117 research outputs found
Association of G22A polymorphism of the adenosine deaminase (ADA) gene with biochemical characteristics in type 2 diabetic Palestinians
The adenosine deaminase G22A polymorphism
(20q.11.33) affects the level of adenosine deaminase (ADA) expression,
which plays an important role in the regulation of intracellular and
extracellular concentrations of adenosine. Recent studies reported
greater ADA activity in diabetic patients and showed the role of ADA in
the modulation of insulin activity and glucose homeostasis. We
investigated whether the G22A polymorphism of the ADA gene is
associated with type 2 diabetes mellitus (T2DM) in the Palestinian
population and assessed the relationship between the G22A variant and
fasting plasma glucose (FPG), glycated hemoglobin (HbA1c) and lipid
profile among T2DM patients. A total of 231 individuals with T2DM
and a control sample of 101 non-diabetic participants were randomly
selected from those who were attending United Nations Relief and
Works Agency (UNRWA) clinics for treatment and/or follow up.
Genomic DNA was extracted from peripheral blood samples and PCRRFLP
was performed to identify the TaqI polymorphism G22A of the
ADA gene. No significant differences were observed in the genotype and
allele frequencies between T2DM patients and the control group. Yet, among diabetic patients, the GG genotype was significantly associated
with higher FPG and HbA1c when compared to the GA+AA genotype
but had no influence on blood pressure, BMI or other metabolic
parameters. In conclusion, we confirm that the GG genotype of the ADA
gene is associated with poor glycemic control in T2DM Palestinians and
points to the association of the G22A variant with decreased activity of
the ADA enzyme, which is of paramount importance in the
pathophysiology of T2DM.The authors thank the patients for participating in the study. This research was
financially supported by the deanship of scientific research of Al-Quds University, Palestine
Molecular characterization of Anaplasma and Ehrlichia in ixodid ticks and reservoir hosts from Palestine: a pilot survey
Tick-borne anaplasmosis and ehrlichiosis are clinically important emerging zoonoses usually overlooked by veterinarians and physicians alike. This study aimed at detecting and genetically characterizing Ehrlichia and Anaplasma species in ixodid ticks and their animal hosts from the West Bank, Palestine. A total of 723 ixodid ticks belonging to three genera (Rhipicephalus, Hyalomma, Haemaphysalis) were collected from dogs, sheep, goats and camels. In addition, 189 blood samples were collected from dogs, sheep, camels, horses and a goat from the West Bank, Palestine. All tick and blood samples were investigated for the presence of Anaplasma and Ehrlichia targeting a 345 bp fragment of the 16S rRNA gene followed by sequence analysis. The infection rate of Anaplasma spp. in ticks was 6.5% (47/723). Anaplasma platys was identified in 28% (13/47) of them. Whereas, based on a partial sequence (851 bp) of msp4 gene, 38% (18/47) were identified as A. ovis. The species of the remaining 16 positive samples (16/47, 34%) could not be identified. Simultaneously, the infection rate of Ehrlichia spp. in the ticks was 0.6% (4/723). Three of which were E. canis and one was Ehrlichia spp. The infection rate of A. platys in dogs' blood samples was 10% (13/135), while it was 1.5% (2/135) for E. canis. The infection rate of Anaplasma in sheep blood samples was 40% (19/47), out of which 26% (5/19) were caused by A. ovis as revealed by msp4-PCR. Implementation of purely-spatial analysis by saTScan for all cases of Anaplasma revealed two statistically significant clusters in two districts; Tubas town and Majdal-Bani-Fadil village on the western hills of the Jordan Valley. Most cases of Anaplasma (83%) were from rural areas where life cycle components (vector, host and reservoir) abundantly interact. This study is the first in Palestine to reveal the presence of Anaplasma and Ehrlichia in ticks, dogs and sheep providing crucial platform for future epidemiological surveys and control strategies in the country and regio
MDR tuberculosis and non-compliance with therapy
The emergence of multidrug-resistant (MDR) tuberculosis is a worldwide public health problem. We reported a case of pulmonary MDR tuberculosis in a 41-year-old man with diabetes from the West Bank, Palestine. 1
The bacteria belonged to the Beijing family, which is highly virulent and easily disseminated. 2
The patient withdrew from treatment after 2 years while still sputum-positive. Despite persistent efforts of the tuberculosis directly observed treatment programme, he disappeared and cannot be located. The patient might have fled to a neighbouring country, and there is a risk that he will pass on MDR tuberculosis to people with whom he has contact
Prevalence of selected intestinal protozoan infections in marginalized rural communities in Palestine
Background: Intestinal parasitic infections are common in rural areas with poor infrastructure and low
socioeconomic status. The aim of this study was to estimate the prevalence of selected parasitic infections in
marginalized rural areas in the northern part of the Palestinian West Bank Region, using conventional and PCRbased
methods, and also to assess risk predictors of infection.
