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This study explores a nanoemulsion formulated with açaí seed oil, known for its rich fatty acid composition and diverse biological activities. This study aimed to characterise a nanoemulsion formulated with açaí seed oil and explore its cytotoxic effects on HeLa and SiHa cervical cancer cell lines, alongside assessing its antioxidant and toxicity properties both in vitro and in vivo. Extracted from fruits sourced in Brazil, the oil underwent thorough chemical characterization using gas chromatography-mass spectrometry. The resulting nanoemulsion was prepared and evaluated for stability, particle size, and antioxidant properties. The nanoemulsion exhibited translucency, fluidity, and stability post centrifugation and temperature tests, with a droplet size of 238.37, PDI -9.59, pH 7, and turbidity 0.267. In vitro assessments on cervical cancer cell lines revealed antitumour effects, including inhibition of cell proliferation, migration, and colony formation. Toxicity tests conducted in cell cultures and female Swiss mice demonstrated no adverse effects of both açaí seed oil and nanoemulsion. Overall, açaí seed oil, particularly when formulated into a nanoemulsion, presents potential for cancer treatment due to its bioactive properties and safety profile.
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ETHNOPHARMACOLOGICAL RELEVANCE: Sepsis poses one of the biggest public health problems, necessitating the search for new therapeutic alternatives. For centuries, propolis has been widely used in folk medicine to treat various inflammatory and infectious diseases. Given its extensive use, it has excellent potential as an adjuvant treatment for patients with sepsis. OBJECTIVE: This study evaluated prophylactic treatment with standardized propolis extract (EPP-AF®) and followed the prognosis of sepsis induced by ligation and cecal ligation and puncture (CLP). METHODS: Initially, for survival assessment, Swiss mice were separated into five groups: Sham (false operated), control (PBS), ATB (received antibiotic, 8 mg/kg), P10 (received EPP-AF®, 10 mg/kg), and P100 (received EPP-AF®, 100 mg/kg). The animals received PBS, antibiotic, or EPP-AF® by the subcutaneous route 6 h before the CLP procedure. Animal survival was assessed every 12 h for five days when all of them were euthanized. RESULTS: We show that the treatment with EPP-AF® significantly increased the life expectancy of animals with sepsis compared to the control group. Interestingly, prophylactic treatment with EPP-AF® showed no effect on the number of colony-forming units in the peritoneum, blood, or lung. However, there was a decrease in cellular influx in the peritoneum. This alteration was unrelated to the number of bone marrow cells or the differential counting of peripheral blood cells. The coagulogram remained unchanged, including the number of platelets and prothrombin time-activated partial thromboplastin time. However, the inflammatory infiltrate and bleeding in the lung tissue were lower in the animals that received EPP-AF®. CONCLUSION: Thus, it was possible to conclude that prophylactic treatment with EPP-AF® preserved the lung parenchyma, resulting in an increased lifespan of mice with sepsis. It can be a helpful adjuvant in prophylactic treatment with antibiotics in presurgical conditions.
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Própolis , Sepsis , Animales , Própolis/farmacología , Sepsis/tratamiento farmacológico , Sepsis/mortalidad , Ratones , Masculino , Abejas , Neumonía/prevención & control , Neumonía/tratamiento farmacológico , Modelos Animales de Enfermedad , Pulmón/efectos de los fármacos , Pulmón/patologíaRESUMEN
Background: Osteoarthritis (OA) is the most common and prevalent musculoskeletal disease associated with population aging, negatively impacting function and quality of life. A consequence of knee OA is quadriceps muscle weakness. Musculoskeletal rehabilitation using low load exercises, associated with Blood Flow Restriction (BFR) may be a useful alternative to high load exercises when those cannot be tolerated. Several systematic reviews have reported inconclusive results due to discrepancies in study findings, heterogeneity of results, evaluated time points, and research questions explored. Objective: To perform an overview of systematic reviews with meta-analyses, synthesizing the most recent evidence on the effects of muscle strength training with BFR for knee OA. Methodology: Systematic reviews that include primary controlled and randomized clinical trials will be considered for inclusion. Articles will be considered only if they present a clear and reproducible methodological structure, and when they clearly demonstrate that a critical analysis of the evidence was carried out using instrumented analysis. Narrative reviews, other types of review, overviews of systematic reviews, and diagnostic, prognostic and economic evaluation studies will be excluded. Studies must include adults aged 40 years and older with a diagnosis of knee OA. Two authors will perform an electronic search with guidance from an experienced librarian. The following databases will be searched: PubMed via MEDLINE, Embase, CENTRAL (Cochrane Central Register of Controlled Trials), PEDro, Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCO host, Web of Science, and the gray literature. The search strategy used in the databases will follow the acronym PICOS (population, intervention, comparison, outcome, and study design). Screening (i.e., titles and abstracts) of studies identified by the search strategy will be selected using Rayyan (http://rayyan.qcri.org). The quality assessment will be performed using the "Assessment of Multiple Systematic Reviews" (AMSTAR-2) tool. Systematic Review Registration: PROSPERO, CRD42022367209.
