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Enolase proteins play a significant role as moonlighting proteins. In their role as surface-associated enolase, they have multiple functions as they interact with extracellular matrix proteins. Type I and III collagens are the major constituents of this extracellular matrix, and collagen is one of the targets of interaction with the enolase of many pathogens, thereby helping the colonization process and promoting the subsequent invasion of the host. This work aimed to determine the participation of non-typeable H. influenzae enolase as a collagen-binding protein. In this study, through the use of in vitro tests it was demonstrated that recombinant enolase of non-typeable H. influenzae (rNTHiENO) strongly binds to type I collagen. Using molecular docking, the residues that could take part in the interaction of non-typeable H. influenzae enolase-type I collagen (NTHiENO-Cln I) and non-typeable H. influenzae enolase-type III collagen (NTHiENO-Cln III) were identified. However, in vitro assays show that NTHiENO has a better affinity to interact with Cln I, concerning type Cln III. The interaction of NTHiENO with collagen could play a significant role in the colonization process; this would allow H. influenzae to increase its virulence factors and strengthen its pathogenesis.
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Infecções por Haemophilus , Haemophilus influenzae , Humanos , Fosfopiruvato Hidratase/genética , Colágeno Tipo I , Simulação de Acoplamento Molecular , Colágeno/metabolismo , Matriz Extracelular/metabolismoRESUMO
OBJECTIVES: This study compares the clinical characteristics of patients with amyotrophic lateral sclerosis (ALS) within three clinic-based populations from Cuba, Uruguay and Ireland and determines the impact of known ALS-associated genetic variants on phenotypic manifestations within the Cuban population. METHODS: Demographic and clinical information was collected on 115 Cuban, 220 Uruguayan and 1038 Irish patients with ALS attending national specialist clinics through 1996-2017. All Cuban patients and 676 Irish patients underwent next-generation DNA sequencing and were screened for the pathogenic C9orf72 repeat expansion. RESULTS: The mean age of onset was younger in the Cuban (53.0 years, 95% CI 50.4 to 55.6) and Uruguayan (58.2 years, 95% CI 56.5 to 60.0) populations compared with the Irish population (61.6 years, 95% CI 60.9 to 62.4). No differences in survival between populations were observed. 1.7 % (95% CI 0.6 to 4.1) of Cubans with ALS carried the C9orf72 repeat expansion compared with 9.9% (95% CI 7.8 to 12.0) of Irish patients with ALS (p=0.004). Other known variants identified in the Cuban population included ANG (one patient), CHCHD10 (one patient) and DCTN1 (three patients). CONCLUSIONS AND RELEVANCE: This study is the first to describe the clinical characteristics of ALS in Cuban and Uruguayan populations and report differences between the Cuban and Irish genetic signature in terms of known ALS-associated genetic variants. These novel clinical and genetic data add to our understanding of ALS across different and understudied populations.
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Esclerose Lateral Amiotrófica/genética , Idade de Início , Esclerose Lateral Amiotrófica/mortalidade , Esclerose Lateral Amiotrófica/patologia , Cuba , Feminino , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Irlanda , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Análise de Sobrevida , Uruguai , Sequenciamento Completo do GenomaRESUMO
Nowadays, Chagas disease is a major health problem in Latin America that has been disseminated also into non-endemic countries. Currently, a vaccine against Chagas disease does not exist. In the present study, the gene encoding Trypanosoma cruzi enolase (TcENO) was amplified, cloned, and sequenced and the recombinant protein was purified. We used in silico and an experimental assay to investigate the immunological role of TcENO. The in silico assays showed that TcENO sequence contains characteristic motifs of enolase; additionally, a transmembranal region was identified, and this could indicate the potential membrane localization of TcENO. Moreover, both B lymphocyte and cytotoxic T lymphocytes (CTL) predicted epitopes were localized; these results suggest the possibility that TcENO can develop both humoral and cellular immune responses. Furthermore, the presence of antibodies was verified by western blot assays, showing that the purified recombinant protein was detected by sera from experimentally infected mice and sera of patients with Chagas disease. These results indicate that TcENO is immunogenic and could be used as a vaccine candidate.
