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1.
BMC Infect Dis ; 24(1): 406, 2024 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-38627642

RESUMO

BACKGROUND: Opportunistic infections (OIs) are common causes of mortality among people living with HIV (PLHIV). We determined prevalence and 30-day mortality due to histoplasmosis, cryptococcosis, and TB in PLHIV with advanced HIV disease (AHD). METHODS: PLHIV 18 years and older, with a CD4 + T-cell count of less than 350 cells/mm3 newly diagnosed with HIV infection or re-engaged in care after being without ART for more than 90 days (Group A). The second group included symptomatic PLHIV regardless of ART status or CD4 + T-cell count (Group B); all followed for 30 days. Detection of Histoplasma Ag (HisAg) in urine was done by enzyme immunoassay (EIA), Cryptococcus antigen (CrAg) was detected in serum and cerebrospinal fluid (CSF) specimens by lateral flow assay (LFA), and lipoarabinomannan (LAM) detection in urine was by LFA (TB LAM) and in sputum by GeneXpert for diagnosis of Mycobacterium infections. RESULTS: From August 2021 to June 2022, 491 PLHIV were enrolled; 482 (98%) had a CD4 + T-cell result, and 381 patients (79%) were classified with AHD according to CD4 + T-cell count (< 200 CD4/mm3). Frequency of an OI was 38% (n = 145/381). Antigen test positivity rate was 16% (72/467) for TB-LAM, 9% (43/464) for HisAg, and 11% (51/484) for CrAg. Twenty-one of 34 (62%) patients receiving CSF CrAg tests were positive, confirming meningitis. Significant differences in 30-day mortality were observed in patients with an OI (16%) vs. no OI (7%) (p = 0.002). Mortality was highest in patients with histoplasmosis (25%), co-infection (22%), cryptococcosis (18% overall; 19% for cryptococcal meningitis), and TB (10%). CONCLUSIONS: TB and fungal OIs, including co-infection, were common in PLHIV in Paraguay and had high associated mortality. Laboratories and health facilities need access to CD4 + T-cell testing and rapid diagnostic assays.


Assuntos
Coinfecção , Criptococose , Infecções por HIV , Histoplasmose , Infecções Oportunistas , Tuberculose , Humanos , Infecções por HIV/epidemiologia , Histoplasmose/diagnóstico , Histoplasmose/epidemiologia , Testes de Diagnóstico Rápido , Paraguai/epidemiologia , Criptococose/complicações , Criptococose/diagnóstico , Criptococose/epidemiologia , Tuberculose/complicações , Tuberculose/diagnóstico , Tuberculose/epidemiologia , Antígenos de Fungos
2.
HIV Med ; 24(9): 990-999, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37128161

RESUMO

INTRODUCTION: HIV prevalence among transgender women is high worldwide. The objectives of the present study were to estimate the current prevalence of HIV and identify factors associated with high HIV burden among transgender women in Paraguay. METHODS: Transgender women aged ≥15 years in four regions of Paraguay were recruited by Starfish sampling between February and March 2021. RESULTS: In total, 322 transgender women were included. Mean age was 31 years (range 15-67), and 102 had positive HIV test results (31.7%, 95% confidence interval [CI] 26.6-37.1). In multivariable analysis, factors associated with HIV infection were age at first intercourse ≤17 years (adjusted odds ratio [aOR] 5.47; 95% CI 1.05-28.42), >10 years difference in age with the last sexual partner (aOR 1.60; 95% CI 1.04-2.46), substance use (mostly cocaine) (aOR 3.00; 95% CI 1.47-6.12), higher risk perception (aOR 3.08; 95% CI 1.53-6.17), not testing for HIV (aOR 1.23; 95% CI 1.09-1.39), and accessed by a peer educator (aOR 3.86; 95% CI 1.77-8.38). CONCLUSIONS: Sexual debut as a minor and a large age difference with sexual partners are associated with high burden of HIV among transgender women in Paraguay. Our study corroborates the finding of cocaine use during sex as a risk factor for HIV. Prevention programmes must address structural and social vulnerabilities to stem the tragically high burden of HIV among transgender women.


Assuntos
Infecções por HIV , Soropositividade para HIV , HIV-1 , Pessoas Transgênero , Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Infecções por HIV/epidemiologia , Paraguai/epidemiologia , Comportamento Sexual , Fatores de Risco , Prevalência
3.
J Antimicrob Chemother ; 77(3): 807-815, 2022 02 23.
Artigo em Inglês | MEDLINE | ID: mdl-34957520

RESUMO

BACKGROUND: Point prevalence surveys (PPSs) on antibiotic use are useful for understanding different aspects related to prescription patterns in hospitals. METHODS: An adaptation of the WHO methodology for a PPS on antibiotic use was applied. Hospital wards were divided into medical (MED), surgical (SUR), ICUs, gynaecology and obstetrics (GO), high-risk (HR) and mixed wards (MIX). A web application (RedCap©) through a mobile device was used for data collection. RESULTS: Between December 2018 and August 2019, 5444 patients in 33 hospitals in five countries were included (10 hospitals in Cuba, 7 in Paraguay, 6 in El Salvador, 5 in Mexico and 5 in Peru). Of these patients, 54.6% received at least one antibiotic, with variations between and within hospitals and countries. Antibiotics were more frequently used in ICUs (67.2%), SUR (64.5%) and MED wards (54.2%), with 51.2% of antibiotics prescribed for community-acquired infections (CAIs), 22.9% for healthcare-associated infections (HAIs), 11.1% for surgical prophylaxis and 6.1% for unknown reasons. Adherence to guidelines was observed in 68.6% of cases (72.8% for CAIs, 72.4% for HAIs and 44.3% for prophylaxis). Third-generation cephalosporins were the class of antibiotics most frequently used (26.8%), followed by carbapenems (10.3%) and fluoroquinolones (8%). Targeted treatments were achieved in 17.3% of cases. CONCLUSIONS: Antibiotic use was generally higher than that published in other studies. There is an urgent need to promote and strengthen the antimicrobial stewardship programmes in Latin America.


