Special Issue: "Parasitic Infection and Host Immunity": Editorial.

Parasite-host interactions depend on a complex interplay between the metabolism of the parasite, their antigens, and the host immune response system [...].

Cuidados paliativos e intervenções psicológicas em uma instituição pública hospitalar / Palliative care and psychological interventions in a public hospital institution / Cuidados paliativos e intervenciones psicológicas en una institución hospitalaria pública

INTRODUÇÃO: Os cuidados paliativos (CP) são baseados em princípios e auxiliam o paciente no enfrentamento do curso de sua condição clínica através da prevenção e alívio do sofrimento. Realizado através de uma equipe multiprofissional, no contexto de uma internação hospitalar, a psicologia contribui com intervenções na situação psicoemocional do paciente em CP e seus familiares. OBJETIVO: Identificar as intervenções psicológicas mais utilizadas no tratamento de pacientes adultos internados em CP. MÉTODOS: Pesquisa documental de caráter retrospectivo, com delineamento transversal e descritivo. De natureza quantitativa, os dados foram investigados através de Análise Estatística Descritiva. Os dados foram coletados com 70 prontuários de pacientes adultos em CP internados entre os anos de 2019 e 2021 em um hospital público e que foram acompanhados pelo setor de psicologia. RESULTADOS: Foram identificadas 32 categorias de intervenções psicológicas relacionadas ao paciente e 38 ao cuidador. As categorias foram agrupadas por similaridade temática resultando no grupo de intervenções em demandas emocionais, intervenções em demandas cognitivas, condutas de orientação e psicoeducação, condutas de humanização e grupo de intervenções em demandas familiares. DISCUSSÃO: As condutas psicológicas nos CP podem auxiliar no acolhimento do sofrimento, integração das perdas e mudanças de papéis, elaboração do luto antecipatório, ressignificação da vida, morte, planos e objetivos, criação ou validação de recursos funcionais de enfrentamento e a dar condições biopsicossocioespirituais de lidar com o adoecimento. CONCLUSÃO: Evidenciou-se um grande número de intervenções psicológicas utilizadas no tratamento de pacientes de CP e seus cuidadores.

INTRODUCTION: Palliative Care (PC) is based on principles and helps the patient to face the course of their clinical condition through the prevention and relief of suffering. Carried out by a multidisciplinary team, in the context of a hospital stay, psychology contributes with interventions in the psycho-emotional situation of patients undergoing PC and their families. OBJECTIVE: To identify the most used psychological interventions in the treatment of adult patients hospitalized in PC. METHODS: Retrospective documentary research, with a cross-sectional and descriptive design. Quantitative in nature, the data were investigated through Descriptive Statistical Analysis. Data were collected from 70 medical records of adult PC patients admitted between the years 2019 and 2021 in a public hospital and who were followed up by the psychology sector. RESULTS: 32 categories of psychological interventions related to the patient and 38 to the caregiver were identified. The categories were grouped by thematic similarity resulting in the group of interventions in emotional demands, interventions in cognitive demands, guidance and psychoeducation conducts, humanization conducts and group of interventions in family demands. DISCUSSION: Psychological behaviors in PC can help in accepting suffering, integrating losses and changing roles, elaborating anticipatory grief, re-signification of life, death, plans and goals, creation or validation of functional coping resources and providing biopsychosocial-spiritual conditions of dealing with illness. CONCLUSION: There was evidence of a large number of psychological interventions used in the treatment of PC patients and their caregivers.

