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Search Results: 1 - 10 of 119320 matches for " Maria da Providencia;Da-Cruz "
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Disseminated American muco-cutaneous leishmaniasis caused by Leishmania brasiliensis brasiliensis in a patient with AIDS: a case report
Machado, Elizabeth S.;Braga, Maria da Providencia;Da-Cruz, Alda Maria;Coutinho, Sérgio G.;Vieira, Alba Regina M.;Rutowitsch, Marcio S.;Cuzzi-Maya, Tulia;Grimaldi Junior, Gabriel;Menezes, Jacquelie A.;
Memórias do Instituto Oswaldo Cruz , 1992, DOI: 10.1590/S0074-02761992000400005
Abstract: the authors report a case of culture-proven disseminated american muco-cutaneous leishmaniasis caused by leishmania brasiliensis brasiliensis in an hiv positive patient. lesions began in the oropharynx and nasal mucosa eventually spreading to much of the skin surface. the response to a short course of glucantime therapy was good.
Lipopolysaccharide-Induced Cellular Activation May Participate in the Immunopathogenesis of Visceral Leishmaniasis Alone or in HIV Coinfection
Joanna Reis Santos-Oliveira,Alda Maria Da-Cruz
International Journal of Microbiology , 2012, DOI: 10.1155/2012/364534
Abstract: Visceral Leishmaniasis (VL) is an infectious disease which constitutes a serious public health problem, integrating the list of neglected tropical diseases. The disease is characterized by a Leishmania-specific immune suppression T-cell depletion and a decrease of other hematopoietic cells. In parallel, an immunostimulatory response also occurs, represented by polyclonal B lymphocytes, T-cell activation, and systemic proinflammatory responses. Parasite antigens were believed to mediate both suppression and activation mechanisms, but these concepts are constantly being revised. Similar to reports on HIV/AIDS, we have proposed that gut parasitation by amastigotes and lymphocyte depletion could also affect gut-associated lymphoid tissue, leading to mucosal barrier breach and predisposing to microbial translocation. An increment of plasmatic lipopolysaccharide (LPS) levels observed in Brazilian VL patients was implicated in the reduced blood CD4
Lipopolysaccharide-Induced Cellular Activation May Participate in the Immunopathogenesis of Visceral Leishmaniasis Alone or in HIV Coinfection
Joanna Reis Santos-Oliveira,Alda Maria Da-Cruz
International Journal of Microbiology , 2012, DOI: 10.1155/2012/364534
Abstract: Visceral Leishmaniasis (VL) is an infectious disease which constitutes a serious public health problem, integrating the list of neglected tropical diseases. The disease is characterized by a Leishmania-specific immune suppression T-cell depletion and a decrease of other hematopoietic cells. In parallel, an immunostimulatory response also occurs, represented by polyclonal B lymphocytes, T-cell activation, and systemic proinflammatory responses. Parasite antigens were believed to mediate both suppression and activation mechanisms, but these concepts are constantly being revised. Similar to reports on HIV/AIDS, we have proposed that gut parasitation by amastigotes and lymphocyte depletion could also affect gut-associated lymphoid tissue, leading to mucosal barrier breach and predisposing to microbial translocation. An increment of plasmatic lipopolysaccharide (LPS) levels observed in Brazilian VL patients was implicated in the reduced blood CD4+ and CD8+ T cell counts, systemic T-cell activation, pro-inflammatory cytokines and MIF plasma levels, suggesting that a bacterial molecule not associated with Leishmania infection can exert deleterious effects on immune system. Recent results also pointed that the proinflammatory response was potentiated in VL/HIV-AIDS coinfected patients. The LPS-mediated cell activation adds another concept to the immunopathogenesis of VL and can bring a rational for new therapeutic interventions that could ameliorate the management of these patients. Visceral leishmaniasis (VL) is an infectious disease caused by protozoans of Leishmania sp. genus. VL