1
|
Conceição-Silva F, Morgado FN. Leishmania Spp-Host Interaction: There Is Always an Onset, but Is There an End? Front Cell Infect Microbiol 2019; 9:330. [PMID: 31608245 PMCID: PMC6761226 DOI: 10.3389/fcimb.2019.00330] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 09/04/2019] [Indexed: 01/09/2023] Open
Abstract
For a long time Leishmaniasis had been considered as a neglected tropical disease. Recently, it has become a priority in public health all over the world for different aspects such as geographic spread, number of population living at risk of infection as well as the potential lethality and/or the development of disfiguring lesions in the, respectively, visceral and tegumentary forms of the disease. As a result, several groups have been bending over this issue and many valuable data have been published. Nevertheless, parasite-host interactions are still not fully known and, consequently, we do not entirely understand the infection dynamics and parasite persistence. This knowledge may point targets for modulation or blockage, being very useful in the development of measures to interfere in the course of infection/ disease and to minimize the risks and morbidity. In the present review we will discuss some aspects of the Leishmania spp-mammalian host interaction in the onset of infection and after the clinical cure of the lesions. We will also examine the information already available concerning the parasite strategy to evade immune response mainly at the beginning of the infection, as well as during the parasite persistence. This knowledge can improve the conditions of treatment, follow-up and cure control of patients, minimizing the potential damages this protozoosis can cause to infected individuals.
Collapse
Affiliation(s)
- Fatima Conceição-Silva
- Laboratory of Immunoparasitology, Oswaldo Cruz Institute, IOC/Fiocruz, Rio de Janeiro, Brazil
| | - Fernanda N Morgado
- Laboratory of Leishmaniasis Research, Oswaldo Cruz Institute, IOC/Fiocruz, Rio de Janeiro, Brazil
| |
Collapse
|
2
|
Fidalgo LM. Essential Oil from Chenopodium ambrosioides as a Promising Antileishmanial Agent. Nat Prod Commun 2019. [DOI: 10.1177/1934578x0700201214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Chenopodium ambrosioides has been used traditionally against parasitic diseases. The essential oil of the plant is a complex mixture of compounds with a rich structural diversity. This review focuses on recent evaluation of the essential oil from C. ambrosioides as a promising antileishmanial agent. The tested product showed activity against promastigotes and amastigotes of Leishmania amazonensis and L. donovani. An optimal dose of 30 mg/Kg was effective by intraperitoneal and oral routes in experimental cutaneous leishmaniasis. The chenopodium oil had a moderate toxicity against peritoneal macrophages of BALB/c mice and no side effects were detected in animals treated by the oral route. Isolates of L. amazonensis from treated mice were susceptible to the essential oil. Synergic effects were observed when the essential oil was incubated in conjunction with pentamidine on L. amazonensis promastigote cultures. Future studies focusing on formulation, toxicity and mechanism of action may help in the development of chenopodium oil as a new antileishmanial drug.
Collapse
Affiliation(s)
- Lianet Monzote Fidalgo
- Departamento de Parasitología, Instituto de Medicina Tropical “Pedro Kourí”. Apartado Postal No. 601, Marianao 13, Ciudad de la Habana, Cuba
| |
Collapse
|
3
|
Effects of a new antiprotozoal drug, N,N′ -diphenyl-4-methoxy-benzamidine, on energy-linked functions of rat liver mitochondria. Chem Biol Interact 2018; 279:34-42. [DOI: 10.1016/j.cbi.2017.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 11/03/2017] [Accepted: 11/07/2017] [Indexed: 11/21/2022]
|
4
|
