Cabozantinib Plus Nivolumab in Patients with Non-Clear Cell Renal Cell Carcinoma: Updated Results from a Phase 2 Trial.

Treatment options are limited for patients with non-clear cell renal cell carcinoma (nccRCC). Patients with nccRCC experienced a favorable objective response rate (ORR) in a phase 2 trial of cabozantinib plus nivolumab. We now report updated efficacy and safety results at median follow-up of 34 mo for patients with papillary, unclassified, or translocation-associated RCC. Cabozantinib and nivolumab were administered at standard doses to patients with metastatic nccRCC that had progressed on zero or one line of systemic therapy. The primary endpoint was the ORR according to Response Evaluation Criteria in Solid Tumors v1.1. Secondary endpoints included progression-free survival (PFS), overall survival (OS), and adverse events. Forty patients were treated. At median follow-up of 34 mo for survivors, the ORR was 48% (95% confidence interval [CI] 31.5-63.9%). Median PFS was 13 mo (95% CI 7-16); the 12-mo and 24-mo PFS rates were 51% (95% CI 34-65%) and 23% (95% CI 11-37%), respectively. Median OS was 28 mo (95% CI 23-43); the 18-mo and 36-mo OS rates were 70% (95% CI 53-82%) and 44% (95% CI 28-60%), respectively. No new safety signals were seen with cabozantinib and nivolumab. This extended follow-up analysis demonstrates promising efficacy, and highlights the potential for sustained responses with cabozantinib plus nivolumab in patients with metastatic nccRCC. PATIENT SUMMARY: We evaluated outcomes for patients with metastatic kidney cancer of the non-clear cell (NCC) type who were treated with cabozantinib + nivolumab. We found that 48% of the patients responded to the treatment, and there were no unexpected side effects. Among patients who responded to the treatment, the response lasted for a median of 17 months. We conclude that cabozantinib + nivolumab is a safe and effective treatment for NCC kidney cancer.

Meta-analysis to Implement Alpha-Synuclein in Extracellular Vesicles as a Potential Biomarker for Parkinson's Disease

ABSTRACT Background: In Parkinson's disease (PD), exosomes carry α-synuclein (α-syn), a fibrillar protein aggregates with potential value as a biomarker. Objective: Evidence on blood levels of exosomal α-syn in PD patients and controls was reviewed for their consistency. Methods: Thirty-six studies on exosomal α-syn concentrations in PD were identified in a systematic literature search and meta-analysis. Results: Both raw and ratio-adjusted blood exosomal α-syn levels were consistently higher in PD patients than in controls. The standardized mean difference (SMD) was 1.54 (0.18-2.90, CI95%, p < 0.01) and 1.53 (0.23-2.83, CI95%, p < 0.01), respectively. Conclusion: Our results suggest that exosomal α-syn concentrations could be a useful biomarker for PD.

Characterization of excretory/secretory products of the Taenia crassiceps cysticercus involved in the induction of regulatory T cells in vivo.

The ability to modulate the host immune response has allowed some parasites to establish themselves in the tissues of an immunocompetent organism. While some parasite excretion/secretion products (ESPs) were recently reported to induce differentiation of regulatory T cells (Tregs), their identity is not known. This work is aimed to identify and characterize ESPs of Taenia crassiceps cysticerci linked with Treg induction in vivo. ESPs were obtained from cultures of T. crassiceps cysticerci and inoculated in mice, measuring Treg levels by flow cytometry. Proteins in ESPs were analyzed by electrophoresis; then, ESPs were classified as either differential or conserved. Differentially included proteins were MS-sequenced and functionally characterized. Only 4 of 10 ESPs induced Tregs. Proteins with catalytic activity and those involved in immunological processes predominated, supporting the idea that these molecules could play an important role in the induction of Tregs.

Efficacy of intravenous immunoglobulin in autoimmune neurological diseases. Literature systematic review and meta-analysis.

