HIRO GOTO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Medicina Preventiva, Faculdade de Medicina - Docente
LIM/38 - Laboratório de Epidemiologia e Imunobiologia, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/38 - Laboratório de Epidemiologia e Imunobiologia, Hospital das Clínicas, Faculdade de Medicina - Líder
8 resultados
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- Use of Recombinant Antigens for Sensitive Serodiagnosis of American Tegumentary Leishmaniasis Caused by Different Leishmania Species(2017) SATO, Camila Massae; SANCHEZ, Maria Carmen Arroyo; CELESTE, Beatriz Julieta; DUTHIE, Malcolm S.; GUDERIAN, Jeffrey; REED, Steven G.; BRITO, Maria Edileuza Felinto de; CAMPOS, Marliane Batista; ENCARNACAO, Helia Valeria de Souza; GUERRA, Jorge; MESQUITA, Tirza Gabrielle Ramos de; PINHEIRO, Suzana Kanawati; RAMASAWMY, Rajendranath; SILVEIRA, Fernando Tobias; SOUZA, Marina de Assis; GOTO, HiroAmerican tegumentary leishmaniasis (ATL) (also known as cutaneous leishmaniasis [CL]) is caused by various species of protozoa of the genus Leishmania. The diagnosis is achieved on a clinical, epidemiological, and pathological basis, supported by positive parasitological exams and demonstration of leishmanin delayed-type hypersensitivity. Serological assays are not routinely used in the diagnosis because many are considered to have low sensitivity and the particular Leishmania species causing the disease can lead to variable performance. In the present study, we generated recombinant versions of two highly conserved Leishmania proteins, Leishmania (Viannia) braziliensis-derived Lb8E and Lb6H, and evaluated both in enzyme-linked immunosorbent assays (ELISA). Recombinant Lb6H (rLb6H) had better performance and reacted with 100.0% of the ATL and 89.4% of the VL samples. These reactions with rLb6H were highly specific (98.5%) when compared against those for samples from healthy control individuals. We then assessed rLb6H against sera from ATL patients infected with different species of Leishmania prevalent in Brazil [Leishmania (Leishmania) amazonensis, L. (Viannia) braziliensis, and L. (V.) guyanensis] and samples from patients with other infectious diseases. In analyses of 500 sera, ELISA using rLb6H detected all 219 ATL samples (sensitivity of 100.0%) with an overall specificity of 93.9% (considering healthy individuals and other infectious diseases patients). Only a minority of samples from Chagas disease patients possessed antibodies against rLb6H, and all of these responses were low (with a highest reactivity index of 2.2). Taken together, our data support further evaluation of rLb6H and the potential for its routine use in the serological diagnosis of ATL.
- Recombinant Leishmania infantum Heat Shock Protein 83 for the Serodiagnosis of Cutaneous, Mucosal, and Visceral Leishmaniases(2014) CELESTE, Beatriz Julieta; SANCHEZ, Maria Carmen Arroyo; RAMOS-SANCHEZ, Eduardo Milton; CASTRO, Luiz Guilherme M.; COSTA, Francisco Assis Lima; GOTO, HiroRoutine serological diagnoses for leishmaniases, except in visceral cases, are performed using whole-parasite antigens. We used enzyme-linked immunosorbent assay (ELISA) to evaluate the performance of Leishmania infantum rHsp83 compared with L. major-like total promastigote antigen in the diagnosis of cutaneous (CL), mucosal (ML), and visceral leishmaniases (VL). ELISA-rHsp83 was significantly more sensitive than ELISA-L. major-like when considering either CL/ML (P = 0.041) or all leishmaniasis patients (P = 0.013). When samples from other infectious disease patients were evaluated for cross-reactivity, ELISA-rHsp83 was more specific than ELISA-L. major-like, specifically for Chagas disease samples (P < 0.001). We also evaluated the anti-rHsp83 antibody titers months after treatment and observed no significant difference in ML (P = 0.607) or CL (P = 0.205). We recommend ELISA-L. infantum-rHsp83 as a routine confirmatory serological assay for the diagnosis of Leishmania infection because of the high sensitivity, the specificity, and the insignificant cross-reactivity with other infectious diseases.
