HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic demyelinating and disabling syndrome caused by human T lymphotropic virus 1 (HTLV-1). Although the pathogenic mechanisms that lead to HAM/TSP outcome have not been elucidated, genetic and immunological factors may be involved in the myelopathy occurrence. This study aimed to compare cytokines, chemokines, and nitric oxide (NO) levels in asymptomatic and HAM/TSP HTLV-1-infected patients. The study group consisted of 21 HAM/TSP and 48 asymptomatic HTLV-1 patients. Chemokines (CCL5, CCL2, CXCL8, CXCL9, and CXCL10) and cytokines [IL-2, interferon gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), IL-4, IL-6, and IL-10] were measured using cytometric bead array, whereas NO production was measured after reaction of supernatants with nitrate reduction solution. CXCL9 and CXCL10 chemokines levels were found to be higher in the HAM/TSP group. CXCL9 was also strongly correlated with CXCL10 and both CXCL9 and CXCL10 were moderately correlated with CCL2 and CCL5 levels, in both HAM/TSP and asymptomatic groups. There was no significant difference related to NO, IL-4, IL-6, and IL-10 levels between the clinical groups but TNF-α and IFN-γ levels were increased in HAM/TSP patients. Thus, factors such as CXCL9, CXCL10, TNF-α, and IFN-γ could be good prognostic biomarker candidates, and further studies may help to clarify their association with HAM/TSP immunopathogenesis.

No abstract

A homeopatia é um método terapêutico que tem como princípio “semelhante cura semelhante”, tendo como base a experimentação das preparações altamente diluídas e sucussionadas, com objetivo de produzir em pessoas sadias sintomas semelhantes aos da doença que devem combater. O interesse da população por ela vem aumentando e há necessidade de formar profissionais qualificados no ensino de práticas integrativas e complementares para que avancem no SUS. Diante disso, o objetivo deste estudo foi descrever as percepções sobre homeopatia na perspectiva de discentes dos cursos de saúde de um centro universitário privado em Recife-PE. Para tanto, foi realizado um estudo transversal, descritivo e quantitativo a partir da aplicação de questionário a 500 estudantes de cursos de saúde, entre outubro e novembro de 2018. Apesar de 65,2% dos discentes relatarem ter ouvido falar sobre homeopatia, 73% declararam ter pouco ou nenhum conhecimento sobre as formas de tratamento. Além disso, 82,8% dos discentes afirmaram não conhecer as PNPIC (Política Nacional de Práticas Integrativas e Complementares no SUS), e nem saber que medicamentos homeopáticos são distribuídos gratuitamente pelo SUS (86%). Existe interesse dos estudantes de saúde em incluir homeopatia como disciplina na grade de seus cursos, afim de estarem aptos para oferecer um atendimento integral aos pacientes. Portanto, há necessidade de instituições de ensino superior investirem e promoverem disciplinas que abordem a homeopatia, para formarem profissionais com maior conhecimento sobre as PIC, o que irá acarretar maior informação para a população, contribuindo na melhoria da saúde individual e coletiva através da saúde pública.

No abstract

Dengue is a global and growing health threat, especially in Southeast Asia, West Pacific and South America. Infection by the dengue virus (DENV) results in dengue fever, which can evolve to severe forms. Cytokines, especially interferons, are involved in the immunopathogenesis of dengue fever, and so may influence the disease outcomes. The aim of this study was to investigate the association between severe forms of dengue and two single nucleotide polymorphisms (SNPs) in the interferon-gamma gene (IFNG): A256G (rs2069716) and A325G (rs2069727). We included 274 patients infected with DENV serotype 3: 119 cases of dengue without warning signs (DWoWS), and 155 with warning signs (DWWS) or severe dengue (SD). DNA was extracted, and genotyped with Illumina Genotyping Kit or real time PCR (TaqMan probes). We estimated the adjusted Odds Ratios (OR) by multivariate logistic regression models. When comparing with the ancestral AA/AA diplotype (A256G/A325G), we found a protective association of the AA/AG against DWWS/SD among patients with secondary dengue (OR 0.51; 95% IC 0.24-1.10, p = 0.085), adjusting for age and sex. The variant genotype at locus A325G of the IFNG, in combination with the ancestral genotype at locus A256G, can protect against severe clinical forms of secondary dengue in Brazilian DENV3-infected patients.