BACKGROUND Dendritic cells (DCs) specific intercellular adhesion molecule (ICAM)-3-grabbing non integrin receptor (DC-SIGN) binds to subgenera Leishmania promastigotes mediating its interaction with DC and neutrophils, potentially influencing the infection outcome. OBJECTIVES In this work, we investigated whether DC-SIGN receptor is expressed in cells from cutaneous leishmaniasis (CL) lesions as well as the in vitro binding pattern of Leishmania (Viannia) braziliensis (Lb) and L. (L.) amazonensis (La) promastigotes. METHODS DC-SIGN receptor was labeled by immunohistochemistry in cryopreserved CL tissue fragments. In vitro binding assay with CFSE-labeled Lb or La promastigotes and RAJI-transfecting cells expressing DC-SIGN (DC-SIGNPOS) or mock-transfected (DC-SIGNNEG) were monitored by flow cytometry at 2 h, 24 h and 48 h in co-culture. RESULTS In CL lesion infiltrate, DC-SIGNPOS cells were present in the dermis and near the epidermis. Both Lb and La bind to DC-SIGNPOS cells, while binding to DC-SIGNNEG was low. La showed precocious and higher affinity to DC-SIGNhi population than to DC-SIGNlow, while Lb binding was similar in these populations. CONCLUSION Our results demonstrate that DC-SIGN receptor is present in L. braziliensis CL lesions and interact with Lb promastigotes. Moreover, the differences in the binding pattern to Lb and La suggest DC-SIGN can influence in a difference way the intake of the parasites at the first hours after Leishmania infection. These results raise the hypothesis that DC-SIGN receptor could participate in the immunopathogenesis of American tegumentary leishmaniasis accounting for the differences in the outcome of the Leishmania spp. infection.

BACKGROUND Left ventricular aneurysm (LVA) is indicator of high morbidity in Chagas’ disease. A cross-sectional study performed identified LVA in 18.8% of the chronic chagasic patients (CCP). OBJECTIVE Determine the risk of death of patients with chronic chagasic cardiopathy (CCC) and LVA in 24-year interval. MATERIAL AND METHODS In 1995 a cohort of 298 CCP was evaluated by anamnesis, physical examination, EKG and ECHO and classified in groups: G0 = 86 without cardiopathy; G1 = 156 with cardiopathy without LVA and G2 = 56 with cardiopathy and LVA. 38 patients of G0 and G1 used benznidazole. Information about the deaths was obtained in the notary, death certificates, hospital records and family members. FINDINGS Were registered 113 deaths (37.9%): 107 (35.9%) attributed to cardiopathy and 6 (2.0%) to other causes (p < 0.05). Amongst these 107 deaths, 10 (11.6%) occurred in G0; 49 (31.4%) occurred in G1 and 48 (85.7%) occurred in G2 (p < 0.05). The risk of death was 2.7 and 7.4 times significantly higher in G2, than in G1 and G0, respectively. CONCLUSION Chronic chagasic patients with LVA and ejection fraction < 45% have a higher risk of death than those without.

Leishmania RNA virus (LRV) has been shown to be a symbiotic component of Leishmania parasites in South America. Nested retro-transcription polymerase chain reaction was employed to investigate LRV1 presence in leishmaniasis lesions from Brazil. In endemic areas of Rio de Janeiro (RJ), no LRV1 infection was observed even with mucosal involvement. LRV1 was only detected in Leishmania (V.) guyanensis cutaneous lesions from the northern region, which were obtained from patients presenting with disease reactivation after clinical cure of their primary lesions. Our results indicated that the severity of leishmaniasis in some areas of RJ, where Leishmania (V.) brazi-liensis is the primary etiological agent, was not associated with Leishmania LRV1 infection.

It is in our interest, in this brief manuscript, to report the creation of the first program of regional integration of a network of research institutes in Biomedicine belonging to members of the MERCOSUR countries. We discuss some of the foundations that gave sustenance to its creation and its objectives in the medium and long term. In addition, we consider the potential of the results of this program in the fields of applied medical research, education and biotechnology.

Se da a conocer la creación del primer programa de integración regional de una red de Institutos de Investigación en Biomedicina pertenecientes a países miembros del MERCOSUR. Se analizan las bases que dieron sustento a su creación y sus objetivos en el mediano y largo plazo. Además, se estima el potencial de los resultados de este programa en los campos de la investigación médica aplicada, educación y biotecnología.

The diagnosis of visceral leishmaniasis (VL) generally requires the use of invasive tests for the collection of infected tissue (aspirates of bone marrow, spleen, liver or lymph nodes). This difficulty has led to the search for safer and less painful techniques to confirm the occurrence of the disease in children. Polymerase chain reaction (PCR) is a method that is advantageous in that it allows the use of peripheral blood samples for diagnosis. This paper reports the utilisation of PCR on peripheral blood samples to diagnose VL in 45 children in Mato Grosso do Sul, Brazil. This technique is compared with methods carried out using tissue collected by invasive procedures, including direct microscopy, culture and detection of Leishmania DNA by PCR in bone marrow aspirates. The results show that PCR of peripheral blood provides great sensitivity (95.6%) that is similar to that from the PCR of bone marrow aspirates (91.1%) and higher than that achieved with microscopy (80%) or culture (26.7%) methods. PCR of peripheral blood proved to be a suitable tool for the diagnosis of VL in children because it is highly sensitive and safe, with tissue collection being less invasive than in traditional tests.

