Targeting Macrophage Polarization in Infectious Diseases: M1/M2 Functional Profiles, Immune Signaling and Microbial Virulence Factors.

INTRODUCTION: An event of increasing interest during host-pathogen interactions is the polarization of patrolling/naive monocytes (MOs) into macrophage subsets (MФs). Therapeutic strategies aimed at modulating this event are under investigation. METHODS: This review focuses on the mechanisms of induction/development and profile of MФs polarized toward classically proinflammatory (M1) or alternatively anti-inflammatory (M2) phenotypes in response to bacteria, fungi, parasites, and viruses. RESULTS AND DISCUSSION: It highlights nuclear, cytoplasmic, and cell surface receptors (pattern recognition receptors/PPRs), microenvironmental mediators, and immune signaling. MФs polarize into phenotypes: M1 MФs, activated by IFN-γ, pathogen-associated molecular patterns (PAMPs, e.g. lipopolysaccharide) and membrane-bound PPRs ligands (TLRs/CLRs ligands); or M2 MФs, induced by interleukins (ILs-4, -10 and -13), antigen-antibody complexes, and helminth PAMPs. Polarization toward M1 and M2 profiles evolve in a pathogen-specific manner, with or without canonicity, and can vary widely. Ultimately, this can result in varying degrees of host protection or more severe disease outcome. On the one hand, the host is driving effective MФs polarization (M1 or M2); but on the other hand, microorganisms may skew the polarization through virulence factors to increase pathogenicity. Cellular/genomic reprogramming also ensures plasticity of M1/M2 phenotypes. Because modulation of polarization can occur at multiple points, new insights and emerging perspectives may have clinical implications during the inflammation-to-resolution transition; translated into practical applications as for therapeutic/vaccine design target to boost microbicidal response (M1, e.g. triggering oxidative burst) with specifics PAMPs/IFN-γ or promote tissue repair (M2, increasing arginase activity) via immunotherapy.

Monocytes are white blood cells (leukocytes) that help fight off various types of aggressive agents, including microorganisms (bacteria, fungi, viruses, and parasites), and help maintain the healthy balance of the human body. These cells differentiate into specific macrophages in tissues such as the lungs, heart, liver, skin, and brain. The present review focuses on the peculiar cellular properties that macrophages can acquire during the human immune response to infectious diseases. In this regard, it is discussed that macrophages are didactically divided into M1 and M2 subtypes. The first subtype (M1) is responsible for fighting pathogens and causing inflammation. The second subtype (M2) is mainly responsible for healing and repairing damaged tissue. Current knowledge shows that although both subtypes are involved in the same immune response aimed at protecting the human body, these M1 and M2 profiles have different characteristics that have implications for therapeutic measures such as developing specific drugs or vaccines to balance the immune response against a given pathogen and promote a complete cure of the disease. Alongside the therapeutic impacts, this review also looks at the characteristics that allow aggressive microorganisms to counteract the immune response developed by these M1 and M2 cell profiles. It highlights how exactly there can be greater protection or detriment to the human host against a given microorganism when there is a predilection to develop a more abundant immune response from one of the two profiles (M1 or M2).

Photobiomodulation enhances the Th1 immune response of human monocytes.

This study aims to evaluate the effects of photobiomodulation (PBM) on human monocytes, assessing the oxidative burst and ultimate fungicidal potential of these cells, as well as the gene expression at the mRNA level of CD68, CD80, CD163, CD204, IL-6, TNF-α and IL-10 in derived macrophages. Primary cultures of human monocytes were irradiated with an InGaAlP (660 nm)/GaAlAs (780 nm) diode laser (parameters: 40 mW, 0.04 cm2, 1 W/cm2; doses: 200, 400 and 600 J/cm2). Cells were submitted to the chemiluminescence assay, and a microbicidal activity assay against Candida albicans was performed. Reactive oxygen species (ROS) and nitric oxide (NO) production were measured, and cell viability was assessed by the exclusion method using 0.2% Trypan blue reagent. Irradiated monocytes were cultured for 72 h towards differentiation into macrophages. Total RNA was extracted, submitted to reverse transcription and real-time PCR. The results were analysed by ANOVA and the Tukey test (α = 0.05). Irradiated monocytes revealed a significant increase in their intracellular and extracellular ROS (P < 0.001). The 660 nm wavelength and 400 J/cm2 dose were the most relevant parameters (P < 0.001). The fungicidal capacity of the monocytes was shown to be greatly increased after PBM (P < 0.001). PBM increased the expression of TNF-α (P = 0.0302) and the production of NO (P < 0.05) and did not impair monocyte viability. PBM induces a pro-inflammatory Th1-driven response in monocytes and macrophages.

Candida species biotypes in the oral cavity of infants and children with orofacial clefts under surgical rehabilitation.

Patients with orofacial clefts present various risk factors for oral infectious diseases, resulting from anatomical and physiological changes and those resulting from rehabilitating therapeutic interventions. The incidence of Candida species in groups of babies and children with orofacial clefts, during pre- and post-operative periods and until return to first consultation, and the profiles for antifungal sensitivity and virulence in vitro were investigated. Oral samples were collected at different times over the surgical procedures and post-surgical clinical consultation and seeded in chromogenic culture media CHROMagar Candida®. Candida biotypes were identified by accessing species-specific genomic DNA sequences by PCR techniques and electrophoretic procedures. Antifungal susceptibility testing was performed by the method of microdilution in broth using the antifungals amphotericin B (AP), nystatin (NYS) and fluconazole (FLC). SAP and PL exoenzyme activities were determined by classical microbiological methods. Some orofacial clefts occurred preferentially in male or female. Low incidence (39.1%) of oral colonization by Candida species (C. albicans, C. krusei, C. tropicalis and Candida spp.) was reported in patient admission to surgical ward, with no correlation to orofacial cleft types or surgical history. Significant reduction in frequencies of Candida and changes of species, over sampling periods, showed dynamic patterns of oral colonization: elimination, maintenance or neocolonization of the biotypes. These biotypes showed sensitivity to AP (100%), partial resistance to FLC (<10%) and variable MICs for NYS (0.125-4 µg/mL), in addition to strong exoenzyme activities, especially for SAP. Clinical and therapeutic conducts for surgical rehabilitation, anatomical and physiological characteristics of patients with orofacial clefts, and cultural behavior and regionalism of the patient population served could influence the frequencies and dynamics of oral colonization by Candida species. The data showed Candida biotypes resistant to FLC and sensitive (AP) or clinically compatible (NYS) to polyenes, especially C. albicans, in the oral cavity of patients predisposed to oral colonization and candidiases, contributing to clinical conducts in possible antifungal therapies. These biotypes were considered potentially virulent and able to partially modulate their virulence factors, especially SAP, under the conditions favored by host.

Tempol modulates the leukocyte response to inflammatory stimuli and attenuates endotoxin-induced sickness behaviour in mice.