Assuntos
Antibacterianos , Infecção Hospitalar , Antibacterianos/uso terapêutico , Infecção Hospitalar/epidemiologia , Hospitais , Humanos , América Latina/epidemiologia , Prevalência
4.
J Med Virol ; 94(10): 5061-5065, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35701340

RESUMO

Human immunodeficiency virus (HIV) drug resistance increases mortality and morbidity and antiretroviral therapy (ART) costs. We describe Paraguay's first nationally representative survey on pretreatment drug resistance (PDR) conducted among persons who initiated or reinitiated ART in 2019. ​​​​We conducted a cross-sectional survey of antiretroviral (ARV) drug resistance in Paraguay in 2019. Participants were sampled at four comprehensive care clinics where 90% of patients with HIV in Paraguay initiate ART. Patients included were adults ≥18 years old who initiated first-line ART or reinitiated the same first-line ART regimen after ≥3 months of discontinuation. Of 208 patients, 93.8% had no prior ART exposure, 3.8% reinitiated the same regimen, 2.4% had unknown prior ART exposure; and 31.3% had a CD4 count <200 cells/µl. Mutations associated with resistance were present in 15.4% of patients. Mutations associated with resistance to nonnucleoside reverse transcriptase inhibitors (NNRTI) were present in 13.0% of patients, nucleoside reverse transcriptase inhibitors in 4.3%, and integrase inhibitors in 3.4%. Mutations associated with resistance to tenofovir were present in 1.0% of patients and emtricitabine/lamivudine in 1.4%. ​​Nearly one in six patients had PDR in Paraguay's first nationally representative sample. High NNRTI PDR prevalence underscores the need to accelerate the transition to dolutegravir-based first-line ART. The low PDR prevalence of tenofovir and emtricitabine is reassuring as these ARVs are part of the World Health Organization (WHO)-recommended oral pre-exposure prophylaxis regimen. The high proportion of individuals initiating ART at a late disease stage highlights the need to improve treatment linkage strategies and implement WHO rapid ART initiation recommendations.


Assuntos
Fármacos Anti-HIV , Infecções por HIV , HIV-1 , Adolescente , Adulto , Fármacos Anti-HIV/farmacologia , Fármacos Anti-HIV/uso terapêutico , Antirretrovirais/uso terapêutico , Estudos Transversais , Farmacorresistência Viral/genética , Emtricitabina/uso terapêutico , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , HIV-1/genética , Humanos , Paraguai/epidemiologia , Inibidores da Transcriptase Reversa/uso terapêutico , Tenofovir/uso terapêutico , Carga Viral
5.
Bull World Health Organ ; 100(3): 231-236, 2022 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-35261411

RESUMO

Problem: In Paraguay, incomplete surveillance data resulted in the burden of congenital syphilis being underestimated, which, in turn, led to missed opportunities for infant diagnosis and treatment. Approach: The prevalence of congenital syphilis, as defined by the World Health Organization (WHO), was estimated for Paraguay using the WHO congenital syphilis estimation tool. This tool was also used to monitor progress towards the elimination of mother-to-child transmission of syphilis. Local setting: The burden of syphilis in Paraguay has historically been high: its prevalence in pregnant women was estimated to be 3% in 2018. Relevant changes: The incidence rate of congenital syphilis estimated using the WHO tool was around nine times the reported prevalence. Subsequently, Paraguay: (i) provided training to improve diagnosis and case reporting; (ii) strengthened information systems for case monitoring and reporting; and (iii) procured additional rapid dual HIV-syphilis and rapid plasma reagin tests to increase syphilis testing capacity. In addition, the Ministry of Health prepared a new national plan for eliminating mother-to-child transmission of syphilis, with clear monitoring milestones. Lessons learnt: Health-care providers' reporting and surveillance procedures for congenital syphilis may not adequately reflect national and international case definitions. Use of the WHO congenital syphilis estimation tool in Paraguay drew attention to congenital syphilis as a national public health problem and highlighted the importance of comprehensive national surveillance systems and accurate data. Ongoing use of the WHO tool can track progress towards the elimination of mother-to-child transmission of syphilis by helping improve syphilis service coverage and national surveillance.