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Doença de Chagas/prevenção & controle , Epitopos/imunologia , Fosfopiruvato Hidratase/imunologia , Trypanosoma cruzi/enzimologia , Sequência de Aminoácidos , Animais , Formação de Anticorpos , Linfócitos B/imunologia , Sequência de Bases , Doença de Chagas/imunologia , Humanos , Imunidade Celular , Camundongos , Dados de Sequência Molecular , Fosfopiruvato Hidratase/genética , Proteínas Recombinantes/genética , Proteínas Recombinantes/imunologia , Linfócitos T/imunologiaRESUMO
There is currently no vaccine against American trypanosomiasis, caused by the parasite Trypanosoma cruzi. This is due to the genomic variation observed in the six DTUs of T. cruzi. This work aims to propose a consensus sequence of the enolase protein from different strains of T. cruzi and mainly evaluate its immunogenic properties at the bioinformatic level. From specialized databases, 15 sequences of the enolase gene were aligned to obtain a consensus sequence, where this sequence was modeled and then evaluated and validated through different bioinformatic programs to learn their immunogenic potential. Finally, chimeric peptides were designed with the most representative epitopes. The results showed high immunogenic potential with six epitopes for MHC-I, and seven epitopes for MHC-II, all of which were highly representative of the enolase present in strains from the American continent as well as five epitopes for B cells. Regarding the computational modeling, molecular docking with Toll-like receptors showed a high affinity and low constant of dissociation, which could lead to an innate-type immune response that helps to eliminate the parasite. In conclusion, the consensus sequence proposed for enolase is capable of providing an ideal immune response; however, the experimental evaluation of this enolase consensus and their chimeric peptides should be a high priority to develop a vaccine against Chagas disease.
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A hallmark of Bacillus thuringiensis bacteria is the formation of one or more parasporal crystal (Cry) proteins during sporulation. The toxicity of these proteins is highly specific to insect larvae, exerting lethal effects in different insect species but not in humans or other mammals. The aim of this review is to summarize previous findings on Bacillus thuringiensis, including the characteristics of the bacterium, its subsequent contribution to biotechnology as a bioinsecticide due to the presence of Cry proteins, and its potential application as an adjuvant. In several studies, Cry proteins have been administered together with specific antigens to immunize experimental animal models. The results have shown that these proteins can enhance immunogenicity by generating an adequate immune response capable of protecting the model against an experimental infectious challenge, whereas protection is decreased when the specific antigen is administered without the Cry protein. Therefore, based on previous results and the structural homology between Cry proteins, these molecules have arisen as potential adjuvants in the development of vaccines for both animals and humans. Finally, a model of the interaction of Cry proteins with different components of the immune response is proposed.
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BACKGROUND: Chagas disease is considered a neglected tropical disease. The acute phase of Chagas disease is characterized by several symptoms: fever, fatigue, body aches, headache and cardiopathy's. Chronic phase could be asymptomatic or symptomatic with cardiac compromise. Since the emergence of the pandemic caused by the SARS-CoV-2 virus, the cardiovascular involvement has been identified as a complication commonly reported in coronavirus disease 2019 (COVID-19). Due to the lack of knowledge of the cardiac affectations that this virus could cause in patients with Chagas disease, the aim of this review is to describe the possible cardiac affectations, as well as the treatment and recommendations that patients with both infections should carry out. METHODS: The authors revised the recent and relevant literature concerning the topic and discussed advances and limitations of studies on COVID-19 and their impact in Chagas disease patients, principally with cardiac affectations. RESULTS: There currently exists little information about the consequences that Chagas disease patients can suffer when they are infected with COVID-19. CONCLUSIONS: This review highlights the emerging challenges of access to medical care and future research needs in order to understand the implications that co-infections (SARS-CoV-2 or other viruses) can generate in Chagas disease-infected people.
