Serum IgA Antibodies Specific to M. leprae Antigens as Biomarkers for Leprosy Detection and Household Contact Tracking

Leprosy remains endemic in several developing countries, such as India and Brazil, in part due to delayed diagnosis that facilitates ongoing transmission. Although immunoglobulins against several Mycobacterium leprae antigens have been indicated for the early diagnosis, and IgA participates in the early stages of leprosy and in subclinical infection, relatively little research has examined anti-M. leprae IgA responses. Here, we investigated serum IgA reactivity against NDO-HSA, LID-1 and NDO-LID, in paucibacillary (PB) and multibacillary (MB) patients and their household contacts, using enzyme-linked immunosorbent assay (ELISA). Diagnostic accuracy of each ELISA was evaluated by receiver operating characteristic (ROC) curve analysis. Our data reveal elevated IgA serum levels against the three M. leprae specific antigens in MB patients, whereas IgA reactivity in PB patients was increased only to NDO-HSA. Further, MB and PB household contacts displayed higher IgA reactivity to NDO-HSA than non-endemic controls. Our data suggest measurement of serum IgA against NDO-HSA as an additional tool in the diagnosis and classification of the disease, with potential utility for household contact follow-up.

Proteínas de checkpoint imunológico como novo alvo da imunoterapia contra o câncer: revisão da literatura

Uma nova era no tratamento do câncer está surgindo com o uso de anticorpos capazes de inibir pontos de bloqueio do sistema imunológico, chamados de “inibidores de checkpoint”. Um novo conceito de “balas mágicas”, que no início do século passado foram imaginadas por Paul Ehrlich como capazes de atuar diretamente na destruição de alvos tumorais, é representado agora por anticorpos direcionadas contra moléculas que bloqueiam a atividade antitumoral do sistema imunológico, como o antígeno de linfócitos T citotóxicos-4 (CTLA-4) e a proteína-1 de morte celular programada (PD-1). Essas novas imunoterapias vêm revolucionando a forma de tratar diferentes tipos de câncer. Nesta revisão selecionamos estudos, sobre CTLA-4 e PD-1, seus ligantes em células apresentadoras de antígenos, assim como destacamos a importância da descoberta de antígenos tumorais e o papel do sistema imunológico na imunovigilância tumoral. Nesse estudo são discutidos aspectos relacionados aos efeitos de imunoterapias baseadas no uso de anticorpos monoclonais anti-CTLA-4 e anti-PD-1/ PD-L1, como o risco de serem estimuladas respostas ​​direcionadas a tecidos saudáveis e outros efeitos adversos, bem como o uso de terapias combinadas que podem contribuir para melhorar a eficiência do tratamento do câncer.

Efeitos contrastantes da vitamina D sobre a resposta imune inata e adquirida e seu impacto na recuperação da tuberculose

A vitamina D é um hormônio essencial para o organismo, podendo ser obtida da dieta ou, principalmente, gerada pela pele após exposição à luz solar ultravioleta B. Na sua forma ativa (1,25(OH)2D) ela controla a absorção de cálcio e fósforo do intestino para a corrente sanguínea e participa de diversos processos celulares e fisiológicos. A ligação da 1,25(OH)2D ao receptor da vitamina D (VDR) presente em diversas células, como as células do sistema imunológico, induz a transcrição de genes que podem, por exemplo, modular a resposta imune inata e adquirida. A deficiência de vitamina D ou do VDR é associada a problemas de saúde como desordens esqueléticas, hipertensão, doenças cardiovasculares, diabetes mellitus, dislipidemias, doenças autoimunes e doenças infecciosas. Neste sentido, a suplementação com vitamina D tem sido proposta como uma possível medida preventiva, podendo ser aplicada em muitas patologias, em especial na tuberculose. Principal causa de morte por um único agente infeccioso, a tuberculose é responsável por cerca de 1,3 milhões de óbitos por ano no mundo. Publicações recentes apontam efeitos diversos da vitamina D na resposta imune inata e adquirida. A 1,25(OH)2D3 na presença do interferon (IFN)-γ é capaz de aumentar a atividade bactericida do macrófago contra o M. tuberculosis, aumentando a produção de peptídios antimicrobianos e estimulando a autofagia, favorecendo assim a lise de bacilos localizados em fagossomos. Por outro lado, a vitamina D em linfócitos T mostra efeito tolerogênico que favorece o controle de respostas inflamatórias excessivas. Neste trabalho de revisão são apresentados estudos recentes envolvendo efeitos da vitamina D na resposta imune inata e adquirida. Além disso, considerações sobre deficiência de vitamina D e maior risco de contrair tuberculose, e efeitos contrastantes da suplementação com vitamina D na prevenção e tratamento da TB, são discutidos.

Testes sorológicos anti-NDO-HSA, anti-LID-1 e anti- NDO-LID em contatos domiciliares de área não endêmica de hanseníase

