Spatio-Temporal Analysis and Clinical-Epidemiological Characterization of Visceral Leishmaniasis in Maranhão, Brazil, from 2009 to 2020.

This study was carried out to identify the spatial distribution and characterize the clinical-epidemiological profile of Visceral Leishmaniasis (VL) in Maranhão state, Brazil, from 2009 to 2020. This descriptive ecological study collected sociodemographic and clinical data of VL cases from the Brazilian Notifiable Diseases Information System database. A spatial autocorrelation analysis (Moran statistics) was performed. From 2009 to 2020, 5699 cases of VL were reported, with incidence of 6.5 cases/100,000 and prevalence of 7.1 cases/100,000. The temporal analysis showed a significant growth in incidence from 2009 to 2018, followed by a significant decrease between 2019 and 2020. The Moran map shows hotspots of high values in the central-west and central-east regions, and hotspots of low values in the northern region of Maranhão. The profile of patients affected by VL comprises males (OR = 1.8; IC95% = 1.72-1.92), aged under 14 years, brown, and with incomplete elementary schooling. The main symptoms reported were fever, fatigue, and edema. The main diagnostic method was laboratory. The mortality rate was 6.8%, and co-infection with HIV was reported by 8.5% of patients. The results of this study indicated the increase in incidence and lethality, as well as the expansion, of leishmaniasis in the state of Maranhão.

In vitro inhibition and eradication of multidrug-resistant Acinetobacter baumannii biofilms by riparin III and colistin combination.

Acinetobacter baumannii, a prominent emerging pathogen, is responsible for persistent and recurrent healthcare-associated infections (HAIs). Its bacterial resistance and virulence factors, such as biofilm formation, contribute to its survival in hospital environments. Combination therapy has proven to be an effective approach for controlling these infections; however, antimicrobial resistance and compound toxicity can hinder antimicrobial efficacy. Numerous in vitro studies have demonstrated the synergistic effect of antimicrobials and natural products against multidrug-resistant (MDR) A. baumannii biofilm. Riparin III, a natural alkamide derived from Aniba riparia (Nees) Mez., possesses various biological activities, including significant antimicrobial potential. Nonetheless, no reports are available on the use of this compound in conjunction with conventional antimicrobials. Hence, this study aimed to investigate the inhibition and eradication of A. baumannii MDR biofilm by combining riparin III and colistin, along with potential ultrastructural changes observed in vitro. Clinical isolates of A. baumannii, known for their robust biofilm production, were inhibited, or eradicated in the presence of the riparin III/colistin combination. Furthermore, the combination resulted in several ultrastructural alterations within the biofilm, such as elongated cells and coccus morphology, partial or complete disruption of the biofilm's extracellular matrix, and cells exhibiting cytoplasmic material extravasation. At the synergistic concentrations, the riparin III/colistin combination exhibited a low hemolytic percentage, ranging from 5.74% to 6.19%, exerting inhibitory and eradicating effects on the A. baumannii biofilm, accompanied by notable ultrastructural changes. These findings suggest its potential as a promising alternative for therapeutic purposes.

Benzonidazole treatment has a beneficial effect on cells infected with the Colombian strain of Trypanosoma cruzi.

Benznidazole (Bz) is the recommended drug for the treatment of Chagas disease; however, its efficacy may vary according to the sensitivity of Trypanosoma cruzi strains to the drug and host immune background. The study evaluated the immune response of peripheral blood mononuclear cells (PBMC) that were infected in vitro with the Colombian strain (Col) and treated with Bz. The co-cultures were incubated for 24 h, 5 and 10 days, where cytokine dosage was performed in the supernatant and evaluation of the cells for CD28+ and CTLA-4+ molecules in CD4+ and CD8+ lymphocytes, and CD80+ , CD86+ and HLA-DR+ in CD14+ cells. The results showed that Col induced a strong inflammatory response, with an increase in IFN-γ and TNF early in the infection (24 h), however, from 5 days of infection on, TNF production declined, and IL-10 production increased, which may be associated with a control mechanism of the exacerbated inflammatory response. The Bz treatment did not significantly alter the frequencies of the phenotypes evaluated both T cell subsets and CD14+ cells. Therefore, this study reinforces the need for typing the patient's strain to guide therapy and promote individualized treatment protocols due to the heterogeneous genetic background among T. cruzi strains.

