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  1. Article ; Online: A link between circulating immune complexes and acute kidney injury in human visceral leishmaniasis.

    Corrêa-Castro, Gabriela / Silva-Freitas, Maria Luciana / de Paula, Ludmila / Soares Pereira, Leonardo / Dutra, Maria Rita Teixeira / Albuquerque, Hermano Gomes / Cota, Glaucia / de Azevedo Martins, Caroline / Da-Cruz, Alda Maria / Gomes-Silva, Adriano / Santos-Oliveira, Joanna Reis

    Scientific reports

    2024  Volume 14, Issue 1, Page(s) 9870

    Abstract: Visceral leishmaniasis (VL) is an infectious disease caused by Leishmania infantum. Clinically, VL evolves with systemic impairment, immunosuppression and hyperactivation with hypergammaglobulinemia. Although renal involvement has been recognized, a ... ...

    Abstract Visceral leishmaniasis (VL) is an infectious disease caused by Leishmania infantum. Clinically, VL evolves with systemic impairment, immunosuppression and hyperactivation with hypergammaglobulinemia. Although renal involvement has been recognized, a dearth of understanding about the underlying mechanisms driving acute kidney injury (AKI) in VL remains. We aimed to evaluate the involvement of immunoglobulins (Igs) and immune complexes (CIC) in the occurrence of AKI in VL patients. Fourteen VL patients were evaluated between early treatment and 12 months post-treatment (mpt). Anti-Leishmania Igs, CIC, cystatin C, C3a and C5a were assessed and correlated with AKI markers. Interestingly, high levels of CIC were observed in VL patients up to 6 mpt. Concomitantly, twelve patients met the criteria for AKI, while high levels of cystatin C were observed up to 6 mpt. Plasmatic cystatin C was positively correlated with CIC and Igs. Moreover, C5a was correlated with cystatin C, CIC and Igs. We did not identify any correlation between amphotericin B use and kidney function markers in VL patients, although this association needs to be further explored in subsequent studies. Our data reinforce the presence of an important renal function impairment during VL, suggesting the involvement of Igs, CIC, and C5a in this clinical condition.
    MeSH term(s) Humans ; Leishmaniasis, Visceral/immunology ; Leishmaniasis, Visceral/blood ; Acute Kidney Injury/blood ; Acute Kidney Injury/immunology ; Acute Kidney Injury/parasitology ; Male ; Female ; Antigen-Antibody Complex/blood ; Adult ; Biomarkers/blood ; Middle Aged ; Cystatin C/blood ; Adolescent ; Young Adult ; Amphotericin B/therapeutic use ; Leishmania infantum/immunology
    Chemical Substances Antigen-Antibody Complex ; Biomarkers ; Cystatin C ; Amphotericin B (7XU7A7DROE)
    Language English
    Publishing date 2024-04-30
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-024-60209-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: High levels of anti-Leishmania IgG3 and low CD4

    Kuschnir, Renata Caetano / Pereira, Leonardo Soares / Dutra, Maria Rita Teixeira / de Paula, Ludmila / Silva-Freitas, Maria Luciana / Corrêa-Castro, Gabriela / da Costa Cruz Silva, Simone / Cota, Glaucia / Santos-Oliveira, Joanna Reis / Da-Cruz, Alda Maria

    BMC infectious diseases

    2021  Volume 21, Issue 1, Page(s) 369

    Abstract: Background: Visceral leishmaniasis (VL) is severe and potentially fatal. Brazil is one of the countries with the greatest endemicity for the disease in the world. The reduction of CD4: Methods: Fifteen VL patients recruited from Hospital Eduardo de ... ...

