In vitro evaluation of 4-phenyl-5-(4'-X-phenyl)-1,3,4-thiadiazolium-2-phenylaminide chlorides and 3[N-4'-X-phenyl]-1,2,3-oxadiazolium-5-olate derivatives on nitric oxide synthase and arginase activities of Leishmania amazonensis.

Leishmaniasis is a spectrum of infectious diseases caused by Leishmania protozoan parasites. The purpose of this study was to perform, in vitro, a comparative analysis of the activity amastigotes. Results showed excellent efficacy of all compounds against axenic amastigotes, compared to pentamidine isethionate, the reference drug used. The cytotoxic effect of these mesoionic compounds of six mesoionic compounds (three 1,3,4-thiadiazolium-2-aminide and three 1,2,3-oxadiazolium-5-olate class compounds) was evaluated in mouse peritoneal macrophages using MTT assay, low toxicity (≈ 10%) for these mammalian cells being observed. In an attempt to define a potential drug target, the activities of nitric oxide synthase (NOS) and arginase of the parasites treated with the mesoionic derivatives were evaluated. NOS was purified from a cell-free extract of infective promastigotes and axenic amastigotes and all derivatives tested were able to inhibit the enzyme as monitored by the decrease of NADPH consumption. Arginase activity from both stages of the parasite was measured using urea production and none of the compounds inhibited the enzyme activity of axenic amastigotes. However, the compounds without substituents (MI-H and SID-H) were able to inhibit arginase activity of these parasites.

Kinetoplastid membrane protein-11 exacerbates infection with Leishmania amazonensis in murine macrophages.

In Leishmania amazonensis, kinetoplastid membrane protein-11 (KMP-11) expression increases during meta-cyclogenesis and is higher in amastigotes than in promastigotes, suggesting a role for this protein in the infection of the mammalian host. We show that the addition of KMP-11 exacerbates L. amazonensis infection in peritoneal macrophages from BALB/c mice by increasing interleukin (IL)-10 secretion and arginase activity while reducing nitric oxide (NO) production. The doses of KMP-11, the IL-10 levels and the intracellular amastigote loads were strongly, positively and significantly correlated. The increase in parasite load induced by KMP-11 was inhibited by anti-KMP-11 or anti-IL-10 neutralising antibodies, but not by isotype controls. The neutralising antibodies, but not the isotype controls, were also able to significantly decrease the parasite load in macrophages cultured without the addition of KMP-11, demonstrating that KMP-11-induced exacerbation of the infection is not dependent on the addition of exogenous KMP-11 and that the protein naturally expressed by the parasite is able to promote it. In this study, the exacerbating effect of KMP-11 on macrophage infection with Leishmania is for the first time demonstrated, implicating it as a virulence factor in L. amazonensis. The stimulation of IL-10 production and arginase activity and the inhibition of NO synthesis are likely involved in this effect.

Kinetoplastid membrane protein-11 exacerbates infection with Leishmania amazonensis in murine macrophages

In Leishmania amazonensis, kinetoplastid membrane protein-11 (KMP-11) expression increases during metacyclogenesis and is higher in amastigotes than in promastigotes, suggesting a role for this protein in the infection of the mammalian host. We show that the addition of KMP-11 exacerbates L. amazonensis infection in peritoneal macrophages from BALB/c mice by increasing interleukin (IL)-10 secretion and arginase activity while reducing nitric oxide (NO) production. The doses of KMP-11, the IL-10 levels and the intracellular amastigote loads were strongly, positively and significantly correlated. The increase in parasite load induced by KMP-11 was inhibited by anti-KMP-11 or anti-IL-10 neutralising antibodies, but not by isotype controls. The neutralising antibodies, but not the isotype controls, were also able to significantly decrease the parasite load in macrophages cultured without the addition of KMP-11, demonstrating that KMP-11-induced exacerbation of the infection is not dependent on the addition of exogenous KMP-11 and that the protein naturally expressed by the parasite is able to promote it. In this study, the exacerbating effect of KMP-11 on macrophage infection with Leishmania is for the first time demonstrated, implicating it as a virulence factor in L. amazonensis. The stimulation of IL-10 production and arginase activity and the inhibition of NO synthesis are likely involved in this effect.

