Regulation of lymphocyte response in vitro and in vivo

CD4+ T helper (Th) cells have an important role in the defence against diverse pathogens. Th cells can differentiate into several functionally distinct subtypes including Th1 and Th2 cells. Th1 cells are important for eradicating intracellular pathogens, whereas Th2 cells pro¬tect our body against extracellular parasites. However if uncontrolled, Th cells can mediate immunopathology such as asthma or allergies, but inappropriate Th response can also lead to autoimmune diseases such as multiple sclerosis or type 1 diabetes. Deeper knowledge of the regulation of the lymphocyte response both in vitro and in vivo is important for un¬derstanding the pathogenesis of immune-mediated diseases and microbe-host interactions. In the work presented in this thesis, the first goal was to elucidate the role of novel factors, PIM kinases and c-FLIP in the regulation of human Th cell differentiation. The oncogenic serine-threonine kinases of the PIM family were shown to be preferentially expressed in Th1 cells and in addition, by using RNA interference, they were also shown to be positive regulators of Th1 differentiation. The PIM depletion experiments suggest that PIM kinases promote the expression of the hallmark cytokine of Th1 cells, IFNγ, and influence the IL12/STAT4 pathway during the early Th1 cell differentiation. In addition to cytokine and T cell receptor (TCR) induced pathways, caspase activity has been shown to regulate Th cell proliferation. In the work presented in this thesis, the two isoforms of the caspase regulator protein, c-FLIP, were shown to be differentially ex¬pressed in Th1 and Th2 cells. Both of the isoforms were up-regulated in response to TCR activation, but the expression of the short isoform was selectively induced by IL4, the Th2 inducing cytokine. Furthermore, the c-FLIP isoforms had distinct and opposite roles during the early differentiation of Th1 and Th2 cells. The knockdown of the long isoform of c-FLIP led to the induction of Th1 marker genes, such as IFNγ and TBET, whereas the depletion of c-FLIP short down-regulated Th2 marker genes IL-4 and GATA3. The third goal was to elucidate the gene expression profiles characterizing the T- and B-lymphocyte responses in vivo during experimental infection by intracellular bacte¬rium Chlamydia pneumoniae. Previously, it has been shown that CD8+ and CD4+ T cells are important for the protection against Chlamydia pneumoniae. In this study, the analysis revealed up-regulation of interferon induced genes during recurrent infection underlining the importance of IFNγ secreted by Th1 and CD8+ T cells in the protection against this pathogen. Taken together, in this study novel regulators of Th cell differ¬entiation were discovered and in addition the gene expression profiles of lymphocytes induced by Chlamydia pneumoniae infection were characterized.

Switchable lanthanide fluorescence probes in homogenous molecular diagnostics

The number of molecular diagnostic assays has increased tremendously in recent years.Nucleic acid diagnostic assays have been developed, especially for the detection of human pathogenic microbes and genetic markers predisposing to certain diseases. Closed-tube methods are preferred because they are usually faster and easier to perform than heterogenous methods and in addition, target nucleic acids are commonly amplified leading to risk of contamination of the following reactions by the amplification product if the reactions are opened. The present study introduces a new closed-tube switchable complementation probes based PCR assay concept where two non-fluorescent probes form a fluorescent lanthanide chelate complex in the presence of the target DNA. In this dual-probe PCR assay method one oligonucleotide probe carries a non-fluorescent lanthanide chelate and another probe a light absorbing antenna ligand. The fluorescent lanthanide chelate complex is formed only when the non-fluorescent probes are hybridized to adjacent positions into the target DNA bringing the reporter moieties in close proximity. The complex is formed by self-assembled lanthanide chelate complementation where the antenna ligand is coordinated to the lanthanide ion captured in the chelate. The complementation probes based assays with time-resolved fluorescence measurement showed low background signal level and hence, relatively high nucleic acid detection sensitivity (low picomolar target concentration). Different lanthanide chelate structures were explored and a new cyclic seven dentate lanthanide chelate was found suitable for complementation probe method. It was also found to resist relatively high PCR reaction temperatures, which was essential for the PCR assay applications. A seven-dentate chelate with two unoccupied coordination sites must be used instead of a more stable eight- or nine-dentate chelate because the antenna ligand needs to be coordinated to the free coordination sites of the lanthanide ion. The previously used linear seven-dentate lanthanide chelate was found to be unstable in PCR conditions and hence, the new cyclic chelate was needed. The complementation probe PCR assay method showed high signal-to-background ratio up to 300 due to a low background fluorescence level and the results (threshold cycles) in real-time PCR were reached approximately 6 amplification cycles earlier compared to the commonly used FRET-based closed-tube PCR method. The suitability of the complementation probe method for different nucleic acid assay applications was studied. 1) A duplex complementation probe C. trachomatis PCR assay with a simple 10-minute urine sample preparation was developed to study suitability of the method for clinical diagnostics. The performance of the C. trachomatis assay was equal to the commercial C. trachomatis nucleic acid amplification assay containing more complex sample preparation based on DNA extraction. 2) A PCR assay for the detection of HLA-DQA1*05 allele, that is used to predict the risk of type 1 diabetes, was developed to study the performance of the method in genotyping. A simple blood sample preparation was used where the nucleic acids were released from dried blood sample punches using high temperature and alkaline reaction conditions. The complementation probe HLA-DQA1*05 PCR assay showed good genotyping performance correlating 100% with the routinely used heterogenous reference assay. 3) To study the suitability of the complementation probe method for direct measurement of the target organism, e.g., in the culture media, the complementation probes were applied to amplificationfree closed-tube bacteriophage quantification by measuring M13 bacteriophage ssDNA. A low picomolar bacteriophage concentration was detected in a rapid 20- minute assay. The assay provides a quick and reliable alternative to the commonly used and relatively unreliable UV-photometry and time-consuming culture based bacteriophage detection methods and indicates that the method could also be used for direct measurement of other micro-organisms. The complementation probe PCR method has a low background signal level leading to a high signal-to-background ratio and relatively sensitive nucleic acid detection. The method is compatible with simple sample preparation and it was shown to tolerate residues of urine, blood, bacteria and bacterial culture media. The common trend in nucleic acid diagnostics is to create easy-to-use assays suitable for rapid near patient analysis. The complementation probe PCR assays with a brief sample preparation should be relatively easy to automate and hence, would allow the development of highperformance nucleic acid amplification assays with a short overall assay time.

