ABSTRACT
The human papillomavirus (HPV) is the main causative agent of cervical cancer, characterized by neoplastic lesions in the cervix. Based on the morphology of the cells of the uterine cervix, the findings are classified as negative intraepithelial lesions for malignancies, low-grade squamous intraepithelial lesions, high-grade squamous intraepithelial lesions (HSILs), atypical squamous cells of undetermined significance and atypical squamous cells of undetermined significance without excluding HSILs (ASCs-H). The progression of neoplastic lesions is related to the cervix's microenvironmental inflammatory process and mediated by the expression and stimulation of cytokines. Cervical mucus is a viscous liquid secretion composed of proteins, inorganic components, pro-and anti-inflammatory agents, and an important protective barrier. This study aimed to quantify and correlate cytokines IL-6, IL-8, and IL-10 and Melatonin in cervical mucus. According to the results, a decrease in MLT was observed in LSIL, HSI, and ASC-H groups than in the NILM group. The cytokines IL-6 and IL-8 showed greater expression in the LSIL and HSIL groups than the NILM group. HSIL group showed a negative correlation between the MLT and IL-6 and IL-8 concentrations. In the ASC-US group, IL8 level was positively correlated to MLT levels. We suggest that IL-6, IL-8, and MLT levels in HSIL groups are decisive for the progression of neoplastic lesions in HPV infections. New cervical cancer treatment strategies may include cytokine and melatonin control targets for effective immunotherapy.
Subject(s)
Cervix Mucus/metabolism , Cytokines/metabolism , Melatonin/metabolism , Papillomaviridae , Papillomavirus Infections/metabolism , Adult , Biomarkers , Cytokines/genetics , DNA, Viral , Female , Histocytochemistry , Humans , Liquid Biopsy , Papillomaviridae/genetics , Papillomavirus Infections/complications , Papillomavirus Infections/virology , Polymerase Chain Reaction , Uterine Cervical Neoplasms/etiology , Uterine Cervical Neoplasms/metabolism , Young AdultABSTRACT
Infection with human papillomavirus (HPV) is the main cause of cervical cancer. Viral persistence is considered the main risk factor for neoplastic progression and evidence suggests that regulatory T cells (Treg) play an important role in the failure of viral elimination. The aim of this study was to detect phenotypic markers of Treg and cytokines interleukin (IL)-10 and transforming growth factor (TGF)-ß, in the cervical microenvironment of HPV-infected patients. One hundred and one samples of uterine cervix embedded in paraffin were analyzed. We used immunohistochemistry to examine the coexpression of the CD25/FOXP3 and CD4/TGF-ß markers, and the expression of GITR and IL-10 in cells present in the cervical stroma. We detected a microenvironment composed of high proportions of CD25+ FOXP3+ , CD4+ TGFß+ , IL-10+ , and GITR+ cells in samples with high viral loads and severe lesions of HPV-infected patients. The abundance of these markers, indicative of the presence of Treg cells and immunosuppressive cytokines, was significantly associated with severe lesions and elevated viral loads in the examined samples. These results suggest that Treg cells may be involved in maintaining a microenvironment favorable for viral persistence and neoplastic progression. Our findings support those of previous studies that suggested that these markers could be used to predict HPV persistence and neoplastic progression, and as potential targets for immune response modulation.
Subject(s)
Cervix Uteri/pathology , Cytokines/analysis , Papillomavirus Infections/pathology , T-Lymphocyte Subsets/chemistry , T-Lymphocyte Subsets/immunology , T-Lymphocytes, Regulatory/chemistry , T-Lymphocytes, Regulatory/immunology , Adolescent , Adult , Aged , Cervix Uteri/virology , Female , Humans , Middle Aged , Papillomaviridae/immunology , Papillomavirus Infections/virology , Viral Load , Young AdultABSTRACT
Persistent infection by high-risk oncogenic human papillomavirus (HR-HPV) is the main cause of cervical cancer and its precursor lesions, and both the systemic and local immunological responses play an important role in eliminating or maintenance this infection. Th17 cells, as well as interleukin (IL)-17, are related to tumor growth and persistence of viral infection. Thus, this study aimed to quantify IL-17 in the serum and exfoliated cervical cells of HR-HPV-infected patients and healthy patients as well as identify CD4+IL17+ cells and IL-17 production in uterine cervix biopsies to better understand the behavior of this cytokine in HPV infections. IL-17 was quantified (pg/mL) in the serum and exfoliated cervical cells of 26 HR-HPV-infected patients, and in 18 healthy patients, using flow cytometry. Fifteen paraffin-embedded biopsy samples from the uterine cervix were subjected to immunohistochemistry to detect CD4+IL-17+ and IL-17+ cells. There was a significant increase in the concentration of IL-17 in HR-HPV-positive patients' serum when compared to that in samples of exfoliated cervical cells (pâ¯<â¯0.05). Likewise, when compared with that in healthy patients, the IL-17 concentration was still higher in HR-HPV-positive patients sera (pâ¯<â¯0.05). We did not find differences in the amount of CD4+IL-17+ cells and other IL-17-secreting cells between different histopathological lesions. Our results suggest that HR-HPV infection predominantly stimulates systemic IL-17 production along with less localized expression.