RESUMO
Haemophilus influenzae is a common organism of the human upper respiratory tract; this bacterium is responsible of a wide spectrum for respiratory infections and can generate invasive diseases such as meningitis and septicemia. These infections are associated with H. influenzae encapsulated serotype b. However, the incidence of invasive disease caused by nontypeable H. influenzae (NTHi) has increased in the post-H. influenzae serotype b (Hib) vaccine era. Currently, an effective vaccine against NTHi is not available; due to this, it is important to find an antigen capable to confer protection against NTHi infection. In this study, 10 linear B cell epitopes and 13 CTL epitopes and a putative plasminogen-binding motif (252FYNKENGMY260) and the presence of enolase on the surface of different strains of H. influenzae were identified in the enolase sequence of H. influenzae. Both in silico and experimental results showed that recombinant enolase from H. influenzae is immunogenic that could induce a humoral immune response; this was observed mediating the generation of specific polyclonal antibodies anti-rNTHiENO that recognize typeable and nontypeable H. influenzae strains. The immunogenic properties and the superficial localization of enolase in H. influenzae, important characteristics to be considered as a new candidate for the development of a vaccine, were demonstrated.
Assuntos
Proteínas de Bactérias/imunologia , Infecções por Haemophilus/prevenção & controle , Vacinas Anti-Haemophilus/imunologia , Haemophilus influenzae/imunologia , Fosfopiruvato Hidratase/imunologia , Infecções Respiratórias/prevenção & controle , Proteínas de Bactérias/genética , Proteínas de Bactérias/isolamento & purificação , Clonagem Molecular , Biologia Computacional , Epitopos/genética , Epitopos/imunologia , Infecções por Haemophilus/imunologia , Infecções por Haemophilus/microbiologia , Vacinas Anti-Haemophilus/genética , Vacinas Anti-Haemophilus/uso terapêutico , Haemophilus influenzae/enzimologia , Haemophilus influenzae/genética , Humanos , Fosfopiruvato Hidratase/genética , Fosfopiruvato Hidratase/isolamento & purificação , Proteínas Recombinantes/genética , Proteínas Recombinantes/imunologia , Proteínas Recombinantes/isolamento & purificação , Infecções Respiratórias/imunologia , Infecções Respiratórias/microbiologia , Desenvolvimento de Vacinas , Vacinas de Subunidades Antigênicas/genética , Vacinas de Subunidades Antigênicas/imunologia , Vacinas de Subunidades Antigênicas/uso terapêuticoRESUMO
Haemophilus influenzae is the causal agent of invasive pediatric diseases, such as meningitis, epiglottitis, pneumonia, septic arthritis, pericarditis, cellulitis, and bacteremia (serotype b). Non-typeable H. influenzae (NTHi) strains are associated with localized infections, such as otitis media, conjunctivitis, sinusitis, bronchitis, and pneumonia, and can cause invasive diseases, such as as meningitis and sepsis in immunocompromised hosts. Enolase is a multifunctional protein and can act as a receptor for plasminogen, promoting its activation to plasmin, which leads to the degradation of components of the extracellular matrix, favoring host tissue invasion. In this study, using molecular docking, three important residues involved in plasminogen interaction through the plasminogen-binding motif (251EFYNKENGMYE262) were identified in non-typeable H. influenzae enolase (NTHiENO). Interaction with the human plasminogen kringle domains is conformationally stable due to the formation of four hydrogen bonds corresponding to enoTYR253-plgGLU1 (K2), enoTYR253-plgGLY310 (K3), and enoLYS255-plgARG471/enoGLU251-plgLYS468 (K5). On the other hand, in vitro assays, such as ELISA and far-western blot, showed that NTHiENO is a plasminogen-binding protein. The inhibition of this interaction using polyclonal anti-NTHiENO antibodies was significant. With these results, we can propose that NTHiENO-plasminogen interaction could be one of the mechanisms used by H. influenzae to adhere to and invade host cells.