Epidemiological and clinical analyses of corneal transplants performed in a reference eye center in Recife, Brazil / Análise epidemiológica e clínica dos transplantes de córnea realizados em um centro de referência oftalmológica em Recife, Brasil

ABSTRACT Purpose: To evaluate the epidemiological and clinical profiles of corneal transplants performed in a reference eye center in Recife, state of Pernambuco, Northeastern Brazil. Methods: This cross-sectional study collected epidemiological and clinical data from the medical records of patients who underwent keratoplasty at the Altino Ventura Foundation between January and December 2017. Results: A total of 356 procedures were performed in 327 patients, of whom 165 (50.5%) were female. The mean age at surgery was 50.9 ± 22.6 years (range, 10-89 years). Most patients (n=152 [46.5%]) were from the capital and metropolitan areas. The mean waiting time for keratoplasty was 52.4 ± 58.9 days (range, 0-460 days). The main indications for keratoplasty were infectious keratitis (n=88 [24.7%]), keratoconus (n=80 [22.5%]), and previous transplant failure (n=75 [21.1%]). Penetrating keratoplasty was the most common surgical technique performed (n=213 [59.9%]) and more frequently performed in men (n=132 [76.7%]), whereas posterior lamellar transplant (n=143 [41.1%]) was more frequently performed in women (p<0.001). Conclusion: Infectious keratitis was the main indication for keratoplasty, which was similarly performed in economically active adults of both sexes. Penetrating keratoplasty was more frequently performed in men and lamellar transplants in women.

RESUMO Objetivo: Avaliar o perfil clínico e epidemiológico dos transplantes de córnea realizados em um centro de referência oftalmológica de Recife no estado de Pernambuco, localizado no nordeste do Brasil. Métodos: Esse estudo transversal coletou através de prontuários médicos dados clínicos e epidemiológicos de pacientes submetidos a ceratoplastia na Fundação Altino Ventura, de janeiro a dezembro de 2017. Resultados: Um total de 356 procedimentos foram realizados em 327 pacientes dos quais 165 (50.5%) eram mulheres. A média de idade na cirurgia foi de 50.9 ± 22.6 anos (variação, 10 - 89 anos). A maioria dos pacientes (n=152 [46.5%]) era da capital e região metropolitana. A média de tempo de espera na fila para o transplante de córnea foi de 52.4 ± 58.9 dias (variação, 0 - 460 dias). As principais indicações de transplante foram ceratite infecciosa (n=88 [24.7%]), ceratocone (n=80 [22.5%]) e falência de transplante prévio (n=75 [21.1%]). Transplante penetrante foi a técnica mais realizada (n=213 [59.9%]) e foi mais comum em homens (n=132 [76.7%]), enquanto os transplantes lamelares posteriores (n=143 [41.1%]) foram mais realizados nas mulheres (p<0.001). Conclusão: Ceratites infecciosas foram a causa mais comum de transplante, com prevalência similar em adultos economicamente ativos de ambos os sexos. Transplante penetrantes foram os prevalentes em homens e os transplantes lamelares em mulheres.

Analysis of ocular emergencies in a reference eye center in Brazil / Análise das emergências oculares em um centro de referência oftalmológica no Brasil

ABSTRACT Purpose: To determine the incidence of ocular emergencies and patient profiles in a public health eye center in Brazil. Methods: The medical record database of the Fundação Altino Ventura, Recife, Brazil was retrospectively analyzed and included all patients assisted at the ophthalmic emergency room between January 2017 and January 2018. Medical records with incomplete data and outpatient complaints were excluded. For records with multiple visits, only the initial visit was considered. Results: In 1 year, 134,788 patients (mean age at admission: 38.7 ± 22 years; range: 0-99 years) were admitted at the emergency room of the Fundação Altino Ventura. The most frequent diagnoses were conjunctivitis (52,732 cases; 37.3%), blepharitis (7,213 cases; 5.1%), and corneal/conjunctival foreign body (6,925 cases; 4.9%). Corneal/conjunctival foreign body and ocular trauma had an eight- and two-fold higher incidence in male patients, respectively (both p<0.001). Female patients presented a two-fold higher incidence of trichiasis and blepharitis than males (p<0.001). Corneal/conjunctival foreign body and ocular trauma affected more patients in a productive age (>15 years), while corneal ulcers, blepharitis, and trichiasis affected more elderly patients. All diagnostic clusters (e.g., infectious diseases, ocular trauma, foreign bodies, retinopathies, eyelid disorders, corneal diseases, glaucomatous crisis, and neuroophthalmological diseases) were more common during the spring season (p<0.001). Conclusion: The most common ocular emergencies in the present study were infectious diseases and foreign body. However, the incidence of ophthalmological emergencies was influenced by the age and sex of patients, as well as the time of the year.

