RESUMO
BACKGROUND: Toxoplasmosis is potentially avoidable, treatable, and curable by simple and direct preventive measures. Knowledge, attitudes, and practices (KAP) assessments concerning gestational toxoplasmosis were evaluated in a cohort of pregnant women from Armenia-Quindío (Colombia, South America). METHODS: This cross-sectional descriptive KAP-type study was performed with informed consent between October 2021 and March 2022. The intervention involved a ten-minute talk administered by prenatal clinic nurses to pregnant women. This took place in the public health clinic RedSalud and the private clinic Happy Maternity with a post-KAP survey after pregnancy. RESULTS: The findings of the initial KAP survey revealed that approximately 42.8 % of the 250 mothers surveyed had IgG anti-T. gondii antibodies present. A strong correlation was observed between a lower frequency of antibodies and a higher level of education. Following an educational intervention, 73 seronegative women demonstrated a significant improvement in their knowledge and behavior. Among the 111 mothers who received the intervention, 42 (37 %) were followed until delivery. Unfortunately, their level of compliance with prenatal serological follow-up was lower compared to previous historical records of cohort of mothers in the same health center during pre-pandemic periods. No seroconversion occurred, although the small number of cases makes the outcome inconclusive with respect to statistical significance. CONCLUSIONS: Education plays a crucial role in imparting valuable knowledge and fostering effective practices. It holds significant potential to prevent toxoplasmosis in pregnant seronegative mothers. Prenatal check-ups have proven to be a critical determinant in leveraging the benefits of education for seronegative mothers. Reporting and observed behaviors differed, identifying areas for improvement.
Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Toxoplasmose , Humanos , Feminino , Gravidez , Estudos Transversais , Adulto , Toxoplasmose/prevenção & controle , Adulto Jovem , Colômbia , Anticorpos Antiprotozoários/sangue , Toxoplasma/imunologia , Inquéritos e Questionários , Complicações Parasitárias na Gravidez/prevenção & controle , Gestantes/psicologia , Cuidado Pré-Natal , Imunoglobulina G/sangue , AdolescenteRESUMO
Toxoplasmosis is the most prevalent parasitic zoonosis worldwide, causing ocular and neurological diseases. No vaccine has been approved for human use. We evaluated the response of peripheral blood mononuclear cells (PBMCs) to a novel construct of Toxoplasma gondii total antigen in maltodextrin nanoparticles (NP/TE) in individuals with varying infectious statuses (uninfected, chronic asymptomatic, or ocular toxoplasmosis). We analyzed the concentration of IFN-γ after NP/TE ex vivo stimulation using ELISA and the immunophenotypes of CD4+ and CD8+ cell populations using flow cytometry. In addition, serotyping of individuals with toxoplasmosis was performed by ELISA using GRA6-derived polypeptides. Low doses of NP/TE stimulation (0.9 µg NP/0.3 µg TE) achieved IFN-γ-specific production in previously exposed human PBMCs without significant differences in the infecting serotype. Increased IFN-γ expression in CD4+ effector memory cell subsets was found in patients with ocular toxoplasmosis with NP/TE but not with TE alone. This is the first study to show how T-cell subsets respond to ex vivo stimulation with a vaccine candidate for human toxoplasmosis, providing crucial insights for future clinical trials.