Methods: A cross-sectional study was conducted on 104 individuals from three rural villages in the Jordan Valley.
Stool samples were collected and examined by a battery of tests that included microscopy of wet fecal samples in
normal saline with iodine, concentration by ethyl acetate sedimentation and also by zinc sulfate floatation, a
conventional PCR and a real-time PCR (qPCR). Risk factors were assessed that included demographic,
socioeconomic, and behavioral characteristics. Data on method performance was analyzed by kappa-statistic,
Cochraneâs Q, and McNemar post hoc test. Mid-P exact test and odds ratio were used to discern association
between outcome and risk predictors.
Results: The overall prevalence of intestinal parasitic infections was 48% (49/102). The predominant parasites were
Giardia lamblia at 37% (37/102) and Hymenolepis nana at 9% (9/102). To concentrate cysts and eggs, sedimentation
can be used as an alternative to floatation with a loss of 1% of positive cases. The methods employing PCRs proved
crucial as it increased the detected infection rate of G. lamblia approximately three-fold from 13% by the
conventional methods to 37% by the qPCR. Multiple infections were present in 13% (13/102) of the study group,
which included double (10%) and triple (3%) infections. Regarding the genus Entamoeba, E. dispar and E. coli were
detected at rates of 2 and 8%, respectively. While none of the individuals were infected with the pathogenic E.
histolytica, E. nana (4%) was detected for the first time in the area. Age was a risk predictor for infection (OR = 2.61,
CI 95% 1.05â6.45, P = 0.038).
Conclusions: The increased prevalence of intestinal parasitic infections in children in marginalized rural areas in
Palestine is worrying. The addition of PCR-based methods is important for the diagnosis of such infections as, with
cautious interpretation, it increases proficiency and overcomes underestimation and misdiagnosis of cases. Control
measures including education on personal hygiene and environmental sanitation, should be introduced to reduce
the prevalence of the intestinal parasites and, thus, the infections they cause in this and other areas.Acknowledgments
We thank L. F. Schnur for reviewing the manuscript.
Authorsâ contributions
AA, conception of the research, study design, data analysis and drafting of
the manuscript. SE and AN, molecular biological testing and analysis. KD and
HA collection of samples and conventional examination. ZA, data analysis
and interpretation. All the authors have read and approved the final
manuscript.
Funding
This research is a self-funded work by the researchers
Prevalence of Trypanosoma evansi in livestock in Palestine
Background: Trypanosoma evansi is the causative agent of surra, a disease that occurs in many animal species. The
disease is responsible for substantial losses in global production and can be fatal if not diagnosed early. This study
aims to determine the prevalence of T. evansi in livestock, equids and dromedary camels in Palestine.
Methods: Blood samples were collected during 2015â2017 from domesticated animals (n = 259 animals; 77%
females and 23% males) including camels (n = 87), horses (n = 46), donkeys (n = 28), mules (n = 2), sheep (n = 49)
and goats (n = 48) from eight districts: Ariha (Jericho), Nablus, Bethlehem, Deir Al Balah, Jenin, Rafah, Tubas, and Khan
Yunis. Parasite prevalence was determined using PCR and blood smear microscopy. PCR-positive samples were further
phylogenetically analyzed using DNA sequences of the 18S ribosomal RNA gene.
