RESUMEN

Reproductive biotechnologies are widely consolidated as a methodology in cattle breeding and have an important impact on the genetic improvement of cattle herds. Semen is an important source of dissemination of pathogenic microorganisms during reproductive procedures. To ensure the sanitary quality of the semen, it is essential to consider the presence of various microorganisms including viruses. One of the main viral agents of reproductive interest is Bovine Alphaherpesvirus 1 (BoHV-1), the etiological agent responsible for bovine rhinotracheitis and vulvovaginitis and frequently associated with reproductive efficiency of matrices and bulls. In artificial insemination centers, semen treatment is generally based only on the use of antibiotics, ignoring the possibility of inactivating other non-bacterial infectious agents. In this context, photodisinfection emerges as a promising alternative to inactivate a wide range of microorganisms, offering a complementary or substitution approach to those conventional semen treatment methods. In this work, we evaluated the use of four halogenated sulfonated porphyrins as potential photosensitizers (PSs) for photodynamic inactivation of Bovine Alphaherpesvirus I (BoHV-1) for bovine semen disinfection. The PSs were synthesized and photophysical parameters, such as UV-Vis absorption spectra and singlet oxygen quantum yield (ΦΔ) were presented. Photoinactivation of BoHV-1 was first shown in cell culture and then confirmed in artificially infected bovine semen and then the phototoxicity of PSs against spermatozoa was evaluated. All PSs were effective in BoHV-1 inactivation; however, the photosensitizer containing two chlorine atoms, showed to be more efficient due to the shorter time required for complete viral inactivation. The slight alterations in sperm kinetics were observed, but remained within those acceptable by regulatory agencies for animal reproduction. Although the methodology used in this work only included bovine semen, we emphasize that the proposed photodisinfection methodology can be adapted and applied to a wide range of biological materials and microorganisms of animal or human interest.

RESUMEN

Do all birds' sex chromosomes follow the same canonical one-way direction of evolution? We combined cytogenetic and genomic approaches to analyze the process of the W chromosomal differentiation in two selected Passeriform species, named the Pale-breasted Thrush Turdus leucomelas and the Rufous-bellied thrush T. rufiventris. We characterized the full catalog of satellite DNAs (satellitome) of T. leucomelas, and the 10 TleSatDNA classes obtained together with 16 microsatellite motifs were in situ mapped in both species. Additionally, using Comparative Genomic Hybridization (CGH) assays, we investigated their intragenomic variations. The W chromosomes of both species did not accumulate higher amounts of both heterochromatin and repetitive sequences. However, while T. leucomelas showed a heterochromatin-poor W chromosome with a very complex evolutionary history, T. rufiventris showed a small and partially heterochromatic W chromosome that represents a differentiated version of its original autosomal complement (Z chromosome). The combined approach of CGH and sequential satDNA mapping suggest the occurrence of a former W-autosomal translocation event in T. leucomelas, which had an impact on the W chromosome in terms of sequence gains and losses. At the same time, an autosome, which is present in both males and females in a polymorphic state, lost sequences and integrated previously W-specific ones. This putative W-autosomal translocation, however, did not result in the emergence of a multiple-sex chromosome system. Instead, the generation of a neo-W chromosome suggests an unexpected evolutionary trajectory that deviates from the standard canonical model of sex chromosome evolution.

Asunto(s)

ADN Satélite , Evolución Molecular , Heterocromatina , Cromosomas Sexuales , Animales , ADN Satélite/genética , Cromosomas Sexuales/genética , Femenino , Masculino , Heterocromatina/genética , Hibridación Genómica Comparativa , Repeticiones de Microsatélite/genética , Passeriformes/genética , Hibridación Fluorescente in Situ