RESUMO Objetivo: Determinar a incidência de emergências oculares em um centro oftalmológico de referência no Brasil. Métodos: O banco de dados de prontuários da Fundação Altino Ventura, Recife, Brasil, foi analisado retrospectivamente e incluiu pacientes atendidos, entre janeiro de 2017 e janeiro de 2018, na sala de emergência oftalmológica. Foram excluídos os prontuários com dados incompletos e com quadros ambulatoriais. Apenas o primeiro atendimento na emergência foi considerado para análise. Resultados: Em um ano, 134.788 pacientes (idade média de 38,7 ± 22 anos [0-99 anos]) foram admitidos na emergência da Fundação Altino Ventura. Os diagnósticos mais frequentes foram conjuntivite (52.732 casos [37,3%]), blefarite (7.213 casos [5,1%]) e corpo estranho na córnea/conjuntiva (6.925 casos [4,9%]). Corpo estranho na córnea/conjuntiva e trauma ocular foram cerca de 8 vezes e 2 vezes mais incidente em indivíduos do sexo masculino, respectivamente (p<0,001 em ambos). Triquíase e blefarite afetaram ~2 vezes mais pacientes do sexo feminino, respectivamente (p<0,001 em ambos). Corpo estranho na córnea/conjuntiva e trauma ocular afetaram mais pacientes em idade produtiva (>15 anos), enquanto úlcera, blefarite e triquíase da córnea afetaram mais pacientes idosos. Todos os grupamentos de diagnóstico (doenças infecciosas, trauma ocular, corpos estranhos, retinopatias, doenças das pálpebras, doenças da córnea, crise glaucomatosa e doenças neurooftalmológicas) foram mais incidentes na primavera (valor de p<0,001). Conclusão: As emergências oftalmológicas mais comuns no presente estudo foram as doenças infecciosas e o corpo estranho. Porém, a incidência das emergências oculares são fluências pela faixa etária e gênero do paciente, além da época do ano.

Epidemiological and clinical analyses of corneal transplants performed in a reference eye center in Recife, Brazil.

PURPOSE: To evaluate the epidemiological and clinical profiles of corneal transplants performed in a reference eye center in Recife, state of Pernambuco, Northeastern Brazil. METHODS: This cross-sectional study collected epidemiological and clinical data from the medical records of patients who underwent keratoplasty at the Altino Ventura Foundation between January and December 2017. RESULTS: A total of 356 procedures were performed in 327 patients, of whom 165 (50.5%) were female. The mean age at surgery was 50.9 ± 22.6 years (range, 10-89 years). Most patients (n=152 [46.5%]) were from the capital and metropolitan areas. The mean waiting time for keratoplasty was 52.4 ± 58.9 days (range, 0-460 days). The main indications for keratoplasty were infectious keratitis (n=88 [24.7%]), keratoconus (n=80 [22.5%]), and previous transplant failure (n=75 [21.1%]). Penetrating keratoplasty was the most common surgical technique performed (n=213 [59.9%]) and more frequently performed in men (n=132 [76.7%]), whereas posterior lamellar transplant (n=143 [41.1%]) was more frequently performed in women (p<0.001). CONCLUSION: Infectious keratitis was the main indication for keratoplasty, which was similarly performed in economically active adults of both sexes. Penetrating keratoplasty was more frequently performed in men and lamellar transplants in women.

Analysis of ocular emergencies in a reference eye center in Brazil.

