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1.
Rev Soc Bras Med Trop ; 52: e20190386, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31800924

RESUMO

INTRODUCTION: Chronic chagasic cardiopathy (CCC) is essentially a dilated cardiomyopathy in which a subacute, but constant chronic inflammatory process causes progressive destruction of the heart tissue. The action of proinflammatory cytokines, such as tumor necrosis factor alpha (TNF-α), interferon gamma (IFN-γ), and anti-inflammatory cytokines, like interleukin IL-10 and IL-17, plays a fundamental role in the immunopathogenesis and evolution of disease. Early anti-congestive therapy, aimed at changing the morbidity and mortality rate, has been shown to reduce disease progression and to alter patients' immune response pattern. METHODS: This cross-sectional study aimed to evaluate the profile of Th1 and Th17 cytokines and IL-17, TNF-α, and IFN-γ expressions in different stages of CCC. Forty patients affected by chronic Chagas disease were divided into different groups according to the stage of the pathology. In agreement with the Brazilian consensus on Chagas disease, patients were classified as presenting an undetermined form, a cardiac form and a digestive form. Serum IFN-γ, TNF-α, IL-10, and IL-17 were evaluated. RESULTS: Lower serum IFN-γ concentrations were detected in patients receiving angiotensin-converting enzyme inhibitors (p = 0.0182), but not in those using angiotensin receptor blockers (p = 0.0783). Patients using amiodarone and aldosterone antagonist presented higher serum TNF-α concentrations (p = 0.0106 and 0.0187, respectively). IL-10 and IL-17 levels did not differ between the study groups (p = 0.7273 and p = 0.6697, respectively). CONCLUSIONS: These results suggest that the cytokine profile and disease progression are altered by anti-congestive medications commonly prescribed for CCC.


Assuntos
Cardiomiopatia Chagásica/imunologia , Citocinas/sangue , Adulto , Idoso , Cardiomiopatia Chagásica/sangue , Cardiomiopatia Chagásica/tratamento farmacológico , Doença Crônica , Estudos Transversais , Citocinas/imunologia , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
2.
Medicine (Baltimore) ; 98(50): e18100, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852069

RESUMO

INTRODUCTION: Pulse wave analysis is an emerging approach that analyzes parameters comprising strong predictors of cardiovascular (CV) events and all-cause mortality, especially in patients with high CV risk based on established risk factors. This study used the oscillometric method, provided by the Mobil-o-Graph (PWA-EMI GmbH, Stolberg, Germany) device, to compare data regarding the pulse wave analysis parameters in hypertensive nondiabetic and diabetic patients. MATERIAL AND METHODS: In this cross-sectional study, 276 individuals were examined in the academic hypertension outpatient care unit of the Federal University of the Triângulo, in Mineiro, Brazil, from January to December 2016. The pulse wave analysis was performed by oscillometry, and its parameters were acquired from all patients. RESULTS: Of the 276 patients, 99 were diabetic and 177 nondiabetic. The mean systolic and pulse central blood pressure were significantly higher in diabetic patients than in nondiabetic patients (P = .008 and.0003, respectively). The mean peripheral systolic blood pressure and pulse pressure were also significantly higher in the diabetic group (P = .001 and P < .0001, respectively). The average pulse wave velocity (PWV, m/s) was 9.4 ±â€Š1.6 and 8.8 ±â€Š1.6 in the diabetic and nondiabetic groups, respectively (P = .003). CONCLUSION: The group of hypertensive diabetic patients had significantly higher central blood pressure, peripheral blood pressure, and PWV than the hypertensive nondiabetic patients. The patients with overlapping established CV risk factors presented values of the pulse wave analysis parameters consistent with higher central pressure and greater arterial stiffness.


Assuntos
Assistência Ambulatorial , Pressão Sanguínea/fisiologia , Diabetes Mellitus/fisiopatologia , Hipertensão/fisiopatologia , Oscilometria/métodos , Análise de Onda de Pulso/métodos , Rigidez Vascular/fisiologia , Brasil/epidemiologia , Estudos Transversais , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Feminino , Seguimentos , Humanos , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Reprodutibilidade dos Testes , Fatores de Risco , Sístole
3.
Infect Immun ; 87(8)2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31085707

