Background
Almost 1000 cases of American cutaneous leishmaniasis have been registered yearly in Rondônia State, Brazil. Little is known about the
Leishmania
transmission cycle (vectors and reservoirs) in the state. This study aimed to evaluate sand fly fauna from two vertical stratification layers in order to identify potential vectors and their blood-meal sources.
Methods
The study was conducted in Jamari National Forest. Sand flies were collected in the canopy (15 m) and at ground level (1 m) using HP light traps during four months, February, April, August and October, 2018. Insects were identified to the species level, and females were subjected to DNA extraction and PCR targeting minicircle
k
DNA and
hsp
70 (for
Leishmania
detection and species identification), and
cytb
(to identify blood-meal sources). Exploratory data analysis was used to determine mean of abundance and species richness between stratifications. The
hsp
70 and
cytb
sequences were analyzed and compared with sequences from GenBank.
Results
Overall, 68 species were identified from 15,457 individuals. On the Potosi trail, 7531 individuals of 49 species were collected; canopy captures totaled 6463 individuals of 46 species, while ground captures totaled 1068 individuals of 38 species. On the Santa Maria trail, 7926 individuals of 61 species were collected; canopy captures totaled 6136 individuals of 51 species, while ground captures totaled 1790 individuals of 53 species. A total of 23 pools were positive for
k
DNA (canopy
n
= 21, ground
n
= 2). Only two samples were sequenced for
hsp
70 (both in canopy); one sequence exhibited similarity with
Leishmania braziliensis
(
Lutzomyia davisi
pool) and another with
L. naiffi
(
Lu. antunesi
pool). The
cytb
fragment was amplified in 11 of 86 samples. Sample sequencing identified
cytb
DNA from 5 blood-meal sources:
Micrastur gilvicollis
,
Psophia viridis
,
Tamandua tetradactyla
,
Homo sapiens
and
Choloepus didactylus
.
Conclusions
Sand fly fauna is more diverse in the canopy than at ground level. Factors such as blood-meal sources, resting sites, and abiotic components probably contribute to high abundance in the canopy. Our results reinforce the possibility that
Lu. antunesi
and
Lu
.
davisi
participate in
Leishmania
...
Human T-lymphotropic virus 1 (HTLV-1) was the first recognized human retrovirus. Infection can lead to two main symptomatologies: adult T-cell lymphoma/leukemia (ATLL) and HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP). Each manifestation is associated with distinct characteristics, as ATLL presents as a leukemia-like disease, while HAM/TSP presents as severe inflammation in the central nervous system, leading to paraparesis. Previous studies have identified molecules associated with disease development, e.g., the downregulation of Foxp3 in Treg cells was associated with increased risk of HAM/TSP. In addition, elevated levels of CXCL10, CXCL9, and Neopterin in cerebrospinal fluid also present increased risk. However, these molecules were only associated with specific patient groups or viral strains. Furthermore, the majority of studies did not jointly compare all clinical manifestations, and robust analysis entails the inclusion of both ATLL and HAM/TSP. The low numbers of samples also pose difficulties in conducting gene expression analysis to identify specific molecular relationships. To address these limitations and increase the power of manifestation-specific gene associations, meta-analysis was performed using publicly available gene expression data. The application of supervised learning techniques identified alterations in two genes observed to act in tandem as potential biomarkers: GBP2 was associated with HAM/TSP, and CD40LG with ATLL. Together, both molecules demonstrated high sample-classification accuracy (AUC values: 0.88 and 1.0, respectively). Next, other genes with expression correlated to these genes were identified, and we attempted to relate the enriched pathways identified with the characteristic of each clinical manifestation. The present findings contribute to knowledge surrounding viral progression and suggest a potentially powerful new tool for the molecular classification of HTLV-associated diseases.
O Sistema UNA-SUS foi instituído em atenção à Política Nacional de Educação Permanente em Saúde, composta de uma rede de 34 instituições responsáveis por ofertas educacionais on-line, em resposta às demandas geradas pelo Ministério da Saúde. Objetivos: verificar o perfil dos usuários e a capilarizarão dos cursos autoinstrucionais da UNA-SUS e a possível contribuição para a democratização da educação permanente dos trabalhadores da saúde. Métodos: levantamento de dados na Plataforma Arouca e análise do software estatístico livre R 3.6. Resultados: houve mais de 2,7 milhões de matrículas em cursos autoinstrucionais da UNA-SUS e capilaridade para todas as regiões de saúde, todos os municípios brasileiros e todos os estados, sendo que a maior procura foi por cursos relacionados a importantes situações clínicas enfrentadas pelos profissionais da Atenção Básica. Houve predomínio de mulheres (80%), brancos (36%), seguidos por pardos (33%), solteiros (57%) e na faixa etária de 21 a 40 anos (70%). Enfermeiros, médicos e dentistas foram os profissionais que mais procuraram cursos da UNA-SUS. Não houve relação entre o número de matrícula em cursos autoinstrucionais ponderados pela população e o IDH do estado, porém foi estabelecida uma relação negativa entre o coeficiente de Gini e o número de matrículas nos cursos; quanto mais desigual a região, menos alunos matriculados ela possuía. Conclusão: o Sistema UNA-SUS mostrou-se efetivo em oportunizar a Educação Permanente aos trabalhadores da saúde residentes em todas as regiões geográficas do país, incluindo aqueles de áreas com poucas ofertas educacionais presenciais ou gratuitas, contribuindo para a democratização da educação no país.
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