Background and aims: Lipopolysaccharide (LPS), an endotoxin, is a component of the outer membrane of Gram-negative bacteria that is able to activate the peripheral immune system, leading to changes in signalling pathways that act locally and systemically to achieve adaptive responses. Sickness behaviour is a motivational state in response to endotoxin exposure and includes depressed activity and a reduction of exploratory behaviour, potentially reorganising organism priorities to cope with infectious diseases. We hypothesised that 4-hydroxy-2,2,6,6-tetramethylpiperidine-1-oxyl (Tempol) modulates the leukocyte response to endotoxins and decreases LPS-induced sickness behaviour in mice.Methods: The effects of Tempol on LPS-induced peritonitis and the respiratory burst of neutrophils primed with LPS and triggered by phorbol 12-myristate-13-acetate (PMA) were evaluated. To evaluate the effects of Tempol on sickness behaviour, the mice were submitted to an open field and forced swim tests.Results: Tempol (50-100 µM/106 cells) decreased the respiratory burst of LPS-primed and PMA-stimulated neutrophils in vitro. In vivo, this nitroxide (30 and 100 mg/kg body weight) inhibited leukocyte migration to the peritoneal cavity after LPS administration in mice. Moreover, Tempol pretreatment (30 and 100 mg/kg body weight) before LPS administration also attenuated sickness behavioural changes.Conclusions: Together, these findings shed light on the mechanisms underlying the anti-inflammatory potential and confirm the therapeutic potential of nitroxides.

Nitroxide Tempol down-regulates kinase activities associated with NADPH oxidase function in phagocytic cells and potentially decreases their fungicidal response.

AIMS: The identification of novel targets to control inflammation in humans is probably the primary challenge that impairs the development of new anti-inflammatory drugs. Therefore, the modulation of intracellular signaling pathways in phagocytes may be an interesting means of achieving this goal. However, this change to signaling can compromise the host's susceptibility to invading pathogens. We investigated whether the antioxidant nitroxide Tempol regulates the activity of kinases associated with the production of oxidants in neutrophils, which affects the fungicidal capability of these cells. MAIN METHODS: The effects of Tempol on PMA- or fMLP-activated neutrophils were examined by oxygen consumption as an index of the oxidative burst, a release of extracellular and total Reactive Oxygen Species (ROS) by chemiluminescence, kinase activities through analysis of ATP consumption during enzyme activities and the dot blot immunoassay and, finally, by neutrophil capacity of killing Candida albicans. KEY FINDINGS: Tempol significantly inhibited the neutrophil oxidative burst in a concentration-dependent manner and decreased oxygen consumption (IC50 = 45 µM) and extracellular/total ROS formation with an increase on the lag period response. In addition, Tempol inhibited neutrophil kinase activities (i.e., a decrease in protein phosphorylation) elicited through different biochemical pathways and consequently impaired the fungicidal activity of these cells. SIGNIFICANCE: Although Tempol has potential anti-inflammatory activity that acts on different intracellular pathways (such as those involving kinases), researchers should be cautious, since this nitroxide down-regulated oxidants production and the fungicidal response of neutrophils.

Critical Factors Associated with Morbimortality in COVID-19 Patients Attended at a Brazilian Public Hospital: a Cross-Sectional Study / Fatores Críticos Associados à Morbimortalidade em Pacientes com COVID-19 Atendidos em um Hospital Público Brasileiro: um Estudo Transversal

The association between death from Covid-19 and case management, especially in small and medium-sized municipalities, is still uncertain. To analyze sociodemographic, clinical, and pharmacological factors associated with death in patients with Coronavirus Disease 2019 (COVID-19), from a Brazilian referral public hospital. This is a cross-sectional study, with data from the hospital records of patients (≥ 18 years old) diagnosed with COVID-19, from March 2020 to March 2021. The sample was classified according to the clinical outcome into two groups (death and discharge), among which statistical associations were performed with the variables of interest, with a 5% significance level. Factors such as need for intensive care, use of mechanical ventilation, and total length of hospital stay was related to higher hospital mortality, as well as the permanence of changes in clinical laboratory testing, including lactic acid, D-dimer, markers of hepatic and renal function, C-Reactive protein, anemia, leukocytosis, lymphopenia, thrombocytopenia, pH, and blood oxygen saturation (SpO2) (P < 0.05). Medications used most frequently in the studied hospital for the treatment of COVID-19, such as enoxaparin, dexamethasone, ivermectin, acetylcysteine, chloroquine, and clarithromycin were correlated with morbimortality (P < 0.05). Clinical outcome was influenced by patient-related factors, such as age and comorbidities, however, therapeutic interventions and the choice of medication also impacted morbimortality. These results reinforce the need for preventive actions and adequate clinical protocols in the treatment of hospitalized COVID-19 patients.(AU)

A associação entre o óbito pela Covid-19 e o manejo dos casos, principalmente em municípios de pequeno e médio porte, ainda é incerta. Analisar os fatores sociodemográficos, clínicos e farmacológicos associados à morte em pacientes com a doença do Coronavírus 2019 (COVID-19) em um hospital público brasileiro de referência. Trata-se de um estudo transversal realizado com dados dos prontuários de pacientes (≥ 18 anos) diagnosticados com COVID-19 no período de março de 2020 a março de 2021. A amostra foi classificada de acordo com o desfecho clínico em dois grupos (óbito e alta) e foram realizados testes de associação estatística com as variáveis de interesse com nível de significância de 5%. Fatores como necessidade de terapia intensiva, uso de ventilação mecânica e tempo total de internação estiveram relacionados com maior mortalidade hospitalar, assim como a permanência de alterações nos exames laboratoriais clínicos, incluindo ácido lático, D-dímero, marcadores de função hepática e renal, proteína C reativa, anemia, leucocitose, linfopenia, trombocitopenia, pH e saturação de oxigênio no sangue (SpO2) (P < 0,05). Os medicamentos utilizados com maior frequência no hospital para o tratamento de COVID-19, como enoxaparina, dexametasona, ivermectina, acetilcisteína, cloroquina e claritromicina, foram correlacionados com morbimortalidade (P < 0,05). O desfecho clínico foi influenciado por fatores relacionados ao paciente, como idade e comorbidades, porém as intervenções terapêuticas e a escolha dos medicamentos também impactaram na morbimortalidade. Esses resultados reforçam a necessidade de ações preventivas e protocolos clínicos adequados no tratamento de pacientes hospitalizados com COVID-19.(AU)

Tempol decreases the levels of reactive oxygen species in human neutrophils and impairs their response to

SUMMARY Background and aims: Mycobacterium tuberculosis (Mtb), the main causative agent of human tuberculosis (TB), remains as a serious public health problem. The innate immune response following Mtb infection plays a crucial role in preventing the onset of active TB and limiting its spread. Since phagocytes-derived reactive oxygen/nitrogen species (ROS/RNS) during the oxidative burst can fight Mtb, we hypothesized that the use of antioxidants could increase the host's susceptibility to Mtb/TB. In that way, we investigated the effects of the nitroxide Tempol, an antioxidant with superoxide dismutase-like activity, on the response of neutrophils against Mtb. Methods: Human blood-derived neutrophils were isolated from healthy volunteers and incubated with Mtb (H37Ra) at different multiplicities of infection (MOIs), in the absence or presence of Tempol. The levels of ROS in neutrophils were evaluated using the cytochrome C reduction assay (extracellular O2 •-) and luminol-(total intracellular and extracellular ROS) and isoluminol-(extracellular ROS) amplified chemiluminescence assay. The killing assay (two-step protocol) checked the mycobactericidal capacity of neutrophils, as calculated the phagocytosis (K p ) and intracellular killing (Kk) rates. Results: The levels of ROS and killing capacity in Mtb-stimulated neutrophils were significantly decreased by 450 µM Tempol (p < 0.05). Interestingly, Tempol decreased the k k of neutrophils, but did not affect their kp, demonstrating that a putative diminution in ROS levels, ultimately, affected the intracellular killing of Mtb. Conclusion: This study provides insights regarding the role of antioxidants on the neutrophil response toward Mtb, so that our findings deserve to be considered regarding further studies and clinical implications.

