MARIA CARMEN ARROYO SANCHEZ

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Departamento de Medicina Preventiva, Faculdade de Medicina
LIM/38 - Laboratório de Epidemiologia e Imunobiologia, Hospital das Clínicas, Faculdade de Medicina

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  • article 20 Citação(ões) na Scopus
    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, Hiro
    American 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.
  • article 13 Citação(ões) na Scopus
    Asymptomatic infections in blood donors harbouring Plasmodium: an invisible risk detected by molecular and serological tools
    (2018) LIMA, Giselle F. M. C.; SANCHEZ, Maria C. Arroyo; LEVI, Jose E.; FUJIMORI, Mahyumi; CARAMELO, Luiza da Cruz; SANCHEZ, Arianni Rondelli; RAMOS-SANCHEZ, Eduardo M.; INOUE, Juliana; COSTA-NASCIMENTO, Maria de Jesus; MENDRONE JUNIOR, Alfredo; SANTI, Silvia M. Di
    Background. Transfusion-transmitted malaria due to asymptomatic Plasmodium infections is a challenge for blood banks. There is a lack of data on the prevalence of asymptomatic infected blood donors and the incidence of transfusion-transmitted malaria in low endemicity areas worldwide. We estimated the frequency of blood donors harbouring Plasmodium in an area in which asymptomatic infections have been reported. Material and methods. To estimate the frequency of blood donors harbouring Plasmodium we used microscopy and molecular tools. Serological tests were applied to measure the exposure of candidates to Plasmodium antigens. Venous blood was collected from 91 candidates attending the ""Pro-Sangue"" Blood Centre Foundation in Sao Paulo, who lived in the municipality of Juquitiba, Sao Paulo, Brazil, where sporadic autochthonous cases of malaria have been described. Blood samples were used for parasitological, molecular and serological studies. Results. Among the 91 samples examined, rare Plasmodium forms were observed in two donors. Genus real-time polymerase chain reaction analysis demonstrated Plasmodium amplification in three candidates and species-specific nested polymerase chain reaction identified P. malariae in two. ELISA-IgG was reactive in 42.9% of samples for P. vivax (Pv-MSP1 19) and in 6.6% for P. falciparum (Pf-Zw). ELISA-IgM was reactive in 2.2% of samples for P. vivax and in 4.4% for P. falciparum. An indirect immunofluorescence assay was reactive for P. malariae in 15.4% of cases. Discussion. Reservoirs of Plasmodium represent a challenge for blood banks, since studies have shown that high levels of submicroscopic infections can occur in low transmission areas. The risk of transfusion-transmitted malaria presented here points to the need to conduct molecular investigations of candidate donors with any positive malarial antibody test.
  • article 8 Citação(ões) na Scopus
    Asymptomatic Plasmodium infection in a residual malaria transmission area in the Atlantic Forest region: Implications for elimination
    (2019) MIGUEL, Renata Bortolasse; ALBUQUERQUE, Hermano Gomes; SANCHEZ, Maria Carmen Arroyo; COURA, Jose Rodrigues; SANTOS, Simone da Silva; SILVA, Sidnei da; MOREIRA, Carlos Jose de Carvalho; SUAREZ-MUTIS, Martha Cecilia
    Introduction: Elimination of malaria in areas of interrupted transmission warrants careful case assessment to avoid the reintroduction of this disease. Occasional malaria cases are reported among visitors of the Atlantic Forest area of Brazil, while data on residents of this area are scarce. Methods: A sectional study was carried out to examine 324 individuals living in a municipality where autochthonous cases were detected. Results: Asymptomatic Plasmodium infections were detected in 2.8% of the individuals by polymerase chain reaction (PCR), with one case of P. falciparum (0.3%), two cases of P. vivax (0.6%), and six cases of P. malariae (1.9%). The thick blood smears were negative in all individuals. Serological tests performed in 314 subjects were reactive in 11.1%, with 3.5% for P. falciparum and 7.7% for R. vivax. A subsample of 42 reactive individuals for any Plasmodium species showed R. malariae in 30.9% of specimens. Individuals who entered the Atlantic Forest region were 2.7 times more likely to exhibit reactive serology for P. vivax compared with individuals who did not enter this region (p<0.05). Children <15 years had a higher chance of reactive serology for P. falciparum and P. vivax than individuals >= 15 years of age (p<0.05). Individuals living in the Paraiso district had a higher chance of reactive serology for P. vivax compared to other districts (p<0.05). No associations were found between sex, past exposure to malaria, or serological response to antibodies of any Plasmodium species. Conclusions: The implications of these results for the elimination of malaria were discussed.
