Prevalence of anti-SARS-CoV-2 antibodies in outpatients of a large public university hospital in Sao Paulo, Brazil

Coronavirus disease 19 (COVID-19) is caused by SARS-Cov-2 and the manifestations of this infection range from an absence of symptoms all the way up to severe disease leading to death. To estimate the prevalence of past infection in a population, the most readily available method is the detection of antibodies against the virus. This study has investigated the prevalence of anti-SARS-CoV-2 antibodies in outpatients of the Hospital das Clinicas, in Sao Paulo city (Brazil), which is a large university hospital belonging to the public health system that cares for patients with complex diseases who need tertiary or quaternary medical care. Our serological inquiry was carried out for 6 weeks, with once-a-week blood sampling and included 439 patients from several outpatient services. Overall, 61 patients tested positive for anti-SARS-CoV-2 IgG (13.9%); 56.1 % of the patients live in Sao Paulo city, with the remaining living in other towns of the metropolitan area; 32.8% of the patients testing positive for IgG antibodies to SARS-CoV-2 were asymptomatic, 55.7% developed mild or moderate disease and 11.5% had to be hospitalized. The prevalence of SARS-CoV-2 positive serology was lower among patients who had received the seasonal influenza vaccine compared to the ones who did not. These findings may indicate that those individuals care more about health issues, and/or that they have a better access to health care and/or a better quality of health care service. The large proportion of patients who were unaware of having had contact with SARS-CoV-2 deserves attention, reflecting the scarcity of tests performed in the population

Impaired CD8+ T cell responses upon Toll-like receptor activation in common variable immunodeficiency

Abstract\ud \ud Background\ud Infections caused by bacteria or viruses are frequent in common variable immunodeficiency (CVID) patients due to antibody deficiencies, which may be associated with altered T cell function. CVID patients are frequently in contact with pathogen-associated molecular patterns (PAMPs), leading to the activation of innate immunity through Toll-like receptors (TLR) affecting T cell activation. We evaluated the effect of TLR activation on T cells in CVID patients undergoing intravenous immunoglobulin (IVIg) replacement using synthetic ligands.\ud \ud \ud Methods\ud Expression of exhaustion, activation and maturation markers on T cells from peripheral blood as well as regulatory T cells and follicular T cells in peripheral blood mononuclear cells (PBMCs) from CVID and healthy individuals were evaluated by flow cytometry. PBMCs cultured with TLR agonists were assessed for intracellular IFN-γ, TNF, IL-10, IL-17a or IL-22 secretion as monofunctional or polyfunctional T cells (simultaneous cytokine secretion) by flow cytometry.\ud \ud \ud Results\ud We found increased expression of the exhaustion marker PD-1 on effector memory CD4+ T cells (CD45RA−CCR7−) in the peripheral blood and increased expression of CD38 in terminally differentiated CD8+ T cells (CD45RA+CCR7−). Furthermore, a decreased frequency of naïve regulatory T cells (CD45RA+Foxp3low), but not of activated regulatory T cells (CD45RA−Foxp3high) was detected in CVID patients with splenomegaly, the non-infectious manifestation in this CVID cohort (43.7 %). Moreover, the frequency of peripheral blood follicular helper T cells (CD3+CD4+CXCR5+PD-1+ICOS+) was similar between the CVID and control groups. Upon in vitro TLR3 activation, a decreased frequency of CD8+ T cells secreting IFN-γ, IL-17a or IL-22 was detected in the CVID group compared to the control group. However, a TLR7/TLR8 agonist and staphylococcal enterotoxin B induced an increased Th22/Tc22 (IL-22+, IFN-γ−, IL-17a−) response in CVID patients. Both TLR2 and TLR7/8/CL097 activation induced an increased response of CD4+ T cells secreting three cytokines (IL-17a, IL-22 and TNF)in CVID patients, whereas CD8+ T cells were unresponsive to these stimuli.\ud \ud \ud Conclusion\ud The data show that despite the unresponsive profile of CD8+ T cells to TLR activation, CD4+ T cells and Tc22/Th22 cells are responsive, suggesting that activation of innate immunity by TLRs could be a strategy to stimulate CD4+ T cells in CVID.We are grateful to all individuals who participated in the study. This work\ud was supported by Fundação de Amparo à Pesquisa do Estado de São Paulo\ud (2012/14110-0) and the Laboratório de Investigação Médica, Unidade 56 do\ud Hospital das Clínicas da Faculdade de Medicina de São Paulo. The funders had\ud no role in the study design, data collection and analysis, decision to publish or\ud manuscript preparation