Introdução: Diversos fatores podem interferir no desenvolvimento da hanseníase, entre eles fatores genéticos, convívio com o caso de hanseníase e classificação operacional do caso. Testes sorológicos que avaliam a reatividade de anticorpos IgM e IgG frente a antígenos específicos para o Mycobacterium leprae (M. leprae) podem atuar como auxiliaresna vigilância dos contatos e/ou população de risco. Objetivo: Analisar o comportamento dos testes sorológicos anti-PGL-1 sintético (NDO-HSA), anti-LID-1 e anti-NDO-LID em área não endêmica de hanseníase e sua relação com características do caso de hanseníase. Material e métodos: Trata-se de um estudo transversal, do tipo analítico, realizado com 35 contatos domiciliares (CD) dos casos de hanseníase. A coleta de dados ocorreu no período de agosto/2016 a fevereiro/2017 por meio de visitas domiciliares. A reatividade de anticorpos IgM e IgG frente aos antígenos Natural disaccharide linked to human serum albumin via octyl (NDOHSA), Leprosy IDRI diagnostic 1 (LID-1) e Natural disaccharideoctyl - Leprosy IDRI Diagnostic 1(NDO-LID) foi avaliada por ensaio imunoenzimático (ELISA). Os dados foram exportados e analisados no software StatisticalPackage for the Social Sciences(SPSS) 24 for Windows. Resultados: Foi observada maior proporção de positividade aos testes em CD de casos multibacilares (MB),que residiam com o caso de hanseníase na época do diagnóstico e que tinham parentesco consanguíneo com o caso. Esses casos de hanseníase MB também apresentaram soropositividade frente aos antígenos testados. O valor do índice ELISA foi maior no grupo de CD de casos MB. Houve concordância moderada e significativa (K= 0,53; p< 0,0001) entre os testes anti-NDO-HSA e anti-NDO-LID, mas não foi detectada diferença entre os testes anti-NDO-HSA e anti-LID-1 (K= -0,05; p= 0,678). A correlação foi positiva entre os três antígenos, porém, entre LID-1 e NDO-HSA, não houve significância estatística (p<0,186). Conclusão: Os resultados sugerem que testes sorológicos em conjunto com as características avaliadas nos contatos domiciliares em área não endêmica de hanseníase,podem atuarcomo auxiliares na detecção de indivíduos infectados pelo M. leprae, contribuindo para vigilância dos contatos domiciliares.

Utility of immunoglobulin isotypes against LID-1 and NDO-LID for, particularly IgG1, confirming the diagnosis of multibacillary leprosy

BACKGROUND

Leprosy remains a health problem in many countries, with difficulties in diagnosis resulting in delayed treatment and more severe disabilities. Antibodies against several Mycobacterium leprae antigens have, however, shown value as diagnostic and/or prognostic markers.

OBJECTIVES

The objective of this study was to evaluate serum immunoglobulin (Ig) IgM and IgG subclass reactivity against three M. leprae specific antigens: NDO-HSA, a conjugate formed by natural octyl disaccharide bound to human serum albumin; LID-1, the fusion protein product of the ml0405 and ml2331 genes; and NDO-LID, a combination of LID-1 and NDO.

METHODS

Sera from healthy controls, paucibacillary (PB) and multibacillary (MB) leprosy patients, and their respective household contacts, were evaluated for the presence of antigen-specific IgM, IgG, and IgG subclass antibodies by enzyme-linked immunosorbent assay (ELISA). The sensitivity and specificity of each ELISA were evaluated by receiver operating characteristic (ROC) curve analysis.

FINDINGS

Our data confirm that serum IgM antibodies against NDO-HSA and IgG antibodies against LID-1, as well as IgG/M antibodies against NDO-LID, are markedly increased in MB patients. For the first time, our data reveal a selective increase in IgG1 and IgG3 antibodies against LID-1 and NDO-LID in MB patients, demonstrating that these antibody isotypes are suitable for differentiation between MB and PB patients. ROC curve analysis indicates an improved capacity for diagnosing MB leprosy patients using the detection of IgG antibodies, particularly the IgG1 isotype, specific to LID-1 and NDO-LID over the performance levels attained with NDO-HSA.

CONCLUSIONS

Our findings indicate that serological tests based on the detection of antigen-specific IgG1 antibodies are a useful tool to differentiate MB from PB patients, and indicate the enhanced performance of the LID-1 and NDO-LID antigens in the serodiagnosis of leprosy.

Obesity promotes prolonged ovalbumin-induced airway inflammation modulating T helper type 1 (Th1), Th2 and Th17 immune responses in BALB/c mice

Clinical and epidemiological studies indicate that obesity affects the development and phenotype of asthma by inducing inflammatory mechanisms in addition to eosinophilic inflammation. The aim of this study was to assess the effect of obesity on allergic airway inflammation and T helper type 2 (Th2) immune responses using an experimental model of asthma in BALB/c mice. Mice fed a high-fat diet (HFD) for 10 weeks were sensitized and challenged with ovalbumin (OVA), and analyses were performed at 24 and 48 h after the last OVA challenge. Obesity induced an increase of inducible nitric oxide synthase (iNOS)-expressing macrophages and neutrophils which peaked at 48 h after the last OVA challenge, and was associated with higher levels of interleukin (IL)-4, IL-9, IL-17A, leptin and interferon (IFN)-γ in the lungs. Higher goblet cell hyperplasia was associated with elevated mast cell influx into the lungs and trachea in the obese allergic mice. In contrast, early eosinophil influx and lower levels of IL-25, thymic stromal lymphopoietin (TSLP), CCL11 and OVA-specific immunoglobulin (IgE) were observed in the obese allergic mice in comparison to non-obese allergic mice. Moreover, obese mice showed higher numbers of mast cells regardless of OVA challenge. These results indicate that obesity affects allergic airway inflammation through mechanisms involving mast cell influx and the release of TSLP and IL-25, which favoured a delayed immune response with an exacerbated Th1, Th2 and Th17 profile. In this scenario, an intense mixed inflammatory granulocyte influx, classically activated macrophage accumulation and intense mucus production may contribute to a refractory therapeutic response and exacerbate asthma severity.

IgG1 and Th1 responses to DosR, Rpf and active growth phase antigens of Mycobacterium tuberculosis in Brazilian tuberculosis patients

