Prevalence of dental, oral, and maxillofacial traumatic injuries among domestic violence victims: A systematic review and meta-analysis.

BACKGROUND/AIMS: Domestic violence (DV) encompasses a series of abusive behaviors, perpetrated in a family environment, against individuals of all ages and genders. Injuries to the head, neck, and face are frequent findings among victims of abuse, negatively impacting their quality of life. Although oral and maxillofacial injuries (OMFI) and traumatic dental injuries (TDI) are commonly diagnosed among DV victims, their prevalence is still unknown. This systematic review was aimed to assess the prevalence of OMFI and TDI among victims of DV. METHODS: The protocol of the review was registered in PROSPERO (CRD42023424235). Literature searches were performed in eight electronic databases, up to August 7th, 2023. Observational studies published in the Latin-roman alphabet and reporting the prevalence of OMFI and/or TDI were included. The Joanna Briggs Institute's critical appraisal tool, checklist for prevalence studies, was used for quality assessment. Results were presented as qualitative and quantitative syntheses. RESULTS: Seventeen studies, totaling 12,375 victims of domestic violence, were included. Meta-analyses showed an overall prevalence of 29% (95% CI: 15%-48%, I2 = 99%) and 4% (95% CI: 1%-10%, I2 = 98%) for OMFI and TDI, respectively. Higher pooled prevalence for OMFI (41%, 95% CI: 13%-46%, I2 = 99%) was demonstrated in samples with only women. OMFI was less prevalent (20%) among DV victims under 18, while TDI was lower among adults (1%). Hospital samples presented higher pooled prevalence of OMFI (32%), and forensic data from fatal victims presented higher prevalence of TDI (8%). CONCLUSION: The overall prevalence of OMFI and TDI in DV victims was 29% and 4%, respectively. Women victims of DV presented higher rates of OFMI (41%) and TDI (6%).

Arrhythmogenic right ventricular cardiomyopathy with left ventricular involvement: a novel splice site mutation in the DSG2 gene.

We report the case of a 37-year-old male patient admitted to the cardiac intensive care unit for acute pulmonary edema. He had a history of excessive alcoholic consumption and had had a viral syndrome in the preceding 10 days. A transthoracic echocardiogram revealed severe biventricular dysfunction, mild dilatation of the left heart chambers, and severe dilatation of the right chambers. Nonsustained ventricular tachycardia with a left bundle branch block morphology was detected during electrocardiographic monitoring. In the follow-up, he underwent a contrast-enhanced transthoracic echocardiogram and a cardiac resonance which were compatible with the diagnosis of arrhythmogenic right ventricular cardiomyopathy with biventricular involvement. Molecular analysis detected the mutation c.1423+2T>G (IVS10 ds +2T>G) in intron 10 of the gene DSG2 (desmoglein-2) in heterozygosity. To our knowledge, this mutation has not been previously described in arrhythmogenic right ventricular cardiomyopathy.

Fracture Resistance of Endodontically Treated Premolars Using Nanohybrid Composite, Fiber-Reinforced Composite, Horizontal Glass Fiber Posts, and Ceramic Inlays: An In Vitro Study.

INTRODUCTION: This study evaluated the resistance to fracture of endodontically treated premolars (ETPs) with mesio-occluso-distal (MOD) cavities filled with nanohybrid composite (NHC), fiber-reinforced composite (FRC), horizontal glass fiber posts (HFP), and ceramic inlays (CI). METHODS: Eighty-four intact maxillary premolars were taken, and endodontic treatment was performed followed by MOD cavity preparations (except in the control group). They were distributed into 7 groups based on type of restoration: intact teeth (control group), ETP + MOD (not restored), NHC, FRC + NHC, HFP + NHC, FRC + HFP + NHC, and CI groups. Samples were subjected to universal testing machine until the fracture occurred and failure mode was visually inspected. RESULTS: Mean and standard deviation of fracture resistance of the 7 groups ranged from 265.6 ± 68.0 N to 1023.7 ± 76.5 N. The highest reading was noted for intact teeth followed by FRC + HFP + NHC group and then the CI group, with no significant difference among the 3 groups. The lowest reading was noted for the ETP + MOD group. Maximum unrepairable fractures were seen in the ETP + MOD and CI groups. CONCLUSION: FRC + HFP + NHC combination and CIs increased the resistance to fracture of ETPs significantly.