SARS-CoV-2 recombinant proteins stimulate distinct cellular and humoral immune response profiles in samples from COVID-19 convalescent patients

OBJECTIVES: In this preliminary study we investigated cellular and humoral immune responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigens in blood samples from 14 recovered coronavirus disease 2019 (COVID-19) patients and compared them to those in samples from 12 uninfected/unvaccinated volunteers. METHODS: Cellular immunity was assessed by intracellular detection of IFN-γ in CD3+ T lymphocytes after stimulation with SARS-CoV-2 spike (S1), nucleocapsid (NC), or receptor-binding domain (RBD) recombinant proteins or overlapping peptide pools covering the sequence of SARS-CoV-2 spike, membrane and nucleocapsid regions. The humoral response was examined by ELISAs and/or chemiluminescence assays for the presence of serum IgG antibodies directed to SARS-CoV-2 proteins. RESULTS: We observed differences between humoral and cellular immune profiles in response to stimulation with the same proteins. Assays of IgG antibodies directed to SARS-CoV-2 NC, RBD and S1/S2 recombinant proteins were able to differentiate convalescent from uninfected/unvaccinated groups. Cellular immune responses to SARS-CoV-2 protein stimuli did not exhibit a specific response, as T cells from both individuals with no history of contact with SARS-CoV-2 and from recovered donors were able to produce IFN-γ. CONCLUSIONS: Determination of the cellular immune response to stimulation with a pool of SARS-CoV-2 peptides but not with SARS-CoV-2 proteins is able to distinguish convalescent individuals from unexposed individuals. Regarding the humoral immune response, the screening for serum IgG antibodies directed to SARS-CoV-2 proteins has been shown to be specific for the response of recovered individuals

Archaea Symbiont of T. cruzi Infection May Explain Heart Failure in Chagas Disease

Background: Archaeal genes present in Trypanosoma cruzi may represent symbionts that would explain development of heart failure in 30% of Chagas disease patients. Extracellular vesicles in peripheral blood, called exosomes (< 0.1 μm) or microvesicles (>0.1 μm), present in larger numbers in heart failure, were analyzed to determine whether they are derived from archaea in heart failure Chagas disease.Methods: Exosomes and microvesicles in serum supernatant from 3 groups were analyzed: heart failure Chagas disease (N = 26), asymptomatic indeterminate form (N = 21) and healthy non-chagasic control (N = 16). Samples were quantified with transmission electron microscopy, flow cytometer immunolabeled with anti-archaemetzincin-1 antibody (AMZ 1, archaea collagenase) and probe anti-archaeal DNA and zymography to determine AMZ1 (Archaeal metalloproteinase) activity.Results: Indeterminate form patients had higher median numbers of exosomes/case vs. heart failure patients (58.5 vs. 25.5, P < 0.001), higher exosome content of AMZ1 antigens (2.0 vs. 0.0; P < 0.001), and lower archaeal DNA content (0.2 vs. 1.5, P = 0.02). A positive correlation between exosomes and AMZ1 content was seen in indeterminate form (r = 0.5, P < 0.001), but not in heart failure patients (r = 0.002, P = 0.98). Higher free archaeal DNA (63.0 vs. 11.1, P < 0.001) in correlation with exosome numbers (r = 0.66, P = 0.01) was seen in heart failure but not in indeterminate form (r = 0.29, P = 0.10). Flow cytometer showed higher numbers of AMZ1 microvesicles in indeterminate form (64 vs. 36, P = 0.02) and higher archaeal DNA microvesicles in heart failure (8.1 vs. 0.9, P < 0.001). Zymography showed strong% collagenase activity in HF group, mild activity in IF compared to non-chagasic healthy group (121 ± 14, 106 ± 13 and 100; P < 0.001).Conclusions: Numerous exosomes, possibly removing and degrading abnormal AMZ1 collagenase, are associated with indeterminate form. Archaeal microvesicles and their exosomes, possibly associated with release of archaeal AMZ1 in heart failure, are future candidates of heart failure biomarkers if confirmed in larger series, and the therapeutic focus in the treatment of Chagas disease

Phenotypic evaluation of regulatory CD4+ T cells, Th17, Th22 and Tc22 in HIV-1-exposed uninfected individuals