MELO NETO BERNARDO, LEITÃO JOSEANAM, OLIVEIRA LUCIANOG, SANTOS SÉRGIOE, CARNEIRO SABRINAM, RODRIGUES KLINGERA, CHAVES MARIANAH, ARCANJO DANIELD, CARVALHO FERNANDOA. Inhibitory effects of Zanthoxylum rhoifolium Lam. (Rutaceae) against the infection and infectivity of macrophages by Leishmania amazonensis. ACTA ACUST UNITED AC 2016; 88:1851-1861. [DOI: 10.1590/0001-3765201620150131] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Accepted: 03/01/2016] [Indexed: 11/22/2022]
Abstract
ABSTRACT Zanthoxylum rhoifolium Lam. (Rutaceae) has been traditionally used in the treatment of microbial infections and parasitic diseases. In the present study, the antileishmanial effect induced by the ethanol extract of stem barks from Z. rhoifolium (ZR-EEtOH) and its n-hexane fraction (ZR-FHEX) on infection and infectivity of murine macrophages by promastigote forms of Leishmania amazonensis were investigated. In different set of experiments, macrophages or promastigotes were pretreated with ZR-EEtOH or ZR-FHEX at non-lethal concentrations for 24 hours, and then macrophages were submitted to infection by promastigotes. Moreover, their effects on activation of macrophages, as well as on the DNA content, size and number of promastigotes by flow cytometry were also evaluated. The infection rate and the number of internalized amastigote forms were markedly decreased after pretreatment of macrophages or promastigotes when compared with non-treated cells. The increase in phagocytic capability and nitrite content was also observed. Furthermore, the decrease of DNA content, size and number of promastigotes was also observed. In conclusion, ZR-EEtOH and ZR-FHEX promoted a markedly significant antileishmanial effect and reduction of infection of macrophages, probably underlying defense mechanisms activation in macrophages. These findings reinforce the potential application of Z. rhoifolium in the treatment of leishmaniasis.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - DANIEL D.R. ARCANJO
- Universidade Federal do Piauí, Brazil; Universidade Federal do Piauí, Brazil
| | | |
Collapse
|
5
|
Lustosa AKM, Arcanjo DD, Ribeiro RG, Rodrigues KAF, Passos FFB, Piauilino CA, Silva-Filho JC, Araújo BQ, Lima-Neto JS, Costa-Júnior JS, Carvalho FAA, Citó AMDGL. Immunomodulatory and toxicological evaluation of the fruit seeds from Platonia insignis, a native species from Brazilian Amazon Rainforest. REVISTA BRASILEIRA DE FARMACOGNOSIA-BRAZILIAN JOURNAL OF PHARMACOGNOSY 2016. [DOI: 10.1016/j.bjp.2015.05.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
6
|
Soares-Bezerra RJ, Leon LL, Echevarria A, Reis CM, Gomes-Silva L, Agostinho CG, Fernandes RA, Canto-Cavalheiro MM, Genestra MS. 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. Exp Parasitol 2013; 135:50-4. [DOI: 10.1016/j.exppara.2013.05.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2011] [Revised: 04/16/2013] [Accepted: 05/05/2013] [Indexed: 10/26/2022]
|
7
|
Synthesis, antileishmanial activity and structure–activity relationship of 1-N-X-phenyl-3-N′-Y-phenyl-benzamidines. Eur J Med Chem 2013; 67:166-74. [DOI: 10.1016/j.ejmech.2013.06.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 05/21/2013] [Accepted: 06/18/2013] [Indexed: 11/23/2022]
|
8
|
Soares RO, Echevarria A, Bellieny MS, Pinho RT, de Leo RM, Seguins WS, Machado GM, Canto-Cavalheiro MM, Leon LL. Evaluation of thiosemicarbazones and semicarbazones as potential agents anti-Trypanosoma cruzi. Exp Parasitol 2011; 129:381-7. [DOI: 10.1016/j.exppara.2011.08.019] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Revised: 08/29/2011] [Accepted: 08/31/2011] [Indexed: 12/20/2022]
|
9
|
Genestra M, Soares-Bezerra RJ, Gomes-Silva L, Fabrino DL, Bellato-Santos T, Castro-Pinto DB, Canto-Cavalheiro MM, Leon LL. In vitro sodium nitroprusside-mediated toxicity towards Leishmania amazonensis promastigotes and axenic amastigotes. Cell Biochem Funct 2008; 26:709-17. [PMID: 18720423 DOI: 10.1002/cbf.1496] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
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.