Results: The overall infection prevalence was 18% (46/259). The positivity rates according to PCR and microscopy
examination were 17% (45/259) and 2.7% (7/259), respectively. The infection rates were as follows: camels, 26/61
(30%); horses, 8/46 (17%); donkeys, 3/28 (11%); mules, 1/2 (50%); sheep, 2/42 (4%); and goats, 6/42 (13%). Phylogenetic
analyses of the 18S rRNA gene showed that 24 positive T. evansi samples from Palestine formed a monophyletic
cluster with seven T. evansi sequences from Africa, Asia and South America, and three T. brucei sequences from Africa
retrieved from GenBank. The spatial analysis showed three statistically significant foci of T. evansi infection in Jenin,
Tubas (P = 0.02) and Ariha (Jericho) (P = 0.04). No statistically significant foci were detected in the Gaza Strip.
Conclusions: To the best of our knowledge, this is the first confirmation of high levels of infection with T. evansi as
a causative agent of surra in Palestine. Our study emphasizes the need for a stringent surveillance system and risk
assessment studies as prerequisites for control measures. Further investigations focusing on vectors and evaluation of
risk factors are needed.Acknowledgments
Not applicable.
Authorsâ contributions
AN, SE, AA-J and ZA conceived and designed the experiments. AN, SE, HA-J,
NA-L and AA-J performed the experiments. SE, AN and AA-J analyzed the data.
AN, AA-J and SE wrote the first draft of the manuscript. AN, SE, NA-L, HA, AA-J
and ZA competed the final revision of the manuscript to be published. All
authors read and approved the final manuscript.
Funding
This research received no financial support
Amphotericin B-loaded nanoparticles for local treatment of cutaneous leishmaniasis
Cutaneous leishmaniasis (CL) is an infectious, parasitic disease caused by the protozoan Leishmania. Amphotericin B (AMB) is
a macrolide polyene antibiotic presenting potent antifungal and antileishmanial activity, but due to poor water solubility at
physiological pH, side effects, and toxicity, its therapeutic efficiency is limited. In the present study, poly(lactic-co-glycolic acid)
(PLGA) nanoparticles (NPs) loaded with AMB were generated to reduce drug toxicity and facilitate localized delivery over a
prolonged time. AMB NPs were characterized for particle size, zeta potential, polydispersity index, and degree of aggregation.
In vitro assessments demonstrated its sustained activity against Leishmania major promastigotes and parasite-infected macrophages.
A single intralesional administration to infected BALB/c mice revealed that AMB NPs were more effective than AMB
deoxycholate in terms of reducing lesion area. Taken together, these findings suggest thatAMB NPs improve AMB delivery and
can be used for local treatment of CL.This research was funded by the GIP program of the
Deutsche Forschungsgemeinschaft (DFG) German Research Foundation.