Description of Lyme disease-like syndrome in Brazil: is it a new tick borne disease or Lyme disease variation?

An emerging clinical entity that reproduces clinical manifestations similar to those observed in Lyme disease (LD) has been recently under discussion in Brazil. Due to etiological and laboratory particularities it is named LD-like syndrome or LD imitator syndrome. The condition is considered to be a zoonosis transmitted by ticks of the genus Amblyomma, possibly caused by interaction of multiple fastidious microorganisms originating a protean clinical picture, including neurological, osteoarticular and erythema migrans-like lesions. When peripheral blood of patients with LD-like syndrome is viewed under a dark-field microscope, mobile uncultivable spirochete-like bacteria are observed. PCR carried out with specific or conservative primers to recognize Borrelia burgdorferi sensu stricto or the genus Borrelia has been negative in ticks and in biological samples. Two different procedures, respectively involving hematoxylin and eosin staining of cerebrospinal fluid and electron microscopy analysis of blood, have revealed spirochetes not belonging to the genera Borrelia, Leptospira or Treponema. Surprisingly, co-infection with microorganisms resembling Mycoplasma and Chlamydia was observed on one occasion by electron microscopy analysis. We discuss here the possible existence of a new tick-borne disease in Brazil imitating LD, except for a higher frequency of recurrence episodes observed along prolonged clinical follow-up.

Las enfermedades de transmisión sexual.

Se detallan cuáles son las enfermedades de transmisión sexual, causas, medios de transmisión y contagio, síntomas, tanto en hombres como en mujeres, diagnóstico y su tratamiento. Estas enfermedades son: gonorrea, sífilis, herpes simple, chlamydia, SIDA, vaginitis, condilomas, infecciones en las vías urinarias. Se indica dónde acudir en caso de contagio y medidas de prevención.

Projeto Prevenir: uma pesquisa acerca das mudanças no perfil das infecções por DST/AIDS, com a perspectiva de detectar pontos vulneráveis da prevenção

Rio Grande do Norte is among the Brazilian States where the tourism and sexual violence increasingly grow in the country, occupying 4th place in 2004. Associated to this fact, it comes the problematic one of the contamination of the women by Sexually Transmitted Disease (STD). Studies in Brazil have presented a considerable increase of the STDs, caused through lack of suitable protection in the sexual relationships. Due to the biological and psychosocial vulnerability, besides failures or inconsistencies in the condom use associated to the raised taxes of sexual activity with different partners, the STDs constitute the main risk of health. Many difficulties are found by the confrontation of this problem. In this context, this project had as aim to evaluate the vulnerability of this population of sexually active women in Natal-RN Ponta Negra neighbourhood to the infections by STDs, such as, Candida sp., Vaginoses Bacterial, Trichomonas Vaginalis and Chlamydia sp., arisen with the explosion of the sex market, showing a current statistical panorama. It was possible to detect vulnerable points in prevention through patient anamnesis, where the study it showed: high number of partners (8,3% with more than five), low age of first relationship and not the use of condoms (31,8% sometimes use and 45,8% had not used in the first relationship). Already consolidated by the preventive cytopathologic examination, these data were strengthened by high incidence of causing agents of STDs (58,6%). In this way, it is clear that the sexuality must to be thought on the context of the deep economic and socio-cultural transformations in which pass societies, and mainly the ones concerning to the sexuality exercise and to the sex market. With the profile change of the infections, new demands are placed in relation to the risk factors. Therefore, it can be concluded that the prevention vulnerable points detected as more important had been the deficiency in self-perception and wareness of the risk existence among the studied women