Subject(s)
Cervix Uteri/pathology , Cervix Uteri/virology , Interleukin-17/blood , Oncogenes , Papillomaviridae/physiology , Papillomavirus Infections/blood , Adult , Biopsy , CD4 Antigens/metabolism , Female , Humans , Middle Aged , Papillomavirus Infections/pathology , Risk FactorsABSTRACT
A specific immune response to human papillomavirus (HPV) in the cervical microenvironment plays a key role in eradicating infection and eliminating mutated cells. However, high-risk HPVs modulate immune cells to create an immunosuppressive microenvironment, and induce these immune cells to produce interleukin 10 (IL-10). This production of IL-10, in conjunction with HPV infection, contributes to the appearance of cervical neoplastic lesions. We sought to characterize the IL-10-producing cellular phenotype, and investigate the influence of host and HPV factors upon the induction of an immunosuppressive microenvironment. Immunohistochemical analysis demonstrated an increase in IL-10 production by keratinocytes, macrophages and Langerhans cells in high-grade cervical lesions and cervical cancer. This increase was more pronounced in patients older than 30 years, and was also correlated with high viral load, and infection with a single HPV type, particularly high-risk HPVs. Our results indicate the existence of a highly immunosuppressive microenvironment composed of different IL-10-producing cellular phenotypes in cervical cancer samples, and samples classified as high-grade cervical lesions (cervical intraepithelial neoplasia stages II and III). The immunosuppressive microenvironment that developed for these different cellular phenotypes favours viral persistence and neoplastic progression.
Subject(s)
Immune Tolerance/immunology , Interleukin-10/biosynthesis , Papillomavirus Infections/immunology , Uterine Cervical Dysplasia/immunology , Uterine Cervical Neoplasms/immunology , Adolescent , Adult , Aged , Aging , Female , Human papillomavirus 16/immunology , Human papillomavirus 18/immunology , Humans , Interleukin-10/immunology , Keratinocytes/metabolism , Langerhans Cells/metabolism , Macrophages/metabolism , Middle Aged , Papillomavirus Infections/virology , Tumor Microenvironment/immunology , Uterine Cervical Neoplasms/virology , Viral Load , Young Adult , Uterine Cervical Dysplasia/virologyABSTRACT
The prevalence of human papillomavirus (HPV) infection is the highest in young, sexually active women less than 35 years of age. Direct diagnosis of infection by enabling genotyping methods is important considering that the viral types are divided into high (HR-HPV) and low (LR-HPV) oncogenic risk. This study aimed to evaluate the epidemiological and molecular characteristics of HPV infection in self-collected samples from young women. A cross-sectional study of 245 sexually active students (18 to 35 years of age) was undertaken with self-collected samples. Extracted DNA was analyzed by polymerase chain reaction (PCR) with the PGMY 09/11 and PC04/GH20 primers for the detection of HPV DNA and the ß-globin gene, respectively. Viral genotyping was performed by type-specific PCR (TS-PCR) and restriction fragment length polymorphism (RFLP). Of the 236 valid samples, 68 (28.9%) were positive for HPV DNA, as genotyped by TS-PCR and RFLP. The HR-HPV were most prevalent, especially HPV-16, -31, -33, and -45, and the most prevalent LR-HPV were HPV-6 and -83. Multi-type HPV infections were detected in 17 (25%) samples. HPV infection was statistically more prevalent among younger women with lower educational levels and who had more partners in the past 2 years. A high prevalence of HPV infection was found in the age group examined, especially HR-HPV types, as well as the presence of risk behaviors associated with HPV infection were observed. Considering these results, vaccinating females before the onset of sexual activity in Brazil should be emphasized.
