griselda, Pujato, Nazarena, D'Amico, Indira, Vicco, Miguel Hernán, Garcia, Luciana, Jurado, Laura, Altcheh, Jaime, and Marcipar, Iván
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IMMUNOGLOBULIN M , *CHAGAS' disease , *CONGENITAL disorders , *VERTICAL transmission (Communicable diseases) , *SAMPLE size (Statistics) , *LIKELIHOOD ratio tests , *BIRTH order - Abstract
• The ELISA technique developed was based on the capture of specific anti-Trypanosoma cruzi IgM antibodies and able to detect them accurately on infected newborns samples. Remarkable performance has been achieved using the new CP4 chimeric recombinant antigen. • This technique can certainly improve the diagnosis of connatal infection for Chagas disease. Transplacental transmission by Trypanosoma cruzi (T. cruzi) infection can be effectively treated if parasiticide drugs are administered as early as possible during childhood. Furthermore, an ideal situation would be to diagnose the infection near birth in order to avoid the loss of patients during the subsequent follow-up. These situation are desirable due to the maximum benefit of drugs in early stages which, consequently, implies a relevant contribution to eliminate mother-to-child transmission. However, available techniques for that purpose have limitations as being operator-dependent (microhematocrit), require several months follow-up (IgG detection) or specialized laboratories (PCR). In this study we propose to detect specific IgM antibodies (Ab) by developing a capture-based ELISA employing an improved antigen (Ag) to diagnose the transplacental transmission of T. cruzi , and in consequence, to enhance access to effective treatment. Firstly, a new chimera Ag (CP4) was obtained from the fusion of CP1 and CP3 protein, carrying FRA, SAPA, MAP, TSSAII/V/VI and TcD Ag from T. cruzi. Then, we optimized the assay by capturing IgM Ab with a polyclonal anti-IgM Ab and evaluating three Ag formulations to detect specific IgM bound. The formulations were formed as follows: i) F1: CP1 and CP3; ii) F2: CP1, CP3, B13 and P2β; iii) F3: by CP4. Detection of Ab-binding Ag was carried out using an anti-His Ab since all Ag were expressed with a His-tag. The evaluation panel consisted of sera from vertically infected children under 1-year-old (6 younger than 15 days, 7 older) and samples from non-infected children of women with chronic Chagas Disease. The ELISA assay employing CP4 showed better performance with notable high sensitivity and specificity (92.3% and 93.9%, respectively). Positive and negative likelihood ratios of the test (15.2 and 0.082) suggest its potential clinical relevance in term of post-test probability of infection. In conclution, we developed a standardized and non-operator dependent test to detect specific anti- T. cruzi IgM Ab. Although increased sample size is needed for its validation, our results indicate that this capture-based technique employing CP4 Ag can certainly improve the diagnosis of connatal infection. Development of a capture-based ELISA using an improved antigen to detect IgM specific antibodies anti-Trypanosoma cruzi for diagnosis of congenital transmission. Image, graphical abstract [ABSTRACT FROM AUTHOR]
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- 2021
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16. Trans-sialidase-based vaccine candidate protects against Trypanosoma cruzi infection, not only inducing an effector immune response but also affecting cells with regulatory/suppressor phenotype.
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Prochetto E, Roldán C, Bontempi IA, Bertona D, Peverengo L, Vicco MH, Rodeles LM, Pérez AR, Marcipar IS, and Cabrera G
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Prophylactic and/or therapeutic vaccines have an important potential to control Trypanosoma cruzi ( T. cruzi )infection. The involvement of regulatory/suppressor immune cells after an immunization treatment and T. cruzi infection has never been addressed. Here we show that a new trans-sialidase-based immunogen (TSf) was able to confer protection, correlating not only with beneficial changes in effector immune parameters, but also influencing populations of cells related to immune control. Regarding the effector response, mice immunized with TSf showed a TS-specific antibody response, significant delayed-type hypersensitivity (DTH) reactivity and increased production of IFN-γ by CD8+ splenocytes. After a challenge with T. cruzi , TSf-immunized mice showed 90% survival and low parasitemia as compared with 40% survival and high parasitemia in PBS-immunized mice. In relation to the regulatory/suppressor arm of the immune system, after T. cruzi infection TSf-immunized mice showed an increase in spleen CD4+ Foxp3+ regulatory T cells (Treg) as compared to PBS-inoculated and infected mice. Moreover, although T. cruzi infection elicited a notable increase in myeloid derived suppressor cells (MDSC) in the spleen of PBS-inoculated mice, TSf-immunized mice showed a significantly lower increase of MDSC. Results presented herein highlight the need of studying the immune response as a whole when a vaccine candidate is rationally tested., Competing Interests: CONFLICTS OF INTEREST None of the authors have a conflict of interest in relation to the content of the present work.