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Although brain scars in adults have been extensively studied, there is less data available regarding scar formation during the neonatal period, and the involvement of peripheral immune cells in this process remains unexplored in neonates. Using a murine model of neonatal hypoxic-ischemic encephalopathy (HIE) and confocal microscopy, we characterized the scarring process and examined the recruitment of peripheral immune cells to cortical and hippocampal scars for up to 1 year post-insult. Regional differences in scar formation were observed, including the presence of reticular fibrotic networks in the cortex and perivascular fibrosis in the hippocampus. We identified chemokines with chronically elevated levels in both regions and demonstrated, through a parabiosis-based strategy, the recruitment of lymphocytes, neutrophils, and monocyte-derived macrophages to the scars several weeks after the neonatal insult. After 1 year, however, neutrophils and lymphocytes were absent from the scars. Our data indicate that peripheral immune cells are transient components of HIE-induced brain scars, opening up new possibilities for late therapeutic interventions.
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Cicatriz , Hipoxia-Isquemia Encefálica , Adulto , Animales , Humanos , Ratones , Cicatriz/patología , Encéfalo/patología , Macrófagos , Hipoxia-Isquemia Encefálica/patologíaRESUMEN
Penile cancer (PeCa) is a rare tumor, generally associated with socioeconomic conditions in low-income countries. Hence, a delay in diagnosis and treatment leads in more advanced tumors, to higher comorbidity, and mortality. Human papillomavirus (HPV) infection has been identified as one of the major risk factors for PeCa. In addition, viral integration sites have been related to copy number alterations, impacting miRNAs/mRNA interactions and, consequently, the molecular pathways related to them. Nonetheless, studies on differentially expressed miRNAs (miRDEs) in PeCa are still scarce, especially in PeCa associated with high-risk HPV (hrHPV). To investigate the role of these gene regulators in PeCa progression, 827 miRNAs (Nanostring Technologies™, Seattle, WA, USA) were evaluated in 22 hrHPV-associated penile squamous cell carcinomas and five non-tumor penile tissues. For functions of miRNAs/target genes and relationship with HPV we conducted an integrated analysis by Diana Tools, KEGG, HPVbase, and InterSPPI-HVPPI platforms. We found that 25 miRNAs of the most differentially expressed impact 43 top molecular pathways, of which the fatty acid biosynthesis pathway, prions, miRNAs in cancer and hippo signaling (P<1.0-325, for each) were the most statistically significant. Notably, 23 out of 25 are located at HPV integration sites (HPVis). MiR-1206, miR-376b-3p and miR-495-3p were downregulated and associated with perineural invasion. In addition, a comparison between advanced and early diseases revealed 143 miRDEs. ROC analysis of a single (miR-376a-2-5p), paired (miR-376a-2-5p, miR-551b-3p) or combination of five miRDEs (miR-99a-5p, miR-150-5p, miR-155-5p, let-7c-5p, miR-342-3p) showed robust discriminatory power (AUC = 0.9; P = 0.0114, for each). Strikingly, miR-376a-2-5p exhibited the highest values of sensitivity and specificity, with 100% and 83.3%, respectively, indicating this miRNA as a potential prognostic marker in hrHPV-penile carcinogenesis.
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The vast spectrum of clinical features of COVID-19 keeps challenging scientists and clinicians. Low resistance to infection might result in long-term viral persistence, but the underlying mechanisms remain unclear. Here, we studied the immune response of immunocompetent COVID-19 patients with prolonged SARS-CoV-2 infection by immunophenotyping, cytokine and serological analysis. Despite viral loads and symptoms comparable to regular mildly symptomatic patients, long-term carriers displayed weaker systemic IFN-I responses and fewer circulating pDCs and NK cells at disease onset. Type 1 cytokines remained low, while type-3 cytokines were in turn enhanced. Of interest, we observed no defects in antigen-specific cytotoxic T cell responses, and circulating antibodies displayed higher affinity against different variants of SARS-CoV-2 Spike protein in these patients. The identification of distinct immune responses in long-term carriers adds up to our understanding of essential host protective mechanisms to ensure tissue damage control despite prolonged viral infection.