Assuntos
Antígenos de Protozoários , Interferon gama , Ativação Linfocitária , Nanopartículas , Polissacarídeos , Toxoplasma , Toxoplasmose , Humanos , Nanopartículas/química , Polissacarídeos/imunologia , Toxoplasma/imunologia , Antígenos de Protozoários/imunologia , Toxoplasmose/imunologia , Interferon gama/metabolismo , Interferon gama/imunologia , Ativação Linfocitária/imunologia , Feminino , Adulto , Leucócitos Mononucleares/imunologia , Leucócitos Mononucleares/metabolismo , Linfócitos T CD4-Positivos/imunologia , Linfócitos T CD4-Positivos/metabolismo , Masculino , Linfócitos T CD8-Positivos/imunologia , Linfócitos T CD8-Positivos/metabolismo , Linfócitos T/imunologia , Linfócitos T/metabolismo , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Congenital toxoplasmosis is a treatable, preventable disease, but untreated causes death, prematurity, loss of sight, cognition and motor function, and substantial costs worldwide. OBJECTIVES: We asked whether high performance of an Immunochromatographic-test (ICT) could enable accurate, rapid diagnosis/treatment, establishing new, improved care-paradigms at point-of-care and clinical laboratory. METHODS: Data were obtained in 12 studies/analyses addressing: 1-feasibility/efficacy; 2-false-positives; 3-acceptability; 4-pink/black-line/all studies; 5-time/cost; 6-Quick-Information/Limit-of-detection; 7, 8-acute;-chronic; 9-epidemiology; 10-ADBio; 11,12-Commentary/Cases/Chronology. FINDINGS: ICT was compared with gold-standard or predicate-tests. Overall, ICT performance for 1093 blood/4967 sera was 99.2%/97.5% sensitive and 99.0%/99.7% specific. However, in clinical trial, FDA-cleared-predicate tests initially caused practical, costly problems due to false-positive-IgM results. For 58 persons, 3/43 seronegative and 2/15 chronically infected persons had false positive IgM predicate tests. This caused substantial anxiety, concerns, and required costly, delayed confirmation in reference centers. Absence of false positive ICT results contributes to solutions: Lyon and Paris France and USA Reference laboratories frequently receive sera with erroneously positive local laboratory IgM results impeding patient care. Therefore, thirty-two such sera referred to Lyon's Reference laboratory were ICT-tested. We collated these with other earlier/ongoing results: 132 of 137 USA or French persons had false-positive local laboratory IgM results identified correctly as negative by ICT. Five false positive ICT results in Tunisia and Marseille, France, emphasize need to confirm positive ICT results with Sabin-Feldman-Dye-test or western blot. Separate studies demonstrated high performance in detecting acute infections, meeting FDA, CLIA, WHO REASSURED, CEMark criteria and patient and physician satisfaction with monthly-gestational-ICT-screening. CONCLUSIONS/SIGNIFICANCE: This novel paradigm using ICT identifies likely false positives or raises suspicion that a result is truly positive, rapidly needing prompt follow up and treatment. Thus, ICT enables well-accepted gestational screening programs that facilitate rapid treatment saving lives, sight, cognition and motor function. This reduces anxiety, delays, work, and cost at point-of-care and clinical laboratories. TRIAL REGISTRATION: NCT04474132, https://clinicaltrials.gov/study/NCT04474132 ClinicalTrials.gov.
Assuntos
Toxoplasmose Congênita , Feminino , Humanos , Recém-Nascido , Gravidez , Anticorpos Antiprotozoários/sangue , Reações Falso-Positivas , Imunoglobulina M/sangue , Diagnóstico Pré-Natal/métodos , Sensibilidade e Especificidade , Toxoplasma/imunologia , Toxoplasmose Congênita/diagnóstico , Toxoplasmose Congênita/prevenção & controleRESUMO
Las infecciones perinatales son una causa de morbilidad, tanto fetal como neonatal, y que compromete la salud de la mujer embarazada, por lo que su diagnóstico, tratamiento, e intento de eliminación son una prioridad en América Latina y el Caribe. Este documento representa la segunda entrega realizada por expertos en la región dentro de la Sociedad Latinoamericana de Infectología Pediátrica (SLIPE), brindando una mirada actualizada en el manejo de las infecciones congénitas y entrega herramientas para detectar posibles momentos estratégicos de intervención y cambio en el manejo de las infecciones congénitas.
Perinatal infections are a major cause of morbidity and mortality in the fetus, neonate, and the health of the pregnant woman. Diagnosis, treatment, and the search for elimination of these diseases are a priority in Latin America and the Caribbean. This document represents the second delivery by a group of experts in the region inside the Latin-American Society of Pediatric Infectious Diseases (SLIPE), presenting a up-to-date look into the management of congenital infectious diseases and give a tool to detect possible strategic sceneries and a change in the management of congenital infections in our region.
Assuntos
Humanos , Feminino , Gravidez , Recém-Nascido , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/terapia , Infecções por Arbovirus/congênito , Infecções por Arbovirus/diagnóstico , Infecções por Arbovirus/terapia , Toxoplasmose/diagnóstico , Toxoplasmose/terapia , Toxoplasmose Congênita , Doenças Transmissíveis , Infecções por Citomegalovirus , Infecções por Citomegalovirus/diagnóstico , Infecções por Citomegalovirus/terapia , Dengue , Infecção por Zika virus , COVID-19 , Herpes Simples/congênito , Herpes Simples/diagnóstico , Herpes Simples/terapiaRESUMO
Ocular toxoplasmosis (OT) is characterized by inflammation within the eye and is the most recognized clinical manifestation of toxoplasmosis. The objective of this study was to identify new single-nucleotide polymorphisms (SNPs) in the P2RX7 gene that may have significance in the immune response to OT in Colombian patients. A case-control study was conducted to investigate the associations between SNPs (rs1718119 and rs2230912) in the P2RX7 gene and OT in 64 Colombian patients with OT and 64 controls. Capillary electrophoresis was used to analyze the amplification products, and in silico algorithms were employed to predict deleterious SNPs. Stability analysis of amino acid changes indicated that both mutations could lead to decreased protein structure stability. A nonsynonymous SNP, Gln460Arg, located in the long cytoplasmic tail of the receptor, showed a significant association with OT (Bonferroni correction (BONF) = 0.029; odds ratio OR = 3.46; confidence interval CI: 1.05 to 11.39), while no significant association between rs1718119 and OT risk was observed. Based on the 3D structure analysis of the P2RX7 protein trimer, it is hypothesized that an increase in the flexibility of the cytoplasmic domain of this receptor could alter its function. This SNP could potentially serve as a biomarker for identifying Colombian patients at risk of OT.
