Summary
Schwann cells (SCs) critically maintain the plasticity of the peripheral nervous system. Peripheral nerve injuries and infections stimulate SCs in order to retrieve homeostasis in neural ...tissues. Previous studies indicate that Mycobacterium leprae (ML) regulates the expression of key factors related to SC identity, suggesting that alterations in cell phenotype may be involved in the pathogenesis of neural damage in leprosy. To better understand whether ML restricts the plasticity of peripheral nerves, the present study sought to determine the expression of Krox‐20, Sox‐10, c‐Jun and p75NTR in SC culture and mice sciatic nerves, both infected by ML Thai‐53 strain. Primary SC cultures were stimulated with two different multiplicities of infection (MOI 100:1; MOI 50:1) and assessed after 7 and 14 days. Sciatic nerves of nude mice (NU‐Foxn1nu) infected with ML were evaluated after 6 and 9 months. In vitro results demonstrate downregulation of Krox‐20 and Sox‐10 along with the increase in p75NTR‐immunolabelled cells. Concurrently, sciatic nerves of infected mice showed a significant decrease in Krox‐20 and increase in p75NTR. Our results corroborate previous findings on the interference of ML in the expression of factors involved in cell maturation, favouring the maintenance of a non‐myelinating phenotype in SCs, with possible implications for the repair of adult peripheral nerves.
The ongoing transmission of Mycobacterium (M.) leprae reflected in a very slow decline in leprosy incidence, forces us to be innovative and conduct cutting-edge research. Single dose rifampicin (SDR) ...as post-exposure prophylaxis (PEP) for contacts of leprosy patients, reduces their risk to develop leprosy by 60%. This is a promising new preventive measure that can be integrated into routine leprosy control programmes, as is being demonstrated in the Leprosy Post-Exposure Programme that is currently ongoing in eight countries.The limited (60%) effectiveness of SDR is likely due to the fact that some contacts have a preclinical infection beyond the early stages for which SDR is not sufficient to prevent the development of clinical signs and symptoms of leprosy. An enhanced regimen, more potent against a higher load of leprosy bacteria, would increase the effectiveness of this preventive measure significantly.The Netherlands Leprosy Relief (NLR) is developing a multi-country study aiming to show that breaking the chain of transmission of M. leprae is possible, evidenced by a dramatic reduction in incidence. In this study the assessment of the effectiveness of an enhanced prophylactic regimen for leprosy is an important component. To define the so called PEP++ regimen for this intervention study, NLR convened an Expert Meeting that was attended by clinical leprologists, public health experts, pharmacologists, dermatologists and microbiologists.The Expert Meeting advised on combinations of available drugs, with known efficacy against leprosy, as well as on the duration of the intake, aiming at a risk reduction of 80-90%. To come to a conclusion the Expert Meeting considered the bactericidal, sterilising and bacteriostatic activity of the potential drugs. The criteria used to determine an optimal enhanced regimen were: effectiveness, safety, acceptability, availability, affordability, feasibility and not inducing drug resistance.The Expert Meeting concluded that the enhanced regimen for the PEP++ study should comprise three standard doses of rifampicin 600 mg (weight adjusted when given to children) plus moxifloxacin 400 mg given at four-weekly intervals. For children and for adults with contraindications for moxifloxacin, moxifloxacin should be replaced by clarithromycin 300 mg (weight adjusted).
Increased hepcidin expression in multibacillary leprosy Souza, Vânia Nieto Brito de; Malaspina, Tatiana Salles de Souza; Campanelli, Ana Paula ...
Memórias do Instituto Oswaldo Cruz
107 Suppl 1, Issue:
suppl 1
Journal Article
Peer reviewed
Open access
Iron is essential for all organisms and its availability can control the growth of microorganisms; therefore, we examined the role of iron metabolism in multibacillary (MB) leprosy, focusing on the ...involvement of hepcidin. Erythrograms, iron metabolism parameters, pro-inflammatory cytokines and urinary hepcidin levels were evaluated in patients with MB and matched control subjects. Hepcidin expression in MB lesions was evaluated by quantitative polymerase chain reaction. The expression of ferroportin and hepcidin was evaluated by immunofluorescence in paucibacillary and MB lesions. Analysis of hepcidin protein levels in urine and of hepcidin mRNA and protein levels in leprosy lesions and skin biopsies from healthy control subjects showed elevated hepcidin levels in MB patients. Decreases in haematologic parameters and total iron binding capacity were observed in patients with MB leprosy. Moreover, interleukin-1 beta, ferritin, soluble transferrin receptor and soluble transferrin receptor/log ferritin index values were increased in leprosy patients. Hepcidin was elevated in lepromatous lesions, whereas ferroportin was more abundant in tuberculoid lesions. In addition, hepcidin and ferroportin were not colocalised in the biopsies from leprosy lesions. Anaemia was not commonly observed in patients with MB; however, the observed changes in haematologic parameters indicating altered iron metabolism appeared to result from a mixture of anaemia of inflammation and iron deficiency. Thus, iron sequestration inside host cells might play a role in leprosy by providing an optimal environment for the bacillus.
Chronic leg ulcer may have an impact on patients' quality of life.
This study aimed to identify the impact of leg ulcers on patient's quality of life using the Dermatology Life Quality Index and to ...define the main factors correlated with this perception.