RESUMEN

Bovine Genital Leptospirosis (BGL) is a chronic reproductive syndrome characterized by genital infection by Leptospira spp. An accurate diagnosis of BGL is crucial to implementing proper control measures in field conditions. This study aimed to evaluate the reliability of serology by Microscopic Agglutination Test (MAT) for diagnosing leptospirosis in subfertile cows with genital infection. Of three herds, 93 non-pregnant cows with reproductive failures were submitted to the blood sampling (serology by MAT) and genital samples (lipL32-PCR). A total of 62/93 (66.6%) cows presented seroreactive to cutoff 100, while 45/93 (48.4%) cows were positive to cutoff 200, mainly against the Sejroe serogroup. In PCR analysis, 55/93 (59.1%) were positive. MAT results were compared with PCR (considered the standard), and test parameters and Cohen's kappa (ƙ) were calculated for the cut-offs 100 and 200. A ROC curve was performed for each cut-off of titers 100 to 1,600. The sensitivity and specificity of MAT100 were calculated at 66.6% and 33.3%, while for MAT200 the sensitivity was estimated as 35% and specificity as 54.5%. The accuracy of MAT was poor, being 54.8% in MAT100 and 42% in MAT200. Furthermore, the area under the curve of ROC analysis was low for all titers, and the correlation was poor for MAT100 and MAT200 (ƙ < 0). The results demonstrated that MAT is a limited technique to diagnose bovine genital carriers individually, and if only MAT is applied, genital carriers may pass undetected, impairing the control programs.

Asunto(s)

Pruebas de Aglutinación , Enfermedades de los Bovinos , Leptospirosis , Sensibilidad y Especificidad , Animales , Leptospirosis/veterinaria , Leptospirosis/diagnóstico , Bovinos , Pruebas de Aglutinación/veterinaria , Femenino , Enfermedades de los Bovinos/diagnóstico , Enfermedades de los Bovinos/microbiología , Enfermedades de los Genitales Femeninos/veterinaria , Enfermedades de los Genitales Femeninos/diagnóstico , Enfermedades de los Genitales Femeninos/microbiología , Leptospira/aislamiento & purificación , Reproducibilidad de los Resultados

RESUMEN

Despite the diagnostic capacity of ultrasonography (US) in cases of bovine enzootic hematuria (BEH), it has been underused in the medical clinic for ruminants. Studies comparing ultrasound findings in healthy animals (HA) with subclinical (SCH) and clinical (CH) BEH are scarce in the literature. As a result, the present work aims to describe the US findings of cattle at different stages of BEH evolution, evaluating the diagnostic capacity and precocity of the technique. The study was carried out on five rural properties in the municipalities of Rio Preto and Bom Jardim de Minas - MG, Brazil, using 46 dairy cattle, females over 18 months of age, evaluated and classified as G1/CH, G2/SCH and G3/HA, according to history, clinical examination and urinalysis, with subsequent ultrasound analysis of the bladder. The mean bladder wall thickness was 36.50 mm in G1/CH, 33.53 mm in G2/SCH and 37.93 mm in G3/HA. Irregular walls were observed in 53.33 % (8/15) of G1/CH, 27 0.78 % (5/18) of G2/SCH and 38.46 % (5/13) of G3/HA. Loss of the architecture of the urothelium layers was observed in 53.33 % (8/15) of G1/CH, 33.33 % (6/18) of G2/SCH and 38.46 % (5/13) of G3/HA. Multifocal and Grade I lesion were the most common. Ultrasonography allowed the identification of lesions in 38.46 % of animals that did not present hematuria and in 33.33 % of animals that presented occult blood and proved to be an efficient technique for detecting pre-clinical cases of BEH, allowing easy identification. and early onset of BEH cases.

RESUMEN

PURPOSE: To demonstrate that the presence of active retinochoroiditis in eyes with previous hyperpigmented old retinochoroidal lesions is not exclusive of ocular toxoplasmosis. METHODS: A case series was constructed by reviewing medical records. RESULTS: Four Brazilian patients presenting active posterior uveitis in eyes with previous hyperpigmented old retinochoroidal lesions were identified. Ocular toxoplasmosis was ruled out in all cases. One case had viral etiology confirmed through vitreous PCR (HSV-2 was positive), and the other 3 cases had a presumed diagnosis of herpetic posterior uveitis. CONCLUSION: Focus active retinitis adjacent to an old cicatricial lesion should not be considered pathognomonic of toxoplasmosis and viral etiology must be considered.