Collapse
Affiliation(s)
- Marcelo Genestra
- Oswaldo Cruz Institute, Oswaldo Cruz Foundation-FIOCRUZ, Rio de Janeiro, Brazil.
| | | | | | | | | | | | | | | |
Collapse
|
10
|
Soares-Bezerra RJ, da Silva EF, Echevarria A, Gomes-da-Silva L, Cysne-Finkelstein L, Monteiro FP, Leon LL, Genestra M. 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. J Enzyme Inhib Med Chem 2008; 23:328-33. [DOI: 10.1080/14756360701585619] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
- Rômulo José Soares-Bezerra
- Department of Immunology-Oswaldo Cruz Institute, Oswaldo Cruz Foundation-FIOCRUZ, Rio de Janeiro, Brazil
| | - Edson F. da Silva
- Department of Chemistry-Federal Rural University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Aurea Echevarria
- Department of Chemistry-Federal Rural University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Liliane Gomes-da-Silva
- Department of Immunology-Oswaldo Cruz Institute, Oswaldo Cruz Foundation-FIOCRUZ, Rio de Janeiro, Brazil
| | - Léa Cysne-Finkelstein
- Department of Immunology-Oswaldo Cruz Institute, Oswaldo Cruz Foundation-FIOCRUZ, Rio de Janeiro, Brazil
| | - Fabiane Pereira Monteiro
- Department of Immunology-Oswaldo Cruz Institute, Oswaldo Cruz Foundation-FIOCRUZ, Rio de Janeiro, Brazil
| | - Leonor L. Leon
- Department of Immunology-Oswaldo Cruz Institute, Oswaldo Cruz Foundation-FIOCRUZ, Rio de Janeiro, Brazil
| | - Marcelo Genestra
- Department of Immunology-Oswaldo Cruz Institute, Oswaldo Cruz Foundation-FIOCRUZ, Rio de Janeiro, Brazil
| |
Collapse
|
11
|
Genestra M, Cysne-Finkelstein L, Guedes-Silva D, Leon LL. Effect of l-Arginine Analogs and a Calcium Chelator on Nitric Oxide (NO˙) Production byLeishmaniasp. J Enzyme Inhib Med Chem 2008; 18:445-52. [PMID: 14692512 DOI: 10.1080/1475636031000138787] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Leishmania amazonensis, L. braziliensis and L. chagasi promastigotes were grown in the presence of L-arginine analogs such as Nomega-nitro-L-arginine methyl ester (L-NAME), NG-nitro-L-arginine (L-NNA) and D-arginine (an inactive L-arginine isomer), besides an intracellular calcium chelator [ethylene glycol-bis (beta-aminoethyl ether)-N,N,N',N'-tetra acetic acid; EGTA] to verify the importance of L-arginine metabolism and the cofactors for these parasites. The parasite's growth curve was followed up and the culture supernatants were used to assay nitric oxide (NO) production by the Griess reaction. The results showed a significant effect of L-arginine analogs on NO production by all Leishmania species studied, especially L-NAME, an irreversible inhibitor of the constitutive nitric oxide synthase (cNOS). When L. amazonensis promastigotes were pre-incubated with L-NAME, the infection range of the murine macrophages was lowered to 61% in 24 h and 19% after 48 h. These data demonstrated that the parasite NO pathway is important to the establishment of the infection.
Collapse
Affiliation(s)
- Marcelo Genestra
- Department of Immunology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, FIOCRUZ, Rio de Janeiro, Brazil.
| | | | | | | |
Collapse
|
12
|
Temporal RM, Cysne-Finkelstein L, Echevarria A, Silva-Gonçalves AJ, Leon LL, Genestra MS. Amidine Derivatives and Leishmania amazonensis: an Evaluation of the Effect of Nitric Oxide (NO) Production on the Parasite-macrophage Interaction. J Enzyme Inhib Med Chem 2008; 20:13-8. [PMID: 15895679 DOI: 10.1080/14756360400015207] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Previous work has demonstrated that N-N'-diphenyl-R-benzamidine was highly effective against Leishmania amazonensis promastigotes/axenic amastigotes and Trypanosoma evansi trypomastigotes and the compound with a methoxy substituent, was the most effective derivative in the parasite-macrophage interaction. Comparative analysis of the nitric oxide (NO) released from the culture infection's supernatant showed the amidine to be less effective than pentamidine Isethionate as a reference drug. Additionally, in order to verify if the methoxylated derivative interferes with NO production by L. amazonensis, the effect of the amidine on the constitutive nitric oxide synthase (cNOS) purified from parasites, was examined, but demonstrated less activity in comparison with the reference drug. This data contributes to studies concerning the metabolic targets present in Leishmania parasites for leishmanicidal drugs.