  • article 25 Citação(ões) na Scopus
    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, Hiro
    Routine 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.
  • article 5 Citação(ões) na Scopus
    Validation of ELISA with recombinant antigens in serological diagnosis of canine Leishmania infantum infection
    (2021) FUJIMORI, Mahyumi; ALMEIDA, Arleana do Bom Parto Ferreira de; BARROUIN-MELO, Stella Maria; CORTEZ, Luiz Ricardo Paes de Barros; DUTHIE, Malcolm Scott; HIRAMOTO, Roberto Mitsuyoshi; PINHO, Flaviane Alves de; REED, Steven Gregory; SOUSA, Valeria Regia Franco; SOUZA, Nazare Fonseca; SOARES, Rodrigo Martins; TOLEZANO, Jose Eduardo; SANCHEZ, Maria Carmen Arroyo; GOTO, Hiro
    BACKGROUND Dogs are the main peridomiciliary reservoir of Leishmania infantum thus the correct diagnosis of infection is essential for the control of the transmission and treatment as well. However, the diagnosis is based on serological assays that are not fully effective. OBJECTIVE We aimed to establish an effective serological assay for the diagnosis of L. infantum infected dogs using Leishmania-derived recombinant antigens. METHODS Leishmania derived rK39-, rK28-, rKR95-based enzyme-linked immunosorbent assay (ELISA) was standardized using symptomatic and asymptomatic L. infantum-infected dogs. Then 2,530 samples from inquiry in endemic areas for VL were evaluated and the results compared with recommended assays by the Brazilian Ministry of Health (MH algorithm). Further samples from a cohort of 30 dogs were searched. FINDINGS For rK39-, rK28- and rKR95-ELISA the sensitivity was around 97% and specificity 100%. The positivity of these three ELISA in the inquiry samples was 27-28%, around 10% higher than the assays currently in use. When cohort samples were searched, we observed likely false-negative results (> 65%) with supposedly negative samples that turned positive six months later with the assays in use (MH algorithm). MAIN CONCLUSIONS For the diagnosis of L. infantum-infected dogs, rK39-based ELISA showed better diagnostic performance than other assays in use in Brazil and worldwide.
  • article 4 Citação(ões) na Scopus
    Asymptomatic infection in individuals from the municipality of Barcelos (Brazilian Amazon) is not associated with the anti-Plasmodium falciparum glycosylphosphatidylinositol antibody response
    (2013) GOMES, Larissa Rodrigues; TOTINO, Paulo Renato Rivas; SANCHEZ, Maria Carmen Arroyo; DANIEL, Elsa Paula da Silva Kaingona; MACEDO, Cristiana Santos de; FORTES, Filomeno; COURA, Jose Rodrigues; SANTI, Silvia Maria Di; WERNECK, Guilherme Loureiro; SUAREZ-MUTIS, Martha Cecilia; FERREIRA-DA-CRUZ, Maria de Fatima; DANIEL-RIBEIRO, Claudio Tadeu
    Anti-glycosylphosphatidylinositol (GPI) antibodies (Abs) may reflect and mediate, at least partially, anti-disease immunity in malaria by neutralising the toxic effect of parasitic GPI. Thus, we assessed the anti-GPI Ab response in asymptomatic individuals living in an area of the Brazilian Amazon that has a high level of malaria transmission. For comparative purposes, we also investigated the Ab response to a crude extract prepared from Plasmodium falciparum, the merozoite surface protein (MSP)3 antigen of P. falciparum and the MSP 1 antigen of Plasmodium vivax (PvMSP1-(19)) in these individuals and in Angolan patients with acute malaria. Our data suggest that the Ab response against P. falciparum GPI is not associated with P. falciparum asymptomatic infection in individuals who have been chronically exposed to malaria in the Brazilian Amazon. However, this Ab response could be related to ongoing parasitaemia (as was previously shown) in the Angolan patients. In addition, our data show that PvMSP1-(19) may be a good marker antigen to reflect previous exposure to Plasmodium in areas that have a high transmission rate of P. vivax.
  • article 18 Citação(ões) na Scopus
    Genotypic distribution of HHV-8 in AIDS individuals without and with Kaposi sarcoma Is genotype B associated with better prognosis of AIDS-KS?