Subject(s)
Papillomaviridae/classification , Papillomaviridae/isolation & purification , Papillomavirus Infections/diagnosis , Papillomavirus Infections/epidemiology , Specimen Handling/methods , Adolescent , Adult , Brazil , Cross-Sectional Studies , DNA, Viral/genetics , Female , Genotype , Genotyping Techniques , Humans , Molecular Epidemiology , Papillomaviridae/genetics , Polymerase Chain Reaction , Polymorphism, Restriction Fragment Length , Prevalence , Self Care/methods , Students , Young AdultABSTRACT
Women infected with human papillomavirus (HPV) are at a higher risk of developing cervical lesions. In the current study, self and clinician-collected vaginal and cervical samples from women were processed to detect HPV DNA using polymerase chain reaction (PCR) with PGMY09/11 primers. HPV genotypes were determined using type-specific PCR. HPV DNA detection showed good concordance between self and clinician-collected samples (84.6%; kappa = 0.72). HPV infection was found in 30% women and genotyping was more concordant among high-risk HPV (HR-HPV) than low-risk HPV (HR-HPV). HPV16 was the most frequently detected among the HR-HPV types. LR-HPV was detected at a higher frequency in self-collected; however, HR-HPV types were more frequently identified in clinician-collected samples than in self-collected samples. HPV infections of multiple types were detected in 20.5% of clinician-collected samples and 15.5% of self-collected samples. In this study, we demonstrated that the HPV DNA detection rate in self-collected samples has good agreement with that of clinician-collected samples. Self-collected sampling, as a primary prevention strategy in countries with few resources, could be effective for identifying cases of HR-HPV, being more acceptable. The use of this method would enhance the coverage of screening programs for cervical cancer.
Subject(s)
Cervix Uteri/virology , Papillomaviridae/genetics , Papillomavirus Infections/diagnosis , Specimen Handling/methods , Adult , Aged , DNA, Viral/analysis , Female , Genotype , Humans , Middle Aged , Papillomaviridae/isolation & purification , Polymerase Chain Reaction , Self Care/methods , Sensitivity and Specificity , Young AdultABSTRACT
OBJECTIVE: To understand health professionals' perceptions about vaccination against human papillomavirus (HPV) in the Santa Mônica rural settlement in Terenos, Mato Grosso do Sul. METHODS: Quantitative and qualitative methodologies, consultations on vaccination cards, records of community health agents and the focus group technique were used. The main factors of hesitation and vaccine refusal were analyzed, as well as the health team's strategies for the process of immunization against HPV, from June to August 2018. RESULTS: Of 121 children and adolescents, 81 (66.94%) received the complete vaccination schedule. Complete vaccination coverage for women was 73.17% (60/82) and for men, 53.8% (21/39). It was observed that, although strategies are adopted for vaccine promotion, such as mobile actions, the public is resistant due to superficial knowledge about the vaccine and its use in an early age group, showing itself to be susceptible to the negative influence of the media and to society's taboos. In addition, difficulties regarding the use of the Unified Health System card and the shortage of professionals were also observed. CONCLUSION: The results explain the immunization coverage below the target and reinforce the need to strengthen the family health strategy, as well as the permanent and continuing education of professionals, in order to increase parental confidence and adherence to vaccination.
