CK2 Secreted by Leishmania braziliensis Mediates Macrophage Association Invasion: A Comparative Study between Virulent and Avirulent Promastigotes.

CK2 is a protein kinase distributed in different compartments of Leishmania braziliensis: an externally oriented ecto-CK2, an intracellular CK2, and a secreted CK2. This latter form is constitutively secreted from the parasite (CsCK2), but such secretion may be highly enhanced by the association of specific molecules, including enzyme substrates, which lead to a higher enzymatic activity, called inductively secreted CK2 (IsCK2). Here, we examined the influence of secreted CK2 (sCK2) activity on the infectivity of a virulent L. braziliensis strain. The virulent strain presented 121-fold higher total CK2 activity than those found in an avirulent strain. The use of specific CK2 inhibitors (TBB, DRB, or heparin) inhibited virulent parasite growth, whereas no effect was observed in the avirulent parasites. When these inhibitors were added to the interaction assays between the virulent L. braziliensis strain and macrophages, association index was drastically inhibited. Polyamines enhanced sCK2 activity and increased the association index between parasites and macrophages. Finally, sCK2 and the supernatant of the virulent strain increased the association index between the avirulent strain and macrophages, which was inhibited by TBB. Thus, the kinase enzyme CK2 seems to be important to invasion mechanisms of L. braziliensis.

Prevalence of discordant microscopic changes with automated CBC analysis / Prevalência de alterações microscópicas discordantes com análise automatizada do hemograma

Introduction: The most common cause of diagnostic error is related to errors in laboratory tests as well as errors of results interpretation. In order to reduce them, the laboratory currently has modern equipment which provides accurate and reliable results. The development of automation has revolutionized the laboratory procedures in Brazil and worldwide. Objective: To determine the prevalence of microscopic changes present in blood slides concordant and discordant with results obtained using fully automated procedures. Materials and method: From January to July 2013, 1,000 hematological parameters slides were analyzed. Automated analysis was performed on last generation equipment, which methodology is based on electrical impedance, and is able to quantify all the figurative elements of the blood in a universe of 22 parameters. The microscopy was performed by two experts in microscopy simultaneously. Results: The data showed that only 42.70% were concordant, comparing with 57.30% discordant. The main findings among discordant were: Changes in red blood cells 43.70% (n = 250), white blood cells 38.46% (n = 220), and number of platelet 17.80% (n = 102). Discussion: The data show that some results are not consistent with clinical or physiological state of an individual, and cannot be explained because they have not been investigated, which may compromise the final diagnosis. Conclusion: It was observed that it is of fundamental importance that the microscopy qualitative analysis must be performed in parallel with automated analysis in order to obtain reliable results, causing a positive impact on the prevention, diagnosis, prognosis, and therapeutic follow-up. .

Introdução: A causa mais comum de erro no diagnóstico relaciona-se com erros de exames laboratoriais, bem como erros de sua interpretação. E com o intuito de reduzi-los, atualmente o laboratório dispõe de equipamentos modernos com resultados precisos e confiáveis. O desenvolvimento da automação revolucionou os procedimentos laboratoriais no Brasil e no mundo. Objetivos: Verificar a prevalência de alterações microscópicas presentes em lâminas hematológicas concordantes e discordantes com resultados obtidos por meio de procedimentos totalmente automatizados. Materiais e métodos: No período de janeiro a julho de 2013, foram analisados os parâmetros hematológicos de 1.000 lâminas. A análise automatizada foi realizada em equipamento de última geração, cuja metodologia baseia-se em impedância elétrica e é capaz de quantificar todos os elementos figurados do sangue em um universo de 22 parâmetros. A hematoscopia foi realizada por dois microscopistas ao mesmo tempo. Resultados: Os dados demonstraram que apenas 42,70% foram concordantes, confrontando com 57,30% discordantes. Os principais achados entre os discordantes foram alterações na série vermelha 43,70% (n = 250), série branca 38,46% (n = 220) e plaquetária 17,80% (n = 102). Discussão: Os dados comprovam que alguns resultados não são compatíveis com a clínica, nem condizem com o estado fisiológico de um indivíduo e podem não ser explicitados por não terem sido investigados, o que pode comprometer o diagnóstico final. Conclusão: Observou-se a importância de a análise hematoscópica qualitativa ser realizada em paralelo à análise automatizada para que se obtenha resultados confiáveis, que cause impacto positivo na prevenção, no diagnóstico, no prognóstico e no seguimento terapêutico. .