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Sepsis is an organ dysfunction syndrome associated with high mortality. To date, no effective treatment is available to combat this disease. Punica granatum L. is a potential alternative treatment due to its anti-inflammatory, antimicrobial, and antioxidant properties. Thus, this study aimed to evaluate the effects of a hydroalcoholic crude extract from the peels of P. granatum (HCEPg) in mice with lethal sepsis. Lethal polymicrobial sepsis was induced in female Swiss mice via cecal ligation and puncture (CLP). Initially, the animals were divided into three groups: Sham (false-operated), CLP-control (phosphate-buffered saline), and CLP-HCEPg (single dose, 5 mg/kg, subcutaneous administration). Treatment was initiated immediately after the induction of sepsis, and survival was evaluated every 12 hr for 5 days. Those who survived were euthanized. Serum cytokine levels were measured using a cytometric bead array Mouse Inflammatory Cytokine Kit. The number of colony-forming units, as well as the number of cells in the lymphoid organs and their activation markers, were analyzed. Results showed that treatment with HCEPg increased lifespan and reduced bacterial counts in the peritoneum, bloodstream, and spleen. HCEPg also decreased hydrogen peroxide secretion by phagocytes and augmented serum IL-10 levels, indicating its systemic anti-inflammatory effects. Additionally, treatment with HCEPg attenuated infection-induced lung hemorrhage. Overall, P. granatum extract improved the lifespan of septic mice, possibly due to its antimicrobial, anti-inflammatory, and immunomodulatory effects, thereby regulating bacterial load and translocation, as well as controlling the systemic inflammation induced by sepsis.
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Granada (Fruta) , Sepsis , Femenino , Animales , Ratones , Longevidad , Sepsis/tratamiento farmacológico , Anticuerpos , CitocinasRESUMEN
Euterpe oleracea (açaí) fruit has approximately 15% pulp, which is partly edible and commercialized, and 85% seeds. Although açaí seeds are rich in catechins-polyphenolic compounds with antioxidant, anti-inflammatory, and antitumor effects-almost 935,000 tons/year of seeds are discarded as industrial waste. This work evaluated the antitumor properties of E. oleracea in vitro and in vivo in a solid Ehrlich tumor in mice. The seed extract presented 86.26 ± 0.189 mg of catechin/g of extract. The palm and pulp extracts did not exhibit in vitro antitumor activity, while the fruit and seed extracts showed cytotoxic effects on the LNCaP prostate cancer cell line, inducing mitochondrial and nuclear alterations. Oral treatments were performed daily at 100, 200, and 400 mg/kg of E. oleracea seed extract. The tumor development and histology were evaluated, along with immunological and toxicological parameters. Treatment at 400 mg/kg reduced the tumor size, nuclear pleomorphism, and mitosis figures, increasing tumor necrosis. Treated groups showed cellularity of lymphoid organs comparable to the untreated group, suggesting less infiltration in the lymph node and spleen and preservation of the bone marrow. The highest doses reduced IL-6 and induced IFN-γ, suggesting antitumor and immunomodulatory effects. Thus, açaí seeds can be an important source of compounds with antitumor and immunoprotective properties.
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The severe acute respiratory syndrome coronavirus 2, the agent of the ongoing coronavirus disease 2019 (COVID-19) pandemic, has spread worldwide since it was first identified in November 2019 in Wuhan, China. Since then, progress in pathogenesis linked severity of this systemic disease to the hyperactivation of network of cytokine-driven pro-inflammatory cascades. Here, we aimed to identify molecular biomarkers of disease severity by measuring the serum levels of inflammatory mediators in a Brazilian cohort of patients with COVID-19 and healthy controls (HCs). Critically ill patients in the intensive care unit were defined as such by dependence on oxygen supplementation (93% intubated and 7% face mask), and computed tomography profiles showing ground-glass opacity pneumonia associated to and high levels of D-dimer. Our panel of mediators included HMGB1, ATP, tissue factor, PGE2 , LTB4 , and cys-LTs. Follow-up studies showed increased serum levels of every inflammatory mediator in patients with COVID-19 as compared to HCs. Originally acting as a transcription factor, HMGB1 acquires pro-inflammatory functions following secretion by activated leukocytes or necrotic tissues. Serum levels of HMGB1 were positively correlated with cys-LTs, D-dimer, aspartate aminotransferase, and alanine aminotransferase. Notably, the levels of the classical alarmin HMGB1 were higher in deceased patients, allowing their discrimination from patients that had been discharged at the early pulmonary and hyperinflammatory phase of COVID-19. In particular, we verified that HMGB1 levels above 125.4 ng/ml is the cutoff that distinguishes patients that are at higher risk of death. In conclusion, we propose the use of serum levels of HMGB1 as a biomarker of severe prognosis of COVID-19.
