Paracoccidioidomicose: atualização epidemiológica, clínica e terapêutica Paracoccidioidomycosis: epidemiological, clinical and treatment up-date

São apresentados dados de atualização epidemiológica, clínica, diagnóstica e terapêutica relativos à paracoccidioidomicose. Discute-se a importância epidemiológica resultante do isolamento do Paracoccidioides brasiliensis a partir do tatu (Dasypus novemcinctus) em regiões do Brasil e Colômbia, assim como dos resultados de inquéritos soroepidemiológicos em cães e do surgimento do primeiro caso de paracoccidioidomicose doença em cão. As dificuldades de isolamento do fungo a partir do solo são correlacionadas com novos informes de investigação epidemiológica. São apresentados aspectos clínicos das manifestações da forma aguda da doença, assim como das manifestações da neuroparacoccidioidomicose e da enfermidade associada à infecção pelo HIV. Discute-se o papel da sorologia e da técnica da PCR no diagnóstico e dos possíveis avanços no tratamento da paracoccidioidomicose com os novos derivados triazólicos.<br>The present report provides new data related to the epidemiology, clinical aspects and treatment of paracoccidioidomycosis. The epidemiological impact of the isolation of Paracoccidioides brasiliensis from the armadillo (Dasypus novemcinctus) in areas of Brazil and Columbia, the results from seroepidemiologic study in dogs and the first case of paracoccidioidomycosis-disease on a dog are presented. New insights related to the classical difficulties of isolation of the fungus from soil are correlated with epidemiological data. Clinical manifestation of the acute form of the disease as well as aspects of the neuroparacoccidioidomycosis, and aspects of the association of the disease with the HIV infection are considered. The role of serology and PCR in the diagnosis, as well as the possible advances in the treatment of paracoccidioidomycosis with the new triazole derivatives are discussed

Inflamm-Aging

Inflammaging is a theory of aging based on the evidence that the evolutionary unpredicted persistent/increasing exposure to a variety of external and internal stressors occurring beyond the age of reproduction activates innate and adaptive immunity pathways involved in inflammatory response. Seventeen years after this theory was launched, it is now recognized that this phenomenon also involves non-immune cells, including adipocytes, fibroblasts, muscle, endothelial, and senescent cells. Recent data suggest that besides classical stimuli, such as cyto- megalovirus persistent infection (non-self), inflammging is fueled by a variety of stimuli derived from the gut microbiota (quasi-self) and by the continuous production of potentially inflammatory molecules released/secreted as a conse- quence of cell death and organelle dysfunction (self). All these products (alarmins) are sensed by a small number of evolutionary-selected sensors, and eventually activate few basic inflammatory pathways such as NF-\u3baB, inflammasomes, and cGAS. These phenomena are physiological and crucial for survival, but they undergo a progressive increase with age, sometimes reaching a threshold over which age-related pathologies ensue, thus representing an example of antagonist pleiotropy. Inflammaging is a dynamic phenomenon, and its final clinical outcome is highly \u201cpersonalized\u201d depending on what we propose to call \u201cimmunobiography,\u201d i.e., the lifelong immunological experiences and stimuli each individual has been exposed to. Finally, a particular attention is devoted to antiaging strategies, showing that most of them have a direct or indirect impact on inflammaging itself