Tuberculosis (TB) is serious problem worldwide. New antigens from Mycobacterium tuberculosis are being investigated in order to improve the diagnosis of latent TB infection and TB disease. In this study, serum levels of IgG1 antibodies against active growth phase antigens (ESAT-6/CFP-10, Rv0717 and Rv3353), dormancy-related (DosR) antigens (Rv1733, Rv1737, Rv2029 and Rv2628), and resuscitation promoting factors (Rpfs Rv0867 and Rv2389) were evaluated in patients with TB before and after chemotherapy using ELISA. Antigen-induced IFN-γ, TNF-α, IL-17, IL-10 and IL-4 were evaluated in supernatants of PBMC cultures. Our results indicate that patients with pulmonary TB express high levels of IgG1 antibodies against ESAT-6/CFP-10, Rv0717, Rv3353, Rv1733, Rv2029 and Rv2628 Rv0867 in the active phase of the disease in comparison to healthy controls (p&lt;0.001). These levels declined to control levels after the completion of six months treatment. ROC analysis confirmed the good performance of Rv0717, Rv1733, Rv3353, Rv0867, Rv2029 and Rv2628 antigens. Interestingly, Rv0717 and Rv1733 antigens induced an IgG1 peak response after 1–3 months of chemotherapy (P&lt;0.01). Similarly, IFN-γ and TNF-α peaked early during treatment in response to ESAT-6/CFP-10, Rv1733 and Rv2029, and declined to control levels after 6 months of chemotherapy. The study groups did not differ in respect to IL-17, IL-10 and IL-4. Taken together, these data further reinforce a possible correlation of IgG1 production with Th1 responses in TB. Moreover, detecting IgG1 antibodies against M. tuberculosis antigens, including DosR and Rpf proteins, may represent an additional tool in the diagnosis of tuberculosis.

Financial support: FAPEMIG, CNPq and CAPES, EU and NWO-TOP.

Detection of IgG1 antibodies against Mycobacterium tuberculosis DosR and Rpf antigens in tuberculosis patients before and after chemotherapy

Diagnosis of tuberculosis (TB) remains challenging. Serum IgG1 antibodies against Mycobacterium tuberculosis active growth phase antigens (ESAT-6/CFP-10, Rv0717 and Rv3353), DosR regulon-encoded proteins (Rv1733, Rv1737, Rv2628 and Rv2029), and resuscitation-promoting factors (Rv0867 and Rv2389) were evaluated in TB patients using ELISA. Active TB patients showed elevated levels of IgG1 antibodies against ESAT-6/CFP-10, Rv0717, Rv3353, Rv1733, Rv2628, Rv2029 and Rv0867 in comparison to healthy controls (p < 0.001). These levels remained high after the initiation of treatment, while responses to Rv0717 and Rv1733 peaked early during treatment. IgG1 responses to ESAT-6/CFP-10, Rv3353, Rv2628, Rv2029 and Rv0867 declined to control levels after the completion of 6 months chemotherapy. ROC analysis confirmed the good diagnostic performance of Rv0717, Rv1733, Rv3353, Rv2628, Rv2029 and Rv0867antigens. These data suggest that detecting IgG1 antibodies against M. tuberculosis antigens, including DosR and Rpf proteins, may represent an additional tool in the diagnosis of tuberculosis.

Challenging Mycobacterium tuberculosis dormancy mechanisms and their immunodiagnostic potential

Mycobacterium tuberculosis is the etiologic agent of tuberculosis, one of the world's greatest cause of morbidity and mortality due to infectious disease. Many evolutionary mechanisms have contributed to its high level of adaptation as a host pathogen. Prior to become dormant, a group of about 50 genes related to metabolic changes are transcribed by the DosR regulon, one of the most complex and important systems of host-pathogen interaction. This genetic mechanism allows the mycobacteria to persist during long time periods, establishing the so-called latent infection. Even in the presence of a competent immune response, the host cannot eliminate the pathogen, only managing to keep it surrounded by an unfavorable microenvironment for its growth. However, conditions such as immunosuppression may reestablish optimal conditions for bacterial growth, culminating in the onset of active disease. The interactions between the pathogen and its host are still not completely elucidated. Nonetheless, many studies are being carried out in order to clarify this complex relationship, thus creating new possibilities for patient approach and laboratory screening.

Antigen-specific assessment of the immunological status of various groups in a leprosy endemic region

BACKGROUND

Serological tests can be important tools to assist in the diagnosis of leprosy and can contribute to an earlier diagnosis. The aim of this study was to evaluate the antibody responses against phenolic glycolipid-1 (PGL-1), natural disaccharide linked to human serum albumin via an octyl (NDO-HSA), Leprosy IDRI Diagnostic-1 (LID-1) and natural disaccharide octyl--Leprosy IDRI Diagnostic-1 (NDO-LID) in leprosy patients, household contacts of patients and the general population.

METHODS

Enzyme-linked immunosorbent assays were used to analyze the antigen-specific antibody responses of 94 leprosy cases, 104 household contacts of cases and 2.494 individuals from the general population.

RESULTS

A positive correlation was observed for the antibody responses to all antigens studied. A higher proportion of seropositivity for all antigens, along with stronger magnitude of response, was observed in multibacillary (MB) leprosy patients and household contacts of MB leprosy patients compared with the levels observed in paucibacillary (PB) leprosy patients and household contacts of PB leprosy patients. A substantial and significant positive correlation was found between seropositivity and the bacterial index for the leprosy patients. Anti-PGL-1 tests were more frequently positive than anti-NDO-HSA tests among patients with all clinical forms of leprosy and among the group of household contacts. The LID-1 and NDO-LID antigens showed a greater capacity to identify household contacts and individuals from the general population infected with M. leprae.

CONCLUSIONS

Tests that measure the antibody responses against LID-1, NDO-LID, NDO-HSA and PGL-1 were effective tools for the detection of patients with MB leprosy. Our data indicate that the anti-LID-1 and anti-NDO-LID responses were more effective than an anti-NDO-HSA response for the identification of individuals with subclinical infection.

CCL2, CXCL8, CXCL9 and CXCL10 serum levels increase with age but are not altered by treatment with hydroxychloroquine in patients with osteoarthritis of the knees

AIM

Osteoarthritis (OA) is a major cause of morbidity and incapacity in the elderly. This study evaluates serum levels of the chemokines CCL2, CXCL8, CXCL9, and CXCL10 in 16 patients with primary OA of the knees, and investigates how treatment with hydroxychloroquine (HCQ) for 4 months affects these chemokine levels.

METHOD

Thirteen elderly patients received a placebo. Healthy control groups consisted of 10 elderly individuals (age > 60 years) with no clinical or radiological evidence of OA (CT-O), and 10 young adult individuals, (CT-Y group, age < 40 years).

