Early Cutaneous Leishmaniasis Patients Infected With Leishmania braziliensis Express Increased Inflammatory Responses After Antimony Therapy.

Background: Early cutaneous leishmaniasis (ECL) is characterized by a nonulcerated papular lesion and illness duration less than 30 days. Approximately 4 weeks later, the cutaneous leishmaniasis (CL) ulcers appear. We were surprised to find that failure after antimony therapy (Sb5) is higher in ECL than CL. We hypothesize that the inflammatory response in ECL patients may increase during Sb5 therapy, which leads to treatment failure. Methods: A cohort of 44 ECL patients infected by Leishmania braziliensis was established to evaluate the response to Sb5 and to compare immunologic responses in ECL patients with CL and healthy subjects. Results: A hierarchical clustering based on cytokine levels showed a weak positive correlation between proinflammatory cytokine levels and those patients that failed Sb5 treatment. Although Sb5 therapy decreased interferon-γ and tumor necrosis factor levels in CL patients, we were surprised to find that an increase in these cytokines was observed in ECL patients. Moreover, interleukin (IL)-10 was less able to down-modulate immune responses in ECL. Conclusions: The enhanced production of proinflammatory cytokines, due in part to the decreased ability of IL-10 to down-modulate immune response during therapy in ECL, promotes the development and persistence of leishmania ulcer despite antimony therapy.

High Anti-Leishmania IgG Antibody Levels Are Associated With Severity of Mucosal Leishmaniasis.

Background: Mucosal leishmaniasis (ML), the most inflammatory form of tegumentary leishmaniasis, is predominantly caused by Leishmania braziliensis. The disease is characterized by the development of lesions, mainly in the nasal mucosa. An exacerbated inflammatory response has been associated with the presence of destructive and disfiguring lesions, with stages of severity ranging from small nodulations to the complete destruction of the nasal pyramid architecture. As Leishmania is an intracellular parasite, most immunological studies have emphasized the cell-mediated immune response, while relatively few studies aimed to investigate the role antibodies in protection against, or the pathology of ML. Methods: Patients with a confirmed diagnosis of ML were classified according to clinical staging criteria. Serum levels of Leishmania-specific IgG, IgG1 and IgG2 antibodies were determined by ELISA before and after treatment with antimony or antimony plus pentoxifylline. Results: Patients in stages IV and V produced higher concentrations of IgG and IgG1 antibodies when compared to those in stage I and II. Significant reductions were seen in the concentrations of IgG and IgG2 antibodies in most patients who responded well to treatment. Conclusions: Our data demonstrate an association between IgG antibody titers and the severity of mucosal disease. The observed reduction in antibody production after successful treatment in most patients preliminarily indicates that these tests can be used to aid in the assessment of therapeutic response.

Virtual extimacy and conjugality: possible repercussions / Extimidade virtual e conjugalidade: possíveis repercussões / Extimidad virtual y conyugalidad: posibles repercusiones

This study aimed to investigate the possible repercussions of "virtual extimacy" in the experience of conjugality today. The notion of intimacy has undergone significant transformations. Historically, intimacy had a strong connection with the idea of privacy. However, today, the transformation of intimacy is remarkable, since the shared information has reached visibility never before imagined. The notion of "virtual extimacy" was constructed to designate this new perspective of intimacy in the internet space. Six married people who were also users of the Facebook social network were interviewed. The interviews were analyzed using the content analysis method. The categories of analysis emerged from these narratives. With these analyses, it was verified that we are facing not a dichotomous phenomenon that separates the virtual from the real, but rather a novelty that joins and intertwines the threads of experience with the other inside and outside the internet.

O presente trabalho tem como objetivo investigar as possíveis repercussões da "extimidade virtual" na vivência da conjugalidade de hoje. A noção de intimidade tem passado por significativas transformações. Historicamente, ela mantinha um forte vínculo com a ideia de privacidade. Contudo, é notória a sua transformação na rede, já que as informações compartilhadas alcançam uma visibilidade nunca antes imaginada. Por esse motivo, a noção de "extimidade virtual" foi escolhida para designar essa nova perspectiva da intimidade na rede. Entrevistaram-se seis pessoas casadas e usuárias do Facebook. As entrevistas foram discutidas por meio do método da análise de conteúdo. Das narrativas emergiram categorias de análise. Verificou-se, a partir das análises, que estamos diante não de um fenômeno dicotômico que separa o virtual do real, mas de uma novidade que une e entrelaça os fios da experiência com o outro, dentro e fora da rede.

El presente trabajo tiene como objetivo investigar las posibles repercusiones de la "extimidad virtual" en la vivencia de la conyugalidad de hoy. La noción de intimidad ha pasado por transformaciones significativas. Históricamente, ella mantenía un fuerte vínculo con la idea de privacidad. Es notoria su transformación en la red, ya que la información compartida alcanza una visibilidad nunca antes imaginada. La "extimidad virtual" fue escogida para designar esta nueva perspectiva de la intimidad observada en el internet. Hemos entrevistado a seis personas casadas y usuarios de Facebook. El análisis de la entrevista fue realizado bajo el método de análisis de contenido. A partir de los relatos han aparecido categorías de análisis. La investigación fue llevada a cabo sin considerar el fenómeno como dicotómico, virtual y real separados, sino como una novedad que une y entrelaza los hilos de la experiencia con otras personas dentro y fuera de la red.