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Rev. Soc. Bras. Med. Trop ; 52: e20180323, 2019. graf
Article in English | LILACS | ID: biblio-1003132


Abstract We report the case of a 32-year-old man from Rio de Janeiro, who was infected in the Amazon region of Brazil by Leishmania (Viannia) naiffi. Generally, patients with L. naiffi cutaneous leishmaniasis exhibit a good therapeutic response to either pentavalent antimonials or pentamidine. However, after pentamidine treatment, this patient's infection evolved to therapeutic failure. To understand this clinical outcome, we investigated the presence of the Leishmania RNA virus (LRV) in parasites isolated from the cutaneous lesion; herein, we discuss the possible association between a poor response to pentamidine therapy and the presence of the LRV.

Humans , Male , Adult , Pentamidine/therapeutic use , RNA Viruses/genetics , Trypanocidal Agents/therapeutic use , Leishmaniasis, Cutaneous/drug therapy , Leishmania/virology , Pentamidine/adverse effects , Trypanocidal Agents/adverse effects , Polymerase Chain Reaction , Treatment Failure
Rev. Soc. Bras. Med. Trop ; 52: e20190315, 2019. tab, graf
Article in English | LILACS | ID: biblio-1057249


Abstract INTRODUCTION: Immunological control of Mycobacterium tuberculosis infection is dependent on the cellular immune response, mediated predominantly by Th1 type CD4+ T cells. Polarization of the immune response to Th2 can inhibit the host immune protection against pathogens. Patients with tuberculosis coinfected with helminths demonstrate more severe pulmonary symptoms, a deficiency in the immune response against tuberculosis, and an impaired response to anti-tuberculosis therapy. METHODS: We evaluated the cellular immune response and the impact of the presence of Ascaris lumbricoides on the immune and clinical response in pulmonary tuberculosis patients. Ninety-one individuals were included in the study: 38 tuberculosis patients, 11 tuberculosis patients coinfected with Ascaris lumbricoides and other helminths, 10 Ascaris lumbricoides patients, and 34 non-infected control individuals. Clinical evolution of pulmonary tuberculosis was studied on 0, 30, 60, and 90 days post-diagnosis of Mycobacterium tuberculosis and Ascaris lumbricoides. Furthermore, immune cells and plasma cytokine profiles were examined in mono/coinfection by Mycobacterium tuberculosis and Ascaris lumbricoides using flow cytometry. RESULTS: There were no statistical differences in any of the evaluated parameters and the results indicated that Ascaris lumbricoides infection does not lead to significant clinical repercussions in the presentation and evolution of pulmonary tuberculosis. CONCLUSIONS: The association with Ascaris lumbricoides did not influence the Th1, Th2, and Th17 type responses, or the proportions of T lymphocyte subpopulations. However, higher serum levels of IL-6 in tuberculosis patients may explain the pulmonary parenchymal damage.

Humans , Animals , Male , Female , Adult , Young Adult , Ascariasis/immunology , Tuberculosis, Pulmonary/immunology , Interleukin-6/blood , Ascaris lumbricoides , Ascariasis/complications , Time Factors , Tuberculosis, Pulmonary/complications , Antibodies, Helminth/blood , Case-Control Studies , Cytokines/immunology , Cytokines/blood , Interleukin-6/immunology , Disease Progression , Coinfection , Flow Cytometry , Middle Aged
Rev. Soc. Bras. Med. Trop ; 51(1): 111-114, Jan.-Feb. 2018. graf
Article in English | LILACS | ID: biblio-897041


Abstract The authors report the first case of fatal septic shock, a rare clinical presentation of paracoccidioidomycosis (PCM) caused by Paracoccidioides brasiliensis S1. We also provide an immunological evaluation of the patient. Severe clinical signs such as organ dysfunction and digital gangrene occurred in this case. The patient presented a remarkable cell activation profile and diminished percentage of peripheral blood T regulatory cells. A decrease in anti-inflammatory IL-1RA plasma level showed the potential for endothelium damage, probably contributing to a vasculitis process. Together with P. lutzii, P. brasiliensis appears to be involved in severe cases of PCM.