RESUMO

The major problem with Chagas disease is evolution of the chronic indeterminate form to a progressive cardiac disease. Treatment diminishes parasitemia but not clinical progression, and the immunological features involved are unclear. Here, we studied the clinical course and the immune response in patients with chronic-phase Chagas disease at 48 months after benznidazole treatment. Progression to the cardiac form of Chagas disease or its aggravation was associated with higher in vitro antigen-specific production of interferon gamma (IFN-γ) in patients with cardiac Chagas disease than in patients with the indeterminate form. Predominance of IFN-γ production over interleukin-10 (IL-10) production in antigen-specific cultures was associated with cardiac involvement. Significantly higher numbers of antigen-specific T helper 1 cells (T-Bet+ IFN-γ+) and a significantly higher IFN-γ+/IL-10+ ratio were observed in patients with cardiac Chagas disease than in patients with the indeterminate form. Cardiac damage was associated with higher numbers of T helper cells than cytotoxic T lymphocytes producing IFN-γ. Patients with cardiac Chagas disease had predominant CD25- and CD25low T regulatory (Treg) subpopulations, whereas patients with the indeterminate form manifested a higher relative mean percentage of CD25high Treg subpopulations. These findings suggest that at 48 months after benznidazole treatment, the disease can worsen or progress to the cardiac form. The progression may be related to increased IFN-γ production (mostly from CD4+ T cells) relative to IL-10 production and increased Treg percentages. Patients with the indeterminate form of Chagas disease show a more balanced ratio of proinflammatory and anti-inflammatory cytokines.


Assuntos
Doença de Chagas/tratamento farmacológico , Citocinas/biossíntese , Nitroimidazóis/uso terapêutico , Linfócitos T/imunologia , Idoso , Doença de Chagas/imunologia , Feminino , Humanos , Imunofenotipagem , Interferon gama/biossíntese , Interleucina-10/biossíntese , Masculino , Pessoa de Meia-Idade , Linfócitos T Reguladores/imunologia
4.
J Ultrasound Med ; 38(8): 2015-2024, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30549307

RESUMO

OBJECTIVES: To evaluate whether abdominal ultrasound (US) with a gallbladder (GB) contractility study or motor function test can be used as a diagnostic tool in patients with dengue and warning signs in acute and recovery phases. METHODS: Fifty-one individuals in the acute phase of dengue presenting with warning signs (dengue group) and 49 healthy individuals without a history of dengue or hepatobiliary disease (control group) were studied with abdominal US and a GB contractility study. RESULTS: Statistical differences in US measurements of the liver (right lobe, P = .012; left lobe, P = .001) and spleen (P = .008) dimensions, GB wall thickness (P < .001), and the GB emptying fraction (P < .001) were observed in dengue during the acute phase compared with the control group. After 60 days, abdominal US of the dengue group showed a statistical difference in liver (right lobe, P < .001; left lobe, P = .078) and spleen (P < .001) dimensions, GB wall thickness, and the GB emptying fraction (P < .001) compared with the results obtained during the acute phase. Furthermore, a statistical difference in the spleen volume and GB emptying fraction (P < .001) was observed when comparing dengue after clinical recovery and the control group. Abdominal pain in patients with dengue was positively associated with hepatomegaly (P = .031), splenomegaly (P = .008), increased GB wall thickness (P = .016), and a reduced GB emptying fraction (P = .038) during the acute phase and with splenomegaly (P = .001) and a reduced GB emptying fraction (P = .003) after clinical recovery. CONCLUSIONS: Abdominal US with a GB motor function test can be used as a diagnostic tool in patients with dengue during acute and recovery phases.

5.
World J Biol Psychiatry ; 20(5): 368-380, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-28441923

RESUMO

Objectives: Mood disorders (MDs) frequently co-exist with cardiovascular disease (CVD) and immune-inflammatory and oxidative stress are important shared pathophysiological pathways. Even though there has been an extensive investigation of the enzyme paraoxonase 1 (PON1) as a biomarker of susceptibility for CVD, there are few reports studying PON1 in MDs. The aim of this study was to determine the association between PON1 activities as well as functional genotypes and MD diagnosis, clinical characteristics and outcomes. Methods: PON1 activities and functional genotypes were assayed in 58 bipolar disorder (BD) and 32 major depressed patients (MDD) and compared with 59 controls. Results: Our findings show significantly lower PON1 total and CMPAase activities in MDs, which are partly related to the number of previous depressive and manic episodes. Lowered CMPAase activity is associated with a worse outcome of MDs as indicated by lowered quality of life (WHOQoL-BREF scale) and increased disability in the Sheeham scale. Conclusions: We hypothesise that lowered PON1 total and CMPAase activities may play a role in the pathophysiology of MDs by lowering antioxidant defences thereby increasing the risk of lipid peroxidation and inflammation; lowered inhibition of quorum-sensing lactones thereby increasing bacterial proliferation; and attenuated homocysteine thiolactone catabolism which may trigger immune-inflammatory response and/or induce neurotoxicity.

