Genetic analysis and virulence factors of clinical isolates of Candida albicans from patients with chronic periodontitis with diabetes mellitus type II

Orientadores: Reginaldo Bruno Gonçalves, Cristiane DuqueTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: Candida spp. são leveduras comensais que habitam diferentes sítios da cavidade bucal. Em indivíduos saudáveis, sem alterações imunológicas, esses microrganismos não causam doença. Entretanto, diante de condições imunossupressoras, essas leveduras podem se tornar mais virulentas e expressar patogenicidade. Espécies de Candida apresentam diversos fatores de virulência, incluindo mecanismos de adesão e invasão celular associado à produção de enzimas que auxiliam na degradação tecidual e facilitam sua proliferação na mucosa bucal. Estudos têm demonstrado a presença de Candida sp. em sítios periodontais de pacientes com periodontite crônica, principalmente quando estes são imunologicamente comprometidos. Entretanto, ainda é desconhecido o papel desses microrganismos na patogênese da doença periodontal. Os objetivos do presente trabalho foram: 1) identificar a presença de espécies de Candida e periodontopatógenos por PCR em sítios bucais de pacientes diabéticos ou não com periodontite crônica; 2) isolar cepas de Candida albicans desses pacientes e avaliá-las quanto à atividade das enzimas proteinase, fosfolipase e hemolisina e os graus de hidrofobicidade da superfície celular, sob diferentes condições atmosféricas, além de realizar a análise genotípica desses isolados; 3) avaliar a capacidade de adesão e invasão de cepas de Candida albicans com diferentes graus de hidrofobicidade, em fibroblastos gengivais humanos. As reações de PCR mostraram que os diabéticos tiveram maior prevalência de Candida spp. principalmente C. albicans e C. dubliniensis, e menor freqüência de Tannerella forsythia, quando comparado aos pacientes não diabéticos, para bolsa periodontal e furcas. C. glabrata e C. tropicalis não foram encontradas em sítios periodontais de pacientes não diabéticos. Dos pacientes diabéticos, foram isoladas 128 cepas de C. albicans, das quais 51.6% foram determinadas como genótipo B e 48.4% como genótipo A. As condições ambientais consideradas neste estudo, níveis reduzidos de oxigênio ou anaerobiose, não modificaram o tipo de hemólise realizado pelo microrganismo, sendo que a maioria das cepas foi alfa-hemolítica. Nesses ensaios, 100% das cepas em anaerobiose apresentaram as colônias rugosas, enquanto que em ambiente de oxigênio reduzido, houve variação em relação à morfologia e a maioria delas apresentou colônia lisa. Com relação à atividade de proteinase e fosfolipase, cepas de C. albicans não produziram as enzimas na ausência total de oxigênio. Em ambiente com nível reduzido de oxigênio, a maioria das cepas de C. albicans foram fortemente produtoras de proteinase e a maioria das cepas foi positiva para fosfolipase. A hidrofobicidade foi mais alta na condição de anaerobiose. A partir desses resultados, foram selecionadas 16 cepas com alta ou baixa hidrofobicidade e avaliadas quanto à capacidade de adesão e invasão em fibroblastos gengivais humanos. Foi verificado que ambos os processos foram maiores nas cepas com alta hidrofobicidade. A produção de óxido nítrico foi maior para as cepas mais hidrofóbicas. Os resultados demonstraram que as espécies de Candida podem ser encontradas, em grande proporção, em bolsas periodontais e furcas de pacientes portadores de periodontite crônica, principalmente naqueles acometidos por diabetes mellitus. A maioria das cepas de C. albicans apresentou atividade enzimática, que atuaria diretamente na degradação tecidual. Além disso, a hidrofobicidade das cepas de C. albicans mostrou estar relacionada à maior capacidade de adesão e invasão em fibroblastos. Todos esses fatores de virulência aumentam a patogenicidade da Candida, que poderia colaborar na progressão da doença periodontal, principalmente em pacientes imunodeficientesAbstract: Candida spp. are commensal yeasts that inhabit different sites of the oral cavity. In healthy subjects, without immunological alterations, these microorganisms do not cause disease. However, in immunosuppressive conditions, these yeasts can become more virulent and express pathogenicity. Candida species have different virulence factors, including mechanisms of cell adhesion and invasion associated with the production of enzymes that facilitate tissue degradation and their proliferation in oral mucosa. Studies have shown the presence of Candida spp. in periodontal sites of patients with chronic periodontitis, especially when they are immunologically compromised. However is still unknown their role in the pathogenesis of periodontal disease. The objectives of this study were: 1) to identify the presence of Candida species and putative periodontopathogens by PCR in periodontal sites of diabetic or non-diabetic patients with chronic periodontitis; 2) to isolate strains of Candida albicans in these patients and evaluate the proteinase, phospholipase and haemolysin activities and degrees of cell surface hydrophobicity under different atmospheric conditions, besides to performe the genotypic analysis of these isolates; 3) to evaluate the ability of adhesion and invasion of Candida albicans strains with different degrees of hydrophobicity, in human gingival fibroblasts. The PCR reactions revealed that diabetics had higher prevalence of Candida spp., mainly C. albicans and C. dubliniensis, and lower T. forsythia frequency, when compared to non-diabetic patients, for both periodontal sites. C. glabrata and C. tropicalis were not found in periodontal pockets and furcation sites of non-diabetic patients. From diabetic patients, it was isolated 128 strains of C. albicans and 51.6% were determined as genotype B and 48.4% as genotype A. The atmospheric conditions, reduced oxygen and anaerobiosis, did not change the type of hemolysis, and the most of strains were alpha-hemolytic. From these assays, 100% of the strains under anaerobiosis showed rough colonies, whereas in an environment with reduced oxyen was no change in relation to morphology and most of them had smooth colony. Considering proteinase and phospholipase activities, C. albicans strains did not produce the enzymes in the total absence of oxygen. In reduced oxygen, the majority of C. albicans strains were strong proteinase producers and most strains were positive for phospholipase. Hydrophobicity was higher in anaerobic condition. From these results, 16 hydrophobic or hydrophilic strains were selected and evaluated their ability of adhesion and invasion in human gingival fibroblasts. Both processes were greater in strains with high hydrophobicity. The production of nitric oxide was higher for hydrophobic strains. The results showed that Candida species can be found in large proportion, in periodontal pockets and furcation of patients with chronic periodontitis, especially diabetics. The most of C. albicans strains showed enzymatic activity, which could act directly on tissue degradation. Moreover, the hydrophobicity of C. albicans seems to be related to higher capacity of adhesion and invasion in fibroblasts. All these virulence factors enhance the pathogenicity of Candida that could collaborate for the progression of periodontal diseaseDoutoradoMicrobiologia e ImunologiaDoutor em Biologia Buco-Denta