Rat models to investigate host macrophage defense against Trypanosoma cruzi.

Trypanosoma cruzi is the causal agent of Chagas' disease, an infection with a great impact on public health in Latin America. One of the challenges to understand Chagas' disease lies on the complex host-parasite interaction. The understanding of this interaction requires the use of appropriate experimental models that mimic the human disease. Here, we have used two lineages of rats (Wistar and Holtzman) to comparatively evaluate the course of the acute infection (Y strain). Infection was monitored by parasitemia, cardiac and skeletal muscle parasitism and inflammation, heart ultrastructure, recruitment of monocytes/macrophages and nitric oxide, and arginase production by these cells. Although both rats were able to infect, only Holtzman rats developed a marked infection in the cardiac and skeletal muscles, in parallel to a high recruitment of first-line defense cells. A high number of inflammatory macrophages directed parasite clearance. By the end of the acute phase, Holtzman rats showed consistent disease control. Interestingly, parasite killing was not related to nitric oxide production likely inhibited by an arginase-dependent mechanism. Our work demonstrates differential responses of Holtzman and Wistar rats to T. cruzi, and highlights the use of Holtzman rats as useful models for further studies of cardiac/skeletal muscle tropism and innate immune responses that protect the host against parasite replication. This is important for the development of proper therapeutic interventions.

Lesões cutâneas em mulheres colhedoras de laranja atendidas no programa de saúde da família da cidade de Planura, Minas Gerais, Brasil / Skin lesions in peasant women attended by the family health program at the orange fields of planura city, Minas Gerais, Brazil

Introdução. O câncer de pele é o tumor mais prevalente no Brasil, constitui 27% de todos os tipos de câncer. Estima-se que ocorram mais de cem mil novos casos em 2010. A exposição à luz solar excessiva é importante fator de risco de lesões benignas e malignas de pele. Objetivo. Identificar lesões de pele entre as mulheres que trabalham nos campos de laranja e fazer avaliação do hábito de proteção contra a exposição solar. Método. Estudo transversal, em que foram avaliadas com exame dermatológico detalhado, mulheres colhedo¬ras de laranja, atendidas em ambulatórios do Programa de Saúde da Família, na cidade de Planura, MG, de março a agosto de 2008. Resultados. Avaliaram-se duzentas mulheres e foram encontrados três casos (1,5%) de câncer de pele: dois basaliomas e um carcinoma espinocelular. Além disso, em 57% das mulheres foram identificadas lesões de pele que poderiam estar relacionadas com a exposição ao sol. Conclusões. É importante implementar medidas preventivas e educativas para reduzir a taxa do câncer de pele e as lesões pré-malignas em trabalhadores rurais com história de longa exposição solar.

Introduction. Skin cancer is the most prevalent tumor in Brazil, 27% of all types of cancer. More than 100.000 new cases are estimated to occur in 2010. Sunlight exposure is the most important risk factor involved. Objective. The purpose of this study is to identify dermal injuries and skin cancer incidence among peasant women at the orange s and make an assessment of their protection habits against sunlight exposure. Method. This is a cross-sectional epidemiologic survey with 200 peasant women at the orange s attended in Family Health Program ambulatory from March through August 2008. Results. Two hundred women were evaluated. Three cases of skin cancer were found: two basaliomas and one squamous cell carcinoma. In 57% of the women, pre-malignant injuries were identified that could be related to sunlight exposure. Conclusions. It is very important to implement preventive and educational measures to reduce skin cancer and pre-malignant injuries in rural workers with long exposure sunlight history.

Immunoenzymatic assay for the diagnosis of American tegumentary leishmaniasis using soluble and membrane-enriched fractions from infectious Leishmania (Viannia) braziliensis.