EZ wish to acknowledge the financial support of the RBNI-The Russell
Berrie Nanotechnology Institute at the Technion. CLJ holds the Michael
and Penny Feiwel Chair of Dermatology
Genetic characterization of Mycobacterium tuberculosis in the West Bank, Palestinian Territories
BACKGROUND: The World Health Organization (WHO) declared human tuberculosis (TB) a global health emergency and launched the âGlobal Plan to Stop Tuberculosisâ which aims to save a million lives by 2015. Global control of TB is increasingly dependent on rapid and accurate genetic typing of species of the Mycobacterium tuberculosis (MTB) complex including M. tuberculosis. The aim of this study was to identify and genetically characterize the MTB isolates circulating in the West Bank, Palestinian Territories. Genotyping of the MTB isolates from patients with pulmonary TB was carried out using two molecular genetic techniques, spoligotyping and mycobacterial interspersed repetitive units-variable number of tandem repeat (MIRU-VNTR) supported by analysis of the MTB specific deletion 1 (TbD1). FINDINGS: A total of 17 MTB patterns were obtained from the 31 clinical isolates analyzed by spoligotyping; corresponding to 2 orphans and 15 shared-types (SITs). Fourteen SITs matched a preexisting shared-type in the SITVIT2 database, whereas a single shared-type SIT3348 was newly created. The most common spoligotyping profile was SIT53 (T1 variant), identified in 35.5â% of the TB cases studied. Genetic characterization of 22 clinical isolates via the 15 loci MIRU-VNTR typing distinguished 19 patterns. The 15-loci MIT144 and MIT145 were newly created within this study. Both methods determined the present of M. bovis strains among the isolates. CONCLUSIONS: Significant diversity among the MTB isolates circulating in the West Bank was identified with SIT53-T1 genotype being the most frequent strain. Our results are used as reference database of the strains circulating in our region and may facilitate the implementation of an efficient TB control program
Simultaneous detection of Mycobacterium bovis and M. tuberculosis in an apparentlyimmunocompetent patient
Mycobacterium tuberculosis remains the main cause
of human tuberculosis (TB), with an unknown proportion
of cases caused by M. bovis. Here we describe
a case of pulmonary TB caused by mixed infection as
studied from sequential sputum sampling and isolation
of M. tuberculosis and M. bovis using a reverse
dot blot (RDB) assay
Case Report: Autochthonous Case of Human Visceral Leishmaniasis in the West Bank, Palestine
Human visceral leishmaniasis (HVL) is a parasitic disease infecting children in the Mediterranean region.
Here,weportray a case of a 2-year-old child with an epidemiological description of the situation surrounding the case. The
patient was suffering from recurrent fever, weakness and abdominal discomfort associated with loss of appetite. Routine
blood investigations showed pancytopenia, whereas examination revealed hepatomegaly. A diagnosis of HVL was made
by demonstrating amastigotes in a Giemsa-stained smear from a bone marrow aspirate followed by genotyping by PCR
and sequencing. In conclusion, early detection of VL infection followed by appropriate treatment protocols is essential to
saving the patient
First-Time Detection of Mycobacterium bovis in Livestock Tissues and Milk in the West Bank, Palestinian Territories
Background: Bovine tuberculosis, bTB, is classified by the WHO as one of the seven neglected zoonontic diseases that cause
animal health problems and has high potential to infect humans. In the West Bank, bTB was not studied among animals and
the prevalence of human tuberculosis caused by M. bovis is unknown. Therefore, the aim of this study was to estimate the
prevalence of bTB among cattle and goats and identify the molecular characteristics of bTB in our area.
Methodology/principal findings: A total of 208 tissue samples, representing 104 animals, and 150 raw milk samples,
obtained from cows and goats were examined for the presence of mycobacteria. The tissue samples were collected during
routine meat inspection from the Jericho abattoir. DNA was extracted from all samples, milk and tissue biopsies (n = 358),
and screened for presence of TB DNA by amplifying a 123-bp segment of the insertion sequence IS6110. Eight out of 254
animals (3.1%) were found to be TB positive based on the IS6110-PCR. Identification of M. bovis among the positive TB
samples was carried out via real time PCR followed by high resolution melt curve analysis, targeting the A/G transition along
the oxyR gene. Spoligotyping analysis revealed a new genotype of M. bovis that was revealed from one tissue sample.
Significance: Detection of M. bovis in tissue and milk of livestock suggests that apparently healthy cattle and goats are a
potential source of infection of bTB and may pose a risk to public health. Hence, appropriate measures including meat
inspection at abattoirs in the region are required together with promotion of a health campaign emphasizing the
importance of drinking pasteurized milk. In addition, further studies are essential at the farm level to determine the exact
prevalence of bTB in goats and cattle herds in the West Bank and Israel.Financial support was provided by the Dutch government; project M27-072NVHU 2009 02 âVector-Borne Pathogens in Israel and the Palestinian Authority.â The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
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