Ninety-one patients with different clinical forms of leprosy, 36 lepromatous (LL), 33 tuberculoid (TL), and 22 dimorphic (DL), and 31 healthy volunteer donors were included in this study. Total complement system (CS) activity was assessed by hemolytic methods, whereas individual components were quantified by the enzyme-linked immunosorbent assay. Under conditions allowing initiation of cascade by the classic pathway (CP) but not alternative pathway (AP) activation, significant CS consumption was detected only in sera from patients with LL. In this group of patients, C4 but not factor B (fB) or C3 was significantly reduced, whereas mannose-binding lectin (MBL) serum levels were significantly higher. These results indicate that the CP is involved in CS activation in patients infected with Mycobacterium leprae manifesting LL clinical form of leprosy. An association is likely between circulating immune complexes and MBL high serum levels for initiation of CS activation in patients with LL form of leprosy.

Leprosy is an infectious disease still highly prevalent in Brazil, having been detected around 27,863 new cases in 2019. Exposure to Mycobacterium leprae may not be sufficient to trigger the disease, which seems to be influenced by host immunogenetics to determine resistance or susceptibility. The purinergic receptor P2X7 plays a crucial role in immunity, inflammation, neurological function, bone homeostasis, and neoplasia and is associated with several infectious and non-infectious diseases. Here, we first compare the P2RX7 expression in RNA-seq experiments from 16 leprosy cases and 16 healthy controls to establish the magnitude of allele-specific expression for single-nucleotide polymorphisms of the gene P2RX7 and to determine the level of gene expression in healthy and diseased skin. In addition, we also evaluated the association of two P2RX7 single-nucleotide polymorphisms (c.1513A>C/rs3751143 and c.1068A>G/rs1718119) with leprosy risk. The expression of P2RX7 was found significantly upregulated at macrophage cells from leprosy patients compared with healthy controls, mainly in macrophages from lepromatous patients. Significant risk for leprosy disease was associated with loss function of rs3751143 homozygous mutant CC [CC vs. AA: p = 0.001; odds ratio (OR) = 1.676, 95% CI = 1.251–2.247] but not with heterozygous AC (AC vs. AA: p = 0.001; OR = 1.429, 95% CI = 1.260–1.621). Contrary, the polymorphic A allele from the gain function of rs1718119 was associated with protection for the development of leprosy, as observed in the dominant model (AA + AG × GG p = 0.0028; OR = 0.03516; CI = 0.1801–0.6864). So, our results suggest that the functional P2X7 purinergic receptor may exert a key role in the Mycobacterium death inside macrophages and inflammatory response, which is necessary to control the disease.

Background: Mycobacterium leprae and Toxoplasma gondii infections are both neglected tropical diseases highly prevalent in Brazil. Infection with certain parasite species can significantly alter susceptibility to other important pathogens, and/or influence the development of pathology. Here we investigated the possible influence of M. leprae/T. gondii co-parasitism on the manifestation of leprosy and its clinical forms. Methods: Participants (n = 291) were recruited in Campos dos Goytacazes city, Rio de Janeiro state, southeast Brazil, from August 2015 to December 2019 and clinically diagnosed for leprosy. Participants were selected based on the presence (patients) or absence (healthy controls) of the leprosy disease. Contacts of patients were also recruited for this study. Serum samples from patients (n = 199) with leprosy, contacts (n = 40) and healthy controls (n = 52) were investigated for levels of IgM and IgG anti-phenolic glycolipid-1 (PGL-1) by ELISA. Additionally, IgG antibody against soluble Toxoplasma antigen (STAg) was measured in sera samples from leprosy patients, contacts and healthy controls for Toxoplasma gondii serology by ELISA. Anti-PGL-1 IgG and IgM levels were compared using one-way ANOVA Kruskal-Wallis or Mann-Whitney, while Spearman test was used to correlate levels of IgG anti-STAg and IgM/ IgG anti-PGL-1 from seropositive and seronegative individuals for T. gondii infection. The risk of T. gondii infection for leprosy disease was assessed using Fisher's test. Results: Levels of IgM anti-PGL-1 antibodies were significantly higher in multibacillary (MB) patients compared to paucibacillary (PB) patients (P = 0.0068). Higher IgM and IgG levels anti-PGL-1 were detected in patients with the lepromatous forms. The serologic prevalence for T. gondii infection was 74.9%. We detected increased anti-STAg antibody levels in leprosy patients (79.4%), reaching 88.8% within those with lepromatous form of this disease. The leprosy risk increase in T. gondii seropositive individuals was twofold (odds ratio [OR] = 2.055; 95% confidence intervals [95% CI]: 1.18-3.51) higher than those seronegative, and considering the lepromatous leprosy risk this increase was even dramatic (OR = 4.33; 95% CI: 1.76-9.69) in T. gondii seropositive individuals. Moreover the leprosy risk in T. gondii seropositive individuals was weakly correlated to the levels of IgG anti-STAg and IgM/IgG anti-PGL-1.