INTRODUÇÃO: A infecção por HIV-1 é um grave problema de saúde pública causando elevada taxa de morbidade e mortalidade. Entretanto, alguns indivíduos são considerados resistentes à infecção por HIV-1, mesmo após repetidas exposições ao vírus. Vários fatores imunológicos e genéticos podem estar associados a resistência à infecção, como ativação de componentes da imunidade inata e também devido ao baixo perfil de ativação das células T. É possível que nos indivíduos expostos e não infectados por HIV-1 (ENI) ocorra uma importante atuação das células T secretoras de IL-17 e IL-22, e também as células T reguladoras, pois são necessárias para a manutenção e homeostase das mucosas associadas ao intestino (GALT). OBJETIVO: Avaliar o fenótipo e a função de células TCD4+ e TCD8+ em casais sorodiscordante ao HIV-1, compostos por indivíduos ENI e os parceiros infectados por HIV-1. MÉTODOS: Os casais sorodiscordantes ao HIV-1, consistiam de 23 indivíduos expostos não-infectados (ENI), 14 mulheres e 9 homens, com mediana de 41 anos e 21 parceiros infectados por HIV-1 (HIV), 20 homens e 1 mulher com mediana de 41 anos. Os controles saudáveis foram 24 indivíduos (14 mulheres e 10 homens) com mediana de 37 anos. Os casais sorodiscordantes foram compostos por 16 heterossexuais e 7 homossexuais, com tempo de relacionamento de 13 anos. As frequências de células Th17, Th22 e Tc22, as células T polifuncionais foram analisadas em células mononucleares (CMNs) do sangue periférico, estimulados com peptídeos da região Gag do HIV-1 e da enterotoxina B do Staphylococcus aureus (SEB), a frequência de células T reguladoras, o perfil fenotípico de exaustão/diferenciação e a expressão da integrina alfa4?7 e CCR9 em células T, foram realizados por citometria de fluxo. RESULTADOS: No grupo HIV, as células T CD4+ e CD8+ do sangue periférico mostrou maior frequência de CD95 e PD-1 e baixa expressão de CD127 comparado ao grupo ENI e controle. A frequência de células Th17 em CMNs aumentou nos grupos ENI e HIV-1 na condição sem estímulo, contudo, após estímulo com os peptídeos da região p24 da Gag do HIV-1 induziu resposta somente no grupo HIV-1. O grupo ENI mostrou resposta antígeno-especifica somente para IL-22. Além disto, avaliando as células Tc22 e Th22, foi verificado aumento da resposta aos peptídeos da Gag e também ao SEB, nos grupos HIV e ENI. A presença de células T polifuncionais antígeno-especificas, secretoras de 5-4 citocinas, foi detectada apenas em células T CD38+ no grupo HIV, enquanto os indivíduos ENI mostraram resposta polifuncional por células T CD38- somente ao estímulo policlonal por SEB. Uma diminuição do número absoluto de células T reguladoras (CD4+CD25+CD127low/-Foxp3+) foi detectada no grupo HIV comparado ao ENI e controle, com maior expressão de moléculas HLA-DR e CD95. Além disto, foi detectado diminuição na frequência de células TCD8+ ?4?7+ no grupo ENI e de células TCD4+ alfa4beta7+ nos grupos ENI e HIV. Houve uma correlação positiva entre as células Tc22 e Th22 com as células TCD8+ e TCD4+ que expressam alfa4beta7, no grupo ENI e HIV-1. CONCLUSÃO: Os indivíduos ENI são capazes de desenvolver resposta antígeno-específicas relacionadas com a IL-22, que possui importante função na imunidade de mucosas. Além disto, mostram presença de células T polifuncionais com baixo perfil de ativação a estímulo policlonal. Os dados evidenciam que os indivíduos ENI, mostram indução de células Tc22, aumento de expressão de moléculas de migração para o intestino e equilíbrio entre as células efetoras e Treg, que em conjunto, devem exercer importante