In Vivo Biofilm Formation of Pathogenic Leptospira spp. in the Vitreous Humor of Horses with Recurrent Uveitis

Ackermann, Kerstin; Kenngott, Rebecca; Settles, Monica; Gerhards, H; Maierl, Johann; Wollanke, B

doi:10.3390/microorganisms9091915

Cited by 16 publications

(24 citation statements)

References 71 publications

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“…The problems of diagnosing chronic intraocular infection with Leptospira spp. by serum testing in horses may be due not only to the immune privileged site in the eye and lack of immune responses, but also to biofilm formation of the bacteria inside the eye [13]. Uveitis caused by Leptospira spp.…”

Section: Discussionmentioning

confidence: 99%

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Detection of Anti-LipL32 Antibodies in Serum Samples from Horses with Chronic Intraocular Infection with Leptospira spp.

2021

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Equine recurrent uveitis (ERU) is typically caused by chronic intraocular leptospiral infection in warm-blooded horses in central Europe. The most effective therapy for leptospiral-induced ERU is the surgical removal of diseased vitreous (vitrectomy). Since vitrectomy is a highly specialized and invasive surgery, the indication must be determined very carefully. In order to obtain evidence of intraocular leptospiral infection by laboratory diagnostics in questionable leptospiral ERU-cases, sampling of aqueous humor is required, because serum tests using microscopic agglutination test (MAT) are too unspecific. The SNAP Lepto is a cross-species rapid test for the detection of anti-Lipl32 antibodies that has a high sensitivity (0.97) and specificity (1.00) for the detection of anti-leptospiral antibodies using aqueous humor or vitreous samples, which is comparable to MAT. To evaluate sensitivity and specificity of SNAP Lepto using serum, serum samples from 90 horses with confirmed leptospiral ERU and from 103 ocularly healthy horses were tested by both MAT and SNAP Lepto. Sensitivity was similar for both tests (0.82 vs. 0.79), but specificity was lower for MAT (0.52 vs. 0.95). Sensitivity and specificity are therefore lower in serum samples compared to intraocular samples, however, the SNAP Lepto is far superior to MAT and suitable as a screening method using equine serum.

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Section: Discussionmentioning

confidence: 99%

“…In the following, the term "ERU" will therefore be used for leptospiral induced recurrent uveitis in warm-blooded horses with painful episodes, and which has been demonstrated to be a chronic intraocular infection. Recently, it has been demonstrated that infectious leptospiral uveitis is accompanied by biofilm formation [12,13].…”

Section: Introductionmentioning

confidence: 99%

Detection of Anti-LipL32 Antibodies in Serum Samples from Horses with Chronic Intraocular Infection with Leptospira spp.

2021

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“…This was based on an apparent lack of detectable spirochetes in the eye, evidence of molecular mimicry in some studies, poor response to antimicrobial therapy, and response to glucocorticoid treatment. 37 However, a 2021 study 38 from Germany that examined equine eyes after vitrectomy indicated that biofilm formation within the eye may explain resistance to systemic antimicrobial therapy.…”

Section: Leptospirosis In Animalsmentioning

confidence: 99%

A global one health perspective on leptospirosis in humans and animals

Sykes

Haake

Gamage

et al. 2022

javma

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Leptospirosis is a quintessential one health disease of humans and animals caused by pathogenic spirochetes of the genus Leptospira. Intra- and interspecies transmission is dependent on 1) reservoir host animals in which organisms replicate and are shed in urine over long periods of time, 2) the persistence of spirochetes in the environment, and 3) subsequent human-animal-environmental interactions. The combination of increased flooding events due to climate change, changes in human-animal-environmental interactions as a result of the pandemic that favor a rise in the incidence of leptospirosis, and under-recognition of leptospirosis because of nonspecific clinical signs and severe signs that resemble COVID-19 represents a “perfect storm” for resurgence of leptospirosis in people and domestic animals. Although often considered a disease that occurs in warm, humid climates with high annual rainfall, pathogenic Leptospira spp have recently been associated with disease in animals and humans that reside in semiarid regions like the southwestern US and have impacted humans that have a wide spectrum of socioeconomic backgrounds. Therefore, it is critical that physicians, veterinarians, and public health experts maintain a high index of suspicion for the disease regardless of geographic and socioeconomic circumstances and work together to understand outbreaks and implement appropriate control measures. Over the last decade, major strides have been made in our understanding of the disease because of improvements in diagnostic tests, molecular epidemiologic tools, educational efforts on preventive measures, and vaccines. These novel approaches are highlighted in the companion Currents in One Health by Sykes et al, AJVR, September 2022.

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“…Recently, there was also a description of in vivo biofilm formation in naturally infected rats [126]. At about the same time, biofilm formation of leptospires in vitreous samples from eyes affected with ERU could be demonstrated by immunohistochemistry (IHC) [45].…”

Section: Pathogenic Leptospira Spp and Biofilmmentioning

confidence: 99%

“…Only recently it was recognized that recurrent uveitis in horses is a biofilmmediated disease [45]. The ERU has many aspects that had raised questions and been incomprehensible before the discovery of biofilm formation of pathogenic Leptospira spp.…”

Section: Introductionmentioning

confidence: 99%

Chronic Intraocular Leptospiral Infection Relying on Biofilm Formation inside the Vitreous Cavity Leads to Recurrent Uveitis in Horses

Wollanke¹,

Gerhards²

2022

Focus on Bacterial Biofilms

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Equine recurrent uveitis (ERU) is a disease known and feared for centuries, as it almost always leads to blindness even with careful and meticulous conservative treatment of the individual episodes of uveitis. In about one-third of horses, both eyes are affected, often necessitating euthanasia. A link between ERU and leptospiral infection has been suspected for nearly 80 years. Vitreous lavage (vitrectomy) can preserve vision in affected eyes. After surgery, no further episodes of uveitis occur in up to more than 95% of operated eyes. With routine performance of vitrectomies, numerous vitreous samples could be used for further investigations. Intraocular anti-Leptospira antibody production was proven, leptospires could be cultured from the vitreous samples, and the LipL32 gene could be detected in the vitreous samples by PCR. Thus, there was convincing evidence of a chronic intraocular leptospiral infection, which can be eliminated most reliably by vitrectomy. Recently, it has been shown that the intraocular leptospires produce biofilm in the equine vitreous. Biofilm formation explains not only the success of vitrectomy, but also the survival of leptospires in the vitreous cavity for many years despite the presence of high intraocular antibody titers and immunocompetent cells, as well as the high tolerance to antibiotics.

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In Vivo Biofilm Formation of Pathogenic Leptospira spp. in the Vitreous Humor of Horses with Recurrent Uveitis

Cited by 16 publications

References 71 publications

Detection of Anti-LipL32 Antibodies in Serum Samples from Horses with Chronic Intraocular Infection with Leptospira spp.

Detection of Anti-LipL32 Antibodies in Serum Samples from Horses with Chronic Intraocular Infection with Leptospira spp.

A global one health perspective on leptospirosis in humans and animals

Chronic Intraocular Leptospiral Infection Relying on Biofilm Formation inside the Vitreous Cavity Leads to Recurrent Uveitis in Horses

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