A cone-beam computed tomographic analysis of total dentin removed, canal transportation, and canal-centering ability following instrumentation with three different file systems: An in vitro study.

Aims: The aim of this study was to evaluate the shaping ability following instrumentation with XP-endo Shaper (XPS), TruNatomy (TRN), and HyFlex CM (HCM) file system. Subjects and Methods: Fifty-four mesiobuccal canals of mandibular molars were selected and allocated into three groups randomly: XPS, TRN system, and HCM file system. Pre- and postinstrumentation scans were taken using a cone-beam computed tomography scanner to determine the amount of root dentin removed, mesiodistal and buccolingual transportation, and canal-centering ratio at 2, 5, and 8 mm from the root end. Statistical Analysis Used: Data were statistically analyzed using Kruskal-Wallis test and the significance level was set at P = 0.05. Results: TRN file system removed the least amount of root dentin. XPS showed statistically higher M-D canal transportation at 5 mm level from the apex. Conclusions: TRN file system showed better dentin preservation as compared to XPS and HCM. XPS showed the highest canal transportation at 5 mm. All three file systems performed similarly in terms of canal-centering ability.

Prevalence of traumatic dental injuries in emergency dental services: A systematic review and meta-analysis.

OBJECTIVES: This study aimed to perform a systematic review and meta-analysis regarding the prevalence of traumatic dental injuries (TDI) in emergency dental services. METHODS: Seven electronic and two grey literature databases were searched, up to December 2021, for studies that reported the TDI prevalence among dental emergencies. The Joanna Briggs Institute critical appraisal checklist for prevalence studies, and The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach were used to assess the risk of bias and quality of evidence respectively. The R software was used to perform a proportion meta-analysis on a random-effects model to estimate the pooled prevalence and respective 95% CI. RESULTS: From a total of 1476 studies identified after excluding duplicates, 38 met the inclusion criteria, and another five were identified through hand searching, summing 43 included observational studies with a total sample of 209099 individuals searching for emergency dental care. The overall pooled prevalence of TDI was 15.4% (95% CI: 11%-21%, I² = 100%). Paediatric dental emergency services and age group from 0 to 21 years presented the highest prevalence, 29% (95% CI: 22%-38%, I² = 99.5%) and 24% (95% CI: 15%-35%, I² = 98%) respectively. CONCLUSIONS: The overall pooled prevalence of TDI in emergency dental services was 15.4%, and 24% in the age group under 21 years. Considering the impact of prompt and correct emergency care in the long-term prognosis of TDI, such knowledge is relevant to organize emergency healthcare and support public policies in this area.

Late right ventricular perforation: a rare complication of a pacemaker implantation.

Right ventricular perforation by a pacemaker lead is a rare complication of pacemaker implantation, with an incidence inferior to 1%. It usually occurs at the time of lead insertion or during the first 24 hours after the procedure (acute perforation).Late right ventricular perforation, defined as occurring at least 1 month after lead implantation, is even rarer. The clinical presentation varies widely and is mainly related to the stimulation of extracardiac structures and/or lead dysfunction.Its diagnosis may be difficult and must be complemented by appropriate imaging methods. The optimal management strategy remains controversial, varying from surgery to more conservative treatments. The authors present a case of late right ventricular myocardium lead perforation occurring in a 56-year-old-male patient, approached with open surgery.

Ventricular lead dysfunction and subclavian vein stenosis: when problems come in pairs.