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COVID-19 , Proteína HMGB1 , Humanos , Tromboplastina , COVID-19/diagnóstico , Biomarcadores , Pronóstico , Lípidos , Adenosina TrifosfatoRESUMEN
Notwithstanding the advances in molecular target-based drugs, chemotherapy remains the most common cancer treatment, despite its high toxicity. Consequently, effective anticancer therapies with fewer adverse effects are needed. Therefore, this study aimed to determine the anticancer activity of the dichloromethane fraction (DCMF) isolated from Arrabidae brachypoda roots, whose components are three unusual dimeric flavonoids. The toxicity of DCMF was investigated in breast (MCF-7), prostate (DU145), and cervical (HeLa) tumor cells, as well as non-tumor cells (PNT2), using sulforhodamine B (cell viability), Comet (genotoxicity), clonogenicity (reproductive capacity) and wound healing (cell migration) assays, and atomic force microscopy (AFM) for ultrastructural cell membrane alterations. Molecular docking revealed affinity between albumin and each rare flavonoid, supporting the impact of fetal bovine serum in DCMF antitumor activity. The IC50 values for MCF7, HeLa, and DU145 were 2.77, 2.46, and 2.51 µg/mL, respectively, and 4.08 µg/mL for PNT2. DCFM was not genotoxic to tumor or normal cells when exposed to twice the IC50 for up to 24 h, but it inhibited tumor cell migration and reproduction compared to normal cells. Additionally, AFM revealed alterations in the ultrastructure of tumor nuclear membrane surfaces, with a positive correlation between DCMF concentration and tumor cell roughness. Finally, we found a negative correlation between roughness and the ability of DCMF-treated tumor cells to migrate and form colonies with more than 50 cells. These findings suggest that DCFM acts by causing ultrastructural changes in tumor cell membranes while having fewer toxicological effects on normal cells.
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Flavonoides , Neoplasias , Masculino , Humanos , Flavonoides/farmacología , Flavonoides/química , Simulación del Acoplamiento Molecular , Células HeLa , Membrana Celular , Supervivencia Celular , Línea Celular TumoralRESUMEN
Introdução: O câncer de cabeça e pescoço ocupa o sexto lugar das neoplasias mais predominantes no mundo. Pela localização anatômica, essas neoplasias podem promover alterações funcionais importantes, relacionadas à alimentação, respiração e comunicação, afetando a interação social. Objetivo: Caracterizar o perfil funcional e clínico de pacientes com neoplasias malignas de cabeça e pescoço. Método: Estudo transversal, descritivo, quali-quantitativo. Foram avaliadas a goniometria e a dinamometria dos membros superiores, e utilizados a Intensive Care Unit Mobility Scale (ICUMS) para avaliar a mobilidade, o índice de performance de Karnofsky (KPS) e a Eastern Cooperative Oncology Group Performance Scale (PS-ECOG), em um hospital público terciário. A coleta ocorreu entre agosto e novembro de 2022. Resultados: Participaram do estudo 39 pacientes do sexo feminino (61,54%) com idade média de 51,51 anos (±16,05). Os fatores de risco mais comuns foram: histórico familiar (53,85%), incidência em Regiões com desigualdade de distribuição de renda (17,95%), em Ceilândia (Região Administrativa do Distrito Federal), e tendo concluído o apenas o ensino fundamental (48,72%). O tumor primário com maior prevalência foi o de tireoide (61,54%), estadiamento T4 (33,33%). No pós-cirúrgico, 10 apresentavam paralisia facial, 11, trismo, 27, escápula alada. A mobilidade no pós-operatório foi mantida durante a internação com ICUMS 10, KPS 90% e PS-ECOG 0-1. Conclusão: A predisposição e o perfil clínico e funcional se correlacionaram com os problemas respiratórios, trismo, paralisia facial, escápula alada e amplitude reduzida de membro superior, como as repercussões mais frequentes, possivelmente decorrentes do tumor ou do tratamento. Entretanto, a mobilidade e a performance pós-cirúrgica não sofreram alterações consideráveis.