BACKGROUND: Corticosteroids are the first-line treatment for several common autoimmune neurological diseases. Other therapeutic approaches, including intravenous immunoglobulin (IVIg) and plasmapheresis, have shown mixed results in patient improvement. OBJECTIVE: To compare the efficacy of IVIg administration with that of corticosteroids, plasmapheresis, and placebo in autoimmune neurological diseases like Guillain-Barré syndrome, myasthenia gravis, chronic inflammatory demyelinating polyneuropathy, optic neuritis, and multiple sclerosis. METHODS: A systematic review was performed on the databases PubMed, MEDLINE, Embase, and Cochrane. Controlled, randomized studies comparing the efficacy of IVIg with placebo, plasmapheresis, and/or glucocorticoid administration were selected. Only studies reporting the number of patients who improved after treatment were included, irrespective of language or publication year. In total, 23 reports were included in the meta-analysis study. RESULTS: Our meta-analysis showed a beneficial effect of IVIg administration on patient improvement over placebo (OR = 2.79, CI [95%] = 1.40-5.55, P = 0.01). Meanwhile, IVIg administration showed virtually identical effects to plasmapheresis (OR = 0.83, CI [95%] = 0.45-1.55, P < 0.01). Finally, no significant differences were found in the efficacy of IVIg and glucocorticoid administration (OR = 0.98, Cl [95%] = 0.58-1.68, P = 0.13). CONCLUSION: IVIg can be regarded as a viable therapeutic approach, either as a first- or second-line therapy, and as an adjuvant therapy for autoimmune neurological diseases.

Regulatory T Cells as an Escape Mechanism to the Immune Response in Taenia crassiceps Infection.

Murine cysticercosis by Taenia crassiceps is a model for human neurocysticercosis. Genetic and/or immune differences may underlie the higher susceptibility to infection in BALB/cAnN with respect to C57BL/6 mice. T regulatory cells (Tregs) could mediate the escape of T. crassiceps from the host immunity. This study is aimed to investigate the role of Tregs in T. crassiceps establishment in susceptible and non-susceptible mouse strains. Treg and effector cells were quantified in lymphoid organs before infection and 5, 30, 90, and 130 days post-infection. The proliferative response post-infection was characterized in vitro. The expression of regulatory and inflammatory molecules was assessed on days 5 and 30 post-infection. Depletion assays were performed to assess Treg functionality. Significantly higher Treg percentages were observed in BALB/cAnN mice, while increased percentages of activated CD127+ cells were found in C57BL/6 mice. The proliferative response was suppressed in susceptible mice, and Treg proliferation occurred only in susceptible mice. Treg-mediated suppression mechanisms may include IL-10 and TGFß secretion, granzyme- and perforin-mediated cytolysis, metabolic disruption, and cell-to-cell contact. Tregs are functional in BALB/cAnN mice. Therefore Tregs could be allowing parasite establishment and survival in susceptible mice but could play a homeostatic role in non-susceptible strains.

A novel, sequencing-free strategy for the functional characterization of Taenia solium proteomic fingerprint.

The flatworm Taenia solium causes human and pig cysticercosis. When cysticerci are established in the human central nervous system, they cause neurocysticercosis, a potentially fatal disease. Neurocysticercosis is a persisting public health problem in rural regions of Mexico and other developing countries of Latin America, Asia, and Africa, where the infection is endemic. The great variability observed in the phenotypic and genotypic traits of cysticerci result in a great heterogeneity in the patterns of molecules secreted by them within their host. This work is aimed to identify and characterize cysticercal secretion proteins of T. solium cysticerci obtained from 5 naturally infected pigs from Guerrero, Mexico, using 2D-PAGE proteomic analysis. The isoelectric point (IP) and molecular weight (MW) of the spots were identified using the software ImageMaster 2D Platinum v.7.0. Since most secreted proteins are impossible to identify by mass spectrometry (MS) due to their low concentration in the sample, a novel strategy to predict their sequence was applied. In total, 108 conserved and 186 differential proteins were identified in five cysticercus cultures. Interestingly, we predicted the sequence of 14 proteins that were common in four out of five cysticercus cultures, which could be used to design vaccines or diagnostic methods for neurocysticercosis. A functional characterization of all sequences was performed using the algorithms SecretomeP, SignalP, and BlastKOALA. We found a possible link between signal transduction pathways in parasite cells and human cancer due to deregulation in signal transduction pathways. Bioinformatics analysis also demonstrated that the parasite release proteins by an exosome-like mechanism, which could be of biological interest.

