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El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / Objective: This study was carried out to determine the prevalence of leptospirosis among febrile patients with a suspicious clinical diagnosis of dengue fever in northern Peru. Results: A total of 276 serum samples from patients with acute febrile illness (AFI) and suspected diagnosis for dengue virus (DENV) were analyzed. We identified an etiological agent in 121 (47.5%) patients, DENV was detected in 30.4% of the cases, leptospirosis in 11.2% and co-infection by both pathogens was observed in 5.9% of the patients. In this study the most common clinical symptoms reported by the patients were: headache 89.1%, myalgias 86.9% and arthralgias 82.9%. No differences in symptomatology was observed among the different study groups. / National Research Foundation of Korea / Revisión por pares

Brugia malayi is a filarial nematode causing lymphatic filariasis in humans characterized by swelling of the lower extremities. The aim of this study was to conduct a real time PCR (qRT-PCR) to verify gene expression levels of Brugia malayi nematodes treated with 20 hydroxyecdysone. Transcriptome analysis was previously performed resulting in the identification of 44 genes that were upregulated by exposure to 20-hydroxyecdysone. Based on transcriptome results, known GO Terms and functions, four genes and one endogenous housekeeping gene were chosen for validation by RT-PCR. Induced samples showed a mean increase of microfilarie by 2.2 fold. Induced wells exhibited a 2.8 fold increase of pre- microfilarie production. On day two adult females treated with 20-HE displayed 3.8-fold increase of microfilaria production as compared to uninduced controls. Overall, all four genes showed upregulation with treatment of 20-hydroxyecdysone at levels that corresponded to the results obtained from the transcriptome analysis. Findings in this experiment expand on the understanding of the ecdysone response system in Brugia malayi, which could serve as a potential drug target against filarial disease.

A presente investigação constitui um estudo de caso sobre a tripanossomíase americana, conhecida como doença de Chagas, em seus aspectos epistemológicos e sociais, articulados através da análise de diferentes valores envolvidos nas pesquisas sobre essa enfermidade. Na elaboração de uma biografia procuramos enfatizar dois aspectos dessa patologia. Por um lado, que a tripanossomíase americana pode ser interpretada como um agente histórico, na medida em que a identidade dessa entidade nosológica não pode ser dissociada de sua caracterização científica e social, tampouco reduzida a apenas uma dessas dimensões. Por outro lado, colocar a doença como protagonista dessa história nos permite evidenciar de que modo o predomínio da narrativa das instituições médicas e científicas legitimou a invisibilização da perspectiva das pessoas afetadas por essa patologia. A primeira parte da tese está centrada sobre a faceta científica e médica da doença, a qual permitiu que a nova patologia humana fosse estabelecida como um fato. Com relação aos aspectos sociais da doença, estes são focalizados na segunda parte da tese, onde examinamos as ideias envolvidas nas representações dos trópicos e das populações rurais como sinônimos de atraso. / The present investigation is a case study of American trypanosomiasis, known as Chagas disease, in its epistemological and social aspects, articulated through an analysis of the different values involved in research on this disease. In the elaboration of a biography, we aim to emphasize two aspects of this pathology. On the one hand, American trypanosomiasis can be interpreted as a historical agent, to the extent that the identity of this nosological entity cannot be dissociated from its scientific and social characterization, nor can it be reduced to just one of these dimensions. On the other hand, to put the disease as the protagonist of this history allows us to show the ways in which the predominance of medical and scientific institutions narrative has legitimated the invisibility of the perspectives of the ones affected by this pathology. The first part of this thesis is centered on the scientific and medical facet of the disease, which allowed the new human pathology to be established as a fact. The social aspects of the disease will be focalized in the second part of the thesis, where we examine the ideas involved in representations of the tropics and of rural populations as synonyms of backwardness.