Introduction: Head and neck cancer is the sixth most prevalent neoplasm in the world. Due to their anatomical location, these cancers can promote important functional changes related to eating, breathing and communication, affecting social interaction. Objective: To characterize the functional and clinical profile of patients with head and neck cancer. Method: Cross-sectional, descriptive, quanti-qualitative study. Goniometry and dynamometry of the upper limbs, the Intensive Care Mobility Scale (ICUMS) to evaluate mobility, the Karnofsky performance scale (KPS) and the Eastern Cooperative Oncology Group Performance Scale (PS-ECOG) were utilized in a tertiary public hospital. Data collection occurred between August and November 2022. Results: There were 39 female patients (61.54%) enrolled in the study with mean age of 51.51(±16.05). The most common risk factors were: family history (53.85%), incidence in social and economically underserved regions (17.95%), in Ceilândia (Administrative Region of the Federal District), and education up to elementary school (48.72%). The primary tumor with the highest prevalence was thyroid (61.54%), staging T4 (33.33%). In the postoperative period, 10 presented facial paralysis, 11, trismus and 27, winged scapula. Postoperative mobility was maintained during hospitalization with ICUMS 10, KPS 90% and PS-ECOG between 0-1. Conclusion: The predisposition and the clinical and functional profile were correlated with respiratory problems, trismus, facial paralysis, winged scapula and reduced upper limb amplitude, as the most frequent repercussions, possibly resulting from the tumor or the treatment. However, post-surgical mobility and performance did not change considerably.
Introducción: El cáncer de cabeza y cuello ocupa el sexto lugar de las neoplasias más prevalentes en el mundo. Por su ubicación anatómica, estos cánceres pueden promover cambios funcionales importantes relacionados con la alimentación, la respiración y la comunicación, afectando la interacción social. Objetivo: Caracterizar el perfil funcional y clínico de los pacientes con cáncer de cabeza y cuello. Método: Estudio transversal, descriptivo, cuali-cuantitativo. En un hospital público de tercer nivel se evaluó la goniometría y dinamometría de miembros superiores, utilizando la Intensive Care Unit Mobility Scale (IUMS) para evaluar la movilidad, el índice de desempeño de Karnofsky (KPS) y la Eastern Cooperative Oncology Group Performance Scale (PS-ECOG). La recolección de datos se realizó entre agosto y noviembre de 2022. Resultados: Participaron en el estudio 39 pacientes de sexo femenino (61,54%) con una edad promedio de 51,51 años (±16,05). Los factores de riesgo más comunes fueron: antecedentes familiares (53,85%), incidencia en regiones con distribución desigual de la renta (17,95%), en Ceilândia (Región Administrativa del Distrito Federal) y escolaridad hasta la enseñanza básica (48,72%). El tumor primario con mayor prevalencia fue el de tiroides (61,54%), categoría de estadificación T4 (33,33%). En el postoperatorio 10 presentaron parálisis facial, 11 trismo, 27 omóplato alado. La movilidad postoperatoria se mantuvo durante la hospitalización con ICUMS 10, KPS 90% y PS-ECOG 0-1. Conclusión: La predisposición y el perfil clínico y funcional se correlacionaron con los problemas respiratorios, trismo, parálisis facial, omóplato alado y la amplitud reducida del miembro superior como las más frecuentes repercusiones, posiblemente debidas al tumor o al tratamiento. Sin embargo, la movi
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Factores de Riesgo , Modalidades de Fisioterapia , Artrometría Articular , Dinamometria Manual , Neoplasias de Cabeza y CuelloRESUMEN
Leishmaniasis presents different types of clinical manifestations that can be divided into cutaneous leishmaniasis and visceral leishmaniasis. The host's immune system, associated with genetic and nutritional factors, is strongly involved in the evolution of the disease or parasite escape. Humoral immunity is characterized by the production of antibodies capable of promoting neutralization, opsonization, and activation of the complement system. In this scenario, B lymphocytes produce antibodies that play an important role in Leishmania infection although neglected for a long time. Thus, relevant aspects in the establishment of Leishmania infection will be addressed, highlighting the importance of humoral immunity during the entire process of Leishmania infection.