RESUMEN

Enteroaggregative E. coli (EAEC) is one of the most frequent pathogens isolated from diarrheal patients as well as from healthy individuals in Brazil and has recently also been implicated as an extraintestinal pathogenic E. coli (ExPEC) associated with bloodstream and urinary tract infections. In this study, 37 EAEC isolates, obtained from fecal samples of non-diarrheic children, were molecularly and phenotypically characterized to access the pathogenic features of these isolates. The EAEC isolates were assigned into the phylogroups A (54.1%), D (29.7%), B1 (13.5%) and B2 (2.7%); and harbored genes responsible for encoding the major pilin subunit of the aggregative adherence fimbriae (AAFs) or aggregate-forming pili (AFP) adhesins as follows: aggA (24.3%), agg3A (5.4%), agg4A (27.0%), agg5A (32.4%) and afpA (10.8%). The most frequent O:H serotypes were O15:H2 (8.1%), O38:H25 (5.4%) and O86:H2 (5.4%). Twenty-one isolates (56.8%) produce the aggregative adherence (AA) pattern on HeLa cells, and biofilm formation was more efficient among EAEC isolates harboring the aggA and agg5A genes. PFGE analysis showed that 31 (83.8%) of the isolates were classified into 10 distinct clusters, which reinforces the high diversity found among the isolates studied. Of note, 40.5% (15/37) of the EAEC isolates have a genetic profile compatible with E. coli isolates with intrinsic potential to cause extraintestinal infections in healthy individuals, and therefore, classified as EAEC/ExPEC hybrids. In conclusion, we showed the presence of EAEC/ExPEC hybrids in the intestinal microbiota of non-diarrheic children, possibly representing the source of some endogenous extraintestinal infections.

RESUMEN

BACKGROUND: Sporotrichosis is the most common subcutaneous mycosis caused by Sporothrix spp. Traditionally, it is transmitted through injuries involving plant debris. However, over the past few decades, there has been an epidemic increase in human cases resulting from contact with infected animals, particularly cats, in various regions of Brazil. In this report, we report a notable increase in both human and animal cases within the Brazilian Amazon state. METHODOLOGY/PRINCIPAL FINDINGS: An ecological study was conducted by analyzing official records of human and animal sporotrichosis diagnosed in the state of Amazon from 2020 to 2023. Data including patient demographics, clinical manifestations, mycological examination results, and species identification through PCR confirmation were evaluated. During this period, a total of 950 human cases and 2,823 animal cases of sporotrichosis were reported at an exponential rate, since no human cases were registered in 2020. The spatial and temporal dispersion of human sporotrichosis followed that of animal cases, moving from downtown areas to the periphery. Contact with infected animals was reported in 77.7% of cases, with cats being the most commonly implicated (73.5%). Only 66.7% of individuals underwent mycological examination. Among the positive cultures for Sporothrix spp., 65.4% were identified as S. brasiliensis. All patients were treated with systemic antifungals. CONCLUSIONS/SIGNIFICANCE: This study highlights a rising incidence of sporotrichosis among animals and humans in the Brazilian Amazon region over the past four years, with S. brasiliensis being the predominant agent. Collaborative efforts involving healthcare professionals, veterinarians, and public health authorities are crucial to implement effective control measures, educate populations at risk, and promote responsible guidance for pet guardians. These measures are essential to mitigate the burden of epidemic sporotrichosis in Brazil.

Asunto(s)

Brotes de Enfermedades , Sporothrix , Esporotricosis , Zoonosis , Esporotricosis/epidemiología , Esporotricosis/microbiología , Esporotricosis/veterinaria , Brasil/epidemiología , Animales , Humanos , Zoonosis/epidemiología , Zoonosis/microbiología , Zoonosis/transmisión , Gatos , Sporothrix/aislamiento & purificación , Sporothrix/genética , Masculino , Femenino , Adulto , Salud Pública , Persona de Mediana Edad , Adolescente , Adulto Joven , Anciano , Niño