is a serious public health problem integrating the list of neglected tropical diseases. In a recent World Health Organization report, 0.2 to 0.4 million cases were globally estimated in the last five years [1]. Ninety percent of them occur in only six countries: India, Bangladesh, Sudan, South Sudan, Brazil, and Ethiopia [1, 2]. The infection is transmitted by sandflies, and nowadays, L. (Leishmania)donovani and L. infantum (sin. L. chagasi) are the main species causing VL [3]. These protozoans are intracellular obligate parasites that infect macrophage cell lineages from lymphoid organs such as bone marrow, spleen, liver, and lymph nodes. VL is classically characterized by fever, hepatosplenomegaly, cachexia, blood cytopenia, and a high parasite burden [4, 5]. It has a high mortality rate, and even in treated patients, the case fatality rates are of 10–20% [1], especially in HIV-coinfected patients [6]. Immunological response is directly involved in the disease’s clinical outcome,
VACINAS:: PROGRESSOS E NOVOS DESAFIOS PARA O CONTROLE DE DOEN?AS IMUNOPREVENíVEIS
FONSECA PINTO,EDUARDO; MATTA,NUBIA ESTELA; DA-CRUZ,ALDA MARIA;
Acta Biológica Colombiana , 2011,
Abstract: for over 200 years, vaccination has been a very effective tool to prevent infectious diseases along with sanitation. in practical terms, it can be considered the greatest public health benefit of the twentieth century. however, vaccine development remains as a developing domain in the field of immunology and in the last decade there has been a shift towards a more rational approach in vaccination design, based on a molecular understanding of microbial pathogenesis, the use of new recombinant technologies and the development of more effective delivery systems for vaccines. this paper describes the progress in vaccine development from the first reports of vaccination practices, through the current state of vaccine development, the new vaccine strategies and the impact of vaccination in the control of preventable diseases.
Enhanced T cell activation in Plasmodium falciparum malaria-infected human immunodeficiency virus-1 patients from Mozambique
Chavale, Helena;Santos-Oliveira, Joanna Reis;Da-Cruz, Alda Maria;Enosse, Sonia;
Memórias do Instituto Oswaldo Cruz , 2012, DOI: 10.1590/S0074-02762012000800004
Abstract: human immunodeficiency virus (hiv)-1 infection has an important impact on malaria. plasmodium falciparum and hiv-1 co-infected patients (pf/hiv) present with a high degree of anaemia, enhanced parasitaemia and decreased cd4+ t cell counts, which increase the risk of developing severe malaria. in addition, infection with either pf or hiv-1 alone causes extensive immune activation. our hypothesis was that lymphocyte activation is potentiated in pf/hiv co-infected patients, consequently worsening their immunosuppressed state. to test this hypothesis, 22 pf/hiv patients, 34 malaria patients, 29 hiv/aids patients and 10 healthy controls without malaria or hiv/acquired immune deficiency syndrome (aids) from maputo/mozambique were recruited for this study. as expected, anaemia was most prevalent in the pf/hiv group. a significant variation in parasite density was observed in the pf/hiv co-infected group (110-75,000 parasites/μl), although the median values were similar to those of the malaria only patients. the cd4+ t cell counts were significantly lower in the pf/hiv group than in the hiv/aids only or malaria only patients. lymphocyte activation was evaluated by the percentage of activation-associated molecules [cd38 expression on cd8+ and human leukocyte antigen-dr expression on cd3+ t cells]. the highest cd38 expression was detected in the pf/hiv co-infected patients (median = 78.2%). the malaria only (median = 50%) and hiv/aids only (median = 52%) patients also exhibited elevated levels of these molecules, although the values were lower than those of the pf/hiv co-infected cases. our findings suggest that enhanced t-cell activation in co-infected patients can worsen the immune response to both diseases.
