LIM/50 - Laboratório de Patologia das Moléstias Infecciosas
URI Permanente desta comunidade
O Laboratório de Patologia das Moléstias Infecciosas é ligado ao Departamento de Patologia da Faculdade de Medicina da Universidade de São Paulo (FMUSP).
Linhas de pesquisa: imunopatologia e patogenia da leishmaniose tegumentar e visceral humana, canina e experimental; resposta inflamatória aguda e crônica do hospedeiro frente à infecção por Leishmania na presença de saliva do vetor; hepatites; doença de Chagas; patogenia das lesões do aparelho digestório; alterações genéticas do câncer do aparelho digestório e sua correlação com a clínica e patologia; estudo das alterações provocadas por diversas técnicas cirúrgicas e sua correlação com a disseminação de neoplasias malignas; aprimoramento de métodos de detecção de metástase de neoplasias digestivas.
Site oficial: http://limhc.fm.usp.br/portal/lim50-laboratorio-de-patologia-das-molestias-infecciosas/
Linhas de pesquisa: imunopatologia e patogenia da leishmaniose tegumentar e visceral humana, canina e experimental; resposta inflamatória aguda e crônica do hospedeiro frente à infecção por Leishmania na presença de saliva do vetor; hepatites; doença de Chagas; patogenia das lesões do aparelho digestório; alterações genéticas do câncer do aparelho digestório e sua correlação com a clínica e patologia; estudo das alterações provocadas por diversas técnicas cirúrgicas e sua correlação com a disseminação de neoplasias malignas; aprimoramento de métodos de detecção de metástase de neoplasias digestivas.
Site oficial: http://limhc.fm.usp.br/portal/lim50-laboratorio-de-patologia-das-molestias-infecciosas/
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- LIM/50 - Laboratório de Patologia das Moléstias Infecciosas
- LIM/50 - Laboratório de Patologia das Moléstias Infecciosas
- LIM/50 - Laboratório de Patologia das Moléstias Infecciosas
Submissões Recentes
Areata-Like Lupus as a Clinical Manifestation of Cutaneous Lupus Erythematosus
(2022) MORAIS, K. L.; SECCHIN, P.; ANZAI, A.; VERUSSA, M. J. M. C.; MUNCK, A.; FECHINE, C. O. C.; VALENTE, N. Y. S.; ROMITI, R.
Introduction: Lupus erythematosus (LE) is a chronic autoimmune disease that frequently causes hair loss and scalp lesions. Hair loss can be scarring and nonscarring, diffuse, or patchy. The nonscarring patchy alopecia is usually related to systemic LE (SLE) and may simulate alopecia areata (AA), reason why it is named areata-like lupus. Our case was diagnosed with areata-like lupus but did not meet criteria for SLE. Case Report: A 63-year-old woman presented with irregular nonscarring patchy alopecia in the temporal and frontoparietal scalp. Trichoscopy showed exclamation mark hairs, vellus hairs, and sparse yellow dots. Histology revealed epidermal vacuolar interface dermatitis, lymphohistiocytic infiltrate around the bulbs of anagen follicles, and eccrine glands. Direct immunofluorescence showed deposits of C3, IgA, and IgG in the basement membrane zone. Discussion: Patients with cutaneous LE can also manifest as nonscarring patchy alopecia that is clinically similar to AA, despite the absence of systemic manifestations. Areata-like lupus is secondary to the lupus autoimmune infiltrate that affects the skin including the hair follicles. Trichoscopy, histology, and direct immunofluorescence are important to differentiate this form of alopecia from AA, which is believed to have a higher incidence in lupus patients.
Small fiber neuropathy and intractable scalp pruritus in dermatomyositis patients
(2023) CIRINO, P. V.; HORDINSKY, M.; MCADAMS, B.; ROMITI, R.