RESUMEN

P21 is a protein secreted by all forms of Trypanosoma cruzi (T. cruzi) with recognized biological activities determined in studies using the recombinant form of the protein. In our recent study, we found that the ablation of P21 gene decreased Y strain axenic epimastigotes multiplication and increased intracellular replication of amastigotes in HeLa cells infected with metacyclic trypomastigotes. In the present study, we investigated the effect of P21 in vitro using C2C12 cell lines infected with tissue culture-derived trypomastigotes (TCT) of wild-type and P21 knockout (TcP21-/-) Y strain, and in vivo using an experimental model of T. cruzi infection in BALB/c mice. Our in-vitro results showed a significant decrease in the host cell invasion rate by TcP21-/- parasites as measured by Giemsa staining and cell count in bright light microscope. Quantitative polymerase chain reaction (qPCR) analysis showed that TcP21-/- parasites multiplied intracellularly to a higher extent than the scrambled parasites at 72h post-infection. In addition, we observed a higher egress of TcP21-/- trypomastigotes from C2C12 cells at 144h and 168h post-infection. Mice infected with Y strain TcP21-/- trypomastigotes displayed higher systemic parasitemia, heart tissue parasite burden, and several histopathological alterations in heart tissues compared to control animals infected with scrambled parasites. Therewith, we propose that P21 is important in the host-pathogen interaction during invasion, cell multiplication, and egress, and may be part of the mechanism that controls parasitism and promotes chronic infection without patent systemic parasitemia.

Asunto(s)

Enfermedad de Chagas , Proteínas Protozoarias , Trypanosoma cruzi , Animales , Humanos , Ratones , Línea Celular , Enfermedad de Chagas/parasitología , Inhibidor p21 de las Quinasas Dependientes de la Ciclina/metabolismo , Inhibidor p21 de las Quinasas Dependientes de la Ciclina/genética , Modelos Animales de Enfermedad , Técnicas de Inactivación de Genes , Interacciones Huésped-Parásitos , Ratones Endogámicos BALB C , Parasitemia , Proteínas Protozoarias/genética , Proteínas Protozoarias/metabolismo , Trypanosoma cruzi/genética , Trypanosoma cruzi/patogenicidad , Trypanosoma cruzi/fisiología , Trypanosoma cruzi/metabolismo , Virulencia

RESUMEN

PURPOSE: To report a challenging case of serologically confirmed posterior uveitis due to leptospirosis. METHODS: Review of medical records. RESULTS: Thirteen-year-old boy presented focal necrotizing retinochoroiditis after flood exposure. Laboratory work-up confirmed leptospirosis infection and proper antibiotic treatment was done. The patient evolved well. but during late follow-up he developed nummular keratitis. CONCLUSION: Leptospirosis is a possible etiology of necrotizing posterior uveitis. The use of antimicrobial therapy is controversial but was used in this case, in association with corticosteroids, leading to resolution of retinal inflammation. Despite treatment, the patient developed late corneal opacities, which did not lead to visual impairment.

RESUMEN

Bovine mastitis is an important and costly disease to dairy cattle. Diagnostic methods usually performed in Brazil are somatic cell counts (SCC) and milk microbiology. Low bacteria shedding in milk implies no colony growth in microbiological tests and false negative results. Streptococcus agalactiae and Staphylococcus aureus are principal pathogens of mixed mastitis. However, S. agalactiae has a higher bacterial release from the mammary gland than S. aureus, affecting microbiological sensitivity to diagnose S. aureus. This study aimed to estimate the SCC and total bacterial count (TBC) from cows according to pathogen isolated in milk and to evaluate variation in S. aureus diagnosis by a microbiological test during S. agalactiae treatment, which is called blitz therapy. Both S. agalactiae and S. aureus presented high SCC means, although S. agalactiae showed shedding of bacteria 2.3 times greater than S. aureus. Microbiological sensitivity to S. aureus increased for 5 months during S. agalactiae treatment. The prevalence of S. agalactiae fell after 5 months of therapeutic procedures. The prevalence of S. aureus increased to 39.0. The results showed that due to high sensitivity, the polymerase chain reaction (PCR) could be used at the beginning of blitz therapy with the goal of S. agalactiae eradication from the dairy herd.