Contextualización y objetivos: Mycobacterium tuberculosis (Mtb), el principal agente causal de la tuberculosis humana (TB), es un grave problema de salud pública. La respuesta inmune innata desencadenada en la infección por Mtb juega un papel crucial en la prevención de la aparición de la tuberculosis activa y en la limitación de su propagación. Dado que las especies reactivas de oxígeno/nitrógeno derivadas de los fagocitos (ERO/ERN) durante el burst oxidativo pueden combatir la infección pulmonar por Mtb, planteamos la hipótesis de que el uso de antioxidantes podría aumentar la susceptibilidad del huésped humano hacia Mtb/TB. De esa manera, investigamos los efectos del nitróxido Tempol, un antioxidante con actividad similar a la superóxido dismutasa, sobre la respuesta de los neutrófilos contra Mtb. Métodos: se aislaron neutrófilos derivados de sangre humana de voluntarios sanos y se incubaron con Mtb (H37Ra) en diferentes multiplicidades de infección (MOI), en ausencia o presencia de Tempol. Los niveles de ERO en neutrófilos se evaluaron mediante el ensayo de la reducción del citocromo C (O2'- extracelular) y el ensayo de quimioluminiscencia, amplificada mediante el uso de luminol (ERO total, intracelular y extracelular) e isoluminol (ERO extracelular). La prueba de actividad microbicida (protocolo de dos pasos) verificó la capacidad micobactericida de los neutrófilos, calculando las tasas de fagocitosis (Kp) y muerte intracelular (Kk). Resultados: los niveles de ERO y la capacidad micobactericida en neutrófilos estimulados con Mtb disminuyeron significativamente en los grupos tratados con 450 µM de Tempol (p < 0,05). Curiosamente, Tempol disminuyó la tasa de muerte intracelular (Kk) en neutrófilos, pero no tuvo ningún efecto sobre la tasa de fagocitosis (Kp), lo que demuestra que una supuesta disminución en los niveles de ERO, en última instancia, afectó la destrucción intracelular de Mtb. Conclusión: este estudio proporciona información sobre el papel de los antioxidantes en la respuesta de los neutrófilos hacia Mtb, por lo que nuestros hallazgos merecen ser considerados con respecto a más estudios e implicaciones clínicas.

Contextualização e objetivos: Mycobacterium tuberculosis (Mtb), principal agente causal da tuberculose humana (TB), é um grave problema de saúde pública. A resposta imune inata desencadeada pela infecção por Mtb desempenha um papel crucial na prevenção do aparecimento da tuberculose ativa e na limitação de sua disseminação. Como as espécies reativas de oxigênio/nitrogênio derivadas de fagó-citos (ERO/ERN) durante a burst oxidativa podem combater a infecção pulmonar por Mtb, hipotetizamos que o uso de antioxidantes poderia aumentar a suscetibilidade do hospedeiro humano ao Mtb/TB. Assim, investigamos os efeitos do nitróxido de Tempol, um antioxidante com atividade semelhante a superóxido dismutase, na resposta de neutrófilos contra o Mtb. Métodos: neutrófilos derivados de sangue humano foram isolados de voluntários saudáveis e incubados com Mtb(H37Ra) em diferentes multiplicidades de infecção (MOI), na ausência ou presença de Tempol. Os níveis de ERO em neutrófilos foram avaliados por ensaio de depleção de citocromo C (O2•- extracelular) e ensaio de quimioluminescência, amplificado com luminol (ERO total, intracelular e extracelular) e isoluminol (ERO extracelular). O teste de atividade microbicida (protocolo de duas etapas) verificou a capacidade micobactericida dos neutrófilos, calculando as taxas de fagocitose (Kp) e morte intracelular (Kk). Resultados: os níveis de ERO e a capacidade micobactericida em neutrófilos estimulados por Mtb diminuíram significativamente nos grupos tratados com Tempol 450 µM (p < 0,05). Curiosamente, Tempol diminuiu a taxa de morte intracelular (Kk) em neutrófilos, mas não teve efeito sobre a taxa de fagocitose (Kp), mostrando que uma diminuição putativa nos níveis de ERO afetou a morte intracelular de Mtb. Conclusão: este estudo fornece informações sobre o papel dos antioxidantes na resposta dos neutrófilos ao Mtb, portanto, nossos achados merecem consideração para estudos adicionais e implicações clínicas.

Tempol improves lipid profile and prevents left ventricular hypertrophy in LDL receptor gene knockout (LDLr-/-) mice on a high-fat diet.

INTRODUCTION AND OBJECTIVE: Dyslipidemia is associated with increased risk of cardiovascular disease and atherosclerosis, and hence with high morbidity and mortality. This study investigated the effects of the nitroxide 4-hydroxy-2,2,6,6-tetramethylpiperidine 1-oxyl (Tempol) on lipid profile and cardiac morphology in low-density lipoprotein (LDL) receptor gene knockout (LDLr-/-) mice. METHODS: Male LDLr-/- mice (three months old, approximately 22 g weight) were divided into the following groups: controls, including (1) standard chow (SC, n=8) and (2) high-fat diet (HFD, n=8); and treatment, including (3) standard chow + Tempol (SC+T, n=8) (30 mg/kg administered by gavage, once daily) and (4) high-fat diet + Tempol (HFD+T, n=8) (30 mg/kg). After 30 days of the diet/treatment, whole blood was collected for analysis of biochemical parameters (total cholesterol, triglycerides [TG], high-density lipoprotein [HDL], LDL, and very low-density lipoprotein [VLDL]). The heart was removed through thoracotomy and histological analysis of the left ventricle was performed. RESULTS: A significant increase in TG, LDL, and VLDL and marked left ventricular hypertrophy (LVH) were demonstrated in the HFD group relative to the SC group (p<0.05), while Tempol treatment (HFD+T group) significantly (p<0.05) prevented increases in the levels of these lipid profile markers and attenuated LVH compared with the HFD group. CONCLUSION: In this study, Tempol showed potential for the prevention of events related to serious diseases of the cardiovascular system.

Nitroxide 4-hydroxy-2,2',6,6'-tetramethylpiperidine 1-oxyl (Tempol) inhibits the reductase activity of protein disulfide isomerase via covalent binding to the Cys400 residue on CXXC redox motif at the a'active site.