papel para a resistência à infecção por HIV-1INTRODUCTION: The HIV-1 infection is a major public health problem causing high morbidity and mortality. However, some individuals are considered resistant to HIV-1 infection even after repeated HIV-1 exposures. Several immunologic and genetic factors could be associated with the resistance to infection, such as activation of innate immunity components and due to the low profile of T-cell activation. It is possible that in HIV-1 exposed uninfected individuals (EU) occurs an important activity of the T cells secreting IL-17 and IL-22, including regulatory T cells, which are necessary to maintenance of homeostasis of gut-associated lymphoid tissue (GALT). AIM: To evaluate the phenotype and function of CD4+ and CD8+ T cells in HIV-1-serodiscordant couples, composed by the EU individuals and the infected HIV-1 partners. METHODS: The HIV-1-serodiscordant couples consisted of 23 EU individuals, 14 women and 9 men, with a median age of 41 years and 21 partners infected by HIV-1, 20 men and 1 woman, with a median of 41 years. Healthy controls consisted of 24 individuals (14 women and 10 men) with a median age of 37 years. The serodiscordant couples were composed by 16 homosexuals and 7 heterosexuals, reporting a median relationship duration of 13 years with a single partner. The frequency of Th17, Th22 and Tc22 cells, the polyfunctional T cells were assessed in mononuclear cells (MNCs) from peripheral blood, stimulated with the peptides from the gag region of HIV-1 and enterotoxin B from Staphylococcus aureus (SEB), the frequency of regulatory T cells and the exhaustion/differentiation phenotypic profile and expression of integrin alfa4beta7 and CCR9 in T cells were assessed by flow cytometry. RESULTS: In HIV group, CD4+ and CD8+ T cells from peripheral blood showed a higher frequency of PD-1, and CD95 and low expression of CD127 compared to ENI and control groups. The frequency of Th17 cells in MNCs increased in ENI and HIV-1 groups in the unstimulated conditions, however, upon stimulation with p24 peptides of HIV-1 Gag induced response only in HIV-1 group. The ENI group showed antigen-specific response only for IL-22. Moreover, evaluating the Tc22 and Th22 cells, it was found increased response to Gag peptides and also for SEB in both, HIV and ENI groups. The presence of polyfunctional antigen-specific T cells secreting 5-4 cytokines, was only detected in CD38+ T cells from HIV group, while ENI individuals showed polyfunctional CD38- T cells response only with the polyclonal stimulus with SEB. A decreased absolute number of regulatory T cells (CD4 + CD25 + CD127low /-Foxp3 +) was detected in HIV group compared to the EU and control groups, with higher expression of HLA-DR and CD95 molecules. In addition, it was detected decreased frequency of CD8+ alfa4beta7 + T cells in the ENI group and CD4+ alfa4beta7+ T cells in both, ENI and HIV groups. There was a positive correlation between Tc22 and Th22 cells with the CD8+ and CD4+ T cells expressing alfa4beta7, in the ENI and HIV-1 groups. CONCLUSION: The EU individuals are able to develop antigen-specific response related to IL-22, which has an important function in the mucosal immunity. In addition, showed presence of polyfunctional T cells with low activation profile to polyclonal stimuli. The data show that the EU individuals, showed induction of Tc22 cells, increased expression of homing molecules into the intestine and balance between effector cells and Treg cells, which together, must play an important role in the HIV-1 resistanc