Treatment-Resistant Human Extraparenchymal Neurocysticercosis: An Immune-Inflammatory Approach to Cysticidal Treatment Outcome.

OBJECTIVE: The aim of this study is to analyze the immune-endocrine profile in neurocysticercosis (NC) patients resistant to cysticidal treatment. METHODS: The inflammatory and regulatory responses of 8 resistant NC patients with extraparenchymal parasites and 5 healthy controls were evaluated through flow cytometry. Serum interleukin levels were measured by ELISA and catecholamines levels by high performance liquid chromatography. RESULTS: Higher percentages of Tr1, CD4+CD25+FOXP3+CD127- and CD4+CD45RO+FOXP3HI were found in NC patients compared with healthy controls, but no difference was found in catecholamine levels. Antigen-specific proliferative immune response was observed in NC patients. Neither anti-inflammatory nor pro-inflammatory cytokines showed differences between patients and controls, but IL-6 levels were lower in treatment-resistant NC patients. In addition, TGFß showed a significant negative correlation with dopamine. CONCLUSIONS: Altogether, these results may point to a modulation of the neuroinflammation in these patients that could indirectly favor cysticercal survival in CNS microenvironment.

Feasibility and results of an intraarterial chemotherapy program for the conservative treatment of retinoblastoma in Argentina.

BACKGROUND: The feasibility and results of intraarterial chemotherapy, also termed ophthalmic artery chemosurgery (OAC), for retinoblastoma in less developed countries have seldom been reported. PROCEDURE: A retrospective evaluation of a program of OAC in Argentina from 2010 to 2015. RESULTS: Ninety-seven eyes from 81 patients (61 bilateral) were analyzed. In 35 eyes, OAC was given as primary therapy and in 62 it was used for the treatment of tumors with partial response or those relapsing after systemic chemoreduction with focal therapy or external-beam radiotherapy. Twenty-two primarily treated eyes had group D and 13 groups B/C. A total of 400 procedures were carried out. Chemotherapy used included combinations of melphalan, carboplatin, and topotecan. There was no mortality associated with OAC. Toxicity included fever and neutropenia in five (1.25%), hypotension and bradycardia during anesthesia in two and femoral thrombosis in one, eyelid edema in nine, and neutropenia or thrombocytopenia in 28 cycles. With a median follow-up of 48.7 months (range 12-79), the 3-year probability of event-free survival (pEFS) (enucleation and/or radiotherapy were considered events) was comparable for patients who received first-line therapy and those treated at relapse (0.65 vs. 0.63, P = 0.5). In the former, the pEFS was 0.91 and 0.43 for groups B/C and D, respectively (P = 0.01). Two patients died of extraocular dissemination after refusal of enucleation. CONCLUSIONS: OAC was feasible with low toxicity. pEFS improved in all groups compared to the previous experience with systemic chemotherapy reducing the use of radiotherapy. The overall mortality associated with OAC is comparable to our previous experience with systemic chemoreduction.

Effect of Transforming Growth Factor-ß upon Taenia solium and Taenia crassiceps Cysticerci.