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Leishmaniasis Cutánea , Leishmaniasis Visceral , Leishmaniasis , Humanos , Inmunidad Humoral , AnticuerposRESUMEN
Staphylococcus aureus is commonly found in wound infections where this pathogen impairs skin repair. The lectin isolated from leaves of Schinus terebinthifolius (named SteLL) has antimicrobial and antivirulence action against S. aureus. This study evaluated the effects of topical administration of SteLL on mice wounds infected by S. aureus. Seventy-two C57/BL6 mice (6−8 weeks old) were allocated into four groups: (i) uninfected wounds; (ii) infected wounds, (iii) infected wounds treated with 32 µg/mL SteLL solution; (iv) infected wounds treated with 64 µg/mL SteLL solution. The excisional wounds (64 mm2) were induced on the dorsum and infected by S. aureus 432170 (4.0 × 106 CFU/wound). The daily treatment started 1-day post-infection (dpi). The topical application of both SteLL concentrations significantly accelerated the healing of S. aureus-infected wounds until the 7th dpi, when compared to untreated infected lesions (reductions of 1.95−4.55-fold and 1.79−2.90-fold for SteLL at 32 µg/mL and 64 µg/mL, respectively). The SteLL-based treatment also amended the severity of wound infection and reduced the bacterial load (12-fold to 72-fold for 32 µg/mL, and 14-fold to 282-fold for 64 µg/mL). SteLL-treated wounds show higher collagen deposition and restoration of skin structure than other groups. The bacterial load and the levels of inflammatory markers (IL-6, MCP-1, TNF-α, and VEGF) were also reduced by both SteLL concentrations. These results corroborate the reported anti-infective properties of SteLL, making this lectin a lead candidate for developing alternative agents for the treatment of S. aureus-infected skin lesions.
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SARS-CoV-2 infection intrigued medicine with diverse outcomes ranging from asymptomatic to severe acute respiratory syndrome (SARS) and death. After more than two years of pandemic, reports of reinfection concern researchers and physicists. Here, we will discuss potential mechanisms that can explain reinfections, including the aggravated ones. The major topics of this hypothesis paper are the disbalance between interferon and antibodies responses, HLA heterogeneity among the affected population, and increased proportion of cytotoxic CD4+ T cells polarization in relation to T follicular cells (Tfh) subtypes. These features affect antibody levels and hamper the humoral immunity necessary to prevent or minimize the viral burden in the case of reinfections.
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Despite the intramuscular route being the most used vaccination strategy against SARS-CoV-2, the intradermal route has been studied around the globe as a strong candidate for immunization against SARS-CoV-2. Adjuvants have shown to be essential vaccine components that are capable of driving robust immune responses and increasing the vaccination efficacy. In this work, our group aimed to develop a vaccination strategy for SARS-CoV-2 using a trimeric spike protein, by testing the best route with formulations containing the adjuvants AddaS03, CpG, MPL, Alum, or a combination of two of them. Our results showed that formulations that were made with AddaS03 or CpG alone or AddaS03 combined with CpG were able to induce high levels of IgG, IgG1, and IgG2a; high titers of neutralizing antibodies against SARS-CoV-2 original strain; and also induced high hypersensitivity during the challenge with Spike protein and a high level of IFN-γ producing CD4+ T-cells in mice. Altogether, those data indicate that AddaS03, CpG, or both combined may be used as adjuvants in vaccines for COVID-19.
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Serological tests detect antibodies generated by infection or vaccination, and are indispensable tools along different phases of a pandemic, from early monitoring of pathogen spread up to seroepidemiological studies supporting immunization policies. This work discusses the development of an accurate and affordable COVID-19 antibody test, from production of a recombinant protein antigen up to test validation and economic analysis. We first developed a cost-effective, scalable technology to produce SARS-COV-2 spike protein and then used this antigen to develop an enzyme-linked immunosorbent assay (ELISA). A receiver operator characteristic (ROC) analysis allowed optimizing the cut-off and confirmed the high accuracy of the test: 98.6% specificity and 95% sensitivity for 11+ days after symptoms onset. We further showed that dried blood spots collected by finger pricking on simple test strips could replace conventional plasma/serum samples. A cost estimate was performed and revealed a final retail price in the range of one US dollar, reflecting the low cost of the ELISA test platform and the elimination of the need for venous blood sampling and refrigerated sample handling in clinical laboratories. The presented workflow can be completed in 4 months from first antigen expression to final test validation. It can be applied to other pathogens and in future pandemics, facilitating reliable and affordable seroepidemiological surveillance also in remote areas and in low-income countries.