Background: Scalp pruritus is a common symptom in Dermatomyositis (DM) patients. There are indications that small nerve fibers neuropathy could be involved in this symptom, however the etiology of scalp pruritus is not fully understood. Objectives: To assess epidermal nerve fiber (ENF) density of dermatomyositis patients with scalp pruritus by biopsy by confocal microscopy and immunohistochemistry with subsequent imaging analysis. Methods: DM patients with severe scalp pruritus from the dermatology outpatient clinic were compared to healthy volunteers. Two 4-mm scalp skin biopsies were obtained above the right ear in the parietal region and below the occipital protuberance in the occipital region. Biopsy specimens were incubated with primary antibodies to protein gene product (PGP 9.5), calcitonin gene–related peptide (CGRP), substance P (SP) were used to visualize nerve fibers (ENF) and collagen IV was used to label the epidermal basement membrane. The number of ENFs per millimeter was counted and recorded as the mean of ± SD of counts in 16 images at two micrometer increments/sections, two from each of the samples. ENF densities were compared between groups and a multiple linear regression model was applied to associated factors with ENF density. Results: Fifteen DM patients with severe scalp pruritus and 12 healthy volunteers were included in the study. The mean number of ENF/mm in occipital region of DM group was 16.0 ± 13.9 while the control group in the same region was 99.8 ± 33.1. In parietal region the number of ENF/mm of DM group was 18.0 ± 20.7 while in control group was 50.4 ± 17.4 (p < 0.001). Conclusion: DM patients with pruritus could have some impairment of small nerve fiber density that could explain their recalcitrant scalp pruritus.
In situ expression of Th17 immunologic mediators in American cutaneous leishmaniasis caused by Leishmania (V.) braziliensis and Leishmania (L.) amazonensis in the Brazilian Amazon
(2023) RODRIGUES, G. F.; ALCâNTARA, L. S.; BARROS, J. P. B.; LIMA, A. C. S. de; CAMPOS, M. B.; MORAES, C.; FERREIRA, A. F.; MATTA, V. L. R.; LAURENTI, M. D.; CORBETT, C. E. P.; SILVEIRA, F. T.; GOMES, C. M. C.
American cutaneous leishmaniasis (ACL) presents a wide spectrum of clinical and immunopathological manifestations. In Brazil, Leishmania (L.) amazonensis[La] and Leishmania(V.)braziliensis[Lb] show the highest pathogenic potential for humans causing different clinical forms: localized cutaneous leishmaniasis (LCL : Lb/La), anergic diffuse cutaneous leishmaniasis (ADCL : La) and mucocutaneous leishmaniasis (MCL : Lb). ADCL and MCL are the most severe forms and infection leads to a cellular immune response at the hyposensitivity and hypersensitivity poles. Th17-cells are involved in the ACL pathogenesis, are derived from naïve TCD4+ cells regulated by RORγt, differentiate in presence of IL-6, TGF-β, IL- 1β, IL-23 and express IL-17. Aim of this study was to characterize the cellular immune response mediated by Th17-profile cells through in situ determination of the expression of RORγt, IL-17, IL-6, TGF-β, IL-1β, and IL-23 in the ACL clinical-immunopathological spectrum caused by L.(L.)amazonensis and L.(V.)braziliensis. Biopsies of skin and mucosal lesions from forty patients including ADCL(n=8), LCL[La](n=17), LCL[Lb](n=9) and MCL(n=6), were examined by immunohistochemistry. The immunostained cells density (cells/mm2) was determined in image analysis system using AxionVision 4.8 software (Zeiss). As the disease evolution time (DET) was different among ACL patients, the effect of DET on the expression of immunological markers was evaluated in different clinical forms and histopathological changes, using ANCOVA. Our results showed significantly increased expression of RORγt, IL-17, IL-6, IL-1β and IL-23 in patients with ACL polar forms (ADCL and MCL); higher TGF-β expression was found in ADCL. DET influenced the expression of RORγt and IL-6 in: clinical forms of ACL and in categories of parasitism. DET also affected the production of RORγt, IL-17, IL-6, TGF-β and IL-1β in types of inflammatory infiltrate, evidencing that DET had effect on the expression of Th17 profile cytokines in ACL. Together, the expression of immunological mediators of Th17 profile in the ACL spectrum, as well as the DET effect, demonstrate the participation of this cell lineage in the immunopathogenesis of ACL, mainly in the polar and more severe forms of ACL spectrum. The dubious role played by Th17-cells may favors immune response suppression and parasitic persistence in ADCL, while in MCL it contributes to an exacerbated immune response and parasite scarcity.
