RESUMO
Chikungunya virus (CHIKV) is a re-emergent arbovirus that causes a disease characterized primarily by fever, rash and severe persistent polyarthralgia, although <1% of cases develop severe neurological manifestations such as inflammatory demyelinating diseases (IDD) of the central nervous system (CNS) like acute disseminated encephalomyelitis (ADEM) and extensive transverse myelitis. Genetic factors associated with host response and disease severity are still poorly understood. In this study, we performed whole-exome sequencing (WES) to identify HLA alleles, genes and cellular pathways associated with CNS IDD clinical phenotype outcomes following CHIKV infection. The cohort includes 345 patients of which 160 were confirmed for CHIKV. Six cases presented neurological manifestation mimetizing CNS IDD. WES data analysis was performed for 12 patients, including the CNS IDD cases and 6 CHIKV patients without any neurological manifestation. We identified 29 candidate genes harboring rare, pathogenic, or probably pathogenic variants in all exomes analyzed. HLA alleles were also determined and patients who developed CNS IDD shared a common signature with diseases such as Multiple sclerosis (MS) and Neuromyelitis Optica Spectrum Disorders (NMOSD). When these genes were included in Gene Ontology analyses, pathways associated with CNS IDD syndromes were retrieved, suggesting that CHIKV-induced CNS outcomesmay share a genetic background with other neurological disorders. To our knowledge, this study was the first genome-wide investigation of genetic risk factors for CNS phenotypes in CHIKV infection. Our data suggest that HLA-DRB1 alleles associated with demyelinating diseases may also confer risk of CNS IDD outcomes in patients with CHIKV infection.
RESUMO
Objective: The purpose of this short communication is to show that although photobiomodulation in the treatment of neurophathic oral pain after COVID-19 contagion could be an option, photobiomodulation is not a new technique. PBMT was used with different protocols and pain was assessed using VAS (visual analogue scale - 0 until 10) before and after the consultation. Results: Evolution of VAS during the sessions showed a decrease in painful symptomatology as treatment was performed. Conclusion: Based on the results obtained in the present case report, we concluded that PBMT with the parameters used in this clinical case was an effective, noninvasive and a new option of treatment for neuralgia resulting from COVID-19. (AU)
Objetivo: O objetivo deste short communication é mostrar que, embora a fotobiomodulação no tratamento de dor oral neuropática após contágio por COVID-19 possa ser uma opção, a fotobiomodulação não é uma técnica recente. TFBM foi utilizado com diferentes protocolos e a dor foi avaliada por EVA (escala visual analógica - 0 a 10) antes e após a consulta. Resultados: A evolução da EAV durante as sessões mostrou uma diminuição da sintomatologia dolorosa à medida que o tratamento era realizado. Conclusão: Com base nos resultados obtidos no presente relato de caso, concluímos que a TFBM com os parâmetros utilizados neste caso clínico foi eficaz, não invasivo e uma nova opção de tratamento para a neuralgia decorrente do COVID-19 (AU)