BACKGROUND AND AIM: Oxidative stress arising from inflammatory processes is a serious cause of cell and tissue damage. Tempol is an efficient antioxidant with superoxide dismutase-like activity. The purpose of this paper is to address the inhibition of protein disulfide isomerase (PDI), an essential redox chaperone whose active sites contain the Cys-Gly-His-Cys (CXXC) motif, by the nitroxide Tempol. RESULTS: In the presence of Tempol (5-120 µM), the reductase activity of PDI was reversibly affected both in vitro and in activated mice neutrophils, with an IC50 of 22.9 ± 10.8 µM. Inhibitory activity was confirmed by using both the insulin method and fluorescent formation of eosin-glutathione (E-GSH). The capacity of Tempol to bind the enzyme was determined by EPR and mass spectrometry. EPR Tempol signal decreased in the presence of PDI while remained unaffected when PDI thiols were previously blocked with NEM. When total protein was analyzed, 1 and 4 molecules of Tempol were bound to the protein. However, only one was found to be covalently bound to PDI at the a'active site. More specifically, Cys400 was modified by Tempol. CONCLUSION: We have shown that the nitroxide Tempol acts as an inhibitor of PDI through covalent binding to the Cys400 of the protein structure. Since PDI is coupled with the assembly of the NADPH oxidase complex of phagocytes, these findings reveal a novel action of Tempol that presents potential clinical applications for therapeutic intervention to target PDI knockdown in pathological processes in which this protein is engaged.

Explorando os estresses oxidativo e nitrosativo contra fungos: um mecanismo subjacente à ação de tradicionais antifúngicos e um potencial novo alvo terapêutico na busca por indutores oriundos de fontes naturais / Explorando los estréses oxidativos y nitrosativos contra hongos: un mecanismo subyacente a la acción de los antifúngicos tradicionales y un potencial nuevo objetivo terapéutico en la búsqueda de inductores de fuentes naturales / Exploring the oxidative and nitrosative stresses against fungi: an underlying mechanism beyond the action of traditional antifungal agents and a potential new therapeutic target in searching for inducers from natural sources

RESUMO Objetivo: Nesta revisão sistemática, nós avaliamos o link entre indutores de estresse oxidativo e/ou nitrosativo (EO/EN) com atividade antifúngica, através de uma ação direta sobre a célula fúngica e/ou modulando a resposta de fagócitos contra fungos de interesse médico (incluindo Candida spp., Cryptococcus spp. e Aspergillus spp.). Ainda, foram avaliadas as implicações clínicas deste evento bioquímico, bem como as perspectivas quanto à busca por novos compostos com atividade antifúngica, principalmente, os provenientes de fonte natural e, que explorem a indução de um EO ou EN como parte de seu mecanismo de ação. Metodologia: Foram avaliados artigos, provenientes de diferentes bases de dados e publicados a qualquer período, acessados entre abril e junho de 2017, através da utilização de diferentes descritores. Resultados: Primeiramente, estabelecemos as definições de EO/EN, como sendo o aumento das concentrações de espécies reativas do oxigênio e/ou nitrogênio (ERO/ ERN) quantificado diretamente e, provenientes de fontes fúngicas mitocondriais, Reação de Fenton, retículo endoplasmático ou outras não definidas, e excedendo a capacidade de defesa antioxidante do microrganismo (avaliados por análises de perfis transcriptômicos ou proteômicos ou metabolômicos ou níveis de atividade enzimática). Este aumento de ERO/ERN causando EO/EN é definido por tempo e condições que conduzem a sinalização de apoptose ou reais danos a biomoléculas com perda de função (peroxidação lipídica ou oxidação proteica ou danos ao DNA) e, consequentemente, gerando morte fúngica ou outro efeito antifúngico associado. Portanto, 64 artigos (apenas um publicado antes do ano 2000 e 50 entre 2007-2017) abordam que a indução de EO ou EN na célula fúngica é parte do mecanismo de ação de clássicos agentes antifúngicos (22 publicações), tais como azóis (fluconazol, itraconazol e miconazol), polienos (anfotericina B [AnB]) e equinocandinas (mica-fungina), assim como tal modulação redox tem sido reportada como um importante alvo terapêutico na busca por novos e promissores compostos naturais com atividade antifúngica (32 publicações), que tem respaldo pela grande variedade de indutores que podem provir da natureza. Ainda, compostos que também induzem o burst oxidativo de fagócitos, incluindo AnB, são potencializadores do efeito antifúngico in vivo. Além do efeito antifúngico contra células planctônicas, os efeitos dos EO ou EN sobre biofilmes fúngicos, também têm sido reportados. Tem sido firmado na literatura recente um claro link entre EO ou EN e a atividade antifúngica, tanto para aqueles agentes antifúngicos já utilizados na terapêutica em humanos, quanto para possíveis candidatos a fármaco. Portanto, a indução do EO ou EN como parte do mecanismo de ação de antifúngicos demonstra ser um importante alvo terapêutico, com perspectivas favoráveis sobre os desfechos na prática clínica.

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SUMMARY Aim: In this systematic review, we evaluated the link between inducers of oxidative or nitrosative stresses (OS/NS) and antifungal activity against fungi of medical relevance (including Candida spp., Cryptococcus spp., and Aspergillus spp.), through a direct action on the fungal cell or modulating phagocyte response. Moreover, the clinical implications of this biochemical event, as well as the perspectives, were examined, highlighting the search for new compounds with antifungal activity, mainly those from natural sources and, which explores the induction of OS or NS as part of the mechanism of action. Methodology: Articles from different databases and published at any time were evaluated, between April and June 2017, and using different descriptors. Results: First, a definition of OS and NS was established in which an increase in reactive oxygen or nitrogen species (ROS/ RNS, quantified directly and from mitochondrial, Fenton reaction, endoplasmic reticulum or other fungal sources) should exceed the antioxidant defense capacity of the microorganism (evaluated by transcriptomic or proteomic or metabolomic profiles or enzyme activity levels). These events, by time and conditions delimited, can lead to the signaling of apoptosis or an actual damage toward biomolecules (lipid peroxidation or protein oxidation or DNA damage) and, consequently, they can cause cell death or other associated antifungal effect. Therefore, 64 articles were found, of these, only one was published before 2000 and 50 between 20072017, reporting the induction of OS or NS directly into the fungal cell via an increase in ROS or RNS as part of the mechanism of action of classical antifungal agents (22 publications), such as: azoles (fluconazole, itraconazole, and miconazole), polyenes (amphotericin B, [AnB]), and echinocandins (micafungin). This redox modulation has also been reported as an important therapeutic target in the search for new natural compounds with antifungal activity (32 publications), which is supported for the great variety of inducers from nature. Compounds that also induce the oxidative burst of phagocytes, including AnB, promote a combinatorial antifungal effect in vivo. In addition to the antifungal effect against plank-tonic cells, the relation between OS or NS and antifungal activity against fungal biofilms has also been reported. It has been established in the recent literature a clear link between OS or NS and antifungal effect, during the action of anti-fungal agents already used in the therapy in humans as well as for possible drug candidates. Thus, the induction of OS or NS as part of the mechanism of action proves to be an important therapeutic target with favorable perspectives on the outcomes in clinical practice.

Green banana pasta diet prevents oxidative damage in liver and kidney and improves biochemical parameters in type 1 diabetic rats.