Taeniids exhibit a great adaptive plasticity, which facilitates their establishment, growth, and reproduction in a hostile inflammatory microenvironment. Transforming Growth Factor-ß (TGFß), a highly pleiotropic cytokine, plays a critical role in vertebrate morphogenesis, cell differentiation, reproduction, and immune suppression. TGFß is secreted by host cells in sites lodging parasites. The role of TGFß in the outcome of T. solium and T. crassiceps cysticercosis is herein explored. Homologues of the TGFß family receptors (TsRI and TsRII) and several members of the TGFß downstream signal transduction pathway were found in T. solium genome, and the expression of Type-I and -II TGFß receptors was confirmed by RT-PCR. Antibodies against TGFß family receptors recognized cysticercal proteins of the expected molecular weight as determined by Western blot, and different structures in the parasite external tegument. In vitro, TGFß promoted the growth and reproduction of T. crassiceps cysticerci and the survival of T. solium cysticerci. High TGFß levels were found in cerebrospinal fluid from untreated neurocysticercotic patients who eventually failed to respond to the treatment (P = 0.03) pointing to the involvement of TGFß in parasite survival. These results indicate the relevance of TGFß in the infection outcome by promoting cysticercus growth and treatment resistance.

Series de Pediatría Garrahan. El niño con cáncer / Garrahan Pediatrics Series. The child with cancer

La sobrevida de los niños con enfermedades oncológicas ha aumentado de manera considerable en las últimas décadas y este logro se alcanzó, entre otros factores, gracias a la detección temprana de la patología, los avances en los métodos diagnósticos, la administración de terapéuticas específicas adaptadas al riesgo y la adecuada implementación de medidas de soporte. Sin embargo, el cuidado de estos pacientes sigue representando un difícil desafío y requiere la conformación de equipos en los que el pediatra cumple un rol fundamental en la atención conjunta con el oncólogo y en la coordinación de la intervención de los demás especialistas. Este nuevo volumen aborda esta interesante temática y entre sus características destacadas se encuentran: El estudio de importantes temas, como la prevención del cáncer en pediatría en el mundo y en la Argentina, y la necesidad de construir programas de integración, educación e investigación en el cáncer pediátrico; el niño con una masa abdominal, con sus estrategias diagnósticas y las eventuales urgencias metabólicas, infectológicas y nutricionales durante el período de inducción, y cómo anticiparlas y prevenirlas; las situaciones clínicas de riesgo, como la compresión medular, el síndrome de vena cava superior y las complicaciones asociadas con la utilización de irinotecán; los aspectos ginecológicos en las niñas con cáncer, como las conductas frente al riesgo de sangrado menstrual durante el período de inducción, la actividad sexual y el embarazo durante el tratamiento, y la preservación de la fertilidad; y la leucemia linfoblástica aguda en etapa de reinducción, período especialmente significativo por la elevada morbilidad y las dificultades en el soporte clínico que requieren estos pacientes. La inclusión en todos los capítulos de casos clínicos ejemplificadores con su evolución y desenlace, textos destacados con los conceptos más importantes y puntos clave para recordar. Una obra sólida y práctica, que transmite la experiencia de los profesionales de una institución del prestigio internacional del Hospital de Pediatría Prof. Dr. Juan P. Garrahan, dedicada a todos los pediatras dondequiera que trabajen al servicio de los niños.

Inmunidad humoral a tétanos, sarampión y rubéola en niños con leucemia linfoblástica aguda luego del tratamiento quimioterápico / Humoral immunity to tetanus, measles and rubella in children with acute lymphoblastic leukemia after chemotherapy

Los regímenes de quimioterapia y los avances en el soporte clínico han mejorado la supervivencia de los niños con leucemia linfoblástica aguda. Son temas de preocupación las secuelas del tratamiento, entre ellas, el daño inmunológico inducido por la terapia inmunosupresora, que se refleja en la pérdida de niveles protectores de anticuerpos provistos por inmunizaciones previas. Nuestro objetivo fue evaluar la presencia de títulos protectores de anticuerpos para sarampión, rubéola y tétanos en pacientes con leucemia linfoblástica aguda luego de haber finalizado el tratamiento quimioterápico. Se incluyeron 61 niños con leucemia linfoblástica aguda asistidos en el Hospital Garrahan, que habían finalizado el tratamiento, como mínimo, 6 meses antes y con vacunación completa previa al diagnóstico. Las tasas de anticuerpos protectores fueron sarampión: 46% (IC 32-59); tétanos: 53% (IC 40-67); rubéola: 60% (IC 47-63). Estos resultados refuerzan la necesidad de reconsiderar la revacunación en este grupo de pacientes.