RESUMO
Multidrug-resistant Pseudomonas aeruginosa is one of the main opportunistic pathogens causing severe infection. One of the mechanisms involved in the resistance to imipenem in clinical isolates is the loss of the OprD porin. Changes like substitutions, deletions, insertions, or mutations in the oprD gene can modify the conformation of OprD porin or inhibit its presence and generate resistance to carbapenems. The aim of this work was to obtain anti-OprD polyclonal antibodies and to determine by both immunofluorescence microscopy (IFI) and Western blot assays, the presence of the OprD porin in resistant-carbapenem P. aeruginosa strains with different changes in the oprD gene. Changes in the gene oprD were identified in clinical isolates of P. aeruginosa. When proteins were translated, several polymorphisms were found; however, these did not affect the presence of OprD porin (PCM25, PCM36, and PCM78). Also it was detected an insertion sequence ISPa1328 (PCM52) and a premature stop codon (PCM91), which inhibited the presence of the OprD porin. This study shows how changes in the oprD gene of P. aeruginosa clinical isolates affect the presence of the OprD porin detected by Western blot and indirect immunofluorescence assays using specific polyclonal anti-OprD antibodies generated in this work.
Assuntos
Resistência Microbiana a Medicamentos/fisiologia , Porinas/genética , Porinas/metabolismo , Pseudomonas aeruginosa/genética , Pseudomonas aeruginosa/metabolismo , Animais , Resistência a Múltiplos Medicamentos/fisiologia , Humanos , CoelhosRESUMO
Trypanosoma cruzi is the protozoan parasite that causes Chagas disease, which is considered by the World Health Organization to be a neglected tropical disease. Two drugs exist for the treatment of Chagas disease, nifurtimox and benznidazole; they are only effective in the acute phase, and a vaccine is currently not available. In this study, we used the recombinant enolase from T. cruzi H8 strain (MHOM/MX/1992/H8 Yucatán) (rTcENO) and its encoding DNA (pBKTcENO) to immunize mice and evaluate their protective effects in an experimental murine model of acute phase infection. Our results showed that mice vaccinated with rTcENO or its encoding DNA were able to generate typical specific antibodies (IgG1, IgG2a, and IgG2b), suggesting that a mixed Th1/Th2 immune response was induced. The parasite burden in the blood was reduced to 69.8% and 71% in mice vaccinated with rTcENO and pBKTcENO, respectively. The group vaccinated with rTcENO achieved 75% survival, in contrast to the group vaccinated with pBKTcENO that showed no survival in comparison to the control groups. Moreover, rTcENO immunization elevated the production of IFN-γ and IL-2 after the parasite challenge, suggesting that the Th1-type immune response was polarized. These results indicated that rTcENO could be used as a vaccine against Chagas disease.
