RÉSUMÉ
The development of regenerative medicine relies in part on the capacity of stem cells to differentiate into specialized cell types and reconstitute tissues and organs. The origin of the stem cells matters. While autologous cells were initially the preferred ones the need for “off the shelf” cells is becoming prevalent. These cells will be immediately available and they originate from young non diseased individuals. However their allogenicity can be viewed as a limitation to their use. Recent works including our own show that allogenicity of stem cell can be viewed as on one hand detrimental leading to their elimination and on the other hand beneficial through a paracrine effect that can induce a local tissue regenerative effect from endogenous stem cells. Also their immune modulatory capacity can be harnessed to favor regeneration. Therefore the immune phenotype of stem cells is an important criteria to be considered before their clinical use. Immuno monitoring of the consequences of their in vivo injection needs to be taken into account. Transplantation immunology knowledge will be instrumental to enable the development of safe personalized regenerative stem cell therapy.
RÉSUMÉ
A world of healthy people living in healthy ecosystems has proven to be an elusive goal of the sustainable development agenda. Numerous science-based assessments agree on the fundamental interdependence between people's health, the economy, and the environment, and on the urgency for more determined and concerted action based on multi-sector participatory approaches at the global and local levels. For knowledge to be policy-relevant and capable of contributing to healthy and sustainable development, it must take into account the dynamic and complex interactions between ecological and social systems (systems thinking), and it must be linked to development actions. This in turn requires greater interaction and exchange between decision-makers, researchers and civil society (a multi-stakeholder participatory process); and the harnessing of different disciplines and of different kinds of knowledge (a transdisciplinary approach). Ecosystem approaches to human health (ecohealth) link these elements in an adaptable framework for research and action. This paper presents an overview of ecohealth research approaches applied to vector-borne diseases, with particular attention to multi-stakeholder participation given its prominence in the sustainable development policy discourse.
Um mundo de pessoas saudáveis em ecossistemas saudáveis tem sido uma meta elusiva da agenda de desenvolvimento sustentável. Inúmeras avaliações de bases científicas concordam com a interdependência fundamental entre saúde, economia e ambiente e, com a urgência de melhores determinações e orquestração de ações baseadas em enfoques participativos multissetoriais em níveis local e global. Para tornar o conhecimento relevante para fundamentar políticas públicas direcionadas para o desenvolvimento sustentável e saudável é necessário considerar as interações complexas e dinâmicas entre sistemas ecológicos e sociais (enfoque sistêmico), que devem estar ligadas às ações de desenvolvimento. Isso requer maior interação entre tomadores(as) de decisões, pesquisadores(as) e representantes da sociedade civil - um processo participativo com múltiplos atores, e a integração de diferentes disciplinas e de diferentes tipos de conhecimento em um enfoque transdisciplinar. Enfoques ecossistêmicos para saúde humana (ecossaúde) conecta esses elementos em um esquema adaptável para pesquisa e ação. Este artigo apresenta exemplos de pesquisas com enfoque em ecossaúde aplicadas às enfermidades transmitidas por vetores, com atenção particular à participação de múltiplos atores, considerando a proeminência desta prerrogativa no discurso político de desenvolvimento sustentável.