RATE OF INFECTION (TUBERCULOSIS) IN BRAZILIANS IBD PRIVATE PATIENTS: FOLLOW-UP 15 YEARS.

BACKGROUND: Latent tuberculosis (LTB) is a condition where the patient is infected with Mycobacterium tuberculosis but does not develop active TB. There's a possibility of tuberculosis (TB) activation following the introduction of anti-TNFs. OBJECTIVE: To assess the risk of biological therapy inducing LTB during inflammatory bowel diseases (IBD) treatment over 15 years in a high-risk area in Brazil. METHODS: A retrospective study of an IBD patients' database was carried out in a private reference clinic in Brazil. All patients underwent TST testing and chest X-ray prior to treatment, and once a year after starting it. Patients were classified according to the Montreal stratification and risk factors were considered for developing TB. RESULTS: Among the analyzed factors, age and gender were risk factors for LTB. DC (B2 and P) and UC (E2) patients showed a higher number of LTB cases with statistical significance, what was also observed for adalimumab and infliximab users, compared to other medications, and time of exposure to them favored it significantly. Other factors such as enclosed working environment have been reported as risk. CONCLUSION: The risk of biological therapy causing LTB is real, so patients with IBD should be continually monitored. This study reveals that the longer the exposure to anti-TNFs, the greater the risk. BACKGROUND: •Rate of infection (tuberculosis) in Brazilians IBD private patients: follow-up 15 years. BACKGROUND: •Patients treated with immunosuppressants and/or anti-TNFs have a higher risk of developing opportunistic infections, among them the most common is latent tuberculosis or even active tuberculosis. BACKGROUND: •Similar risks may be noted in patients with inflammatory bowel diseases (IBDs). BACKGROUND: •This study reveals that the longer the exposure to anti-TNFs, the greater the risk for de IBD patients. BACKGROUND: •The study demonstrated the importance of monitoring these patients permanently and continuously.

Taxa de infecção (tuberculose) em pacientes particulares brasileiros com DII: acompanhamento de 15 anos / Rate of infection (tuberculosis) in brazilians ibd private patients: follow-up 15 years

ABSTRACT Background: Latent tuberculosis (LTB) is a condition where the patient is infected with Mycobacterium tuberculosis but does not develop active TB. There's a possibility of tuberculosis (TB) activation following the introduction of anti-TNFs. Objective: To assess the risk of biological therapy inducing LTB during inflammatory bowel diseases (IBD) treatment over 15 years in a high-risk area in Brazil. Methods: A retrospective study of an IBD patients' database was carried out in a private reference clinic in Brazil. All patients underwent TST testing and chest X-ray prior to treatment, and once a year after starting it. Patients were classified according to the Montreal stratification and risk factors were considered for developing TB. Results: Among the analyzed factors, age and gender were risk factors for LTB. DC (B2 and P) and UC (E2) patients showed a higher number of LTB cases with statistical significance, what was also observed for adalimumab and infliximab users, compared to other medications, and time of exposure to them favored it significantly. Other factors such as enclosed working environment have been reported as risk. Conclusion: The risk of biological therapy causing LTB is real, so patients with IBD should be continually monitored. This study reveals that the longer the exposure to anti-TNFs, the greater the risk.

RESUMO Contexto: A tuberculose latente (TBL) é uma condição em que o paciente está infectado com Mycobacterium tuberculosis, mas não desenvolve tuberculose (TB) ativa. Existe a possibilidade de ativação da TB após a introdução de anti-TNFs. Objetivo: Avaliar o risco da terapia biológica induzindo TBL durante o tratamento de doenças inflamatórias intestinais (DII) ao longo de 15 anos em uma área de alto risco no Brasil. Métodos: Foi realizado um estudo retrospectivo de um banco de dados de pacientes com DII em uma clínica privada de referência no Brasil. Todos os pacientes foram submetidos a teste de TST e radiografia de tórax antes do tratamento e uma vez por ano após seu início. Os pacientes foram classificados de acordo com a estratificação de Montreal e foram considerados fatores de risco para o desenvolvimento de TB. Resultados: Entre os fatores analisados, a idade e o sexo foram fatores de risco para TBL. Os pacientes com doença de Crohn' (B2 e P) e colite ulcerativa (E2) apresentaram maior número de casos de TBL com significância estatística, o que também foi observado para usuários de adalimumab e infliximab, em comparação com outros medicamentos, e o tempo de exposição a eles favoreceu significativamente. Outros fatores, como ambiente de trabalho fechado, foram relatados como riscos. Conclusão: O risco da terapia biológica causar TBL é real, por isso os pacientes com DII devem ser monitorados continuamente. Este estudo revela que quanto maior a exposição aos anti-TNFs, maior o risco.

Antimicrobial potential of Pectis substriata essential oil (Asteraceae) against drug-resistant Staphylococcus strains.

Resistant bacterial infections represent one of the major threats in worldwide health services. In this scenario, plant essential oils are considered promising antimicrobial agents. Therefore, this study aimed to evaluate the antimicrobial potential of Pectis substriata essential oil alone and in combination with antibiotics, against clinical drug-resistant bacterial strains. The essential oil from the plant aerial parts was obtained by hydrodistillation. Antimicrobial activity was assessed against standard and clinical bacterial strains by broth microdilution method, and the synergistic effect was evaluated by checkerboard microtiter assay. The oil alone showed significant activity against clinical Staphylococcus warneri (62.5 µg.mL-1), and was moderately active on Staphylococcus aureus (standard strain) and clinical Staphylococcus intermedius (125 and 250 µg.mL-1, respectively). Synergism was achieved for the combinations of essential oil and ampicillin on S. warneri and of oil and kanamycin on S. intermedius. Additive effects were also observed. This is the first report of the chemical composition of P. substriata essential oil, and the results revealed the presence of compounds with proven antimicrobial activity. The oil proved active against resistant Gram-positive cocci, and showed synergism with antibiotics, revealing its potential use as adjuvant or in the development of new alternative treatments of drug-resistant antimicrobial infections.

Immunostimulatory effects of the phenolic compounds from lichens on nitric oxide and hydrogen peroxide production / Efeito imunoestimulante de compostos fenólicos de líquens na produção de peróxido de hidrogênio e óxido nítrico

The effects of isolated compounds from Brazilian lichens and their derivatives on H2O2 and NO production were studied using murine macrophages as a part of an attempt to understand their possible immunomodulatory properties. The compound cytotoxicity was studied using MTT assay. Macrophage stimulation was evaluated by the determination of NO (Griess assay) and H2O2 (horseradish peroxidase/phenol red) in supernatants of peritoneal macrophage cultures of Swiss mice. This research demonstrated stimulatory activities of some phenolic compounds isolated from lichens and their derivatives on H2O2 and NO production. Structure-activity relationships suggest several synthetic directions for further improvement of immunological activity.

Os efeitos dos compostos isolados de líquens brasileiros e seus derivados na produção de NO e H2O2 foram estudados utilizando macrófagos murinos na tentativa de desvendar suas possíveis propriedades imunomodulatórias. A citotoxicidade dos compostos foi estudada utilizando o ensaio de MTT. A estimulação dos macrófagos foi avaliada através da determinação de NO (metodologia de Griess) e H2O2 (peroxidase de raíz forte/vermelho de fenol) no sobrenadante de culturas de macrófagos peritoneais de camundongos Swiss. Este estudo demonstrou atividade estimulante de alguns compostos fenólicos e seus derivados na produção de NO e H2O2. A relação estrutura atividade sugere inúmeras direções sintéticas para futuros melhoramentos da atividade imunológica.