    Abstract Background: Visceral leishmaniasis (VL) is severe and potentially fatal. Brazil is one of the countries with the greatest endemicity for the disease in the world. The reduction of CD4
    Methods: Fifteen VL patients recruited from Hospital Eduardo de Menezes (BH-MG) were grouped into relapsing (R-VL, n = 5) and non-relapsing (NR-VL, n = 10) and evaluated during active disease, immediately after treatment (post-treatment) and 6 months post-treatment (6mpt). Clinical and laboratory data obtained from medical records were correlated with CD4
    Results: During the active phase of VL, despite similarity in the clinical symptoms, the rates of thrombocytopenia, elevated transaminases (AST and ALT) and hyperbilirubinemia were higher in the NR-VL group compared to R-VL (p < 0.05), a profile reversed during the post-treatment phase. All patients had low CD4
    Conclusions: During active phase of VL, the NR-VL patients presented more severe laboratorial abnormalities compared to R-VL, probably because the latter had already received previous treatment. On the other hand, R-VL exhibited greater impairment of immune reconstitution and a high degree of B lymphocyte activation, which must be a factor that favored relapses.
    MeSH term(s) Adult ; Amphotericin B/therapeutic use ; Antibodies, Protozoan/blood ; Brazil ; CD4-Positive T-Lymphocytes/cytology ; CD4-Positive T-Lymphocytes/immunology ; CD4-Positive T-Lymphocytes/metabolism ; Deoxycholic Acid/therapeutic use ; Drug Combinations ; Female ; HIV Infections/complications ; Humans ; Immunoglobulin G/blood ; Interleukin-6/blood ; Leishmania/immunology ; Leishmaniasis, Visceral/drug therapy ; Leishmaniasis, Visceral/immunology ; Leishmaniasis, Visceral/pathology ; Male ; Middle Aged ; Recurrence
    Chemical Substances Antibodies, Protozoan ; Drug Combinations ; Immunoglobulin G ; Interleukin-6 ; Deoxycholic Acid (005990WHZZ) ; Amphotericin B (7XU7A7DROE) ; amphotericin B, deoxycholate drug combination (87687-70-5)
    Language English
    Publishing date 2021-04-20
    Publishing country England
    Document type Journal Article
    ISSN 1471-2334
    ISSN (online) 1471-2334
    DOI 10.1186/s12879-021-06051-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Serum soluble mediators as prognostic biomarkers for morbidity, disease outcome, and late-relapsing hepatitis in yellow fever patients.

    Fradico, Jordana Rodrigues Barbosa / Campi-Azevedo, Ana Carolina / Speziali, Elaine / do Valle Antonelli, Lis Ribeiro / Peruhype-Magalhães, Vanessa / de Rezende, Izabela Maurício / Alves, Pedro Augusto / Pascoal-Xavier, Marcelo Antônio / Pereira, Leonardo Soares / Dutra, Maria Rita Teixeira / Ramalho, Dario Brock / Cenachi, Adriana / de Paula, Ludmila / Santos, Tayrine Araujo / do Carmo Said, Rodrigo Fabiano / Calzavara-Silva, Carlos Eduardo / Coelho-Dos-Reis, Jordana Grazziela Alves / de Magalhães, Clara Ramos / Rabelo, Lara Luíza Cerávolo /
    Valim, Valéria / Brito-de-Sousa, Joaquim Pedro / da Costa-Rocha, Ismael Artur / de Souza Gomes, Matheus / Amaral, Laurence Rodrigues / de Lima, Sheila Maria Barbosa / Trindade, Gisela Freitas / Santos, Renata Tourinho / da Silva, Juliana Fernandes Amorim / Monath, Thomas / LaBeaud, Angelle Desiree / Drumond, Betânia Paiva / Martins-Filho, Olindo Assis / Teixeira-Carvalho, Andréa

    Clinical immunology (Orlando, Fla.)

    2023  Volume 251, Page(s) 109321

    Abstract: This study described a soluble mediator storm in acute Yellow Fever/YF infection along the kinetics timeline towards convalescent disease. The analyses of the YF Viral RNAnemia, chemokines, cytokines, and growth factors were performed in YF patients at ... ...