The widespread and increasing use of cardiac devices implantation naturally augments the number of device related complications. Lead failure is a known complication associated with increased morbidity, mortality and need for reintervention.Chronic stenosis or occlusions of coronary, cephalic or subclavian veins, especially at the site of previous device implantation,can limit lead passage through the target vein, imposing great technical difficulties, especially in patients needing follow-up procedures such as lead revisions and/or system upgrades. Venous balloon angioplasty can be a valuable and safe tool for successful implantation, helping to avoid more complex and hazardous procedures. The authors report the case of a 65 years old male presenting with a "Sprint Fidelis" defibrillator lead malfunction and severe asymptomatic left subclavian vein stenosis after cardiac resynchronization defibrillator therapy. The patient was submitted to a successful percutaneous balloon venoplasty in order to regain adequate venous access and enable reimplantation of the right ventricular lead.

Apexification and dentinal wall reinforcement using Biodentine and glass fiber post.

A 21-year-old male patient reported with chief complaint of pain in the upper front teeth. Clinical examination revealed tooth fracture in teeth # 11, 21, and prior attempted endodontic treatment. The radiographic examination revealed periapical radiolucency in relation to upper central incisors with thinning of dentinal walls. The upper left central incisor had grossly diminished root canal dentin walls with immature apex, whereas the upper right central incisor had moderate loss of dentin from the root canal wall with an open apex. Hence, it was decided to extract the upper left central incisor, whereas apexification and root canal dentin wall reinforcement with Biodentine were carried out for the upper right central incisor. The patient was asymptomatic at 1-, 4-, and 6-month follow-up visits.

Influence of two remineralizing agents on bleached enamel surface morphology and mineral composition - An In Vitro study.

Aim: To investigate the effects of bleaching with 35% hydrogen peroxide on the structure of tooth enamel and the role of two remineralizing agents for their potential to remineralize any damaged regions of enamel. Materials and Methods: Freshly extracted 32 mature permanent central incisors were selected and sectioned at the level of the cemento-enamel junction. The teeth were divided into four groups consisting of eight teeth each: No bleaching (control) [Group 1], bleaching with 35% hydrogen peroxide [Group 2], bleaching with 35% hydrogen peroxide followed by application of casein phosphopeptide amorphous calcium phosphate fluoride paste [Group 3], and bleaching with 35% hydrogen peroxide followed by application of xylitol-coated calcium phosphate fluoride varnish [Group 4]. The enamel surfaces were analyzed under the scanning electron microscope and quantitative energy dispersive X-ray analysis. Results: Results were statistically analyzed by one-way analysis of variance and Tukey's posthoc test. Group 2 revealed changes in enamel surface morphology and a statistically significant decrease in mineral content. Groups 3 and 4 showed statistically significant remineralization potential. Intergroup comparison showed that samples in Group 4 had a higher mineral content compared to Group 3. Conclusions: The application of the tested remineralizing agents following bleaching was effective in repairing the enamel surface morphology with higher efficacy for the fluoride varnish product. Since bleaching regimes with high concentrations of hydrogen peroxide adversely affect the enamel surface, these findings can translate to clinical practice to reduce the long-term damaging effects of tooth bleaching.

Three-dimensional Printer Molds for Vaginal Agenesis: An Individualized Approach as Conservative Treatment.

OBJECTIVE: The aim of this study was to evaluate the use of vaginal molds, made with three-dimensional (3D) printing, for conservative treatment through vaginal dilation in patients with vaginal agenesis (VA). METHODS: A total of 16 patients with a diagnosis of VA (Mayer-Rokitansky-Küster-Hauser syndrome, total androgen insensitivity syndrome, and cervicovaginal agenesis) from the Federal University of São Paulo were selected. Device production was performed in a 3D printer, and the polymeric filament of the lactic polyacid (PLA) was used as raw material. A personalized treatment was proposed and developed for each patient. RESULTS: There were 14 patients who reached a final vaginal length of 6 cm or more. The initial total vaginal length (TVL) mean (SD) was 1.81(1.05) and the final TVL mean (SD) was 6.37 (0.94); the difference, analyzed as 95% confidence interval (95% CI) was 4.56 (5.27-3.84) and the effect size (95% CI) was 4.58 (2.88-6.28). CONCLUSION: The 3D printing molds for vaginal dilation were successful in 87.5% of the patients. They did not present any major adverse effects and offered an economical, accessible, and reproducible strategy for the treatment of VA.

