Heparin-binding protein release is strongly induced by Leptospira species and is a candidate for an early diagnostic marker of human Leptospirosis

Background Leptospirosis, caused by spirochetes of the genus Leptospira, is one of the most widespread zoonoses worldwide. Efficient diagnostic methods for early diagnosis of leptospirosis are still lacking, and acute disease presents with nonspecific symptomatology and is often misdiagnosed. The leptospires pathogenic processes and virulence mechanisms remain virtually unknown. In severe infections, hemostatic impairment is frequently observed, and pathophysiological complications often develop when the host response is modulated by the pathogen. The neutrophil heparin-binding protein (HBP) is an inflammatory mediator and potent inducer of vascular leakage. Results In this study, we found that leptospires and their secreted products induce the release of HBP from stimulated neutrophils through a controlled degranulation mechanism. We acknowledged 2 leptospiral proteins as able to induce HBP degranulation. These findings have clinical implications, as high levels of HBP were detected in serum from patients with leptospirosis, especially at the early phase of the disease. Conclusion In conclusion, we describe a new mechanism by which the leptospirosis pathophysiological complications may arise, such as vascular leakage and edema formation. We also propose HBP as a new early screening biomarker for human leptospirosis.
Keywords
Leptospira;  inflammation;  infection;  neutrophils;  host-pathogen-interactions

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Vieira ML, Persson S, Lopes-Ferreira M, Romero EC., Kirchgatter K, Nascimento ALTO, et al. Heparin-binding protein release is strongly induced by Leptospira species and is a candidate for an early diagnostic marker of human Leptospirosis. J infect dis. 2019 Mar;219(6):996–1006. doi:10.1093/infdis/jiy589.
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