FUNDAMENTOS: Métodos moleculares têm-se mostrados mais eficazes para o diagnóstico da LTA. OBJETIVOS: Comparar os resultados da intradermorreação de Montenegro (IRM), presença de leishmania em biópsia (Bc), reação de imunofluorescência indireta (Rifi), seqüenciamento de DNA e PCR-RFLP (-restriction fragment lenght polymorphism) para o diagnóstico da LTA. MÉTODOS: Foram estudados 152 pacientes com LTA. Para a PCR em Bc, utilizaram-se primers específicos para seqüência de 120bp do kDNA do minicírculo comum a todas as espécies de leishmanias. O produto da PCR, utilizado para seqüenciamento e para restrição enzimática com Hae III, foi comparado às culturas L. (L.) amazonensis e L. (V.) braziliensis. RESULTADOS: Houve predomínio do sexo masculino (75%), da cor branca (80%) e da profissão urbana (48%). A idade variou de três a 77 anos, com 56,5% entre 21 e 50 anos. 65,8% eram do Estado de São Paulo, prevalecendo a forma cutânea (79,6%). A IRM foi positiva em 73,4%, e a Rifi em 59,7%, enquanto a Bc evidenciou presença de leishmania em 30,6%. A PCR foi positiva em 81,6%, e a PCR-RFLP identificou L. (V.) braziliensis como espécie predominante (66%), o que também ocorreu com o seqüenciamento. Comparando PCR-RFLP e seqüenciamento, houve 61% de concordância entre os resultados, mostrando significância da PCR-RFLP para L. (V.) braziliensis. CONCLUSÕES: A IRM e a PCR foram estatisticamente equivalentes como métodos subsidiários para o diagnóstico da LTA, a PCR-RFLP e o seqüenciamento também o foram na identificação das espécies de leishmania, o primeiro apresentando menores custo e tempo de execução comparado ao seqüenciamento de DNA.
SUMMARYConcomitant skin lesions in visceral leishmaniasis (VL) or kala-azar are rare, being more common the description of postkala-azar dermal leishmaniasis occurring post treatment of kala-azar. Skin lesions caused by Leishmania donovani are frequently seen in the aids-VL co-infection. In Brazil cutaneous or mucosal forms of tegumentary leishmaniasis concomitant with aids are more commonly registered. Here we present a case of aids-VL co-infection, with unusual cutaneous and digestive compromising attributed to L. (L.) chagasi, with special attention to ecthymatous aspect of the lesion, allied to the absence of parasite on the histological skin biopsy.
Myosin-Va has been implicated in melanosome translocation, but the exact molecular mechanisms underlying this function are not known. In the dilute, S91 melanoma cells, melanosomes move to the cell periphery but do not accumulate in the tips of dendrites as occurs in wild-type B16 melanocytes; rather, they return and accumulate primarily at the pericentrosomal region in a microtubule-dependent manner. Expression of the full-length neuronal isoform of myosin-Va in S91 cells causes melanosomes to disperse, occupying a cellular area approximately twice that observed in non-transfected cells, suggesting a partial rescue of the dilute phenotype. Overexpression of the full tail domain in S91 cells is not sufficient to induce melanosome dispersion, rather it causes melanosomal clumping. Overexpression of the head and head-neck domains of myosin-Va in B16 cells does not alter the melanosome distribution. However, overexpression of the full tail domain in these cells induces melanosome aggregation and the appearance of tail-associated, aggregated particles or vesicular structures that exhibit variable degrees of staining for melanosomal and Golgi beta-COP markers, as well as colocalization with the endogenous myosin-Va. Altogether, the present data suggest that myosin-Va plays a role in regulating the direction of microtubule-dependent melanosome translocation, in addition to promoting the capture of melanosomes at the cell periphery as suggested by previous studies. These studies also reinforce the notion that myosin-V has a broader function in melanocytes by acting on vesicular targeting or intracellular protein trafficking.
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