Assuntos
Complicações Infecciosas na Gravidez , Sífilis Congênita , Sífilis , Feminino , Humanos , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Paraguai/epidemiologia , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Cuidado Pré-Natal , Sífilis/diagnóstico , Sífilis/epidemiologia , Sífilis Congênita/diagnóstico , Sífilis Congênita/epidemiologia , Sífilis Congênita/prevenção & controle , Organização Mundial da Saúde
6.
Salud Publica Mex ; 63(1, ene-feb): 21-26, 2020 12 22.
Artigo em Espanhol | MEDLINE | ID: mdl-33984207

RESUMO

Objetivo. Determinar la prevalencia y los factores de riesgo para sífilis en población indígena masculina de Paraguay durante el año 2017. Material y métodos. Se realizó un estudio observacional, descriptivo, con muestro probabilístico, estratificado y multietápico. Fueron incluidos indígenas de sexo masculino, mayores de 15 años de edad, de cinco familias lingüísticas residentes en Paraguay durante el periodo de estudio. Resultados. La prevalencia de sífilis en hombres de la población indígena de Paraguay fue de 4.50%. Los indígenas que tenían entre 15 y 20 años tuvieron 2.70 probabilidades de presentar sífilis. Asimismo, los participantes que reportaron múltiples parejas en el último año, sexo transaccional y consumir alcohol en la última relación sexual tuvieron 2.69, 3.06 ym 2.16 veces la probabilidad de presentar sífilis, respectivamente. Conclusiones. Se encontró una prevalencia moderada de sífilis en la población indígena masculina. La prevalencia fue de dos veces más para aquéllos que tenían más de dos parejas sexuales, sexo transaccional y que involucraban alcohol durante la práctica sexual.


Assuntos
Povos Indígenas , Sífilis , Humanos , Masculino , Paraguai/epidemiologia , Prevalência , Fatores de Risco , Sífilis/etnologia
7.
J Sci Food Agric ; 100(14): 5171-5181, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32530046

RESUMO

BACKGROUND: The fruit of Cucurbita ficifolia Bouché is known in Mexico as 'chilacayote'. The scientific interest that C. ficifolia Bouché has acquired is due to its important hypoglycemic effect. The present research aimed (i) to discover whether this hypoglycemic property is present at different stages of development of this fruit, and (ii) to characterize some bioactive compounds with antioxidant or anti-inflammatory properties. Ethylene production, respiration rate, and maturity indices were determined during fruit development. The chemical characterization of the aqueous extracts of each stage of maturity studied was determined and their hypoglycemic effects were bioassayed using groups of normal mice with diabetes induced by streptozotocin at a dose of 500 mg-1 kg-1 body weight. RESULTS: Respiration rate and ethylene production showed a typical pattern for non-climacteric fruit and the quality parameters did not show significant changes. Phenolic compounds such as gallic acid and chlorogenic acid were found to have the highest concentration at 15 days of development. Extracts at 15 days showed a hypoglycemic effect that was 11% greater than that of glibenclamide in diabetized mice. CONCLUSION: All stages of development of C. ficifolia fruit had a hypoglycemic effect; however, the aqueous extract from the fruit at 15 days of development showed a better effect than glibenclamide. This finding highlights the potential of this maturity stage, and shows that it is appropriate for inclusion in treatments of type 2 diabetes mellitus. The results also indicate that phenolic compounds are mainly responsible for this effect and not d-chiro-inositol as previously thought. © 2020 Society of Chemical Industry.


Assuntos
Cucurbita/crescimento & desenvolvimento , Diabetes Mellitus Tipo 2/tratamento farmacológico , Frutas/química , Hipoglicemiantes/administração & dosagem , Extratos Vegetais/administração & dosagem , Animais , Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios/análise , Anti-Inflamatórios/metabolismo , Antioxidantes/administração & dosagem , Antioxidantes/análise , Antioxidantes/metabolismo , Glicemia/metabolismo , Cucurbita/química , Cucurbita/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Frutas/crescimento & desenvolvimento , Frutas/metabolismo , Humanos , Hipoglicemiantes/análise , Hipoglicemiantes/metabolismo , Masculino , Camundongos , Fenóis/administração & dosagem , Fenóis/análise , Fenóis/metabolismo , Fitoterapia , Extratos Vegetais/análise , Extratos Vegetais/metabolismo
8.
Sex Transm Dis ; 46(4): 246-249, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30461594

RESUMO

BACKGROUND: The objective of this study was to measure the prevalence of syphilis among women of reproductive age from 5 distinct indigenous populations in Paraguay. We also sought to identify the demographic profile and behaviors of women with elevated prevalence of syphilis. METHODS: We conducted a population-based, cross-sectional survey among women aged 15 to 49 years from 5 distinct language families in Paraguay in 2016. The 5 language families were Guaraní, Maskoy, Mataco, Guaicurú, and Zamuco, sampled through a probability-based, multistage cluster design. Participants completed a questionnaire on demographic characteristics and risk-related behavior. Blood samples were drawn for rapid testing for syphilis with confirmation and titers. Participants provided written informed consent; minors had written parental consent and provided their own assent. RESULTS: A total of 1732 indigenous women were enrolled. Overall syphilis prevalence was 6.8% (95% confidence interval [CI], 5.6-8.0). Syphilis prevalence varied by language family/ethnic group (P = 0.010), with Mataco having the highest prevalence (8.2%; 95% CI, 5.3-11.9) and Maskoy having the lowest (2.5%; 95% CI, 1.1-4.7). Women reporting multiple partners (11.3%; 95% CI, 6.9-17.1; P = 0.031) and transactional sex in the last year (18.7%; 95% CI, 7.2-36.4; P = 0.010) had higher prevalence of syphilis. CONCLUSIONS: Our survey found high prevalence of syphilis in indigenous women in Paraguay, in association with transactional sex and multiple partners. Interventions to reduce sexual behaviors associated with an increased risk of sexually transmitted infections (STI) in indigenous women must be carried out with programs aimed at addressing transactional sex, appropriately framed to respect interculturality and an indigenous worldview.