    (2016) TOZETTO-MENDOZA, Tania Regina; IBRAHIM, Karim Yaqub; TATENO, Adriana Fumie; OLIVEIRA, Cristiane Mendes de; SUMITA, Laura Massami; SANCHEZ, Maria Carmem Arroyo; LUNA, Expedito Jose; PIERROTTI, Ligia Camara; DREXLER, Jan Felix; BRAZ-SILVA, Paulo Henrique; PANNUTI, Claudio Sergio; ROMANO, Camila Malta
    AIDS-associated Kaposi's sarcoma (AIDS-KS) caused by human herpes virus 8 (HHV-8) is the most severe and resistant form of KS tumor. Our aim was to verify whether there is an association between HHV-8 variability and development of AIDS-KS in Brazil by comparing the HHV-8 variability between individuals without and with KS. Saliva samples and blood, when available, were analyzed by PCR techniques for detection of the fragments of ORF K1 of HHV-8, which were then genotyped and analyzed regarding the genetic variability. Our study described 106 positive cases for HHV-8 in the saliva from 751 AIDS patients without previous KS. In addition, we performed a phylogenetic analysis of HHV-8 in 34 of the 106 AIDS patients without KS and in 33 of the 37 patients with active KS. The distribution of HHV-8 genotypes A, B, C, and F in AIDS individuals was indistinguishable by comparing non-KS and KS groups, as well as regarding ethnicity. Considering the KS group, genotype B was associated with better prognosis of KS tumor. Interestingly. we found a particular profile of diversity within Glade C and 2 recombinant patterns of HHV-8 in the saliva of AIDS individuals without KS. We emphasize the need to achieve standard genotyping protocol for ORF K1 amplification, thus allowing for substantial detection of HHV-8 variants. Our findings can shed light on the role of HHV-8 variability in the pathogenesis of AIDS-KS.
  • article 31 Citação(ões) na Scopus
    Malaria diagnosis from pooled blood samples: comparative analysis of real-time PCR, nested PCR and immunoassay as a platform for the molecular and serological diagnosis of malaria on a large-scale
    (2011) LIMA, Giselle F. M. C.; LEVI, Jose E.; GERALDI, Marcelo P.; SANCHEZ, Maria Carmen A.; SEGURADO, Aluisio A. C.; HRISTOV, Angelica D.; INOUE, Juliana; COSTA-NASCIMENTO, Maria de Jesus; SANTI, Silvia M. Di
    Malaria diagnoses has traditionally been made using thick blood smears, but more sensitive and faster techniques are required to process large numbers of samples in clinical and epidemiological studies and in blood donor screening. Here, we evaluated molecular and serological tools to build a screening platform for pooled samples aimed at reducing both the time and the cost of these diagnoses. Positive and negative samples were analysed in individual and pooled experiments using real-time polymerase chain reaction (PCR), nested PCR and an immunochromatographic test. For the individual tests, 46/49 samples were positive by real-time PCR, 46/49 were positive by nested PCR and 32/46 were positive by immunochromatographic test. For the assays performed using pooled samples, 13/15 samples were positive by real-time PCR and nested PCR and 11/15 were positive by immunochromatographic test. These molecular methods demonstrated sensitivity and specificity for both the individual and pooled samples. Due to the advantages of the real-time PCR, such as the fast processing and the closed system, this method should be indicated as the first choice for use in large-scale diagnosis and the nested PCR should be used for species differentiation. However, additional field isolates should be tested to confirm the results achieved using cultured parasites and the serological test should only be adopted as a complementary method for malaria diagnosis.
  • conferenceObject
    Evaluation of immunochromatographic assay with recombinant antigen K39, using whole blood, serum and oral fluid, in the diagnosis of visceral leishmaniasis in Brazilian endemic areas
    (2015) CELESTE, B. J.; SANCHEZ, M. C. A.; ALMEIDA, R. P. D.; BRANCO, C. M. F. Castelo; LINDOSO, J. A. L.; PANIAGO, A. M. M.; QUEIROZ, I. T.; FUJIMORI, M.; CARAMELO, L. D. C.; GOTO, H.
  • conferenceObject
    PREVENTION OF TRANSFUSIONAL MALARIA IN THE STATE OF SAO PAULO BRAZIL
    (2017) SANTI, Silvia M. Di; SANCHEZ, Maria Carmen A.; MENDRONE JR., Alfredo; LIMA, Giselle F.; ROCHA, Mussya C.; COSTA-NASCIMENTO, Maria J.; FUJIMORI, Mahyumi; LEVI, Jose E.