RESUMO
This work analyzed exhaustion markers in CD8+ T-cell subpopulations in 21 samples of peripheral blood mononuclear cells (PBMCs) from individuals with ocular toxoplasmosis (n = 9), chronic asymptomatic toxoplasmosis (n = 7), and non-infected people (n = 5) by using RT-qPCR and flow cytometry techniques. The study found that gene expression of PD-1 and CD244, but not LAG-3, was higher in individuals with ocular toxoplasmosis versus individuals with asymptomatic infection or uninfected. Expression of PD1 in CD8+ central memory (CM) cells was higher in nine individuals with toxoplasmosis versus five uninfected individuals (p = .003). After ex vivo stimulation, an inverse correlation was found between the exhaustion markers and quantitative clinical characteristics (lesion size, recurrence index, and number of lesions). A total exhaustion phenotype was found in 55.5% (5/9) of individuals with ocular toxoplasmosis. Our results suggest that the CD8+ exhaustion phenotype is involved in the pathogenesis of ocular toxoplasmosis.
RESUMO
Strong evidence exists based on metanalysis of the relationship between toxoplasmosis and many psychiatric diseases: schizophrenia, bipolar disorder, and suicidal behavior. Herein, we estimate the number of cases based on the attributable fraction due to toxoplasmosis on these diseases. The population attributable fraction of mental disease associated with toxoplasmosis was 20,4% for schizophrenia; 27,3% for bipolar disorder; and 0,29% for suicidal behavior (self-harm). The lower and upper estimated number of people with mental disease associated with toxoplasmosis was 4'816.491 and 5'564.407 for schizophrenia; 6'348.946 and 7'510.118,82 for bipolar disorder; and 24.310 and 28.151 for self-harm; for a global total lower estimated number of 11'189.748 and global total upper estimated number of 13'102.678 people with mental disease associated with toxoplasmosis for the year 2019. According to the prediction through the Bayesian model of risk factors for toxoplasmosis associated with mental disease, these varied in importance geographically; thus, in Africa, the most important risk factor was water contamination and in the European region, the cooking conditions of meats. Toxoplasmosis and mental health should be a research priority given the enormous potential impact of reducing this parasite in the general population.
Assuntos
Transtornos Mentais , Toxoplasma , Toxoplasmose , Humanos , Teorema de Bayes , Transtornos Mentais/epidemiologia , Transtornos Mentais/complicações , Toxoplasmose/complicações , Toxoplasmose/epidemiologia , Toxoplasmose/parasitologia , Fatores de RiscoRESUMO
Toxoplasma gondii (T. gondii) is a zoonotic apicomplexan parasite that is an important cause of clinical disability in humans. On a global scale, one third of the human population is infected with T. gondii. Mice and other small rodents are believed to be responsible for transmission of T. gondii to the domestic cat, its definitive host. Interferon-inducible Immunity-Related GTPases (IRG proteins) are important for control of murine T. gondii infections. Virulence differences between T. gondii strains are linked to polymorphic rhoptry proteins (ROPs) that cooperate to inactivate individual IRG family members. In particular, the pseudokinase ROP5 isoform B is critically important in laboratory strains of mice. We identified T. gondii ROP39 in complex with ROP5B and demonstrate its contribution to acute T. gondii virulence. ROP39 directly targets Irgb10 and inhibits homodimer formation of the GTPase leading to an overall reduction of IRG protein loading onto the parasitophorous vacuolar membrane (PVM). Maintenance of PVM integrity rescues the parasite from IRG protein-mediated clearance in vitro and in vivo. This study identifies a novel T. gondii effector that is important for specific inactivation of the IRG resistance system. Our data reveal that yet unknown T. gondii effectors can emerge from identification of direct interaction partners of ROP5B.