Subject(s)
Papillomavirus Infections , Papillomavirus Vaccines , Male , Child , Adolescent , Humans , Female , Human Papillomavirus Viruses , Papillomavirus Infections/prevention & control , Immunization Programs , Brazil , Vaccination , Health Knowledge, Attitudes, Practice , Patient Acceptance of Health CareABSTRACT
Persistent human papillomavirus (HPV) infection is closely associated with cervical carcinoma. Co-infection in the endocervical environment with other microorganisms, such as Chlamydia trachomatis, may increase the risk of HPV infection and neoplastic progression. While in some individuals, Chlamydia trachomatis infection is resolved with the activation of Th1/IFN-γ-mediated immune response, others develop a chronic infection marked by Th2-mediated immune response, resulting in intracellular persistence of the bacterium and increasing the risk of HPV infection. This work aimed to quantify cytokines of the Th1/Th2/Th17 profile in exfoliated cervix cells (ECC) and peripheral blood (PB) of patients positive for Chlamydia trachomatis DNA, patients positive for Papillomavirus DNA, and healthy patients. Cytokine levels were quantified by flow cytometry in ECC and PB samples from patients positive for C. trachomatis DNA (n = 18), patients positive for HPV DNA (n = 30), and healthy patients (n = 17) treated at the Hospital de Amor, Campo Grande-MS. After analysis, a higher concentration of IL-17, IL-6, and IL-4 (p <0.05) in ECC; INF-γ and IL-10 (p <0.05) in PB was found in samples from patients positive for C. trachomatis DNA compared to samples from healthy patients. When comparing samples from patients positive for HPV DNA, there was a higher concentration of cytokines IL-17, IL-10, IL-6, and IL-4 (p <0.05) in ECC and IL-4 and IL-2 (p <0.05) in PB of patients positive for C. trachomatis DNA. These results suggest that induction of Th2- and Th17 mediated immune response occurs in patients positive for C. trachomatis DNA, indicating chronic infection. Our results also demonstrate a high concentration of pro-inflammatory cytokines in ECC of patients positive for C. trachomatis DNA.
Subject(s)
Chlamydia Infections , Papillomavirus Infections , Female , Humans , Chlamydia trachomatis/genetics , Human Papillomavirus Viruses , Interleukin-10 , Interleukin-17 , Interleukin-6 , Interleukin-4 , Persistent Infection , Chlamydia Infections/microbiology , Cytokines , Papillomaviridae/geneticsABSTRACT
Persistent infection by high-risk human papillomavirus (HR-HPV) is the main cause of cervical cancer and its precursor lesions. While some cytokines help immune cells in virus clearance, others contribute to the persistence of infection and neoplastic progression. Here, the levels of interferon (IFN)-γ, tumor necrosis factor (TNF)-α, interleukin (IL)-10, IL-6, IL-4, and IL-2 were quantified in the serum and exfoliated cervical cells (ECCs) of patients with HR-HPV, and the presence of IL-6+ cells was investigated in uterine cervix biopsies. Cytokine levels in the serum and ECCs of 26 HR-HPV DNA-positive patients and 18 HPV DNA-negative patients were measured using flow cytometry. Fifteen uterine cervix biopsy samples embedded in paraffin were subjected to immunohistochemical analysis for the detection of IL-6+ cells. HR-HPV-positive patients showed increased IL-6 and IL-10 in the ECCs and serum, respectively. Compared with HPV DNA-positive patients, HPV DNA-negative patients had higher levels of IL-6 in ECCs. Patients with multiple infections of HPV had higher levels of IL-6 in their ECCs than those with a single infection. Immunostaining of uterine cervix biopsy samples revealed no differences in IL-6 expression between the different classes of histopathological lesions. However, differences were observed in the expression levels of IL-6 and IL-10 at the systemic and local levels in HR-HPV-positive patients without cervical lesions. Considering the functional characteristics of these cytokines, it can be inferred that such patients are prone to persistent HPV infection.
Subject(s)
Interleukin-10/blood , Interleukin-6/blood , Papillomavirus Infections/blood , Uterine Cervical Dysplasia/blood , Adult , Aged , Alphapapillomavirus/isolation & purification , Alphapapillomavirus/pathogenicity , Biopsy , Cervix Uteri/pathology , Cervix Uteri/virology , DNA, Viral/isolation & purification , Female , Humans , Middle Aged , Papillomaviridae/genetics , Papillomaviridae/isolation & purification , Papillomaviridae/pathogenicity , Papillomavirus Infections/genetics , Papillomavirus Infections/pathology , Papillomavirus Infections/virology , Tumor Necrosis Factor-alpha/blood , Uterine Cervical Dysplasia/genetics , Uterine Cervical Dysplasia/pathology , Uterine Cervical Dysplasia/virologyABSTRACT
Butanolides have shown a variety of biological effects including anti-inflammatory, antibacterial, and antiprotozoal effects against certain strains of Trypanosoma cruzi. Considering the lack of an effective drug to treat T. cruzi infections and the prominent results obtained in literature with this class of lactones, we investigated the anti-T. cruzi activity of five butanolides isolated from two species of Lauraceae, Aiouea trinervis and Mezilaurus crassiramea. Initially, the activity of these compounds was evaluated on epimastigote forms of the parasite, after a treatment period of 4 h, followed by testing on amastigotes, trypomastigotes, and mammalian cells. Next, the synergistic effect of active butanolides against amastigotes was evaluated. Further, metacyclogenesis inhibition and infectivity assays were performed for the most active compound, followed by ultrastructural analysis of the treated amastigotes and trypomastigotes. Among the five butanolides studied, majoranolide and isoobtusilactone A were active against all forms of the parasite, with good selectivity indexes in Vero cells. Both butanolides were more active than the control drug against trypomastigote and epimastigote forms and also had a synergic effect on amastigotes. The most active compound, isoobtusilactone A, which showed activity against all tested strains inhibited metacyclogenesis and infection of new host cells. In addition, ultrastructural analysis revealed that this butanolide caused extensive damage to the mitochondria of both amastigotes and trypomastigotes, resulting in severe morphological changes in the infective forms of the parasite. Altogether, our results highlight the potential of butanolides against the etiologic agent of Chagas disease and the relevance of isoobtusilactone A as a strong anti-T. cruzi drug, affecting different events of the life cycle and all evolutionary forms of parasite after a short period of exposure.