6.
Curr Neuropharmacol ; 17(11): 1004-1020, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30592255

RESUMO

BACKGROUND: Nitro-oxidative stress (NOS) has been implicated in the pathophysiology of psychiatric disorders. The activity of the polymorphic antioxidant enzyme paraoxonase 1 (PON1) is altered in diseases where NOS is involved. PON1 activity may be estimated using different substrates some of which are influenced by PON1 polymorphisms. OBJECTIVES: 1) to review the association between PON1 activities and psychiatric diseases using a standardized PON1 substrate terminology in order to offer a state-of-the-art review; and 2) to review the efficacy of different strategies (nutrition, drugs, lifestyle) to enhance PON1 activities. METHODS: The PubMed database was searched using the terms paraoxonase 1 and psychiatric diseases. Moreover, the database was also searched for clinical trials investigating strategies to enhance PON1 activity. RESULTS: The studies support decreased PON1 activity as determined using phenylacetate (i.e., arylesterase or AREase) as a substrate, in depression, bipolar disorder, generalized anxiety disorder (GAD) and schizophrenia, especially in antipsychotic-free patients. PON1 activity as determined with paraoxon (i.e., POase activity) yields more controversial results, which can be explained by the lack of adjustment for the Q192R polymorphism. The few clinical trials investigating the influence of nutritional, lifestyle and drugs on PON1 activities in the general population suggest that some polyphenols, oleic acid, Mediterranean diet, no smoking, being physically active and statins may be effective strategies that increase PON1 activity. CONCLUSION: Lowered PON1 activities appear to be a key component in the ongoing NOS processes that accompany affective disorders, GAD and schizophrenia. Treatments increasing attenuated PON1 activity could possibly be new drug targets for treating these disorders.

7.
Rev Soc Bras Med Trop ; 51(5): 660-664, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30304273

RESUMO

INTRODUCTION: We evaluated clinical and epidemiological characteristics of Trypanosoma cruzi infection in Sergipe. METHODS: In this cross-sectional study, we collected serum samples to identify serological markers of Chagas disease. A questionnaire was used, and electrocardiogram, echocardiogram, chest radiography, and contrast radiography of esophagus and colon were performed. RESULTS: T. cruzi infection seroprevalence was 12.1%, mean age of subjects was 55 years, 90% had an elementary school education, 78.6% were agriculture workers, and 60.5% had electrocardiographic abnormalities. CONCLUSIONS: A high prevalence of T. cruzi infection was observed in mostly elderly individuals.


Assuntos
Anticorpos Antiprotozoários/sangue , Doença de Chagas/epidemiologia , Doenças Endêmicas , Trypanosoma cruzi/imunologia , Adulto , Brasil/epidemiologia , Doença de Chagas/diagnóstico , Doença de Chagas/imunologia , Estudos Transversais , Ensaio de Imunoadsorção Enzimática , Feminino , Técnica Indireta de Fluorescência para Anticorpo , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Soroepidemiológicos , Fatores Socioeconômicos
8.
Rev. Soc. Bras. Med. Trop ; 51(5): 660-664, Sept.-Oct. 2018. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-1041481

RESUMO

Abstract INTRODUCTION: We evaluated clinical and epidemiological characteristics of Trypanosoma cruzi infection in Sergipe. METHODS: In this cross-sectional study, we collected serum samples to identify serological markers of Chagas disease. A questionnaire was used, and electrocardiogram, echocardiogram, chest radiography, and contrast radiography of esophagus and colon were performed. RESULTS: T. cruzi infection seroprevalence was 12.1%, mean age of subjects was 55 years, 90% had an elementary school education, 78.6% were agriculture workers, and 60.5% had electrocardiographic abnormalities. CONCLUSIONS: A high prevalence of T. cruzi infection was observed in mostly elderly individuals.