Alternative low doses and routes of administering a prostaglandin F2α analogue to induce luteolysis in Nelore cows

The present study was conducted in order to verify the efficacy of lower doses and alternative routes of a prostaglandin F2α analogue, luprostiol (PGF), for the induction of luteolysis and the precipitation of estrus in nonlactating Nelore cows (Bos taurus indicus). A conventional dose (15 mg) of PGF was compared to doses lower than the conventional dose, which ranges from 10 to 50%, that were administered intramuscularly (IM), intravulvosubmucosally (IVSM), or in the Bai-hui acupuncture site located within the lumbosacral area. The cows were administered PGF 8 day after estrus in the presence of a corpus luteum, and randomly assigned to the following groups: G1 (positive control), 15 mg, IM (n = 23); G2, 7.5 mg, IM (n = 23); G3, 3.75 mg, IM (n = 24); G4, 7.5 mg, IVSM (n = 25); G5, 3.75 mg, Bai-hui acupoint (n = 24); and G6, 1.5 mg, Bai-hui acupoint (n = 25). The results indicated that 50% of a conventional dose of PGF (7.5 mg) resulted in a complete luteal regression (plasma progesterone <1 ng/ml) at Hour 48, and hastened estrus, regardless of whether or not PGF was administered IM or IVSM. Comparatively, 10 or 25% of the conventional dose, even when administered to the Bai-hui acupoint, resulted in an initial reduction in the concentration of progesterone at Hour 24, followed by an increase observed at Hour 48. In conclusion, 25% of a conventional PGF dose administered via the Bai-hui acupoint proved inadequate to induce a complete luteal regression, whereas 50% of a conventional dose administered IM or IVSM was found to be the minimal dose required to induce effectively a complete luteal regression, and to precipitate the onset of estrus in nonlactating Nelore cows