The diagnosis of American tegumentary leishmaniasis (ATL) is based on the visualization or isolation of the parasite, which is a time-consuming and poorly sensitive method. In this study, we evaluated the accuracy and reliability of ELISA for the diagnosis of ATL using soluble (SF) and membrane-enriched (MF) antigen fractions obtained from an infectious strain of Leishmania (Viannia) braziliensis. A total of 152 serum samples investigated at a referral center in Rio de Janeiro, Brazil, between 2005 and 2007 were studied. Each sample was tested twice with each fraction for the calculation of reliability (intraclass coefficient (ICC)). Cut-off values of 0.22 (SF) and 0.33 (MF) were defined. The use of the fractions resulted in good discrimination between patients, with a large area under the curve (P<0.0001), but no difference was observed between the two fractions (P=0.45). Sensitivity was 89.5% for each fraction, specificity was 89.5% for SF and 93.4% for MF, and the positive likelihood ratio was 8.5 for SF and 13.6 for MF. The ICCs were excellent (SF: 0.96 and MF: 0.90). The antigens tested provided precision and accuracy for the diagnosis of ATL, with SF being recommended due to its lower cost and greater practicality.

WITHDRAWN: Roles of tetrahydrobiopterin (BH4) cofactor in nitric oxide synthase (NOS) catalysis.

This article has been withdrawn at the request of the Editors. The Publisher apologises for any inconvenience that this may cause. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.

In vitro sodium nitroprusside-mediated toxicity towards Leishmania amazonensis promastigotes and axenic amastigotes.

Leishmania parasites survive despite exposure to the toxic nitrosative oxidants during phagocytosis by the host cell. In this work, the authors investigated comparatively the resistance of Leishmania amazonensis promastigotes and axenic amastigotes to a relatively strong nitrosating agent that acts as a nitric oxide (NO) donor, sodium nitroprusside (SNP). Results demonstrate that SNP is able to decrease, in vitro, the number of L. amazonensis promastigotes and axenic amastigotes in a dose-dependent maner. Promastigotes, cultured in the presence of 0.25, 0.5, and 1 mmol L(-1) SNP for 24 h showed about 75% growth inhibition, and 97-100% when the cultures were treated with >2 mmol L(-1) SNP. In contrast, when axenic amastigotes were growing in the presence of 0.25-8 mM SNP added to the culture medium, 50% was the maximum of growth inhibition observed. Treated promastigotes presented reduced motility and became round in shape further confirming the leishmanicidal activity of SNP. On the other hand, axenic amastigotes, besides being much more resistant to SNP-mediated cytotoxicity, did not show marked morphological alteration when incubated for 24 h, until 8 mM concentrations of this nitrosating agent were used. The cytotoxicity toward L. amazonensis was attenuated by reduced glutathione (GSH), supporting the view that SNP-mediated toxicity triggered multiple oxidative mechanisms, including oxidation of thiols groups and metal-independent oxidation of biomolecules to free radical intermediates.

Effect of mesoionic 4-phenyl-5-(cinnamoyl)-1,3,4-thiadiazolium-2-phenylamine chloride derivative salts on the activities of the nitric oxide synthase and arginase of Leishmania amazonensis.

L-arginine is involved in the production of both nitric oxide (NO), mediated by nitric oxide synthase (NOS) and L-ornithine, by arginase activity. It is generally accepted that NO regulation occurs mainly at the transcriptional level of NOS. In a previous work we purported that there is evidence that Leishmania sp. can produce NO from L-arginine. An arginase activity in its gene sequence has also been reported in Leishmania parasites. In a search for intracellular targets as potential antileishmanicidal agents, such as the L-arginine metabolism, we used 1,3,4-thiadiazolium mesoionic compounds, that have been demonstrated to be cytotoxic to the Leishmania amazonensis, when compared to Pentamidine isethionate as a reference drug. Parasites were assayed in absence/presence of 4'- and 3'-methoxy mesoionic derivatives in order to verify the effect on NO production and arginase activity in L. amazonensis. The results indicated that the drugs reduce from 70 to 90% of the NO production by the parasite and act on a soluble nitric oxide synthase purified from L. amazonensis promastigotes and axenic amastigotes.