INTRODUCCIÓN: Los cuidados paliativos (CP) se basan en principios y ayudan al paciente a afrontar el curso de su cuadro clínico a través de la prevención y el alivio del sufrimiento. Realizada por un equipo multidisciplinario, en el contexto de una estancia hospitalaria, la psicología contribuye con intervenciones en la situación psicoemocional de los pacientes en CP y sus familias. OBJETIVO: Identificar las intervenciones psicológicas más utilizadas en el tratamiento de pacientes adultos hospitalizados en CP. MÉTODOS: Investigación documental retrospectiva, con un diseño transversal y descriptivo. De naturaleza cuantitativa, los datos fueron investigados a través del Análisis Estadístico Descriptivo. Se recogieron datos de 70 historias clínicas de pacientes adultos en CP ingresados entre los años 2019 y 2021 en un hospital público y que fueron seguidos por el sector de psicología. RESULTADOS: Se identificaron 32 categorías de intervenciones psicológicas relacionadas con el paciente y 38 con el cuidador. Las categorías fueron agrupadas por similitud temática resultando el grupo de intervenciones en demandas emocionales, intervenciones en demandas cognitivas, conductas de orientación y psicoeducación, conductas de humanización y grupo de intervenciones en demandas familiares. DISCUSIÓN: Los comportamientos psicológicos en CP pueden auxiliar en la aceptación del sufrimiento, la integración de las pérdidas y el cambio de roles, la elaboración del duelo anticipatorio, la resignificación de la vida, la muerte, los planes y metas, la creación o validación de recursos funcionales de afrontamiento y la provisión de condiciones biopsicosociales-espirituales de enfrentamiento de la enfermedad. CONCLUSIÓN: Se evidenció un gran número de intervenciones psicológicas utilizadas en el tratamiento de pacientes en CP y sus cuidadores.

Adsorption of cationic surfactant as a probe of the montmorillonite surface reactivity in the alginate hydrogel composites.

Adsorption of a cationic surfactant allowed to probe the surface reactivity of montmorillonite encapsulated in a composite of alginate hydrogels (A-MMT). Dodecylbenzyldimethylammonium chloride (BAC-12) was the surfactant used for these studies. BAC-12 is part of the widely used surfactant mixture known as benzalkonium chloride. XRD showed that up to three different types of basal spacing (d 001) were present within the composite indicating that as the concentration of adsorbed BAC-12 increases, populations with different adsorption conformational arrangements are present, even unexpanded clay remains. From the SEM-EDS spectra it is observed that the clay is distributed in the whole composite. In addition, the effect of the presence of cationic and anionic biocides on BAC-12 adsorption was studied. Cationic biocides such as tetradecyllbenzyldimethylammonium chlorides (BAC-14) and paraquat (PQ) show a competitive behavior for the clay adsorption sites at BAC-12 low concentration indicating an electrostatic adsorption mechanism. However, the presence of anionic contaminants such as 2,4-D and metsulfuron methyl do not affect surfactant adsorption. In all scenarios is observed an abrupt increase of BAC-12 adsorbed amount reaching values higher than the clay CEC suggesting strong tail-tail interactions. This occurs at concentrations 10 times lower than the CMC of BAC-12 promoted by clay encapsulation in the composite. In these composites the alginate does not affect the surface reactivity of the clay, but the formation of the hydrogel allows it to be easily extracted from aqueous media which makes it an interesting material with a potential use in water remediation.

Immune Responses in Leishmaniasis: An Overview.

Leishmaniasis is a parasitic, widespread, and neglected disease that affects more than 90 countries in the world. More than 20 Leishmania species cause different forms of leishmaniasis that range in severity from cutaneous lesions to systemic infection. The diversity of leishmaniasis forms is due to the species of parasite, vector, environmental and social factors, genetic background, nutritional status, as well as immunocompetence of the host. Here, we discuss the role of the immune system, its molecules, and responses in the establishment, development, and outcome of Leishmaniasis, focusing on innate immune cells and Leishmania major interactions.

X-linked immunodeficient (XID) mice exhibit high susceptibility to Cryptococcus gattii infection.

Cryptococcosis is an opportunistic disease caused by the fungus Cryptococcus neoformans and Cryptococcus gattii. It starts as a pulmonary infection that can spread to other organs, such as the brain, leading to the most serious occurrence of the disease, meningoencephalitis. The humoral response has already been described in limiting the progression of cryptococcosis where the B-1 cell seems to be responsible for producing natural IgM antibodies, crucial for combating fungal infections. The role of the B-1 cell in C. neoformans infection has been initially described, however the role of the humoral response of B-1 cells has not yet been evaluated during C. gattii infections. In the present study we tried to unravel this issue using XID mice, a murine model deficient in the Btk protein which compromises the development of B-1 lymphocytes. We use the XID mice compared to BALB/c mice that are sufficient for the B-1 population during C. gattii infection. Our model of chronic lung infection revealed that XID mice, unlike the sufficient group of B-1, had early mortality with significant weight loss, in addition to reduced levels of IgM and IgG specific to GXM isolated from the capsule of C. neoformans. In addition to this, we observed an increased fungal load in the blood and in the brain. We described an increase in the capsular size of C. gattii and the predominant presence of cytokines with a Th2 profile was also observed in these animals. Thus, the present study strongly points to a higher susceptibility of the XID mouse to C. gattii, which suggests that the presence of B-1 cells and anti-GXM antibodies is fundamental during the control of infection by C. gattii.