Novas tendências terapêuticas de enfermagem: terapias naturais - programa de atendimento

O presente estudo relata a experiência vivenciada pelos enfermeiros na Clínica de Enfermagem do Campus Universitário do Grande ABC (UniABC), utilizando as terapias naturais: balanceamento muscular, acupuntura e reflexologia como ações terapêuticas de enfermagem. Conclui ressaltando a relevância da aplicação técnico-científica no desenvolvimento das atividades de enfermagem e a sua conseqüente repercussão no cuidado de enfermagem

Alternative animal and non-animal models for drug discovery and development: bonus or burden?

FAPESP - FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULOCNPQ - CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICOMammalian models have served as a basis for R&D over the past decades. Nevertheless, these models are expensive, laborious, may yield results that cannot always be translated into the human in vivo situation and, more recently, have reverberated great social and ethical dilemmas. Hence, the prospect of changes in the global scientific scenario and the Three Rs principle (Reduction, Replacement and Refinement) have encouraged the development of alternative methods to the use of mammals. Despite the efforts, suitable alternative tests are not available in all areas of biomedical research, as regulatory acceptance requires time, prior validation and robust financial and scientific investment. In this perspective, we aim to shed light on the concepts, challenges and perspectives for implementation of innovative alternative animal and non-animal methods in scientific research. The applicability and meaningfulness of invertebrate animal models, in silico analysis and reverse pharmacology are discussed, among other aspects of relevance in today's scenario. Overall, the use of alternative models, including Artemia salina (brine shrimp), Caenorhabditis elegans (roundworm), Danio rerio (zebra fish), Drosophila melanogaster (fruit fly), Galleria mellonella (greater waxmoth) and in silico modelling, increased 909% from 1990 to 2015, as compared to 154% of conventional mammals in the same period. Thus, technological and scientific advancements in the fields of toxicology and drug development seem to have diminished the need for mammalian models. Today, however, mammals still remain critically indispensable to provide - in most cases -reliable data subsidizing and validating translation into the clinical setting.Mammalian models have served as a basis for R&D over the past decades. Nevertheless, these models are expensive, laborious, may yield results that cannot always be translated into the human in vivo situation and, more recently, have reverberated great social and ethical dilemmas. Hence, the prospect of changes in the global scientific scenario and the Three Rs principle (Reduction, Replacement and Refinement) have encouraged the development of alternative methods to the use of mammals. Despite the efforts, suitable alternative tests are not available in all areas of biomedical research, as regulatory acceptance requires time, prior validation and robust financial and scientific investment. In this perspective, we aim to shed light on the concepts, challenges and perspectives for implementation of innovative alternative animal and non-animal methods in scientific research. The applicability and meaningfulness of invertebrate animal models, in silico analysis and reverse pharmacology are discussed, among other aspects of relevance in today's scenario. Overall, the use of alternative models, including Artemia salina (brine shrimp), Caenorhabditis elegans (roundworm), Danio rerio (zebra fish), Drosophila melanogaster (fruit fly), Galleria mellonella (greater waxmoth) and in silico modelling, increased 909% from 1990 to 2015, as compared to 154% of conventional mammals in the same period. Thus, technological and scientific advancements in the fields of toxicology and drug development seem to have diminished the need for mammalian models. Today, however, mammals still remain critically indispensable to provide - in most cases -reliable data subsidizing and validating translation into the clinical setting344681686FAPESP - FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULOCNPQ - CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICOFAPESP - FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULOCNPQ - CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO2011/15984-0; 2013/25080-7310522/2015-

REVISÃO BIBLIOGRÁFICA DO COMPLEXO HIPERPLASIA ENDOMETRIAL CÍSTICA – PIOMETRA EM CADELAS.