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- 2017
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17. The potential influence of atherogenic dyslipidemia on the severity of chronic Chagas heart disease.
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Peverengo L, Rodeles L, Vicco MH, and Marcipar I
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- Adult, Aged, Analysis of Variance, Atherosclerosis complications, Chagas Cardiomyopathy complications, Chronic Disease, Cross-Sectional Studies, Dyslipidemias complications, Enzyme-Linked Immunosorbent Assay, Female, Humans, Hypertension complications, Hypertension physiopathology, Male, Middle Aged, Reference Values, Risk Factors, Severity of Illness Index, Statistics, Nonparametric, Atherosclerosis physiopathology, Blood Pressure physiology, Chagas Cardiomyopathy physiopathology, Dyslipidemias physiopathology
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Introduction: chronic Chagas heart disease (CCHD) is the most common manifestation of American Trypanosomiasis, causing about 50,000 deaths annually. Several factors bear correlation with the severity of CCHD. However, to our knowledge, the assessment on the contribution of major cardiovascular risk factors (CRF), such as hypertension and atherogenic dyslipidemia (AD) to CCHD severity is scarce, despite their well-established role in coronary artery disease, heart failure and stroke., Objective: to explore the potential relationship of blood pressure and AD with the clinical profile of patients with CCHD., Methods: we performed a cross-sectional study in T. cruziseropositive patients categorized according to a standard CCHD classification. All individuals were subjected to complete clinical examination. Autoantibodies induced by T. cruzi were assessed by ELISA., Results: we observed that Atherogenic index (AI) levels rose significantly in relation to the severity of the CCHD stage, with CCHD III cases showing the highest values of AI. Furthermore, those patients with globally dilated cardiomyopathy with reduced ejection fraction showed higher levels of AI. In regard to autoantibodies, anti-B13 also showed relation with the severity of the disease., Conclusion: we observed that AI correlated with CCHD stages and contributed, in association with anti-B13 antibodies and age, to the prediction of systolic heart failure.
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- 2016
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18. In-hospital mortality risk factors in community acquired pneumonia: evaluation of immunocompetent adult patients without comorbidities.
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Vicco MH, Ferini F, Rodeles L, Scholtus P, Long AK, and Musacchio HM
- Subjects
- Adult, Aged, Aged, 80 and over, Brazil epidemiology, Community-Acquired Infections mortality, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, ROC Curve, Random Allocation, Risk Assessment, Severity of Illness Index, Hospital Mortality, Immunocompetence, Pneumonia mortality
- Abstract
Objective: several scores were developed in order to improve the determination of community acquired pneumonia (CAP) severity and its management, mainly CURB-65 and SACP score. However, none of them were evaluated for risk assessment of in-hospital mortality, particularly in individuals who were non-immunosuppressed and/or without any comorbidity. In this regard, the present study was carried out., Methods: we performed a cross-sectional study in 272 immunocompetent patients without comorbidities and with a diagnosis of CAP. Performance of CURB- 65 and SCAP scores in predicting in-hospital mortality was evaluated. Also, variables related to death were assessed. Furthermore, in order to design a model of in-hospital mortality prediction, sampled individuals were randomly divided in two groups. The association of the variables with mortality was weighed and, by multiple binary regression, a model was constructed in one of the subgroups. Then, it was validated in the other subgroup., Results: both scores yielded a fair strength of agreement, and CURB-65 showed a better performance in predicting in-hospital mortality. In our casuistry, age, white blood cell counts, serum urea and diastolic blood pressure were related to death. The model constructed with these variables showed a good performance in predicting in-hospital mortality; moreover, only one patient with fatal outcome was not correctly classified in the group where the model was constructed and in the group where it was validated., Conclusion: our findings suggest that a simple model that uses only 4 variables, which are easily accessible and interpretable, can identify seriously ill patients with CAP.
