Anti-neutrophil cytoplasmic antibodies (ANCA) in the clinical forms of leprosy

Anti-neutrophil cytoplasmic antibodies (ANCA) are autoantibodies against enzymes present in primary granules of neutrophils and lysosomes of monocytes detected in systemic vasculitis and in other diseases, including infections, ANCA are markers of active Wegener granulomatosis, which presents some anatomo-pathologic and immune response features similar to those of leprosy. Thus, we raised the hypothesis that ANCA may be present in leprosy as markers specifically linked to the presence of vasculitis. The aim of this study was to determine the presence of ANCA in leprosy and its correlation with the clinical forms of the disease. Sera from 60 normal individuals and from 59 patients with different clinical forms of leprosy were studied. The patients were also allocated into reactional and nonreactional groups. By indirect immunofluorescence, ANCA were positive, an atypical pattern A-ANCA, in 28.8% of the patient sera. A-ANCA predominated, although not significantly (p >0,05), in the reactional groups (37.9% vs 20.0%), and in those at the lepromatous pole (41.6% vs 20.0%). There was no correlation between ANCA positivity and either disease duration, disease activity, or therapeutic regimen (p >0.05), An interesting finding was the correlation between ANCA and gender: 94.1% of ANCA-positive patients were males (p <0.01), a feature that so far has not been reported in ANCA-related diseases and for which there is no explanation at the moment. By ELISA, the sera of the lepromatous leprosy patients did not show activity against either PR3, MPO, HLE, the most common ANCA antigens. Because A-ANCA are nonspecific, this finding requires further investigation for the determination of the responsible antigen(s), in conclusion, A-ANCA are present in 28.8% of leprosy patients but are not related to vasculitis in the erythema nodosum leprosum reaction and are not a marker of a specific clinical form.

Renal lesions in leprosy: A retrospective study of 199 autopsies

In the present work, 199 patients with leprosy who underwent autopsy between 1970 and 1986 were retrospectively studied to determine the prevalence, types, clinical characteristics, and etiologic factors of renal lesions (RLs) in leprosy. Patients were divided into two groups: 144 patients with RLs (RL+) and 55 patients without RLs (RL-), RLs observed in 72% of the autopsied patients were amyloidosis (AMY) in 61 patients (31%), glomerulonephritis (GN) in 29 patients (14%), nephrosclerosis (NPS) in 22 patients (11%), tubulointerstitial nephritis (TIN) in 18 patients (9%), granuloma in 2 patients (1%), and other lesions in 12 patients (6%), AMY occurred most frequently in patients with lepromatous leprosy (36%; nonlepromatous leprosy, 5%; P < 0.01), recurrent erythema nodosum leprosum (33%; P < 0.02), and trophic ulcers (27%; 0.05 < P < 0.10), Ninety-seven percent of AMY was found in patients with lepromatous leprosy, 88% showed recurrent trophic ulcers, and 76% presented with erythema nodosum leprosum, NPS was found in older patients with arterial hypertension, neoplastic diseases, infectious diseases, and vasculitis associated with GN, Most patients with AMY presented with proteinuria (95%) and renal failure (88%), the most frequent causes of death were renal failure in patients with AMY (57%), infectious diseases in patients with GN (41%) and TIN (45%), and cardiovascular diseases in patients with NPS (41%), No difference in survival rates was observed among RL- patients and those with AMY, GN, NPS, or TIN. (C) 2001 by the National Kidney Foundation, Inc.

Prevention of repeated episodes of type 2 reaction of leprosy with the use of thalidomide 100 mg/day

BACKGROUND: Leprosy can have its course interrupted by type 1 and 2 reactional episodes, the last named of erythema nodosum leprosum (ENL). Thalidomide has been the medication of choice for the control of ENL episodes since 1965. OBJECTIVES: These episodes can repeat and cause damages to the patient. In order to prevent these episodes, an extra dose of 100 mg/day thalidomide was used during six months, followed by a follow-up period of six more months after thalidomide discontinuation. METHODS: We included 42 patients with multibacillary (MB) leprosy who had episodes of ENL. They were male and female patients aged between 18 and 84 years. RESULTS: Of the 42 patients, 39 (92.85%) had the lepromatous form and three (7.15%) had the borderline form. We found that 100% of patients had no reactional episode during the use of the drug. During the follow-up period after thalidomide discontinuation, 33 (78.57%) patients had no reactional episode and nine (21.43%), all of them with the lepromatous form, had mild episodes, which were controlled using non-steroidal anti-inflammatory. There were no thalidomide-related side effects. CONCLUSION: A maintenance dose of 100 mg/day of thalidomide showed to be effective to prevent repeated type 2 reactional episodes of ENL.