RESULTS

The CT-Y group presented lower levels of all chemokines studied, in comparison to the other groups. HCQ treatment did not alter the serum levels of CCL2 (P = 0.80), CXCL8 (P = 0.76), CXCL9 (P = 0.95) and CXCL10 (P = 0.74) in OA patients.

CONCLUSION

Hydroxychloroquine treatment did not alter the serum levels of CCL2, CXCL8, CXCL9 or CXCL10 in patients with OA of the knees, although increased serum levels correlated with aging for all subjects, including controls.

Altered neurotrophin, neuropeptide, cytokines and nitric oxide levels in autism

INTRODUCTION

Modifications in neurotrophins, neuropeptides, cytokines and nitric oxide (NO) levels in autism may represent different biological aspects of the disease. In the present study we investigate simultaneously all these variables as an attempt to clarify their interrelationships in autism.

METHODS

Plasma levels of vasoactive intestinal peptide (VIP), neurotrophin-3 (NT-3), cytokines and nitric oxide (NO) were determined in children with DSM-IV autistic disorder (n = 24) and in age- and gender-matched healthy controls (n = 24). VIP, NT-3, IFN-γ and IL-1β levels were measured by ELISA, TNF-α, IL-10, IL-6, IL-4, IL-2 were evaluated by fl ow cytometry, and NO by Griess reaction.

RESULTS

Plasma levels of VIP, IFN-γ and NO were significantly higher and NT-3 plasma levels were significantly lower in children with autism, compared to the healthy subjects. In children with autism there was a positive correlation between plasma levels of NO and IFN-γ.

DISCUSSION

Our results indicate the presence of altered levels of neurotrophin and neuropeptide in infantile autism and provide additional evidence that higher levels of IFN-γ may be associated with increased oxidative stress in autism.

Lower production of IL-17A and increased susceptibility to Mycobacterium bovis in mice coinfected with Strongyloides venezuelensis

The presence of intestinal helminths can down-regulate the immune response required to control mycobacterial infection. BALB/c mice infected with Mycobacterium bovis following an infection with the intestinal helminth Strongyloides venezuelensis showed reduced interleukin-17A production by lung cells and increased bacterial burden. Also, small granulomas and a high accumulation of cells expressing the inhibitory molecule CTLA-4 were observed in the lung. These data suggest that intestinal helminth infection could have a detrimental effect on the control of tuberculosis (TB) and render coinfected individuals more susceptible to the development of TB.

Effects of aqueous extract of Echinodorus grandiflorus on the immune response in ovalbumin-induced pulmonary allergy

BACKGROUND

Asthma is a disease characterized by intermittent obstruction of the airways and chronic inflammation that affects approximately 300 million people worldwide. The immune response in asthma is predominantly T(H)2, with high levels of total and allergen-specific IgE and bronchial eosinophilia. Asthma treatment is aimed at controlling the disease, and the drugs used currently have systemic adverse effects and generally are not effective in difficult-to-control cases.

OBJECTIVE

To investigate the effect of aqueous extract of Echinodorus grandiflorus, a plant used in folk medicine for its diuretic and anti-inflammatory properties, in a model of pulmonary allergy.

METHODS

BALB/c mice were intraperitoneally sensitized and nasally challenged with ovalbumin. Aqueous extract and dexamethasone treatments (0.1 mL/d per mouse) were initiated on day 32 and concluded on day 40. Eight hours after the last challenge evaluations, of serum, bronchoalveolar lavage, and lung tissue were performed.

RESULTS

Oral treatment with the extract markedly reduced the number of total cells and eosinophils in bronchoalveolar lavage. The eosinophil peroxidase activity in lung tissue, the levels of ovalbumin-specific IgE in serum, the levels of CCL11, and the gene expression of interleukin 4 and interleukin 13 in lung tissue were also lower after treatment.

CONCLUSIONS

These results suggest that the aqueous extract of E grandiflorus is able to modulate allergic pulmonary inflammation and may be useful as a potential therapeutic agent for asthma.

Anti-mycobacterial treatment reduces high plasma levels of CXC-chemokines detected in active tuberculosis by cytometric bead array

Chemokines recruit and activate leukocytes, assisting granuloma formation. Herein, we evaluated plasma chemokines in patients with active tuberculosis (ATB) and after completing treatment (TTB) and compared them to BCG-vaccinated healthy controls (HC). Levels of chemokines were measured by cytometric bead array. Levels of CXCL8, CXCL9 and CXCL10 were higher in ATB patients compared to HC, but they decreased in TTB. Levels of CCL2 and CCL5 in ATB patients were similar to those observed in HC. Thus, the high levels of CXC-chemokines detected during ATB, which can modulate the trafficking of immune cells from the periphery to the site of infection, were reversed by anti-mycobacterial treatment.

Splenic autotransplantation restores IL-17 production and antibody response to Streptococcus pneumoniae in splenectomized mice

The high incidence of overwhelming postsplenectomy infection caused by Streptococcus pneumoniae can be reduced by splenic autotransplantation. In this study the effect of splenectomy and splenic autotransplantation on the immune response to S. pneumoniae infection was investigated. Balb/c mice were divided into three groups: splenectomized (SP), splenectomized and autotransplanted (AT), and sham operated control (CT). Five days post-infection the serum antibody levels were measured and the number of S. pneumoniae CFU, neutrophil accumulation and IL-17 production in the liver and lungs were investigated. SP mice showed greater number of bacteria in both organs and lower serum levels of S. pneumoniae-specific IgM, IgG1 and IgG2a antibodies. IL-17 production and neutrophil recruitment to the liver and lungs were lower in SP mice, in comparison with both the CT and the AT groups. Levels of S. pneumoniae-specific IgM, CFU counts, neutrophil accumulation and IL-17 production did not differ significantly between the CT and AT groups. These results suggest that splenic autotransplantation restores the capacity of splenectomized mice to fight S. pneumoniae infection.

