Fatores de proteção relacionados à promoção de resiliência em pessoas que vivem com HIV/AIDS Protective factors and resilience in people living with HIV/AIDS

Este artigo busca, com base na revisão da literatura, articular o conceito de resiliência com questões da realidade de vida de pessoas portadoras de HIV/AIDS. Em especial, será enfatizada a análise dos fatores de proteção tradicionalmente descritos como promotores de resiliência (características individuais e rede de apoio social e afetiva). Os estudos revisados revelam que existem importantes fatores de proteção, que contribuem para a saúde e bem-estar dos portadores de HIV/AIDS, entre eles o enfrentamento cognitivo e a aceitação da infecção; a participação da família no tratamento e como fonte de apoio afetivo; o papel das organizações governamentais e não-governamentais e a religiosidade. Acredita-se que a compreensão da resiliência como uma "capacidade do ser humano de superar adversidades" é essencial ao entendimento da infecção e tratamento de pacientes com HIV/AIDS. Isso contribui para acabar com o estigma e preconceito em relação à doença e aos seus portadores. Essa perspectiva desmistifica a questão de que bem-estar e qualidade de vida são estados contraditórios à vida das pessoas infectadas, além de contribuir para a elaboração de novas perspectivas de prevenção e tratamento da infecção por HIV/AIDS.<br>The aim of this theoretical review was to articulate the resilience concept with key aspects in the lives of people living with HIV/AIDS. We emphasize the analysis of protective factors traditionally related to resilience (personal characteristics and social and affective support networks). The reviewed studies show important protective factors that contribute to the health and well-being of people with HIV/AIDS, such as cognitive coping and acceptance of their HIV status, family participation in treatment and family support, the role of governmental and nongovernmental institutions, and religious beliefs. The concept of resilience defined as a dynamic process that allows human beings to overcome adversities is essential for understanding HIV infection and treatment of AIDS patients. It helps decrease stigmatization and prejudice towards the disease and patients. It also helps alter the notion that living with AIDS is incompatible with well-being and quality of life and fosters the creation of new HIV/AIDS prevention and treatment perspectives

Actin dynamics shape microglia effector functions

Impaired actin filament dynamics have been associated with cellular senescence. Microglia, the resident immune cells of the brain, are emerging as a central pathophysiological player in neurodegeneration. Microglia activation, which ranges on a continuum between classical and alternative, may be of critical importance to brain disease. Using genetic and pharmacological manipulations, we studied the effects of alterations in actin dynamics on microglia effector functions. Disruption of actin dynamics did not affect transcription of genes involved in the LPS-triggered classical inflammatory response. By contrast, in consequence of impaired nuclear translocation of phospho-STAT6, genes involved in IL-4 induced alternative activation were strongly downregulated. Functionally, impaired actin dynamics resulted in reduced NO secretion and reduced release of TNFalpha and IL-6 from LPS-stimulated microglia and of IGF-1 from IL-4 stimulated microglia. However, pathological stabilization of the actin cytoskeleton increased LPS-induced release of IL-1beta and IL-18, which belong to an unconventional secretory pathway. Reduced NO release was associated with decreased cytoplasmic iNOS protein expression and decreased intracellular arginine uptake. Furthermore, disruption of actin dynamics resulted in reduced microglia migration, proliferation and phagocytosis. Finally, baseline and ATP-induced [Ca(2+)]int levels were significantly increased in microglia lacking gelsolin, a key actin-severing protein. Together, the dynamic state of the actin cytoskeleton profoundly and distinctly affects microglia behaviours. Disruption of actin dynamics attenuates M2 polarization by inhibiting transcription of alternative activation genes. In classical activation, the role of actin remodelling is complex, does not relate to gene transcription and shows a major divergence between cytokines following conventional and unconventional secretion