High IL-10 levels are pivotal to parasite survival in visceral leishmaniasis (VL). Antigenic stimuli induce IL-10 expression and release of adenosine by CD39/CD73. Due their intrinsic ability to express IL-10 and produce adenosine from extracellular ATP, we evaluated the IL-10, CD39, and CD73 expression by Regulatory T cells (Treg) correlated with VL pathology. Using flow cytometry, Treg cells was analyzed in peripheral blood samples from VL patients (in the presence and absence of Leishmania infantum soluble antigen (SLA)) and healthy individuals (negative endemic control—NEC group), without any treatment. Additionally, IL-10 levels in leukocytes culture supernatant were measured in all groups by ELISA assay. VL patients presented more Treg frequency than NEC group, independently of stimulation. ELISA results demonstrated that SLA induced higher IL-10 expression in the VL group. However, the NEC group had a higher Treg IL-10+ compared to the VL group without stimulation and SLA restored the IL-10 in Treg. Additionally, an increase in Treg CD73+ in the VL group independently of stimuli compared to that in the NEC group was observed. We suggest that Treg are not the main source of IL-10, while the CD73 pathway may be an attempt to modulate the exacerbation of immune response in VL disease.

The spirituality has been pointed as a valuable resource that helps the human being to face the sickness process. This study aimed to investigate the opinion of a multi professional health team about the spirituality on the health-disease process and; verify the multi professional health team perspectives about the spiritual care integrated to the health assistance. It is about a descriptive research with qualitative approach, developed with members of a school-hospital multi professional team, in João Pessoa city -PB. Analyzed qualitatively, through content analyze technique, in the thematic modality, proposed by Bardin. From the analyzes of empirical material obtained through subjective questions, emerged two thematic categories: spirituality with religiosity interface, transcendence, life style and culture; spirituality influence on the promotion of comfort to the patient and on the professional ethical posture. It was understood in this study that the multi professional team understanding about the spirituality is ambiguous and permeated by fragile significances. The professionals don't feel prepared and comfortable yet to insert this therapeutic modality in their routine, however there is a more exponential perception of this gape in the assistance plan.