OBJECTIVE: In this study, the effects of a green banana pasta diet on the oxidative damage from type 1 diabetes mellitus (DM) were investigated. MATERIALS AND METHODS: Formulations containing 25 (F25), 50 (F50), and 75% (F75) of green banana pasta were prepared and included in a 12-week diet of Wistar rats with alloxan-induced type 1 DM. The effects of these formulations in preventing oxidative damage in kidneys and liver homogenates of rats were evaluated using the TBARS assay (lipid peroxidation in liver) and the DNPH assay (protein oxidation in liver and kidneys). Furthermore, the effects of the formulations on the fasting glycemia, fructosamine levels, renal function (creatinine), liver function (enzymes aspartate aminotransferase [AST] and alanine aminotransferase [ALT]), and lipid profile (total cholesterol and fractions) in the serum of rats were evaluated in addition to the evaluation of the centesimal composition and microbiological analysis of the produced green banana pasta. RESULTS: An F75 diet prevented hyperglycemia in diabetic rats (p < 0.05) compared to the diabetic rats fed a standard diet (commercial feed). Notably, the protein oxidation in both the liver and kidneys were prevented in diabetic rats on the F50 or F75 diets compared to the control group, whereas the lipid peroxidation was only prevented in the liver (p < 0.05). Moreover, all formulations prevented an increase in the amount of triglycerides in the serum of the rats. The F25 and F50 diet prevented the increase of cholesterol, and the F75-based diet of ALT and fructosamine (p < 0.05) supported the anti-hyperglycemic effects and the protection against oxidative damage. CONCLUSION: The green banana pasta (F75) diet showed great potential for preventing complications associated with diabetes.

Low-level laser therapy stimulates the oxidative burst in human neutrophils and increases their fungicidal capacity.

Low-level laser therapy (LLLT) is known to enhance mitochondrial electron transfer and ATP production; thus, this study asked whether LLLT could stimulate the oxidative burst in human neutrophils (PMN) and improve their ability to kill microorganisms. Blood from healthy human subjects was collected and PMN were isolated from the samples. PMN were treated in vitro with 660 nm or 780 nm CW laser light at 40 mW power and increasing energies up to 19.2 J and were subsequently incubated with Candida albicans cells. Generation of hydroxyl radicals, hypochlorite anions and superoxide anions by PMN were checked using fluorescent probes and chemiluminescence assays; a microbicidal activity assay against C. albicans was also performed. LLLT excited PMN to a higher functional profile, which was translated as superior production of reactive oxygen species (ROS) and increased fungicidal capacity. The most efficacious energy was 19.2 J and, interestingly, the 660 nm light was even more efficacious than 780 nm at increasing the respiratory burst of PMN and the fungicidal capacity. Human neutrophils (PMN) were stimulated in vitro with 660 nm or 780 nm CW laser light at 40 mW of power and a total energy of 19.2 J. Low-level laser therapy (LLLT) excited PMN to a higher functional profile, which was translated as a superior production of reactive oxygen species (ROS) such as hydroxyl radicals (HO• ) and hypochlorite anions (ClO- ) (Figure) and increased fungicidal capacity against Candida albicans cells.

Talinumpaniculatum: a plant with antifungal potential mitigates fluconazole-induced oxidative damage-mediated growth inhibition of Candida albicans / Talinum paniculatum: una planta con potencial antifúngico atenúa la inhibición del crecimiento de Candida albicans mediada por el daño oxidativo inducido por fluconazol

SUMMARY Aims: This study investigated the bioactivity of the crude leaf extract (CLE) and fractions hexane (HX) and ethyl acetate (EtOAc) from Talinum paniculatum alone and in association with fluconazole (FLC) against reference strain and clinical isolates of FLC-resistant Candida albicans. Furthermore, the antioxidant capability, chemical composition of this plant, and the effect's underlying mechanisms were evaluated. Methods: The antifungal activity was evaluated using checkerboard assay to establish the minimum inhibitory (MIC) and minimum microbicidal concen trations (MMC). During FLC and plant products challenges, the reactive oxygen species (ROS) generation (hydroxyl radicals [HO●]) were detected in C. albicans cells using the membrane-permeable fluorescent probes APF and HPF. High-performance liquid chromatography (HPLC) profile, quantitative analysis of antioxidant compounds, and free radical scavenging activity (DPPH assay) tests were performed. Results: The CLE and fractions presented outstanding antifungal activity and selectivity against C. albicans cells but had no synergistic effect's with FLC. The MIC values for CLE and its fractions against C. albicans reference strain were in the order of HX (31.25 µg ml-1) < EtOAc (62.5 μg ml-1) < CLE (500 μg ml-1), and against FLC-resistant C. albicans HX (125 μg ml-1) = EtOAc < CLE (500 μg ml-1). CLE and its fractions had more potent antifungal activities than FLC against the clinical isolates. Moreover, fungicidal effect's for these plant products were demonstrated against FLC-resistant C. albicans, which further conirmed an antifungal potential. Conversely, during association, plant products were shown to cause an increase in FLC MIC anywhere from 2- to 16-fold. FLC exposure led to an increase in the steady-state levels of ROS (HO●) in C. albicans cells. Next, we found that the increases in FLC MICs were owing to action of antioxidants containing-CLE and its fractions in preventing FLC-induced ROS-mediated growth inhibition of C. albicans. Conclusion: T. paniculatum can be a source of bioactive compounds with antifungal potential. However, because of the common use of its edible leaf, caution is advised during therapy with FLC (since it can decrease FLC susceptibility).

RESUMEN Objetivos: este estudio investigó la bioactividad del extracto de hoja en bruto (EHB) y las fracciones hexano (HX) y acetato de etilo (AcOEt) de Talinum paniculatum solo y en asociación con fluconazol (FLC) contra cepas de referencia y aislados clínicos de Candida albicans resistente a FLC. Además, evaluó la capacidad antioxidante, la composición química de esta planta y los mecanismos subyacentes del efecto fungicida. Métodos: la actividad antifúngica se evaluó mediante microdilución en caldo para establecer las concentraciones inhibitorias mínimas (CIM) y microbicidas mínimas (CMM). Durante el tratamiento con FLC y productos vegetales se detectó la generación de especies reactivas de oxígeno (ERO) (radicales hidroxilo [HO●]) en células de C. albicans utilizando las sondas fluorescentes permeables a la membrana APF y HPF. El perfil de cromatografía líquida de alta resolución (CLAR), el análisis cuantitativo de compuestos antioxidantes y el ensayo DPPH fueron evaluados. Resultados: el EHB y las fracciones presentaron una excelente actividad antifúngica y selectividad contra las células de C. albicans, pero no tuvieron efectos sinérgicos con FLC. Los valores de CIM para EHB y sus fracciones contra la cepa referencia de C. albicans fueron del orden de: HX (31,25 μg ml-1) < AcOEt (62,5 μg ml-1) < EHB (500 μg ml-1), y contra C. albicans resistente a FLC: HX (125 μg ml-1)= AcOEt < EHB (500 µg ml-1). EHB y sus fracciones fueron más potentes antifúngicos que FLC contra los aislados clínicos. Además, estos productos vegetales tienen efectos fungicidas contra C. albicans resistentes a FLC, esto conirmó el potencial antifúngico. Por el contrario, durante la asociación se demostró que los productos vegetales causan un aumento en la CIM de FLC de 2 a 16 veces. La exposición a FLC aumentó los niveles de ERO (HO●) en las células de C. albicans. Los aumentos en las CIM de FLC se debieron a la acción de los antioxidantes presentes en EHB y sus fracciones para prevenir la inhibición del crecimiento mediada por ERO inducida por FLC en C. albicans. Conclusión: T. paniculatum puede ser una fuente de compuestos bioactivos con potencial antifúngico. Sin embargo, debido al uso común de su hoja comestible, se recomienda usarla con precaución durante la terapia con FLC (ya que puede disminuir la susceptibilidad a FLC).

