RESUMO
BACKGROUND: The SARS-CoV-2 pandemic has spurred an unparalleled scientific endeavor to elucidate the virus' structure, infection mechanisms, and pathogenesis. Two-dimensional culture systems have been instrumental in shedding light on numerous aspects of COVID-19. However, these in vitro systems lack the physiological complexity to comprehend the infection process and explore treatment options. Three-dimensional (3D) models have been proposed to fill the gap between 2D cultures and in vivo studies. Specifically, spheroids, composed of lung cell types, have been suggested for studying SARS-CoV-2 infection and serving as a drug screening platform. METHODS: 3D lung spheroids were prepared by coculturing human alveolar or bronchial epithelial cells with human lung stromal cells. The morphology, size, and ultrastructure of spheroids before and after SARS-CoV-2 infection were analyzed using optical and electron microscopy. Immunohistochemistry was used to detect spike protein and, thus, the virus presence in the spheroids. Multiplex analysis elucidated the cytokine release after virus infection. RESULTS: The spheroids were stable and kept their size and morphology after SARS-CoV-2 infection despite the presence of multivesicular bodies, endoplasmic reticulum rearrangement, tubular compartment-enclosed vesicles, and the accumulation of viral particles. The spheroid responded to the infection releasing IL-6 and IL-8 cytokines. CONCLUSION: This study demonstrates that coculture spheroids of epithelial and stromal cells can serve as a cost-effective infection model for the SARS-CoV-2 virus. We suggest using this 3D spheroid as a drug screening platform to explore new treatments related to the cytokines released during virus infection, especially for long COVID treatment.
Assuntos
COVID-19 , Avaliação Pré-Clínica de Medicamentos , Pulmão , SARS-CoV-2 , Esferoides Celulares , Humanos , Esferoides Celulares/virologia , COVID-19/virologia , SARS-CoV-2/fisiologia , Pulmão/virologia , Pulmão/patologia , Tratamento Farmacológico da COVID-19 , Antivirais/farmacologia , Antivirais/uso terapêutico , Técnicas de Cocultura , Citocinas/metabolismo , Análise Custo-Benefício , Células Epiteliais/virologiaRESUMO
BACKGROUND: Zika virus infections and suspected microcephaly cases have been reported in Angola since late 2016, but no data are available about the origins, epidemiology, and diversity of the virus. We aimed to investigate the emergence and circulation of Zika virus in Angola. METHODS: Diagnostic samples collected by the Angolan Ministry of Health as part of routine arboviral surveillance were tested by real-time reverse transcription PCR by the Instituto Nacional de Investigação em Saúde (Ministry of Health, Luanda, Angola). To identify further samples positive for Zika virus and appropriate for genomic sequencing, we also tested samples from a 2017 study of people with HIV in Luanda. Portable sequencing was used to generate Angolan Zika virus genome sequences from three people positive for Zika virus infection by real-time reverse transcription PCR, including one neonate with microcephaly. Genetic and mobility data were analysed to investigate the date of introduction and geographical origin of Zika virus in Angola. Brain CT and MRI, and serological assays were done on a child with microcephaly to confirm microcephaly and assess previous Zika virus infection. FINDINGS: Serum samples from 54 people with suspected acute Zika virus infection, 76 infants with suspected microcephaly, 24 mothers of infants with suspected microcephaly, 336 patients with suspected dengue virus or chikungunya virus infection, and 349 samples from the HIV study were tested by real-time reverse transcription PCR. Four cases identified between December, 2016, and June, 2017, tested positive for Zika virus. Analyses of viral genomic and human mobility data suggest that Zika virus was probably introduced to Angola from Brazil between July, 2015, and June, 2016. This introduction probably initiated local circulation of Zika virus in Angola that continued until at least June, 2017. The infant with microcephaly in whom CT and MRI were done had brain abnormalities consistent with congenital Zika syndrome and serological evidence for Zika virus infection. INTERPRETATION: Our analyses show that autochthonous transmission of the Asian lineage of Zika virus has taken place in Africa. Zika virus surveillance and surveillance of associated cases of microcephaly throughout the continent is crucial. FUNDING: Royal Society, Wellcome Trust, Global Challenges Research Fund (UK Research and Innovation), Africa Oxford, John Fell Fund, Oxford Martin School, European Research Council, Departamento de Ciência e Tecnologia/Ministério da Saúde/National Council for Scientific and Technological Development, and Ministério da Educação/Coordenação de Aperfeicoamento de Pessoal de Nível Superior.