Subject(s)
Alkanes/pharmacology , Lactones/pharmacology , Trypanocidal Agents/pharmacology , Trypanosoma cruzi/drug effects , Animals , Chlorocebus aethiops , Drug Synergism , Life Cycle Stages/drug effects , Mitochondria/drug effects , Mitochondria/ultrastructure , Trypanosoma cruzi/growth & development , Trypanosoma cruzi/ultrastructure , Vero CellsABSTRACT
Serum levels of interleukin 2 (IL-2), interleukin 4 (IL-4), interleukin 6 (IL-6), interleukin 10 (IL-10), interleukin 17 (IL-17), interferon gamma (IFN-γ), tumor necrosis factor α (TNF-α), and interleukin 1ß (IL-1ß), cytokines involved in the immune response, were investigated in 75 Leishmania-positive blood donors living in endemic areas. Based on their status in 2011 and 2015, the subjects were clustered into three groups: positive for at least one diagnostic method in both years, but lacking clinical progression to disease (G1); positive on at least one method in 2011 but negative in 2015 (G2); negative on all methods in both years (G3). Donors were interviewed for sociodemographic data collection and underwent clinical evaluation and laboratory tests. Serum cytokines were quantified using a CBA Flex set (BD Biosciences). Significant differences were found for all the cytokines evaluated, with lower concentrations in consistently Leishmania-negative individuals. The exception was IFN-γ, with similar levels among all donors. No changes consistent with active disease were observed in the laboratory results for Leishmania-positive donors who underwent clinical evaluation, none of whom progressed to disease. This suggests that infection control is associated with serum IL-17 levels. Resolution of Leishmania infection in positive donors may be related to high levels of IL-17 and low levels of IL-10, highlighting the role played by IL-17 in asymptomatic Leishmania-infected individuals.
Subject(s)
Blood Donors/statistics & numerical data , Cytokines/blood , Leishmania/immunology , Leishmaniasis/immunology , Adult , Asymptomatic Diseases , Female , Humans , Interleukin-10/blood , Interleukin-17/blood , Leishmaniasis/blood , Male , Middle Aged , Up-Regulation , Young AdultABSTRACT
PURPOSE OF REVIEW: Cervical cancer, the third cause of death by cancer among Brazil's women, is associated with human papillomavirus (HPV) infection. In some countries of South America, North America, Europe, and Oceania, initial screening for HPV DNA and subsequent follow-up with HPV-positive patients using colposcopy and cytological testing are used as preventative measures. RECENT FINDINGS: For HPV DNA detection, it is necessary to obtain cervical cells by conventional clinical collection method or self-collection of the cells that flake off from the uterine cervix and vaginal canal. Self-collection has been shown to be a viable option for obtaining samples and is a less invasive method that is more accepted by women. Thus, it can potentially decrease the limitations of the conventional clinical collection methods. The efficiency of the self-collection method aligned with the implementation of HPV molecular testing, if adopted by public and private health care systems, may extend the reach of current cervical cancer prevention efforts. In addition, considering all phases from triage to treatment, this method may reduce health care costs and the time spent by patients and health care teams to conduct examinations and collect samples.