Assuntos
Grupos Populacionais/estatística & dados numéricos , Assunção de Riscos , Comportamento Sexual/etnologia , Infecções Sexualmente Transmissíveis/etnologia , Sífilis/etnologia , Adolescente , Adulto , Anticorpos Antibacterianos/sangue , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Paraguai/epidemiologia , Vigilância da População , Prevalência , Fatores de Risco , Parceiros Sexuais , Infecções Sexualmente Transmissíveis/microbiologia , Inquéritos e Questionários , Adulto Jovem
9.
J Nutr ; 148(4): 542-551, 2018 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-29659954

RESUMO

Background: Animal models that mimic diet-induced human pathogenesis of chronic diseases are of increasing importance in preclinical studies. The Ossabaw pig is an established model for obesity-related metabolic disorders when fed extreme diets in caloric excess. Objective: To increase the translational nature of this model, we evaluated the effect of diets resembling 2 human dietary patterns, the Western diet (WD) and the Heart Healthy Diet (HHD), without or with atorvastatin (-S or +S) therapy, on cardiometabolic risk factors and atherosclerosis development. Methods: Ossabaw pigs (n = 32; 16 boars and 16 gilts, aged 5-8 wk) were randomized according to a 2 × 2 factorial design into 4 groups (WD-S, WD+S, HHD-S, and HHD+S) and were fed the respective diets for 6 mo. The WD (high in saturated fat, cholesterol, and refined grain) and the HHD (high in unsaturated fat, whole grain, and fruit and vegetables) were isocaloric [38% of energy (%E) from fat, 47%E from carbohydrate, and 15%E from protein]. Body composition was determined by using dual-energy X-ray absorptiometry, serum fatty acid (FA) profiles by gas chromatography, cardiometabolic risk profile by standard procedures, and degree of atherosclerosis by histopathology. Results: Serum FA profiles reflected the predominant dietary FA. Pigs fed the WD had 1- to 4-fold higher concentrations of LDL cholesterol, non-HDL cholesterol, HDL cholesterol, high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor α (TNF-α), alkaline phosphatase (ALP), and alanine aminotransferase (ALT) compared with HHD-fed pigs (all P-diet < 0.05). Statin therapy significantly lowered concentrations of LDL cholesterol (-39%), non-HDL cholesterol (-38%), and triglycerides (-6%) (P-statin < 0.02). A greater degree of atheromatous changes (macrophage infiltration, foam cells, fatty streaks) and lesion incidence was documented in the coronary arteries (P-diet < 0.05), as well as 2- to 3-fold higher lipid deposition in the aortic arch or thoracic aorta of WD- compared with HHD-fed pigs (P-diet < 0.001). Conclusions: Ossabaw pigs manifested a dyslipidemic and inflammatory profile accompanied by early-stage atherosclerosis when fed a WD compared with an HHD, which was moderately reduced by atorvastatin therapy. This phenotype presents a translational model to examine mechanistic pathways of whole food-based dietary patterns on atherosclerosis development.


Assuntos
Aterosclerose/etiologia , Doença da Artéria Coronariana/etiologia , Dieta Saudável , Dieta Ocidental , Gorduras na Dieta/sangue , Modelos Animais de Doenças , Lipídeos/sangue , Animais , Aterosclerose/patologia , Atorvastatina/uso terapêutico , Colesterol/sangue , Doença da Artéria Coronariana/patologia , Dislipidemias/sangue , Dislipidemias/etiologia , Ingestão de Energia , Ácidos Graxos/sangue , Comportamento Alimentar , Feminino , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Inflamação/sangue , Inflamação/etiologia , Masculino , Fatores de Risco , Suínos , Triglicerídeos/sangue
10.
Virol J ; 15(1): 193, 2018 12 27.
Artigo em Inglês | MEDLINE | ID: mdl-30587198

RESUMO

BACKGROUND: Zika virus (ZIKV) has become a global threat with immediate need for accurate diagnostics, efficacious vaccines and therapeutics. Several ZIKV envelope (Env)-based vaccines have been developed recently. However, many commercially available ZIKV Env are based on the African lineage and produced in insect cells. Here, we sought to produce Asian-lineage ZIKV Env in mammalian cells for research and clinical applications. METHODS: We designed various gene expression constructs to optimize the production of ZIKV using prM-Env and full or C-terminal truncations of Env; with or without a rat CD4 fusion partner to allow large-scale production of soluble protein in mammalian HEK293 cells. Protein expression was verified by mass spectrometry and western-blot with a pan-flavivirus antibody, a ZIKV Env monoclonal antibody and with immune sera from adenoviral (ChAdOx1) ZIKV Env-vaccinated mice. The resulting Env-CD4 was used as a coating reagent for immunoassay (ELISA) using both mouse and human seropositive sera. RESULTS: Replacement of the C-terminus transmembrane Env domain by a rat CD4 and addition of prM supported optimal expression and secretion of Env. Binding between the antigens and the antibodies was similar to binding when using commercially available ZIKV Env reagents. Furthermore, antibodies from ZIKV patients bound ZIKV Env-CD4 in ELISA assays, whereas sera from healthy blood donors yielded minimal OD background. The serological outcomes of this assay correlated also with ZIKV neutralisation capacity in vitro. CONCLUSIONS: Results obtained from this study indicate the potential of the Asian-lineage Zika Env-CD4 and Env proteins in ELISA assays to monitor humoral immune responses in upcoming clinical trials as well as a sero-diagnostic tool in ZIKV infection.