Evidence of Chlamydophila psittaci infection in captive Amazon parrots in Brazil

The prevalence of Chlamydophila psittaci (formerly Chlamydia psittaci) infection was assessed in 95 apparently healthy, captive Amazon parrots from three breeder collections in southeastern and west-central Brazil. Cloacal swabs from 95 birds were tested for chlamydial antigen, which was detected by direct immunofluorescence (DIF), and serum samples from 44 of these birds were tested for antibodies to C. psittaci using an enzyme-linked immunosorbent assay. The prevalences of active infection as detected by DIF were 16.7%, 22.2%, and 56.1%, and seroprevalences were 100%, 87.5%, and 60% in flocks A, B, and C, respectively. We can therefore infer that C. psittaci may be widespread in captive parrot populations in Brazil.

Prevalência de doenças sexualmente transmissíveis em mulheres profissionais do sexo, em um município do interior paulista, Brasil

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

Esparfloxacino e as fluorquinolonas: Uma revisao de sua classificacao, atividade antibacteriana, mecanismo de acao, caracteristicas farmacocineticas, tolerabilidade e perspectivas farmaceuticas

A revision was accomplished in the literature on the quinolones, antibacterial class that presents wide action spectrum, focusing, mainly, the sparfloxacin, third generation fluorquinolone which has potente activity against Gram positive organisms, including Streptococcus pneumoniae and methicillin-resistant Staphylococcus aureus (MRSA), Gram negative organisms, Legionelia spp, Mycoplasma spp, Chlamydia spp and Mycobacterium spp, including multidrug resistant organisms.

Analise citotoxica de esparfloxacino e seus produtos de degradaçao em células mononucleares humanas

Sparfloxacin, a difluorquinolone derivative, is a potent antibacterial agent active against a wide range of gram-positive and gram-negative organisms including Streptococcus pneumoniae, Staphylococcus aureus, methicillin resistant S. aureus, Legionella spp, Mycoplasma spp; Chlamydia spp. and Mycobacteria. A drawback of fluorquinolones is their photoreactivity. Sparfloxacin has been studied in terms of therapeutic activities. However, few reports about analytical methods of sparfloxacin are available in the literature. The aim of this study was to determine cytotoxic effects, using sparfloxacin reference substance (SPAX-SR), sparfloxacin tablets (SPAX-COMP) and sparfloxacin tablets submitted UV light during 36 hours (SPAX-COMP.36) solution, and two isolated products (7 and 9) of SPAX-SR submitted UV-C light, in concentrations of 31.25, 62.5, 125 and 250 μg/mL by in vitro mononuclear humane culture cells. The results, statistically analyzed by Teste de Tukey, showed SPAX, SPAX-COMP and SPAX-COMP.36 solutions could reduce the cells number in these conditions. These results could not be observed for products 7 or 9. These results can suggest that isolated product can be less cytotoxic than SPAX-SR, is method can also be used to identified products degradation of sparfloxacin in stability study. However, the low activity achieved with sparfloxacin submitted to UV-light is a source of concern and requires further investigation about its photodegradation mechanism.

Photodegradation of sparfloxacin and isolation of its degradation products by preparative HPLC

Sparfloxacin, a third generation fluoroquinolone derivative, is a potent antibacterial agent active against a wide range of Gram-positive and Gram-negative organisms including Streptococcus pneuinoniae, Staphylococcus aureus, methicillin resistant S. aureus, Legionella spp., Mycoplasina spp., Chlamydia spp. and Mycobacterium spp. A drawback of fluoroquinolones is their photoreactivity. Sparfloxacin has been studied in terms of therapeutic activities. However, there are few published of analytical methods being applied to sparfloxacin. The aim in this study was to determine the photodegradation products of sparfloxacin, when submitted to UV light, and to characterize two of these products, designated SPAX-PDP1 and SPAX-PDP2. An accelerated study of stability in methanol solution was carried out by exposing a solution of sparfloxacin to UV light (peak wavelength 290 nm) for 36 hours at room temperature. The products were analyzed by NMR spectrophotometry, IR spectrometry and mass spectrophotometry. The results suggest that the products isolated here could be used to estimate the degradation of sparfloxacin in a stability study. However, the low activity exhibited by UV-irradiated sparfloxacin is a source of concern that demands further investigation of the mechanism of its photodegradation mechanism.