ABSTRACT
Human Papillomavirus (HPV) has considerable tropism for epithelial and mucosal tissues and can therefore be found in several anatomical sites, including the oral cavity. This study aimed to investigate the presence of HPV-DNA and the most frequent viral types in patients using full dentures, compare to patients not using full dentures and to associate its presence with socio-epidemiological and behavioral factors. The study consisted of 90 patients with or without full dentures at the time of collection, treated at a public dental clinic. The samples were obtained by exfoliating the oral cavity, and analyzed for HPV-DNA using the nested PCR with PGMY09/11 (450-bp), and general primers GP5+/GP6+ (150-bp). Genotyping was performed by specific-type PCR to HPV 6, 11, 16, 18, 31, 33, and 45; and Restriction Fragment Length Polymorphism (RFLP). Pearson's Chi-square test (x 2 ) or Fisher's exact test were applied and significant variables in these tests were analyzed by multinomial logistic regression analysis to estimate odds ratio (OR). HPV-DNA was detected in 27.7% of samples and, among those obtained from patients using full dentures, positivity for HPV-DNA was 41.9% (p = 0.025). The most frequent viral types were low-risk HPV 6 and 11, and high-risk HPV 31 and 45. Patients who used full dentures had an odds ratio of 2.1 to be positive for HPV DNA. Our results indicate the need for periodic dental follow-up of patients with full dentures in order to preserve the basic conditions of oral health, and also to monitor the appearance of lesions with malignant potential.
Subject(s)
Denture, Complete/virology , Oncogenic Viruses/isolation & purification , Papillomaviridae/genetics , Papillomaviridae/isolation & purification , Papillomavirus Infections/virology , Adult , Aged , Aged, 80 and over , Brazil/epidemiology , Carcinogenesis , Cross-Sectional Studies , DNA, Viral/isolation & purification , Female , Humans , Logistic Models , Male , Middle Aged , Mouth Mucosa/virology , Papillomavirus Infections/epidemiology , Polymerase Chain Reaction , Prevalence , Risk Factors , Socioeconomic FactorsSubject(s)
Heterosexuality , Papillomaviridae/isolation & purification , Papillomavirus Infections/diagnosis , Penis/pathology , Penis/virology , Adolescent , Adult , Aged , Clinical Medicine/methods , DNA, Viral/genetics , DNA, Viral/isolation & purification , Genotype , Humans , Male , Middle Aged , Molecular Diagnostic Techniques/methods , Papillomaviridae/genetics , Papillomavirus Infections/pathology , Papillomavirus Infections/virology , Polymorphism, Restriction Fragment Length , Real-Time Polymerase Chain Reaction , Virology/methods , Young AdultABSTRACT
We analyzed fecal samples from hospitalized children up to three years of age with acute gastroenteritis at Campo Grande, Mato Grosso do Sul, Brazil, from May 2000-January 2004. Astrovirus and calicivirus were detected by Reverse Transcription-Polymerase Chain Reaction and adenovirus was detected using the Rotavirus and Adenovirus combined immunoenzyme assay. Astrovirus, adenovirus and calicivirus were detected at rates of 3.1%, 3.6% and 7.6%, respectively. These results re-emphasize the need for the establishment of regional vigilance systems to evaluate the impact of enteric viruses on viral gastroenteritis.
Subject(s)
Adenovirus Infections, Human/epidemiology , Astroviridae Infections/epidemiology , Caliciviridae Infections/epidemiology , Diarrhea/virology , Gastroenteritis/virology , Acute Disease , Adenovirus Infections, Human/diagnosis , Adenoviruses, Human/isolation & purification , Astroviridae Infections/diagnosis , Brazil/epidemiology , Caliciviridae/isolation & purification , Caliciviridae Infections/diagnosis , Child, Preschool , Feces/virology , Humans , Immunoenzyme Techniques , Infant , Infant, Newborn , Mamastrovirus/isolation & purification , Reverse Transcriptase Polymerase Chain ReactionABSTRACT
The HIV-1 initial viral infection may present diverse clinical and laboratory course and lead to rapid, intermediate, or long-term progression. Among the group of non-progressors, the elite controllers are those who control the infection most effectively, in the absence of antiretroviral therapy (ART). In this paper, the TH1, TH2 and TH17 cytokines profiles are described, as well as clinical and laboratory aspects of an HIV-infected patient with undetectable viral load without antiretroviral therapy. Production of IL-6, IL-10, TNF-α, IFN-γ, and IL-17 was detected; in contrast IL-4 was identified. Host-related factors could help explain such a level of infection control, namely the differentiated modulation of the cellular immune response and a non-polarized cytokine response of the TH1 and TH2 profiles.