Staphylococcus aureus infection after splenectomy and splenic autotransplantation in BALB/c mice

Splenectomy results in an increased risk of sepsis. The autogenous transplant of the spleen is an option for preserving splenic functions after total splenectomy. In this study, the capacity of animals undergoing autogenous spleen transplantation to respond to Staphylococcus aureus infection was investigated. BALB/c mice were divided into three groups: splenectomy followed by autotransplantation in the retroperitonium (AT), splenectomized only (SP) and operated non-splenectomized sham control (CT). Thirty days after surgery the mice were infected intravenously with S. aureus. Splenectomized mice had a higher number of colony-forming units (CFU) of S. aureus in liver and lungs in comparison with either AT or with CT mice (P < 0.05). Higher CFU numbers in lung of SP mice correlated with elevated production of interleukin-10 associated with a lower production of interferon-gamma and tumour necrosis factor-alpha. However, systemically, the level of tumour necrosis factor-alpha was higher in the SP group than in CT or AT. Lower titres of specific anti-S. aureus immunoglobulin (Ig)M and IgG1 were observed 6 days after infection in SP mice in comparison either with the AT or CT groups. Thus, splenectomy is detrimental to the immune response of BALB/c mice against infection by S. aureus which can be re-established by autogenous implantation of the spleen.

Human serum antibody reactivity towards Paracoccidioides brasiliensis antigens treated with sodium metaperiodate

In this study, we evaluated the profile of anti-Paracoccidioides brasiliensis immunoglobulin isotypes in serum from patients with the acute and chronic forms of paracoccidioidomycosis, using the whole Paracoccidioides brasiliensis antigen and the antigen treated with sodium metaperiodate. All the immunoglobulin isotypes present in the serum from patients with the acute and chronic forms of paracoccidioidomycosis presented higher reactivity towards the whole antigen than to the antigen treated with metaperiodate (P < 0.05). The reactivity of IgG and IgM to the antigen treated with metaperiodate was greater in serum from patients with the acute form of the disease (P < 0.05), while IgA was more reactive in serum from patients with the chronic form (P < 0.05). There was greater reactivity of IgG1 and IgG2 to the whole antigen and the antigen treated with metaperiodate in the serum from patients with paracoccidioidomycosis than there was in serum from patients with other parasitic infections (P < 0.05). Furthermore, IgG1 from patients with the acute form recognized the 19kDa, 27kDa and 31kDa antigens in the western blot test. Thus, the results suggest that modifications to the epitopes of Paracoccidioides brasiliensis antigens may help to improve the immunodiagnosis of paracoccidioidomycosis.

Non-influence of fetal gender on ductus venosus Doppler flow in the first trimester

OBJECTIVES

Recent findings have suggested that ductus venosus blood flow may be influenced by fetal gender. The aim of this study was to investigate further the influence of fetal gender on ductus venosus Doppler flow in the first trimester.

METHODS

This was a cross-sectional and retrospective study performed between January 1998 and January 2003. A total of 932 fetuses at between 10 and 14 weeks' gestation were included. The following inclusion criteria were used: singleton gestation; crown-rump length between 39 and 84 mm; and absence of fetal anomalies. The following variables of the ductus venosus were evaluated: peak velocity during ventricular systole (S-wave) and diastole (D-wave); nadir during atrial contraction in late diastole (A-wave); pulsatility index for veins (PIV); peak velocity index for veins (PVIV); and time-averaged maximum velocity (TAMXV).

RESULTS

Four hundred and forty-eight (48.1%) female and 484 (51.9%) male fetuses were included in the study. Comparing males and females at between 10 and 14 weeks' gestation, there was no statistically significant difference in S-wave, D-wave, A-wave, PIV, PVIV or TAMXV.

CONCLUSIONS

Our study suggests that fetal gender does not influence ductus venosus blood flow in the first trimester.

Influência do baço, da asplenia e do implante esplênico autógeno no metabolismo lipídico de camundongos

OBJETIVO: Estudar a influência do baço, da asplenia e do implante esplênico autógeno no metabolismo lipídico, por meio da avaliação do lipidograma sérico de camundongos e da verificação do efeito do transplante autógeno de baço em diferentes locais do abdome. MÉTODO: Foram utilizados camundongos BALB/c distribuídos em sete grupos de 10 animais: controle normal (CN); controle obeso (CO); operação simulada (OS); esplenectomia total (ET); três grupos submetidos ao transplante autógeno do baço: omento maior (OM), retroperitônio (RP), tecido subcutâneo da parede abdominal (PA). Os animais, com exceção do grupo CN, foram submetidos a dieta com 1,25% de colesterol. A intervenção cirúrgica foi realizada 30 dias após o início da dieta. A coleta de sangue ocorreu no 60º dia pós-operatório. Foram dosados os níveis de triglicérides, de colesterol total e de suas frações, bem como a glicemia. O baço, os implantes esplênicos e o fígado foram submetidos a estudo histológico. RESULTADOS: A dieta aumentou os níveis plasmáticos de colesterol total, HDL e LDL dos camundongos (p < 0,05 versus CN). Entre os animais em uso da dieta, não houve diferença no lipidograma dos grupos controles (CO e OS) quando comparados ao grupo esplenectomizado (ET), assim como em relação aos animais submetidos ao transplante autógeno do baço (OM, RP, PA). A capacidade de preservação da arquitetura histológica esplênica foi semelhante nos três locais de implante. Todos os animais que utilizaram a dieta enriquecida apresentaram esteatose hepática. CONCLUSÃO: De acordo com os resultados obtidos o baço não parece participar da regulação dos níveis de lipídeos plasmáticos em camundongos BALB/c.