Chemotherapy regimens and clinical support advances have improved survival in children with acute lymphoblastic leukemia. The after-effects of treatment are a reason for concern, including damage to the immune system induced by immunosuppressive therapy which is reflected in the loss of antibody protection provided by prior immunizations. Our goal was to assess the presence of measles, rubella, and tetanus protective antibody titers among patients with acute lymphoblastic leukemia after completing chemotherapy. Sixty-one children with acute lymphoblastic leukemia seen at the Hospital Garrahan were included; patients had finished their chemotherapy at least 6 months earlier and had a complete immunization schedule before diagnosis. The rates of protective antibodies were 46% (CI: 32-59) for measles, 53% (CI 40-67) for tetanus, and 60% (CI 47-63) for rubella. These results strengthen the need to reconsider revaccination in this group of patients.

Humoral immunity to tetanus, measles and rubella in children with acute lymphoblastic leukemia after chemotherapy. / Inmunidad humoral a tétanos, sarampión y rubéola en niños con leucemia linfoblástica aguda luego del tratamiento quimioterápico.

Chemotherapy regimens and clinical support advances have improved survival in children with acute lymphoblastic leukemia. The after-effects of treatment are a reason for concern, including damage to the immune system induced by immunosuppressive therapy which is reflected in the loss of antibody protection provided by prior immunizations. Our goal was to assess the presence of measles, rubella, and tetanus protective antibody titers among patients with acute lymphoblastic leukemia after completing chemotherapy. Sixty-one children with acute lymphoblastic leukemia seen at the Hospital Garrahan were included; patients had finished their chemotherapy at least 6 months earlier and had a complete immunization schedule before diagnosis. The rates of protective antibodies were 46% (CI: 32-59) for measles, 53% (CI 40-67) for tetanus, and 60% (CI 47-63) for rubella. These results strengthen the need to reconsider revaccination in this group of patients.

Los regímenes de quimioterapia y los avances en el soporte clínico han mejorado la supervivencia de los niños con leucemia linfoblástica aguda. Son temas de preocupación las secuelas del tratamiento, entre ellas, el daño inmunológico inducido por la terapia inmunosupresora, que se refleja en la pérdida de niveles protectores de anticuerpos provistos por inmunizaciones previas. Nuestro objetivo fue evaluar la presencia de títulos protectores de anticuerpos para sarampión, rubéola y tétanos en pacientes con leucemia linfoblástica aguda luego de haber finalizado el tratamiento quimioterápico. Se incluyeron 61 niños con leucemia linfoblástica aguda asistidos en el Hospital Garrahan, que habían finalizado el tratamiento, como mínimo, 6 meses antes y con vacunación completa previa al diagnóstico. Las tasas de anticuerpos protectores fueron sarampión: 46% (IC 32-59); tétanos: 53% (IC 40-67); rubéola: 60% (IC 47-63). Estos resultados refuerzan la necesidad de reconsiderar la revacunación en este grupo de pacientes.

Regulatory T Cells: Molecular Actions on Effector Cells in Immune Regulation.

T regulatory cells play a key role in the control of the immune response, both in health and during illness. While the mechanisms through which T regulatory cells exert their function have been extensively described, their molecular effects on effector cells have received little attention. Thus, this revision is aimed at summarizing our current knowledge on those regulation mechanisms on the target cells from a molecular perspective.

[Omental hernia through esophageal hiatus simulates mediastinal lipomatous tumor]. / Hernia omental a través de hiato esofâgico que imita tumor lipomatoso mediastinal.

Omental hernia through the esophageal hiatus is extemely infrequent. Paraesophageal hiatal hernia with omentum in the herniary sac mimics a mediastinal lipomatous tumor and differential diagnosis should be made. This diagnosis requires experience and knowledge of the differences between these two pathologies. In the following study we describe the case of an omental hernia and the characteristics that make it different from other pathologies.