Subject(s)
Cytokines/immunology , HIV Infections/immunology , HIV Long-Term Survivors , HIV-1 , Adult , Antiretroviral Therapy, Highly Active , CD4-Positive T-Lymphocytes/immunology , CD8-Positive T-Lymphocytes/immunology , Female , HIV Infections/blood , HIV Infections/virology , Humans , Immunity, Cellular/immunology , Th1 Cells/immunology , Th2 Cells/immunology , Viral LoadABSTRACT
ABSTRACT OBJECTIVE To understand health professionals' perceptions about vaccination against human papillomavirus (HPV) in the Santa Mônica rural settlement in Terenos, Mato Grosso do Sul. METHODS Quantitative and qualitative methodologies, consultations on vaccination cards, records of community health agents and the focus group technique were used. The main factors of hesitation and vaccine refusal were analyzed, as well as the health team's strategies for the process of immunization against HPV, from June to August 2018. RESULTS Of 121 children and adolescents, 81 (66.94%) received the complete vaccination schedule. Complete vaccination coverage for women was 73.17% (60/82) and for men, 53.8% (21/39). It was observed that, although strategies are adopted for vaccine promotion, such as mobile actions, the public is resistant due to superficial knowledge about the vaccine and its use in an early age group, showing itself to be susceptible to the negative influence of the media and to society's taboos. In addition, difficulties regarding the use of the Unified Health System card and the shortage of professionals were also observed. CONCLUSION The results explain the immunization coverage below the target and reinforce the need to strengthen the family health strategy, as well as the permanent and continuing education of professionals, in order to increase parental confidence and adherence to vaccination.
RESUMO OBJETIVO Compreender as percepções dos profissionais de saúde acerca da vacinação contra o papilomavírus humano (HPV) no Complexo de assentamentos Santa Mônica, em Terenos, Mato Grosso do Sul. MÉTODOS Foram utilizadas metodologias quanti-qualitativas, consultas em cartões vacinais, registros de agente comunitários de saúde e a técnica de grupo focal. Foram analisados os principais fatores de hesitação e recusa vacinal, bem como as estratégias da equipe de saúde para o processo de imunização contra o HPV, de junho a agosto de 2018. RESULTADOS De 121 crianças e adolescentes, 81 (66,94%) receberam o esquema vacinal completo. A cobertura vacinal completa feminina foi de 73,17% (60/82) e a masculina de 53,8% (21/39). Observou-se que, embora sejam adotadas estratégias para a promoção da vacina, como ações volantes, o público encontra-se resistente devido ao conhecimento superficial sobre a vacina e sua utilização em faixa etária precoce, mostrando-se suscetível à influência negativa da mídia e aos tabus da sociedade. Além disso, dificuldades quanto ao uso do cartão do Sistema Único de Saúde e a escassez de profissionais também foram observadas. CONCLUSÃO Os resultados justificam a cobertura vacinal abaixo da meta e reforçam a necessidade de fortalecimento da estratégia de saúde da família, bem como da educação permanente e continuada dos profissionais, a fim de aumentar a confiança dos pais e a adesão à vacinação.
Subject(s)
Humans , Male , Female , Rural Population , Health Knowledge, Attitudes, Practice , Family Health , Papillomavirus Infections/prevention & control , Vaccination Coverage , Vaccination RefusalABSTRACT
Polyacrylamide gel electrophoresis and combined immunoenzyme assay for rotavirus and adenovirus were used to analyze 380 fecal samples from children up to three years of age who were hospitalized with acute diarrhea in Campo Grande, State of Mato Grosso do Sul, between May 2000 and January 2004. Among all the samples, 88 (23.2%) were positive for Rotavirus A. Out of these, 81 (92%) had a defined electrophoretic pattern: 77 (87.5%) with a long pattern and four (4.5%) with a short pattern. Genotype G and P characterization was done by nested RT-PCR for 85 samples, of which 56 (65.9%) were genotyped as type G. Among these, 49 (87.5%) were G1, five (8.9%) were G4, one (1.8%) was G3 and one (1.8%) was G9. The genotype was found to be type P in 37 samples (43.5%) and all of these were P[8]. The G and P association most observed was G1P[8], with 33 samples (89.2%), followed by G4P[8], two samples (5.4%); G3P[8], one sample (2.7%); and G9P[8], one sample (2.7%).
