Late peripheral facial paralysis after COVID-19: a rapid systematic review and two case reports

Peripheral facial paralysis (PFP) has been shown to be a neurological manifestation of COVID-19. The current study presents two cases of PFP after COVID-19, along with a rapid review of known cases in the literature. Both case reports were conducted following CARE guidelines. We also performed a systematic review of PFP cases temporally related to COVID-19 using PubMed, Embase, and Cochrane Library databases on August 30, 2021, using a rapid review methodology. The two patients experienced PFP 102 and 110 days after COVID-19 symptom onset. SARS-CoV-2 RNA was detected in nasal samples through reverse-transcription real-time polymerase chain reaction (RT-qPCR) testing. Anosmia was the only other neurological manifestation. PFP was treated with steroids in both cases, with complete subsequent recovery. In the rapid review, we identified 764 articles and included 43 studies. From those, 128 patients with PFP were analyzed, of whom 42.1% (54/128) were male, 39.06% (50/128) female, and in 23 cases the gender was not reported. The age range was 18 to 59 (54.68%). The median time between COVID-19 and PFP was three days (ranging from the first symptom of COVID-19 to 40 days after the acute phase of infection). Late PFP associated with COVID-19 presents mild symptoms and improves with time, with no identified predictors. Late PFP should be added to the spectrum of neurological manifestations associated with the long-term effects of SARS-CoV-2 infection as a post COVID-19 condition.

Increased peripheral blood TCD4+ counts and serum SP-D levels in patients with chronic paracoccidioidomycosis, during and after antifungal therapy

BACKGROUND The main clinical forms of paracoccidioidomycosis (PCM) are the acute/subacute form (AF) and the chronic form (CF), and they both display considerable clinical variability. The immune responses of PCM patients, during and after treatment, remain neglected, mainly in the case of CF patients, due to the high prevalence of pulmonary sequelae. OBJECTIVE To evaluate the distribution of whole blood T cell subsets, serum cytokines, and biomarkers of pulmonary fibrosis in PCM patients, according to the clinical form and at different time points, during the antifungal therapy. METHODS Eighty-seven PCM patients, from an endemic area in Brazil, were categorised into groups, according to the clinical form (AF or CF) and the moment of treatment. The peripheral blood T lymphocyte subsets of these patients were analysed using fluorescence-activated cell sorting. The serum levels of cytokines, basic fibroblast growth factor and surfactant protein-D (SP-D) were also analysed. FINDINGS In the CF patients, an expansion of the peripheral blood TCD4+ cells was observed during the treatment, and this persisted even after two years of antifungal treatment. In addition, these patients showed high serum levels of SP-D. CONCLUSION Our findings highlight the immunological changes CF patients undergo, during and after treatment, possibly due to the hypoxia triggered by pulmonary fibrosis and emphysema.

Influência da condição de hipoinsulinemia-hiperglicemia na candidíase experimental sistêmica: avalição da atividade macrofágica e da distribuição das subpopulações de monócitos sanguíneos / Influence the condition of hypoinsulinemia - hyperglycemic in experimental systemic candidiasis: evalution of macrophage activity and distribution of subpopulations of monocytes blood

Diabetes mellitus (DM) é um importante fator de predisposição para o desenvolvimento de infecções, incluindo a candidíase. Embora a incidência e a gravidade das doenças infecciosas em pacientes diabéticos estejam com frequência relacionadas a disfunções da resposta imune, seus mecanismos ainda não foram bem esclarecidos. No presente estudo avaliou-se a influência da condição de hipoinsulinemia-hiperglicemia (HH) na evolução da candidíase experimental sistêmica. Parâmetros histológicos, microbiológicos e imunológicos envolvendo medula óssea, cérebro, baço e fígado, níveis plasmáticos de quimiocina e de citocinas, atividade macrofágica e distribuição de granulócitos e subpopulações de monócitos do sangue periférico foram avaliados. Para tanto, camundongos suiços, HH-induzidos ou não pela aloxana, foram inoculados com Candida albicans pela veia da cauda e avaliados 12, 24 e 96 horas e 7 dias após infecção. A presença de fungos foi avaliada em: sangue, medula óssea, rins, fígado, cérebro e baço. A atividade macrofágica foi estudada pela resposta de fagócitos peritoneais cultivados ou não com C. albicans mortas pelo calor, avaliando-se a produção de peróxido de hidrogénio e de óxido nítrico e os níveis de TNF-α, IL-6, IL-10, IFN-γ, IL-12p70 e CCL2 em sobrenadande de cultura. Os níveis plasmáticos destas citocinas também foram determinados. A distribuição de granulócitos e das subpopulações de monócitos circulantes foi determinada por citometria de fluxo. Os resultados mostraram aumento da mortalidade em camundongos HH; apesar da ausência de diferenças de resposta tecidual entre os grupos infectados; notamos diferenças importantes na carga fúngica presente nos diversos tecidos examinados...

