Molecular typing of Strongyloides stercoralis in Latin America, the clinical connection
Molecular typing of Strongyloides stercoralis in Latin America, the clinical connection
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DOI：
10.1017/s0031182021001517
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发表时间：
2022-01-01
期刊：
影响因子：
2.4
通讯作者：
Ruybal, Paula
中科院分区：
文献类型：
--
作者：
Analia Repetto, Silvia;Quarroz Braghini, Juan;Ruybal, Paula
本研究分析了粪类圆线虫的遗传变异性的基础上，从拉丁美洲样本的cox 1基因的404 bp区域的临床背景下，包括流行病学，诊断和随访变量。进行了一项前瞻性、描述性、观察性研究，以评价伊维菌素治疗41例感染沙门氏菌的患者后临床和寄生虫学演变。粪虫通过治疗后30天或之后的临床症状外观和/或直接幼虫检测来定义疾病的再激活。我们描述了10个单倍型组织在两个集群。在亚洲大陆的人（HP 24和HP 93）和犬（HP 24）样本中也描述了最常见的变体。临床表现（肠道，严重，皮肤和无症状），免疫状态和嗜酸性粒细胞计数与特定的单倍型或集群。然而，在诊断过程中存在簇1单倍型增加了再激活的风险，比值比（OR）为7.51 [置信区间（CI）95% 1.38-44.29，P = 0.026]。相反，如果检测到簇2（I152 V突变），则再激活概率降低83倍（OR = 0.17，CI 95%0.02 -0.80，P = 0.02）。这是对S.临床背景下的Stercoralis cox 1多样性。在诊断过程中确定聚类可以促进和改善后续策略的设计，以防止这种慢性疾病的严重再激活。
This study analysed Strongyloides stercoralis genetic variability based on a 404 bp region of the cox1 gene from Latin-American samples in a clinical context including epidemiological, diagnosis and follow-up variables. A prospective, descriptive, observational study was conducted to evaluate clinical and parasitological evolution after ivermectin treatment of 41 patients infected with S. stercoralis. Reactivation of the disease was defined both by clinical symptoms appearance and/or direct larvae detection 30 days after treatment or later. We described 10 haplotypes organized in two clusters. Most frequent variants were also described in the Asian continent in human (HP24 and HP93) and canine (HP24) samples. Clinical presentation (intestinal, severe, cutaneous and asymptomatic), immunological status and eosinophil count were not associated with specific haplotypes or clusters. Nevertheless, presence of cluster 1 haplotypes during diagnosis increased the risk of reactivation with an odds ratio (OR) of 7.51 [confidence interval (CI) 95% 1.38-44.29, P = 0.026]. In contrast, reactivation probability was 83 times lower if cluster 2 (I152V mutation) was detected (OR = 0.17, CI 95% 0.02-0.80, P = 0.02). This is the first analysis of S. stercoralis cox1 diversity in the clinical context. Determination of clusters during the diagnosis could facilitate and improve the design of follow-up strategies to prevent severe reactivations of this chronic disease.