PURPOSE: To determine the incidence of ocular emergencies and patient profiles in a public health eye center in Brazil. METHODS: The medical record database of the Fundação Altino Ventura, Recife, Brazil was retrospectively analyzed and included all patients assisted at the ophthalmic emergency room between January 2017 and January 2018. Medical records with incomplete data and outpatient complaints were excluded. For records with multiple visits, only the initial visit was considered. RESULTS: In 1 year, 134,788 patients (mean age at admission: 38.7 ± 22 years; range: 0-99 years) were admitted at the emergency room of the Fundação Altino Ventura. The most frequent diagnoses were conjunctivitis (52,732 cases; 37.3%), blepharitis (7,213 cases; 5.1%), and corneal/conjunctival foreign body (6,925 cases; 4.9%). Corneal/conjunctival foreign body and ocular trauma had an eight- and two-fold higher incidence in male patients, respectively (both p<0.001). Female patients presented a two-fold higher incidence of trichiasis and blepharitis than males (p<0.001). Corneal/conjunctival foreign body and ocular trauma affected more patients in a productive age (>15 years), while corneal ulcers, blepharitis, and trichiasis affected more elderly patients. All diagnostic clusters (e.g., infectious diseases, ocular trauma, foreign bodies, retinopathies, eyelid disorders, corneal diseases, glaucomatous crisis, and neuroophthalmological diseases) were more common during the spring season (p<0.001). CONCLUSION: The most common ocular emergencies in the present study were infectious diseases and foreign body. However, the incidence of ophthalmological emergencies was influenced by the age and sex of patients, as well as the time of the year.

Surto de conjuntivite aguda no período de 2017-2018 em Recife, Brasil / Outbreak of acute conjunctivitis in the period 2017-2018 in Recife, Brazil

RESUMO Objetivo: Avaliar o perfil clínico, epidemiológico e o impacto econômico do surto de conjuntivite no período 2017-2018 no município de Recife-PE. Métodos: Estudo transversal com base na análise de prontuários de pacientes com diagnóstico de conjuntivite, atendidos na emergência da Fundação Altino Ventura entre dezembro/2017 e março/2018. Os dados coletados incluíram manifestações oculares no exame, complicações subsequentes, manejo e dias de licença médica. Resultados: Dos 12.712 pacientes atendidos na FAV entre dezembro de 2017 e março de 2018, 6.359 (50,0%) foram diagnosticados com conjuntivite, dos quais 3.543 pacientes (55,7%) foram atendimentos únicos. A média de idade dos pacientes ao atendimento foi de 29,5 ± 14,1 anos (variação, 1-85 anos), com distribuição semelhante entre os sexos (2.288 casos [50,1%] masculino; 2.282 casos [49,9%] feminino). O diagnóstico mais comum foi conjuntivite sem pseudomembrana (5.645 casos [88,8%]). Hiperemia conjuntival (6.278 casos [98,7%]) e reação folicular (6.255 casos [98,4%]) foram os achados mais frequentes ao exame. A complicação mais frequente foi pseudomembrana (1.062 casos [16,7%]). Os colírios lubrificantes (4.308 [67,7%]) e os colírios de associação antibiótico com corticoide (2.033 [32%]) foram os mais prescritos no tratamento. A média de dias de atestado médico foi de 4,8 ± 2,9 dias (variação, 1- 47 dias) e a perda de produtividade estimada em R$1.159.329,14. Conclusão: O surto de conjuntivite em Pernambuco foi responsável por metade das consultas em um pronto-socorro oftalmológico. Surtos de conjuntivite podem causar um impacto econômico, uma vez que afeta principalmente adultos jovens em idade produtiva. As características clínicas observadas sugerem um surto de conjuntivite de etiologia viral.

Abstract Purpose: To evaluate the epidemiological and clinical profile and economic impact of the acute conjunctivitis outbreak in the period of 2017-2018 in Recife-PE. Methods: Cross-sectional study based on the analysis of medical records of patients diagnosed with conjunctivitis at the emergency room of the Altino Ventura Foundation (FAV) between December 2017 and March 2018. The collected data included ocular manifestations at examination, subsequent complications, management, and days of sick leave. Results: Out of 12,712 patients assisted at FAV from December 2017 to March 2018, 6,359 (50.0%) were diagnosed with conjunctivitis. The mean age of patients was 29.5 ± 14.1 years (range, 01-85 years), with similar distribution between sex (2,288 50.1% male; 2,282 49.9% female). The most common diagnosis was non-pseudomembranous conjunctivitis (5,645 cases 88.8%). Conjunctival hyperemia (6,278 cases 98.7%) and follicular reaction (6,255 cases 98.4%) were the most frequent ocular findings. The most common complication was pseudomembrane in 1,062 cases (16.7%). Lubricants (4,308 67.7%) and antibiotic associated to corticosteroid eyedrops (2,033 32.0%) were the most prescribed medications. The average days of sick leave per patient was 4.8 ± 2.9 days (range, 1- 47 days) and the productivity loss estimated in R$1.159.329,14. Conclusion: The conjunctivitis outbreak in Pernambuco, Brazil was responsible for half of the consultations in an ophthalmic emergency room. Conjunctivitis outbreaks may cause an economic impact as it mostly affects young adults in their productive ages and take in average a 5-day sick leave. The clinical characteristics observed suggest an outbreak of conjunctivitis of viral etiology.