Diagnóstico imunológico da tuberculose: problemas e estratégias para o sucesso

A tuberculose continua sendo um grave problema social e de saúde, afetando milhões de pessoas anualmente. A vacina Bacille Calmette-Guerin (BCG), usada no controle profilático, é incapaz de conter a progressão da doença, que usualmente se manifesta através da queda da imunidade celular do indivíduo. O diagnóstico da tuberculose em seus estágios iniciais, aliado à poliquimioterapia, pode contribuir para o controle da disseminação da infecção. Os atuais métodos de diagnóstico apresentam problemas, como: baixa sensibilidade da baciloscopia; longo tempo de realização das culturas microbiológicas; e baixa especificidade do teste cutâneo com o derivado protéico purificado do M. tuberculosis. Novos métodos de diagnóstico que utilizam antígenos específicos (por exemplo, os conhecidos em inglês como o early secreted antigenic target 6-kDa e o culture filtrate protein 10-kDa), estão sendo testados. Os genes que codificam esses antígenos estão localizados na região de diferença 1 do M. tuberculosis, M. africanum e M. bovis, mas estão ausentes no M. bovis (BCG) e na maioria das micobactérias do meio ambiente. Métodos de diagnóstico baseados na produção de interferon-gama por linfócitos T, em resposta a esses antígenos, como o QuantiFERON-TB® e o T SPOT.TB®, estão sendo testados, e superam o teste cutâneo com o derivado protéico purificado nas seguintes características: maior sensibilidade; menor reatividade cruzada devido à vacinação com o BCG ou infecção por micobactérias do meio ambiente; e tempo de execução. A introdução de métodos de diagnóstico mais específicos e sensíveis, assim como um maior entendimento dos mecanismos moleculares e celulares que regulam a interação parasito-hospedeiro, pode contribuir para um eficiente combate à tuberculose.

Thalidomide Analogs from Diamines: Synthesis and Evaluation as Inhibitors of TNF-.ALPHA. Production

Fourteen thalidomide analogs bearing two phthalimido units were prepared in high yields (83-94%) by condensation of different diamines with phthalic or 3-nitrophthalic anhydride. An in vitro investigation of the compounds as inhibitors of the TNF-alpha production was performed. The inhibition was higher for compounds bearing amino and nitro groups and was modulated by increasing the size of the spacers between the phthalimide groups.

Immunomodulatory activity of Mollugo verticillata L

This article describes the evaluation of immunomodulatory activity of Mollugo verticillata L. (Molluginaceae), a weed plant common in warm and/or wet regions of the American continent. Nitric oxide (NO) release was evaluated in mice peritoneal cell cultures treated in vivo using the ethanolic extract of M. verticillata with and without BCG. The plant extract showed immunostimulatory activity when peritoneal cells were stimulated in vitro with BCG antigen only. However, mice peritoneal cells treated with M. verticillata plus BCG showed a drastic reduction in NO production when they received the additional stimulus in vitro with BCG. Ethanolic extracts of M. verticillata could directly increase NO release by peritoneal cells, but suppress the immune response of these cells when treated with BCG antigen and Mycobacterium tuberculosis whole antigen (TB). Preliminary phytochemical tests allowed the detection of quercetin and triterpenoid glycosides in the ethanolic extract of M. verticillata, and those compounds are probably responsible for the effect of this plant material on the immune system.

Chronic Chagas' disease cardiomyopathy patients display an increased IFN-gamma response to Trypanosoma cruzi infection

One-third of all Trypanosoma cruzi -infected patients eventually develop chronic Chagas' disease cardiomyopathy (CCC), a particularly lethal inflammatory dilated cardiomyopathy, where parasites are scarce and heart-infiltrating mononuclear cells seem to be the effectors of tissue damage. Since T. cruzi is a major inducer of interleukin-12 production, the role of inflammatory cytokines in the pathogenesis of CCC was investigated. We assayed cytokine production by peripheral blood mononuclear cells (PBMC) from CCC and asymptomatic T. cruzi -infected (ASY) individuals, as well as by T cell lines from endomyocardial biopsies from CCC patients. PBMC from CCC and ASY patients produced higher IFN-gamma levels than normal (N) individuals in response to B13 protein and phytohaemagglutinin PHA; IFN-gamma high responders (> or =1 ng/ml) were 2-3 fold more frequent among CCC patients than ASY individuals. Conversely, IL-4 production in response to the same stimuli was suppressed among T. cruzi -infected patients. The frequency of PHA-induced IFN gammaproducing cells on PBMC was significantly higher among CCC than ASY and N individuals. IFN-gamma and TNF-alpha were produced by ten out of ten PHAstimulated T cell lines from CCC patients; IL-2 and IL-10 were produced by four out of ten and one out of ten lines, respectively; IL-4, IL-1alpha, IL-1beta, IL-6 and IL-12 were undetectable. Our results suggest that CCC and ASY patients may respond differentially to the IFN-gamma-inducing stimulus provided by T. cruzi infection. Given the T(1)-type cytokine profile of heart-infiltrating T cell lines from CCC patients, the ability to mount a vigorous IFN-gamma response may play a role on the differential susceptibility to CCC development.

Biogenic amines occurrence in wine. Amino acid decarboxylase and proteolytic activities expression by Oenococcus oeni

This work deals with the study of the proteolytic and amino acid decarboxylase activities of selected Oenococcus oeni isolates and the effect of yeast autolysis on biogenic amines production in wine. A total of 220 isolates of O. oeni were tested for decarboxylase and proteolytic activity. Only six isolates showed both activities, but only after a period of adaptation in a growth medium containing wine. The results reported on this paper show that proteolytic activity was dependent on medium composition and bacterial growth phase. It can be assumed that the ability of O. oeni to use wine peptides and to produce biogenic amines is not a constant characteristic of this species, and enzymatic system expression appears to be closely dependent on nutritional and energetical composition of the medium. It also seems to be strain dependent and not widespread among this bacterial community.

