Evaluation of cellular immune response in patients with recurrent candidiasis

A candidíase recorrente cutânea ou mucosa é caracterizada pela ocorrência de, no mínimo, 4 episódios de candidíase no período de um ano. Não são conhecidos os fatores que levam à recorrência desta infecção. O presente estudo avaliou a resposta linfoproliferativa e a produção de IFN-g de pacientes com candidíase recorrente. Os índices de estimulação da resposta linfoproliferativa em culturas de células de pacientes com candidíase recorrente estimuladas com antígeno de Candida albicans, PPD e TT foram respectivamente de 6±8, 17±20 e 65±30. A adição de anticorpo monoclonal anti-IL-10 às culturas de células de 6 pacientes aumentou a resposta linfoproliferativa de 735±415 para 4143±1746 cpm. A produção de IFN-g em culturas de células estimuladas com antígeno de Candida, foi 162±345pg/ml. Pacientes com candidíase recorrente apresentam uma deficiência na resposta linfoproliferativa e na produção de IFN-g, podendo a resposta imune celular ao antígeno de Candida ser restaurada parcialmente através da neutralização da IL-10 in vitro. _________________________________________________________________________________________ ABSTRACT: Recurrent cutaneous or mucosal candidiasis is characterized by the occurrence of at least four candidiasis episodes within a one-year period. The factors involved in recurrence of infection are still unknown. In the present study the lymphoproliferative response and the IFN-g production by candidiasis patients were evaluated. The stimulation index of mononuclear cell cultures of candidiasis patients stimulated with Candida albicans antigen, PPD and TT were 6±8, 17±20 and 65±30, respectively. The addition of monoclonal antibody anti-IL-10 to Candida albicans antigen stimulated cultures raised the lymphoproliferative response from 735±415 to 4143±1746 cpm. The IFN-g production by cells of candidiasis patients stimulated with Candida albicans antigen was 162±345pg/ml. Candidiasis patients have an impairment in the lymphoproliferative response specific to C. albicans antigen and on IFN-g production and the lymphoproliferative response can be partially restored, in vitro, by IL-10 neutralization

Neurological disability in leprosy: incidence and gender association in Sergipe, Brazil

Leprosy remains a public health problem in many countries. The disease affects skin and peripheral nerves and can cause irreversible disabilities. In Brazil, the detection rate of new cases is 18.2/100,000 inhabitants and leprosy control is considered a priority in the state of Sergipe. Studies showing the epidemiological profile and geographical distribution of leprosy cases are needed for effective epidemiological control measures. The objective of this study was to assess the detection rate of new cases, the geographical distribution and association with gender and clinical forms in Sergipe. Data were obtained from the Brazilian Institute of Geography and Statistics and the Information System for Notifiable Diseases. Maps indicating the geographical distribution of leprosy cases and the degree of neurological disabilities of all municipalities of the state were created using Spring, version 5.1.8 and ArcGIS, version 9.3.1. Hyper-endemic leprosy municipalities exist in Sergipe, indicating that the disease remains a major public health problem. The leprosy cases were found to be in municipalities with a higher number of dwellings with nine people per house. A detection rate of 33.0/100,000 inhabitants was noted in 2005, followed by a progressive reduction in the number of new cases until 2010. However, in the same period, an increase of cases with neurological disability was observed. A significant association of males with the multi-bacillary form and neurological disability was observed. This predisposition to severe forms of leprosy in males may be due to a delay in diagnosis and treatment emphasising the need for special attention by the leprosy control programme

Neurological disability in leprosy: incidence and gender association in Sergipe, Brazil

Leprosy remains a public health problem in many countries. The disease affects skin and peripheral nerves and can cause irreversible disabilities. In Brazil, the detection rate of new cases is 18.2/100,000 inhabitants and leprosy control is considered a priority in the state of Sergipe. Studies showing the epidemiological profile and geographical distribution of leprosy cases are needed for effective epidemiological control measures. The objective of this study was to assess the detection rate of new cases, the geographical distribution and association with gender and clinical forms in Sergipe. Data were obtained from the Brazilian Institute of Geography and Statistics and the Information System for Notifiable Diseases. Maps indicating the geographical distribution of leprosy cases and the degree of neurological disabilities of all municipalities of the state were created using Spring, version 5.1.8 and ArcGIS, version 9.3.1. Hyper-endemic leprosy municipalities exist in Sergipe, indicating that the disease remains a major public health problem. The leprosy cases were found to be in municipalities with a higher number of dwellings with nine people per house. A detection rate of 33.0/100,000 inhabitants was noted in 2005, followed by a progressive reduction in the number of new cases until 2010. However, in the same period, an increase of cases with neurological disability was observed. A significant association of males with the multi-bacillary form and neurological disability was observed. This predisposition to severe forms of leprosy in males may be due to a delay in diagnosis and treatment emphasising the need for special attention by the leprosy control programme

Effect of periodontal therapy on metabolic control and levels of IL-6 in the gingival crevicular fluid in type 2 diabetes mellitus

Background: The aim of this study was to compare the efficacy of metabolic control and levels of interleukin 6 (IL-6) in gingival crevicular fluid after periodontal therapy in type 2 diabetes mellitus (DM) and nondiabetic (NDM) patients. Methods: This study was performed in 20 subjects (10 type 2 DM and 10 NDM patients with generalized chronic periodontal disease. Both groups were recorded for clinical parameters (plaque index (PI), gingival index (GI), probing depth (PD), gingival recession (GR) and clinical attachment level (CAL)), metabolic control (fasting glucose levels, glycated a-hemoglobin (HbA1c), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TR)), and IL-6 levels at baseline and 3 months after periodontal treatment. Results: DM and NDM patients revealed significant statistical reductions for clinical parameters (P < 0.05, RM ANOVA) after 3 months. DM group had improvements on HbA1c and had significant statistical increased of TRG (P < 0.05, RM ANOVA) after 3 months. No differences of LDL/HDL and IL-6 levels were found after 3 months in both groups. Conclusion: DM group presented a significant reduction of HbA1c levels after periodontal therapy. However, TRG levels increased after 3 months, which suggest more confirmatory studies to investigate if these results will be repeated in other studies