Hernia omental a través de hiato esofÔgico que imita tumor lipomatoso mediastinal / [Omental hernia through esophageal hiatus simulates mediastinal lipomatous tumor].

Omental hernia through the esophageal hiatus is extemely infrequent. Paraesophageal hiatal hernia with omentum in the herniary sac mimics a mediastinal lipomatous tumor and differential diagnosis should be made. This diagnosis requires experience and knowledge of the differences between these two pathologies. In the following study we describe the case of an omental hernia and the characteristics that make it different from other pathologies.

[Endocarditis caused by Trichoderma longibrachiatumin a patient receiving home parenteral nutrition]. / Endocarditis por Trichoderma longibrachiatum en paciente con nutrición parenteral domiciliaria.

Home parenteral nutrition (HPN) improves the quality of life of the patients although it has complications. Catheter-related infections and mechanical complications are the most frequent ones. We report the case of endocarditis over catheter in a man suffering from short bowel and receiving HPN. The special features of the case are firstly the catheter was a remaining fragment on the right atrial and secondly the infection was caused by Trichoderma longibrachiatum, an isolated fact regarding this pathology so far. Conventional surgery was applied to take the catheter out. Staphylococcus epidermidis, Ochrobactrum anthropi and Trichoderma longibrachiatum were isolated from the surgical specimen. The extraction of the infected catheter along with antibiotic therapy led to the complete recovery of the subject. Ochrobactrum anthropi and Trichoderma longibrachiatum are unusual microorganisms but they are acquiring more relevance. Although there is no agreement about intravascular retained catheter management, the most recommended approach consists on monitoring them and removing the device in case of complications.

La modalidad domiciliaria de la nutrición parenteral (NPD) mejora la calidad de vida de los pacientes, pero tiene complicaciones como infecciones asociadas a catéter (IAC) y complicaciones mecánicas. Presentamos el caso de un paciente con NPD por intestino corto que desarrolla una endocarditis sobre catéter con matices especiales: asentar sobre un catéter abandonado en aurícula derecha y tratarse de una infección con participación de un microorganismo no descrito hasta el momento en esta patología, Trichoderma longibrachiatum. El catéter se extrajo mediante cirugía convencional. En la pieza quirúrgica se aislaron Staphylococcus epidermidis, Ochrobactrum anthropi y Trichoderma longibrachiatum. Combinando el tratamiento antibiótico y la eliminación del foco infeccioso se consiguió la recuperación completa. Ochrobactrum anthropi y Trichoderma longibrachiatum son microorganismos poco habituales, pero que cada vez adquieren mayor relevancia. Aunque no existe acuerdo en el manejo de los catéteres intravasculares "abandonados", es recomendable el seguimiento y eliminarlos en caso de complicación.

Cysticerci drive dendritic cells to promote in vitro and in vivo Tregs differentiation.

Regulatory T cells (Tregs) play a crucial role in immune homeostasis. Treg induction is a strategy that parasites have evolved to modulate the host's inflammatory environment, facilitating their establishment and permanence. In human Taenia solium neurocysticercosis (NC), the concurrence of increased peripheral and central Treg levels and their capacity to inhibit T cell activation and proliferation support their role in controlling neuroinflammation. This study is aimed at identifing possible mechanisms of Treg induction in human NC. Monocyte-derived dendritic cells (DC) from healthy human donors, cocultivated with autologous CD4(+) naïve cells either in the presence or absence of cysticerci, promoted CD25(high)Foxp3+ Treg differentiation. An increased Treg induction was observed when cysticerci were present. Moreover, an augmentation of suppressive-related molecules (SLAMF1, B7-H1, and CD205) was found in parasite-induced DC differentiation. Increased Tregs and a higher in vivo DC expression of the regulatory molecules SLAMF1 and CD205 in NC patients were also found. SLAMF1 gene was downregulated in NC patients with extraparenchymal cysticerci, exhibiting higher inflammation levels than patients with parenchymal parasites. Our findings suggest that cysticerci may modulate DC to favor a suppressive environment, which may help parasite establishment, minimizing the excessive inflammation, which may lead to tissue damage.