The impact of multidrug therapy on the epidemiological pattern of leprosy in Juiz de Fora, Brazil

We investigated the impact of multidrug therapy (MDT) on the epidemiological pattern of leprosy in Juiz de Fora, Brazil, from 1978 to 1995. Evaluation of 1,283 medical charts was performed according to the treatment regimen used in two different periods. Following the introduction of MDT in 1987, prevalence of leprosy decreased from 22 patients/10,000 inhabitants to 5.2 patients/10,000 inhabitants in 1995. Incidence rate of leprosy was lower in period II (1987-1995) than in period I (1978-1986). Decreasing prevalence and incidence appear to be related to drug efficacy rather than decreased case identification, since both self-referred and professionally referred treatment increased markedly from period I to period II. For both periods, multibacillary leprosy was the most frequent clinical form of the disease (+/-68%), and the main infection risk factor identified was household contact. Leprosy is predominantly manifested in adults, but an increase in the number of very old and very young patients was observed in period II. The MDT program has been effective both in combating leprosy and in promoting awareness of the disease.

Effect of the injection of an extract of Ascaris suum on macrophage activation during the early phase of Mycobacterium bovis BCG infection in C57Bl/6 mice

Injection of an Ascaris suum extract (Asc) affects both the humoral and cellular immune responses to unrelated antigens when it is co-administered with these antigens. In the present study we evaluated the effect of Asc on macrophage activation in the early phase of Mycobacterium bovis BCG (Pasteur strain TMCC 1173) infection in C57Bl/6 mice. C57Bl/6 mice were injected intraperitoneally (ip) with 0.1 mg BCG (BCG group) or BCG plus 1 mg Asc (BCG + Asc group). The peritoneal exudates were obtained at 2, 7 and 14 days after infection. The numbers of IFN-gamma-secreting cells were assessed by the ELISPOT assay. Nitric oxide (NO) production was measured by the Griess method and by the evaluation of NADPH diaphorase activity in the peritoneal exudates. The administration of Asc extract increased NADPH diaphorase activity (2 days: control = 0, BCG = 7%, BCG + Asc = 13%, and Asc = 4%; 7 days: control = 4, BCG = 13%, BCG + Asc = 21%, and Asc = 4.5%) and TNF-alpha levels (mean +/- SD; 2 days: control = 0, BCG = 169 +/- 13, BCG + Asc = 202 +/- 37, and Asc = 0; 7 days: control = 0, BCG = 545 +/- 15.5, BCG + Asc = 2206 +/- 160.6, and Asc = 126 +/- 26; 14 days: control = 10 +/- 1.45, BCG = 9 +/- 1.15, BCG + Asc = 126 +/- 18, and Asc = 880 +/- 47.67 pg/ml) in the early phase of BCG infection. Low levels of NO production were detected at 2 and 7 days after BCG infection, increasing at 14 days (mean +/- SD; 2 days: control = 0, BCG = 3.7 +/- 1.59, BCG + Asc = 0.82 +/- 0.005, Asc = 0.48 +/- 0.33; 7 days: control = 0, BCG = 2.78 +/- 1.54, BCG + Asc = 3.07 +/- 1.05, Asc = 0; 14 days: control = 0, BCG = 9.05 +/- 0.53, BCG + Asc = 9.61 +/- 0.81, Asc = 10.5 +/- 0.2 (2 x 10(6)) cells/ml). Furthermore, we also observed that Asc co-injection induced a decrease of BCG-colony-forming units (CFU) in the spleens of BCG-infected mice during the first week of infection (mean +/- SD; 2 days: BCG = 1.13 +/- 0.07 and BCG + Asc = 0.798 +/- 0.305; 7 days: BCG = 1.375 +/- 0. 194 and BCG + Asc = 0.548 +/- 0.0226; 14 days: BCG = 0.473 +/- 0.184 and BCG + Asc = 0.675 +/- 0.065 (x 10(2)) CFU). The present data suggest that Asc induces the enhancement of the immune response in the early phase of BCG infection.

Frequencies of IFN gamma- and IL-4-producing cells during Mycobacterium bovis BCG infection in two genetically susceptible mouse strains: role of alpha/beta T cells and NK1.1 cells

Frequencies of IFN gamma- and IL-4-producing spleen cells in response to Mycobacterium bovis BCG infection were determined in C57BL/6 and BALB/c mice. Both mouse strains express equal innate susceptibility to M. bovis BCG (Bcgs), but differ in their NK1.1 and T-cell activities. M. bovis BCG infection induced higher frequencies (f approximately 1/500) of antigen-induced IFN gamma-secreting spleen cells in C57BL/6 mice as compared to BALB/c mice (f approximately 1/8000). Concanavalin A stimulated almost equal numbers of IFN gamma-secreting cells in both mouse strains (f approximately 1/50). Treatment with anti-NK1.1 mAb of M. bovis BCG-infected C57BL/6 mice did not alter frequencies of IFN gamma-secreting cells. Equally low numbers of antigen-induced IL-4-producing cells (f approximately 1/3000) were determined in both C57BL/6 and BALB/c mice during M. bovis BCG infection and treatment of C57BL/6 mice with anti-NK1.1 mAb had no measurable effect on IL-4 producers. Finally, frequencies of IFN gamma-producing cells were markedly reduced (10-fold) in M. bovis BCG-infected TCR-beta-/- gene deletion mutants as compared to their heterozygous controls. Our findings verify that M. bovis BCG infection primarily induces IFN gamma-secreting alpha/beta T cells of TH1 type and show that the frequencies of these IFN gamma producers differ in the two Bcgs mouse strains C57BL/6 and BALB/c.

Human alpha beta and gamma delta T cells from unexposed individuals respond to protein antigens of the yeast form of Paracoccidioides brasiliensis

Paracoccidioides brasiliensis, a dimorphic fungus, causes chronic granulomatous mycosis in susceptible individuals. Different reports have shown that cell-mediated immunity is essential for protection against systemic mycosis, including paracoccidioidomycosis. We analyzed the reactivity of alpha beta and gamma delta T cells from unexposed Caucasian donors to P. brasiliensis yeast form components. Our results indicate: (i) alpha beta and gamma delta T cells proliferate after in vitro stimulation with lysates of P. brasiliensis; (ii) similar numbers of alpha beta T cells (f = 1/21,000) and of gamma delta T cells (f = 1/8000) respond to P. brasiliensis; (iii) P. brasiliensis-reactive gamma delta T cells express the V gamma 9V delta 2 TCR; (iv) the stimulatory activity of P. brasiliensis for both alpha beta and gamma delta T cells primarily resides in a high molecular weight (100 kDa) and in a low molecular weight (< 1 kDa) fraction; (v) the ligands responsible for stimulation of both alpha beta and gamma delta T cells are sensitive to proteinase treatment. We conclude that both alpha beta and gamma delta T cells from healthy individuals respond to ubiquitous protein antigens of P. brasiliensis.