Assuntos
Antígenos de Protozoários/imunologia , Doença de Chagas/imunologia , Fosfopiruvato Hidratase/imunologia , Vacinas Protozoárias/imunologia , Proteínas Recombinantes/imunologia , Células Th1/imunologia , Trypanosoma cruzi/fisiologia , Doença Aguda , Animais , Antígenos de Protozoários/genética , Modelos Animais de Doenças , Feminino , Humanos , Interferon gama/metabolismo , Interleucina-2/metabolismo , Camundongos , Camundongos Endogâmicos BALB C , Carga Parasitária , Fosfopiruvato Hidratase/genética , Proteínas Recombinantes/genética , Vacinas de DNARESUMO
PURPOSE: Pseudomonas aeruginosa infections in hospitals constitute an important problem due to the increasing multidrug resistance (MDR) and carbapenems resistance. The knowledge of resistance mechanisms in Pseudomonas strains is an important issue for an adequate antimicrobial treatment. Therefore, the objective was to investigate other antimicrobial resistance mechanisms in MDR P. aeruginosa strains carrying bla IMP, make a partial plasmids characterization, and determine if modifications in oprD gene affect the expression of the OprD protein. METHODOLOGY: Susceptibility testing was performed by Kirby Baüer and by Minimum Inhibitory Concentration (presence/absence of efflux pump inhibitor); molecular typing by Pulsed-field gel electrophoresis (PFGE), resistance genotyping and integrons by PCR and sequencing; OprD expression by Western blot; plasmid characterization by MOB Typing Technique, molecular size by PFGE-S1; and bla IMP location by Southern blot. RESULTS: Among the 59 studied P. aeruginosa isolates, 41 multidrug resistance and carbapenems resistance isolates were detected and classified in 38 different PFGE patterns. Thirteen strains carried bla IMP; 16 bla GES and four carried both genes. This study centered on the 17 strains har-boring bla IMP. New variants of ß-lactamases were identified (bla GES-32, bla IMP-56, bla IMP-62) inside of new arrangements of class 1 integrons. The presence of bla IMP gene was detected in two plasmids in the same strain. The participation of the OprD protein and efflux pumps in the resistance to carbapenems and quinolones is shown. No expression of the porin OprD due to stop codon or IS in the gene was found. CONCLUSIONS: This study shows the participation of different resistance mechanisms, which are reflected in the levels of MIC to carbapenems. This is the first report of the presence of three new variants of ß-lactamases inside of new arrangements of class 1 integrons, as well as the presence of two plasmids carrying bla IMP in the same P. aeruginosa strain isolated in a Mexican hospital.
RESUMO
BACKGROUND AND AIMS: Breast cancer is the most common cancer and the main cause of cancer deaths in women worldwide. Microvesicles (MVs) are fragments of the plasma membrane secreted from cytoplasmic membrane compartments by normal and malignant cells. An increase in MV number has been found in peripheral blood of patients with several diseases including cancer. We hypothesized that MV number and the relative amount of focal adhesion kinase (FAK) and epidermal growth factor receptor (EGFR) proteins in plasma fractions enriched in MVs and deprived of platelet-derived MVs are related to the presence of breast cancer. METHODS: Plasma fractions enriched in MVs and deprived of platelet-derived MVs were obtained by differential centrifugation of blood samples. MV number was evaluated by BD TruCOUNT Tubes (BD Biosciences). FAK and EGFR proteins were analyzed by Western blot. RESULTS: MV number in plasma fractions enriched with MVs and deprived of platelet-derived MVs is higher in breast cancer patients with stages I-IV as well as with T2-T4 tumors, in comparison to control group. In addition, plasma fractions enriched in MVs present FAK and EGFR proteins and their amount is increased in some stages of breast cancer in comparison to control group. CONCLUSIONS: Our findings strongly suggest that MV number and the amount of FAK and EGFR in plasma fractions enriched in MVs are associated with some stages of breast cancer.
Assuntos
Neoplasias da Mama/sangue , Neoplasias da Mama/patologia , Membrana Celular/metabolismo , Vesículas Citoplasmáticas , Adulto , Idoso , Idoso de 80 Anos ou mais , Plaquetas/citologia , Neoplasias da Mama/enzimologia , Neoplasias da Mama/metabolismo , Receptores ErbB/metabolismo , Feminino , Quinase 1 de Adesão Focal/metabolismo , Proteína-Tirosina Quinases de Adesão Focal/metabolismo , Humanos , Pessoa de Meia-Idade , Plasma/citologia , Plasma/enzimologiaRESUMO
Chagas disease is a parasitic infection caused by the protozoan Trypanosoma cruzi, a flagellated organism that is transmitted mainly to humans through the infected feces of triatomine kissing bugs (vector transmission in endemic areas) or by transfusion of infected blood, donations of infected organ, or transmission from an infected mother to her child at birth. Chagas disease was first described in 1909 by the Brazilian physician Carlos Chagas, and due to the parasite's distribution throughout North, Central and South America, the disease is commonly known as American trypanosomiasis. However, this disease is now present in non-endemic countries such as Canada, the United States of America, and several countries in Europe (principally Spain). Moreover, Chagas disease was recently designated by the World Health Organization as one of the main neglected tropical diseases. The aim of this review is to summarize the research efforts recently described in studies conducted in Mexico on Chagas disease. In this country, there are no existing vector control programs. In addition, there is no consensus on the diagnostic methods for acute and chronic Chagas disease in maternity wards and blood banks, and trypanocidal therapy is not administered to chronic patients. The actual prevalence of the disease is unknown because no official reporting of cases is performed. Therefore, the number of people infected by different routes of transmission (vector, congenital, blood transfusion, organ transplantation, or oral) is unknown. We believe that by promoting education about Chagas disease in schools starting at the basic elementary level and including reinforcement at higher education levels will ensure that the Mexican population would be aware of this health problem and that the control measures adopted will have more acceptance and success. We hope that this review sensitizes the relevant authorities and that the appropriate measures to reduce the risk of infection by T. cruzi are undertaken to provide the Mexican people a better quality of life.