Synthesis and evaluation of novel dapsone-thalidomide hybrids for the treatment of type 2 leprosy reactions

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Lepromatous leprosy and perianal tuberculosis: a case report and literature review

Leprosy is a chronic infectious disease caused by Mycobacterium leprae, a microorganism that usually affects skin and nerves. Although it is usually well-controlled by multidrug therapy (MDT), the disease may be aggravated by acute inflammatory reaction episodes that cause permanent tissue damage particularly to peripheral nerves. Tuberculosis is predominantly a disease of the lungs; however, it may spread to other organs and cause an extrapulmonary infection. Both mycobacterial infections are endemic in developing countries including Brazil, and cases of coinfection have been reported in the last decade. Nevertheless, simultaneous occurrence of perianal cutaneous tuberculosis and erythema nodosum leprosum is very rare, even in countries where both mycobacterial infections are endemic.

Importância de Yersinia enterocolitica em microbiologia médica

Y. enterocolitica is a human invasive enteropathogen which causes a number of intestinal and extraintestinal clinical symptoms of various degrees of severity, ranging from mild gastroenteritis to mesenteric lymphadenitis, which mimics appendicitis and in rare cases can evolve to septicemia. Infection by Y. enterocolitica can also lead to post-infection immunological sequelae including arthritis, erythema nodosum and glomerulonephritis. Pathogenic Y. enterocolitica strains have traditionally been linked to specific biotypes and serogroups and associated to a variety of phenotypic characteristics related to virulence. Molecular genetics studies have pointed to the importance of the pYV virulence plasmid, which encodes various virulence genes, as well that of specific chromosomal virulence genes, in determining the pathogenesis of this bacterium. Intestinal infections by Y. enterocolitica are mostly self-limiting and usually do not need an antibiotic treatment. The occurrence of this microorganism is not as frequently described in Brazil as it is in other countries, such as Japan, USA and many European countries. This review focuses on the general characteristics, pathogenesis, clinical symptoms, virulence characteristics, treatment and antibiotic susceptibility of Yersinia enterocolitica strains isolated in Brazil and around the world.

Effects of Yersinia enterocolitica O:3 derivatives on B lymphocyte activation in vivo

The potential sequelae of intestinal infection with Yersinia enterocolitica include reactive arthritis, erythema nodosum, Reiter's syndrome and other autoimmune diseases. The role of the immune response in the pathogenesis of these diseases has not been fully defined, but autoimmune manifestations may be a consequence of the increase in autoantibodies as a result of polyclonal B-cell activation induced by Yersinia. We investigated the effects of Y enterocolitica 0:3 derivatives on B lymphocyte activation in vivo. Groups of five specific pathogen free (SPF) Swiss mice were inoculated with bacterial cell extract, Yersinia outermembrane proteins (Yops) or lipopolysaccharide (LPS) obtained from Y enterocolitica 0:3 and their immunoglobulin-secreting spleen cells were detected by isotype-specific protein A plaque assay. The presence of specific anti-Yersinia antibodies and autoantibodies was determined in mouse sera by ELISA. In all experiments a marked increase in the number of secretory cells of different isotypes was observed as early as the third day after inoculation. IgG and IgM anti-Yersinia antibodies were detected in the sera of all inoculated mice, and autoantibodies against myosin in the sera of those inoculated with bacterial cell extract. The sera from animals stimulated with LPS reacted with myelin, actin and laminin, while the sera from mice inoculated with Yops reacted with myelin, thyroglobulin and cardiolipin. These results suggest that SPF Swiss mice inoculated with any one of the Y enterocolitica derivatives tested exhibited polyclonal activation of B lymphocytes as a result of stimulation by various bacterial components and not only LPS stimulation.