The role of Toll-like receptor 9 in a murine model of Cryptococcus gattii infection.

Toll-like receptor 9 (TLR9) is crucial to the host immune response against fungi, such as Candida albicans, Aspergillus fumigatus and Cryptococcus neoformans, but its importance in Cryptococcus gattii infection is unknown. Our study aimed to understand the role of TLR9 during the course of experimental C. gattii infection in vivo, considering that the cryptococcal DNA interaction with the receptor could contribute to host immunity even in an extremely susceptible model. We inoculated C57BL/6 (WT) and TLR9 knock-out (TLR9-/-) mice intratracheally with 104 C. gattii yeast cells. TLR9-/- mice had a higher mortality rate compared to WT mice and more yeast cells that had abnormal size, known as titan cells, in the lungs. TLR9-/- mice also had a greater number of CFUs in the spleen and brain than WT mice, in addition to having lower levels of IFN-γ and IL-17 in the lung. With these markers of aggressive cryptococcosis, we can state that TLR9-/- mice are more susceptible to C. gattii, probably due to a mechanism associated with the decrease of a Th1 and Th17-type immune response that promotes the formation of titan cells in the lungs. Therefore, our results indicate the participation of TLR9 in murine resistance to C. gattii infection.

On line kinetic analysis of permeation profiles for UV filter loaded microemulsions using an automatic system with spectroscopic detection and a chemometric approach.

The analysis of the permeation kinetics of new UV filter formulations is of great importance since the kinetic parameters are related to the effectiveness of the product over time. The dynamics of this process can be evaluated by means of the calculation of the permeation kinetic constants, which can be obtained from the respective permeation profiles. This paper is aimed at improving the analytical performance of permeation assays using an on-line automatic system with spectrometric detection avoiding the chromatographic procedure and the usually manual sampling steps required using the traditional Franz diffusion cell. Then, the kinetics of permeation of octyl p-methoxycinnamate loaded in different microemulsions through a synthetic membrane (polyamide) was analysed at real time by UV-Vis and fluorescence spectroscopies. The spectral data were obtained at regular intervals of time (5 min) during 60 min, and the concentration of the permeated UV-filter was at each time calculated using univariate linear calibration. The interference caused by the presence of basil essential oil (oily phase) in some microemulsion samples was overcome using synchronous fluorescence spectroscopy (Δλ = 60 nm) and partial least squares. In all cases, the permeation profiles were obtained (first-order kinetics) and the respective permeation kinetic constants were calculated. The validation of the proposed method was assessed by gas chromatographic-mass spectroscopy and non-significant differences for the obtained permeation kinetic constants were found between methods (p = 0.05). Additionally, a commercial sample was analysed with the proposed methods and the results were validated by high performance liquid chromatography technique.

Análise de custo por desfecho das novas terapias de combinação tripla com lenalidomida para o mieloma múltiplo recidivado/refratário no Brasil / Cost by outcomes analysis of novel triplecombination therapies with lenalidomide for relapsed/refractory multiple myeloma in Brazil