Assuntos
Parasitos , Toxoplasma , Toxoplasmose , Animais , Camundongos , Humanos , Gatos , Toxoplasma/metabolismo , Parasitos/metabolismo , Virulência , Proteínas de Protozoários/genética , Proteínas de Protozoários/metabolismo , GTP Fosfo-Hidrolases/metabolismoRESUMO
BACKGROUND: A new point of care test (POC) was developed that is promising as a tool to enhance impact of prenatal care programs for toxoplasmosis, however, no reports exist about its use or acceptability for healthcare personnel and mothers in Colombia. METHODS: This was a translational research - phase III study of the acceptability of a new POC test (Toxoplasma ICT IgG-IgM, LDBio) for qualitative diagnosis of toxoplasmosis in 783 pregnant women and 30 health personnel in primary health care sites in the city of Armenia, Quindío (Colombia). Along with collection of the results of diagnostic POC and confirmatory test and demographic information, we evaluated acceptability through measure of the willingness, credibility, and satisfaction by using questionnaires with a Likert scale during routine prenatal care visits. RESULTS: POC positivity was 46.5% among pregnant participants and was significantly related to socioeconomic factors, including education level (p = 0.00000000) and insurance status (p = 0.00000015). A total of 93-97% of healthcare personnel indicated agreement to positive statements regarding total satisfaction and total credibility of the LDBio test, but qualitative questions identified "Difficulty in the test procedure" as the most common response about barriers to apply the test. Greater than 90% of pregnant participants agree that POC test should be routine for all pregnant woman and permanently implemented. CONCLUSIONS: The test had near complete acceptability. In future studies it is necessary to examine the effect of non-differentiation between IgG and IgM isotypes.
Assuntos
Toxoplasma , Toxoplasmose Congênita , Toxoplasmose , Feminino , Humanos , Gravidez , Anticorpos Antiprotozoários , Imunoglobulina G , Imunoglobulina M , Testes Imediatos , Toxoplasmose/diagnóstico , Pesquisa Translacional BiomédicaRESUMO
Two zoonotic protozoan pathogens, Giardia duodenalis and Toxoplasma gondii, are important causes of waterborne infections in the Quindío region in Colombia. No previous data exist on how contamination occurs at the source for drinking water consumed by the human population in this region. Our aim was to describe the frequency of G. duodenalis and T. gondii DNA in 11 sampling points during a five-month period in water and adjacent soil at the Quindío River basin (Andean region in the central western part of Colombia). The study employed nested PCR for T. gondii, using the B1 gene as the amplification target, and single-round PCR for G. duodenalis assemblage A and assemblage B, amplifying the gdh gene, followed by DNA sequencing. In 50 soil samples, 28% (14/50) were positive for T. gondii. For G. duodenalis, distribution was in equal parts for assemblage A (8%; 4/50) and assemblage B (8%, 4/50). Genotyping of T. gondii sequences showed two soil samples with type I strain, another two samples of soil with type III strain, but most samples were of unidentified strains. In water samples, T. gondii was detected in 9.1% (5/55), G. duodenalis assemblage A in 34.5% (19/55), and G. duodenalis assemblage B in 12.7% (7/55). T. gondii DNA positivity was associated with lower soil temperature (p = 0.0239). Presence of G. duodenalis and T. gondii was evidenced in soil and water samples in the Quindío River basin, indicating soil as the potential source of contamination for the river that it is destined for human consumption. Monitoring these protozoa in drinking water is necessary to prevent public health risks in human populations.
RESUMO
Interpretation of IgM anti-Toxoplasma can be problematic given the phenomena of "natural" IgM. We analyzed 1,503 sera obtained during prenatal care program, and we established natural and false-positive results by doing follow-up. In 101 samples the concordance between enzyme linked immunosorbent assay (ELISA) and two semi-automatized systems: electro-chemiluminescence immunoassay (ELECSYS) and vitek immunodiagnostic assay system (VIDAS) was calculated. In 1,503 serum, 71 (4,7%) had ELISA IgG negative and ELISA IgM positive results and in 44 of these had a second sample 4 weeks later. In second samples, 27 (61,3 %) were IgM and IgG negative (false positive result in the first sample) and 13 (29,5%) were ELISA IgM positive and IgG negative (natural IgM). ELISA assay had a poor concordance with enzyme-linked fluorescent immunoassay as well as ELECSYS tests, contrarily, enzyme-linked fluorescent immunoassay and ELECSYS had optimal concordance, with 100 of 101 sera obtaining the same result by both tests. We recommended to use automatized assays to measure IgM anti-Toxoplasma.