OBJETIVO: O objetivo deste estudo foi avaliar o uso de moldes dilatadores vaginais, confeccionados com impressão tridimensional (3D), para tratamento conservador através da dilatação vaginal em pacientes com agenesia vaginal (AV). MéTODOS: Foram selecionadas 16 pacientes com diagnóstico de AV (síndrome de Mayer-Rokitansky-Küster-Hauser, síndrome de insensibilidade androgênica total e agenesia cervicovaginal), da Universidade Federal de São Paulo. A produção dos dispositivos foi realizada em uma impressora 3D e, como matéria-prima, foi utilizado o filamento polimérico do poliácido lático (PLA). Um tratamento personalizado foi proposto e desenvolvido para cada paciente. RESULTADOS: Quatorze pacientes atingiram um comprimento vaginal final (CVF) de 6 cm ou mais. A média inicial do CVF (DP) foi de 1,81 (1,05) e a média final do CVF (DP) 6,37 (0,94); a diferença (IC 95%) foi de 4,56 (5,27­3,84) e o tamanho do efeito (IC 95%) foi de 4,58 (2,88­6,28). CONCLUSãO: Os moldes de impressão 3D para dilatação vaginal obtiveram sucesso em 87,5% das pacientes. Como impacto secundário, não apresentaram efeitos adversos importantes e ofereceram uma estratégia econômica, acessível e reprodutível para o tratamento da AV.

Spectrophotometric Analysis of Coronal Discolouration Induced by ProRoot MTA, Biodentine and MTA Repair HP Used for Pulpotomy Procedures.

OBJECTIVE: To assess and quantify coronal tooth discolouration by ProRoot MTA, Biodentine and MTA repair HP as pulpotomy agents and to identify colour stability of these materials in presence of blood contamination. METHODS: 120 human premolar teeth were used in the study. The teeth were sectioned horizontally 1 mm apical to the cementoenamel junction. A retrograde cavity extending within 2 mm of the incisal edge was prepared. The specimens were randomly distributed as; Control: Group 1, ProRoot MTA: Group 2, Biodentine: Group 3 and MTA repair HP: Group 4. The groups werefurther subdivided on basis of exposure to saline (subgroup A) or blood (subgroup B). The access was sealed with light cured Glass ionomer cemet and the specimens were stored in artificial saliva at 37°C. The Colour change was evaluated with a spectrophotometer at: day 0 (T0), day 1 (T1), day 7 (T7), 1 month (T30), 2 months (T60), and 6 months (T180). The colour measurements were recorded using the Commission Internationale de l'Eclairage L*a*b* value. RESULTS: For all groups, there was a sharp increase in L* parameter at T1. At 6 months, Group 1B (Control + blood) showed maximum decrease in luminosity followed by Group 2A (ProRoot + saline) > Group 4B (MTA repair HP + blood) > Group 2B (ProRoot + blood). Group 3A (Biodentine + saline) showed the least amount of decrease in luminosity followed by Group 4A (MTA repair HP + saline) and Group 3B (Biodentine + blood). No significant difference was found in ∆E change between any of the groups from baseline to 180 days (P>0.05). CONCLUSION: Relative to L* parameter, it was possible to observe a statistically significant decrease in luminosity in the Group1B (Control + blood) followed by ProRoot MTA (Group 2A and 2B) and MTA repair HP (Group 4A and 4B). Biodentine (Group 3A and 3B) showed least tooth discolouration in terms of L* parameter.

Shear bond strength evaluation of an alkasite restorative material to three different liners with and without using adhesive system: An in vitro study.