    Abstract This study described a soluble mediator storm in acute Yellow Fever/YF infection along the kinetics timeline towards convalescent disease. The analyses of the YF Viral RNAnemia, chemokines, cytokines, and growth factors were performed in YF patients at acute/(D1-15) and convalescent/(D16-315) phases. Patients with acute YF infection displayed a trimodal viremia profile spreading along D3, D6, and D8-14. A massive storm of mediators was observed in acute YF. Higher levels of mediators were observed in YF with higher morbidity scores, patients under intensive care, and those progressing to death than in YF patients who progress to late-relapsing hepatitis/L-Hep. A unimodal peak of biomarkers around D4-6 with a progressive decrease towards D181-315 was observed in non-L-Hep patients, while a bimodal pattern with a second peak around D61-90 was associated with L-Hep. This study provided a comprehensive landscape of evidence that distinct immune responses drive pathogenesis, disease progression, and L-Hep in YF patients.
    MeSH term(s) Humans ; Yellow Fever/pathology ; Prognosis ; Cytokines ; Biomarkers ; Hepatitis ; Yellow Fever Vaccine
    Chemical Substances Cytokines ; Biomarkers ; Yellow Fever Vaccine
    Language English
    Publishing date 2023-04-03
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 1459903-x
    ISSN 1521-7035 ; 1521-6616
    ISSN (online) 1521-7035
    ISSN 1521-6616
    DOI 10.1016/j.clim.2023.109321
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Randomized, phase 1/2, double-blind pioglitazone repositioning trial combined with antifungals for the treatment of cryptococcal meningitis - PIO study.

    Gouveia-Eufrasio, Ludmila / Ribeiro, Noelly Queiroz / Santos, Julliana Ribeiro Alves / da Costa, Marliete Carvalho / Emídio, Elúzia Castro Peres / de Freitas, Gustavo José Cota / do Carmo, Paulo Henrique Fonseca / Miranda, Bárbara Alves / de Oliveira, João Carlos Maia Dornelas / da Silva, Lívia Mara Vitorino / Teixeira Leocádio, Victor Augusto / Randi Magalhães, Vanessa Caroline / Penido, Indiara / Pereira, Leonardo Soares / Rabelo, Lívia Frota / de Almeida Faria, Flávio Augusto / Teixeira Dutra, Maria Rita / Aspahan, Maíra / de Paula, Ludmila /
    da Silva, Dirce Inês / Tavares Melo, Márcia Gregory / de Andrade Zambelli, Virginia Antunes / Gomes Faraco, André Augusto / da Costa César, Isabela / Alves, Glauciene Prado / da Cunha Melo, Lívia Fulgêncio / de Aguiar Peres, Nalu Teixeira / Santos, Daniel Assis

    Contemporary clinical trials communications

    2021  Volume 22, Page(s) 100745

    Abstract: Background: Cryptococcosis affects more than 220,000 patients/year, with high mortality even when the standard treatment [amphotericin B (AMB), 5-flucytosin (5-FC) and fluconazole] is used. AMB presents high toxicity and 5-FC is not currently available ... ...

    Abstract Background: Cryptococcosis affects more than 220,000 patients/year, with high mortality even when the standard treatment [amphotericin B (AMB), 5-flucytosin (5-FC) and fluconazole] is used. AMB presents high toxicity and 5-FC is not currently available in Brazil. In a pre-clinical study, pioglitazone (PIO - an antidiabetic drug) decreased AMB toxicity and lead to an increased mice survival, reduced morbidity and fungal burden in brain and lungs. The aim of this trial is to evaluate the efficacy and safety of PIO combined with standard antifungal treatment for human cryptococcosis.
    Methods: A phase 1/2, randomized, double blind, placebo-controlled trial will be performed with patients from Belo Horizonte, Brazil. They will be divided into three groups (placebo, PIO 15 mg/day or PIO 45 mg/day) and will receive an additional pill during the induction phase of cryptococcosis' treatment. Our hypothesis is that treated patients will have increased survival, so the primary outcome will be the mortality rate. Patients will be monitored for survival, side effects, fungal burden and inflammatory mediators in blood and cerebrospinal fluid. The follow up will occur for up 60 days.
    Conclusions: We expect that PIO will be an adequate adjuvant to the standard cryptococcosis' treatment.
    Trial registration: ICTRP/WHO (and International Clinical Trial Registry Plataform (ICTRP/WHO) (http://apps.who.int/trialsearch/Trial2.aspx?TrialID=RBR-9fv3f4), RBR-9fv3f4 (http://www.ensaiosclinicos.gov.br/rg/RBR-9fv3f4). UTN Number: U1111-1226-1535. Ethical approvement number: CAAE 17377019.0.0000.5149.
    Language English
    Publishing date 2021-02-10
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2451-8654
    ISSN (online) 2451-8654
    DOI 10.1016/j.conctc.2021.100745
    Database MEDical Literature Analysis and Retrieval System OnLINE

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