9.
Rev Soc Bras Med Trop ; 51(3): 310-317, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29972561

RESUMO

INTRODUCTION: Chagas disease is caused by the flagellate protozoan Trypanosoma cruzi, being one of the leading causes of morbidity and mortality in the Americas with an estimated six to seven million infected people worldwide. In Brazil, the improvement in vector control and blood donor screening has evidenced the important epidemiological role of congenital transmission of Chagas disease. METHODS: A serological survey for Chagas disease was performed in 3,952 newborns in the southern region of Sergipe using paper filter disks of dried blood samples. The newborns were screened using the Sergipe State Neonatal Screening Program between July 2015 and July 2016, and 3,749 and 750 blood samples were obtained for the IgG enzyme-linked immunosorbent assay and indirect immunofluorescence assay, respectively. In addition, mothers of the children who presented initial reagent serology were examined. RESULTS: Among 3,749 blood samples, samples of two children were positive for the enzyme-linked immunosorbent assay; however, their confirmation test results were negative, suggesting passive transfer of the mother's antibody. One puerpera was identified with Chagas disease, with a prevalence of 0.02%. CONCLUSIONS: Congenital Chagas disease was not observed in newborns in the Southern region of Sergipe. However, Chagas disease was observed in women of reproductive age. Therefore, effective measurements for monitoring and systematic evaluation should be conducted. The Neonatal Screening Program proved to be an effective public health strategy for the prevention and control of Chagas disease.


Assuntos
Anticorpos Antiprotozoários/sangue , Doença de Chagas/congênito , Doença de Chagas/diagnóstico , Trypanosoma cruzi/imunologia , Brasil/epidemiologia , Doença de Chagas/epidemiologia , Estudos Transversais , Ensaio de Imunoadsorção Enzimática , Feminino , Técnica Indireta de Fluorescência para Anticorpo , Humanos , Recém-Nascido , Masculino , Triagem Neonatal , Prevalência , Estudos Soroepidemiológicos
10.
Rev. Soc. Bras. Med. Trop ; 51(3): 310-317, Apr.-June 2018. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-957421

RESUMO

Abstract INTRODUCTION: Chagas disease is caused by the flagellate protozoan Trypanosoma cruzi, being one of the leading causes of morbidity and mortality in the Americas with an estimated six to seven million infected people worldwide. In Brazil, the improvement in vector control and blood donor screening has evidenced the important epidemiological role of congenital transmission of Chagas disease. METHODS: A serological survey for Chagas disease was performed in 3,952 newborns in the southern region of Sergipe using paper filter disks of dried blood samples. The newborns were screened using the Sergipe State Neonatal Screening Program between July 2015 and July 2016, and 3,749 and 750 blood samples were obtained for the IgG enzyme-linked immunosorbent assay and indirect immunofluorescence assay, respectively. In addition, mothers of the children who presented initial reagent serology were examined. RESULTS: Among 3,749 blood samples, samples of two children were positive for the enzyme-linked immunosorbent assay; however, their confirmation test results were negative, suggesting passive transfer of the mother's antibody. One puerpera was identified with Chagas disease, with a prevalence of 0.02%. CONCLUSIONS: Congenital Chagas disease was not observed in newborns in the Southern region of Sergipe. However, Chagas disease was observed in women of reproductive age. Therefore, effective measurements for monitoring and systematic evaluation should be conducted. The Neonatal Screening Program proved to be an effective public health strategy for the prevention and control of Chagas disease.

11.
Pacing Clin Electrophysiol ; 41(7): 788-798, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29781516

RESUMO

BACKGROUND: Patients with chronic Chagas cardiopathy (CCC), which may be associated with cardiac arrhythmias, frequently use amiodarone, an antiarrhythmic drug that, experimentally, appears to modulate the cardiac autonomic function. OBJECTIVE: The present cross-sectional observational study aimed to evaluate autonomic cardiac modulation in patients with CCC undergoing chronic amiodarone therapy. METHODS: Three groups were investigated: Group 1 included patients with CCC not treated with amiodarone (n = 27); Group 2 included patients with CCC with prolonged use (at least 6 months) of amiodarone (n = 16); and Group 3 included non-Chagasic control patients (n = 23). All patients underwent a complete clinical and laboratory assessment, followed by autonomic function tests, consisting of a basal continuous electrocardiogram in the resting supine position for 10 minutes, followed by a change the orthostatic posture for a further 5 minutes. Heart rate variability (HRV) parameters (median and interquartile interval) were quantified using linear methods in the time- and frequency-domains (autoregressive spectral analysis) and nonlinear methods, including symbolic analysis. RESULTS: Patients with CCC using amiodarone had changes in HRV suggestive of an offset in the sympatho-vagal balance with a vagal modulation predominance (normalized HF, 49.7[27.4] vs 31.1[22.8] [P < 0.05]; and percentage 2V, 40.1 [14.6] vs 21.5 [13.4] [P < 0.05] vs untreated CCC group). These changes were further accompanied by increases in parameters indicative of greater complexity of HRV. CONCLUSIONS: The deviation in the sympatho-vagal balance and the increase in the complexity of HRV strongly suggest that amiodarone may have a cardioprotective effect, in addition to its antiarrhythmic effects, which could increase the survival of these patients.