Psoriasis And Mental Health Comorbidities: A Multinational Analysis Using the Global Healthcare Study on Psoriasis (GHSP)
(2023) PETERSON, Hannah; KOROURI, Edwin; KINGSTON, Paige; LEE, Kathryn; HUANG, Margaret; YEE, Danielle; AGUERO, Rosario; ARTIGA, Kevin; VALENZUELA, Fernando; ROMITI, Ricardo; DIDASKALU, Johannes; EGEBERG, Alexander; OON, Hazel H.; MAUL, Julia-Tatjana; ARMSTRONG, April W.
Comparison of COVID-19 Vaccination Rates Among Psoriasis Patients Globally Using the Global Healthcare Study on Psoriasis (GHSP)
(2023) KOROURI, Edwin; PETERSON, Hannah; VALENZUELA, Fernando; ROMITI, Ricardo; DIDASKALU, Johannes; EGEBERG, Alexander; OON, Hazel H.; YEE, Danielle; ARTIGA, Kevin; AGUERO, Rosario; KINGSTON, Paige; LEE, Kathryn; HUANG, Margaret Y.; MAUL, Julia-Tatjana; ARMSTRONG, April W.
Correlation between DLQI and PASI in patients with psoriasis - a cross-sectional Global Healthcare Study on Psoriasis (GHSP)
(2023) NIELSEN, Mia-Louise; MAUL, Lara Valeska; DIDASKALU, Johannes A.; VALENZUELA, Fernando; ROMITI, Ricardo; GRIFFITHS, Christopher E. M.; NOVOA, Farah; OON, Hazel H.; EGEBERG, Alexander; ARMSTRONG, April W.; MAUL, Julia-Tatjana
Frontal fibrosing alopecia associated with lichen planus pigmentosus: A multicentre retrospective descriptive analytical study of 104 patients
(2023) BRITO, Flavia Oliveira Xavier de; ALMEIDA, Rita Fernanda Cortez de; MACHADO, Carla Jorge; LEMES, Luciana Rodino; DONDA, Andre Luiz Vairo; BLANCO, Aline; SILVEIRA, Aline Lucy Galavotti; MUNCK, Andreia; LIMA, Caren dos Santos; CANELA, Carolina Porto Cotrim; FECHINE, Carolina Oliveira Costa; OBADIA, Daniel Lago; PINTO, Giselle Martins; ALVES, Lorena Dourado; DIAS, Maria Fernanda Reis Gavazzoni; BENEZ, Marcela; RIGATTI, Marcelo; KADI, Nadia El; KAKIZAKI, Priscila; MINOTTO, Renan; FRATTINI, Sidney; RAMOS, Paulo Mueller; MELO, Daniel Fernandes
Sensitive Scalp and Trichodynia: Epidemiology, Etiopathogenesis, Diagnosis, and Management
(2023) SOUZA, Emilly Neves; ANZAI, Alessandra; FECHINE, Carolina Oliveira Costa; VALENTE, Neusa Yuriko Sakai; ROMITI, Ricardo
Sensitive scalp (SSc) is considered a sensitive skin on the scalp, with its particularities. Although it is not rare in the dermatological practice and the term is commonly present in personal care products, this entity is poorly investigated in the medical literature. The etiopathogenesis is still uncertain, and the sensitivity may be associated with hair loss. Clinical manifestations are subjective symptoms of pruritus, burning, pain, pricking, and/or trichodynia, often with scalp erythema. SSc can be triggered by several factors (endogenous or exogenous). The diagnosis is guided by the anamnesis, and there are still no specific trichoscopic features. Trigeminal trophic syndrome and postherpetic neuralgia are the main differential diagnosis to be considered. We organized the therapeutical approach in three steps: scalp care, topical and systemic treatment.