Talinum paniculatum leaves with in vitro antimicrobial activity against reference and clinical strains of Staphylococcus aureus interfere with oxacillin action / Las hojas de Talinum paniculatum con actividad antimicrobiana in vitro contra cepas de referencia y clínicas de Staphylococcus aureus interfieren con la acción de la oxacilina

SUMMARY Propose: We evaluated the antibacterial potential of the crude leaf extract (CLE) and fractions hexane (HX) and ethyl acetate (EtOAc) from Talinum paniculatum alone and in association with oxacillin (OXA) against OXA-resistant Staphylococcus aureus (ORSA, environment isolates) and OXA-sensitive S. aureus (OSSA, ATCC 25923). Furthermore, toxicity tests were performed. Methods: The antibacterial activity was evaluated through checkerboard assay (broth microdilution) to establish the minimum inhibitory (MIC) and minimum bactericidal concentrations (MBC). Toxicity test in mice was assessed. Results: The MIC values for the CLE and its fractions against ORSA and OSSA were in the order of HX (500 μg ml-1) = EtOAc < CLE (4000 μg ml-1). EtOAc and HX presented outstanding antibacterial activities against ORSA, and these fractions were bactericidal toward OSSA. Conversely, the associations between plant product (CLE, EtOAc, or HX) and OXA exhibited no synergistic effects. During these associations, there was an increase in OXA MICs anywhere from 2- to 4092-fold. The CLE presented absence of toxicity at a dose of 5 g kg-1 (in vivo). Conclusion: Although T. paniculatum be a good source of bioactive compounds with antistaphylococcal potential, the researchers should be cautious, since its edible leaf may interfere with OXA therapy (mitigating OXA-induced growth inhibition or killing of S. aureus and enhancing S. aureus resistance).

RESUMEN Propósito: evaluamos el potencial antibacteriano del extracto de hoja en bruto (EHB) y las fracciones hexano (HX) y acetato de etilo (AcOEt) de Talinum paniculatum solo y en asociación con oxacilina (OXA) contra Staphylococcus aureus resistente a OXA (ORSA, ambientales) y S. aureus sensible a OXA (OSSA, ATCC 25923). Además, se realizaron pruebas de toxicidad. Métodos: la actividad antibacteriana se evaluó mediante microdilución en caldo para establecer las concentraciones inhibitorias mínimas (CIM) y bactericidas mínimas (CBM). Se evaluó la toxicidad en ratones. Resultados: los valores de CIM para el EHB y sus fracciones contra ORSA y OSSA fueron del orden de HX (500 μg ml-1) = AcOEt < EHB (4000 μg ml-1). AcOEt y HX presentaron actividades antibacterianas sobresalientes contra ORSA, y estas fracciones fueron bactericidas hacia OSSA. Por el contrario, las asociaciones entre el producto vegetal (EHB, AcOEt o HX) y OXA no mostraron efectos sinérgicos. Durante estas asociaciones, hubo un aumento en las CIM de OXA de 2 a 4092 veces. EHB no mostró toxicidad a una dosis de 5 g kg-1. Conclusión: aunque T. paniculatum es una buena fuente de compuestos bioactivos con potencial antiestofilocócico, los investigadores deben ser cautelosos, ya que su hoja comestible puede interferir con la terapia con OXA (mitigando la inhibición del crecimiento inducida por OXA o la muerte de S. aureus y promoviendo resistencia bacteriana).

Study and evaluation of antimicrobial activity and antioxidant capacity of dry extract and fractions of leaves of Raphanus sativus var. oleiferus Metzg / Estudo e avaliação da atividade antimicrobiana e capacidade antioxidante do extrato seco e frações de folhas de Raphanus sativus var. oleiferus Metzg

The radish (Raphanus sativus L.) is a vegetable of the Brassicaceae family cultivated worldwide and has several medicinal properties. Its biological activities are related to various secondary metabolites present in the species, especially phenolics. Thus, the objectives of this study were the chemical analysis and evaluation of the antioxidant and antimicrobial activities of the dry extract and fractions of the fodder turnip leaves (R. sativus var. oleiferus Metzg.). Samples were analyzed by mass spectrometry and the antioxidant activity was evaluated using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical method and the reducing power method. Antimicrobial activity was determined by the agar diffusion and microdilution methods. The total phenols were concentrated in the butanol fraction (121.27 mg GAE/g) and the flavonoids were concentrated in the ethyl acetate fraction (98.02 mg EQ/g). The ethyl acetate fraction showed the best antioxidants results, with 83.45% of free radical scavenging and 11.34% of ferric ions reduction. The analysis of antimicrobial activity showed that the dry extract had the highest average zone of inhibition against Bacillus subtilis (18.67 mm). Smaller values of the minimum inhibitory concentration for Micrococcus luteus were, and the ethyl acetate fraction showed a lower minimum inhibitory concentration (0.1 mg/ml) for that microorganism. There was a strong correlation between the antioxidant activity and the content of phenols and flavonoids. The results showed the potential antioxidant and antimicrobial activities of this extract with the ethyl acetate fraction being most promising for further studies.

O rabanete(Raphanus sativus L.) é um vegetal da família Brassicaceae cultivado em todo o mundo e possui diversas propriedades medicinais. Suas atividades biológicas estão relacionadas aos vários metabólitos secundários presentes na espécie, especialmente os compostos fenólicos. Desta forma, os objetivos deste estudo foram realizar análises químicas e avaliar as atividades antioxidante e antimicrobiana do extrato seco e das frações das folhas de R. sativus var. oleiferus Metzg. As amostras foram analisadas em espectrômetro de massas e o potencial antioxidante foi avaliado pelos métodos do radical DPPH (2,2-difenil-1-picrilhidrazila) e do poder redutor. A atividade antimicrobiana foi determinada pelos métodos de difusão em ágar e da microdiluição. Observou-se que os fenóis totais se concentraram na fração butanólica (121,27 mg EAG/g), enquanto que e os teores de flavonoides concentraram-se na fração acetato de etila (98,02 mg EQ/g). A fração acetato de etila apresentou os melhores resultados antioxidantes, com porcentagem de sequestro dos radicais DPPH de 83,45% e com porcentagem de redução dos íons férrico de 11,34%. A análise da atividade antimicrobiana revelou que o extrato seco teve maior média de halos de inibição frente ao Bacillus subtilis(18,67 mm). Os menores valores da concentração inibitória mínima foram para Micrococcus luteus, sendo que a fração acetato de etila demonstrou menor concentração inibitória mínima (0,1 mg/mL) para esse micro-organismo. Houve uma forte correlação entre a atividade antioxidante e o teor de fenóis e de flavonoides. Os resultados demonstraram potenciais ações antioxidante e antimicrobiana do extrato e das frações avaliados, sendo a fração acetato de etila promissora para estudos posteriores.