Asteraceae Plants as Sources of Compounds Against Leishmaniasis and Chagas Disease.

Leishmaniasis and Chagas disease cause great impact on social and economic aspects of people living in developing countries. The treatments for these diseases are based on the same regimen for over 40 years, thus, there is an urgent need for the development of new drugs. In this scenario, Asteraceae plants (a family widely used in folk medicine worldwide) are emerging as an interesting source for new trypanocidal and leishmanicidal compounds. Herein, we provide a non-exhaustive review about the activity of plant-derived products from Asteraceae with inhibitory action toward Leishmania spp. and T. cruzi. Special attention was given to those studies aiming the isolation (or identification) of the bioactive compounds. Ferulic acid, rosmarinic acid, and ursolic acid (Baccharis uncinella DC.) were efficient to treat experimental leishmaniasis; while deoxymikanolide (Mikania micrantha) and (+)-15-hydroxy-labd-7-en-17-al (Aristeguietia glutinosa Lam.) showed in vivo anti-T. cruzi action. It is also important to highlight that several plant-derived products (compounds, essential oils) from Artemisia plants have shown high inhibitory potential against Leishmania spp., such as artemisinin and its derivatives. In summary, these compounds may help the development of new effective agents against these neglected diseases.

pCramoll and rCramoll as New Preventive Agents against the Oxidative Dysfunction Induced by Hydrogen Peroxide.

Oxidative stress plays an important role in the induction of cell death and is associated with various pathologic disorders; therefore, the search for natural products that attenuate the effects produced by oxidant agents is greatly increased. Here, the protective effects of native lectin from Cratylia mollis seeds (pCramoll) and recombinant Cramoll 1 (rCramoll) against H2O2-induced oxidative stress in Vero cells were evaluated. Both lectins significantly attenuated the H2O2-induced cytotoxicity in a concentration-dependent way. The maximum protective effects were 96.85 ± 15.59% (rCramoll) and 59.48 ± 23.44% (pCramoll). The Live/Dead analysis showed a reduction in the percentage of dead cells from 65.04 ± 3.29% (H2O2) to 39.77 ± 2.93% (pCramoll) and 13.90 ± 9.01% (rCramoll). The deleterious effects of H2O2 on cell proliferation were reduced to 10.83% (pCramoll) and 24.17% (rCramoll). Lectins treatment attenuated the excessive superoxide production, the collapse of the mitochondrial membrane potential, and the lysosomal and DNA damage in H2O2-treated cells. In conclusion, our results suggest that pCramoll and rCramoll blocked H2O2-induced cytotoxicity through decreasing reactive oxygen species, restoring the mitochondrial potential, preventing the lysosomal damage and DNA fragmentation, and thus promoting cell survival and proliferation.

The in vitro biological activity of the Brazilian brown seaweed Dictyota mertensii against Leishmania amazonensis.

Seaweeds present a wide variety of interesting bioactive molecules. In the present work we evaluated the biological activity of the dichloromethane/methanol (2:1) extract (DME) from the brown seaweed Dictyota mertensii against Leishmania amazonensis and its cytotoxic potential on mammalian cells. The extract showed significant inhibitory effect on the growth of promastigote forms (IC50=71.60 µg/mL) and low toxicity against mammalian cells (CC50=233.10 µg/mL). The DME was also efficient in inhibiting the infection in macrophages, with CC50 of 81.4 µg/mL and significantly decreased the survival of amastigote forms within these cells. The selectivity index showed that DME was more toxic to both promastigote (SI=3.25) and amastigote (SI=2.86) forms than to macrophages. Increased NO production was observed in treated macrophages suggesting that besides acting directly on the parasites, the DME also shows an immunomodulatory effect on macrophages. Drastic ultrastructural alterations consistent with loss of viability and cell death were observed in treated parasites. Confocal microscopy and cytometry analyzes showed no significant impairment of plasma membrane integrity, whereas an intense depolarization of mitochondrial membrane could be observed by using propidium iodide and rhodamine 123 staining, respectively. The low toxicity to mammalian cells and the effective activity against promastigotes and amastigotes, point to the use of DME as a promising agent for the treatment of cutaneous leishmaniasis.