Assuntos
Anticorpos Neutralizantes/sangue , Anticorpos Antivirais/sangue , Proteínas Recombinantes de Fusão/imunologia , Proteínas do Envelope Viral/imunologia , Proteínas do Envelope Viral/isolamento & purificação , Zika virus/imunologia , Animais , Antígenos CD4/genética , Ensaio de Imunoadsorção Enzimática/métodos , Células HEK293 , Humanos , México , Camundongos , Testes de Neutralização/métodos , Ratos , Proteínas Recombinantes de Fusão/genética , Proteínas Recombinantes de Fusão/isolamento & purificação , Proteínas Recombinantes de Fusão/metabolismo , Proteínas do Envelope Viral/genética , Proteínas do Envelope Viral/metabolismo , Zika virus/genética
11.
AIDS Behav ; 22(Suppl 1): 99-104, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29455264

RESUMO

We estimated mortality rate and predictors of death in children and adolescents who acquired HIV through mother-to-child transmission in Paraguay. In 2000-2014, we conducted a cohort study among children and adolescents aged < 15 years. We abstracted data from medical records and death certificates. We used the Cox proportional hazards model for the multivariable analysis of mortality predictors. A total of 302 subjects were included in the survey; 216 (71.5%) were younger than 5 years, 148 (51.0%) were male, and 214 (70.9%) resided in the Asunción metropolitan area. There were 52 (17.2%) deaths, resulting in an overall mortality rate of 2.06 deaths per 100 person-years. The children and adolescents with hemoglobin levels ≤ 9 g/dL at baseline had a 2-times higher hazard of death compared with those who had levels > 9 g/dL (HR 2.27, 95% CI 1.01-5.10). The mortality of HIV-infected children and adolescents in Paraguay is high, and anemia is associated with mortality. Improving prenatal screening to find cases earlier and improving pediatric follow-up are needed.


Assuntos
Infecções por HIV/mortalidade , Infecções por HIV/transmissão , Transmissão Vertical de Doenças Infecciosas/estatística & dados numéricos , Cuidado Pré-Natal/normas , Adolescente , Anemia/complicações , Anemia/mortalidade , Criança , Pré-Escolar , Feminino , Infecções por HIV/complicações , Humanos , Lactente , Recém-Nascido , Masculino , Paraguai/epidemiologia , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores de Risco
12.
Risk Anal ; 38(10): 2013-2028, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-29900563

RESUMO

SRA Dose-Response and Microbial Risk Analysis Specialty Groups jointly sponsored symposia that addressed the intersections between the "microbiome revolution" and dose response. Invited speakers presented on innovations and advances in gut and nasal microbiota (normal microbial communities) in the first decade after the Human Microbiome Project began. The microbiota and their metabolites are now known to influence health and disease directly and indirectly, through modulation of innate and adaptive immune systems and barrier function. Disruption of healthy microbiota is often associated with changes in abundance and diversity of core microbial species (dysbiosis), caused by stressors including antibiotics, chemotherapy, and disease. Nucleic-acid-based metagenomic methods demonstrated that the dysbiotic host microbiota no longer provide normal colonization resistance to pathogens, a critical component of innate immunity of the superorganism. Diverse pathogens, probiotics, and prebiotics were considered in human and animal models (in vivo and in vitro). Discussion included approaches for design of future microbial dose-response studies to account for the presence of the indigenous microbiota that provide normal colonization resistance, and the absence of the protective microbiota in dysbiosis. As NextGen risk analysis methodology advances with the "microbiome revolution," a proposed new framework, the Health Triangle, may replace the old paradigm based on the Disease Triangle (focused on host, pathogen, and environment) and germophobia. Collaborative experimental designs are needed for testing hypotheses about causality in dose-response relationships for pathogens present in our environments that clearly compete in complex ecosystems with thousands of bacterial species dominating the healthy superorganism.


Assuntos
Bactérias , Disbiose , Microbioma Gastrointestinal , Probióticos/análise , Medição de Risco/métodos , Animais , Genômica , Humanos , Imunidade Inata , Imunidade nas Mucosas , Intestinos/imunologia , Intestinos/microbiologia , Camundongos , Modelos Biológicos , Prebióticos
14.
Rev Invest Clin ; 69(5): 262-269, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29077698