- Published
- 2015
- Full Text
- View/download PDF
19. In-hospital mortality risk factors in patients with ascites due to cirrhosis.
- Author
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Vicco MH, Rodeles L, Ferini F, Long AK, and Musacchio HM
- Subjects
- Adult, Argentina, Ascites etiology, Cross-Sectional Studies, Female, Humans, Liver Cirrhosis, Alcoholic complications, Male, Prothrombin Time, Renal Insufficiency etiology, Renal Insufficiency mortality, Risk Factors, Ascites mortality, Hospital Mortality, Liver Cirrhosis, Alcoholic mortality
- Abstract
Introduction: ascites is one of the most common complications of cirrhosis associated with a high rate of mortality. Although several scores have been developed in order to assess the prognosis of the disease, they were designed for predicting liver transplantation requirements and mortality in the short term, but not while in hospital. The aim of this study was to weigh risk factors for in-hospital mortality in adult patients with ascites due to alcoholic cirrhosis., Material and Methods: we performed a cross-sectional study in 180 adult patients with diagnosis of cirrhosis with portal hypertension associated with high alcohol intake. The diagnosis of cirrhosis was made by liver echography and portal hypertension was defined by clinical features plus serum-ascites albumin gradient. Sampled individuals were subjected to complete clinical examination. Child Pugh and the MELD scores were applied in all the patients., Results: nineteen patients died while in-hospital. Mortality was associated with increased levels of serum white blood cell, urea, creatinine, prolonged prothrombin time, aspartate aminotransferase and alanine aminotransferase. We conducted a multiple binary logistic to predict in-hospital mortality which yielded that serum urea, creatinine and prothrombin time made a significant contribution to prediction with an OR 14 (95% CI 12.8 - 16.7 p = 0.03), 2 (95% CI 0.5 - 3.47, p = 0.04), and 2 (95% CI 1.03 - 2.31, p = 0.01) linearly-related., Conclusions: our results suggest that acute renal failure and prolonged prothrombin time are predictors of in-hospital mortality in patients with portal hypertension due to alcoholic cirrhosis.
- Published
- 2015
- Full Text
- View/download PDF
20. β1-selective adrenoceptor antagonists increase plasma levels of anti-p2β antibodies and decrease cardiac involvement in chronic progressive Chagas heart disease.
- Author
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Vicco MH, Pujato N, Bontempi I, Rodeles L, Marcipar I, and Bottasso OA
- Subjects
- Adult, Animals, Antibodies, Protozoan blood, Biomarkers blood, Chagas Cardiomyopathy immunology, Chronic Disease, Cross-Sectional Studies, Disease Progression, Enzyme-Linked Immunosorbent Assay, Female, Follow-Up Studies, Humans, Male, Middle Aged, Adrenergic beta-1 Receptor Antagonists blood, Antibodies, Protozoan immunology, Chagas Cardiomyopathy blood, Trypanosoma cruzi immunology
- Abstract
Background: Studies indicate that antibodies cross-reacting with cardiac β1 adrenergic receptors are likely to play a role in the development of chronic Chagas heart disease (CCHD). In parallel, clinical trials have shown that β1 antagonist drugs exert beneficial effects in the prognosis of patients with CCHD. In a group of patients with CCHD undergoing therapy with β1-blockers, we have now evaluated the levels of anti-p2β antibodies and the severity of CCHD., Methods: We performed a cross-sectional study in Trypanosoma cruzi seropositive patients categorized according to a standard CCHD classification. All individuals were subjected to a complete clinical examination., Results: There was no association between CCHD stages, electrocardiographic conduction disturbances, and echocardiogram pathological signs with the levels of autoantibodies. However, when patients were analyzed according to selective cardio-β1-blocker therapy, those receiving treatment had higher levels of anti-p2β. Patients from CCHD stage III treated with combined therapy of cardio-β1-selective blockers, enalapril, and statins, presented decreased cardiac involvement and lower score of risk of mortality than individuals from the same group who were not treated., Conclusions: Our results suggest that selective cardio-β1-blockers might modify the autoantibody anti-p2β levels, and that combined therapy in patients with stage III CCHD might be associated with lower cardiac involvement and risk score of mortality in patients with heart failure. Longitudinal studies will help to ascertain the proper role of β1-blockers in the immunopathological processes underlying chronic Chagas disease., (Copyright © 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)
- Published
- 2014
- Full Text
- View/download PDF
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