Chagas' Disease and HIV Co-infection: Genotypic Characterization of the Trypanosoma cruzi Strain
Pacheco, Raquel S;Ferreira, Marcelo S;Machado, Maria Inês;Brito, Célia MM;Pires, Marize Q;Da-Cruz, Alda M;Coutinho, Sérgio G;
Memórias do Instituto Oswaldo Cruz , 1998, DOI: 10.1590/S0074-02761998000200005
Abstract: in the past few years, new aspects of the immunopathology of chagas' disease have been described in immunosuppressed patients, such as fatal central nervous system lesions related to the reactivation of the parasite. this article is the first description of the genotypic characterization, at the strain level, of trypanosoma cruzi isolated from a patient with chagas` disease/aids co-infection. the presence of four hypodense lesions was observed in the cranial compute tomographic scan. the diagnosis of aids was assessed by the detection of anti-hiv antibodies using enzyme-linked immunosorbent assay (elisa) and western blot techniques. the cd4+ lymphocyte counts were maintained under 200 cells/mm3 during one year demonstrating the severity of the state of immunosuppression. chagas' disease was confirmed by serological and parasitological methods. trypomastigote forms were visualized in a thick blood smear. the parasite isolated is genotypically similar to the cl strain. the paper reinforces that cerebral chagas' disease can be considered as another potential opportunistic infection in aids resulting from the reactivation of a dormant t. cruzi infection acquired years earlier.
Tumor necrosis factor-α in human American tegumentary leishmaniasis
Da-Cruz, Alda Maria;Oliveira, Márcia Pereira de;De Luca, Paula Mello;Mendon?a, Sergio CF;Coutinho, Sergio G;
Memórias do Instituto Oswaldo Cruz , 1996, DOI: 10.1590/S0074-02761996000200019
Abstract: tumor necrosis factor-alpha (tnf-α) is a cytokine produced by activated macrophages and other cells. in order to verify whether the serum levels of tnf-α in american tegumentary leishmaniasis patients are associated with the process of cure or aggravation of the disease, 41 patients were studied: 26 cases of cutaneous leishmaniasis (cl) and 15 of mucocutaneous leishmaniasis (mcl). during active disease the serum levels of tnf-α of mcl patients were significantly higher than those of cl patients and control subjects (healthy individuals and cutaneous lesions from other etiologies). the mcl patients had serum titers of tnf-α significantly lower at the end of antimonial therapy than before therapy. after a six-month follow-up, the mcl patients had serum levels of tnf-α similar to those observed at the end of the therapy as well as to those of cl patients and control subjects. no significant variation in the serum levels of tnf-α was observed in cl patients throughout the study period (before, at the end of therapy and after a six-month follow-up). the possible relationship between the high tnf-α serum levels and severity of the disease is discussed.
Dyarrheal Syndrome in a Patient Co-Infected with Leishmania infantum and Schistosoma mansoni
Gláucia Fernandes Cota,Luciana Inácia Gomes,Bruna Fernandes Pinto,Joanna R. Santos-Oliveira,Alda Maria Da-Cruz,Moisés Salgado Pedrosa,Wagner Luiz Tafuri,Ana Rabello
Case Reports in Medicine , 2012, DOI: 10.1155/2012/240512
Abstract: This case report describes an atypical clinical presentation of visceral leishmaniasis affecting the digestive tract and causing malabsorption syndrome in a patient without recognized immunosuppressive condition. After appropriate treatment for the classical visceral form of the disease, diarrhea persisted as the main symptom and massive infection by Leishmania was detected by histopathology analysis of the duodenal mucosa. Schistosoma mansoni coinfection was also confirmed and treated without impact on diarrhea. New course of amphotericin B finally led to complete improvement of diarrhea. Atypical visceral leishmaniasis involving the gastrointestinal tract is well recognized in HIV coinfection but very rare in immunocompetent patients. The factors determining the control or evolution of the Leishmania infection have not been completely identified. This case stresses the importance of atypical symptoms and the unusual location of visceral leishmaniasis, not only in immunodepressed patients, and raises the possible influence of chronic infection by S. mansoni reducing the immune response to Leishmania.