Cross-sectional, non-probabilistic sampling study. We included patients with chronic leg ulcers being treated for at least 3 months. A sociodemographic and clinical survey was conducted to assess the profile of the ulcers. We administered a screening for depressive symptoms and the Dermatology Life Quality Index. We performed a descriptive statistical analysis, chi-square test and Mann-Whitney test for categorical data, Pearson for numeric variables, and multiple regression for categorical data.
Forty-one patients were assessed. Their mean age was 61.78 years. Venous ulcers (48.8%) were the most prevalent. Seventy-three percent of the sample perceived no impact/low impact on quality of life in the past week, and 26.8% perceived moderate/high impact. A multiple regression analysis identified the causes of lesion, pain related to the ulcers, time of onset, and severity of the depressive symptoms as the variables that had an influence on quality of life.
The majority of the sample perceived low or no impact of the condition on the quality of the life. The variables etiology of the lesion (p<0.001), pain related to the ulcers (p=0.001), time of onset (p=0.006), and severity of the depressive symptoms (p<0.001) had an influence on the quality of life, suggesting the need for further studies with more robust designs to confirm the causal relationship between these characteristics and quality of life.
A clofazimina, um corante riminofenazínico, sintetizado, por BARRY et al, em 1957, apresenta atividade antimicobacteriana e foi inicialmente empregada no tratamento de tuberculose. A atividade ...antimicobacteriana, contra o M. tuberculosis, in vitro foi muito efetiva. Entretanto, estudos experimentais em camundongos e como monoterapia, sua atividade foi considerada mal sucedida, para M. tuberculosis e M. leprae.
A clofazimina, um corante riminofenazínico, sintetizado, por BARRY et al, em 1957, apresenta atividade antimicobacteriana e foi inicialmente empregada no tratamento de tuberculose. A atividade ...antimicobacteriana, contra o M. tuberculosis, in vitro foi muito efetiva. Entretanto, estudos experimentais em camundongos e como monoterapia, sua atividade foi considerada mal sucedida, para M. tuberculosis e M. leprae.
Relatos de casos em hanseníase Nascimento, Dejair Caitano do; Laguiche, Laila de
Hansenologia internationalis,
08/2024, Volume:
49
Journal Article
O relato de caso é uma modalidade de divulgação científica resultante de estudos observacionais descritivos cuja finalidade é relatar um fato raro, às vezes inédito, ou ainda que apresenta aspectos ...peculiares no que concerne à história clínica, à sintomatologia, à epidemiologia, à população alvo, às técnicas de diagnóstico e à conduta terapêutica.
Relatos de casos em hanseníase Dejair Caitano do Nascimento; Laila de Laguiche
Hansenologia internationalis,
08/2024, Volume:
49
Journal Article
Open access
O relato de caso é uma modalidade de divulgação científica resultante de estudos observacionais descritivos cuja finalidade é relatar um fato raro, às vezes inédito, ou ainda que apresenta aspectos ...peculiares no que concerne à história clínica, à sintomatologia, à epidemiologia, à população alvo, às técnicas de diagnóstico e à conduta terapêutica.
Mycobacterium peregrinum Skin Infection Wachholz, Patrick Alexander; Sette, Christiane Salgado; Caitano do Nascimento, Dejair ...
Journal of cutaneous medicine and surgery,
05/2016, Volume:
20, Issue:
3
Journal Article
Peer reviewed
Open access
Background:
Mycobacterium peregrinum is a rapidly growing mycobacterium (RGM) that rarely causes skin infections. The correct identification of the specific RGM infecting the skin will enhance ...therapeutic success.
Objective:
To highlight the importance of rapid and precise identification of the Mycobacterium involved in skin infections in order to enhance therapeutic success.
Methods:
We describe an RGM skin infection in an immunocompetent patient.
Results:
Classic methods (biochemical tests and culture) of RGM identification are time-consuming, and the histopathological features are not specific. Some molecular methods are reliable but expensive. The PRAhsp-65 is a simple procedure that is helpful in identifying the specific agent of an RGM.
Conclusion:
Although skin infections caused by M peregrinum are rare, they represent a substantial clinical challenge. Specific and more effective treatment options depend on the development of precise and rapid methods for identifying mycobacterial species.
Leishmaniose Tegumentar Americana (LTA) é uma doença infecciosa, causada por protozoários do gênero Leishmania. É uma das doenças infectoparasitárias mais incidentes no mundo. No presente trabalho ...realizou-se um estudo transversal retrospectivo das características clínicas, epidemiológicas e imunológicas de portadores de Leishmaniose Tegumentar Americana. Foram utilizados prontuários de 34 pacientes com diagnóstico de LTA. A análise estatística foi realizada pelo Teste de Spearman. O sexo masculino foi acometido em 68% e o feminino 32%. A idade variou de 1 a 92 anos. A forma cutânea localizada ocorreu em 79,5%, sendo as úlceras a forma clínica mais comum (56%). Principal área acometida foi face (44%). O tempo para o diagnóstico foi menor que 10 meses em 68% dos indivíduos. Intradermorreação de Montenegro (IDRM) foi realizada em 29 pacientes, com positividade em 89,6% e a imunofluorescência indireta (IFI) em apenas 16 pacientes, sendo positiva em 13. A idade e o tempo de evolução da doença apresentaram associação significativa com IDRM. Entretanto não foi observada associação da IFI com a idade do paciente e o tempo de doença, pelo teste de Spearman. O tratamento foi realizado na maioria dos casos com glucantime (71%), seguido de pentamidina (17%). Os resultados evidenciam que os exames sorológicos constituem uma ferramenta auxiliar e a correlação com achados clínicos e histopatológicos são imprescindíveis.
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