Estudo terapêntico comparando a associação de rifampicina, ofloxacina e minociclina com a associação rifampicina, clofazimina e dapsona em pacientes multibacilar

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Antinociceptive effect on mice of the hydroalcoholic fraction and (-) epicatechin obtained from Combretum leprosum Mart & Eich

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação da eficácia e segurança de um sistema emulsionado contendo extrato de Ascophyllum nodosum

Pós-graduação em Ciências Farmacêuticas - FCFAR

Uso de Ascophyllum nodosum para o enraizamento de microestacas de eucalipto

Pós-graduação em Agronomia (Irrigação e Drenagem) - FCA

Flora Polínica da Reserva do Parque Estadual das Fontes do Ipiranga (São Paulo, Brasil): Família: 136-Solanaceae

Foram estudados os grãos de pólen de 12 gêneros e 41 espécies de Solanaceae ocorrentes na Reserva do Parque Estadual das Fontes do Ipiranga: Acnistus arborescens (L.) Schlecht., Athenaea picta (Mart.) Sendtn., Brunfelsia latifolia Benth., Brunfelsia pauciflora (Cham. & Schlecht.) Benth., Capsicum flexuosum (L.) Sendtn., Capsicum villosum (L.) Sendtn., Cestrum amictum (L.) Schlecht., Cestrum corymbosum (L.) Schlecht., Cestrum lanceolatum (L.) Miers, Cestrum schlechtendalii (L.) G. Don, Cestrum sendtnerianum (L.) Mart. ex Sendtn., Cyphomandra diploconos Sendtn., Cyphomandra velutina Sendtn., Dyssochroma viridiflora (Sims) Ducke, Nicotiana langsdorffii (Weinm.) Roem. & Schult., Physalis peruviana L., Physalis viscosa L., Sessea brasiliensis Tol., Solandra grandiflora Sw, Solanum americanum Mill., Solanum atropurpureum Schrank., Solanum bullatum Vell., Solanum capsicoides Allion., Solanum cernuum Vell., Solanum concinnum Schott ex Sendtn., Solanum didynum Dun., Solanum diflorum Vell., Solanum excelsum St. Hil. ex Dun., Solanum granuloso-leprosum Dun., Solanum hoehnei Morton, Solanum inaequale Vell., Solanum inodornum Vell., Solanum lycocarpum St. Hil. ex Dun., Solanum mauritianum Scop., Solanum paniculatum L., Solanum rufescens Sendtn., Solanum sisymbriifolium Lam., Solanum swartzianum Roem. & Schult., Solanum vaillantii Dun., Solanum variabile Mart., Solanum viarum Dun. São apresentadas descrições para todas as espécies estudadas, ilustrações, observações e seis chaves polínicas.

Morfologia de frutos e sementes de espécies arbóreas do gênero Solanum L.

O objetivo do trabalho foi caracterizar a morfologia do fruto e da semente de três espécies florestais nativas do Brasil, Solanum granuloso-leprosum Dunal, S. lycocarpum A.St.-Hil. e S. pseudoquina A.St.-Hil., recomendadas para plantações destinadas à recuperação de áreas degradadas. Os frutos são indeiscentes, carnosos, do tipo baga, globosos, polispérmicos e constituídos por dois ou mais lóculos. As sementes são estenospérmicas, campilótropas, elipsóides, comprimidas, apresentando seção longitudinal largo-ovalada ou achatado-ovalada e seção transversal elíptica. Hilo mediano-marginal localizado em uma depressão e micrópila arredondada. Sementes albuminosas, com endosperma abundante, periférico, carnoso-firme, semitransparente e de coloração esbranquiçada. Embrião axial, linear, contínuo e curvado. em Solanum lycocarpum e S. pseudoquina o embrião é circinado e em S. granuloso-leprosum é espiralado.

Bases para a padronização do teste de germinação em três espécies de Solanum L.

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)