Leishmaniasis is an endemic disease in developing countries. The efficacy of therapy is usually evaluated through clinical parameters. To define the parasitologic cure, 20 patients were biopsied ...before and 1 month to 8 years after treatment. Paraffin-embedded tissue was used for DNA isolation. All patients had a positive polymerase chain reaction (PCR) result before therapy, except 1, for whom no histopathologic material was available. The causative agent was identified as belonging to the Leishmania (Viannia) subgenus by hybridization. Despite clinical healing and absence of reactivation or development of mucosal lesions, PCR was positive in scars of 16 patients (80%). The results suggest that parasites persist in the skin for many years despite treatment. Depending on specific pathogenetic features of the parasite and the immune status of the host, this phenomenon might result in mucosal lesions. Alternatively, it could have a role in the maintenance of immunologic memory in patients living in areas in which leishmaniasis is endemic.
Leishmania RNA virus (LRV) has been shown to be a symbiotic component of Leishmania parasites in South America. Nested retro-transcription polymerase chain reaction was employed to investigate LRV1 ...presence in leishmaniasis lesions from Brazil. In endemic areas of Rio de Janeiro (RJ), no LRV1 infection was observed even with mucosal involvement. LRV1 was only detected in Leishmania (V.) guyanensis cutaneous lesions from the northern region, which were obtained from patients presenting with disease reactivation after clinical cure of their primary lesions. Our results indicated that the severity of leishmaniasis in some areas of RJ, where Leishmania (V.) brazi-liensis is the primary etiological agent, was not associated with Leishmania LRV1 infection.
Background Leishmaniasis recidiva cutis (LRC) is rare in New World leishmaniasis. Only seven cases have been reported so far.
Materials and methods Four cases are reported here. Parasite diagnosis ...was performed by classical methods of touch preparations, histopathologic sections, and cultures. In addition, the detection of parasite DNA by the polymerase chain reaction (PCR) was performed in all cases.
Results Parasites were detected by at least one of the classical methods in all primary lesions; however, only the PCR was positive in the recidivant lesions.
Discussion LRC cases most likely represent a reactivation of an initial infection, probably due to the persistence of parasites in scarred tissue. Although lupoid leishmaniasis (LL) has been used as a synonym of LRC, a clear difference between LRC and LL can be defined as LL is the initial clinical presentation while LRC is a recurrent lesion.
Conclusions The results indicate that it is not appropriate to use these two denominations as synonyms. The designation of LRC should be maintained in order to define recidives occurring at the border of an old scar of cutaneous leishmaniasis, avoiding the confusion with the lupoid form of the disease.
Subclinical or asymptomatic infection is documented in individuals
living in endemic areas for leishmaniasis suggesting that the
development of an appropriate immune response can control parasite
...replication and maintain tissue integrity. A low morbidity indicates
that intrinsic factors could favor resistance to Leishmania infection.
Herein, leishmanial T-cell responses induced in subjects with low
susceptibility to leishmaniasis as asymptomatic subjects were compared
to those observed in cured cutaneous leishmaniasis (CCL) patients, who
controlled the disease after antimonial therapy. All of them have shown
maintenance of specific long-term immune responses characterized by
expansion of higher proportions of CD4+ as compared to CD8+ Leishmania
reactive T-lymphocytes. Asymptomatic subjects had lower indexes of in
vitro Leishmania induced lym-phoproliferative responses and
interferon-gamma (IFN-γ) production in comparison to CCL patients.
On the other hand, interleukin (IL-10) production was much higher in
asymptomatics than in CCL, while no differences in IL-5 levels were
found. In conclusion, long lived T-cell responses achieved by
asymptomatic individuals differed from those who had developed
symptomatic leishmaniasis in terms of intensity of lymphocyte
activation (proliferation or IFN-γ) and regulatory mechanisms
(IL-10). The absence of the disease in asymptomatics could be explained
by their intrinsic ability to create a balance between immunoregulatory
(IL-10) and effector cytokines (IFN-γ), leading to parasite
destruction without producing skin tissue damage. The establishment of
profiles of cell-mediated immune responses associated with resistance
against Leishmania infection is likely to make new inroads into
understanding the long-lived immune protection against the disease.
We report a case of cutaneous mucormycosis in a healthy, immunocompetent young girl (age 14 years). The patient had a 5-year history of a slowly enlarging, erythematous plaque with slight elevated, ...scaling, circinate borders on the right thigh. Histopathology showed a granulomatous infiltrate with broad, pale, non-septate hyphae. Mycological study identified Mucor hiemalis (Wehmer).
Mitochondrial swelling is involved in the pathogenesis of many human diseases associated with oxidative stress including obesity. One of the strategies for prevention of deleterious effects related ...to obesity and overweight is engaging in regular physical activity, of which high intensity interval training (HIIT) is efficient in promoting biogenesis and improving the function of mitochondria. Therefore, our aims were to investigate the effects of HIIT on metabolic and neuro-cardiovascular dynamic control and mitochondrial swelling induced by high-fat diet (HFD). Twenty-three male Wistar rats (60 - 80g) were divided into 4 subgroups: control (C), HIIT, HFD and HFD+HIIT. The whole experimentation period lasted for 22 weeks and HIIT sessions were performed 5 days a week during the last 4 weeks. At the end of the experiments, fasting glucose and insulin tolerance tests were performed. Cerebral microcirculation was analyzed using cortical intravital microscopy for capillary diameter and functional density. Cardiac function and ergoespirometric parameters were also investigated. Mitochondrial swelling was evaluated on brain and heart extracts. HFD promoted an increase on body adiposity (p<0.001), fasting glucose levels (p<0.001), insulin resistance index (p<0.05), cardiac hypertrophy index (p<0.05) and diastolic blood pressure (p<0.05), along with worsened cardiac function (p<0.05), reduced functional cerebral capillary density (p<0.05) and its diameter (p<0.01), and heart and brain mitochondrial function (p<0.001). HFD did not affect any ergoespirometric parameter. After 4 weeks of training, HIIT was able to improve cardiac hypertrophy index, diastolic blood pressure, cerebral functional capillary density (p<0.01) and heart and brain mitochondrial swelling (p<0.001). In animals subjected to HFD, HIIT ameliorated both cerebral mitochondrial swelling and functional capillary density, but it did not improve cardiovascular function suggesting that the cardiovascular dysfunction elicited by HFD was not due to heart mitochondrial swelling.
Studies have shown that autologous hematopoietic SCT (HSCT) can be used as an intensive immunosuppressive therapy to treat refractory patients and to prevent the progression of multiple sclerosis ...(MS). This is a prospective multicentric Brazilian MS trial comparing two conditioning regimens: BEAM/horse ATG and CY/rabbit ATG. Most (80.4%) of the 41 subjects in the study had the secondary progressive MS subtype and the mean age was 42 years. The baseline EDSS score in 58.5% of the subjects was 6.5 and 78% had a score of 6.0 or higher, respectively. The complication rate during the intra-transplantation period was 56% for all patients: 71.4% of the patients in the BEAM/hATG group and 40% in the CY/rATG group (P=0.04). Three subjects (7.5%) died of cardiac toxicity, sepsis and alveolar hemorrhage, all of them in the BEAM/ATG group. EFS was 58.54% for all patients: 47% in the BEAM/hATG group and 70% in the CY/rATG group (P=0.288). In conclusion, the CY/rATG regimen seems to be associated with similar outcome results, but presented less toxicity when compared with the BEAM/hATG regimen. Long-term follow-up would be required to fully assess the differences in therapeutic effectiveness between the two regimens.
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