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Doença de Chagas/epidemiologia , Animais , Doença de Chagas/prevenção & controle , Humanos , México/epidemiologia , Doenças Negligenciadas , Vacinas ProtozoáriasRESUMO
A 30-kDa surface collagen binding protein peroxiredoxin of Entamoeba histolytica (EhCBP30) was evaluated either alone or fused to the chaperone (CHP) or ATPase (ATP) domains of heat shock protein 70 of Trypanosoma cruzi (TcHSP70) as a vaccine candidate in a hamster model of experimental amoebic liver abscess (ALA) development. Three constructs were produced containing the EhCBP30 DNA sequence, one expressing EhCBP30 and two expressing EhCBP30 fused to either CHP or ATP domains of TcHSP70. High purity recombinant proteins rEhCBP30, rEhCBP30-CHP and rEhCBP30-ATP with N-terminal His tag were obtained by single step affinity purification. Hamsters were immunized without adjuvant with the antigenic recombinant proteins and then challenged intrahepatically with E. histolytica trophozoites. A 70% decrease in ALA development was detected in hamsters immunized with rEhCBP30 and rEhCBP30-CHP, while animals immunized with rEhCBP30-ATP did not show a statistically significant decrease in ALA formation compared with non-immunized animals. Histological analysis of liver tissue showed that the inflammatory infiltrate was discrete or moderate in hamsters immunized with rEhCBP30 or rEhCBP30-CHP compared with that observed in control hamsters or hamsters immunized with rEhCBP30-ATP. These results suggest that rEhCBP30 and rEhCBP30-CHP are able to induce an effective immune response that may protect hamsters against ALA development.
Assuntos
Anticorpos Antiprotozoários/sangue , Antígenos de Protozoários/imunologia , Entamoeba histolytica/imunologia , Abscesso Hepático Amebiano/prevenção & controle , Vacinas Protozoárias/imunologia , Animais , Antígenos de Protozoários/isolamento & purificação , Clonagem Molecular , Cricetinae , Entamoeba histolytica/genética , Feminino , Proteínas de Choque Térmico HSP70/imunologia , Proteínas de Choque Térmico HSP70/isolamento & purificação , Imunização , Fígado/patologia , Abscesso Hepático Amebiano/parasitologia , Masculino , Mesocricetus , Camundongos , Camundongos Endogâmicos BALB C , Modelos Animais , Proteínas de Protozoários/imunologia , Proteínas de Protozoários/isolamento & purificação , Proteínas Recombinantes/imunologia , Proteínas Recombinantes/isolamento & purificação , Trofozoítos , Trypanosoma cruzi/genéticaRESUMO
Introducción: la parálisis de Bell es una afección frecuente que presenta en 15% de los casos una recuperación incompleta. En los últimos años se ha acumulado evidencia del posible roldel virus herpes simple tipo 1 en su etiología. Objetivos: comparar la eficacia de valaciclovir y prednisona versus prednisona placebo en laparálisis de Bell. Material y método: se realizó un ensayo prospectivo, randomizado y placebo controlado. Delos 41 pacientes incluidos, 21 fueron tratados con valaciclovir 2 g día durante siete días más prednisona (PV) y 19 con prednisona más placebo (PP) administrados oralmente.Los controles clínicos se realizaron a las 2, 4, 8 y 12 semanas, los pacientes con recuperación incompleta fueron seguidos durante seis meses. La recuperación fue definida comosatisfactoria con un puntaje mayor a 90 usando una escala compuesta de