Memorias do Instituto Oswaldo Cruz最新文献

{"title":"In vitro immunogenic profile of recombinant SARS-CoV2 S1-RBD peptide in murine macrophage and microglial cells.","authors":"Adriano José Maia Chaves Filho,&nbsp;Paloma Marinho Jucá,&nbsp;Michelle Verde Ramo Soares,&nbsp;Caio Andrade de Oliveira,&nbsp;Raul Cavalcante de Sousa,&nbsp;Deniele Bezerra Lós,&nbsp;Remo Castro Russo,&nbsp;Juliana Navarro Ueda Yaochite,&nbsp;Danielle S Macedo","doi":"10.1590/0074-02760220144","DOIUrl":"https://doi.org/10.1590/0074-02760220144","url":null,"abstract":"<p><strong>Background: </strong>The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants can infect common mice inducing significant pathological lung lesions and inflammatory responses. This substantially mimics coronavirus disease 19 (COVID-19) infection and pathogenesis in humans.</p><p><strong>Objectives: </strong>To characterise the effects of recombinant SARS-CoV-2 S1 receptor-binding domain (RBD) peptide in murine macrophage and microglial cells' immune activation compared with classical PAMPs in vitro.</p><p><strong>Methods: </strong>Murine RAW 264.7 macrophages and BV2 microglial cells were exposed to increasing concentrations of the RBD peptide (0.01, 0.05, and 0.1 µg/mL), Lipopolysaccharide (LPS) and Poly(I:C) and evaluated after two and 24 h for significant markers of macrophage activation. We determined the effects of RBD peptide on cell viability, cleaved caspase 3 expressions, and nuclear morphometry analysis.</p><p><strong>Findings: </strong>In RAW cells, RBD peptide was cytotoxic, but not for BV2 cells. RAW cells presented increased arginase activity and IL-10 production; however, BV2 cells expressed iNOS and IL-6 after RBD peptide exposure. In addition, RAW cells increased cleaved-caspase-3, apoptosis, and mitotic catastrophe after RBD peptide stimulation but not BV2 cells.</p><p><strong>Conclusion: </strong>RBD peptide exposure has different effects depending on the cell line, exposure time, and concentration. This study brings new evidence about the immunogenic profile of RBD in macrophage and microglial cells, advancing the understanding of SARS-Cov2 immuno- and neuropathology.</p>","PeriodicalId":18469,"journal":{"name":"Memorias do Instituto Oswaldo Cruz","volume":"118 ","pages":"e220144"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10065410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9263154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Population size regulation is density-dependent in Rhodnius prolixus (Hemiptera: Reduviidae) through an irritability mechanism.","authors":"Enrique Hector Weir,&nbsp;Jorge Eduardo Rabinovich","doi":"10.1590/0074-02760220211","DOIUrl":"https://doi.org/10.1590/0074-02760220211","url":null,"abstract":"<p><strong>Background: </strong>Physical factors can determine the level of triatomine abundance, but do not regulate their population densities, and neither do natural enemies.</p><p><strong>Objectives: </strong>To identify the processes associated with density-dependent triatomine population regulation.</p><p><strong>Methods: </strong>We set-up a laboratory experiment with four interconnected boxes; the central box harbored Rhodnius prolixus bugs and one hamster. Stage 5 and adult densities of 10, 20, 30, 40, and 60 bugs per hamster, were replicated four times (except the density of 60 bugs). Hamster's irritability and several triatomine responses were measured: feeding, development time and longevity, mortality, fecundity, dispersal, and the net reproductive value (R o ).</p><p><strong>Findings: </strong>Density had a statistically significant effect on irritability, but not on the percent of bugs feeding. Density was significant on blood meal size ingested in bugs that did not move between boxes, but not significant when the bugs moved. Density and irritability affected the proportion of stage 5 nymphs molting, and the proportion of adult bugs dying per day and over a three-week period. There was a highly significant effect of density and irritability on R o .</p><p><strong>Main conclusions: </strong>We showed that a density-dependent mechanism, acting through the irritability of the host, seems the most plausible process regulating populations in triatomines.