Assuntos
Toxoplasma , Toxoplasmose , Anticorpos Antiprotozoários , Colômbia , Ensaio de Imunoadsorção Enzimática/métodos , Feminino , Humanos , Imunoglobulina G , Imunoglobulina M , Gravidez , Gestantes , Toxoplasmose/diagnósticoRESUMO
Resumen Objetivo: Describir la efectividad del tratamiento antiparasitario intestinal brindado a niños de cuatro a nueve años atendidos en el centro de Salud de la Universidad del Quindío entre Julio de 2017 a marzo de 2018. Materiales y métodos: Estudio observacional prospectivo. Se extrajeron datos de historias clínicas de pacientes con rango de edad de 4 a 9 años, quienes consultaron en el Centro de Salud de la Universidad del Quindío y se diagnosticaron mediante coprológico con blastocistosis o giardiasis. Se seleccionaron las historias cuyo tratamiento fuese Nitazoxanida y tuviesen un coprológico control postratamiento. Se presentan estadísticas descriptivas; porcentaje de eficacia y tolerabilidad. Resultados: De 15 niños tratados con Nitazoxanida, respondieron al tratamiento 10, en quienes no se hallaron parásitos en el coprológico control. Con una eficacia del 83,3% (IC95% 60 - 100) en blastocistosis, 57,1% (IC95% 32 - 82%) en giardiasis. Conclusión: Se evidenciaron resultados porcentuales similares a los reportados en la literatura, siendo más eficaz en blastocisotisis que en giardiasis.
Abstract Objective: To describe the effectiveness of the intestinal antiparasitic treatment given to children ranging between 4 and 9 years old that were attended in the Health Center of the University of Quindío in the period of July 2017 and March 2018. Materials and methods: Prospective observational study. Data were extracted from medical records of patients with an age range of 4 to 9 years, who consulted at the Health Center of the University of Quindío and were diagnosed through coprological tests with Blastocystis and Giardiasis. The clinical records were selected by whose treatment was done with Nitazoxanide or Albendazole with coprological results of post-treatment check-up. Descriptive statistics are presented along with percentage of efficacy and tolerability. Results: From 15 children treated with Nitazoxanide, 10 responded to the treatment, who presented no parasites in the coprological check-up. The remaining population presented some type of parasitic infection (n = 5). With an efficiency of 83,3% (IC95% 32 - 82%) in blastocystis, and 57,1% (IC95% 32 - 82%) in giardiasis. Conclusion: Percentage results similar to those reported in the literature were evidenced, being more effective in blastocystis than in giardiasis.
RESUMO
Toxoplasma gondii, as other apicomplexa, employs adhesins transmembrane proteins for binding and invasion to host cells. Search and characterization of adhesins is pivotal in understanding Apicomplexa invasion mechanisms and targeting new druggable candidates. This work developed a machine learning software called ApiPredictor UniQE V2.0, based on two approaches: support vector machines and multilayer perceptron, to predict adhesins proteins from amino acid sequences. By using ApiPredictor UniQE V2.0, five SAG-Related Sequences (SRSs) were identified within the Toxoplasma gondii proteome. One of those candidates, TgSRS12B, was cloned in plasmid pEXP5-CT/TOPO and expressed in E. coli BL21 DE3. The resulting recombinant protein was purified via affinity chromatography. Co-precipitation assays in CaCo and Muller cells showed interactions between TgSRS12B-His-tagged and the membrane fractions from both human cell lines. In conclusion, we demonstrated that ApiPredictor UniQE V2.0, a bioinformatic free software, was able to identify TgSRS12B as a new adhesin protein.