Les parasites de la classe des Kinetoplastidae, comprenant notamment les trypanosomes et les leishmanies, sont responsables pour plusieurs maladies d’importance socio-économique et de santé publique. La maladie du sommeil, la maladie de Chagas et la leishmaniose, classées comme maladies tropicales négligées (NTD) par l’Organisation mondiale de la santé (OMS) et la Surra, reportée par l’Organisation pour l’alimentation et l’agriculture, des Nations Unies (FAO). La Trypanosomiase Animale Africain sub-saharienne entraîne la mort de 3 millions bovins par an accompagné d'une perte annuelle de l'économie de 4,5 milliards de dollars américains. La leishmaniose cutanée, une maladie zoonose, présente 1,5 millions de nouveaux cas chaque année.Trypanosoma brucei (T. brucei) est un ancien eucaryote, utilisé comme organisme modèle dans le laboratoire pour l’étude des cils et des flagelles. Le remodelage du cytosquelette des trypanosomes est essentiel pour la morphologie cellulaire, le positionnement et la division des organites. L’étude des protéines essentielles du cytosquelette permet de mieux comprendre les processus cellulaires. Ces protéines pourraient également constituer des cibles potentielles pour des traitements thérapeutiques. Les trypanosomes échappent au système immunitaire de l’hôte en modifiant périodiquement les antigènes de présent à leur surface. En effet ces antigènes de surface sont endocytés, ainsi que les anticorps de l’hôte qui y sont attachés, au niveau d’une structure appelée la poche flagellaire (FP). TbBILBO1 est une protéine structurelle du collier de la poche flagellaire (FPC), essentielle à la biogenèse du FPC et à la survie du parasite. En raison du rôle majeur de la protéine TbBILBO1 dans le parasite, des partenaires de TbBILBO1 ont été recherchés.Dans ce travail, j’ai pu caractériser une nouvelle protéine essentielle du cytoskelette, la protéine FPC6, partenaire de TbBILBO1, qui se situe au niveau du complexe FPC/Complexe du Hook de T. brucei. L’ARN interférence de FPC6 conduit à une mort rapide des formes sanguines des trypanosomes, accompagnée d’un blocage de l’endocytose. Ensuite, j’ai produit un nanobody (Nb48), dirigé contre TbBILBO1, dans le système d’expression bactérien. Je l’ai également exprimé dans les lignées de trypanosomes. Le Nb48 reconnait TbBILBO1 sur les trypanosomes fixés par immunofluorescence et dans les extraits totaux de protéines dénaturées. L’analyse par résonance plasmonique de surface (SPR) a confirmé une haute affinité du Nb48 pour TbBILBO1. L’expression de Nb48 dans le parasite T. brucei en tant qu’intrabody demontrant que ce nanobody pouvait être exprimé de manière fonctionnelle, capable de reconnaitre spécifiquement sa cible protéique, TbBILBO1, intra-cellulaire et de bloquer sa fonction conduit à un effet trypanocide rapide. Ces études ouvrant ainsi la voie pour de nouvelles utilisations potentielles thérapeutiques dans le traitement des trypanosomiases. / Kinetoplastid parasites, including trypanosomes and leishmania, are responsible for several diseases of socio-economic and public health importance worldwide. These include the Neglected Tropical Diseases: Sleeping Sickness, Chagas disease and Leishmaniasis, as classified by the World Health Organisation (WHO) and the global wasting disease of animals, Surra, as reported by the Food and Agricultural Organisation of the United Nations (FAO). Animal African Trypanosomiais (AAT) causes the death of 3 million cattle per year in sub-Saharan Africa, with an annual loss of 4.5 billion US dollars to the African economy. Cutaneaous leishmaniasis is a zoonotic disease, with 1.5 million new cases reported globally each year.Trypanosoma brucei is an ancient, early diverging eukaryote, used as a model organism in the laboratory for studying eukaryotic cilia and flagella. Remodelling of the trypanosome cytoskeleton is essential for cell morphology, organelle positioning and division. Study of essential proteins of the cytoskeleton provides insight into intracellular processes and could provide potential targets for therapeutic interventions. Trypanosomes evade the host immune system by periodically changing their external surface coat, which is endocytosed, along with any attached host antibodies, via a structure called the flagellar pocket. TbBILBO1 is a structural protein of the Flagellar Pocket Collar (FPC) that is essential for FPC biogenesis and parasite survival. Due to the importance of TbBILBO1 for the parasite, protein partners were investigated.In my thesis, I describe, firstly, the characterisation of a novel and essential cytoskeletal protein, FPC6, of the FPC/Hook complex of T. brucei; FPC6 is a partner of TbBILBO1. RNAi Knock-down of FPC6 protein leads to rapid cell death in the blood-stream form of the parasite accompanied with a block in endocytosis. Secondly, I describe the purification and intracellular expression of a nanobody (Nb48), raised against TbBILBO1. The purified Nb is able to identify TbBILBO1 in fixed trypanosomes and denatured protein. Surface Plasmon Resonance analysis confirmed a high affinity of Nb48 to TbBILBO1. Expression of Nb48 as an intrabody in T. brucei, reveals that it binds precisely to its target, TbBILBO1 and leads to rapid cell death. Further exploration of the potential uses of this trypanocidal nanobody is warranted.