RESUMO

BACKGROUND: Human papillomaviruses (HPVs), the leading cause of cervical cancer, are distributed worldwide, with high prevalence in developing countries. OBJECTIVE: The objective of the study is to know the prevalence and genotypes of HPV in women from the state of Michoacán and the Women's Hospital in Morelia, Michoacán. MATERIALS AND METHODS: Cervical smear samples (159,288) were subjected to HPV detection by hybrid capture 2. A subsample of 484 patients from the Women's Hospital was studied by Papanicolaou test and linear array HPV genotyping, and when positive, patients were also examined by colposcopy and histopathology. RESULTS: The overall prevalence for HPV in Michoacán State was 7.74%; 7.11% in 2009, 6.46% in 2010, 9.58% in 2011, and 8.43% in 2012. The highest prevalence was found in the age groups < 25 and 25-34 years. The prevalence at the Women's Hospital was 8.51%. Cytological examination revealed normal cytology in 64.44% of samples, 26.66 % with low-grade and 8.88 % with high-grade squamous intraepithelial lesion (HSIL). However, by colposcopy, normal tissue appearance was found only in 26.66%; 51% were reclassified as low-grade squamous intraepithelial lesion, 17.77% as HSIL, and in 4.4% atrophy was observed. The most prevalent genotype in single infections was HPV59, followed by HPV51 and HPV45. Double infections occurred with the following genotypes: 52-53, 51-59, 61-67, 66-11, 16-62, 53-62, 59-CP6108, 45-66, and 45-51. Triple infections were identified as: 6-31-39, 51-59-62, 51-62-81, 54-55-59, 16-58-71, and 16-59-62. CONCLUSIONS: The prevalent genotype found among women from Michoacán, HPV59, was different to the rest of the country. The high prevalence of HPV59 could be due to cases imported to Michoacán by agricultural workers migrating to the USA or may be associated to ethnicity differences. Implications of this finding for immunization programs should be explored.


Assuntos
Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/epidemiologia , Lesões Intraepiteliais Escamosas Cervicais/epidemiologia , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Colposcopia , Feminino , Genótipo , Humanos , México/epidemiologia , Pessoa de Meia-Idade , Teste de Papanicolaou , Papillomaviridae/genética , Infecções por Papillomavirus/virologia , Prevalência , Lesões Intraepiteliais Escamosas Cervicais/virologia , Adulto Jovem
15.
J Nutr ; 146(4): 673-80, 2016 04.
Artigo em Inglês | MEDLINE | ID: mdl-26936136

RESUMO

BACKGROUND: Consumption of cocoa-derived polyphenols has been associated with several health benefits; however, their effects on the intestinal microbiome and related features of host intestinal health are not adequately understood. OBJECTIVE: The objective of this study was to determine the effects of eating flavanol-enriched cocoa powder on the composition of the gut microbiota, tissue metabolite profiles, and intestinal immune status. METHODS: Male pigs (5 mo old, 28 kg mean body weight) were supplemented with 0, 2.5, 10, or 20 g flavanol-enriched cocoa powder/d for 27 d. Metabolites in serum, urine, the proximal colon contents, liver, and adipose tissue; bacterial abundance in the intestinal contents and feces; and intestinal tissue gene expression of inflammatory markers and Toll-like receptors (TLRs) were then determined. RESULTS: O-methyl-epicatechin-glucuronide conjugates dose-dependently increased (P< 0.01) in the urine (35- to 204-fold), serum (6- to 186-fold), and adipose tissue (34- to 1144-fold) of pigs fed cocoa powder. The concentration of 3-hydroxyphenylpropionic acid isomers in urine decreased as the dose of cocoa powder fed to pigs increased (75-85%,P< 0.05). Compared with the unsupplemented pigs, the abundance ofLactobacillusspecies was greater in the feces (7-fold,P= 0.005) and that ofBifidobacteriumspecies was greater in the proximal colon contents (9-fold,P= 0.01) in pigs fed only 20 or 10 g cocoa powder/d, respectively. Moreover, consumption of cocoa powder reducedTLR9gene expression in ileal Peyer's patches (67-80%,P< 0.05) and mesenteric lymph nodes (43-71%,P< 0.05) of pigs fed 2.5-20 g cocoa powder/d compared with pigs not supplemented with cocoa powder. CONCLUSION: This study demonstrates that consumption of cocoa powder by pigs can contribute to gut health by enhancing the abundance ofLactobacillusandBifidobacteriumspecies and modulating markers of localized intestinal immunity.


Assuntos
Chocolate/análise , Flavonoides/farmacologia , Microbioma Gastrointestinal , Intestinos/microbiologia , Tecido Adiposo/metabolismo , Animais , Bifidobacterium/isolamento & purificação , Biomarcadores/sangue , Biomarcadores/urina , Peso Corporal , Catequina/análogos & derivados , Catequina/urina , Relação Dose-Resposta a Droga , Fezes/química , Fezes/microbiologia , Expressão Gênica , Glucuronídeos/urina , Mucosa Intestinal/metabolismo , Lactobacillus/isolamento & purificação , Masculino , Nódulos Linfáticos Agregados/metabolismo , Fenóis/urina , Polifenóis/farmacologia , Propionatos/urina , Suínos , Receptor Toll-Like 9/genética , Receptor Toll-Like 9/metabolismo
16.
Rev Biol Trop ; 64(4): 1759-70, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29465951