Análise térmica de esparfloxacino

Sparfloxacin, a third-generation fluoroquinolone, is a potent antibacterial agent against a wide range of Gram-positive and Gram-negative organisms, for example Streptococcus pneumonias, Staphylococcus aureus (including methicillin-resistant strains), Legionella spp., Mycoplasma spp., Chlamydia spp. and Mycobacterium spp. This compound has been submitted to thermal analysis and the results are presented here. The DSC curve of sparfloxacin has an endothermic peak that indicates a melting point at 276.5 °C. The DTA curve of the sample in synthetic air shows two exothermic peaks, at 341.6 and 579.2 °C, attributed to compound decomposition. In the TG curve, the loss of mass can be seen to occur in two steps between 285.5 and 645.3 °C. The DTA curve obtained in a nitrogen atmosphere shows an exothermic peak, with decomposition of sparfloxacin at 340.0 °C; from the corresponding TG plot, the loss of mass starts at 254.4 °C.

Prevalência das doenças sexualmente transmissíveis em mulheres profissionais do sexo do Município de Botucatu/SP

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

Diagnóstico citológico e molecular da infecção pelo HPV em mulheres do município de Barcarena, Pará, Norte do Brasil

O HPV (Papilomavírus humano) foi apontado pela OMS (Organização Mundial de Saúde - WHO) como principal fator de risco para o desenvolvimento do câncer de colo uterino, tornando-se assim um importante e gravíssimo problema de saúde pública, especialmente nos países subdesenvolvidos ou em desenvolvimento. A precocidade das atividades sexuais, múltiplos parceiros e sexo casual, o tabagismo, a imunossupressão (por exemplo, na população de pacientes aidéticos), gravidez, doenças sexualmente transmissíveis prévias como herpes e clamídia, além do não cumprimento das medidas já adotadas como prevenção de Doenças Sexualmente Transmissíveis (DST), como por exemplo, o simples uso de preservativos, está reconhecidamente associado à incidência da infecção por HPV. Essa pesquisa teve como objetivo avaliar o desempenho diagnóstico das metodologias de citologia convencional (Exame de Papanicolau) em relação à citologia em base líquida, além de determinar a prevalência dos genótipos 16 e 18 do HPV em mulheres sem efeito citopático compatível com HPV e relacionar a presença de quadros inflamatórios, associados ou não ao HPV, com dados epidemiológicos como idade, escolaridade, condição sociocultural de mulheres provenientes do município de Barcarena – Pará – Brasil. Para tanto, participaram deste estudo, voluntariamente, 50 mulheres atendidas na Unidade de Saúde de Barcarena – Pará, através de campanha para coleta de Exame de Papanicolau como método de prevenção de câncer do colo do útero. Estas mulheres receberam informações referentes a todos os procedimentos realizados pelo corpo de saúde deste estudo e aos resultados desta pesquisa e somente após as voluntárias terem assinado o Termo de Consentimento Livre e Esclarecido, as mesmas foram incluídas para as coletas de amostras. As análises e os resultados dos testes de citologia de base líquida e convencional foram realizados segundo a Classificação de Bethesda e revisados cegamente por dois citopatologistas. Para a análise estatístca foi utilizado o teste exato de Fisher e o "Screening Test" visando determinar a especificidade/ sensibilidade dos métodos, considerando significativo o valor de p ≤ 0,05. Como resultado, observamos que o uso da citologia de base líquida tem demonstrado uma série de vantagens em relação à citologia convencional. No diagnóstico molecular (PCR) foram observadas ocorrências de HPV dos tipos 16 e 18 em 10% das mulheres atendidas. Dentre os casos que apresentaram PCR positivo para os tipos 16 ou 16/18 a maioria das mulheres tinham 27,4 anos de idade em média; com maior escolaridade; que exercem atividades domésticas e rurais; e com ocorrências de co-infecção por agentes infecciosos causadores de outras doenças sexualmente transmissíveis. Os resultados obtidos neste estudo reforçam a importância da manutenção de campanhas gratuitas de prevenção do câncer de colo do útero como uma medida preventiva no combate desta doença, principalmente no Estado do Pará onde, provavelmente, o perfil epidemiológico da doença está associado às grandes distâncias que as mulheres de comunidades ribeirinhas têm que percorrer para realizar este exame de forma gratuita; ao tipo de atividade econômica da região; ao preconceito local ainda existente com o exame; e ao grau de dificuldade de implementação de ações efetivas de retorno das pacientes às consultas médicas após a obtenção do resultado do exame e mesmo o encaminhamento para diagnóstico molecular dos casos positivos para lesões do tipo ASC-H e NIC I, II e III.