Usefulness of serological ELISA assay for Taenia saginata to detect naturally infected bovines.

Bovine cysticercosis, a cosmopolitan disease caused by Taenia saginata, leads to economic losses due to carcass devaluation at slaughter. Sanitary inspection at slaughterhouses, the routine diagnostic method in Brazil, lacks the necessary sensitivity to detect the mildly infected cattle that are typically encoutered in Brazil. In this study we have tested cattle sera from animals diagnosed as positive and negative by veterianry inspection for (1) anti-parasite antibodies using metacestodes antigens (T. solium vesicular fluid and T. saginata secretions) and (2) the HP10 secreted antigen of viable metacestodes. The cut-off values were calculated by ROC curve for intense and mild infections conditions, and by the classical method ( for negative samples). The sensitivity and specificity of these diagnostic tests were different depending on the assumed cut-off value and, importantly, whether the infection was mild or intense. In spite of these observations, however, such ELISA assays for serum antibodies and parasite antigens constitute an important tool for epidemiological porposes, and in establishing priorities for the control of bovine cysticercosis.

Usefulness of serological ELISA assay for Taenia saginata to detect naturally infected bovines / Utilização de teste sorológico ELISA para a detecção de bovinos naturalmente infectados por Taenia saginata

Bovine cysticercosis, a cosmopolitan disease caused by Taenia saginata, leads to economic losses due to carcass devaluation at slaughter. Sanitary inspection at slaughterhouses, the routine diagnostic method in Brazil, lacks the necessary sensitivity to detect the mildly infected cattle that are typically encoutered in Brazil. In this study we have tested cattle sera from animals diagnosed as positive and negative by veterianry inspection for (1) anti-parasite antibodies using metacestodes antigens (T. solium vesicular fluid and T. saginata secretions) and (2) the HP10 secreted antigen of viable metacestodes. The cut-off values were calculated by ROC curve for intense and mild infections conditions, and by the classical method ( X + 2DP for negative samples). The sensitivity and specificity of these diagnostic tests were different depending on the assumed cut-off value and, importantly, whether the infection was mild or intense. In spite of these observations, however, such ELISA assays for serum antibodies and parasite antigens constitute an important tool for epidemiological porposes, and in establishing priorities for the control of bovine cysticercosis.

A cisticercose bovina, uma doença cosmopolita causada pela Taenia saginata, resulta em perdas econômicas devido á desvalorização de carcaças durante o abate. A inspeção sanitária nos frigoríficos, método de diagnóstico de rotina no Brasil, não possui sensibilidade necessária para detectar animais levemente infectados, os quais são tipicamente encontrados no Brasil. Neste estudo testou-se soro de animais diagnosticados positivos e negativos pela inspeção veterinária por (1) anticorpos anti-parasita usando antígenos de metacestóides (fluido vesicular de T. solium e secreções de T. saginata) e (2) antígeno secretado de metacestóides viáveis. Os pontos de corte foram calculados pela curva ROC, considerando condições de intensa e leve infeção, e pelo método clássicoo ( X + 2DP das amostras negativas).. A sensibilidade e a especificidade dos testes diagnósticos foram diferentes dependendo do valor de ponto de corte assumido e, sobretudo, se a infecção era intensa ou leve. Apesar destas observações, no entanto, tanto o ensaio ELISA para anticorpos séricos quanto para antígeno de parasita constituem importante ferramenta para propósitos epidemiológicos e no estabelecimento de prioridades no controle da cisticercose bovina.

Human neurocysticercosis: immunological features involved in the host's susceptibility to become infected and to develop disease.

Human neurocysticercosis (NC) is a clinically and radiologically heterogeneous disease caused by the establishment of Taenia solium larvae in the central nervous system. Herein, the immunological and endocrinological features involved in resistance to infection and severe forms of the disease are reviewed, and their clinical relevance is discussed.