Interplay among differential exposure to Mycobacterium leprae and TLR4 polymorphism impacts the immune response in household contacts of leprosy patients.

Introduction: The aim of the present study was to investigate the association between the single nucleotide polymorphism (SNP) rs1927914 A/G in TLR4 gene and the immunological profile of household contacts (HHC) of leprosy patients. Leprosy classification is usually complex and requires the assessment of several clinical and laboratorial features. Methods: Herein, we have applied distinct models of descriptive analysis to explore qualitative/quantitative changes in chemokine and cytokine production in HHC further categorized according to operational classification [HHC(PB) and HHC(MB)] and according to TLR4SNP. Results and discussion: Our results showed that M. leprae stimuli induced an outstanding production of chemokines (CXCL8;CCL2; CXCL9; CXCL10) by HHC(PB), while increase levels of pro-inflammatory cytokines (IL-6; TNF; IFN-γ; IL-17) were observed for HHC(MB). Moreover, the analysis of chemokine and cytokine signatures demonstrated that A allele was associated with a prominent soluble mediator secretion (CXCL8; CXCL9; IL-6; TNF; IFN-γ). Data analysis according to TLR4 SNP genotypes further demonstrated that AA and AG were associated with a more prominent secretion of soluble mediators as compared to GG, supporting the clustering of AA and AG genotypes into dominant genetic model. CXCL8, IL-6, TNF and IL-17 displayed distinct profiles in HHC(PB) vs HHC(MB) or AA+AG vs GG genotype. In general, chemokine/cytokine networks analysis showed an overall profile of AA+GA-selective (CXCL9-CXCL10) and GG-selective (CXCL10-IL-6) axis regardless of the operational classification. However, mirrored inverted CCL2-IL-10 axis and a (IFN-γ-IL-2)-selective axis were identified in HHC(MB). CXCL8 presented outstanding performance to classify AA+AG from GG genotypes and HHC(PB) from HHC(MB). TNF and IL-17 presented elevated accuracy to classify AA+AG from GG genotypes and HHC(PB) (low levels) from HHC(MB) (high levels), respectively. Our results highlighted that both factors: i) differential exposure to M. leprae and ii) TLR4 rs1927914 genetic background impact the immune response of HHC. Our main results reinforce the relevance of integrated studies of immunological and genetic biomarkers that may have implications to improve the classification and monitoring of HHC in future studies.

[Nutritional status of patients with breast cancer attended in the Mastology Service of Belo Horizonte's Hospital das Clínicas in the state of Minas Gerais, Brazil]. / Avaliação nutricional de pacientes com câncer de mama atendidas no Serviço de Mastologia do Hospital das Clínicas, Belo Horizonte (MG), Brasil.

The scope of this article is to evaluate the nutritional status, body composition and tumor characteristics of 31 patients with breast cancer attended at the Mastology Service of Hospital das Clínicas of the Federal University of Minas Gerais. Dietary data were obtained from the 24-hour dietary recall in the pre-operative state and analyzed by the DietWin Professional 2008 Nutrition Software. Body composition was assessed by bioelectrical impedance analysis. The tumor characterization data were collected from medical records. The mean age of patients was 50.75 ± 14.34 years. Excess body weight was found in 58% and waist circumference greater than 80 cm in 64.5% of patients Excessive consumption of oils and sugars was observed in 90.3% and 83.8%, respectively. Most had low intakes of calcium and vitamins B6, B12 and A. The predominant diagnosis was type II histological grade invasive ductal carcinoma in stage II or III. The prevalence of overweight and inadequate dietary intake demonstrate the need for individualized nutritional guidance and monitoring to improve the prognosis and quality of the life of patients.

Effect of giardiasis combined with low-protein diet on intestinal absorption of glucose and electrolytes in gerbils.

Studies have shown that symptomatic infection by Giardia lamblia causes acute or chronic diarrhea, dehydration, abdominal pain and malabsorption, leading to undernutrition and weight loss. The aim of the present study was to evaluate the effects of giardiasis and its combination with a low-protein diet on the intestinal absorption of glucose and electrolytes in gerbils. The intestinal absorption of glucose, sodium and potassium was investigated in male gerbils weighing 46-64 g (n≥5). A Tyrode solution containing twice the glucose, sodium and potassium concentration (pH 7.4) was infused through the intestinal loops for 40 min. Glucose absorption was not significantly affected by diet and infection. However, there was a significant increase in sodium absorption in the Giardia-infected group (57.2±6.1, p<0.05) in comparison to the control, low-protein diet and low-protein diet+Giardia-infected groups (8.9±6.5, 2.8±11.1 and 0.8±7.9, respectively; p<0.05). Moreover, potassium was absorbed in the Giardia-infected group (0.45±0.30), while the other groups exhibited potassium secretion. A low-protein diet and Giardia infection had no influence over glucose absorption. However, Giardia infection increased sodium and potassium uptake, suggesting a compensatory mechanism for maintaining homeostasis after likely hypernatremia and hypokalemia caused by the diarrhea that accompanies giardiasis.