</p>","PeriodicalId":18469,"journal":{"name":"Memorias do Instituto Oswaldo Cruz","volume":"118 ","pages":"e220211"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10243471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9652500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the performance of Escherichia coli outer membrane vesicles as a tool for vaccine development against Chagas disease.","authors":"María Elisa Vázquez,&nbsp;Andrea Cecilia Mesías,&nbsp;Leonardo Acuña,&nbsp;Joseph Spangler,&nbsp;Brenda Zabala,&nbsp;Cecilia Parodi,&nbsp;Meghna Thakur,&nbsp;Eunkeu Oh,&nbsp;Scott Allan Walper,&nbsp;Cecilia Pérez Brandán","doi":"10.1590/0074-02760220263","DOIUrl":"https://doi.org/10.1590/0074-02760220263","url":null,"abstract":"<p><strong>Background: </strong>Vaccine development is a laborious craftwork in which at least two main components must be defined: a highly immunogenic antigen and a suitable delivery method. Hence, the interplay of these elements could elicit the required immune response to cope with the targeted pathogen with a long-lasting protective capacity.</p><p><strong>Objectives: </strong>Here we evaluate the properties of Escherichia coli spherical proteoliposomes - known as outer membrane vesicles (OMVs) - as particles with natural adjuvant capacities and as antigen-carrier structures to assemble an innovative prophylactic vaccine for Chagas disease.</p><p><strong>Methods: </strong>To achieve this, genetic manipulation was carried out on E. coli using an engineered plasmid containing the Tc24 Trypanosoma cruzi antigen. The goal was to induce the release of OMVs displaying the parasite protein on their surface.</p><p><strong>Findings: </strong>As a proof of principle, we observed that native OMVs - as well as those carrying the T. cruzi antigen - were able to trigger a slight, but functional humoral response at low immunization doses. Of note, compared to the non-immunized group, native OMVs-vaccinated animals survived the lethal challenge and showed minor parasitemia values, suggesting a possible involvement of innate trained immunity mechanism.</p><p><strong>Main conclusion: </strong>These results open the range for further research on the design of new carrier strategies focused on innate immunity activation as an additional immunization target and venture to seek for alternative forms in which OMVs could be used for optimizing vaccine development.</p>","PeriodicalId":18469,"journal":{"name":"Memorias do Instituto Oswaldo Cruz","volume":"118 ","pages":"e220263"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10207902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9892781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genomic surveillance: a potential shortcut for effective Chagas disease management.","authors":"Sophia Lincoln Cardoso de Azevedo,&nbsp;Marcos Catanho,&nbsp;Ana Carolina Ramos Guimarães,&nbsp;Teca Calcagno Galvão","doi":"10.1590/0074-02760220164","DOIUrl":"https://doi.org/10.1590/0074-02760220164","url":null,"abstract":"<p><p>Chagas disease is an enduring public health issue in many Latin American countries, receiving insufficient investment in research and development. Strategies for disease control and management currently lack efficient pharmaceuticals, commercial diagnostic kits with improved sensitivity, and vaccines. Genetic heterogeneity of Trypanosoma cruzi is a key aspect for novel drug design since pharmacological technologies rely on the degree of conservation of parasite target proteins. Therefore, there is a need to expand the knowledge regarding parasite genetics which, if fulfilled, could leverage Chagas disease research and development, and improve disease control strategies. The growing capacity of whole-genome sequencing technology and its adoption as disease surveillance routine may be key for solving this long-lasting problem.</p>","PeriodicalId":18469,"journal":{"name":"Memorias do Instituto Oswaldo Cruz","volume":"117 ","pages":"e220164"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9870261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10601763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracing the relationship among HIV-1 sub-subtype F1 strains: a phylodynamic perspective.","authors":"Gabriela Porto Santos Almeida Silva,&nbsp;Rodrigo Cunha Oliveira,&nbsp;Juliana Sacramento Mota de Souza,&nbsp;Marta Giovanetti,&nbsp;Monick Lindenmeyer Guimarães,&nbsp;Carlos Brites,&nbsp;Joana Paixão Monteiro-Cunha","doi":"10.1590/0074-02760220109","DOIUrl":"https://doi.org/10.1590/0074-02760220109","url":null,"abstract":"<p><strong>Background: </strong>The human immunodeficiency virus type 1, F1 sub-subtype (HIV-1 F1) circulates in three continents: Africa, Europe, and South America. In Brazil, this sub-subtype co-circulates with subtypes B and C and several recombinant forms, mainly BF1 variants.</p><p><strong>Objectives: </strong>This study aimed to reconstruct the dynamic history of HIV-1 F1 in Brazil.</p><p><strong>Methods: </strong>HIV-1 near full-length genome and pol gene nucleotide sequences available in public databases were assembled in two datasets (POL671 and NFLG53) to cover the largest number of F1 sub-subtype sequences. Phylodynamic and temporal analyses were performed.