An early immune response to Zika virus (ZIKV) infection may determine its clinical manifestation and outcome, including neurological effects. However, low-grade and transient viremia limits the prompt diagnosis of acute ZIKV infection. We have investigated the plasma cytokine, chemokine, and growth factor profiles of 36 individuals from an endemic area displaying different symptoms such as exanthema, headache, myalgia, arthralgia, fever, hyperemia, swelling, itching, and nausea during early-phase infection. These profiles were then associated with symptoms, revealing important aspects of the immunopathophysiology of ZIKV infection. The levels of some cytokines/chemokines were significantly higher in acute ZIKV-infected individuals compared to healthy donors, including interferon (IFN) gamma-induced protein 10 (IP-10), regulated on activation, normal T cell expressed and secreted (RANTES), IFN-γ, interleukin (IL)-9, IL-7, IL-5, and IL-1ra, including some with predominantly immunoregulatory activity. Of note, we found that higher levels of IP-10 and IL-5 in ZIKV-infected individuals were strongly associated with exanthema and headache, respectively. Also, higher levels of IL-1ra were associated with subjects with arthralgia, whereas those with fever showed lower levels of granulocyte-colony stimulating factor (G-CSF). No correlation was observed between the number of symptoms and ZIKV viral load. Interestingly, only IP-10 showed significantly decreased levels in the recovery phase. In conclusion, our results indicate that acute ZIKV infection in a larger cohort resident to an endemic area displays a modest systemic immune activation profile, involving both proinflammatory and immunoregulatory cytokines and chemokines that could participate of virus control. In addition, we showed that differential cytokine/chemokine levels are related to specific clinical symptoms, suggesting their participation in underlying mechanisms.
This study aimed to estimate the prevalence of infection by the hepatitis B virus (HBV) and hepatitis C virus (HCV) in people infected by the human immunodeficiency virus (HIV) and analyze sociodemographic and behavioral factors associated with such co-infection. A cross-section study was performed in 495 individuals treated at a public center in the city of Goiânia. Participants were interviewed and blood collected for evaluation of serological and molecular markers for HBV and HCV. The rate of exposure to HBV was 33.5% (95% CI 29.4-37.9). Nineteen patients (3.8%) were diagnosed as HBV carriers, of whom 68.4% were HBV DNA positive. The prevalence of anti-HCV was 9.7% (95% CI 7.3-12.7). Genotype 1a was identified in 72.7% of the PCR samples positive for HCV. Co-infection by all three viruses was 4.4% (95% CI 2.9-6.8). Being, male, aged ≥40 years, history of sexually transmitted disease (STD), and having homosexual practices were independently associated with the presence of markers of HBV exposure. A history of injectable drugs use and STDs showed association with HCV seropositivity. Approximately 50% of participants were not aware of their HBV and HCV serostatus. The results obtained may contribute to assess the burden of viral hepatitis in people living with HIV and to guiding preventive measures for more vulnerable groups.
A análise da presença de auto-anticorpos feita por imunofluorescência indireta em células HEp-2 constitui-se em um método de triagem escolhido na maioria dos laboratórios clínicos. A ausência de uma nomenclatura definida para a descrição dos laudos tem trazido problemas na utilização clínica do teste, pelas dificuldades no controle de qualidade e na padronização dos resultados, que, por sua vez, embora similares, recebiam denominações diferentes. O I Consenso Brasileiro para Padronização dos Laudos de FAN HEp-2 reuniu em agosto de 2000, em Goiânia, diversos especialistas de todo o Brasil. Esses emitiram pareceres em consenso para os distintos padrões: nucleares, nucleolares, citoplasmáticos e aparelho mitótico. Foram feitas recomendações sobre os critérios para a leitura de uma lâmina, bem como para relação entre a diluição de triagem e o sistema óptico utilizado.
Zika virus (ZIKV) is an arbovirus from the Flaviviridae family and Flavivirus genus. Neurological events have been associated with ZIKV-infected individuals, such as Guillain-Barré syndrome, an autoimmune acute neuropathy that causes nerve demyelination and can induce paralysis. With the increase of ZIKV infection incidence in 2015, malformation and microcephaly cases in newborns have grown considerably, which suggested congenital transmission. Therefore, the development of an effective vaccine against ZIKV became an urgent need. Live attenuated vaccines present some theoretical risks for administration in pregnant women. Thus, we developed an in silico multiepitope vaccine against ZIKV. All structural and non-structural proteins were investigated using immunoinformatics tools designed for the prediction of CD4 + and CD8 + T cell epitopes. We selected 13 CD8 + and 12 CD4 + T cell epitopes considering parameters such as binding affinity to HLA class I and II molecules, promiscuity based on the number of different HLA alleles that bind to the epitopes, and immunogenicity. ZIKV Envelope protein domain III (EDIII) was added to the vaccine construct, creating a hybrid protein domain-multiepitope vaccine. Three high scoring continuous and two discontinuous B cell epitopes were found in EDIII. Aiming to increase the candidate vaccine antigenicity even further, we tested secondary and tertiary structures and physicochemical parameters of the vaccine conjugated to four different protein adjuvants: flagellin, 50S ribosomal protein L7/L12, heparin-binding hemagglutinin, or RS09 synthetic peptide. The addition of the flagellin adjuvant increased the vaccine's predicted antigenicity. In silico predictions revealed that the protein is a probable antigen, non-allergenic and predicted to be stable. The vaccine’s average population coverage is estimated to be 87.86%, which indicates it can be administered worldwide. Peripheral Blood Mononuclear Cells (PBMC) of individuals with previous ZIKV infection were tested for cytokine production in response to the pool of CD4 and CD8 ZIKV peptide selected. CD4 + and CD8 + T cells showed significant production of IFN-γ upon stimulation and IL-2 production was also detected by CD8 + T cells, which indicated the potential of our peptides to be recognized by specific T cells and induce immune response. In conclusion, we developed an in silico universal vaccine predicted to induce broad and high-coverage cellular and humoral immune responses against ZIKV, which can be a good candidate for posterior in vivo validation.