Profilaxia da trombose venosa profunda em pós-operatório de cirurgias ortopédicas em um hospital de traumato-ortopedia / Prophylaxis of deep venous thrombosis in the posthoperative period of orthopedic surgeries in a traumato-orthopaedic hospital

O tromboembolismo venoso é uma patologia potencialmente fatal que pode complicar a recuperação de pacientes hospitalizados. Pacientes especialmente submetidos a procedimentos cirúrgicos de grande porte estão sob risco. A trombose venosa profunda (TVP) e a embolia pulmonar (EP) são complicações pós-operatórias reconhecidamente difíceis de diagnosticar, e o tratamento pode, freqüentemente, ser iniciado demasiadamente tarde para ser eficaz. Sem profilaxia, um em cada quatro pacientes com idade superior a 40 anos, submetidos a cirurgia geral de porte com mais de uma hora de duração, desenvolverão trombose venosa profunda. Os pacientes de risco podem ser identificados e receber profilaxia - um método menos oneroso para reduzir a morbidade e a mortalidade. Desta forma, a prática de Atenção Farmacêutica, realizada em pós-operatório de cirurgia ortopédica constitui-se numa ferramenta útil para evitar a progressão desta patologia. Através da identificação dos sintomas sugestivos consegue-se prevenir o agravamento desta doença, o que torna mais fácil a sua cura.

Venous thromboembolism is a potentially fatal pathology that can complicate the recovery of hospitalized patients. Surgery patients, especially those submitted to major surgical procedures, are particularly at risk. Deep venous thrombosis (DUT) and pulmonary embolism are recognized postoperative complications whose diagnosis is difficult and whose treatment is frequently initiated too late to be effective. Without prophylaxis one in every four over 40-year-old patients who are submitted to general surgery of more than one hour will develop DVT. At-risk patients can be identified and receive prophylaxis - the least onerous method to reduce morbidity and mortality. Thus, the practice of Pharmaceutical care, use in the postoperative period of orthopedic surgery, is a useful tool to avoid the progression of this pathology. Through the identification of suggestive symptoms, it is possible to prevent the aggravation of this disease, facilitating its treatment.

Cloning and expression of trypanothione reductase from a New World Leishmania species.

Trypanothione disulfide (T[S]2), an unusual form of glutathione found in parasitic protozoa, plays a crucial role in the regulation of the intracellular thiol redox balance and in the defense against oxidative stress. Trypanothione reductase (TR) is central to the thiol metabolism in all trypanosomatids, including the human pathogens Trypanosoma cruzi, Trypanosoma brucei and Leishmania. Here we report the cloning, sequencing and expression of the TR encoding gene from L. (L.) amazonensis. Multiple protein sequence alignment of all known trypanosomatid TRs highlights the high degree of conservation and illustrates the phylogenetic relationships. A 3D homology model for L. amazonensis TR was constructed based on the previously reported Crithidia fasciculata structure. The purified recombinant TR shows enzyme activity and in vivo expression of the native enzyme could be detected in infective promastigotes, both by Western blotting and by immunofluorescence.

Oxyl radicals, redox-sensitive signalling cascades and antioxidants.

Oxidative stress is an increase in the reduction potential or a large decrease in the reducing capacity of the cellular redox couples. A particularly destructive aspect of oxidative stress is the production of reactive oxygen species (ROS), which include free radicals and peroxides. Some of the less reactive of these species can be converted by oxidoreduction reactions with transition metals into more aggressive radical species that can cause extensive cellular damage. In animals, ROS may influence cell proliferation, cell death (either apoptosis or necrosis) and the expression of genes, and may be involved in the activation of several signalling pathways, activating cell signalling cascades, such as those involving mitogen-activated protein kinases. Most of these oxygen-derived species are produced at a low level by normal aerobic metabolism and the damage they cause to cells is constantly repaired. The cellular redox environment is preserved by enzymes and antioxidants that maintain the reduced state through a constant input of metabolic energy. This review summarizes current studies that have been regarding the production of ROS and the general redox-sensitive targets of cell signalling cascades.

