Clinical Spectrum of Pulmonary Involvement in Leptospirosis in a Region of Endemicity, with Quantification of Leptospiral Burden

Segura, Eddy R.; Ganoza, Christian A.; Campos, Kalina; Ricaldi, Jessica N.; Torres, Sonia Felipe; Silva, Hermann; Céspedes, Manuel; Matthias, Michael; Swancutt, Mark A.; Liñán, Renzo Loópez; Gotuzzo, Eduardo; Guerra, Humberto; Gilman, Robert H.; Vinetz, Joseph M.

doi:10.1086/427110

Cited by 200 publications

(168 citation statements)

References 24 publications

Supporting

Mentioning

149

Contrasting

Unclassified

Order By: Relevance

“…Seven patients (3.7%) with history of only urban exposure to leptospires had severe pulmonary manifestations; of these, five patients died, four of them due to pulmonary hemorrhage and one due to ARDS and multiorgan failure. This study demonstrated the underdiagnosis of leptospirosis and the underrecognition of severe pulmonary involvement in this disease in a region of high endemicity [15].…”

Section: Pulmonary Involvement In Leptospirosismentioning

confidence: 75%

Pathology and pathophysiology of pulmonary manifestations in leptospirosis

Dolhnikoff¹,

Mauad²,

Bethlem³

et al. 2007

Braz J Infect Dis

119

102

View full text Add to dashboard Cite

Leptospirosis is a re-emerging zoonosis occurring as large outbreaks throughout the world caused by Leptospira interrogans. The incidence of pulmonary involvement in leptospirosis has been reported to be increasing in the last years, affecting up to 70% of the patients. Alveolar hemorrhage presented as dyspnea and hemoptysis is the main pulmonary manifestation. The emergence of massive hemoptysis and acute respiratory distress syndrome has characterized the recent changes reported in the clinical patterns of leptospirosis. The pulmonary involvement has been emerged as a serious life threat, becoming the main cause of death due to leptospirosis in some countries. In this review we present the main clinical and pathological manifestations of pulmonary involvement in leptospirosis, with special focus on recent data concerning the pathophysiological mechanisms underlying lung injury.

show abstract

Section: Pulmonary Involvement In Leptospirosismentioning

confidence: 75%

Pathology and pathophysiology of pulmonary manifestations in leptospirosis

Dolhnikoff¹,

Mauad²,

Bethlem³

et al. 2007

Braz J Infect Dis

119

102

View full text Add to dashboard Cite

show abstract

“…Weil's syndrome, a severe form of this disease, is an acute febrile illness associated with multiorgan damage, including liver failure (jaundice), renal failure (nephritis), pulmonary hemorrhage, and meningitis (1), and has a 15% mortality rate if not treated (2). The molecular pathogenesis of leptospirosis is poorly understood, and the bacterial virulence factors involved are largely unknown.…”

mentioning

confidence: 99%

Fibronectin Binds to and Induces Conformational Change in a Disordered Region of Leptospiral Immunoglobulin-like Protein B

Lin¹,

Greenwood

Nicholson

et al. 2009

Journal of Biological Chemistry

View full text Add to dashboard Cite

Leptospira interrogans is a pathogenic spirochete that causes disease in both humans and animals. LigB (Leptospiral immunoglobulin-like protein B) contributes to the binding of Leptospira to extracellular matrix proteins such as fibronectin (Fn), fibrinogen, laminin, and collagen. A high affinity Fn-binding region of LigB has been recently localized to LigBCen2, which contains the partial eleventh and full twelfth immunoglobulin-like repeats (LigBCen2R) and 47 amino acids of the non-repeat region (LigBCen2NR) of LigB. In this study, LigBCen2NR was shown to bind to the N-terminal domain (NTD) of Fn (K D ‫؍‬ 379 nM) by an enzyme-linked immunosorbent assay and isothermal titration calorimetry. Interestingly, this sequence was not observed to adopt secondary structure by far UV circular dichroism or by differential scanning calorimetry, in agreement with computer-based secondary structure predictions. A low partition coefficient (K av ) measured with gel permeation chromatography, a high hydrodynamic radius (R h ) measured with dynamic light scattering, and the insensitivity of the intrinsic viscosity to guanidine hydrochloride treatment all suggest that LigBCen2NR possesses an extended and disordered structure. Two-dimensional 15 N-1 H HSQC NMR spectra of intact LigBCen2 in the absence and presence of NTD are consistent with these observations, suggesting the presence of both a ␤-rich region and an unstructured region in LigBCen2 and that the latter of these selectively interacts with NTD. Upon binding to NTD, LigBCen2NR was observed by CD to adopt a ␤-strand-rich structure, suggestive of the known ␤-zipper mode of NTD binding.Leptospira interrogans is a pathogenic spirochete that causes leptospirosis throughout the world, especially in developing countries but also in regions of the United States where it has reemerged (1). Weil's syndrome, a severe form of this disease, is an acute febrile illness associated with multiorgan damage, including liver failure (jaundice), renal failure (nephritis), pulmonary hemorrhage, and meningitis (1), and has a 15% mortality rate if not treated (2). The molecular pathogenesis of leptospirosis is poorly understood, and the bacterial virulence factors involved are largely unknown. Recently, several potential Leptospira virulence factors have been described, including sphingomyelinases, serine proteases, zinc-dependent proteases, and collagenase (3); LipL32 (4); lipopolysaccharide (5); a novel factor H, laminin, and Fn-binding protein (Lsa24 or Len) (6 -8); Loa 22 (9); and Lig (Leptospiral immunoglobulin-like) proteins (10 -12).Lig proteins, including LigA, LigB, and LigC, contain multiple immunoglobulin-like repeat domains (13 in LigA, 12 in LigB and LigC) (10 -12). Interestingly, the first 630 residues, from the N terminus to the first half of the seventh immunoglobulinlike domain, are conserved between LigA and LigB, but the rest of the immunoglobulin-like domains are variable (10 -12) between the two proteins. Also, a non-immunoglobulin-like repeat region found on the C-terminal...

show abstract

“…Generalmente, es leve a moderado y excepcionalmente, comanda la gravedad del cuadro. El hallazgo predominante es un compromiso hemorrágico traqueal, intersticial e intra-alveolar, que se traduce en hipoxia, insuficiencia respiratoria y en ocasiones, hemoptisis [33][34][35] . En 80 a 85% de los casos con hemoptisis la radiología de tórax demuestra infiltrados reticulo-nodulares.…”

Section: Manifestaciones Clínicasunclassified

Leptospirosis: Puesta al día

M¹,

P²

2007

Rev. chil. infectol.

View full text Add to dashboard Cite

Clinical Spectrum of Pulmonary Involvement in Leptospirosis in a Region of Endemicity, with Quantification of Leptospiral Burden

Cited by 200 publications

References 24 publications

Pathology and pathophysiology of pulmonary manifestations in leptospirosis

Pathology and pathophysiology of pulmonary manifestations in leptospirosis

Fibronectin Binds to and Induces Conformational Change in a Disordered Region of Leptospiral Immunoglobulin-like Protein B

Leptospirosis: Puesta al día

Contact Info

Product

Resources

About