RESUMEN

Toxoplasmosis affects about one-third of the world's population. The disease treatment methods pose several side effects and do not efficiently eliminate the parasite, making the search for new therapeutic approaches necessary. We aimed to assess the anti-Toxoplasma gondii activity of four Copaifera oleoresins (ORs) and two isolated diterpene acids, named ent-kaurenoic and ent-polyalthic acid. We used HeLa cells as an experimental model of toxoplasmosis. Uninfected and infected HeLa cells were submitted to the treatments, and the parasite intracellular proliferation, cytokine levels and ROS production were measured. Also, tachyzoites were pre-treated and the parasite invasion was determined. Finally, an in silico analysis was performed to identify potential parasite targets. Our data show that the non-cytotoxic concentrations of ORs and diterpene acids controlled the invasion and proliferation of T. gondii in HeLa cells, thus highlighting the possible direct action on parasites. In addition, some compounds tested controlled parasite proliferation in an irreversible manner. An additional and non-exclusive mechanism of action involves the modulation of host cell components, by affecting the upregulation of the IL-6. Additionally, molecular docking suggested that ent-polyalthic acid has a high affinity for the active site of the TgCDPK1 protein. Copaifera ORs have great antiparasitic activity against T. gondii, and this effect can be partially explained by the presence of the isolated compounds ent-kaurenoic and ent-polyalthic acid.

Asunto(s)

Diterpenos , Fabaceae , Extractos Vegetales , Toxoplasma , Células HeLa , Humanos , Diterpenos/farmacología , Diterpenos/aislamiento & purificación , Diterpenos/química , Toxoplasma/efectos de los fármacos , Toxoplasma/crecimiento & desarrollo , Fabaceae/química , Extractos Vegetales/farmacología , Extractos Vegetales/química , Extractos Vegetales/aislamiento & purificación , Especies Reactivas de Oxígeno/metabolismo , Citocinas/metabolismo , Interleucina-6/metabolismo , Simulación del Acoplamiento Molecular

RESUMEN

Charadriiformes, which comprises shorebirds and their relatives, is one of the most diverse avian orders, with over 390 species showing a wide range of karyotypes. Here, we isolated and characterized the whole collection of satellite DNAs (satDNAs) at both molecular and cytogenetic levels of one of its representative species, named the wattled jacana (Jacana jacana), a species that contains a typical ZZ/ZW sex chromosome system and a highly rearranged karyotype. In addition, we also investigate the in situ location of telomeric and microsatellite repeats. A small catalog of 11 satDNAs was identified that typically accumulated on microchromosomes and on the W chromosome. The latter also showed a significant accumulation of telomeric signals, being (GA)10 the only microsatellite with positive hybridization signals among all the 16 tested ones. These current findings contribute to our understanding of the genomic organization of repetitive DNAs in a bird species with high degree of chromosomal reorganization contrary to the majority of bird species that have stable karyotypes.

Asunto(s)

Charadriiformes , Animales , Charadriiformes/genética , ADN Satélite/genética , Heterocromatina/genética , Secuencias Repetitivas de Ácidos Nucleicos , Cromosomas Sexuales/genética , Cariotipo , Aves/genética , Evolución Molecular

RESUMEN

Rhinovirus causes respiratory tract infections in children and is found in co-infections. The objective of this research was to study the clinical profile of rhinovirus infection and co-infection in children with severe acute respiratory infection (SARI) during the COVID-19 pandemic period. We included 606 children ranging in age from 0.1 to 144 months of age from March 2020 to December 2021, hospitalized in the Pediatric Intensive Care Unit (PICU). The samples were collected by secretion from the nasopharynx region. A total of 259 children were tested positive for viral infection, 153 (59.07%) of them had a single rhinovirus infection and, 56 (36.6%) were aged between 60.1 and 144 months. Nine types of co-infections were identified and were found coinfection with three or more viruses (22/104, 21.15%). Observing the seasonality, the number of cases was similar between 2020 (49.53%) and 2021 (51.47%). Patients with a single infection (86.88%) and coinfection (67.30%) were more likely to have coughed. Patients with co-infection required the use of O2 for longer than those with a single rhinovirus infection. Hemogram results obtained from individuals with a single infection had higher levels of urea when compared to patients with co-infection with and other respiratory viruses. Multiple correspondence analyses indicated different clinical symptoms and comorbidities in patients with co-infection compared to those with single infection. The results found that the rhinovirus was much prevalent virus during the pandemic period and was found in co-infection with other virus types, what is important to diagnostic for the correct treatment of patients.