Synthesis and evaluation of new difluoromethyl azoles as antileishmanial agents.

Several compounds of great pharmacological interest contain the triazole and imidazole rings. In order to find new drugs with antileishmanial activity we have synthesized and evaluated new imidazole and triazole compounds carrying either the carbaldehyde or the difluoromethylene functionalities against promastigote forms of Leishmania amazonensis. Among the compounds tested difluoromethylene azoles 4b and 8f have inhibited the parasite growth significantly. Our results show that the introduction of the difluoromethylene moieties has turned the inactive carbaldehydes into active antileishmanial compounds.

Leishmania amazonensis trypanothione reductase: evaluation of the effect of glutathione analogs on parasite growth, infectivity and enzyme activity.

Trypanothione reductase (TR) is a major enzyme in trypanosomatids. Its substrate, trypanothione is a molecule containing a tripeptide (L-glutamic acid-cysteine-glycine) coupled to a polyamine, spermidine. This redox system (TR/Trypanothione) is vital for parasite survival within the host cell and has been described as a good target for chemotherapy anti-Leishmania. The use of tripeptides analogs of glutathione would result in a decrease in trypanothione synthesis and as a consequence in TR activity. In this work, besides the enzyme potential inhibition, it also evaluated the influence of those analogs on parasite growth and on its infective capacity. The results showed a significant effect on parasite growth and infectivity and in addition TR activity was highly inhibited. These results are very promising, suggesting a potential use of those analogs as therapeutic drugs against experimental diseases caused by trypanosomatids.

Nitric oxide biosynthesis by Leishmania amazonensis promastigotes containing a high percentage of metacyclic forms.

Due to the diversity of its physiological and pathophysiological functions and general ubiquity, the study of nitric oxide (NO) has become of great interest. In this work, it was demonstrated that Leishmania amazonensis promastigotes produces NO, a free radical synthesized from L: -arginine by nitric oxide synthase (NOS). A soluble NOS was purified from L. amazonensis promastigotes by affinity chromatography (2', 5'-ADP-agarose) and on SDS-PAGE the enzyme migrates as a single protein band of 116.2 (+/-6) kDa. Furthermore, the presence of a constitutive NOS was detected through indirect immunofluorescence using anti-cNOS and in NADPH consumption assays. The present work show that NO production, detected as nitrite in culture supernatant, is prominent in promastigotes preparations with high number of metacyclic forms, suggesting an association with the differentiation and the infectivity of the parasite.

Nitric oxide synthase (NOS) characterization in Leishmania amazonensis axenic amastigotes.

BACKGROUND: Although Leishmania virulence may be modulated by environmental and genetic factors of their mammalian hosts and sand fly vectors, molecular determinants of Leishmania sp. are the key elements. This work evidences that Leishmania amazonensis axenic amastigotes produce comparatively more NO than infective promastigotes. METHODS: A soluble NOS was purified from L. amazonensis axenic amastigotes by affinity chromatography (2',5'-ADP-agarose), and on SDS-PAGE the enzyme migrates as a single protein band. RESULTS: The presence of a constitutive NOS was detected through immunofluorescence using antibody against neuronal NOS (nNOS) and in NADPH consumption assays. CONCLUSIONS: The present data show that NOS is prominent in axenic amastigote preparations, suggesting an association with the infectivity and/or an escaping mechanism of the parasite. The relationship between the NO-generating systems in the parasite and in their host cell warrants further investigation.

Peripheral blood monocytes show morphological pattern of activation and decreased nitric oxide production during acute Chagas' disease in rats.