RESUMO

Sulfate-reducing bacteria (SRB) and methanogenic archaea (MA) share common niches in coastal sediments during the terminal phases of the anaerobic mineralization of organic matter. The purpose of this study was to analyze the spatial - temporal variation of SRB and MA in the sediments of a tropical coastal lagoon with ephemeral inlet (La Mancha, Veracruz, Gulf of Mexico) and its relationship with environmental changes. A total of 24 sediment samples were collected during the dry (April, May), rainy (July, September) and Northern (November, February) seasons in the period 2013-2014. Microbiological analyses included the quantification of the viable SRB and MA with different substrates, as well as mineralization experiments to determine the effect of sulfate on acetate oxidation. The analyzed environmental variables in the sediments included: temperature, pH, Eh, salinity, sulfates, H2S, volatile solids, carbohydrates, and granulometric characteristics. Major changes occurred between the dry and rainy seasons. During the dry season, sulfate-reducing abundance was significantly greater with lactate (8.3x105 - 1.2x107 cells / g) and propionate (1.8x105 - 6.6x106 cells / g) as substrates, while the MA that use methanol were dominant (4.2x105 - 9.1x106 cells / g). In contrast, during the rainy season, hydrogenophylic (2.6x105 - 8.3x106 cells/g) and acetoclastic (5.4x105-6.4x106 cells / g) MA increased significantly and SRB decreased in the analyzed substrates. An apparent competition for acetate was observed, with a greater oxidation in the media with sulfates in the dry season (0.06 mM acetate / g sediment / day), and a greater oxidation in the media without sulfates in the rainy season (0.02 mM acetate / g sediment / day). SRB and MA were present throughout the sediment column, however SRB dominated in the first centimeters of the sediment while MA were abundant in deeper layers. In conclusion, SRB and MA together played a role in the mineralization of organic matter in the sediments of La Mancha lagoon, with sulfate-reduction dominating in the dry season (closed inlet) and methanogenesis during the rainy season (open inlet). Changes in rainfall and river input in this lagoon significantly affect salinity and sulfate content, the main factors that regulate the dynamics of SRB and MA in the sediments.


Assuntos
Archaea/isolamento & purificação , Água Doce/microbiologia , Sedimentos Geológicos/microbiologia , Microbiota , Análise Espaço-Temporal , Bactérias Redutoras de Enxofre/isolamento & purificação , Acetatos/metabolismo , Análise de Variância , Archaea/metabolismo , Golfo do México , Metano/biossíntese , Chuva , Valores de Referência , Estações do Ano , Sulfatos/metabolismo , Temperatura , Fatores de Tempo , Clima Tropical
17.
J Nutr ; 145(11): 2448-55, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26423732

RESUMO

BACKGROUND: Preclinical and epidemiologic studies suggest that garlic intake is inversely associated with the progression of cancer and cardiovascular disease. OBJECTIVE: We designed a study to probe the mechanisms of garlic action in humans. METHODS: We conducted a randomized crossover feeding trial in which 17 volunteers consumed a garlic-containing meal (100 g white bread, 15 g butter, and 5 g raw, crushed garlic) or a garlic-free control meal (100 g white bread and 15 g butter) after 10 d of consuming a controlled, garlic-free diet. Blood was collected before and 3 h after test meal consumption for gene expression analysis in whole blood. Illumina BeadArray was used to screen for genes of interest, followed by real-time quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) on selected genes. To augment human study findings, Mono Mac 6 cells were treated with a purified garlic extract (0.5 µL/mL), and mRNA was measured by qRT-PCR at 0, 3, 6, and 24 h. RESULTS: The following 7 genes were found to be upregulated by garlic intake: aryl hydrocarbon receptor (AHR), aryl hydrocarbon receptor nuclear translocator (ARNT), hypoxia-inducible factor 1α (HIF1A), proto-oncogene c-Jun (JUN), nuclear factor of activated T cells (NFAT) activating protein with immunoreceptor tyrosine-based activation motif 1 (NFAM1), oncostatin M (OSM), and V-rel avian reticuloendotheliosis viral oncogene homolog (REL). Fold-increases in mRNA transcripts ranged from 1.6 (HIF1A) to 3.0 (NFAM1) (P < 0.05). The mRNA levels of 5 of the 7 genes that were upregulated in the human trial were also upregulated in cell culture at 3 and 6 h: AHR, HIF1A, JUN, OSM, and REL. Fold-increases in mRNA transcripts in cell culture ranged from 1.7 (HIF1A) to 12.1 (JUN) (P < 0.01). OSM protein was measured by ELISA and was significantly higher than the control at 3, 6, and 24 h (24 h: 19.5 ± 1.4 and 74.8 ± 1.4 pg/mL for control and garlic, respectively). OSM is a pleiotropic cytokine that inhibits several tumor cell lines in culture. CONCLUSION: These data indicate that the bioactivity of garlic is multifaceted and includes activation of genes related to immunity, apoptosis, and xenobiotic metabolism in humans and Mono Mac 6 cells. This trial is registered at clinicaltrials.gov as NCT01293591.