Asunto(s)

COVID-19 , Coinfección , Infecciones por Enterovirus , Neumonía , Infecciones del Sistema Respiratorio , Virus , Niño , Humanos , Lactante , Preescolar , Coinfección/epidemiología , Rhinovirus , Pandemias , COVID-19/epidemiología , Infecciones del Sistema Respiratorio/epidemiología

RESUMEN

The bovine tick Rhipicephalus microplus, a primary ectoparasite of veterinary concern, contributes significantly to disease transmission and reduced cattle productivity, resulting in substantial economic losses. The overuse of chemical acaricides has led to the emergence of resistant strains, posing a considerable challenge to veterinary medicine. Consequently, the development of alternative parasite control methods is essential to ensure livestock quality and enhance food safety worldwide. Our study introduces an innovative approach to photodynamic inactivation (PDI) of the bovine tick, harnessing natural daylight for a potential field application. Reproductive parameters (female and egg mass, egg production index, and larval hatch) were evaluated in engorged female ticks under photodynamic action using the hematoporphyrin (HP) and tetra-cationic porphyrins free-base meso-tetra-ruthenated (4-pyridyl) (RuTPyP) and its zinc(II) complex (ZnRuTPyP) as photosensitizers (PS). The results showed that there was no significant difference between the groups treated with tetra­ruthenium porphyrins and the control group. However, HP exhibits a control percentage of 97.9% at a concentration of 2.5 µmol.L-1, aligning with the expected control rates achieved by conventional chemical acaricides. Photophysical and physicochemical parameters such as the number of singlet oxygen produced and lipophilicity were discussed for each PS and related to tick control percentages. Furthermore, the interaction between HP and chitin, an important macromolecule presents in the tick's cuticle, considered as the primary target tick structure during PDI was observed by the absorption and fluorescence emission spectroscopic techniques. Therefore, the results presented here extend the potential for controlling R. microplus through photodynamic inactivation while utilizing sunlight as a source of natural irradiation.

Asunto(s)

Acaricidas , Porfirinas , Rhipicephalus , Animales , Femenino , Bovinos , Acaricidas/farmacología , Rhipicephalus/fisiología , Porfirinas/farmacología , Reproducción

Asunto(s)

Coriorretinitis , Retinitis , Toxoplasmosis Ocular , Niño , Humanos , Toxoplasmosis Ocular/complicaciones , Toxoplasmosis Ocular/diagnóstico , Retinitis/diagnóstico , Retinitis/etiología

RESUMEN

BACKGROUND: The Brazilian Northeast region is notable for its high prevalence of consanguineous marriages and isolated populations, which has led to a significant prevalence of rare genetic disorders. This study describes the clinical presentation of four affected individuals from the same family, comprising two siblings and their cousins, with ages ranging from 11 to 20 years. METHODS: In a small and isolated community in Northeastern Brazil, affected individuals initially underwent a clinical assessment. Subsequently, written consent was obtained from their legal guardians, and an extensive clinical evaluation was conducted at a medical genetics center. Family data provided the basis for constructing the pedigree, and biological samples (blood or oral swabs) were collected from both affected and unaffected family members. Following informed consent from one patient, Whole Exome Sequencing (WES) was carried out, encompassing exome sequencing, assembly, genotyping, and annotation. A potentially deleterious variant was then singled out for further segregation analysis through Sanger Sequencing, involving both the proband and select family members. RESULTS AND CONCLUSION: These individuals exhibit severe neurodevelopmental delays, encompassing symptoms such as spastic paraplegia, neuropathy, intellectual impairments, and language challenges. Through next-generation sequencing (NGS) techniques, a previously unreported homozygous variant within the ERLIN2 gene linked to spastic paraplegia 18 (SPG18) was identified across all four patients. Also, all patients displayed childhood cataract, expanding the known clinical spectrum of SPG18.