AIMS: The aim of the study is to compare and evaluate the bonding ability of alkasite restorative material to TheraCal LC™ (TLC), Biodentine™ (BD), resin-modified glass ionomer cement (RMGIC) using an universal adhesive and characterizing their failure modes. SUBJECTS AND METHODS: Ninety extracted intact human molars were divided into three groups of (n = 30) as Group I (TLC), Group II (RMGIC), and Group III (BD). Each group was subdivided into two based on application of universal adhesive. Cention N was bonded to each sample. Shear bond strength analysis was performed. The data were analyzed using SPSS version 22 software. RESULTS: No significant difference was observed between Group I and Group II (P < 0.05) while Group III showed the least bond strength (P < 0.05). The modes of failure were predominantly cohesive in Groups I and III (TLC and BD) while RMGIC showed mixed and adhesive failures. CONCLUSIONS: The bond strength of Cention N to TLC and RMGIC was similar and significantly higher than that of BD following application of universal adhesive.

Comparative evaluation of sealing ability of two self-adhesive flowable composites following various restorative techniques in Class V lesions: An in vitro study.

Background: Self- adhesive flowable composite (SAFC) has been introduced to eliminate etching and bonding procedures. However, they have shown increased microleakage and poor bonding ability when used as per the manufacturer's instructions. It is unclear if prerestorative techniques can improve the same. Aims: This study aimed to evaluate the effects of acid etching, bevel placement and air abrasion on the marginal sealing ability of SAFCs when used in Class V restorations. Materials and Methods: 56 human mandibular premolars were taken and standard Class V cavities were prepared on the buccal aspect. They were divided into 4 groups comprising of control and three restorative techniques. Group A: SAFC used alone formed the control group, Group B: Acid-etched using 37.5% phosphoric acid gel, Group C: 1 mm bevel placed on the occlusal margin, Group D: Subjected to air abrasion. Each group was further subdivided into two, with one half being restored with Dyad flow (Kerr) while the remaining with Constic (DMG). The samples were thermocycled and the dye extraction method was used to assess microleakage using ultraviolet spectrophotometer. Statistical Analysis: Microleakage values were subjected to analysis of variance and post hoc analysis. Results: Statistically significant differences in the absorbance values were seen between the two SAFCs. Results with P < 0.05 were considered statistically significant. For Dyad flow, there was a statistically significant difference between Groups B and D (P = 0.028), while for Constic, it was between Groups A and B (P = 0.031) and Groups B and D (P = 0.025). CONCLUSIONS: Among restorative techniques, air abrasion showed the least microleakage, while acid etching showed the highest values. Among the two SAFCs, Constic presented lower microleakage than Dyad Flow.

Aripiprazole prevents stress-induced anxiety and social impairment, but impairs antipredatory behavior in zebrafish.

Environmental pollution caused by antipsychotic residues is a relevant ecological problem. Studies revealed that residues of these drugs are present in a wide range of different ecosystems and can have adverse effects on non-target organisms even in low environmental concentrations. Among these antipsychotic drugs, aripiprazole (APPZ) is a second-generation atypical antipsychotic that is a partial agonist of dopaminergic and serotoninergic receptors. APPZ is used to treat schizophrenia, bipolar disorder, autism, obsessive-compulsive disorder, and anxiety or panic disorders. Thus, in this study we posed the following question: "What will be the behavioral effects of waterborne APPZ on fish?" To answer this question, we exposed adult zebrafish to different APPZ concentrations (0.556, 5.56, and 556 ng/L) for 15 min and evaluated their exploratory, anxiety-like, social, and anti-predatory behaviors. Our results showed that, despite the apparent beneficial reversal of stress-induced social impairment and anxiety-like behavior, APPZ exposure impaired the anti-predatory reaction of adult zebrafish. Taken altogether, our results show that APPZ-exposed zebrafish may have a decreased perception of predators, even at concentrations lower than those already detected in the environment. A failure to exhibit an antipredatory response may favor the predator, decrease the fitness of the prey species, and, consequently, affect the food chain. Our results highlight the risks and consequences associated with APPZ residues in water, which may affect aquatic life and endanger species that depend on appropriate behavioral responses for survival.

Use of thermography in skin grafts after the application of therapeutic ultrasound in Wistar rats.