Descrição de outras doenças sexualmente transmissíveis em pessoas infectadas pelo vírus da imunodeficiência humana do tipo 1

Noventa pacientes soropositivos para o HIV-1 foram estudados, visando-se a descrição de manifestações clínicas e de marcadores de outras doenças sexualmente transmissíveis, assim como de fatores demográficos e comportamentais que possam estar relacionados com a infecção pelo HIV-1 e em pacientes com SIDA/AIDS. A maioria dos entrevistados (83,3%) foi do sexo masculino, apresentou a média de idade 31,4 anos (variando entre 18 e 60 anos) e a distribuição da renda familiar mensal mostrou que 79,5% tinham um ganho inferior a cinco salários mínimos. Pelos menos um tipo de droga, foi consumido por 51,1%, sendo que 20.7% usaram droga não medicamentosa de uso injetável. Destes, 94,4% referiram antecedentes de doenças sexualmente transmissíveis. A observação dos hábitos sexuais revelou que 41,6% eram bissexuais, 38,2% heterossexuais e 20,2% eram homossexuais. Cerca de 51,1% dos bissexuais usaram drogas injetáveis e todos referiram a prática de sexo anal e foram positivos para a presença de anticorpos para Chlamydia. A média de idade da primeira relação sexual com penetração foi de 14.7 anos, enquanto que a média de idade em que ocorreu a primeira doença sexualmente transmissível foi de 20.6 anos. A quase totalidade (95,5%) dos entrevistados tiveram múltiplos parceiros sexuais, antes do conhecimento da soropositividade para o HIV-1. Dentre os 90 soropositivos, 73,3% referiram antecedentes de doenças sexualmente transmissíveis. Destes, 82,2% referiram a presença de secreção uretraI, de sífilis e de herpes simples. No momento da avaliação, 36,6% (33/90) apresentaram secreção uretral, anal e/ou vaginal, lesão genital, anal, perianal e/ou adenopatia inguinal, assim discriminado: Secreção (51,1%), vesículas (18,1%), lesão verrucosa (18,1%), Adenopatias iguinais ( 18,1% ), úlceras ( 12,1 %) e pápulas (6% ). A reação do VDRL foi positiva em 13,7% (11/80), sendo que neste grupo, 90,9% referiram a prática do sexo anal e 81,8% revelaram antecedentes de DST. Cerca de 96,4% (81/84) apresentaram anticorpos para Chlamydia, sendo que 81,8% revelaram a prática do sexo anal e 72,8% relataram antecedentes de DST .

Perfil epidemiológico e prevalência de doenças sexualmente transmissíveis em escolares da área urbana no município de Porto Velho - Rondônia

As doenças sexualmente transmissíveis (DST) estão entre os problemas de saúde pública mais comuns em todo o mundo, principalmente entre os adolescentes, pois eles são mais vulneráveis em relação à sexualidade, tanto em países industrializados como nos em desenvolvimento. Este estudo tem por objetivo investigar a prevalência de doenças sexualmente transmissíveis em escolares da rede pública municipal de ensino da área urbana do município de Porto Velho, Estado de Rondônia. Foram investigados 122 alunos da Escola Municipal de Ensino Fundamental Marechal Joaquim Vicente Rondon, na faixa etária de 11 a 19 anos, através de questionário de autopreenchimento e coleta de amostras de sangue, secreção uretral e vaginal. O método sorológico ELISA (Ensaio imunoenzimático) e a bacterioscopia pelo método de Gram foram os testes utilizados para detecção e identificação de DST. 84,4% dos estudantes responderam saber o que é uma DST, 82,8% informaram que usavam preservativo durante as relações sexuais para prevenir DST, 11,5% não utilizavam o preservativo e 5,7% afirmaram que selecionavam seus parceiros sexuais. Foram examinadas 83 amostras de soro pelo teste ELISA e 41 esfregaços corados pelo método de Gram. A prevalência encontrada para Chlamydia foi de 65,3% no sexo feminino e 34,6% no sexo masculino. Os agentes biopatogênicos encontrados com mais freqüência foram Gardnerella vaginalis, Candida albicans e Trichomonas vaginalis.