Assuntos
Amiodarona/farmacologia , Antiarrítmicos/farmacologia , Sistema Nervoso Autônomo/efeitos dos fármacos , Cardiomiopatia Chagásica/fisiopatologia , Frequência Cardíaca/efeitos dos fármacos , Idoso , Amiodarona/uso terapêutico , Antiarrítmicos/uso terapêutico , Arritmias Cardíacas/complicações , Arritmias Cardíacas/tratamento farmacológico , Cardiomiopatia Chagásica/complicações , Doença Crônica , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo
12.
Int J Infect Dis ; 67: 84-85, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29247801

RESUMO

Cranial computed tomography (CT) remains valuable for the identification of opportunistic pathologies in AIDS patients in low-income countries. Delayed iodinated contrast medium CT images have the potential to better demonstrate inflammatory-infectious or neoplastic opportunistic pathologies. The main objective of this study was to optimize the protocol for cranial CT in patients with AIDS and clinical signs of opportunistic pathologies at the authors' institution. It was hypothesized that 20-min delayed contrast-enhanced CT images would be sufficient to optimize the detection of brain pathologies and that no additional delayed images would be necessary. Twenty-six adult patients with AIDS and brain pathologies were enrolled and had their cranial CT images analyzed by three evaluators. The numbers of lesions identified at two predetermined delayed time-points were compared. There was no variation in the number of lesions depicted by each evaluator, between the 20-min delayed contrast-enhanced CT image and the image obtained at the other predetermined delayed time-point.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/diagnóstico por imagem , Síndrome de Imunodeficiência Adquirida/complicações , Doenças do Sistema Nervoso/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Infecções Oportunistas Relacionadas com a AIDS/patologia , Adulto , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Meios de Contraste , Humanos , Masculino , Doenças do Sistema Nervoso/etiologia , Doenças do Sistema Nervoso/patologia , Estudos Prospectivos
14.
Rev Soc Bras Med Trop ; 49Suppl 1(Suppl 1): 3-60, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27982292

RESUMO

Chagas disease is a neglected chronic condition with a high burden of morbidity and mortality. It has considerable psychological, social, and economic impacts. The disease represents a significant public health issue in Brazil, with different regional patterns. This document presents the evidence that resulted in the Brazilian Consensus on Chagas Disease. The objective was to review and standardize strategies for diagnosis, treatment, prevention, and control of Chagas disease in the country, based on the available scientific evidence. The consensus is based on the articulation and strategic contribution of renowned Brazilian experts with knowledge and experience on various aspects of the disease. It is the result of a close collaboration between the Brazilian Society of Tropical Medicine and the Ministry of Health. It is hoped that this document will strengthen the development of integrated actions against Chagas disease in the country, focusing on epidemiology, management, comprehensive care (including families and communities), communication, information, education, and research .


Assuntos
Doença de Chagas , Consenso , Brasil/epidemiologia , Doença de Chagas/diagnóstico , Doença de Chagas/epidemiologia , Doença de Chagas/terapia , Doença de Chagas/transmissão , Humanos
15.
Epidemiol Serv Saude ; 25(spe): 7-86, 2016 06.
Artigo em Português | MEDLINE | ID: mdl-27869914

RESUMO

Chagas disease is a neglected chronic condition that presents high morbidity and mortality burden, with considerable psychological, social, and economic impact. The disease represents a significant public health issue in Brazil, with different regional patterns. This document presents the evidence that resulted in the Brazilian Consensus on Chagas Disease. The objective was to review and standardize strategies for diagnosis, treatment, prevention, and control of Chagas disease in the country, based on the available scientific evidence. The consensus is based on collaboration and contribution of renowned Brazilian experts with vast knowledge and experience on various aspects of the disease. It is the result of close collaboration between the Brazilian Society of Tropical Medicine and the Ministry of Health. This document shall strengthen the development of integrated control measures against Chagas disease in the country, focusing on epidemiology, management, comprehensive care (including families and communities), communication, information, education, and research.