Purpose To analyze changes in the thermal pattern in the skin graft receptor bed, after the use of therapeutic ultrasound through the thermographic images. Methods Eighteen Rattus norvegicus albinus Wistar, separated into two groups: GST groups (without tumor and without treatment with ultrasound) and GT (with tumor and treatment with ultrasound). In the GT group, induction of carcinogenesis was performed by single intradermal application of 0.05 ml DMBA at 0.5%, diluted in acetone. Subsequently, a technique of reconstructive grafting surgery of the mesh type was performed in both groups and treatment with therapeutic ultrasound was performed in the GT group the alternate day protocol at 3, 6, 10 and 15 days after the procedure. The thermographic evaluation occurred on days 3, 6, 10 and 15 after the grafting. Results There was a significant difference between the statistical evaluation of the temperature of the control group when compared to the treated group, on the different evaluation days (p <0.0001). Conclusion The thermographic analysis of the images was effective in evaluating the healing process, being the use of thermography feasible to evaluate changes in the thermal standard in the surgical bed, besides the beneficial effects of the US.

Effect of bromelain enzyme on the microleakage of composite resin restorations after external tooth bleaching: An in vitro study.

AIMS: The aim of this study is to evaluate in vitro the effect of application of bromelain enzyme on the microleakage of composite resin restorations after external tooth bleaching using spectrophotometric evaluation. SUBJECTS AND METHODS: Buccal Class V cavities were prepared on the surface of fifty intact premolars, which were randomly divided into five groups. All cavities were filled with composite resin. Group I: Teeth were not bleached but restored (n = 10). External bleaching with 35% hydrogen peroxide was carried out for the rest of the specimensGroup II: Cavities were restored immediately after bleaching (n = 10)Group III: Cavities were restored after a delay of 3 weeks (n = 10)Group IV: Cavities were treated with sodium ascorbate after bleaching and then restored (n = 10)Group V: Cavities were treated with bromelain enzyme solution after bleaching and then restored (n = 10). Microleakage was assessed by the dye extraction method using a spectrophotometer. STATISTICAL ANALYSIS USED: The data were analyzed statistically by comparison of mean microleakage and post hoc test using SPSS 2.0 software. RESULTS: Group I displayed the least amount of microleakage, whereas Group II showed the greatest amount of microleakage (P < 0.05). Groups III, IV, and V showed a significantly lower amount of microleakage compared to Group II (P < 0.05). There was no statistically significant difference between Groups IV and V. CONCLUSIONS: Microleakage increased significantly after external bleaching with 35% hydrogen peroxide, and decreased when the bleached teeth were treated with antioxidants. Ten percent bromelain enzyme was effective in decreasing microleakage; however, its efficacy was similar to 10% sodium ascorbate.

On the understanding of zinc-oxide eugenol cement use prior to etch-rinse bonding strategies.

CONTEXT: Zinc-oxide eugenol (ZOE) is frequently used due to its satisfactory biological response, sedative effect on the pulp, and easy removal. However, literature is very controversial about the influence of the temporary cement-containing eugenol on the bond strength properties. AIMS: This study aims to clarify the literature controversy by evaluating the bond strength of ZOE or ZOE-free applied before bonding procedures and the 7-day resting period after the first session. SETTINGS AND DESIGNS: Twelve recently extracted third molars were randomly divided into three groups: Group 1: Control (without treatment), Group 2: Temp-Bond NE; Group 3: Temp-Bond. SUBJECTS AND METHODS: After temporary restorations, the teeth were immersed in distilled water and stored for 7 days at 37°C. The temporary cement was mechanically removed, and prophylaxis was performed. The adhesive procedures were performed, and a 6-mm-high composite resin block was built. The teeth were immediately stored at 100% relative humidity at 37°C for 24 hours. Specimens with 0.7 (±0.2) mm2 of cross-sectional area were obtained and subjected to a microtensile bond strength (µTBS) test at 1 mm/min until failure. STATISTICAL ANALYSIS USED: Analysis of variance (ANOVA) and Tukey's post hoc test were used for statistical analysis. RESULTS: ZOE or ZOE-free cement did not interfere in the µTBS between resin composite and dentine when used with a two-step-etch-rinse adhesive material, considering 7 days of resting period after the first session, by the ANOVA and Tukey's post hoc test (P < 0.05). CONCLUSIONS: The authors recommend the removal of the temporary cementation at least seven days after the first session and suggest that the clinicians follow-up further studies to use the cement in case its removal is recommended within a longer period.