Delivery of microRNAs by Extracellular Vesicles in Viral Infections: Could the News be Packaged?

Extracellular vesicles (EVs) are released by various cells and recently have attracted attention because they constitute a refined system of cell–cell communication. EVs deliver a diverse array of biomolecules including messenger RNAs (mRNAs), microRNAs (miRNAs), proteins and lipids, and they can be used as potential biomarkers in normal and pathological conditions. The cargo of EVs is a snapshot of the donor cell profile; thus, in viral infections, EVs produced by infected cells could be a central player in disease pathogenesis. In this context, miRNAs incorporated into EVs can affect the immune recognition of viruses and promote or restrict their replication in target cells. In this review, we provide an updated overview of the roles played by EV-delivered miRNAs in viral infections and discuss the potential consequences for the host response. The full understanding of the functions of EVs and miRNAs can turn into useful biomarkers for infection detection and monitoring and/or uncover potential therapeutic targets

Evaluation of systemic immunity in atypical cutaneous leishmaniasis caused by Leishmania (L.) infantum chagasi

Universidade de São Paulo. Faculdade de Medicina. Departamento de Patologia. Laboratório de Patologia de Moléstias Infecciosas. São Paulo, SP, Brasil.Universidade de São Paulo. Faculdade de Medicina. Departamento de Patologia. Laboratório de Patologia de Moléstias Infecciosas. São Paulo, SP, Brasil / Universidad Nacional Autónoma de Honduras. Instituto de Investigaciones en Microbiología. Tegucigalpa, Honduras.Universidade de São Paulo. Faculdade de Medicina. Departamento de Patologia. Laboratório de Patologia de Moléstias Infecciosas. São Paulo, SP, BrasilUniversidade de São Paulo. Faculdade de Medicina. Departamento de Patologia. Laboratório de Patologia de Moléstias Infecciosas. São Paulo, SP, BrasilUniversidade de São Paulo. Faculdade de Medicina. Departamento de Patologia. Laboratório de Patologia de Moléstias Infecciosas. São Paulo, SP, BrasilUniversidade de São Paulo. Instituto de Medicina Tropical de São Paulo. Faculdade de Medicina. Laboratório de Dermatologia e Imunodeficiências. São Paulo, SP, Brasil.Hospital Escuela. Departamento de Vigilancia de la Salud. Tegucigalpa, Honduras.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Laboratório de Parasitologia. Ananindeua, PA, Brasil / Universidade Federal do Pará. Núcleo de Medicina Tropical. Belém, PA, Brasil.Universidade de São Paulo. Faculdade de Medicina. Departamento de Patologia. Laboratório de Patologia de Moléstias Infecciosas. São Paulo, SP, BrasilIn some central-American countries, Leishmania (L.) infantum chagasi infection can cause non-ulcerated or atypical cutaneous leishmaniasis (NUCL) in addition to the classic clinical form, visceral leishmaniasis (VL). Little is known about the host-parasite relationship that can contribute to the determination of one or another clinical form. The present study had the objective to evaluate the humoral and cellular immunity in the sera of individuals affected by NUCL to improve the comprehension of this atypical host-parasite interaction. Based on clinical and laboratory diagnosis, serum of 80 individuals was collected to evaluate the cytokines and immunoglobulins profile of NUCL (n = 47), VL patients (n = 5), and negative controls (n = 28). Cytokines were detected using Cytokine Bead Array (CBA) Human Th1/Th2/Th17 kit according to the manufacturer's instructions; class (IgG and IgM), and subclass of (IgG1 and IgG2) immunoglobulins was evaluated by ELISA using specific antigens. The concentration of TNF-α, IFN-γ, IL-2 and IL-4 cytokines in NUCL, VL and control was present below the detection threshold of CBA kit. IL-6, IL-10 and IL-17A cytokines was lower in NUCL compared to LV patients. Regarding to immunoglobulins, NUCL patients produced 4.0 times more IgG than the control, while VL patients produced 6.6 times more; and IgM level was 1.6 times higher in NUCL and 2.6 times in VL patients compared to the control. Concerning the immunoglobulins subclass, only VL patients showed positive reaction for IgG1, and IgG2 did not show positive reaction among the groups. The results showed a weak cellular and humoral systemic immune response in NUCL patients

TLR7/TLR8 Activation Restores Defective Cytokine Secretion by Myeloid Dendritic Cells but Not by Plasmacytoid Dendritic Cells in HIV-Infected Pregnant Women and Newborns

<div><p>Mother-to-child transmission (MTCT) of HIV-1 has been significantly reduced with the use of antiretroviral therapies, resulting in an increased number of HIV-exposed uninfected infants. The consequences of HIV infection on the innate immune system of both mother-newborn are not well understood. In this study, we analyzed peripheral blood and umbilical cord blood (CB) collected from HIV-1-infected and uninfected pregnant women. We measured TNF-α, IL-10 and IFN-α secretion after the stimulation of the cells with agonists of both extracellular Toll-like receptors (TLRs) (TLR2, TLR4 and TLR5) and intracellular TLRs (TLR7, TLR7/8 and TLR9). Moreover, as an indicator of the innate immune response, we evaluated the responsiveness of myeloid dendritic cells (mDCs) and plasmacytoid DCs (pDCs) to TLRs that are associated with the antiviral response. Our results showed that peripheral blood mononuclear cells (PBMCs) from HIV-1-infected mothers and CB were defective in TNF-α production after activation by TLR2, TLR5, TLR3 and TLR7. However, the TNF-α response was preserved after TLR7/8 (CL097) stimulation, mainly in the neonatal cells. Furthermore, only CL097 activation was able to induce IL-10 and IFN-α secretion in both maternal and CB cells in the infected group. An increase in IFN-α secretion was observed in CL097-treated CB from HIV-infected mothers compared with control mothers. The effectiveness of CL097 stimulation was confirmed by observation of similar mRNA levels of interferon regulatory factor-7 (IRF-7), IFN-α and TNF-α in PBMCs of both groups. The function of both mDCs and pDCs was markedly compromised in the HIV-infected group, and although TLR7/TLR8 activation overcame the impairment in TNF-α secretion by mDCs, such stimulation was unable to reverse the dysfunctional type I IFN response by pDCs in the HIV-infected samples. Our findings highlight the dysfunction of innate immunity in HIV-infected mother-newborn pairs. The activation of the TLR7/8 pathway could function as an adjuvant to improve maternal-neonatal innate immunity.</p></div