Background: Human African Trypanosomiasis (HAT) also called sleeping sickness is an infectious disease in humans caused by an extracellular protozoan parasite. The disease, if left untreated, results in 100% mortality. Currently available drugs are full of severe drawbacks and fail to escape the fast development of trypanosoma resistance. Due to similarities in cell metabolism between cancerous tumors and trypanosoma cells, some of the current registered drugs against HAT have also been tested in cancer chemotherapy. Here we demonstrate for the first time that the simple ester, ethyl pyruvate, comprises such properties. Results: The current study covers the efficacy and corresponding target evaluation of ethyl pyruvate on T. brucei cell lines using a combination of biochemical techniques including cell proliferation assays, enzyme kinetics, phasecontrast microscopic video imaging and ex vivo toxicity tests. We have shown that ethyl pyruvate effectively kills trypanosomes most probably by net ATP depletion through inhibition of pyruvate kinase (Ki = 3.0±0.29 mM). The potential of ethyl pyruvate as a trypanocidal compound is also strengthened by its fast acting property, killing cells within three hours post exposure. This has been demonstrated using video imaging of live cells as well as concentration and time dependency experiments. Most importantly, ethyl pyruvate produces minimal side effects in human red cells and is known to easily cross the blood-brain-barrier. This makes it a promising candidate for effective treatment of the two clinical stages of sleeping sickness. Trypanosome drug-resistance tests indicate irreversible cell death and a low incidence of resistance development under experimental conditions. Conclusion: Our results present ethyl pyruvate as a safe and fast acting trypanocidal compound and show that it inhibits the enzyme pyruvate kinase. Competitive inhibition of this enzyme was found to cause ATP depletion and cell death. Due to its ability to easily cross the bloodbrain- barrier, ethyl pyruvate could be considered as new candidate agent to treat the hemolymphatic as well as neurological stages of sleeping sickness.

A presente investigação constitui um estudo de caso sobre a tripanossomíase americana, conhecida como doença de Chagas, em seus aspectos epistemológicos e sociais, articulados através da análise de diferentes valores envolvidos nas pesquisas sobre essa enfermidade. Na elaboração de uma biografia procuramos enfatizar dois aspectos dessa patologia. Por um lado, que a tripanossomíase americana pode ser interpretada como um agente histórico, na medida em que a identidade dessa entidade nosológica não pode ser dissociada de sua caracterização científica e social, tampouco reduzida a apenas uma dessas dimensões. Por outro lado, colocar a doença como protagonista dessa história nos permite evidenciar de que modo o predomínio da narrativa das instituições médicas e científicas legitimou a invisibilização da perspectiva das pessoas afetadas por essa patologia. A primeira parte da tese está centrada sobre a faceta científica e médica da doença, a qual permitiu que a nova patologia humana fosse estabelecida como um fato. Com relação aos aspectos sociais da doença, estes são focalizados na segunda parte da tese, onde examinamos as ideias envolvidas nas representações dos trópicos e das populações rurais como sinônimos de atraso. / The present investigation is a case study of American trypanosomiasis, known as Chagas disease, in its epistemological and social aspects, articulated through an analysis of the different values involved in research on this disease. In the elaboration of a biography, we aim to emphasize two aspects of this pathology. On the one hand, American trypanosomiasis can be interpreted as a historical agent, to the extent that the identity of this nosological entity cannot be dissociated from its scientific and social characterization, nor can it be reduced to just one of these dimensions. On the other hand, to put the disease as the protagonist of this history allows us to show the ways in which the predominance of medical and scientific institutions narrative has legitimated the invisibility of the perspectives of the ones affected by this pathology. The first part of this thesis is centered on the scientific and medical facet of the disease, which allowed the new human pathology to be established as a fact. The social aspects of the disease will be focalized in the second part of the thesis, where we examine the ideas involved in representations of the tropics and of rural populations as synonyms of backwardness.