</p><p><strong>Findings: </strong>Two main strains of the F1 sub-subtype are circulating worldwide. The first (F1.I) was found among Brazilian samples (75%) and the second (F1.II) among Romanian (62%) and other European and African isolates. The F1 subtype epidemic in Brazil originated from a single entry into the country around 1970. This ancestral sample is related to samples isolated in European countries (France, Finland, and Belgium), which are possibly of African origin. Moreover, further migration (1998 CI: 1994-2003) of strains from Brazil to Europe (Spain and the UK) was observed. Interestingly, all different recombinant BF patterns found, even those from outside Brazil, present the same F1 lineage (F1.I) as an ancestor, which could be related to the acquisition of adaptive advantages for the recombinant progenies.</p><p><strong>Main conclusions: </strong>These findings are important for the understanding of the origin and dynamics of the F1 sub-subtype and a consequent better and greater understanding of the HIV-1 F1 and BF epidemic that still spreads from Brazil to other countries.</p>","PeriodicalId":18469,"journal":{"name":"Memorias do Instituto Oswaldo Cruz","volume":"117 ","pages":"e220109"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9870255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10724155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microbiome and virome on indoor surfaces of an Antarctic research ship.","authors":"Tatiana Prado,&nbsp;Maithê Gaspar Pontes Magalhães,&nbsp;Daniel Andrade Moreira,&nbsp;Martha Lima Brandão,&nbsp;Tulio Machado Fumian,&nbsp;Fernando Cesar Ferreira,&nbsp;Marcia Chame,&nbsp;Luciana Leomil,&nbsp;Wim Maurits Sylvain Degrave,&nbsp;José Paulo Gagliardi Leite,&nbsp;Marize Pereira Miagostovich","doi":"10.1590/0074-02760230084","DOIUrl":"https://doi.org/10.1590/0074-02760230084","url":null,"abstract":"<p><strong>Background: </strong>Few studies have focused on microbial diversity in indoor environments of ships, as well as the role of the microbiome and its ecological interconnections. In this study, we investigated the microbiome and virome present on the internal surfaces of a polar ship in different stages (beginning, during, and at the end) of the Brazilian Antarctic expedition in order to evaluate abundance of microorganisms in different periods.</p><p><strong>Objectives and methods: </strong>We used shotgun metagenomic analysis on pooled samples from sampling surfaces in the ship's interior to track the microbial diversity.</p><p><strong>Findings: </strong>Considering the total fraction of the microbiome, the relative abundance of bacteria, eukaryotes, viruses, and archaea was 83.7%, 16.2%, 0.04%, and 0.002%, respectively. Proteobacteria was the most abundant bacterial phyla, followed by Firmicutes, Actinobacteria, and Bacteroidetes. Concerning the virome, the greatest richness of viral species was identified during the middle of the trip, including ten viral families after de novo assembly: Autographiviridae, Chrysoviridae, Genomoviridae, Herelleviridae, Myoviridae, Partitiviridae, Podoviridae, Potyviridae, Siphoviridae, and Virgaviridae.</p><p><strong>Main conclusions: </strong>This study contributed to the knowledge of microbial diversity in naval transportation facilities, and variations in the abundance of microorganisms probably occurred due to factors such as the number of passengers and activities on the ship.</p>","PeriodicalId":18469,"journal":{"name":"Memorias do Instituto Oswaldo Cruz","volume":"118 ","pages":"e230084"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10481937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10182669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discovery of new Schistosoma mansoni aspartyl protease inhibitors by structure-based virtual screening.","authors":"Bárbara Figueira Gomes,&nbsp;Mario Roberto Senger,&nbsp;José Teófilo Moreira-Filho,&nbsp;Fabio Jorge de Vasconcellos Junior,&nbsp;Rafael Ferreira Dantas,&nbsp;Raymond Owens,&nbsp;Carolina Horta Andrade,&nbsp;Bruno Junior Neves,&nbsp;Floriano Paes Silva-Junior","doi":"10.1590/0074-02760230031","DOIUrl":"https://doi.org/10.1590/0074-02760230031","url":null,"abstract":"<p><strong>Background: </strong>Schistosomiasis is a neglected tropical disease caused by trematodes of the genus Schistosoma, with a limited treatment, mainly based on the use of praziquantel (PZQ). Currently, several aspartic proteases genes have already been identified within the genome of Schistosoma species. At least one enzyme encoded from this gene family (SmAP), named SmCD1, has been validated for the development of schistosomicidal drugs, since it has a key role in haemoglobin digestion by worms.