Evaluation of antimicrobial and cytotoxic activities of plant extracts from southern Minas Gerais cerrado.

The antimicrobial activity of plant hidroethanolic extracts on bacteria Gram positive, Gram negative, yeasts, Mycobacterium tuberculosis H37 and Mycobacterium bovis was evaluated by using the technique of Agar diffusion and microdilution in broth. Among the extracts evaluated by Agar diffusion, the extract of Bidens pilosa leaf presented the most expressive average of haloes of growth inhibition to the microorganisms, followed by the extract of B. pilosa flower, of Eugenia pyriformis' leaf and seed, of Plinia cauliflora leaf which statistically presented the same average of haloes inhibitory formation on bacteria Gram positive, Gram negative and yeasts. The extracts of Heliconia rostrata did not present activity. Mycobacterium tuberculosis H37 and Mycobacterium bovis (BCG) appeared resistant to all the extracts. The susceptibility profile of Candida albicans and Saccharomyces cerevisiae fungi were compared to one another and to the Gram positive Bacillus subtilis, Enterococcus faecalis and the Gram negative Salmonella typhimurium bacteria (p > 0.05). The evaluation of cytotoxicity was carried out on C6-36 larvae cells of the Aedes albopictus mosquito. The extracts of stem and flower of Heliconia rostrata, leaf and stem of Plinia cauliflora, seed of Anonna crassiflora and stem, flower and root of B. pilosa did not present toxicity in the analyzed concentrations. The highest rates of selectivity appeared in the extracts of stem of A. crassiflora and flower of B. pilosa to Staphylococcus aureus, presenting potential for future studies about a new drug development.

In vitro screening antibacterial activity of Bidens pilosa Linné and Annona crassiflora Mart. against oxacillin resistant Staphylococcus aureus (ORSA) from the aerial environment at the dental clinic.

Currently multiresistant Staphylococcus aureus is one common cause of infections with high rates of morbidity and mortality worldwide, which directs scientific endeavors in search for novel antimicrobials. In this study, nine extracts from Bidens pilosa (root, stem, flower and leaves) and Annona crassiflora (rind fruit, stem, leaves, seed and pulp) were obtained with ethanol: water (7:3, v/v) and their in vitro antibacterial activity evaluated through both the agar diffusion and broth microdilution methods against 60 Oxacillin Resistant S. aureus (ORSA) strains and against S. aureus ATCC6538. The extracts from B. pilosa and A. crassiflora inhibited the growth of the ORSA isolates in both methods. Leaves of B. pilosa presented mean of the inhibition zone diameters significantly higher than chlorexidine 0.12% against ORSA, and the extracts were more active against S. aureus ATCC (p < 0.05). Parallel, toxicity testing by using MTT method and phytochemical screening were assessed, and three extracts (B. pilosa, root and leaf, and A. crassiflora, seed) did not evidence toxicity. On the other hand, the cytotoxic concentrations (CC50 and CC90) for other extracts ranged from 2.06 to 10.77 mg/mL. The presence of variable alkaloids, flavonoids, tannins and saponins was observed, even though there was a total absence of anthraquinones. Thus, the extracts from the leaves of B. pilosa revealed good anti-ORSA activity and did not exhibit toxicity.

Triagem oftalmológica e análise dos potenciais fatores de risco para a baixa acuidade visual de alunos no Ensino Fundamental I (primeira a quarta série) da rede pública em Alfenas/MG (Brasil) / Ophthalmologic screening and analysis of potential risk factors for the low visual acuity in children from first to fourth grade attending Alfenas City/MG (Brazil) public elementary schools

Objetivos: Neste estudo foi realizada uma triagem oftalmológica em crianças matriculadas em duas escolas (1ª a 4ª série) da rede pública de ensino no município de Alfenas ­ MG (Brasil), posteriormente relacionando a baixa acuidade visual (AV) com fatores de risco. Metodologia: Este é um estudo transversal no qual a AV foi avaliada por meio do teste de Snellen e questionários foram respondidos pelos pais e professores das crianças que apresentaram alterações da AV. Resultados: Foram avaliadas 764 crianças (n = 764, 52% do sexo feminino; IC(95%) 48-55%) de 6 a 10 anos de idade, tendo sido observado que 97 delas (13%; IC(95%) 10-15%) apresentaram alguma alteração na AV e, dentre as 97, 53% (IC(95%) 43-63%) foram do sexo masculino. Não houve relação entre a prevalência de baixa AV e sexo da criança (χ² com p>0,05). O teste exato de Fisher revelou que a alta percentagem de crianças que nunca realizaram um exame oftalmológico teve uma significativa relação com a baixa AV (p<0,0001). 30% das crianças alegaram aos pais "enxergar bem" (autopercepção da visão), apesar de apresentarem baixa AV, indicando que a simples falta do parâmetro de comparação para a percepção de problemas na AV torna as triagens oftalmológicas essenciais nesta faixa etária. Em entrevista com professores, foi verificado haver uma infra-estrutura inadequada no sistema educacional e dificuldades para satisfazer as necessidades básicas educacionais de crianças com problemas visuais, bem como para identificar alterações na AV dos alunos e propiciar promoção de saúde no espaço escolar. Conclusão: Neste estudo a prevalência de baixa AV foi 13%, assim, é destacada a importância de uma triagem oftalmológica em crianças em idade pré-escolar e escolar visando o diagnóstico precoce dos problemas de visão e posterior esclarecimento e tratamento, possibilitando os desenvolvimentos social e cognitivo normais dos estudantes.

Aims: In this study, an ophthalmologic screening was performed in children attending two public schools (from 1st to 4th grade) in Alfenas city/MG (Brazil), and later correlated low visual acuity (VA) with risk factors. Methodology: This is a cross-sectional study, in which the VA was evaluated through the Snellen test and the parents and teachers of the children who presented alterations then answered questionnaires. Results: A total of 764 children (n = 764, 52.0% were females; CI(95%) 48.0-55.0%) from 6 to 10 years of age were evaluated, with 97 (13.0%; CI(95%) 10.0-15.0%) suffering impairment in the VA; of these, 53.0% (CI(95%) 43.0-63.0%) were males. The prevalence of low VA in male and female children was statistically the same (χ² with p>0.05). The Fisher test evidenced that the higher percentage of children who had never ever performed an ophthalmologic examination had a significant relation with low VA (p<0.0001). To 30% parents' awareness, the children claimed "see well" (despite they present low VA, as detected here), indicating that the simple lack of a comparison parameter for the perception of visual impairments makes ophthalmologic screening essential in this age group. In an interview with teachers, the respondents reported an inadequate infrastructure in the educational system and difficulties to satisfy the basic educational needs of children with sight problems, as well as to identify alterations in the VA of them, and to afford health promotion at schools. Conclusion: We reported that the prevalence of low VA was 13% accordingly is highlighted the importance of ophthalmologic screening of school-age children is highlighted, aiming at the early detection of eye problems in childhood and subsequent clarification and treatment, making possible a normal social and cognitive development of the students.