Humans , Male , Young Adult , Paracoccidioides/genetics , Paracoccidioidomycosis/complications , Paracoccidioidomycosis/diagnosis , Phylogeny , Shock, Septic/microbiology , Severity of Illness Index , Fatal Outcome , Immunocompetence
Rev. Soc. Bras. Med. Trop ; 41(2): 135-141, mar.-abr. 2008. ilus, graf
Article in English | LILACS | ID: lil-484217


Total antigen from Leishmania (Leishmania) amazonensis and isolates from the Leishmania braziliensis complex, along with their respective antigenic fractions obtained by affinity chromatography on concanavalin-A-Sepharose and jacalin-agarose columns evaluated using immunoenzymatic ELISA assay. For this, serum samples from 229 patients were used, grouped as American tegmental leishmaniasis (nº=58), visceral leishmaniasis (nº=28), Chagas disease (nº=49), malaria (nº=32), tuberculosis (nº=13) and healthy volunteers (nº=49). Samples from American tegmentary leishmaniasis showed higher reactivity with antigens isolated from the Leishmania braziliensis complex than with antigens from Leishmania amazonensis (p<0.001). ELISA assays showed a sensitivity range from 60 percent to 95 percent with antigens isolated from the Leishmania braziliensis complex. There was marked nonspecific reactivity among serum samples with the use of antigenic fractions binding with concanavalin-A and jacalin from both Leishmania complexes, in comparison with other antigens (p<0.001). The results presented in this study suggest that the use of homologous antigens increases the efficiency of anti-Leishmania immunoglobulin detection, which may be very valuable for diagnostic purposes.

Antígeno total de Leishmania (Leishmania) amazonensis e isolado do complexo Leishmania brazilienis, assim como suas respectivas frações antigênicas obtidas por cromatografia de afinidade em coluna de concanavalina-A ligada a sepharose e Jacalina ligada a agarose foram avaliadas por ensaio imunoenzimático ELISA. Para tanto, foram utilizadas amostras de soros de 229 pacientes agrupadas em leishmaniose tegumentar americana (nº=58), leishmaniose visceral (nº=28), doença de Chagas (nº=49), malaria (nº=32), tuberculose (nº=13) e voluntários saudáveis (nº=49). Houve maior reatividade das amostras de leishmaniose tegumentar americana com a utilização dos antígenos obtidos do isolado do complexo Leishmania braziliensis quando comparado com antígenos de Leishmania amazonensis (p<0,001). Observou-se ainda que a sensibilidade do teste ELISA variou de 60 a 95 por cento entre os antígenos obtidos do isolado do complexo Leishmania braziliensis. Houve acentuada reatividade inespecífica das amostras de soros com a utilização das frações antigênicas ligantes de Concanavalina-A e Jacalina de ambos os complexos Leishmania em comparação aos demais antígenos (p<0,001). Os resultados apresentados no presente trabalho sugerem que a utilização de antígenos homólogos aumentam a eficiência de detecção de imunoglobulina anti-Leishmania o que pode ser de grande valia para o propósito de diagnóstico.

Animals , Humans , Antigens, Helminth , Leishmania braziliensis/immunology , Leishmania mexicana/immunology , Leishmaniasis, Mucocutaneous/diagnosis , Leishmaniasis, Visceral/diagnosis , Antigens, Helminth/isolation & purification , Case-Control Studies , Chromatography, Affinity , Cross Reactions , Chagas Disease/immunology , Enzyme-Linked Immunosorbent Assay , Leishmaniasis, Mucocutaneous/immunology , Leishmaniasis, Visceral/immunology , Malaria/immunology , Plant Lectins , Sensitivity and Specificity , Sepharose/analogs & derivatives , Sepharose , Tuberculosis/immunology