Peripheral blood monocytes (PBM) recruitment is a rapid and remarkable phenomenon during acute infection with the intracellular protozoan parasite Trypanosoma cruzi, the causative agent of Chagas' disease. The functional capabilities of these cells during the infection, however, are poorly understood. The purpose of the present study was to determine whether PBM are morphologically activated and produce nitric oxide (NO), a mediator of host cell defense when challenged with the parasite at different time points of acute disease. In parallel, the parasite load was monitored in the blood and heart, a target organ of the disease, as well as the PBM numbers. The infection did not induce NO release by PBM, although these cells exhibited a clear morphological pattern of activation characterized by irregular surface, increase of organelle amount, especially Golgi complex, and cell size. On the contrary, there was significant inhibition of NO production by PBM at the beginning (day 6) and end of acute disease (day 20). At this time, the levels of NO were inversely related to the arginase activity, an enzyme that affects the NO synthesis. The mobilization process of PBM occurred in parallel to parasite load and was associated with the resolution mechanism of parasitemia and heart parasitism. Our results showed that activated PBM are notably involved in the host response to the acute T. cruzi infection in rats. However, the in vivo NO production by these cells seems to be inhibited during the acute Chagas' disease through a mechanism involving the arginase pathway.

Protein kinase A activity is associated with metacyclogenesis in Leishmania amazonensis.

Because of the importance of cell signalling processes in proliferation and differentiation, the adenylate cyclase pathway was studied, specifically the protein kinase A (PKA) in Leishmania amazonensis. The PKAs of soluble (SF) and enriched membrane fractions (MF) from infective/non-infective promastigotes and axenic amastigotes were assayed. In order to purify the PKA molecule, fractions were chromatographed on DEAE-cellulose columns and the phosphorylative activity was evaluated using [gamma(32)P]-ATP as the phosphate source. These experiments were performed in the presence of cyclic adenosine monophosphate (cAMP) and an inhibitor of PKA. Our data demonstrated that the PKA activity was significantly higher (about two times) in SF from promastigotes with a high concentration of metacyclic forms, when compared with the non-infective promastigotes, suggesting an association of this activity and the metacyclogenesis process. A discrete phosphorylative activity in axenic amastigotes was observed. As the adenylate cyclase/cAMP pathway would be involved in the parasite-host interiorization, the PKA activity may constitute a good intracellular target for studies of leishmanicidal drugs.

Trypanothione reductase activity is prominent in metacyclic promastigotes and axenic amastigotes of Leishmania amazonesis. Evaluation of its potential as a therapeutic target.

The activity of trypanothione reductase in Leishmania amazonensis was evaluated and it was demonstrated that TR is expressed in the soluble fractions of infective promastigotes and amastigotes, while non-infective promastigotes expressed the enzyme at basal levels. This data allows an association of enzyme activity and the infective capacity of the parasite. We have also previously demonstrated that amidine compounds (N, N'-diphenyl-4-methoxy-benzamidine and pentamidine) were active against this parasite. Here, experiments concerning the effect of these compounds on TR activity, showed that both compounds significantly inhibited the enzyme. However, against glutathione reductase, only pentamidine showed a significant inhibitory action, suggesting an association with the toxic effects of this drug used in the clinic for the treatment of leishmaniasis.

Recentes avanços da quimioterapia das leishmanioses: moléculas intracelulares como alvo de fármacos / Recent advances on leishmaniasis chemotherapy: intracelular molecules as a drug target

Leishmanioses são doenças causadas por protozoários do gênero Leishmania sp., que se apresentam na forma promastigota ou amastigota; os promastigotas infectam o inseto vetor e os amastigotas são as formas infectivas antes presentes em macrófagos humanos. O tratamento utilizado pela clínica tem se mostrado ineficaz; os fármacos utilizados se apresentam na forma injetável, o que dificulta o tratamento, já que o paciente, para ser tratado, deve ser internado para as aplicações - que são dolorosas - e assim muitos pacientes desistem do tratamento. Outra razão para a internação é a monitoração dos efeitos colaterais causados pelos fármacos...