</p><p><strong>Objective: </strong>In this work, we integrated a structure-based virtual screening campaign, enzymatic assays and adult worms ex vivo experiments aiming to discover the first classes of SmCD1 inhibitors.</p><p><strong>Methods: </strong>Initially, the 3D-structures of SmCD1, SmCD2 and SmCD3 were generated using homology modelling approach. Using these models, we prioritised 50 compounds from 20,000 compounds from ChemBridge database for further testing in adult worm aqueous extract (AWAE) and recombinant SmCD1 using enzymatic assays.</p><p><strong>Findings: </strong>Seven compounds were confirmed as hits and among them, two compounds representing new chemical scaffolds, named 5 and 19, had IC50 values against SmCD1 close to 100 μM while presenting binding efficiency indexes comparable to or even higher than pepstatin, a classical tight-binding peptide inhibitor of aspartyl proteases. Upon activity comparison against mammalian enzymes, compound 50 was selective and the most potent against the AWAE aspartic protease activity (IC50 = 77.7 μM). Combination of computational and experimental results indicate that compound 50 is a selective inhibitor of SmCD2. Compounds 5, 19 and 50 tested at low concentrations (10 uM) were neither cytotoxic against WSS-1 cells (48 h) nor could kill adult worms ex-vivo, although compounds 5 and 50 presented a slight decrease on female worms motility on late incubations times (48 or 72 h).</p><p><strong>Main conclusion: </strong>Overall, the inhibitors identified in this work represent promising hits for further hit-to-lead optimisation.</p>","PeriodicalId":18469,"journal":{"name":"Memorias do Instituto Oswaldo Cruz","volume":"118 ","pages":"e230031"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10481938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10182670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravenous whole blood transfusion results in faster recovery of vascular integrity and increased survival in experimental cerebral malaria.","authors":"Saba Gul,&nbsp;Hans C Ackerman,&nbsp;Cláudio Tadeu Daniel-Ribeiro,&nbsp;Leonardo Jm Carvalho","doi":"10.1590/0074-02760220184","DOIUrl":"https://doi.org/10.1590/0074-02760220184","url":null,"abstract":"<p><strong>Background: </strong>Cerebral malaria is a lethal complication of Plasmodium falciparum infections in need of better therapies. Previous work in murine experimental cerebral malaria (ECM) indicated that the combination of artemether plus intraperitoneal whole blood improved vascular integrity and increased survival compared to artemether alone. However, the effects of blood or plasma transfusion administered via the intravenous route have not previously been evaluated in ECM.</p><p><strong>Objectives: </strong>To evaluate the effects of intravenous whole blood compared to intravenous plasma on hematological parameters, vascular integrity, and survival in artemether-treated ECM.</p><p><strong>Methods: </strong>Mice with late-stage ECM received artemether alone or in combination with whole blood or plasma administered via the jugular vein. The outcome measures were hematocrit and platelets; plasma angiopoietin 1, angiopoietin 2, and haptoglobin; blood-brain barrier permeability; and survival.</p><p><strong>Findings: </strong>Survival increased from 54% with artemether alone to 90% with the combination of artemether and intravenous whole blood. Intravenous plasma lowered survival to 18%. Intravenous transfusion provided fast and pronounced recoveries of hematocrit, platelets, angiopoietins levels and blood brain barrier integrity.</p><p><strong>Main conclusions: </strong>The outcome of artemether-treated ECM was improved by intravenous whole blood but worsened by intravenous plasma. Compared to prior studies of transfusion via the intraperitoneal route, intravenous administration was more efficacious.</p>","PeriodicalId":18469,"journal":{"name":"Memorias do Instituto Oswaldo Cruz","volume":"117 ","pages":"e220184"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9870258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10592405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A straightforward one-step strategy for SARS-CoV-2 diagnosis and screening of variants of concern: a multicentre study.","authors":"Marcela Fontana-Maurell,&nbsp;Fernando do Couto Motta,&nbsp;Monica Barcellos Arruda,&nbsp;Pedro Cardoso,&nbsp;Marisa Ribeiro,&nbsp;Elisabete Andrade,&nbsp;Daniela T Godoy,&nbsp;Elaine Costa,&nbsp;Daniele Rocha,&nbsp;Marilda Agudo Mt Siqueira,&nbsp;Rodrigo Brindeiro,&nbsp;Patrícia Alvarez","doi":"10.1590/0074-02760220202","DOIUrl":"https://doi.org/10.1590/0074-02760220202","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOCs) has changed unevenly over time around the world. Although whole genome sequencing is the gold standard for virus characterisation, the discovery of alpha VOC causing spike gene target failure (SGTF) result, when tested using an reverse transcription real-time polymerase chain reaction (RT-qPCR) assay, has provided a simple tool for tracking the frequencies of variants.