conferenceObject ANTI-LEISHMANIA ANTIBODIES IN SAMPLES OF BLOOD DONORS FROM ENDEMIC AREAS OF BRAZIL(2017) FUJIMORI, Mahyumi; CARAMELO, Luiza da Cruz; DORNELAS, Marina Portanova; CELESTE, Beatriz Julieta; WENDEL, Silvano; GOTO, Hiro; SANCHEZ, Maria Carmen- Recombinant protein KR95 as an alternative for serological diagnosis of human visceral leishmaniasis in the Americas(2023) FUJIMORI, Mahyumi; VALENCIA-PORTILLO, Ruth Tamara; LINDOSO, Jose Angelo Lauletta; CELESTE, Beatriz Julieta; ALMEIDA, Roque Pacheco de; COSTA, Carlos Henrique Nery; CRUZ, Alda Maria da; DRUZIAN, Angelita Fernandes; DUTHIE, Malcolm Scott; FORTALEZA, Carlos Magno Castelo Branco; OLIVEIRA, Ana Lucia Lyrio de; PANIAGO, Anamaria Mello C. Miranda; QUEIROZ, Igor Thiago; REED, Steve; VALLUR, Aarthy; GOTO, Hiro; SANCHEZ, Maria Carmen ArroyoIn the Americas, visceral leishmaniasis (VL) is caused by the protozoan Leishmania infantum, leading to death if not promptly diagnosed and treated. In Brazil, the disease reaches all regions, and in 2020, 1,933 VL cases were reported with 9.5% lethality. Thus, an accurate diagnosis is essential to provide the appropriate treatment. Serological VL diagnosis is based mainly on immunochromatographic tests, but their performance may vary by location, and evaluation of diagnostic alternatives is necessary. In this study, we aimed to evaluate the performance of ELISA with the scantily studied recombinant antigens, K18 and KR95, comparing their performance with the already known rK28 and rK39. Sera from parasitologically confirmed symptomatic VL patients (n = 90) and healthy endemic controls (n = 90) were submitted to ELISA with rK18 and rKR95. Sensitivity (95% CI) was, respectively, 83.3% (74.2-89.7) and 95.6% (88.8-98.6), and specificity (95% CI) was 93.3% (85.9-97.2) and 97.8% (91.8-99.9). For validation of ELISA with the recombinant antigens, we included samples from 122 VL patients and 83 healthy controls collected in three regions in Brazil (Northeast, Southeast, and Midwest). When comparing the results obtained with the VL patients' samples, significantly lower sensitivity was obtained by rK18-ELISA (88.5%, 95% CI: 81.5-93.2) compared with rK28-ELISA (95.9%, 95% CI: 90.5-98.5), but the sensitivity was similar comparing rKR95-ELISA (95.1%, 95% CI: 89.5-98.0), rK28-ELISA (95.9%, 95% CI: 90.5-98.5), and rK39-ELISA (94.3%, 95% CI: 88.4-97.4). Analyzing the specificity, it was lowest with rK18-ELISA (62.7%, 95% CI: 51.9-72.3) with 83 healthy control samples. Conversely, higher and similar specificity was obtained by rKR95-ELISA (96.4%, 95% CI: 89.5-99.2), rK28-ELISA (95.2%, 95% CI: 87.9-98.5), and rK39-ELISA (95.2%, 95% CI: 87.9-98.5). There was no difference in sensitivity and specificity across localities. Cross-reactivity assessment, performed with sera of patients diagnosed with inflammatory disorders and other infectious diseases, was 34.2% with rK18-ELISA and 3.1% with rKR95-ELISA. Based on these data, we suggest using recombinant antigen KR95 in serological assays for VL diagnosis.
- Performance of rK39-based immunochromatographic rapid diagnostic test for serodiagnosis of visceral leishmaniasis using whole blood, serum and oral fluid(2020) SANCHEZ, Maria Carmen Arroyo; CELESTE, Beatriz Julieta; LINDOSO, Jose Angelo Lauletta; FUJIMORI, Mahyumi; ALMEIDA, Roque Pacheco de; FORTALEZA, Carlos Magno Castelo Branco; DRUZIAN, Angelita Fernandes; LEMOS, Ana Priscila Freitas; MELO, Vanessa Campos Andrade de; PANIAGO, Anamaria Mello Miranda; QUEIROZ, Igor Thiago; GOTO, HiroBackground The development of rK39-based immunochromatographic rapid diagnostic tests represents an important advance for serodiagnosis of visceral leishmaniasis, being cheap and easy to use at the point of care (POC). Although the use of rK39 have considerably improved the sensitivity and specificity of serological tests compared with total antigens, great variability in sensitivity and specificity was reported. This study aimed at the evaluation of ""Kalazar Detect (TM) Rapid Test, Whole Blood"" (Kalazar Detect RDT) for Visceral Leishmaniasis (VL) diagnosis using oral fluid, whole blood and serum specimens collected at different endemic areas of VL of Brazil. Methodology To evaluate Kalazar Detect RDT, oral fluid, whole blood and serum specimens from 128 VL patients, 85 healthy individuals, 22 patients with possible cross-reactivity diseases and 20 VL/aids coinfected patients were collected and assayed at the POC. Principal findings and conclusions The performance of Kalazar Detect RDT in whole blood and serum was similar; however, using oral fluid, the sensitivity was low. Particularly in samples from the city of Natal, Rio Grande do Norte state in Northeastern Brazil, we observed low sensitivity, 80.0% (95% CI: 62.7-90.5), using whole blood and serum, and poor sensitivity, 43.3% (95% CI: 27.4-60.8) with oral fluid. Those values were much lower than in the other regions, where sensitivity ranged from 92.7-96.3% in whole blood and serum, and 80.0-88.9% in oral fluid. Besides, in VL/aids coinfected patients, lower sensitivity was achieved compared with VL patients. In samples from Natal, the sensitivity was 0.0% (95% CI: 0.0-49.0) and 25.0% (95% CI: 4.6-69.9), using oral fluid and serum/whole blood, respectively; in samples from the other regions, the sensitivity ranged from 40.0-63.6% and 80.0-81.8%, respectively. As for specificity, high values were observed across the fluids, 100.0% (95% CI: 96.5-100.0) in whole blood, 96.3% (95% CI: 90.8-98.5) in serum, and 95.3% (95% CI: 89.5-98.0) in oral fluid; across localities, specificity ranged from 85.7-100.0%. Serum samples sent by the collaborating centers to Instituto de Medicina Tropical (n = 250) were tested by Kalazar Detect RDT, Direct Agglutination Test, Indirect immunofluorescence assay, Enzyme-linked immunosorbent assay, and IT-Leish (R) RDT. The regional difference in the performance of rK39-based RDT and lower sensitivity in Leishmania/HIV coinfected patients raise concern on the routine use of these products for the diagnosis of VL.