Objetivo: Estimar o custo de tratamento das novas terapias de combinação tripla com lenalidomida no manejo dos pacientes com mieloma múltiplo recidivado/refratário (MMRR) sob a perspectiva do sistema de saúde privado brasileiro. Métodos: Os custos associados da combinação de lenalidomida + dexametasona com carfilzomibe (KRd), daratumumabe (DRd), elotuzumabe (ERd) e ixazomibe (IRd) foram comparados. Para cada terapia, a duração de tratamento foi estimada pela média do tempo de sobrevida livre de progressão (SLP) restrita a três anos a partir de dados de SLP dos estudos pivotais das respectivas terapias. Os custos de tratamento foram estimados para a duração de tratamento, considerando a posologia específica dos regimes terapêuticos. Os preços dos medicamentos foram baseados no preço fábrica de abril de 2020. Não foi considerado o compartilhamento de doses. O custo total do tratamento, o custo médio por ciclo e o custo por taxa de resposta objetiva (TRO) em três anos foram comparados. Resultados: A duração de tratamento no período de três anos foi de 23,3, 27,6, 20,3 e 20,9 meses para KRd, DRd, ERd e IRd, respectivamente. O custo médio total de tratamento foi estimado em 975.557 reais (BRL) para KRd, 1.507.544 BRL para DRd (+55% versus KRd), 1.207.899 BRL para ERd (+24% versus KRd) e 983.917 para IRd (+1% versus KRd). KRd teve o menor custo médio por mês de SLP (horizonte de três anos) entre as terapias, 41.957 BRL versus 54.709 BRL para DRd (+30% versus KRd), 59.635 BRL para ERd (+42% versus KRd) e 47.147 para IRd (+12% versus KRd). Similarmente, o custo por TRO foi 31% menor para KRd (1.119.770 BRL), comparado ao DRd (1.621.015 BRL), 27% menor, comparado ao ERd (1.528.986 BRL), e 11% menor, comparado ao IRd (1.256.064). Conclusões: Resultados da presente análise indicam que KRd está associado a um menor custo médio de tratamento, acompanhado de maior previsibilidade, menor custo por TRO e por mês de SLP, comparado ao DRd, ERd e IRd no horizonte de três anos sob a perspectiva do sistema de saúde privado brasileiro. Os resultados estão associados com alguma incerteza em razão das diferenças nas populações dos estudos, desenho dos estudos (duração fixa de carfilzomibe vs. tratamento até a progressão para daratumumabe, elotuzumabe e ixazomibe) e porque a duração de tratamento é tipicamente menor do que a SLP.

Objective: To estimate treatment costs for novel triple-combination therapies with lenalidomide in the management of relapsed/refractory multiple myeloma (RRMM) patients from the Brazilian private healthcare perspective. Methods: Treatment costs associated with lenalidomide + dexamethasone combinations with carfilzomib (KRd), daratumumab (DRd), elotuzumab (ERd) and ixazomib (IRd) were compared. For each therapy, treatment duration was estimated as the mean progression-free survival (PFS) time restricted to three years using published PFS data from pivotal trials available for these treatments. Treatment costs were estimated for the modeled treatment duration considering therapy-specific dosing schedules. Drug prices were based on April 2020 Brazilian list prices. No vial sharing was assumed. Total treatment costs, average cost per cycle, and cost per overall response rate (ORR) over the three-year period were compared. Results: Modeled treatment duration over the three-year period was 23.3, 27.6, 20.3 and 20.9 months for KRd, DRd, ERd and IRd respectively. Corresponding average total treatment costs were estimated to be 975,557 Brazilian Real (BRL) for KRd; 1,507,544 BRL for DRd (+55% versus KRd); 1,207,899 BRL for ERd (+24% versus KRd) and 983,917 for IRd (+1% versus KRd). KRd had the lowest average cost per month of restricted PFS (3-year time frame) among the therapies, 41,957 BRL versus 54,709 BRL for DRd (+30% versus KRd); 59,635 BRL for ERd (+42% versus KRd); and 47,147 for IRd (+12% versus KRd). Similarly, the cost per achieved ORR was lower for KRd (1,119,770 BRL) than that for DRd (1,621,015 BRL); ERd (1,528,986 BRL); and IRd (1,256,064) by 31%, 27% and 11%, respectively. Conclusions: Results of the present analysis indicate that KRd is associated with lower mean treatment costs and more predictable costs, lower cost per ORR and per month in PFS than DRd, ERd and IRd over a relevant three-year time horizon from the Brazilian private healthcare perspective. The results are associated with some uncertainty due to differences in trial populations, trial design (fixed duration for carfilzomib vs treatment till progression for daratumumab, elotuzumab and ixazomib) and because treatment duration is typically shorter than PFS.

Interception and early treatment with rapid maxillary expansion for the impacted maxillary permanent central incisor in children: Two cases report with 5-years follow-up.