Role of NK1.1+ cells in experimental listeriosis. NK1+ cells are early IFN-gamma producers but impair resistance to Listeria monocytogenes infection

An enzyme-linked immunospot assay was used for detection of splenic IFN-gamma and IL-4 spot-forming cells from, C57Bl/6 and BALB/c mice, which differ in resistance to systemic L. monocytogenes infection. Numbers of spontaneous and Ag (heat-killed listeriae)-induced IFN-gamma SFC were 5- to 10-fold higher in C57Bl/6 as compared to BALB/c mice at day 1, day 7, and day 14 postinfection. In both strains of mice, Ag-induced IFN-gamma production reached maximum levels at day 7 postinfection and IL-4 production was slightly increased at day 1, decreasing thereafter. The early IFN-gamma production (day 1) in C57Bl/6 mice was abrogated by in vitro and in vivo depletion of NK1+ cells with PK136 mAbs, indicating that NK1+ cells are major IFN-gamma producers at day 1 after infection. In vivo depletion of NK1+ cells markedly increased numbers of IL-4 spot-forming cells in spleens of C57Bl/6 mice, suggesting a modulatory effect of NK1+ cells and IFN-gamma on IL-4 production. At day 5 postinfection, bacterial numbers in spleens were higher in C57Bl/6 than in BALB/c mice. Treatment with the anti-NK1.1 mAb and in vivo neutralization of IL-4 with the 11B11 mAb enhanced listerial clearing in C57Bl/6 mice. These findings suggest 1) BALB/c mice are more resistant than C57Bl/6 mice to L. monocytogenes EGD infection, 2) NK1+ cells and IL-4 play a detrimental role in L. monocytogenes infection, and 3) antilisterial resistance and levels of IFN-gamma are dissociable.

Role of NK1.1+ cells in experimental listeriosis. NK1+ cells are early IFN-gamma producers but impair resistance to Listeria monocytogenes infection

An enzyme-linked immunospot assay was used for detection of splenic IFN-gamma and IL-4 spot-forming cells from, C57Bl/6 and BALB/c mice, which differ in resistance to systemic L. monocytogenes infection. Numbers of spontaneous and Ag (heat-killed listeriae)-induced IFN-gamma SFC were 5- to 10-fold higher in C57Bl/6 as compared to BALB/c mice at day 1, day 7, and day 14 postinfection. In both strains of mice, Ag-induced IFN-gamma production reached maximum levels at day 7 postinfection and IL-4 production was slightly increased at day 1, decreasing thereafter. The early IFN-gamma production (day 1) in C57Bl/6 mice was abrogated by in vitro and in vivo depletion of NK1+ cells with PK136 mAbs, indicating that NK1+ cells are major IFN-gamma producers at day 1 after infection. In vivo depletion of NK1+ cells markedly increased numbers of IL-4 spot-forming cells in spleens of C57Bl/6 mice, suggesting a modulatory effect of NK1+ cells and IFN-gamma on IL-4 production. At day 5 postinfection, bacterial numbers in spleens were higher in C57Bl/6 than in BALB/c mice. Treatment with the anti-NK1.1 mAb and in vivo neutralization of IL-4 with the 11B11 mAb enhanced listerial clearing in C57Bl/6 mice. These findings suggest 1) BALB/c mice are more resistant than C57Bl/6 mice to L. monocytogenes EGD infection, 2) NK1+ cells and IL-4 play a detrimental role in L. monocytogenes infection, and 3) antilisterial resistance and levels of IFN-gamma are dissociable.

Listeria monocytogenes-induced gamma interferon secretion by intestinal intraepithelial gamma/delta T lymphocytes

gamma/delta T cells represent a major proportion of intestinal intraepithelial lymphocytes (IEL), and it has been suggested that these IEL serve as a first immune barrier against microbial invasion and that they do so by destroying infected epithelial cells. In the present study, we confirm that both alpha/beta and gamma/delta IEL from naive mice express potent cytotoxicity and produce gamma interferon (IFN-gamma) after T-cell receptor (TCR) engagement by specific monoclonal antibodies (MAb). Intraperitoneal administration of the anti-gamma/delta TCR MAb GL3 caused downregulation of the gamma/delta TCR in IEL, and IEL from gamma/delta TCR-modulated mice failed to express cytotoxic activity and to secrete IFN-gamma after gamma/delta TCR engagement. In contrast, alpha/beta IEL from such mice were still cytolytic and secreted IFN-gamma. Mice were infected orally with virulent Listeria monocytogenes at doses which caused bacterial invasion through the intestinal epithelia. Although alpha/beta and gamma/delta IEL from these mice expressed high cytolytic activities in antibody-redirected killer assays, target cells pulsed with listerial antigens were not lysed. In contrast, IFN-gamma secretion by IEL from L. monocytogenes-infected mice was induced not only by anti-TCR MAb but also by target cells pulsed with listerial antigens, whereas irrelevant antigens, including heat shock protein 60, did not induce IFN-gamma secretion. Furthermore, the number of IFN-gamma-secreting IEL, as assessed by the enzyme-linked immunospot technique, was increased during listeriosis. gamma/delta TCR modulation by GL3 administration abrogated antigen-induced IFN-gamma secretion by IEL from infected mice. These findings suggest that L. monocytogenes induced IFN-gamma secretion by gamma/delta IEL from mice suffering from intestinal L. monocytogenes infection and invasion. Thus, the data provide evidence for a role of IFN-gamma-secreting IEL in local resistance against listeriosis and perhaps other food-borne diseases.