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The SARS-CoV-2 pandemic has had a social and economic impact worldwide, and vaccination is an efficient strategy for diminishing those damages. New adjuvant formulations are required for the high vaccine demands, especially adjuvant formulations that induce a Th1 phenotype. Herein we assess a vaccination strategy using a combination of Alum and polyinosinic:polycytidylic acid [Poly(I:C)] adjuvants plus the SARS-CoV-2 spike protein in a prefusion trimeric conformation by an intradermal (ID) route. We found high levels of IgG anti-spike antibodies in the serum by enzyme linked immunosorbent assay (ELISA) and high neutralizing titers against SARS-CoV-2 in vitro by neutralization assay, after two or three immunizations. By evaluating the production of IgG subtypes, as expected, we found that formulations containing Poly(I:C) induced IgG2a whereas Alum did not. The combination of these two adjuvants induced high levels of both IgG1 and IgG2a. In addition, cellular immune responses of CD4+ and CD8+ T cells producing interferon-gamma were equivalent, demonstrating that the Alum + Poly(I:C) combination supported a Th1 profile. Based on the high neutralizing titers, we evaluated B cells in the germinal centers, which are specific for receptor-binding domain (RBD) and spike, and observed that more positive B cells were induced upon the Alum + Poly(I:C) combination. Moreover, these B cells produced antibodies against both RBD and non-RBD sites. We also studied the impact of this vaccination preparation [spike protein with Alum + Poly(I:C)] in the lungs of mice challenged with inactivated SARS-CoV-2 virus. We found a production of IgG, but not IgA, and a reduction in neutrophil recruitment in the bronchoalveolar lavage fluid (BALF) of mice, suggesting that our immunization scheme reduced lung inflammation. Altogether, our data suggest that Alum and Poly(I:C) together is a possible adjuvant combination for vaccines against SARS-CoV-2 by the intradermal route.
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COVID-19 , Vacunas Virales , Adyuvantes Inmunológicos , Compuestos de Alumbre , Animales , Linfocitos T CD8-positivos , Vacunas contra la COVID-19 , Humanos , Inmunoglobulina G , Ratones , Poli I-C , SARS-CoV-2 , Glicoproteína de la Espiga del CoronavirusRESUMEN
Baseando-nos nas análises genealógica e epistemológica propostas por Foucault e Lantéri-Laura, nosso objetivo principal é discernir quais são as principais linhas discursivas que constituíram o saber em torno da perversão, produzindo um sujeito dito perverso. Emerge de maneira fundamental dessa leitura como a ideia de transgressão de limites acompanha a história dos perversos: seja o limite moral imposto pela autoridade divina, seja o limite jurídico determinado pela lei penal, seja o limite do normal definido pela medicina, a perversão sempre aponta para o excesso transgressor. Tais leituras constituem o solo epistemológico sobre o qual Freud se apoia na concepção de uma metapsicologia cujo eixo central é a sexualidade. O discurso freudiano subverte o estatuto da perversão ao afirmá-la como dimensão inescapável da sexualidade e da constituição da subjetividade humana.
Based on the genealogical and epistemological analyzes proposed by Foucault and Lanteri-Laura, we aim to discern which are the main discursive lines that constituted the knowledge around perversion, producing a so-called perverse subject. It emerges in a fundamental way from this reading how the idea of transgression of limits accompanies the history of the perverse: whether the moral limit imposed by divine authority, whether the legal limit determined by criminal law, or the normal limit defined by medicine, perversion always points towards the transgressive excess. Such readings constitute the epistemological ground on which Freud relies to develop the conception of a metapsychology whose central axis is sexuality. The Freudian discourse subverts the status of perversion by affrming it as an inescapable dimension of sexuality and of the constitution of human subjectivity.
Sur la base des analyses généalogique et épistémologique proposées par Foucault et Lanteri-Laura, notre objectif principal est de discerner quelles sont les principales lignes discursives qui constituaient les connaissances autour de la perversion, produisant un sujet dit pervers. Il ressort de manière fondamentale de cette lecture comment l'idée de transgression des limites accompagne l'histoire du pervers : soit la limite morale imposée par l'autorité divine, soit la limite légale déterminée par le droit pénal, ou la limite normale définie par la médecine, la perversion pointe toujours dans la direction de l'excès transgressif. Ces lectures constituent le terrain épistémologique sur lequel Freud s'appuie pour la conception d'une métapsychologie dont l'axe central est la sexualité. Le discours freudien subvertit le statut de perversion en l'affrmant comme une dimension incontournable de la sexualité et de la constitution de la subjectivité humaine.