- Comparison of flow cytometry and indirect immunofluorescence assay in the diagnosis and cure criterion after therapy of American tegumentary leishmaniasis by anti-live Leishmania (Viannia) braziliensis immunoglobulin G(2013) OLIVEIRA, Andresa Pereira de; CASTRO, Maria Carolina Accioly Brelaz de; ALMEIDA, Amanda Ferreira de; SOUZA, Marina de Assis; OLIVEIRA, Beatriz Coutinho de; REIS, Luiza Campos; GOTO, Hiro; BRITO, Maria Edileuza Felinto de; CELESTE, Beatriz Julieta; MARTINS-FILHO, Olindo Assis; PEREIRA, Valeria Rego AlvesThe aim of this study was to compare the techniques of indirect immunofluorescence assay (IFA) and flow cytometry to clinical and laboratorial evaluation of patients before and after clinical cure and to evaluate the applicability of flow cytometry in post-therapeutic monitoring of patients with American tegumentary leishmaniasis (ATL). Sera from 14 patients before treatment (BT), 13 patients 1 year after treatment (AT), 10 patients 2 and 5 years AT were evaluated. The results from flow cytometry were expressed as levels of IgG reactivity, based on the percentage of positive fluorescent parasites (PPFP). The 1:256 sample dilution allowed us to differentiate individuals BT and AT. Comparative analysis of IFA and flow cytometry by ROC (receiver operating characteristic curve) showed, respectively, AUC (area under curve) = 0.8 (95% CI=0.64-0.89) and AUC = 0.90 (95% CI= 0.75-0.95), demonstrating that the flow cytometry had equivalent accuracy. Our data demonstrated that 20% was the best cut-off point identified by the ROC curve for the flow cytometry assay. This test showed a sensitivity of 86% and specificity of 77% while the IFA had a sensitivity of 78% and specificity of 85%. The after-treatment screening, through comparative analysis of the technique performance indexes, 1, 2 and 5 years AT, showed an equal performance of the flow cytometry compared with the IFA. However, flow cytometry shows to be a better diagnostic alternative when applied to the study of ATL in the cure criterion. The information obtained in this work opens perspectives to monitor cure after treatment of ATL. Crown
- Unusual manifestation of genital cutaneous leishmaniasis in an immunocompetent patient from Sao Paulo, Brazil: A case report(2021) REIS, Luiza Campos; LINDOSO, Jose Angelo Lauletta; CELESTE, Beatriz Julieta; BRAZ, Lucia Maria Almeida; RAMOS-SANCHEZ, Eduardo Milton; YAMASHIRO-KANASHIRO, Edite Hatsumi; GOTO, Hiro; OYAFUSO, Luiza Keiko MatsukaA 31-year-old male patient developed an ulcer on the glans penis that evolved for three months without healing. We diagnosed it as leishmaniasis using polymerase chain reaction. No immunosuppression or associated diseases were observed. The patient was treated with meglumine antimoniate that cured the lesion in a month post-treatment. Here, we report this case of cutaneous leishmaniasis lesion at the unusual location of glans penis in an immunocompetent individual. The lesion likely developed due to the bite of a vector, highlighting the need for considering cutaneous leishmaniasis among differential diagnosis of sexually transmitted diseases in areas endemic for leishmaniasis.
- Performance of rK39-based immunochromatographic rapid diagnostic test for serodiagnosis of visceral leishmaniasis using whole blood, serum and oral fluid (vol 15, e0230610, 2020)(2020) CARMEN, Maria; SANCHEZ, Arroyo; CELESTE, Beatriz Julieta; LINDOSO, Jose Angelo Lauletta; FUJIMORI, Mahyumi; ALMEIDA, Roque Pacheco de; FORTALEZA, Carlos Magno Castelo Branco; DRUZIAN, Angelita Fernandes; LEMOS, Ana Priscila Freitas; MELO, Vanessa Campos Andrade de; PANIAGO, Anamaria Mello Miranda; QUEIROZ, Igor Thiago; GOTO, Hiro