</p><p><strong>Objectives: </strong>The aim of this study was to investigate if a multiplex RT-qPCR assay (BioM 4Plex VOC) could be used to detect SARS-CoV-2 and to perform a VOC screening test in a single reaction tube. Here, we present the multicentre study evaluating this assay.</p><p><strong>Methods: </strong>Twelve laboratories have participated in the multicentre study. The BioM 4Plex VOC was distributed to them with detailed instructions of how to perform the test. They were asked to test the BioM 4Plex VOC in parallel with their routine Commercial SARS-CoV-2 diagnostic assay. Additionally, they were requested to select SARS-CoV-2-positive samples with genome sequenced and lineage definition according to PANGO lineage classification.</p><p><strong>Findings: </strong>The BioM 4Plex VOC and commercial RT-PCR assay are equally effective in detecting SARS-CoV-2. Results revealed a specificity of 96.5-100% [95% confidence interval (CI)], a sensitivity of 99.8-100% (95% CI), and an accuracy of 99.8-100% (95% CI). A 99% concordance rate was found between results from the BioM 4Plex VOC and that from available genome sequencing data.</p><p><strong>Main conclusions: </strong>The BioM 4Plex VOC provides an effective solution to detect SARS-CoV-2 infections and screening for VOCs in a single reaction. It is a straightforward method to help us monitor the frequency and distribution of VOCs and develop strategies to better cope with the pandemics.</p>","PeriodicalId":18469,"journal":{"name":"Memorias do Instituto Oswaldo Cruz","volume":"118 ","pages":"e220202"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10023132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9187546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progressive neuropathy in patients with lepromatous leprosy after multidrug therapy.","authors":"Patricia Sola Penna,&nbsp;Izabela Jardim Rodrigues Pitta,&nbsp;Robson Teixeira Vital,&nbsp;Mariana Andrea Vilas Boas Hacker,&nbsp;Ana Maria Salles,&nbsp;Roberta Olmo Pinheiro,&nbsp;Sergio Luiz Gomes Antunes,&nbsp;Euzenir Nunes Sarno,&nbsp;Márcia Rodrigues Jardim","doi":"10.1590/0074-02760220150","DOIUrl":"https://doi.org/10.1590/0074-02760220150","url":null,"abstract":"<p><strong>Background: </strong>The lepromatous pole is a stigmatising prototype for patients with leprosy. Generally, these patients have little or no symptoms of peripheral nerve involvement at the time of their diagnosis. However, signs of advanced peripheral neuropathy would be visible during the initial neurological evaluation and could worsen during and after multidrug therapy (MDT). Disabilities caused by peripheral nerve injuries greatly affect these patients' lives, and the pathophysiological mechanisms underlying nerve damage remain unclear.</p><p><strong>Objectives: </strong>To evaluate the outcome of peripheral neuropathy in patients with lepromatous leprosy (LL) and persistent neuropathic symptoms years after completing MDT.</p><p><strong>Methods: </strong>We evaluated the medical records of 14 patients with LL who underwent nerve biopsies due to worsening neuropathy at least four years after MDT.</p><p><strong>Findings: </strong>Neuropathic pain developed in 64.3% of the patients, and a neurological examination showed that most patients had alterations in the medium- and large-caliber fibers at the beginning of treatment. Neurological symptoms and signs deteriorated despite complete MDT and prednisone or thalidomide use for years. Nerve conduction studies showed that sensory nerves were the most affected.</p><p><strong>Main conclusions: </strong>Patients with LL can develop progressive peripheral neuropathy, which continues to develop even when they are on long-term anti-inflammatory and immunosuppressive therapy.</p>","PeriodicalId":18469,"journal":{"name":"Memorias do Instituto Oswaldo Cruz","volume":"117 ","pages":"e220150"},"PeriodicalIF":2.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9870262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10598431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}