Assuntos
Doença de Chagas/diagnóstico , Doença de Chagas/terapia , Doenças Negligenciadas/diagnóstico , Doenças Negligenciadas/terapia , Brasil/epidemiologia , Doença de Chagas/mortalidade , Doença de Chagas/transmissão , Doença Crônica , Consenso , Gerenciamento Clínico , Humanos , Doenças Negligenciadas/mortalidade , Doenças Negligenciadas/prevenção & controle , Saúde Pública , Medicina Tropical
16.
Rev Soc Bras Med Trop ; 49(2): 245-7, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27192597

RESUMO

INTRODUCTION: Chagas disease is considered one of the 17 most neglected tropical diseases in the World, with the most common form of vector transmission. METHODS: This structured cross-sectional study was conducted through an epidemiological survey in the Tobias Barreto municipality of Sergipe. RESULTS: Of the 255 participants, 1 (0.4%) participant was positive for human Chagas disease. Approximately 30.2% of the participants found the triatomine bugs in their houses and outbuildings. CONCLUSIONS: The detection of a case indicated transmission, which was also evidenced by the presence of triatomines and poor housing conditions.


Assuntos
Doença de Chagas/epidemiologia , Insetos Vetores/parasitologia , Triatominae/parasitologia , Trypanosoma cruzi , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Brasil/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Habitação , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Fatores de Risco , População Rural , Adulto Jovem
17.
Eur J Pharmacol ; 777: 26-32, 2016 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-26927755

RESUMO

Chagas disease is caused by Trypanosoma cruzi (T. cruzi). In some patients with Chagas disease, symptoms progress to chronic chagasic cardiomyopathy. Endogenously, inflammation is resolved in the presence of lipid mediators such as aspirin-triggered RvD1 (AT-RvD1) which has anti-inflammatory and pro-resolution effects. Here, we demonstrated, for the first time, the effects of AT-RvD1 on T. cruzi antigen-stimulated peripheral blood mononuclear cells (PBMCs) from patients with Chagas heart disease. The levels of IFN-γ, TNF-α, IL-10, and IL-13 increased in PBMCs from cardiac-form Chagas patients in stage B1 (patients with fewer heart abnormalities) stimulated with T. cruzi antigen compared to those in non-stimulated PBMCs. AT-RvD1 reduced the IFN-γ concentrations in PBMCs from patients with Chagas disease stimulated with T. cruzi antigen compared to stimulated with T. cruzi antigen cells. AT-RvD1 treatment resulted in no observable changes in TNF-α, IL-10, and IL-13 levels. AT-RvD1 significantly decreased the percentage of necrotic cells and caused a significant reduction in the proliferation rate of T. cruzi antigen-stimulated PBMCs from patients with Chagas disease. These findings demonstrate that AT-RvD1 modulates the immune response in Chagas disease patients and might have potential to be used as an alternative approach for slowing the development of further heart damage.


Assuntos
Anti-Inflamatórios não Esteroides/farmacologia , Aspirina/farmacologia , Cardiomiopatia Chagásica/sangue , Cardiomiopatia Chagásica/metabolismo , Ácidos Docosa-Hexaenoicos/metabolismo , Leucócitos Mononucleares/efeitos dos fármacos , Leucócitos Mononucleares/metabolismo , Adolescente , Adulto , Anti-Inflamatórios não Esteroides/uso terapêutico , Aspirina/uso terapêutico , Contagem de Células , Proliferação de Células/efeitos dos fármacos , Cardiomiopatia Chagásica/tratamento farmacológico , Cardiomiopatia Chagásica/patologia , Humanos , Interferon gama/metabolismo , Leucócitos Mononucleares/patologia , Pessoa de Meia-Idade , Necrose/patologia , Adulto Jovem
18.
Rev. Soc. Bras. Med. Trop ; 49(Suppl 1): 3-60, 2016.
Artigo em Inglês | Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: ses-34635