The aim of this study was to evaluate the sensitivity and specificity of polymerase chain reaction (PCR) in the detection of Leishmania DNA in archived Giemsa-stained bone marrow slides for diagnosis of visceral leishmaniasis (VL), and to compare PCR with conventional diagnostic techniques, like direct microscopy and parasite culture. Specimens of archived Giemsa-stained bone marrow slides from 91 patients with VL and from 79 controls with other diseases or conditions were studied. PCR showed the highest sensitivity (92.3%) and had good specificity (97.5%). Direct examination detected 79.1% and culture 59% of positive samples. In addition, PCR was able to detect VL in 16 of 19 patients (84.2%) with negative microscopy. PCR in Giemsa-stained bone marrow slides is a suitable tool for confirming diagnosis in patients with VL and may be useful in the diagnosis of difficult cases. Slide smears are easily stored, do not require special storage conditions such as low temperatures, and can be easily mailed to centers where PCR is available, making it an excellent option for diagnosis in the field.

Introducción. La reacción a la prueba cutánea de Montenegro (a leishmanina) y la lesión de leishmaniasis comparten características fundamentales de la reacción de hipersensibilidad de tipo retardado. Objetivos. Determinar si la respuesta cutánea a leishmanina se aproxima y podría modelar la respuesta inflamatoria e inmune temprana a la infección por Leishmania. Materiales y métodos. Este estudio comparó la respuesta inflamatoria de biopsias de lesiones agudas (tiempo de evolución £1 mes) y lesiones crónicas (tiempo de evolución ³6 meses) con su respectiva reacción a la prueba cutánea de Montenegro, y con la reacción a la prueba de Montenegro de individuos infectados asintomáticos. Resultados. La proporción de linfocitos T CD4+ y CD8+, células fagocíticas mononucleares y granulocitos fue similar entre lesiones agudas y sus reacciones a la prueba cutánea a leishmanina. En contraste, los linfocitos CD4+ (32,6%) representaron una proporción significativamente mas baja, y los linfocitos B (20%) y macrófagos (27%) una proporción significativamente más alta del infiltrado celular en lesiones crónicas que en sus correspondientes reacciones a la prueba cutánea de Montenegro (CD4+: 43,7%, linfocitos B: 0.9%; macrófagos: 17,5%). Se encontró una asociación positiva entre linfocitos T CD8+ y macrófagos ( P=0,038) en la reacción a la prueba cutánea de Montenegro de los individuos con infección asintomática, mientras que los linfocitos T CD8+ y CD4+ estuvieron asociados positivamente en las reacciones a la prueba cutánea de Montenegro de pacientes crónicos ( P=0,002). Adicionalmente, la proporción de linfocitos B en lesiones crónicas (20%) fue más alta que en lesiones agudas (5,3%) ( P=0,002). Conclusión. La reacción cutánea de Montenegro permitió diferenciar la respuesta celular inmune entre infección asintomática y enfermedad crónica, y simula la respuesta temprana a la infección.

Introduction. The Montenegro skin test reaction and leishmaniasis lesions share fundamental characteristics of a delayed type hypersensitivity reaction. Objectives. To determine whether the Montenegro skin test reaction (response to leishmanin) might approximate and thereby provide insight into the early inflammatory and immune response to Leishmania infection. Materials and methods. We compared the inflammatory response in biopsies of acute (evolution time £one month), and chronic lesions (evolution time ³6 months) with the Montenegro skin test reaction in the corresponding patients, and with the Montenegro skin test of asymptomatically infected volunteers. Results. The proportion of CD4+ and CD8+ T lymphocytes, mononuclear phagocytes and granulocytes were similar in acute lesions and in their corresponding Montenegro skin test reactions. In contrast, CD4+ lymphocytes (32.6%) represented a significantly lower, and B cells (20%) and macrophages (27%) a significantly higher proportion of the cellular infiltrate in chronic lesions as compared to reactions in the corresponding skin test site (CD4+: 43.7%, B cells: 0.9%; macrophages: 17.5%). CD8+ T lymphocytes and macrophages were positively associated ( P=0.038) in the Montenegro skin test of asymptomatically infected individuals whereas CD8+ and CD4+ T cells were positively associated in the Montenegro skin test of chronic patients ( P=0.002). Notably, B cells were markedly more frequent in chronic lesions (20%) than in acute lesions (5.3%) ( P=0.002). Conclusion. The Montenegro skin test distinguished the cellular immune response to Leishmania in asymptomatic infection and chronic disease and may provide a surrogate of the early response to infection.