INTRODUCTION: In this study, we report a clonal dissemination of carbapenem resistant Acinetobacter baumannii isolates due to the acquisition of bla OXA-23 in a regional hospital located in Brazilian Amazon Region. METHODS: The isolates were identified by MALDI-TOF and the carbapenemase-encoding genes were detected by multiplex-PCR. The genetic similarity was investigated by pulsed-field gel electrophoresis (PFGE). RESULTS: Only 10 (55.6%) isolates harbored the gene bla OXA-23 . PFGE analysis revealed that these isolates belong to a single clone. CONCLUSIONS: This dissemination strategy indicates the need for surveillance, adoption of control procedures defined in guidelines, and the careful administration of antimicrobials should be reinforced.
RESUMOObjetivo: analisar os aspectos clínicos e epidemiológicos da hanseníase. Método: trata-se de um estudo quantitativo, descritivo, transversal, envolvendo 35.853 casos de hanseníase, no período de 2005 a 2015. Informa-se que a análise dos dados adveio do Sistema de Informação de Agravos de Notificação, e os resultados foram apresentados em forma de tabela e figura. Resultados: registraram-se 35.853 casos de hanseníase, sendo a maioria do sexo masculino na faixa etária entre 40-59 anos, de cor parda, com nível fundamental incompleto e residente em zona urbana. Revela-se que a forma clínica dimorfa, multibacilar e o grau zero de incapacidade física foram os mais incidentes, e o modo de entrada mais frequente foi o de casos novos; a cura foi a principal forma de saída, a baciloscopia não foi realizada na maioria dos casos e o esquema terapêutico inicial foi a poliquimioterapia para multibacilares. Conclusão: conclui-se que a hanseníase é endêmica e ainda constitui um problema de saúde pública, e é fundamental que sejam desenvolvidas atividades educativas de forma permanente, sobretudo para a população vulnerável. Deve-se fundamentar esta ação na compreensão da representação social que esses grupos populacionais têm acerca da hanseníase. Descritores: Doenças Negligenciadas; Mycobacterium leprae; Hanseníase; Saúde Pública; Epidemiologia; Infecção.ABSTRACT Objective: to analyze the clinical and epidemiological aspects of leprosy. Method: this is a quantitative study, descriptive, cross-sectional, involving 35,853 cases of leprosy in the period from 2005 to 2015. Informs you that the analysis of the data came from the Information System of Reportable Diseases, and the results were presented in the form of table and figure. Results: it was registered 35,853 cases of leprosy, the majority being male aged between 40-59 years old, brown color, with incomplete primary education and residing in the urban area. It turns out that the dimorphic clinical form, multibacillary leprosy and the zero degree of physical disability were the most incidents, and the mode of entry more frequent was the new cases; the cure was the main form of output, the sputum smear microscopy was not performed in the majority of cases and the initial therapeutic regimen was the polychemotherapy for multibacillary patients. Conclusion: it is concluded that leprosy is endemic and still constitutes a public health problem, and it is essential to be developed educational activities on a permanent basis, especially for the vulnerable population. You must substantiate this action in the understanding of the social representation that these population groups have about leprosy. Descriptors: Neglected Diseases; Mycobacterium leprae; Leprosy; Public Health; Epidemiology; Infection.RESUMEN Objetivo: analizar los aspectos clínicos y epidemiológicos de la lepra. Método: se trata de un estudio cuantitativo, descriptivo y transversal que envuelven 35,853 casos de lepra en el período de 2005 a 2015. Le informa de que el análisis de los datos proviene del Sistema de Información de Agravios de Notificación, y los resultados se presentaron en forma de tablas y figuras. Resultados: se registraron 35,853 casos de lepra, la mayoría son varones con edades comprendidas entre 40-59 años, de color marrón, con primaria incompleta y que residen en el área urbana. Resulta que la forma clínica dimorfa, lepra multibacilar y el grado cero de la discapacidad física fueron la mayoría de los incidentes, y el modo de entrada más frecuente fue el de casos nuevos; la curación fue la principal forma de producción, la baciloscopía no se llevó a cabo en la mayoría de los casos y la pauta terapéutica inicial fue la poliquimioterapia para pacientes multibacilares. Conclusión: se concluye que la lepra es endémica y aún constituye un problema de salud pública y es esencial que se desarrollen actividades educativas sobre una base permanente, especialmente para la población más vulnerable. Debe justificar esta acción en la comprensión de la representación social que estos grupos de población tienen acerca de la lepra. Descriptores: Enfermedades Olvidadas; Mycobacterium leprae; lepra; Salud Pública; Epidemiología; Infección.
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