Enhancing Hepatitis C virus pseudoparticles infectivity through p7NS2 cellular expression.

Hepatitis C pseudoparticles (HCVpp) are used to evaluate HCV cell entry while screening for neutralizing antibodies induced upon vaccination or while screening for new antiviral drugs. In this work we explore the stable production of HCVpp aiming to reduce the variability associated with transient productions. The performance of stably produced HCVpp was assessed by evaluating the influence of Human Serum and the impact of CD81 cellular expression on the infectivity of HCVpp. After evaluating the performance of stably produced HCVpp we studied the effect of co-expressing p7NS2 openreading frame (ORF) on HCVpp infectivity. Our data clearly shows an enhanced infectivity of HCVppp7NS2. Even though the exact mechanism was not completely elucidated, the enhanced infectivity of HCVppp7NS2 is neither a result of an increase production of virus particles nor a result from increased envelope density. The inhibitory effect of p7 inhibitory molecules such as rimantadine suggests a direct contribution of p7 ion channel for the enhanced infectivity of HCVppp7NS2 which is coherent with a pH-dependent cell entry mechanism. In conclusion, we report the establishment of a stable production system of HCVpp with enhanced infectivity through the overexpression of p7NS2 ORF contributing to improve HCV entry assessment assays widely used in antiviral drug discovery and vaccine development.

The Aspergillus fumigatus Mucin MsbA Regulates the Cell Wall Integrity Pathway and Controls Recognition of the Fungus by the Immune System.

Aspergillus fumigatus is a filamentous fungus which causes invasive pulmonary aspergillosis in immunocompromised individuals. In fungi, cell signaling and cell wall plasticity are crucial for maintaining physiologic processes. In this context, Msb2 is an important signaling mucin responsible for activation of a variety of mitogen-activated protein kinase (MAPK)-dependent signaling pathways that regulate cell growth in several organisms, such as the cell wall integrity (CWI) pathway. Here, we aimed to characterize the MSB2 homologue in A. fumigatus Our results showed that MsbA plays a role in the vegetative and reproductive development of the fungus, in stress adaptation, and in resistance to antifungal drugs by modulating the CWI pathway gene expression. Importantly, cell wall composition is also responsible for activation of diverse receptors of the host immune system, thus leading to a proper immune response. In a model of acute Aspergillus pulmonary infection, results demonstrate that the ΔmsbA mutant strain induced less inflammation with diminished cell influx into the lungs and lower cytokine production, culminating in increased lethality rate. These results characterize for the first time the role of the signaling mucin MsbA in the pathogen A. fumigatus, as a core sensor for cell wall morphogenesis and an important regulator of virulence.IMPORTANCEAspergillus fumigatus is an opportunistic fungus with great medical importance. During infection, Aspergillus grows, forming hyphae that colonize the lung tissue and invade and spread over the mammal host, resulting in high mortality rates. The knowledge of the mechanisms responsible for regulation of fungal growth and virulence comprises an important point to better understand fungal physiology and host-pathogen interactions. Msb2 is a mucin that acts as a sensor and an upstream regulator of the MAPK pathway responsible for fungal development in Candida albicans and Aspergillus nidulans Here, we show the role of the signaling mucin MsbA in the pathogen A. fumigatus, as a core sensor for cell wall morphogenesis, fungal growth, and virulence. Moreover, we show that cell wall composition, controlled by MsbA, is detrimental for fungal recognition and clearance by immune cells. Our findings are important for the understanding of how fungal sensors modulate cell physiology.