Subject(s)
Diarrhea/virology , Gastroenteritis/epidemiology , Rotavirus Infections/virology , Rotavirus/classification , Acute Disease , Brazil/epidemiology , Child , Child, Preschool , Diarrhea/epidemiology , Electrophoresis, Polyacrylamide Gel , Feces/virology , Female , Gastroenteritis/virology , Genotype , Humans , Infant , Infant, Newborn , Male , Prevalence , Reverse Transcriptase Polymerase Chain Reaction , Rotavirus/genetics , Rotavirus Infections/epidemiology , SeasonsABSTRACT
The lifetime risk of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) development differs among ethnic groups. To better understand these differences, this prospective cohort study was conducted to investigate the cytokine profile and the HTLV-1 proviral load (PVL) in Japanese and non-Japanese populations with HAM/TSP and asymptomatic carriers (ACs). The serum IL-2, IL-4, IL-6, IL-10, IL-17, TNF-α, and IFN-γ levels were quantified using the Cytometric Bead Array in 40 HTLV-1-infected patients (11 HAM/TSP and 29 ACs) and 18 healthy controls (HCs) in Brazil. Among ACs, 15 were Japanese descendants and 14 were non-Japanese. Of 11 patients with HAM/TSP, only one was a Japanese descendant. The HTLV-1 PVL was quantified by real-time PCR. The HTLV-1 PVL was 2.7-fold higher in HAM/TSP patients than ACs. Regardless of the clinical outcome, the PVL was significantly higher in patients younger than 60 years than older patients. The HAM/TSP and ACs had higher IL-10 serum concentrations than that of HCs. The ACs also showed higher IL-6 serum levels than those of HCs. According to age, the IL-10 and IL-6 levels were higher in ACs non-Japanese patients older than 60 years. HAM/TSP patients showed a positive correlation between IL-6 and IL-17 and a negative correlation between the PVL and IL-17 and IFN-γ. In the all ACs, a significant positive correlation was observed between IL-2 and IL-17 and a negative correlation was detected between IL-10 and TNF-α. Only 6.25% of the Japanese patients were symptomatic carriers, compared with 41.67% of the non-Japanese patients. In conclusion, this study showed that high levels of HTLV-1 PVL was intrinsicaly associated with the development of HAM/TSP. A higher HTLV-1 PVL and IL10 levels found in non-Japanese ACs over 60 years old, which compared with the Japanese group depicts that the ethnic background may interfere in the host immune status. More researches also need to be undertaken regarding the host genetic background to better understand the low frequency of HAM/TSP in Japanese HTLV-1-infected individuals.
Subject(s)
Cytokines/blood , HTLV-I Infections/immunology , HTLV-I Infections/virology , Human T-lymphotropic virus 1 , Aged , Asian People , Brazil/epidemiology , Carrier State/epidemiology , Carrier State/immunology , Carrier State/virology , Case-Control Studies , Cohort Studies , Emigrants and Immigrants , Female , HTLV-I Infections/epidemiology , Human T-lymphotropic virus 1/isolation & purification , Human T-lymphotropic virus 1/pathogenicity , Humans , Japan/ethnology , Male , Middle Aged , Paraparesis, Tropical Spastic/epidemiology , Paraparesis, Tropical Spastic/immunology , Paraparesis, Tropical Spastic/virology , Prospective Studies , Proviruses/isolation & purification , Viral LoadABSTRACT
We analyzed 87 cervical samples from Campo Grande, Mato Grosso do Sul, with a PGMY/GP+ nested PCR system. Positive samples were typed using E7 type-specific primer pairs for HPV 6/11, 16, 18, 45 and 66. Eighteen samples (22%) were infected with HPV6/11, 18 samples (22%) with HPV66, 13 samples (15.9%) with HPV45, 8 samples (9.8%) with HPV18 and 7 samples (8.5%) with HPV16. Seventeen samples (20.7%) were infected by two HPV types, and five samples (6.1%) by three HPV types. We conclude that infection with multiple types is present at a high frequency in our population and that there is a relation between some types and cytological finds.