INTRODUCTION: The maxillary central incisor impaction represents a complex challenge in paediatric dentistry practice and may result in aesthetic and functional disharmony. The causes of this condition include physical barriers associated or not with a lack of space making eruption not possible, idiopathic ectopic positioning of the teeth or by trauma, non-coordination in rhizalysis and rhizogenesis between deciduous and successor or tooth shape abnormalities. The incidence of this involvement is quite rare, around 1% of the population. Opening of space through disjunction of the palatal suture is the main treatment proposed to solve this situation and, when necessary, the orthodontic traction assisted by surgery. DESCRIPTION: Were presented two cases of maxillary central incisors impaction in children treated with rapid maxillary expansion, alignment and levelling, and a follow-up after 5 years of treatment. RESULTS AND CONCLUSIONS: The challenge of these treatments were based on the early treatment in mixed dentition with expansion. The treatment of permanent maxillary central incisor impaction in children enabled excellent periodontal response and post-treatment occlusal stability.

Impacto econômico da adoção de denosumabe em pacientes com metástases ósseas ou mieloma múltiplo sob a perspectiva do sistema de saúde privado brasileiro / Economic impact of denosumab adoption in cancer patients with bone metastases or multiple myeloma from the Brazilian private healthcare system's perspective

Objetivo: Estimar o custo por evento relacionado ao esqueleto (ERE) e o impacto econômico anual da adoção de denosumabe em pacientes com metástases ósseas secundárias ao câncer de mama, próstata e outros tumores sólidos ou mieloma múltiplo sob a perspectiva do sistema de saúde privado brasileiro. Métodos: Um modelo econômico foi desenvolvido para comparar os custos relacionados com denosumabe versus ácido zoledrônico na prevenção de EREs. O modelo incluiu os seguintes custos: medicamento, administração, monitoramento e manejo de ERE. O custo anual foi apresentado em reais (BRL) para 100 pacientes. Os custos do manejo de ERE [fratura vertebral (FV), fratura não vertebral (FNV), radiação óssea (RO), cirurgia óssea (CO) e compressão da medula espinhal (CME)] foram estimados a partir dos recursos e procedimentos coletados da revisão de literatura, bases de dados e painel Delphi. Dados coletados dos estudos clínicos randomizados relacionados com cada tipo de tumor na análise e de um estudo prospectivo observacional foram utilizados para estimar a eficácia clínica de denosumabe versus ácido zoledrônico. Resultados: O custo por cada tipo de ERE variou de BRL 27.246 a BRL 28.035 para FV, BRL 18.023 a BRL 18.811 para FNV, BRL 42.750 a BRL 43.538 para RO, BRL 18.023 a BRL 18.811 para CO e BRL 12.472 a BRL 13.260 para CME. A introdução de denosumabe foi estimada em economia anual por 100 pacientes de até BRL 1.072.043,14 para câncer de mama, BRL 1.212.822,79 para outros tumores sólidos, BRL 1.929.660,67 para câncer de próstata e BRL 77.965,07 para mieloma múltiplo. Conclusão: Esta análise sugere que EREs adicionam custos substanciais no manejo de pacientes com metástases ósseas. Dessa forma, o uso de denosumabe pode prevenir e retardar EREs em pacientes com câncer e pode possivelmente levar à redução do impacto econômico associado aos EREs sob a perspectiva dos pagadores de saúde privada brasileira.

Objective: To estimate the cost per SRE and annual economic impact of denosumab adoption in patients with bone metastases (BM) secondary to breast cancer, prostate cancer, other solid tumors or multiple myeloma from the Brazilian private healthcare system's perspective. Methods: An economic model was developed to compare the cost outcomes associated with denosumab instead of zoledronic acid for SRE prevention. The model included the following costs: drug, administration, monitoring and SRE management. Annual costs per 100 patients were reported in 2019 Brazilian currency (BRL). The SRE management costs (vertebral fracture (VF), non-vertebral fracture (NVF), radiation to bone (RB), surgery to bone (SB) and spinal cord compression (SCC)) were estimated from the resources and procedures collected from literature review, official database, and a Delphi panel. Data collected from randomized clinical trials related to each tumor type in the analysis and from a prospective observational study was used to estimate the clinical efficacy of denosumab vs zoledronic acid. Results: The cost per each type of SREs across all tumors ranged BRL 27,246 ­ BRL 28,035 for VF, BRL 18,023 ­ BRL 18,811 for NVF, BRL 42,750 ­ BRL 43,538 for RB, BRL 18,023 ­ BRL 18,811 for SB and BRL 12,472 ­ BRL 13,260 for SCC. The introduction of denosumab was estimated to result in annual savings per 100 patients of up to BRL 1,072,043.14 for breast cancer, BRL 1,212,822.79 for other solid tumors, BRL 1,929,660.67 for prostate cancer and BRL 77,965.07 for multiple myeloma. Conclusion: This analysis suggests that SREs add substantial costs to the management of patients with bone metastases. In this way, the use of denosumab would prevent and delay SREs in cancer patients and might possibly lead to reduce the economic burden associated with SREs, borne by Brazilian private healthcare payers.

