IL-1β, IL-6, and RANTES as Biomarkers of Chikungunya Severity

Little is known about the immunopathogenesis of Chikungunya virus. Circulating levels of immune mediators and growth factors were analyzed from patients infected during the first Singaporean Chikungunya fever outbreak in early 2008 to establish biomarkers associated with infection and/or disease severity.Adult patients with laboratory-confirmed Chikungunya fever infection, who were referred to the Communicable Disease Centre/Tan Tock Seng Hospital during the period from January to February 2008, were included in this retrospective study. Plasma fractions were analyzed using a multiplex-microbead immunoassay. Among the patients, the most common clinical features were fever (100%), arthralgia (90%), rash (50%) and conjunctivitis (40%). Profiles of 30 cytokines, chemokines, and growth factors were able to discriminate the clinical forms of Chikungunya from healthy controls, with patients classified as non-severe and severe disease. Levels of 8 plasma cytokines and 4 growth factors were significantly elevated. Statistical analysis showed that an increase in IL-1beta, IL-6 and a decrease in RANTES were associated with disease severity.This is the first comprehensive report on the production of cytokines, chemokines, and growth factors during acute Chikungunya virus infection. Using these biomarkers, we were able to distinguish between mild disease and more severe forms of Chikungunya fever, thus enabling the identification of patients with poor prognosis and monitoring of the disease

A definição de medicamentos prioritários para o monitoramento da qualidade laboratorial no Brasil: articulação entre a vigilância sanitária e a Política Nacional de Medicamentos Definition of priority medicines for monitoring laboratory quality in Brazil: the interface between health surveillance and the National Drug Policy

A Política Nacional de Medicamentos tem como importante diretriz a qualidade dos medicamentos oferecidos à população. Objetivou-se definir prioridades para análise pelo Programa Nacional de Verificação da Qualidade de Medicamentos. Como critério, utilizou-se a presença do medicamento em, no mínimo, três Programas de Assistência Farmacêutica do Ministério da Saúde. Critérios adicionais foram a presença na Relação Nacional de Medicamentos Essenciais de 2002 (RENAME) e a indicação para as vinte principais causas de Anos de Vida Perdidos Ajustados por Incapacidade (DALY). Informações do Ministério da Saúde e legislação foram fontes da pesquisa. Classificaram-se os medicamentos segundo o Anatomical Therapeutic Chemical Classification System (ATC) da OMS. Nos 13 programas de assistência farmacêutica, existiam 893 produtos classificados em 449 diferentes códigos ATC. Foram considerados prioritários 28 fármacos, 26 constantes na RENAME e 12 indicados nas causas de DALY. Recomenda-se, à Agência Nacional de Vigilância Sanitária e à Secretaria de Ciência, Tecnologia e Insumos Estratégicos, estabelecer estratégia integrada para garantia de qualidade integral desses medicamentos, abrangendo qualidade laboratorial, registro, boas práticas de fabricação e informações para profissionais de saúde e população.<br>A key objective of the Brazilian National Drug Policy is the quality of medicines supplied to the population. This study aimed to set priorities for the analysis of the National Program for Quality Control of Medicines. The main criterion was the drug's presence in at least three Pharmaceutical Care Programs under the Ministry of Health. Additional criteria were presence on the National List of Essential Drugs (RENAME) in 2002 and its indication for the 20 main causes of disability-adjusted life years (DALY). The sources were data from the Ministry of Health and related legislation. The drugs were classified according to the Anatomical Therapeutic Chemical Classification System (ATC) of the WHO. The 13 pharmaceutical care programs included 893 products classified in 449 different ATC codes. Twenty-eight drugs were considered priorities, 26 of which were listed on the RENAME and 12 indicated as causes of DALY. It is recommended that the National Health Surveillance Agency and Secretariat of Science, Technology, and Strategic Inputs establish an integrated strategy to guarantee comprehensive quality of these drugs, including laboratory quality, registration, good manufacturing practices, and information for health professionals and the general population