Aspecto clínico-epidemiológicos e imunológicos da hanseníase em área heperendêmica do estado do Maranhão / epidemiological and immunological aspect of leprosy in hyperendemic area of the state of Maranhão

A hanseníase ou mal de Hansen (MH), causada pelo patógeno Mycobacterium leprae, ainda constitui um problema de saúde pública no Brasil, e em especial no Maranhão. A doença é hiperendêmica em 77 municípios do Estado. A resposta imune ao patógeno de indivíduos dessas regiões permanece obscuro podendo contribuir na manutenção da hiperendemia. Por isso, este estudo teve por objetivo caracterizar o perfil clínico-epidemiológico e imunológico de pacientes infectados por M. leprae, e de seus contatos, procedentes de área hiperendêmica. Para o desenvolvimento deste trabalho foi realizado um estudo transversal foi realizado nos municípios de Açailândia, Imperatriz e São Luís, no período 2009 a 2012. Pacientes e contatos foram clinicamente avaliados e tiveram os dados epidemiológicos coletados. Uma amostra de sangue foi obtida para realização das sorologias para detecção de anticorpos IgM anti-PGL1 pelos testes de ELISA e ML-Flow, e dosagem de citocinas e quimiocinas. A análise descritiva demonstrou que a maioria dos pacientes eram adultos, do gênero masculino, diagnosticados principalmente com as formas intermediárias da doença (60%)...

Leprosy, caused by the pathogen Mycobacterium leprae, it is a public health problem in Brazil yet, especially in Maranhão. The disease is hyperendemic in 77 counties of the State. Immune response to the pathogen of individuals in these regions remains unclear and may be contributing to maintenance of high endemicity. Therefore, this study aimed to characterize epidemiological and immunological profile of patients infected with M. leprae, and their contacts, from hyperendemic regions. Cross-sectional study was accomplished in Açailândia, Imperatriz and São Luís counties, 2009-2012. Patients and contacts were clinically evaluated and had their epidemiological data collected. A blood sample was obtained for performing serological tests IgM anti-PGL1 detection by ELISA and ML-Flow and measurement of cytokines and chemokines. Descriptive analysis showed that most patients were adults, male, diagnosed with intermediate forms mainly (60%)...

Cytokines and visceral leishmaniasis: a comparison of plasma cytokine profiles between the clinical forms of visceral leishmaniasis

It is not well established whether cytokine production differs in response to different clinical forms of visceral leishmaniasis (VL). In this work, we performed a cross-sectional study to investigate the plasma levels of cytokines [interferon (IFN)-γ, tumour necrosis factor (TNF)-α, interleukin (IL)-2, IL-4, IL-10 and IL-12] involved in the pathogenesis of VL in 80 subjects from VL endemic areas, including subjects with active VL, subjects with asymptomatic infection, subjects with cured VL and uninfected controls. The patients were recruited by sampling from a referral hospital and by random selection from a population-based cohort study. The results showed significant differences in the plasma concentration of all cytokines between the groups (p < 0.05). Patients with the active disease had higher plasma levels of IL-10, IL-4, INF-γ and TNF-α relative to the other groups and they produced more IL-12 than asymptomatic and cured subjects. Only the IL-2 concentration was higher in the asymptomatic and cured subjects relative to the patients with active disease (p < 0.05). Our results suggest that these cytokines can be used as markers in epidemiological studies conducted in endemic areas to distinguish between different clinical forms of VL. However, their usefulness should be confirmed in investigations conducted in other endemic areas.