RESUMO

Chagas disease is a neglected chronic condition with ahigh burden of morbidity and mortality. It has considerable psychological, social, and economic impacts. The disease represents a significant public health issue in Brazil, with different regional patterns. This document presents the evidence that resulted in the Brazilian Consensus on Chagas Disease. The objective was to review and standardize strategies for diagnosis, treatment, prevention, and controlof Chagas disease in the country, based on the available scientific evidence. The consensus is based on the articulation and strategic contribution of renowned Brazilian experts with knowledge and experience on various aspects of the disease. It is the result of a close collaboration between the Brazilian Society of Tropical Medicine and the Ministry of Health...(AU)


Assuntos
Doença de Chagas , Epidemiologia , Assistência à Saúde , Brasil , Controle , Diagnóstico , Terapêutica , Consenso
19.
J Immunol Res ; 2015: 152741, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26495321

RESUMO

Interleukin-10 overproduction has been associated with worse prognosis in human cutaneous leishmaniasis, while IFN-γ-dependent responses are associated with parasite killing and host protection. Innovative strategies are needed to overcome therapeutic failure observed in endemic areas. The use of monoclonal antibody-based immunotherapy targeting IL-10 cytokine was evaluated here. Partial IL-10 blockade in Leishmania braziliensis whole soluble antigen-stimulated cells from endemic area CL patients with active or healed lesions and asymptomatic controls was evaluated. Overall decrease in IL-10, IL-4, and TNF-α production was observed in all groups of subjects. Only patients with active lesions still produced some levels of TNF-α after anti-IL-10 stimulation in association with Leishmania antigens. Moreover, this strategy showed limited modulatory effects on IFN-γ-dependent chemokine CXCL10 production. Results suggest the potential immunotherapeutic use of partial IL-10 blockade in localized cutaneous leishmaniasis.


Assuntos
Anticorpos Monoclonais/uso terapêutico , Interleucina-10/antagonistas & inibidores , Interleucina-10/metabolismo , Leishmaniose Cutânea/tratamento farmacológico , Leishmaniose Cutânea/metabolismo , Adulto , Anticorpos Monoclonais/farmacologia , Quimiocinas/metabolismo , Citocinas/metabolismo , Humanos , Imunomodulação/efeitos dos fármacos , Leishmaniose Cutânea/imunologia , Leucócitos Mononucleares/imunologia , Leucócitos Mononucleares/metabolismo , Masculino , Subpopulações de Linfócitos T/efeitos dos fármacos , Subpopulações de Linfócitos T/imunologia , Subpopulações de Linfócitos T/metabolismo
20.
Rev Inst Med Trop Sao Paulo ; 57(3): 211-4, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26200960

RESUMO

Intestinal parasites are a problem for public health all over the world. The infection with Blastocystis, a protozoan of controversial pathogenicity, is one of the most common among them all. In this study, the occurrence of intestinal parasites, with emphasis on Blastocystis, in patients at the Universidade Federal do Triângulo Mineiro was investigated in Uberaba (MG) through microscopy of direct smears and fecal concentrates using Ritchie's method. Feces of 1,323 patients were examined from April 2011 to May 2012. In 28.7% of them at least one intestinal parasite was identified, and the most frequent organisms were Blastocystis spp. (17.8%) and Giardia intestinalis (7.4%). The occurrence of parasitism was higher in children aged 6 -10 years old, and the infection with Blastocystis spp. was higher above the age of six (p < 0.001). The exclusive presence of G. intestinalis and of Blastocystis spp. was observed in 5.4% and 12.2% of the patients, respectively. Regarding patients with diarrheic feces, 8% revealed unique parasitism of Blastocystis spp. Other intestinal parasites observed in children were Ascaris lumbricoides (0.3%) and Entamoeba histolytica/dispar/moshkovskii (1.4%). The Ritchie's method was more sensitive (92.8%) when compared to direct microscopy (89.8%), with high agreement between them (97.7%, kappa = 0.92). In conclusion, the occurrence of Blastocystis spp. in Uberaba is high and the presence of diarrheic feces with exclusive presence of the parasite of Blastocystis spp. was observed.


Assuntos
Fezes/parasitologia , Helmintíase/epidemiologia , Enteropatias Parasitárias/epidemiologia , Infecções por Protozoários/epidemiologia , Adolescente , Adulto , Brasil/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Helmintíase/parasitologia , Humanos , Enteropatias Parasitárias/parasitologia , Masculino , Pessoa de Meia-Idade , Infecções por Protozoários/parasitologia , Fatores de Risco , Adulto Jovem
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