Paniculite eosinofílica pode ser desencadeada por muitos fatores; aqui os autores descrevem a síndrome em conseqüência de injeções intramusculares de compostos de antimônio para tratamento de leishmaniose tegumentar americana em três pacientes. Todos eles desenvolveram lesões em placa, profundamente infiltradas, no local da injeção antimonial. A histopatologia mostrou acentuado infiltrado inflamatório da hipoderme com numerosos eosinófilos. O estudo imunológico não demonstrou imunoglobulinas ou frações do complemento nas lesões. O diagnóstico final foi de paniculite eosinofílica ocorrendo como efeito colateral da terapia antimonial. O mecanismo patogênico dessa paniculite não pôde ser definido. As hipóteses sugeridas foram de lesão induzida por fenômeno físico - a pressão exercida pelo volume do líquido injetado - ou de uma reação alérgica ao antimônio.

Eosinophilic panniculitis may be induced by several triggering factors and this syndrome is described here following the intramuscular injection of antimonial compounds for treatment of American muco-cutaneous leishmaniasis. Three patients, treated with intramuscular injections of pentavalent antimony (Glucantime®) were studied through clinical examination, histopathology and immunologic methods. The three patients developed deep infiltrated plaques at the site of antimony injection. Histopathology disclosed a prominent inflammatory infiltrate of the subcutaneous fat with numerous eosinophils. Immunologic studies could not detect immunoglobulins or complement fractions in the lesions. The final diagnosis was eosinophilic panniculitis occurring as a side-effect of antimonial therapy. The pathogenesis was not clear and it is suggested that the disease could be induced by a physical factor such as pressure or an immunological reaction to antimony.

A partir de relato de diagnóstico de leishmaniose visceral em cinco cães dos municípios de Santa Maria, Itaara e Júlio de Castilhos, no centro do Estado do Rio Grande do Sul, foi realizado levantamento sorológico através de teste de imunofluorescência indireta em sangue obtido em papel de filtro de 40 cães de Santa Maria, 20 de Itaara e 11 de Júlio de Castilhos, em geral relacionados aos cinco cães considerados como positivos. Além destes, foi também examinado o sangue de 44 cães vadios de Júlio de Castilhos, 68 de Cachoeira do Sul e 20 de Caçapava do Sul. Soros fracamente reagentes com títulos < 1:40 foram avaliados em ensaios de Ensaio Imuno-enzimático. Amostras de fígado, baço, pulmão e linfonodos de um sexto cão de Santa Maria, considerado como positivo à necropsia, foram examinadas através de histopatologia e PCR. Todos os resultados dos 204 cães foram negativos, indicando que, apesar de não ser impossível a ocorrência de leishmaniose visceral na região, por vários fatores aqui discutidos, ela deve ser pelo menos extremamente rara, sendo necessários estudos mais detalhados do material dos cinco cães tidos como positivos.

Five dogs from the municipalities of Santa Maria, Itaara and Júlio de Castilhos, in the centre of the Brazilian State of Rio Grande do Sul, were diagnosed as positive for visceral leishmaniasis. A survey was developed by indirect immunofluorescence in blood obtained in filter paper from 40 dogs from Santa Maria, 20 from Itaara and 11 from Júlio de Castilhos. Examined dogs were generally related to those reputedly positive. Besides the above dogs, blood from 44 stray dogs from Júlio de Castilhos, 68 from Cachoeira do Sul and 20 from Caçapava do Sul was also examined. Slightly positive sera (£1:40) were examined with ELISA. PCR and histology was used to examine the liver, spleen, lungs and lymph nodes from a sixth dog considered at necropsy to be positive for visceral leishmaniasis. All results for the 204 dogs were negative. This indicates that visceral leishmaniasis, due to various factors discussed below, is extremely rare in this region. A more detailed exam of the material from the five dogs considered positive is necessary.

Com o objetivo de estudar o comportamento biológico de cepas do T. cruzi e determinar a possível relação entre o biodema da cepa e as formas clínicas da doença de Chagas, 14 cepas do protozoário isoladas de humanos, procedentes de Pains, Iguatama e Berilo, foram avaliadas. Para estudar o comportamento biológico das cepas, grupos de camundongos albinos suíços, machos, pesando entre 10-15 gramas foram infectados com 1x10(4) tripomastigotas sangüíneos para avaliação da infectividade, parasitemia, morfologia dos tripomastigotas sangüíneos, virulência e distribuição do protozoário nos tecidos. Nove cepas apresentaram comportamento similar ao da cepa São Felipe do biodema II e cinco se caracterizaram como pertencentes ao biodema III. Não foi possível estabelecer uma relação entre o biodema da cepa e gravidade da doença nos pacientes.

In order to study the biological behavior of T. cruzi strains and to determine a putative association between their biodeme and the clinical forms of Chagas disease, 14 strains isolated from humans were evaluated. The individuals were from the municipalities of Pains, Iguatama and Berilo (Minas Gerais State). The biological behavior was evaluated in albino swiss mice, weighing 10 to 15 grams, which were infected with 1x10(4) blood tripomastigotes. The infectivity, parasitemia, tripomastigote morphology, virulence and the tissue distribution of the protozoan were analyzed. A behavior similar to biodeme II (São Felipe strain) was observed in 9 strains, while 5 stocks were characterized as belonging to biodeme III. It was not possible to establish a relationship between the biodeme strain and the severity of the disease in the patients.