Leprosy causes the most common peripheral neuropathy of infectious etiology, posing an important public health problem worldwide. Understanding the molecular and immunological mechanisms of nerve damage induced by M. leprae is mandatory to develop tools for early diagnosis and preventive measures. The phenolic glycolipid 1 (PGL-1) and lipoarabinomannan (LAM) antigens are major components of the bacterial surface and are implicated on leprosy immunopathogenesis and neural damage. Although the anti-PGL-1 serum IgM is highly used for operational classification of patients, the anti-LAM salivary IgA (sIgA) has not been investigated as diagnostic or prognostic marker in leprosy. Our aim was to assess the presence of anti-LAM sIgA in leprosy patients and their contacts in order to demonstrate whether such expression was associated with leprosy reactions. Distinct patterns of anti-LAM slgA were observed among groups, which were stratified into treatment-naïve patients (116), patients who completed multidrug therapy—MDT (39), household contacts (111), and endemic controls (11). Both anti-LAM sIgA and anti-PGL-I serum IgM presented similar prognostic odds toward leprosy reactions [(odds ratio) OR = 2.33 and 2.78, respectively]. Furthermore, the anti-LAM sIgA was highly correlated with multibacillary (MB) forms (OR = 4.15). Contrarily, among contacts the positive anti-LAM sIgA was highly correlated with those with positive Mitsuda test, suggesting that the presence of anti-LAM slgA may act as an indicator of cellular immunity conferred to contacts. Our data suggest that anti-LAM slgA may be used as a tool to monitor patients undergoing treatment to predict reactional episodes and may also be used in contacts to evaluate their cellular immunity without the need of Mitsuda tests.

Osseointegrated dental implants are inserted into the alveolar ridge, and for them to function as tooth replacements, the surrounding tissues need to adapt to them. Just as with teeth, dental implants traverse the oral mucosa and have access to the contaminated environment of the oral cavity. Therefore, periodontal and peri-implant tissues are important for establishing a protective barrier. The aim of the present study was to perform a histologic analysis of the mucosa surrounding osseointegrated implant cover screws. For this study, 17 mucosal specimens were obtained from 12 patients during the second surgical session for implant exposure to the oral environment. After histologic preparation, specimens were sectioned perpendicularly to the mucosal surface to a thickness of about 3 microm, stained with 1% toluidine blue, and examined under light microscopy. All specimens showed a keratinized, stratified, squamous epithelium with well-defined strata. In the lamina propria, unorganized dense connective tissue was noted in the reticular layer, and in 4 samples, a chronic inflammatory infiltrate was seen in this region. The papillary layer presented tall connective papillae consisting of loose connective tissue. The results of this study confirm the hypothesis that the mucosa that conceals osseointegrated implant cover screws has the same morphologic characteristics as the alveolar masticatory mucosa. Furthermore, clinical conditions of normality in peri-implant tissues may not coincide with situations of histologic normality.

Humano que ainda quero ser". À minha família: minha admirável Mãe (Dona Lídia), Pai, Irmãos, Irmã (Ivana), Sobrinhos, Sobrinhas, Cunhadas, ao Sr. Angel e à Dona Conceição pelo valioso suporte e apoio à Talita; e a todos os amigos, pelo incentivo. À minha esposa Talita agradeço carinhosamente por tudo, principalmente pela amiga e companheira comprometida (e apaixonante) que sempre foi. Aos meus filhos João Bento e Felipe pelo constante incentivo e pela alegria que diariamente me proporcionam. Ao prof. Luiz Ricardo minha imensa e sincera gratidão pelo aprendizado, por sua postura ética e profissional, pela paciência com minhas limitações e pela valiosa dedicação ao crescimento intelectual de seus alunos. À profa. Isabela por possibilitar nosso franco acesso ao CREDESH/HC/UFU e pelo suporte na interpretação dos dados e confecção da tese. Aos professores David, Ana Maria, Jair, Robinson, Paula e Letícia que gentilmente aceitaram fazer parte de minha banca de defesa. Agradeço à dra. Cida, que com entusiasmo me tirou tantas dúvidas, à Dulcinéa, Rafaela, Maria Cristina, Josiela e à toda equipe do CREDESH/HC/UFU pelo exemplo de dedicação à causa da hanseníase. Agradeço em especial aos pacientes e contatos que frequentemente contribuem e se comprometem com tantos importantes trabalhos científicos realizados no CREDESH/HC/UFU. vi Às auxiliares e demais funcionários do Centro Integrado Odonto Médico (CIOM) em que trabalho, em especial à Cleonice, Julicéia e Cecília, pela torcida e incentivo.Aos colegas de laboratório: à Mayara por ter feito meu treinamento no ELISA, e aos colegas Galber,

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