O complexo hiperplasia endometrial cística ou piometra é uma doença que acomete grande quantidade de cadelas na clinica veterinária. É uma doença de alta morbidade e mortalidade principalmente em animais de meia idade em fase de diestro. As cadelas com esta enfermidade geralmente encontram-se com apatia, anorexia, e eventualmente sinais mais graves por insuficiência renal, como vômitos diarréia, poliúria e polidipsia devido a lesões no parênquima renal por imunocomplexos previamente formados. A piometra pode se apresentar de duas formas. Nas piometras de cérvix aberta o corrimento vaginal purulento é comum, e nas de cérvix fechada o diagnóstico é facilitado pela palpação abdominal, por exames laboratoriais, RX, e ultrassonografia. Se não tratada pode levar a insuficiência renal, septse seguida de choque séptico e morte. O tratamento pode ser médico ou cirúrgico, e a escolha varia de acordo com a apresentação clínica da paciente

COMPLEXO HIPERPLASIA ENDOMETRIAL CÍSTICA (PIOMETRA) EM CADELAS – DIAGNÓSTICO E TERAPÊUTICA

Cystic endometrial hyperplasia-pyometra complex is a disease that affects a large number of bitches. It has high morbity and mortality routes, and it occurs particularly in middle-aged bitches during diestrus phase. The bitches with pyometra exhibit apathy, anorexia and possible signs of acute renal failure due to renal parenchyma injuries. There are two types of pyometra: open and closed. The most common sign of open pyometra is the purulent vaginal discharge. In closed pyometra, diagnostic is facilitated by abdominal palpation, laboratory test, ultrasound and X-ray. If untreated, pyometra can cause renal failure, sepsis, septic shock and death. Treatment of pyometra is based on medical or surgical procedures. The treatment choice may vary according to the clinical signs and the state of the patient

New antimicrobial therapies used against fungi present in subgingival sites-A brief review

Although the main reservoir of Candida spp. is believed to be the buccal mucosa, these microorganisms can coaggregate with bacteria in subgingival biofilm and adhere to epithelial cells. The treatment of periodontal disease includes scaling and root planning (SR?) associated with proper oral hygiene. However, some patients may have negative responses to different therapeutic procedures, with a continuous loss of insertion, so the use of antimicrobials is needed as an adjuvant to SRP treatment. The use of a broad-spectrum antibiotic, such as tetracycline and metronidazole, as an aid in periodontal treatment has also been a factor for the development of superinfections by resistant bacteria and Candida species, even in patients with HIV. In the dental practice, the most commonly used antifungals are nystatin and fluconazole. However, the introduction of new drugs like the next generation of azoles is essential before the onset of emergent species in periodontal disease. Plants are good options for obtaining a wide variety of drugs. This alternative could benefit a large population that uses plants as a first treatment option. Plants have been used in medicine for a long time and are extensively used in folk medicine, because they represent an economic alternative, are easily accessible and are applicable to various diseases. Herein, we briefly review the literature pertaining the presence of Candida sp. in periodontal pockets, the conventional antifungal resistance and new therapies that include natural antifungal agents are reviewed. (C) 2011 Elsevier Ltd. All rights reserved

In silico approaches for screening molecular targets in Candida albicans: A proteomic insight into drug discovery and development