Integrin αDß2 influences cerebral edema, leukocyte accumulation and neurologic outcomes in experimental severe malaria.

Malaria is an infectious disease of major worldwide clinical importance that causes a variety of severe, or complicated, syndromes including cerebral malaria, which is often fatal. Leukocyte integrins are essential for host defense but also mediate physiologic responses of the innate and adaptive immune systems. We previously showed that targeted deletion of the αD subunit (αD-/-) of the αDß2 integrin, which is expressed on key leukocyte subsets in mice and humans, leads to absent expression of the integrin heterodimer on murine macrophages and reduces mortality in mice infected with Plasmodium berghei ANKA (P. berghei ANKA). To further identify mechanisms involved in the protective effect of αD deletion in this model of severe malaria we examined wild type C57BL/6 (WT) and αD-/- mice after P. berghei ANKA infection and found that vessel plugging and leukocyte infiltration were significantly decreased in the brains of αD-/- animals. Intravital microscopy demonstrated decreased rolling and adhesion of leukocytes in cerebral vessels of αD-/- mice. Flow cytometry analysis showed decreased T-lymphocyte accumulation in the brains of infected αD-/- animals. Evans blue dye exclusion assays demonstrated significantly less dye extravasation in the brains of αD-/- mice, indicating preserved blood-brain barrier integrity. WT mice that were salvaged from P. berghei ANKA infection by treatment with chloroquine had impaired aversive memory, which was not observed in αD-/- mice. We conclude that deletion of integrin αDß2 alters the natural course of experimental severe malaria, demonstrating previously unrecognized activities of a key leukocyte integrin in immune-inflammatory responses that mediate cerebral involvement.

Immunomodulatory Role of Capsular Polysaccharides Constituents of Cryptococcus neoformans.

Cryptococcosis is a systemic fungal infection caused by Cryptococcus neoformans. In immunocompetent patients, cryptococcal infection is often confined to the lungs. In immunocompromised individuals, C. neoformans may cause life-threatening illness, either from novel exposure or through reactivation of a previously acquired latent infection. For example, cryptococcal meningitis is a severe clinical disease that can manifest in people that are immunocompromised due to AIDS. The major constituents of the Cryptococcus polysaccharide capsule, glucuronoxylomannan (GXM), and galactoxylomannan (GalXM), also known as glucuronoxylomanogalactan (GXMGal), are considered the primary virulence factors of Cryptococcus. Despite the predominance of GXM in the polysaccharide capsule, GalXM has more robust immunomodulatory effects on host cellular immunity. This review summarizes current knowledge regarding host-Crytococcus neoformans interactions and the role of capsular polysaccharides in host immunomodulation. Future studies will likely facilitate a better understanding of the mechanisms involved in antigenic recognition and host immune response to C. neoformans and lead to the development of new therapeutic pathways for cryptococcal infection.

Distribution and sources of polycyclic aromatic hydrocarbons (PAHs) in surface sediments of a Tropical Bay influenced by anthropogenic activities (Todos os Santos Bay, BA, Brazil).

The present study aimed to evaluate the distribution and origin of 16 Priority PAHs in surficial sediment samples of Todos os Santos Bay (TSB, Brazil). Total PAHs concentrations ranged from below the method detection limit (

Involvement of the capsular GalXM-induced IL-17 cytokine in the control of Cryptococcus neoformans infection.