Collapse
Affiliation(s)
- R M Temporal
- Department of Immunology, Instituto Oswaldo Cruz/FIOCRUZ, Rio de Janeiro, Brazil.
| | | | | | | | | | | |
Collapse
|
13
|
Castro-Pinto DB, Echevarria A, Genestra MS, Cysne-Finkelstein L, Leon LL. Trypanothione Reductase Activity is Prominent in Metacyclic Promastigotes and Axenic Amastigotes of Leishmania amazonesis. Evaluation of its Potential as a Therapeutic Target. J Enzyme Inhib Med Chem 2008; 19:57-63. [PMID: 15202494 DOI: 10.1080/14756360310001624966] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Denise B Castro-Pinto
- Department of Immunology, Oswaldo Cruz Institute, FIOCRUZ, Av. Brasil, 4365-Manguinhos CEP 21042-900, Rio de Janeiro, RJ, Brazil
| | | | | | | | | |
Collapse
|
14
|
Monzote L, Montalvo AM, Scull R, Miranda M, Abreu J. Activity, toxicity and analysis of resistance of essential oil from Chenopodium ambrosioides after intraperitoneal, oral and intralesional administration in BALB/c mice infected with Leishmania amazonensis: A preliminary study. Biomed Pharmacother 2007; 61:148-53. [PMID: 17254746 DOI: 10.1016/j.biopha.2006.12.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2006] [Revised: 08/30/2006] [Accepted: 12/04/2006] [Indexed: 09/30/2022] Open
Abstract
The World Health Organization has classified the leishmaniasis as a major tropical disease. Current therapy is toxic, expensive and cause several adverse effects. The majority of people in endemic areas of leishmaniasis depend of natural and traditional medicine. This study was developed to examine the activity of the essential oil from Chenopodium ambrosioides in BALB/c mice infected with Leishmania amazonensis. The infected animals received two cycle of treatment by different routes (intraperitoneal, oral or intralesional route). The intraperitoneal administration of the essential oil at dose of 30 mg/Kg prevented lesion development and decrease the parasite burden. Oral administration retarded the infection in the experimental model compared with untreated mice, although it was less effective that the intraperitoneal route. The administration by intralesional route did not show activity. Intraperitoneal and oral treatment at 30 mg/Kg with the essential oil had better antileishmanial effect that treatment with the reference drug, amphotericin B at 1 mg/Kg. Preliminarily, we examined the toxicity and the resistance after treatment. Signs of toxicity were evident only in the animals treated by intraperitoneal route. No resistance was detected in L. amazonensis isolates obtained from treated mice. These data clearly demonstrated that this natural product could be an alternative for the development of a new drug against cutaneous leishmaniasis based in the ethnomedical information.
Collapse
Affiliation(s)
- Lianet Monzote
- Parasitology Department, Institute of Medicine Tropical "Pedro Kourí", Apartado Postal No. 601, Marianao 13, Havana City, Cuba.
| | | | | | | | | |
Collapse
|
15
|
Genestra M, Guedes-Silva D, Souza WJS, Cysne-Finkelstein L, Soares-Bezerra RJ, Monteiro FP, Leon LL. Nitric Oxide Synthase (NOS) Characterization in Leishmania amazonensis Axenic Amastigotes. Arch Med Res 2006; 37:328-33. [PMID: 16513480 DOI: 10.1016/j.arcmed.2005.07.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2005] [Accepted: 07/27/2005] [Indexed: 11/16/2022]
Abstract
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.
Collapse
Affiliation(s)
- Marcelo Genestra
- Department of Immunology, Oswaldo Cruz Foundation, FIOCRUZ, Rio de Janeiro, Brazil.
| | | | | | | | | | | | | |
Collapse
|
16
|
Genestra M, Souza WJS, Guedes-Silva D, Machado GMC, Cysne-Finkelstein L, Bezerra RJS, Monteiro F, Leon LL. Nitric oxide biosynthesis by Leishmania amazonensis promastigotes containing a high percentage of metacyclic forms. Arch Microbiol 2006; 185:348-54. [PMID: 16575586 DOI: 10.1007/s00203-006-0105-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2005] [Revised: 01/03/2006] [Accepted: 02/20/2006] [Indexed: 10/24/2022]
Abstract
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.
Collapse
Affiliation(s)
- Marcelo Genestra
- Department of Immunology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation - FIOCRUZ, Rio de Janeiro, Brazil.
| | | | | | | | | | | | | | | |
Collapse
|