Assuntos
Surtos de Doenças , Transmissão Vertical de Doenças Infecciosas , Filogenia , Complicações Infecciosas na Gravidez/virologia , Infecção por Zika virus/epidemiologia , Infecção por Zika virus/transmissão , Zika virus/genética , Angola/epidemiologia , Sequência de Bases , Feminino , Genoma Viral/genética , Genótipo , Humanos , Lactente , Recém-Nascido , Masculino , Microcefalia/sangue , Microcefalia/etiologia , Microcefalia/virologia , Mães , Gravidez , RNA Viral/genética , Infecção por Zika virus/complicações , Infecção por Zika virus/virologiaRESUMO
Brazil is a low-and-middle income country (LMIC) that, despite having a large population and continental dimensions, has been able to successfully fight HIV/AIDS through a number of governmental and societal measures. These included an early response to the epidemic, the development of a universal and free public health system, incisive discussions with pharmaceutical companies to reduce antiretroviral (ARV) drug prices, investments towards the development of generic drugs and compulsory licensing of ARVs. Through such measures, Brazil is among the leading LMIC towards achieving the 90-90-90 UNAIDS goals in the years to come. In this review, we analyze Brazil's progress throughout the HIV/AIDS epidemic to achieve state-of-the-art ARV treatment and to reduce AIDS mortality in the country. The top-quality HIV/AIDS research in Brazil towards HIV prophylactic and functional cure, the next step towards the economic sustainability of the battle against HIV, is also discussed.
Assuntos
Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Síndrome da Imunodeficiência Adquirida/economia , Antirretrovirais/economia , Antirretrovirais/uso terapêutico , Política de Saúde , Síndrome da Imunodeficiência Adquirida/prevenção & controle , Brasil , Atenção à Saúde/economia , Atenção à Saúde/normas , Acessibilidade aos Serviços de Saúde , Humanos , Pesquisa/economia , Pesquisa/legislação & jurisprudênciaRESUMO
Antiretroviral therapy (ART) can be compromised by selection of drug resistance strains, which can be promoted by lack of adherence during therapy and drug tolerance, and some of these drug-resistant strains can persist for years as minority populations. The K103N drug resistance mutation is selected by the use of non-nucleotide reverse transcriptase inhibitors, including nevirapine or efavirenz (EFV), used in low-income countries. Here we describe the use of a less expensive qualitative point mutation polymerase chain reaction (PMqPCRK103N) targeting K103N mutation. To validate the use of this methodology, we tested previously sequenced samples from patients treated with highly active ART with viral loads above 2,000 copies/ml and compared the results of our assay with Illumina deep sequencing. Due to its low cost and high specificity, this test is particularly suitable for low-income countries to screen for pretreatment resistance in patients either initiating ART or failing first-line regimens containing EFV.
Assuntos
Monitoramento de Medicamentos/métodos , Farmacorresistência Viral , Infecções por HIV/diagnóstico , Infecções por HIV/tratamento farmacológico , Reação em Cadeia da Polimerase/métodos , Inibidores da Transcriptase Reversa/uso terapêutico , Alcinos , Benzoxazinas/uso terapêutico , Custos e Análise de Custo , Ciclopropanos , Monitoramento de Medicamentos/economia , Técnicas de Genotipagem/economia , Técnicas de Genotipagem/métodos , Infecções por HIV/virologia , Humanos , Mutação de Sentido Incorreto , Nevirapina/uso terapêutico , Mutação Puntual , Reação em Cadeia da Polimerase/economia , Sensibilidade e Especificidade , Falha de TratamentoRESUMO
This article examines the Brazilian innovation policy for vaccines and its impact on infectious diseases, with emphasis on advances in translational science. The results indicate significant progress, with a rapid increase over the past two decades in the number of vaccine research groups, indicating scientific excellence. Advances and gaps in technological development and in public-private partnership initiatives were also identified. We stress the crucial role of partnerships, technology transfer, and targeted policies that could accelerate Brazil's participation in global vaccine research and development. We propose that new strategies should be urgently conceived to strengthen the links between the scientific and technological policies, the National Health System, and the National Immunizations Program in Brazil to provide access to low-cost vaccines to address major public health challenges. We also discuss the lessons learned from the Brazilian experience in the implementation of governmental policies on vaccine innovation that could be applicable to other developing countries.