Trypanocidal and cytotoxic activities of essential oils from medicinal plants of Northeast of Brazil.

Chagas disease, caused by Trypanosoma cruzi, is an important cause of mortality and morbidity in Latin America. There are no vaccines available, the chemotherapy used to treat this illness has serious side effects and its efficacy on the chronic phase of disease is still a matter of debate. In a search for alternative treatment for Chagas disease, essential oils extracted from traditional medicinal plants Lippia sidoides, Lippia origanoides, Chenopodium ambrosioides, Ocimum gratissimum, Justicia pectorales and Vitex agnus-castus were investigated in vitro for trypanocidal and cytotoxic activities. Essential Oils were extracted by hydrodistillation and submitted to chemical analysis by gas chromatography/mass spectrometry. The concentration of essential oils necessary to inhibit 50% of the epimastigotes or amastigotes growth (IC(50)) and to kill 50% of trypomastigote forms (LC(50)) was estimated. The most prevalent chemical constituents of these essential oils were monoterpenes and sesquiterpenes. All essential oils tested demonstrated an inhibitory effect on the parasite growth and survival. L. sidoides and L. origanoides essential oils were the most effective against trypomastigote and amastigote forms respectively. No significant cytotoxic effects were observed in mouse peritoneal macrophages incubated with essential oils which were more selective against the parasites than mammalian cells. Taken together, our results point towards the use of these essential oils as potential chemotherapeutic agent against T. cruzi.

Novas perspectivas de fármacos com propriedade tripanocida: estudos biológicos de compostos heterocíclicos / Novel perspectives of drugs with tripanocidal properties: biological study of heterocyclic compounds

Os compostos mesoiônicos são moléculas não aromáticas planas, pertencentes à classe das betaínas, os quais apresentam um grande número de atividades biológicas incluindo antibacteriana, anti-inflamatória e anti-protozoária. A despeito do potencial quimoterápico destes compostos, estudos destas moléculas contra o Trypanosoma cruzi, agente etiológico da doença de Chagas, ainda são incipientes. No presente trabalho nós avaliamos as atividades tripanocida e citotóxica dos mesoiônicos MECPYR-04, MEC-02, MC-01 e MC-02. Nossos resultados demonstraram que todos os compostos inibiram o crescimento de formas epimastigotas e causaram decréscimo da viabilidade celular em tripomastigotas. Estes compostos também foram efetivos em inibir a infecção de macrófagos e diminuir a viabilidade das formas amastigotas. MECPYR-04 foi o mais efetivo contra todas as formas evolutivas do parasito, entretanto também apresentou alta toxicidade para células de mamíferos, enquanto MEC02, MC-01 e MC-02 apresentaram baixa toxidade em células de mamíferos e alta seletividade para os parasitas. Apenas MEC-02 e MECPYR-04 aumentaram a produção de NO em macrófagos quando comparados com o controle, sugerindo um potencial imunomodulatório destes compostos. Com objetivo de analisar os efeitos de MEC-02, MC-01 e MC-02 sobre a integridade da membrana plasmática e o potencial de membrana mitocondrial, células tratadas e controles foram submetidas a marcação com iodeto de propidio e rodamina 123 respectivamente, e analisadas por microscopia confocal. Nenhuma diferença significativa na integridade da membrana foi observada em células tratadas. Estes achados foram confirmados pela microscopia eletrônica de varredura. Apenas MC-01 e MC-02 foram capazes de induzir alterações no potencial de membrana mitocondrial como observado por microscopia confocal e citometria de fluxo. Análise ultraestrutural revelou apenas pequenas alterações em formas tripomastigotas tratadas com MEC-02. Por outro lado, células tratadas com MC-01 e MC-02 apresentaram drástico inchaço da mitocôndria com desorganização ou perda do material da matriz mitocondrial, sugerindo que esta estrutura seja o alvo de ação de MC-01 e MC-02. Todos estes resultados apontam MEC-02, MC-01 e MC-02 como candidatos a fármacos contra a doença de Chagas.