SummaryThere is common agreement that fibromyalgia (FM) is an extremely heterogeneous entity. Patients differ in their clinical symptoms, endocrine and immune parameters. In this study we evaluated endocrine and immunological features of distinct subsets of FM patients. In contrast to previous attempts to identify subsets of FM patients, based solely on their psychological and cognitive features, herein we propose to separate FM patients by genetic features. Allelic expression of the polymorphic promoter region of the serotonin transporter (5-HTTLPR) was analysed as a relevant genetic factor for FM. Seventy-five patients meeting the American College of Rheumatology criteria and 27 healthy age-matched controls participated in this study. All controls and FM patients were submitted to genotyping of 5-HTTLPR. Twenty-seven FM patients, who were able to discontinue hypnotic, sedative or psychotropic prescription medications for at least 2 weeks, were then subdivided into L (homozygote LL) or S groups (genotypes LS and SS). They were evaluated for salivary cortisol levels, absolute number of leucocyte subpopulations, including natural killer (NK) cells and activated T and B lymphocytes. Both groups presented decreased cortisol levels, more intense in the L group, increased all B lymphocytes subsets and reduced CD4 + CD25 high T lymphocytes. The L group had increased CD4 + CD25 low activated T lymphocytes, while the S group displayed elevated CD4 + human leucocyte antigen D-related (HLA-DR) + activated T lymphocytes and decreased NK cells. We demonstrate that genetic factors may help to identify FM individuals with differentially altered frequencies of immune cells.

Micronutrient malnutrition is usually highly prevalent in areas endemic for Chagas disease. Nevertheless, the contribution of micronutrient deficiency to the immunopathology of this infection is often overlooked. In the present work, we assessed the effects of vitamin E deficiency on acute Trypanosoma cruzi (Y strain) infection of Holtzman rats. At 20 days post infection, vitamin E deficiency induced changes in leukocyte levels and exacerbated the myocarditis and sympathetic denervation of ventricular hearts. Vitamin E-deficient infected rats displayed significant leukopenia, evidenced by the decline in the numbers of CD45RA(+)CD3(-) B-cells and CD3(+)CD4(+) T-lymphocytes in the peripheral blood compared with infected control rats. In contrast, vitamin E deficiency induced monocytosis as well as an increased differentiation rate of monocytes to macrophages, as revealed by immunohistochemical analysis.

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Introdução: Leishmaniose visceral (LV) e infecção pelo vírus da imunodeficiência humana (HIV) são problemas de saúde pública, com altos números de casos e letalidade no mundo. Objetivo: Avaliar os fatores associados a coinfecção leishmania/HIV no Brasil. Metodologia: Estudo de coorte retrospectiva com análise univariada e multivariada de 28.265 indivíduos, notificados e com diagnóstico confirmado de LV, no Sistema Nacional de Agravos de Notificação (SINAN), de 2007 a 2018, no Brasil. Resultados: A maioria dos indivíduos coinfectados era jovem, homem, da raça não branca, moradores da zona urbana, com até oito anos de escolaridade e que entraram nesse estudo como caso novo. Maiores chances de coinfecção foram observadas para indivíduos de faixas etárias de onze a dezenove anos (OR=1,74), vinte a trinta e nove anos (OR=13,06) e acima de quarenta anos (OR=6,96), que fizeram uso de antimoniato de N-metilglucamina (OR=4,36), anfotericina B desoxicolato (OR=6,21) e anfotericina B lipossomal (OR=1,60), que apresentaram recidiva (OR=3,99), cujos casos evoluíram para abandono de tratamento (OR=2,00), e óbitos por outras causas que não LV (OR=4,00) e transferência (OR=1,50). Menores chances de coinfecção foram observadas em mulheres (OR=0,80), moradores da zona rural (OR=0,54), que apresentaram de cinco a seis sintomas (OR=0,82). Conclusão: Os resultados apontam para a necessidade de melhoria no acompanhamento de indivíduos coinfectados com LV/HIV, no intuito de diminuir recidivas, transferências e abandono ao tratamento. Atenção especial deve ser dada para a realização do diagnóstico oportuno da infecção pelo HIV em indivíduos com LV, especialmente em homens jovens que residem na zona urbana.

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