Leishmania amazonensis causes different diseases depending on the host and parasitic virulence factors. In this study, CBA mice were infected with L. amazonensis isolates from patients with localized (Ba125), diffuse cutaneous (Ba276) or visceral leishmaniasis (Ba109). Mice infected with Ba125 and Ba276 progressed rapidly and lesions displayed an infiltrate rich in parasitized macrophages and were necrotic and ulcerated. Ba109 induced smaller lesions and a mixed inflammatory infiltrate without necrosis or ulceration. Ba109 induced an insidious disease with lower parasite load in CBA mice, similar to human disease. Levels of IFN-γ, IL-4 and IL-10 did not differ among the groups. Because all groups were unable to control the infection, expression of IL-4 associated with low production of IFN-γ in the early phase of infection may account for susceptibility, but others factors may contribute to the differences observed in inflammatory responses and infection progression. Evaluation of some parasitic virulence factors revealed that Ba276 exhibits higher ecto-ADPase and 5'-nucleotidase activities compared to the Ba109 and Ba125 strains. Both Ba276 and Ba125 had higher arginase activity in comparison to Ba109. Finally, these data suggest that the differences in enzyme activities among parasites can account for differences in host inflammatory responses and infection progression
CBA/J mice are resistant to Leishmania major and susceptible to Leishmania amazonensis. Early events determine infection outcome. Until now, PIV (in vitro priming) immune response to L. amazonensis has not been assessed. Herein, we have shown that compared to L. major, L. amazonensis induced higher parasite burden associated to similar IL-4, IFN-gamma, and TNF-alpha mRNA expressions and IFN-gamma and IL-10 levels. Although similar amounts of IL-10 were detected, the frequency of intracellular IL-10 positive B cells was enhanced in spleen cells stimulated with anti-CD3/anti-CD28, or anti-CD3/anti-CD28 and L. amazonensis, compared to L. major-stimulation. Interestingly, IL-10- producing B cells were reduced in response to anti-CD3/anti-CD28 stimulation combined with L. major compared to the other groups. L. amazonensis may favor T regulatory cell development, since 40% of all the CD4+CD25+ were CD25(high) cells. These data suggest that in PIV, susceptibility to L. amazonensis is not related to Th cell polarization, but to the presence and activity of regulatory T and B cells.
Apesar do maior reconhecimento da importância das relações entre saúde, religião e espiritualidade no cuidado em saúde, as universidades brasileiras ainda não fornecem treinamento adequado nesse âmbito. O objetivo desse artigo é compreender como docentes de uma universidade pública brasileira percebem as relações entre saúde, religião, espiritualidade e seu ensino. 10 professores foram submetidos à entrevista semiestruturada e os dados foram analisados por meio da análise de conteúdo. Apreenderam-se três núcleos temáticos e, a partir destes, emergiram cinco categorias: Religião e Espiritualidade: Conceitos superpostos?; Bom ou ruim para a saúde?; Dimensão excluída da prática clínica; Ensino: Seria bom, mas não agora; Questionamentos e barreiras à inclusão no ensino. Os resultados demonstraram que os participantes superpunham os conceitos de religião e espiritualidade, reconheceram seus impactos positivos sobre a saúde, entretanto, enfatizaram seus aspectos problemáticos. O ensino de saúde, religião e espiritualidade não foi considerado prioritário e as crenças do corpo docente parecem influenciar nesta posição. Diante da quantidade e qualidade das evidências científicas sobre o impacto positivo da religião/espiritualidade na saúde, a inserção desse tópico na formação dos profissionais de saúde não deve depender apenas das percepções e/ou preferências do corpo docente universitário.
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