Parâmetros Nutricionais em Pacientes Oncológicos atendidos em um Centro de Referência no Sul de Minas Gerais, Brasil / Nutritional Parameters in Patients with Cancer attended at a Reference Center in the south of Minas Gerais state, Brazil / Parámetros Nutricionales en Pacientes Oncológicos asistidos en un Centro de Referencia en el Sur de Minas Gerais, Brasil

Introdução: a orientação nutricional é de extrema importância para pacientes oncológicos, prevenindo deficiências nutricionais que podem gerar sérias complicações. Objetivo: avaliar o perfil nutricional de pacientes oncológicos. Método: estudo transversal, realizado em um centro de referência em oncologia de alfenas - MG. Para traçar o perfil nutricional de 52 pacientes oncológicos (n=52) durante o tratamento quimioterápico, foram utilizados métodos dietéticos e antropométricos (índice de massa corporal [iMc], prega cutânea tricipital [Pct], circunferência do braço [cB], circunferência muscular do braço [cMB] e percentagem da perda de peso [%PP]). dados gerais de saúde dos pacientes foram também avaliados. Resultados: Houve predominância do sexo feminino (63%), faixa etária >50 anos (40% ic95% 27-53,7). o tipo de câncer correlacionou-se ao sexo (p<0,01). no sexo feminino, o de mama teve prevalência de 51%, seguido pelo uterino (18%). no masculino, a prevalência de câncer de próstata foi de 10% e, comum aos dois sexos, o câncer de pulmão, de 15%, sendo o mais prevalente no masculino (32%). Hipertensão arterial sistêmica foi a comorbidade mais reportada (75%) e enjoos, o efeito adverso mais comum (69%). as médias dos parâmetros iMc, Pct, cB e cMB não sofreram alterações significativas (p>0,05) ao final do tratamento, mas 40% dos pacientes tiveram um grave %PP, 23% não grave %PP, 4% mantiveram o peso e 33% apresentaram ganho de peso. entre os pacientes avaliados, 48% usavam suplementos nutricionais. Conclusão: a orientação nutricional deve ser desenvolvida junto aos pacientes oncológicos, desde que se demonstrou um variado perfil nutricional em uma amostra heterogênea de pacientes

Introduction: nutritional counseling for patients with cancer is very important, because it can prevent nutritional deficiencies and other serious complications. Objective: to evaluate the nutritional profile of oncological patients. Method: cross-sectional study, carried out at a reference center in oncology, alfenas, Minas Gerais, Brazil. dietary and anthropometric methods (body mass index [BMi], triceps skinfold [ts], arm circumference [aB], arm muscle circumference [aMc], and percentage of weight loss [PWl]) were used to trace the nutritional profile of 52 oncological patients (n=52) during chemotherapy. other conditions of health were also evaluated. Results: There was a predominance of female sex (63%), and the age group >50 years (40% ci95[%] 27-53.7). The type of cancer correlated with patient's sex (p<0.01). in female sex, the breast cancer had a prevalence of 51%, followed by the uterus cancer (18%). in male sex, the prevalence of prostate cancer was 10%, and, common to both sexes, lung cancer had a prevalence of 15%, being the most prevalent in males (32%). systemic arterial hypertension was the most reported comorbidity (75%), and motion sickness the most common adverse event (69%). The mean values of the parameters BMi, ts, aB and aMc did not change significantly (p>0.05) at the end of the treatment, but 40% of the patients had a severe PWl, 23% no severe PWl, 4% kept the weight, and 33% presented weight gain. among the patients evaluated, 48% used nutritional supplements. Conclusion: nutritional counseling should be developed together with oncological patients, since we showed a variable nutritional profile in a heterogeneous sample of patients.

ntroducción: la orientación nutricional es de extrema importancia para los pacientes oncológicos, previniendo deficiencias nutricionales que pueden generar serias complicaciones. Objetivo: evaluar el perfil nutricional de 52 pacientes oncológicos. Método: estudio transversal, realizado en un centro de referencia en oncología de alfenas, Minas Gerais, Brasil. Para desenar el perfil nutricional de 52 pacientes oncológicos (n=52) durante la quimioterapia, se utilizaron métodos dietéticos y antropométricos (índice de masa corporal [iMc], pliegue cutáneo tricipital [Pct], circunferencia del brazo [cB], circunferencia muscular del brazo [cMB]) y el porcentaje de la pérdida de peso [% PP]). se evaluaron también los datos generales de salud de los pacientes. Resultados: Hubo predominancia del sexo femenino (63%), y la franja de edad >50 años (40% ic95% 27-53,7). el tipo de cáncer se correlacionó con el sexo (p<0,01). en el sexo femenino, el de mama tuvo prevalencia del 51%, seguido por el uterino (18%). Para el sexo masculino, la prevalencia de cáncer de próstata fue del 10% y, común a los dos sexos, el cáncer de pulmón tuvo una prevalencia del 15%, siendo el más prevalente el sexo masculino (32%). Hipertensión arterial sistémica fue la comorbilidad más reportada (75%), y mareo el efecto adverso más común (69%). los valores de los parámetros iMc, Pct, cB y cMB no sufrieron cambios significativos (p>0,05) al final del tratamiento, pero el 40% de los pacientes tuvieron una grave % PP, el 23% una no grave % PP, el 4% mantuvieron el peso y el 33% de los evaluados presentaron una ganancia de peso. entre los pacientes evaluados, 48% usaban suplementos nutricionales. Conclusión: la orientación nutricional debe desarrollarse junto a los pacientes oncológicos, una vez que se haya demostrado un variado perfil nutricional en una muestra heterogéneo de pacientes

Green banana pasta diet prevents oxidative damage in liver and kidney and improves biochemical parameters in type 1 diabetic rats

ABSTRACT Objective In this study, the effects of a green banana pasta diet on the oxidative damage from type 1 diabetes mellitus (DM) were investigated. Materials and methods Formulations containing 25 (F25), 50 (F50), and 75% (F75) of green banana pasta were prepared and included in a 12-week diet of Wistar rats with alloxan-induced type 1 DM. The effects of these formulations in preventing oxidative damage in kidneys and liver homogenates of rats were evaluated using the TBARS assay (lipid peroxidation in liver) and the DNPH assay (protein oxidation in liver and kidneys). Furthermore, the effects of the formulations on the fasting glycemia, fructosamine levels, renal function (creatinine), liver function (enzymes aspartate aminotransferase [AST] and alanine aminotransferase [ALT]), and lipid profile (total cholesterol and fractions) in the serum of rats were evaluated in addition to the evaluation of the centesimal composition and microbiological analysis of the produced green banana pasta. Results An F75 diet prevented hyperglycemia in diabetic rats (p < 0.05) compared to the diabetic rats fed a standard diet (commercial feed). Notably, the protein oxidation in both the liver and kidneys were prevented in diabetic rats on the F50 or F75 diets compared to the control group, whereas the lipid peroxidation was only prevented in the liver (p < 0.05). Moreover, all formulations prevented an increase in the amount of triglycerides in the serum of the rats. The F25 and F50 diet prevented the increase of cholesterol, and the F75-based diet of ALT and fructosamine (p < 0.05) supported the anti-hyperglycemic effects and the protection against oxidative damage. Conclusion The green banana pasta (F75) diet showed great potential for preventing complications associated with diabetes.