Cryptococcus neoformans is an opportunistic fungus that can cause lethal brain infections in immunosuppressed individuals. Infection usually occurs via the inhalation of a spore or desiccated yeast which can then disseminate from the lung to the brain and other tissues. Dissemination and disease is largely influence by the production of copious amounts of cryptococcal polysaccharides, both which are secreted to the extracellular environment or assembled into a thick capsule surrounding the cell body. There are two important polysaccharides: glucuronoxylomannan (GXM) and galactoxylomannan, also called as glucuronoxylomanogalactan (GXMGal or GalXM). Although GXM is more abundant, GalXM has a more potent modulatory effect. In the present study, we show that GalXM is a potent activator of murine dendritic cells, and when co-cultured with T cells, induces a Th17 cytokine response. We also demonstrated that treating mice with GalXM prior to infection with C. neoformans protects from infection, and this phenomenon is dependent on IL-6 and IL-17. These findings help us understand the immune biology of capsular polysaccharides in fungal pathogenesis.

Human Kinetoplastid Protozoan Infections: Where Are We Going Next?

Kinetoplastida trypanosomatidae microorganisms are protozoan parasites exhibiting a developmental stage in the gut of insect vectors and tissues of vertebrate hosts. During the vertebrate infective stages, these parasites alter the differential expression of virulence genes, modifying their biological and antigenic properties in order to subvert the host protective immune responses and establish a persistent infection. One of the hallmarks of kinetoplastid parasites is their evasion mechanisms from host immunity, leading to disease chronification. The diseases caused by kinetoplastid parasites are neglected by the global expenditures in research and development, affecting millions of individuals in the low and middle-income countries located mainly in the tropical and subtropical regions. However, investments made by public and private initiatives have over the past decade leveraged important lines of intervention that if well-integrated to health care programs will likely accelerate disease control initiatives. This review summarizes recent advances in public health care principles, including new drug discoveries and their rational use with chemotherapeutic vaccines, and the implementation of control efforts to spatially mapping the kinetoplastid infections through monitoring of infected individuals in epidemic areas. These approaches should bring us the means to track genetic variation of parasites and drug resistance, integrating this knowledge into effective stewardship programs to prevent vector-borne kinetoplastid infections in areas at risk of disease spreading.

Trypanosoma cruzi Infection Induces Cellular Stress Response and Senescence-Like Phenotype in Murine Fibroblasts.

Trypanosoma cruzi infects and replicates within a wide variety of immune and non-immune cells. Here, we investigated early cellular responses induced in NIH-3T3 fibroblasts upon infection with trypomastigote forms of T. cruzi. We show that fibroblasts were susceptible to T. cruzi infection and started to release trypomastigotes to the culture medium after 4 days of infection. Also, we found that T. cruzi infection reduced the number of fibroblasts in 3-day cell cultures, by altering fibroblast proliferation. Infected fibroblasts displayed distinctive phenotypic alterations, including enlarged and flattened morphology with a nuclei accumulation of senescence-associated heterochromatin foci. In addition, infection induced an overexpression of the enzyme senescence-associated ß-galactosidase (SA-ß-gal), an activation marker of the cellular senescence program, as well as the production of cytokines and chemokines involved with the senescence-associated secretory phenotype (SASP) such as IL-6, TNF-α, IL-1ß, and MCP-1. Infected fibroblasts released increased amounts of stress-associated factors nitric oxide (NO) and reactive oxygen species (ROS), and the treatment with antioxidants deferoxamine (DFO) and N-acetylcysteine reduced ROS generation, secretion of SASP-related cytokine IL-6, SA-ß-gal activity, and parasite load by infected fibroblasts. Taken together, our data suggest that T. cruzi infection triggers a rapid cellular stress response followed by induction of a senescent-like phenotype in NIH-3T3 fibroblasts, enabling them to act as reservoirs of parasites during the early stages of the Chagas disease.

Integrin αDß2 (CD11d/CD18) Modulates Leukocyte Accumulation, Pathogen Clearance, and Pyroptosis in Experimental Salmonella Typhimurium Infection.