Assuntos
Toxoplasma , Escherichia coli/metabolismo , Humanos , Aprendizado de Máquina , Plasmídeos/genética , Proteínas de Protozoários/genética , Proteínas de Protozoários/metabolismo , Toxoplasma/genética , Toxoplasma/metabolismoRESUMO
Resumen Objetivo: Describir los conocimientos, las actitudes y las prácticas acerca de la toxoplasmosis en dos comunas de Armenia, Quindío, con alta prevalencia de la infección. Metodología: Estudio descriptivo con población de dos comunas de Armenia, Quindío. Se aplicó un cuestionario autodiligenciado tipo conocimientos, actitudes y prácticas. Esta herramienta incluyó elementos sobre el parásito Toxoplasma gondii, sus vías de transmisión, aspectos clínicos, diagnósticos y de tratamiento generales, así como prácticas para evitar la infección. El instrumento se aplicó antes y después de una intervención educativa. Se describieron las frecuencias en el número de respuestas correctas antes y después de la intervención para cada comuna. Resultados: Participaron 27 personas, con una media de edad de 57 años. El 59 % fueron mujeres. El 48% había completado la educación media y el 40,7 % la primaria. El conocimiento del agente causal antes de la intervención fue del 22 %, mientras que posterior a la intervención fue del 92,3 % en la comuna 1 y del 81,8 % en la comuna 6. Posterior a la intervención, cerca del 90 % de los encuestados reconoció la retina como la principal estructura afectada y todos los encuestados reconocieron el consumo de agua hervida como factor protector. Conclusión: Los conocimientos sobre la toxoplasmosis en las dos comunas eran limitados. Luego de la intervención educativa, se evidenció un aumento en el porcentaje de respuestas correctas en la mayoría de las preguntas. Se recomienda realizar nuevas intervenciones educativas y en salud pública, para evaluar los efectos de estas a largo plazo.
Abstract Objective: To describe knowledge, attitudes and practices related to toxoplasmosis in two districts of high prevalence in Armenia, Quindío. Methodology: descriptive study; the population of two districts of Armenia, Quindío were engaged. A self-administered questionnaire regarding knowledge, attitudes, and practices was applied. This tool included elements related to Toxoplasma gondii, its transmission pathways, general clinical, diagnostic and treatment aspects, as well as practices to prevent infection. The instrument was applied before and after an educational intervention. Frequencies were described as the number of correct answers before and after the intervention for each district. Results: 27 people participated, with an average age of 57 years. 59 % were women; 48 % had completed high school and 40.7 % had completed elementary school. Before the intervention, the knowledge of the causal agent was 22 %, while after the intervention, it was 92.3 % in district 1 and 81.8 % in district 6. After the intervention, about 90 % of participants recognized the retina as the main compromised structure and all participants recognized the consumption of boiled water as a protective factor. Conclusion: The knowledge regarding toxoplasmosis in the two districts was limited. After the educational intervention, there was an increase in the percentage of correct answers in most of the questions. New educational and public health interventions are recommended to assess the long-term effects of these interventions.
Resumo Objetivos: O objetivo deste estudo é descrever os problemas, as ações e as práticas sobre a toxoplasmose nas comunidades da Armênia, Quindío, onde se nota alta prevalência da infecção. Metodologia: Este é um estudo descritivo que abrange uma população de duas comunas na Armênia, Quindío. Foi implementada uma ferramenta, que consiste em questionários destinados àquela população e aplicáveis pelos seus próprios membros, que correspondem a conhecimentos, atitudes e práticas. Essa ferramenta inclui elementos sobre o parasito Toxoplasma gondii, suas vias de transmissão, aspectos clínicos gerais, diagnósticos e tratamento, e práticas de prevenção. O instrumento foi aplicado antes e após uma intervenção educativa exata. Foram descritas as frequências do número de acertos, antes e depois da intervenção para cada comuna. Resultados: participaram 27 pessoas, com média de idade de 57 anos, das quais 59 % eram mulheres e 48 % tinham ensino médio completo e 40,7 % ensino primário. O conhecimento do agente causal antes da intervenção havia em 22 %, enquanto que após a intervenção, passou para 92,3 % na comuna 1, e 81,8 % na comuna 6. Após a intervenção, cerca de 90 % dos entrevistados reconheceram a retina como a estrutura mais afetada e todos os entrevistados reconheceram que o consumo de água fervida é um fator de proteção. Conclusão: Desconhecimento sobre a toxoplasmose nas duas comunas. Após a intervenção educativa, houve evidência de aumento do percentual de acertos na maioria das questões. Recomenda-se a realização de novas intervenções educacionais e de saúde pública, para avaliar os efeitos destas a longo prazo na populacão.