Dyarrheal Syndrome in a Patient Co-Infected with Leishmania infantum and Schistosoma mansoni
Gláucia Fernandes Cota,Luciana Inácia Gomes,Bruna Fernandes Pinto,Joanna R. Santos-Oliveira,Alda Maria Da-Cruz,Moisés Salgado Pedrosa,Wagner Luiz Tafuri,Ana Rabello
Case Reports in Medicine , 2012, DOI: 10.1155/2012/240512
Abstract: This case report describes an atypical clinical presentation of visceral leishmaniasis affecting the digestive tract and causing malabsorption syndrome in a patient without recognized immunosuppressive condition. After appropriate treatment for the classical visceral form of the disease, diarrhea persisted as the main symptom and massive infection by Leishmania was detected by histopathology analysis of the duodenal mucosa. Schistosoma mansoni coinfection was also confirmed and treated without impact on diarrhea. New course of amphotericin B finally led to complete improvement of diarrhea. Atypical visceral leishmaniasis involving the gastrointestinal tract is well recognized in HIV coinfection but very rare in immunocompetent patients. The factors determining the control or evolution of the Leishmania infection have not been completely identified. This case stresses the importance of atypical symptoms and the unusual location of visceral leishmaniasis, not only in immunodepressed patients, and raises the possible influence of chronic infection by S. mansoni reducing the immune response to Leishmania. 1. Introduction Visceral leishmaniasis (VL) due to (Leishmania) infantum (sin L. chagasi) is endemic in Brazil. The incidence in adult patients has increased in recent years [1]. Typical clinical features are fever, hepatosplenomegaly, hypergammaglobulinaemia, and pancytopenia. Cases of VL have also presented atypically involving the lungs, pleura, oral mucosa, larynx, esophagus, stomach, small intestine, and skin [2, 3]. These atypical cases were described mostly in patients infected with HIV [4, 5] or with any recognized immunosuppressive condition such as diabetes, lymphoma and elderly [3, 6, 7]. It suggested that the clinical manifestations may be influenced by the immunological status of the host. 2. Case Report A 42-year-old man presented with a six-month history of nonbloody diarrhea associated with the clinical triad of fever, splenomegaly, and pancytopenia. Anti-Leishmania antibodies serological tests (indirect immunofluorescence title 1?:?640 and rapid test with the recombinant k39) were positive. The diagnosis of visceral leishmaniasis was firmed by the detection of amastigotes in a bone marrow aspirate smears. Because of upper gastrointestinal symptoms (mild dysphagia and vomiting), an esophagogastroduodenoscopy was performed, revealing in duodenum the presence of erosions coated with fibrin, plates of enanthema, and thickened pleats with small whitish spots distributed diffusely. In a tissue fragment obtained by biopsy, the duodenal mucosa
HIV/AIDS-associated visceral leishmaniasis in patients from an endemic area in Central-west Brazil
Alexandrino-de-Oliveira, Priscilla;Santos-Oliveira, Joanna Reis;Dorval, Maria Elizabeth Cavalheiros;Da-Costa, Francisco das Chagas Brand?o;Pereira, Gracy Regina Oliveira Leite;Cunha, Rivaldo Venancio da;Paniago, Anamaria Mello Miranda;Da-Cruz, Alda Maria;
Memórias do Instituto Oswaldo Cruz , 2010, DOI: 10.1590/S0074-02762010000500016
Abstract: an increase in morbidity associated with visceral leishmaniasis (vl) in human immunodeficiency virus (hiv)/aids patients has been described in africa and the mediterranean. despite the high endemicity of vl and hiv-1/aids in brazil, this association has not been thoroughly investigated. our aim was to evaluate the epidemiologic and clinical characteristics of vl-hiv-1/aids cases from central-west [mato grosso do sul (ms)] brazil. medical records of 23 vl-hiv-1/aids patients were reviewed. patients were predominantly adult males (87%) and 34.8% of the patients were intravenous drug users (ivdu). leishmaniasis was the first opportunistic infection in 60% of the hiv-1 patients. fever occurred in all patients, although splenomegaly and hepatomegaly were absent in 21.7% of the cases. cd4+ t-cell counts were below 200 cells/mm3 in 80% of the cases and the counts did not increase after clinical remission despite antiretroviral therapy. the first drug chosen to treat the cases was antimonial, but the therapeutic regimen was altered to amphotericin b in 12 of 17 cases due to side effects. relapses were reported in 56.5% of the patients. ivdu may constitute an important risk factor for the transmission of both diseases in ms. vl-hiv-1/aids patients in ms share similar clinical characteristics as those from other endemic regions worldwide. thus, these findings are critical for improving the surveillance of vl-hiv/aids patients.
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