Assuntos
Administração Oral , Linfócitos B/imunologia , Alho , Linfócitos T/imunologia , Translocador Nuclear Receptor Aril Hidrocarboneto/sangue , Translocador Nuclear Receptor Aril Hidrocarboneto/genética , Fatores de Transcrição Hélice-Alça-Hélice Básicos/sangue , Fatores de Transcrição Hélice-Alça-Hélice Básicos/genética , Linhagem Celular , Estudos Cross-Over , Feminino , Humanos , Subunidade alfa do Fator 1 Induzível por Hipóxia/sangue , Subunidade alfa do Fator 1 Induzível por Hipóxia/genética , Masculino , Proteínas de Membrana/sangue , Proteínas de Membrana/genética , Pessoa de Meia-Idade , Oncostatina M/sangue , Oncostatina M/genética , Proto-Oncogene Mas , Proteínas Proto-Oncogênicas c-jun/sangue , Proteínas Proto-Oncogênicas c-jun/genética , RNA Mensageiro/sangue , RNA Mensageiro/metabolismo , Receptores de Hidrocarboneto Arílico/sangue , Receptores de Hidrocarboneto Arílico/genética , Fator de Transcrição RelA/sangue , Fator de Transcrição RelA/genética , Regulação para Cima
18.
J Proteome Res ; 12(9): 3980-92, 2013 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-23805856

RESUMO

Typical clinical biomarker analyses on urine and plasma samples from human dietary interventions do not provide adequate information about diet-induced metabolic changes taking place in tissues. The aim of this study was to show how a large-scale nontargeted metabolomic approach can be used to reveal metabolite groups for generating new hypotheses of obesity-related metabolic disturbances produced in an animal model. A large spectrum of metabolites in the semipolar region, including small water-soluble molecules like betaine and dihydroxyindole, and a wide range of bile acids as well as various lipid species were detected. The high-fat diet influenced metabolic homeostasis of Ossabaw pigs, especially the lipid metabolome, throughout all the analyzed sample types, including plasma, urine, bile, liver, pancreas, brain cortex, intestinal jejunum and proximal colon. However, even dramatic metabolic changes in tissues were not necessarily observed in plasma and urine. Metabolite profiling involving multiple sample types was shown to be a feasible method for the examination of a wide spectrum of metabolic species extending from small water-soluble metabolites to an array of bile acids and lipids, thus pointing to the pathways of metabolism affected by the dietary treatment.


Assuntos
Dieta Hiperlipídica/efeitos adversos , Metabolismo dos Lipídeos , Obesidade/metabolismo , Animais , Ácidos e Sais Biliares/metabolismo , Biomarcadores/sangue , Biomarcadores/urina , Feminino , Humanos , Metaboloma , Obesidade/etiologia , Especificidade de Órgãos , Sus scrofa
19.
J Pediatr Gastroenterol Nutr ; 56(5): 503-11, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23254448

RESUMO

OBJECTIVES: Diarrhea is a leading cause of mortality and morbidity in children younger than 5 years in impoverished regions of the world. Our aim was to compare the fecal microbiota of healthy children with that of children with clinical diarrhea in a population from a tropical highland in Colombia, South America. Our hypothesis was that a reduced prevalence of inherent Lactobacillus and Bifidobacterium species would be associated with enteric viral and bacterial pathogens. METHODS: Children between 1 and 5 years of age from 2 different locations were evaluated for presence of clinical diarrhea. Nucleic acid, isolated from fecal samples, was used to determine by molecular protocols the abundance of inherent bacterial species and presence of enteric pathogens compared with clinically healthy children. The effect of host demographic factors on incidence of diarrhea was also analyzed. RESULTS: : The composition of the fecal microbiota was affected by host demographic factors: age, health status, location, and sex. In partial support of our hypothesis, the relative abundance of commensal Bifidobacterium and Lactobacillus species was inversely correlated with incidence of diarrhea regardless of location. CONCLUSIONS: Our results suggested that changes in fecal microbiota composition of children with clinical diarrhea are associated with certain demographic factors that should be considered before designing a prophylactic intervention. Delivery of certain Lactobacillus species and Bifidobacterium species or a diet rich in bifidogenic components that promote growth of Bifidobacterium species could provide a prophylactic effect to ameliorate the effect of diarrhea in children at risk.


Assuntos
Bifidobacterium , Colo/microbiologia , Diarreia/microbiologia , Fezes/microbiologia , Lactobacillus , Metagenoma , Bifidobacterium/genética , Bifidobacterium/isolamento & purificação , Criança , Pré-Escolar , Colômbia , DNA Bacteriano , Feminino , Humanos , Lactente , Lactobacillus/genética , Lactobacillus/isolamento & purificação , Masculino , Valores de Referência , Clima Tropical
20.
Metabolites ; 13(3)2023 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-36984798

RESUMO

Over 33% of Americans are labeled as obese, leading the World Health Organization to designate obesity as a major public health problem. One consequence of obesity is the development of metabolic syndrome, a condition which has been correlated to an increased risk for developing cardiovascular disease and Type 2 diabetes. Prolonged ingestion of a higher-fat diet, one cause of obesity, results in alterations to the gut microbiome. These alterations are implicated to have a profound role in the evolution and progression of obesity-linked diseases. Probiotics are associated with positive health effects such as limiting pathogen colonization, aiding in digestion, and vitamin synthesis. Using Ossabaw pigs as a model for obesity, and in conjunction with our previous research, we performed an in-depth, nontargeted, metabolomic analysis on select organs to elucidate the effects of dietary supplementation with the probiotic Lacticaseibacillus paracasei. We focused our analysis on the effects of probiotic supplementation on a higher-fat (obesogenic) diet and a nutritionally balanced diet. Notably, our findings reveal that the brain cortex is highly sensitive to dietary influencers, and with probiotic supplementation, several aberrant metabolites associated with a higher-fat diet revert to healthy levels, thus demonstrating the potential for a probiotic intervention for obesity-linked disease.

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