Diabetis mellitus (DM) is an important predisposing factor for the development of infections, including candidiasis. Although the incidence and severity of infectious diseases in diabetic patients are related to dysfunction in the immune function, the mechanisms involved in the high susceptibility to this fungal infection are not clear. In the present study, we evaluated the influence of hypoinsulinemia-hyperglycemia (HH) on plasma levels of chemokine/cytokines, macrophage activity and distribution of peripheral blood granulocytes and monocytes subsets in a murine model of systemic candidiasis. C. albicans was intravenously inoculated in alloxan-induced HH mice, which were evaluated 12, 24 and 96 hours, and 7 days after infection. Colony-forming unit analysis and/or histopathological examination were performed on blood, bone-marrow, kidney, brain, liver and spleen. Peritoneal phagocytes were cultured with or without heat-killed C. albicans, and the production of hydrogen peroxide and nitric oxide were determined. The levels of TNF-α, IL-6, IL-10, IFN-γ, IL-12p70 and CCL2 were measured in the culture supernatants and also in the plasma of the mice. The distribution of peripheral blood granulocytes and monocytes subsets were performed by flow cytometry. Our findings showed an increased mortality in the infected HH mice, but they showed no significant differences in fungal recovery. Upon histopathological examination, no differences were observed between both infected groups, but strong discrepancies in fungal load were found among the tissues examined. High plasma levels of IL-6 and TNF-α as well as an excessive TNF-α-mediated macrophage response were also observed in the infected HH-induced mice. Soon after the fungal challenge, increased percentage of granulocytes and inflammatory monocytes was observed...

The effect of phosphoethanolamine intake on mortality and macrophage activity in mice with solid ehrlich tumors

The aim of the present study was to examine the effect of a diet rich in synthetic PEtn on the metabolism macrophages of tumor-bearing mice. The results demonstrated that PEtn increased the animals' survival time. In addition, the treated animals released smaller amounts of hydrogen peroxide (H2O2) and nitric oxide (NO) than the non-treated animals, particularly after day 14. From the results it could be concluded that H2O2 and NO were important in the modulation of neoplastic growth, and pointed to a promising role of PEtn in the control of human neoplasms.

Hanseniase Dimorfa: perfil de citocinas em sobrenadante de cultura de células mononucleares e in situ / Leprosy bordeline: profile of cytokines in the culture supernatant of mononuclear cells and in situ

Visando contribuir para o melhor entendimento da participação das citocinas na hanseníase dimorfa, o presente estudo investigou a produção desses mediadores in vitro e in situ em pacientes dimorfos-tuberculóides (HDT) e dimorfos-virchovianos(HDV). Foram avaliados 7 pacientes HDT e 12 HDV, virgens de tratamento, além de 19 indivíduos sádios (grupo controle). Culturas de células mononucleares do sangue periférico (PBMC) foram estimuladas ou não com estímulos inespecíficos e específicos do M. Leprae (antígeno inteiro e sonicado) e após 48 horas o sobrenadante foi recolhido para dosagens das citocinas TNF-a, IFN-y, IL-10 e TGF-B1. Biópsias das lesões cutâneas foram submetidas aos procedimentos histológicos por meio da coloração com hematoxilina-Eosina e Faraco-Fite; os cortes foram submetidos, ainda, à detecção in situ de iNOS, IL-10 e TGF-B1 por imunoistoquímica. A quantificação de citocinas em sobrenadante de PBMC revelou que pacientes HDT produziram níveis menores de TGF-B1 e pacientes HDV, níveis menores de IL-10...

Influência da testosterona na atividade macrofágica frente ao Trichophyton mentagrophytes / Influence of testosterone on macrophages activity cocultured with Trichophyton mentagrophytes

O objetivo deste estudo foi avaliar a influência da testosterona sobre a atividade funcional de macrófagos murinos residentes frente ao Trichophyton mentagrophytes. Nas condições ensaiadas, a testosterona influenciou a liberação da H2O2 levando a redução da atividade microbicida dos macrófagos, facilitando o crescimento e diferenciação dos conídeos fagocitados.

The aim of this study was to evaluating the influence of male sexual hormone on activity of Swiss mice resident macrophages cocultured with Trichophyton mentagrophytes. In assayed conditions, testosterone influenced H2O2 release, leading to inhibition of killed macrophage activity in ingested conidia, facilitating its growth and differentiation inside macrophage.