Basado en los análisis genealógico y epistemológico propuestos por Foucault y por Lanteri-Laura, nuestro principal objetivo es discernir cuáles son las principales líneas discursivas que constituyeron el conocimiento en materia de perversión, produciendo un sujeto denominado perverso. De esta lectura surge de manera fundamental la idea de que la transgresión de los límites acompaña la historia de lo perverso: ya sea el límite moral impuesto por la autoridad divina, el límite legal determinado por el derecho penal o el límite normal definido por la medicina, la perversión siempre señala el exceso transgresor. Tales lecturas constituyen el fundamento epistemológico en el que Freud se basa para la concepción de una metapsicología cuyo eje central es la sexualidad. El discurso freudiano trastorna el estatuto de la perversión al afirmarla como una dimensión ineludible de la sexualidad y de la constitución de la subjetividad humana.
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BACKGROUND: Large-scale epidemiological studies of seroprevalence of antibodies against SARS-CoV-2 often rely on point-of-care tests that provide immediate results to participants. Yet, little is known on how long rapid tests remain positive after the COVID-19 episode, or how much variability exists across different brands and even among batches of the same test. METHODS: In November 2020, we assessed the sensitivity of three tests applied to 133 individuals with a previous positive PCR result between April and October. All subjects provided finger prick blood samples for two batches (A and B) of the Wondfo lateral-flow IgG/IgM test, and dried blood spot samples for the S-UFRJ ELISA test. RESULTS: Overall sensitivity levels were 92.5% (95% CI 86.6-96.3), 63.2% (95% CI 54.4-71.4) and 33.8% (95% CI 25.9-42.5) for the S-UFRJ test, Wondfo A and Wondfo B tests, respectively. There was no evidence of a decline in the positivity of S-UFRJ with time since the diagnosis, but the two Wondfo batches showed sharp reductions to as low as 41.9% and 19.4%, respectively, for subjects with a positive PCR in June or earlier. Positive results for batch B of the rapid test were 35% to 54% lower than for batch A at any given month of diagnosis. INTERPRETATION: Whereas the ELISA test showed high sensitivity and stability of results over the five months of the study, both batches of the rapid test showed substantial declines, with one of the batches consistently showing lower sensitivity levels than the other. ELISA tests based on dried-blood spots are an inexpensive alternative to rapid lateral-flow tests in large-scale epidemiological studies. FUNDING: The study was funded by the "Todos Pela Saúde" initiative, Instituto Serrapilheira, Brazilian Ministry of Health, Brazilian Collective Health Association (ABRASCO) and the JBS S.A. initiative 'Fazer o Bem Faz Bem'.
Asunto(s)
COVID-19 , SARS-CoV-2 , Anticuerpos Antivirales , Ensayo de Inmunoadsorción Enzimática , Humanos , Inmunoglobulina M , Sensibilidad y Especificidad , Estudios SeroepidemiológicosRESUMEN
BACKGROUND: The Neutrophil-to-Lymphocyte Ratio (NLR) and the Platelet-to-Lymphocyte Ratio (PLR) are inflammatory biomarkers for several diseases, such as cancer and cardiovascular morbidities; however, there are currently few studies on kidney diseases. We aimed to evaluate nondialysis patients and determine the association of NLR and PLR with inflammation in these patients. METHODS: A prospective cross-sectional study was conducted with 85 patients at different stages of chronic kidney disease (CKD), treated at the Kidney Disease Prevention Center of the University Hospital of the Federal University of Maranhão. This study included adult nondialysis patients diagnosed with CKD. The participants' blood samples were collected for a high-sensitivity C-reactive protein (hs-CRP) test and blood count. They were divided into two groups according to the presence or absence of inflammation based on the hs-CRP value (<0.5 mg/dL). NLR and PLR were calculated based on the absolute number of neutrophils, lymphocytes, and platelets and were compared between them and with hs-CRP. Statistical analysis was performed using the Stata software, with the Shapiro-Wilk, Mann-Whitney, Spearman's Correlation, and receiver operating characteristic curve tests. This study was approved by the local ethics committee. RESULTS: The participants were categorized into two groups: with inflammation (n = 64) and without inflammation (n = 21). The mean age was 61.43 ± 14.63 y. The NLR and PLR values were significantly different between the groups with and without inflammation (p=0.045and p=0.004, respectively). However, only PLR showed a significant positive correlation with hs-CRP (p=0.015). The best cutoff point for NLR to detect inflammation was 1.98, with 76.19% sensitivity and 48.44% specificity. For PLR, it was 116.07, with 85.71% sensitivity and 51.56% specificity. There was no significant difference between the area under the NLR and PLR curve (0.71 vs. 0.64; p=0.186) for this population. CONCLUSIONS: This study showed that PLR was positively correlated with hs-CRP in nondialysis CKD patients and can be used to identify inflammation in this population.