A Esporotricose é a micose subcutânea mais comum, geralmente adquirida a partir da inoculação traumática acidental do fungo por animais domésticos, tendo como agente etiológico uma das espécies do gênero Sporothrix. O estado do Rio de Janeiro endêmico para a doença, em sido apontado como um dos epicentros no Brasil. O objetivo deste trabalho é descrever a taxa de notificação e localização desta zoonose em Campos dos Goytacazes, RJ. Logo, dados conglomerados da primeira notificação em 25/03/1986 até 15 de julho de 2022 foram obtidos da secretaria municipal de saúde e por esse motivo não há necessidade de aprovação ao CEP. Para análises estatísticas descritivas o software livre R foi utilizado e um critério de pelo menos 6 meses entre a data de diagnóstico e data de óbito foi adotado para refinamento da possibilidade de óbito causada por Esporotricose. Os dados conglomerados totalizaram 1809 casos sendo o perfil dos pacientes na época do diagnóstico caracterizado por jovens com média de 37 ± 12,515 anos e do sexo masculino 1154 (63,8%). Os dois primeiros casos notificados ocorreram no sexo masculino em 1986 (17 anos) morador do bairro Jardim Carioca e em 1989 (39 anos) do bairro Presidente Vargas. Após um período de 8 anos sem notificação iniciou-se a série com no mínimo 1 caso por ano e em 2001 a taxa de notificação de casos novos foi de 1,229 casos por 100.000 habitantes, alcançando o ápice em 2018 com 47,657 por 100.000 habitantes. Com a instalação da pandemia do novo coronavírus a taxa de notificação reduziu drasticamente com 13,694 e 26,426 por 100.000 habitantes nos anos de 2020 e 2021. Entretanto, neste ano de 2022, foram já computadas 87 notificações até a data de 15 de julho (16,905 casos por 100.000 habitantes). No total, 98 (80,3%) dos 122 bairros de Campos dos Goytacazes possuem notificação de quatro casos ou mais nos últimos 36 anos. Os dez bairros em ordem decrescente de número de notificação são: Centro (127), Penha (63), Jardim Carioca (59), Novo Jockey (41), Guarus (41), Parque Aurora (38), Turf Club (36), Novo Eldorado (34), Travessão (33) e Parque Rosario (29). A localização dos casos não foi identificada ou foi considerada “Outros” em 427 (24%) notificações. Dos pacientes notificados, 122 (7%) casos foram a óbito, sendo 67 (55%) do sexo masculino com 39 anos em média. Se considerarmos o critério de menos de 6 meses para apontar os óbitos como altamente suspeito por esporotricose, apenas 38 pacientes seriam incluídos. Os resultados demonstraram que ocorreu uma ampla disseminação da doença em todo o município principalmente na última década devido a instalação da notificação compulsória de esporotricose em 2013, quando a incidência se manteve sempre com pelo menos 13 casos a cada 100.000 habitantes. A alta incidência de casos e a ampla distribuição geográfica da esporotricose nos bairros do município deve sempre ser lembrada na formulação das hipóteses diagnósticas no contexto da epidemia zoonótica vivenciada no estado do Rio de Janeiro. Este estudo revela que há um crescente número de novos casos e que 4 a cada 5 bairros da cidade de Campos dos Goytacazes já possui pelo menos uma notificação. Como o período de tratamento é longo, apesar de variar de acordo com a forma clínica da doença e da idade dos pacientes, há a necessidade da educação dos profissionais de saúde para diagnóstico precoce, aderência ao tratamento farmacológico e reavaliação a fim de alcançar a erradicação da doença.

The sexually transmitted enteric infections topic is one of the chapters of the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections, published by the Brazilian Ministry of Health in 2020. The document was developed based on scientific evidence and validated in discussions with specialists. This article presents epidemiological and clinical aspects of these infections and guidance for service managers on their programmatic and operational management. The aim is to assist health professionals with screening, diagnosis, and treatment of people with sexually transmitted enteric infections and their sexual partners, in addition to supporting strategies for their surveillance, prevention, and control.