Yellow fever (YF) may cause lesions in different organs. There are no studies regarding the in situ immune response in the human lung and investigating immunopathological aspects in fatal cases can help to better understand the evolution of the infection. Lung tissue samples were collected from 10 fatal cases of human yellow fever and three flavivirus-negative controls who died of other causes and whose lung parenchymal architecture was preserved. In YFV-positive fatal cases, the main histopathological changes included the massive presence of diffuse alveolar inflammatory infiltrate, in addition to congestion and severe hemorrhage. The immunohistochemical analysis of tissues in the lung parenchyma showed significantly higher expression of E-selectin, P-selectin, ICAM-1, VCAM-1 in addition to cytokines such as IL-4, IL-10, IL-13, TNF- α, IFN-γ and TGF-β compared to the negative control. The increase in immunoglobulins ICAM-1 and VCAM-1 results in strengthening of tissue transmigration signaling. E-selectin and P-selectin actively participate in this process of cell migration and formation of the inflammatory infiltrate. IFN-γ and TNF-α participate in the process of cell injury and viral clearance. The cytokines IL-4 and TGF-β, acting in synergism, participate in the process of tissue regeneration and breakdown. The anti-inflammatory cytokines IL-4, IL-10 and IL-13 also act in the reduction of inflammation and tissue repair. Our study indicates that the activation of the endothelium aggravates the inflammatory response by inducing the expression of adhesion molecules and cytokines that contribute to the rolling, recruitment, migration and eliciting of the inflammatory process in the lung parenchyma, contributing to the fatal outcome of the disease.
Chagas disease (CD) is caused by the protozoan Trypanosoma cruzi, whose transmission involves triatomine insects. However, in the Brazilian Amazon there is a predominance of oral transmission through the ingestion of food contaminated with Trypanosoma cruzi. Brazil is one of the largest endemic centers of Chagas Disease in Latin America, and this disease is associated with human actions. An ecological, crosssectional and retrospective study was designed. The number of diagnosed cases of Chagas Disease in the states of the Brazilian Amazon from 2009 to 2019 were analyzed. The North Region had 2,832 cases of CD in the period in question, corresponding to 94.3% of the total cases in the country. Pará was the state with the highest number of cases (2,251), followed by Amapá (161) and Amazonas (138). Oral transmission was the main means of transmission (76.2%), followed by vectorial (8.43%) and vertical (0.39%). In this scenario, the consumption of açaí was the factor associated with the highest number of cases in the region, since the pulp of this food can be contaminated by waste from reservoir animals or vectors. Thus, the handling of açaí must be carried out properly to prevent this public health problem. Still, it is necessary to carry out further studies in the affected regions, evaluating such preventive measures.
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