ß2 integrins are critical in host defense responses to invading pathogens and inflammation. Previously, we reported that genetic deficiency of integrin αDß2 in mice altered outcomes in experimental systemic infections including accelerated mortality in animals infected with Salmonella enterica serovar Typhimurium. Here, we show that deficiency of αDß2 results in impaired accumulation of leukocytes in response to peritoneal infection by S. Typhimurium, impaired pathogen clearance in vivo, defective bacterial elimination by cultured peritoneal macrophages, and enhanced pyroptosis, a cell death process triggered by Salmonella. Salmonella-infected animals deficient in αDß2 had increased levels of peritoneal cytokines in addition to other markers of pyroptosis, which may contribute to inflammatory injury and increased mortality in the context of impaired bacterial killing. These observations indicate important contributions of leukocyte integrins to the host response in experimental Salmonella infection and reveal previous activities of αDß2 in bacterial infection.

Antibody Repertoires Identify ß-Tubulin as a Host Protective Parasite Antigen in Mice Infected With Trypanosoma cruzi.

Few studies investigate the major protein antigens targeted by the antibody diversity of infected mice with Trypanosoma cruzi. To detect global IgG antibody specificities, sera from infected mice were immunoblotted against whole T. cruzi extracts. By proteomic analysis, we were able to identify the most immunogenic T. cruzi proteins. We identified three major antigens as pyruvate phosphate dikinase, Hsp-85, and ß-tubulin. The major protein band recognized by host IgG was T. cruzi ß-tubulin. The T. cruzi ß-tubulin gene was cloned, expressed in E. coli, and recombinant T. cruzi ß-tubulin was obtained. Infection increased IgG reactivity against recombinant T. cruzi ß-tubulin. A single immunization of mice with recombinant T. cruzi ß-tubulin increased specific IgG reactivity and induced protection against T. cruzi infection. These results indicate that repertoire analysis is a valid approach to identify antigens for vaccines against Chagas disease.

Photolysis study of octyl p-methoxycinnamate loaded microemulsion by molecular fluorescence and chemometric approach.

Octyl p-methoxycinnamate (OMC) is one of the most widely used sunscreen agents. However, the efficiency of OMC as UV filter over time is affected due to the formation of the cis-isomer which presents a markedly lower extinction coefficient (εcis=12,600L mol-1cm-1 at 291nm) than the original trans-isomer (εtrans=24,000L mol-1cm-1 at 310nm). In this work, a novel carrier for OMC based on an oil-in-water microemulsion is proposed in order to improve the photostability of this sunscreen. The formulation was composed of 29.2% (w/w) of a 3:1 mixture of ethanol (co-surfactant) and decaethylene glycol mono-dodecyl ether (surfactant), 1.5% (w/w) of oleic acid (oil phase) and 69.2% (w/w) of water. This microemulsion was prepared in a simple way, under moderate stirring at 25°C and using acceptable, biocompatible and accessible materials for topical use. OMC was incorporated in the vehicle at a final concentration of 5.0% (w/w), taking into account the maximum permitted levels established by international norms. Then, a photolysis study of the loaded formulation was performed using a continuous flow system. The direct photolysis was monitored over time by molecular fluorescence. The recorded spectra data between 370 y 490nm were analyzed by multivariate curve resolution-alternating least squares algorithm. The kinetic rate constants corresponding to the photolysis of the trans-OMC were calculated from the concentration profiles, resulting in 0.0049s-1 for the trans-OMC loaded microemulsion and 0.0131s-1 for the trans-OMC in aqueous media. These results demonstrate a higher photostability of the trans-OMC when loaded in the proposed vehicle with respect to the free trans-OMC in aqueous media.

Fast Determination of Biodiesel Content in Commercial Diesel/Biodiesel Blends by Using Digital Images and Multivariate Calibration.

A new simple, rapid and inexpensive analytical method was developed to determine the biodiesel percentage in biodiesel/diesel blends through simple digital images of samples obtained by scanning with a commercial scanner. Soybean biodiesel and petroleum diesel samples were acquired from refineries currently in operation. There were prepared several mixtures within the range 1.5 to 12.0% of biodiesel in diesel oil, using the same procedure as is done in industry. The analytical signals were images recorded with a scanner. This data was decomposed with different color systems: RGB, HSV, HLS, CMYK and Grayscale. Chemometrics models based on color signals obtained from different mixtures of biodiesel/diesel were built. The quantification by using partial least squares (PLS) resulted in a RMSEP value for biodiesel of 0.9% (w/w); this load approximately 10-times smaller than the corresponding calibration range, with a correlation of 0.96 between predicted and reference values.