RESUMO
AIMS: Cytokines, soluble mediators of immunity, are key factors of the innate and adaptive immune system. They are secreted from and interact with various types of immune cells to manipulate host body's immune cell physiology for a counter-attack on the foreign body. A study was designed to explore the mechanism of Toxoplasma gondii (T. gondii) resistance from host immune response. METHODS AND RESULTS: The published data on aspect of host (murine and human) immune response against T. gondii was taken from Google scholar and PubMed. Most relevant literature was included in this study. The basic mechanism of immune response starts from the interactions of antigens with host immune cells to trigger the production of cytokines (pro-inflammatory and anti-inflammatory) which then act by forming a cytokinome (network of cytokine). Their secretory equilibrium is essential for endowing resistance to the host against infectious diseases, particularly toxoplasmosis. A narrow balance lying between Th1, Th2, and Th17 cytokines (as demonstrated until now) is essential for the development of resistance against T. gondii as well as for the survival of host. Excessive production of pro-inflammatory cytokines leads to tissue damage resulting in the production of anti-inflammatory cytokines which enhances the proliferation of Toxoplasma. Stress and other infectious diseases (human immunodeficiency virus (HIV)) that weaken the host immunity particularly the cellular component, make the host susceptible to toxoplasmosis especially in pregnant women. CONCLUSION: The current review findings state that in vitro harvesting of IL12 from DCs, Np and MΦ upon exposure with T. gondii might be a source for therapeutic use in toxoplasmosis. Current review also suggests that therapeutic interventions leading to up-regulation/supplementation of SOCS-3, IL12, and IFNγ to the infected host could be a solution to sterile immunity against T. gondii infection. This would be of interest particularly in patients passing through immunosuppression owing to any reason like the ones receiving anti-cancer therapy, the ones undergoing immunosuppressive therapy for graft/transplantation, the ones suffering from immunodeficiency virus (HIV) or having AIDS. Another imortant suggestion is to launch the efforts for a vaccine based on GRA6Nt or other similar antigens of T. gondii as a probable tool to destroy tissue cysts.
Assuntos
Toxoplasma , Toxoplasmose , Animais , Citocinas , Feminino , Humanos , Imunidade , Camundongos , GravidezRESUMO
AIMS: To evaluate the biological activity of extracts from cultures of marine bacteria against Toxoplasma gondii and Mycobacterium tuberculosis. METHODS AND RESULTS: Ethyl acetate extracts obtained from seven marine bacteria were tested against T. gondii GFP-RH and M. tuberculosis H37Rv. The cytotoxicity on HFF-1 cells was measured by a microplate resazurin fluorescent approach, and the haemolytic activity was determined photometrically. The extracts from Bacillus sp. (INV FIR35 and INV FIR48) affected the tachyzoite viability. The extracts from Bacillus, Pseudoalteromonas, Streptomyces and Micromonospora exhibited effects on infection and proliferation processes of parasite. Bacillus sp. INV FIR48 extract showed an minimum inhibitory concentration value of 50 µg ml-1 against M. tuberculosis H37Rv. All the extracts exhibited relatively low toxicity to HFF-1 cells and the primary culture of erythrocytes, except Bacillus sp. INV FIR35, which decreased cell viability under 20%. Liquid chromatography coupled to mass spectrometry analysis of the most active bacterial extract Bacillus sp. INV FIR48 showed the presence of peptide metabolites related to surfactin. CONCLUSIONS: The extract from culture of deep-sea Bacillus sp. INV FIR48 showed anti-T. gondii and anti-tuberculosis (TB) biological activity with low cytotoxicity. In addition, peptide metabolites were detected in the extract. SIGNIFICANCE AND IMPACT OF THE STUDY: Toxoplasmosis and TB are among the most prevalent diseases worldwide, and the current treatment drugs exhibit side effects. This study confirm that marine bacteria are on hand sources of anti-infective natural products.
Assuntos
Mycobacterium tuberculosis , Toxoplasma , Tuberculose , Humanos , Testes de Sensibilidade Microbiana , Extratos Vegetais/farmacologia , Tuberculose/tratamento farmacológicoRESUMO
La pandemia por COVID-19 ha obligado a los gobiernos de todo el mundo a la toma de decisiones con información preliminar, insuficiente o discutible en argumentos científicos, algo que como académicos debemos entender y acompañar y se convierte en un reto mayor: ¿cómo dar recomendaciones con información limitada y reducir las incertidumbres? Para ello, primero que todo, se debe reconocer que estos procesos están sometidos a cambios según la evolución del conocimiento y la comunicación de la información se vuelve crucial para evitar minar la confianza pública ante los cambios. Es así como muchas recomendaciones para el manejo de COVID 19 han venido evolucionando a medida que se conoce mejor la patogénesis, sus mecanismos de transmisión y las particularidades en la respuesta inmune y, por ejemplo, pasamos de una recomendación inicial de medidas de prevención que incluía limpieza de superficies a una en la cual el énfasis es la limitación en número de personas en reunión. La Asociación Colombiana de infectología junto con otras 27 sociedades científicas lleva tres diferentes actualizaciones de recomendaciones basadas en evidencia en los primeros 12 meses de pandemia, es decir cada tres meses se han venido revisando las más de 250 recomendaciones, lo cual ha significado un trabajo enorme de revisión, discusión y presentación final las cuales, afortunadamente, han sido acogidas y tomadas como base de las decisiones gubernamentales.