Asunto(s)

Linaje , Fenotipo , Adolescente , Niño , Femenino , Humanos , Masculino , Adulto Joven , Brasil , Secuenciación del Exoma , Proteínas de la Membrana/genética , Paraplejía Espástica Hereditaria/genética

RESUMEN

Failure to recognize the different possible clinical presentations of ocular toxoplasmosis may delay diagnosis and treatment, compromising visual prognosis. The aim of this paper is to describe an atypical pattern of ocular toxoplasmosis, not yet described. Five Brazilian patients, from 4 different referral centers, presented similar atypical pattern of ocular toxoplasmosis characterized by mild vitritis, foveal cavitation involving predominantly all retinal layers associated with adjacent inner retinal necrosis (a necrotizing retinitis with a persisting inner retinal tissue bridge and loss of subjacent retinal layers). The appearance of the OCT image resembling a "rift", led the authors to define this pattern as a Recurrent Inner Foveal Toxoplasmic Retinitis (RIFTER), which can be considered as a new description of an atypical pattern of toxoplasma retinochoroiditis, and clinicians should be aware of it and consider testing for toxoplasmosis in patients with similar findings.

RESUMEN

BACKGROUND: Critical illness is a major ongoing health care burden worldwide and is associated with high mortality rates. Sodium-glucose cotransporter-2 inhibitors have consistently shown benefits in cardiovascular and renal outcomes. The effects of sodium-glucose cotransporter-2 inhibitors in acute illness have not been properly investigated. METHODS: DEFENDER is an investigator-initiated, multicenter, randomized, open-label trial designed to evaluate the efficacy and safety of dapagliflozin in 500 adult participants with acute organ dysfunction who are hospitalized in the intensive care unit. Eligible participants will be randomized 1:1 to receive dapagliflozin 10mg plus standard of care for up to 14 days or standard of care alone. The primary outcome is a hierarchical composite of hospital mortality, initiation of kidney replacement therapy, and intensive care unit length of stay, up to 28 days. Safety will be strictly monitored throughout the study. CONCLUSION: DEFENDER is the first study designed to investigate the use of a sodium-glucose cotransporter-2 inhibitor in general intensive care unit patients with acute organ dysfunction. It will provide relevant information on the use of drugs of this promising class in critically ill patients. CLINICALTRIALS.GOV REGISTRY: NCT05558098.

Asunto(s)

Enfermedad Crítica , Inhibidores del Cotransportador de Sodio-Glucosa 2 , Adulto , Humanos , Enfermedad Crítica/terapia , Insuficiencia Multiorgánica/tratamiento farmacológico , Inhibidores del Cotransportador de Sodio-Glucosa 2/uso terapéutico , Estudios Multicéntricos como Asunto

RESUMEN

Introduction: Toxoplasma gondii is the etiologic agent of toxoplasmosis, a disease that affects about one-third of the human population. Most infected individuals are asymptomatic, but severe cases can occur such as in congenital transmission, which can be aggravated in individuals infected with other pathogens, such as HIV-positive pregnant women. However, it is unknown whether infection by other pathogens, such as Trypanosoma cruzi, the etiologic agent of Chagas disease, as well as one of its proteins, P21, could aggravate T. gondii infection. Methods: In this sense, we aimed to investigate the impact of T. cruzi and recombinant P21 (rP21) on T. gondii infection in BeWo cells and human placental explants. Results: Our results showed that T. cruzi infection, as well as rP21, increases invasion and decreases intracellular proliferation of T. gondii in BeWo cells. The increase in invasion promoted by rP21 is dependent on its binding to CXCR4 and the actin cytoskeleton polymerization, while the decrease in proliferation is due to an arrest in the S/M phase in the parasite cell cycle, as well as interleukin (IL)-6 upregulation and IL-8 downmodulation. On the other hand, in human placental villi, rP21 can either increase or decrease T. gondii proliferation, whereas T. cruzi infection increases T. gondii proliferation. This increase can be explained by the induction of an anti-inflammatory environment through an increase in IL-4 and a decrease in IL-6, IL-8, macrophage migration inhibitory factor (MIF), and tumor necrosis factor (TNF)-α production. Discussion: In conclusion, in situations of coinfection, the presence of T. cruzi may favor the congenital transmission of T. gondii, highlighting the importance of neonatal screening for both diseases, as well as the importance of studies with P21 as a future therapeutic target for the treatment of Chagas disease, since it can also favor T. gondii infection.

Asunto(s)

Enfermedad de Chagas , Toxoplasmosis , Trypanosoma cruzi , Recién Nacido , Humanos , Femenino , Embarazo , Placenta/patología , Interleucina-8 , Toxoplasmosis/patología , Enfermedad de Chagas/patología , Proteínas Recombinantes