parálisis facial (FGS). Resultados: la evolución de la escala de parálisis facial no mostró diferencias significativasentre ambos grupos. La recuperación a los seis meses fue de 86,4% en el grupo PV y 89,5% en el grupo PP (p=0,86). El tiempo medio de recuperación en días fue 70,2 y 71,1, respectivamente (p=0,88). Conclusiones: nuestros resultados no demuestran un beneficio adicional del valaciclovir en eltratamiento de la parálisis de Bell.De acuerdo con las evidencias actuales, no hay consenso respecto al uso rutinario de antivirales en todos los caso de parálisis de Bell (NCT00561106).
Introduction: Bells Palsy is a frequent condition, and 15% of patients affected show incomplete recoveries. Over thepast years, wide evidence has been gathered as to the possible incidence of Herpes simplex virus type 1 in itsetiology. Objectives: to compare the efficacy of valacyclovir and prednisone versus prednisone plus placebo. Of 41 patients included in the study, 21 were treated with valacyclovir, 2g a day for seven days, and prednisone; and 19with prednisone plus placebo, administered orally. Clinical controls were carried out at weeks 2, 4, 8 and12. Patients who had incomplete recoveries were followed studied for six months. Recovery was defined as satisfactory when the score was over 90, using a facial paralysis complex scale (FGS Facial Grading Scale).Results: no meaningful difference in the evolution of the facial paralysis were found between the two groups. After six months, recovery was 86.4% in the valacyclovir and prednisone group, and 89.5% in the prednisone plus placebo group (p=0,86). Average recovery time was 70.2 and 71.1 days, respectively (p=0,88). Conclusions: our results fail to prove additional benefits of the alacyclovir in the treatment of Bells Palsy. According to current evidence available, there is no agreementregarding the antivirals ordinary use in all cases of Bells Palsy (NCT00561106).
Introdução: a paralisia de Bell é uma afecção freqüente que em 15% dos casos apresenta recuperação incompleta.Nos últimos anos tem-se observado evidência da participação do vírus herpes simplex tipo 1 em sua etiologia.Objetivos: comparar a eficácia da associação valaciclovir e prednisona versus prednisona placebo na paralisiade Bell. Material e método: foi realizado um estudo prospectivo, randomizado e placebo controlado. Dos 41 pacientesincluídos, 21 foram tratados com valaciclovir 2 g/dia durante sete dias mais prednisona (PV) e 19 com prednisona mais placebo (PP) administrados por via oral. Os controles clínicos foram realizados nas semanas 2,4, 8 e 12; os pacientes com recuperação incompleta foram seguidos durante seis meses. A recuperação foi definida como satisfatória quando apresentavam pontuação superior a 90 usando uma escala composta de paralisia facial(FGS). Resultados: a evolução da escala de paralisia facial não mostrou diferenças significativas entre ambos os grupos. A recuperação aos seis meses foi de 86,4% no grupo PV e 89,5% no grupo PP (p=0,86). O tempo médio derecuperação em dias foi 70,2 e 71,1 ,respectivamente (p=0,88).Conclusões: nossos resultados não mostraram um beneficio adicional do uso do valaciclovir no tratamentoda paralisia de Bell. De acordo com as evidências atuais, não existe consensosobre o uso rotineiro de anti-virais em todos los caso de paralisia de Bell (NCT00561106).