The COVID-19 pandemic has forced governments around the world to take decisions on preliminary, insufficient The COVID-19 pandemic has forced governments around the world to make decisions with preliminary, insufficient or debatable information on scientific grounds, something that as academics we must understand and accompany and which becomes a major challenge: how to give recommendations with limited information and reduce uncertainties? To do this, first of all, it must be recognised that these processes are subject to change as knowledge evolves and the communication of information becomes crucial to avoid undermining public confidence in the face of change. Thus, many recommendations for the management of COVID 19 have evolved as the pathogenesis, transmission mechanisms and particularities of the immune response have become better understood and, for example, we have gone from an initial recommendation of measures to be taken in response to COVID 19 to a recommendation of measures to be taken in response to COVID 19, we have moved from an initial recommendation for prevention measures that included surface cleaning to one in which the emphasis is on limiting the number of people at a meeting. The Colombian Association of Infectious Diseases, together with 27 other scientific societies, has scientific societies has three different updates of evidence-based evidence-based recommendations in the first 12 months of a pandemic, i.e. every months of the pandemic, i.e. every three months, the more than 250 recommendations have been This has meant an enormous work of review, discussion and final presentation which, fortunately, have been accepted and taken as a basis for governmental decisions. and taken as a basis for governmental decisions.
Assuntos
Humanos , Masculino , Feminino , Comunicação , Ciência , Sociedades Científicas , Tomada de Decisões , Pandemias , GovernoRESUMO
Frente al escepticismo de encontrar una vacuna para COVID19, los resultados de los ensayos clínicos de Fase III dieron la sentencia: se lograron vacunas con alto grado de eficacia que llega al 70% a 95%. Al momento de escribir esta editorial, dos de ellas ya tienen autorización para uso de emergencia por el FDA. La OMS realiza un seguimiento cotidiano a los avances de candidatos vacunales, el reporte para el 22 de Diciembre encontraba 57 en fases de evaluación clínica (entre estas 11 en fase III) y 166 en fase preclínica.
In the face of skepticism about finding a vaccine for COVID19 , the results of the Phase III clinical trials were conclusive: vaccines with a high degree of efficacy of 70% to 95% were achieved. At the time of writing this editorial, two of them have already been authorized for emergency use by the FDA. The WHO monitors the progress of vaccine candidates on a daily basis; the report as of December 22nd found 57 in clinical evaluation phases (including 11 in Phase III) and 166 in preclinical phase.
Assuntos
Humanos , Vacinas , COVID-19 , Ciência , Bioensaio , EficáciaRESUMO
Treatments for toxoplasmosis such as pyrimethamine have shown numerous side effects. It has been reported that the likelihood of relapse associated with pyrimethamine-based therapy in patients with HIV and toxoplasmic encephalitis (TE) can have significant implications, even for patients who often develop new lesions in areas of the brain previously free of infection. This led us to research for new agents against Toxoplasma gondii. Recent findings have shown the potent biological activity of 4-thiazolidinones. We proposed to design and synthesize a new series of 2-hydrazono-4-thiazolidinones derivatives to evaluate the in vitro growth inhibition effect on T. gondii. The growth rates of T. gondii tachyzoites in Human Foreskin Fibroblast (HFF) cell culture were identified by two in vitro methodologies. The first one was by fluorescence in which green fluorescent RH parasites and cherry-red fluorescent ME49 parasites were used. The second one was a colorimetric methodology using ß-Gal parasites of the RH strain constitutively expressing the enzyme beta-galactosidase. The 4-thiazolidinone derivatives 1B, 2B and 3B showed growth inhibition at the same level of Pyrimethamine. These compounds showed IC50 values of 1B (0.468-0.952 µM), 2B (0.204-0.349 µM) and 3B (0.661-1.015 µM) against T. gondii. As a measure of cytotoxicity the compounds showed a TD50 values of: 1B (60 µM), 2B (206 µM) and 3B (125 µM). The in vitro assays and molecular modeling results suggest that these compounds could act as possible inhibitors of the Calcium-Dependent Protein Kinase 1 of T. gondii. Further, our results support the fact that of combining appropriate detection technologies, combinatorial chemistry and computational biology is a good strategy for efficient drug discovery. These compounds merit in vivo analysis for anti-parasitic drug detection.