Candida species are opportunistic pathogens which can cause conditions ranging from simple mucocutaneous infections to fungemia and death in immunosuppressed and hospitalized patients. Candida albicans is considered to be the species mostly associated with fungal infections in humans and, therefore, the mostly studied yeast. This microorganism has survival and virulence factors which, allied to a decreased host immunity response, make infection more difficult to control. Today, the current limited antifungal arsenal and a dramatic increase in fungal resistance have driven the need for the synthesis of drugs with novel mechanisms of action. However, the development of a new drug from discovery to marketing takes a long time and is highly costly. The objective of this review is to show that with advances in biotechnology and biofinformatics, in silico tools such as molecular docking can optimize such a timeline and reduce costs, while contributing to the design and development of targeted drugs. Here we highlight the most promising protein targets in Candida albicans for the development of drugs with new mechanisms of action8426469CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQ141129/2017-

Unexplored endemic fruit species from Brazil: antibiofilm properties, insights into mode of action, and systemic toxicity of four Eugenia spp

CNPQ - CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICOFAPESP - FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULOBrazilian endemic fruit species have aroused attention due to their highly valuable, yet unexplored, agroindustrial, food and therapeutic potential. Herein, we describe the antifungal activity of four Eugenia spp. against Candida albicans biofilms, and further demonstrate insights into their potential mode(s) of action and toxicity in vitro and in vivo. Extracts from different parts (seeds, pulps, leaves) of E. leitonii (EL), E. brasiliensis (EB), E. myrcianthes (EM) and E. involucrata (EI) were obtained (S23 degrees 23',W45 degrees 39') and chemically characterized by GC/MS. The active extracts were tested against C albicans biofilm viability and architecture, as well as mode of action, and toxicology using RAW 264.7 macrophages and Galleria mellonella larvae. The MIC values ranged from 15.62 to > 2000 mu g/mL. The most active extracts were EL (seed, 15.62 mu g/mL) and EB (leaf and seeds, 31.25 and 15.62 mu g/mL, respectively). Treatment with these extracts at 10xMIC reduced biofilm viability by 54-55% (P 0.05) and G. mellonella larvae, with mean in vivo LD50 of 1500 mg/kg (EL, seeds); 2500 mg/kg (EB, seeds); and 1250 mg/kg (EB, leaf). The phenolic compounds epicatechin and gallic acid were the major constituents in the extracts. Our findings may open avenues for the application of these yet unexplored native fruits in the food and pharmaceutical industry. (C) 2017 Elsevier Ltd. All rights reserved.Brazilian endemic fruit species have aroused attention due to their highly valuable, yet unexplored, agroindustrial, food and therapeutic potential. Herein, we describe the antifungal activity of four Eugenia spp. against Candida albicans biofilms, and further demonstrate insights into their potential mode(s) of action and toxicity in vitro and in vivo. Extracts from different parts (seeds, pulps, leaves) of E. leitonii (EL), E. brasiliensis (EB), E. myrcianthes (EM) and E. involucrata (EI) were obtained (S23 degrees 23',W45 degrees 39') and chemically characterized by GC/MS. The active extracts were tested against C albicans biofilm viability and architecture, as well as mode of action, and toxicology using RAW 264.7 macrophages and Galleria mellonella larvae. The MIC values ranged from 15.62 to > 2000 mu g/mL. The most active extracts were EL (seed, 15.62 mu g/mL) and EB (leaf and seeds, 31.25 and 15.62 mu g/mL, respectively). Treatment with these extracts at 10xMIC reduced biofilm viability by 54-55% (P 0.05) and G. mellonella larvae, with mean in vivo LD50 of 1500 mg/kg (EL, seeds); 2500 mg/kg (EB, seeds); and 1250 mg/kg (EB, leaf). The phenolic compounds epicatechin and gallic acid were the major constituents in the extracts. Our findings may open avenues for the application of these yet unexplored native fruits in the food and pharmaceutical industry105280287CNPQ - CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICOFAPESP - FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULOCNPQ - CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICOFAPESP - FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO474335/201352011/15984-0; 2011/25080-7; 2013/26251-