Therapeutic Activity of a Topical Formulation Containing 8-Hydroxyquinoline for Cutaneous Leishmaniasis
(2023) LIMA, Sarah Kymberly Santos de; CAVALLONE, italo Novaes; SERRANO, Dolores Remedios; ANAYA, Brayan J.; LALATSA, Aikaterini; LAURENTI, Marcia Dalastra; LAGO, Joao Henrique Ghilardi; SOUZA, Dalete Christine da Silva; MARINSEK, Gabriela Pustiglione; LOPES, Beatriz Soares; MARI, Renata de Britto; PASSERO, Luiz Felipe Domingues; MICHNIAK-KOHN, Bozena B.
Cutaneous leishmaniasis exhibits a wide spectrum of clinical manifestations; however, only a limited number of drugs are available and include Glucantime (R) and amphotericin B, which induce unacceptable side effects in patients, limiting their use. Thus, there is an urgent demand to develop a treatment for leishmaniasis. Recently, it was demonstrated that 8-hydroxyquinoline (8-HQ) showed significant leishmanicidal effects in vitro and in vivo. Based on that, this work aimed to develop a topical formulation containing 8-HQ and assess its activity in experimental cutaneous leishmaniasis. 8-HQ was formulated using a Beeler base at 1 and 2% and showed an emulsion size with a D-50 of 25 and 51.3 mu m, respectively, with a shear-thinning rheological behaviour. The creams were able to permeate artificial Strat-M membranes and excised porcine skin without causing any morphological changes in the porcine skin or murine skin tested. In BALB/c mice infected with L. (L.) amazonensis, topical treatment with creams containing 1 or 2% of 8-HQ was found to reduce the parasite burden and lesion size compared to infected controls with comparable efficacy to Glucantime (R) (50 mg/kg) administered at the site of the cutaneous lesion. In the histological section of the skin from infected controls, a diffuse inflammatory infiltrate with many heavily infected macrophages that were associated with areas of necrosis was observed. On the other hand, animals treated with both creams showed only moderate inflammatory infiltrate, characterised by few infected macrophages, while tissue necrosis was not observed. These histological characteristics in topically treated animals were associated with an increase in the amount of IFN-gamma and a reduction in IL-4 levels. The topical use of 8-HQ was active in decreasing tissue parasitism and should therefore be considered an interesting alternative directed to the treatment of leishmaniasis, considering that this type of treatment is non-invasive, painless, and, importantly, does not require hospitalisation, improving patient compliance by allowing the treatment to be conducted.
Prevalence and incidence of canine visceral leishmaniasis and its clinical-immunological features in an endemic area of the Brazilian Amazon
(2023) CARNEIRO, Liliane A.; LIMA, Luciana V.; CAMPOS, Marliane B.; SANTOS, Thiago Vasconcelos dos; RAMOS, Patricia K.; LAURENTI, Marcia D.; SILVEIRA, Fernando T.
Background: A cohort study for 2 years period analysed the prevalence, incidence and clinical-immunological features of canine Leishmania (L.) chagasi-infection in 316 mongrel dogs in a visceral leishmaniasis-endemic area in Para State, Brazil.Objective/Methods: Diagnosis of infection was performed by the indirect fluorescent antibody test (IFAT-IgG), the leishmanin skin test (LST) and a parasite search (from the popliteal lymph node aspiration) at the beginning of the study and at 6, 12 and 24 months intervals.Results: IFAT/LST revealed three immune profiles of infection: (I) IFAT((+))/LST(-) (81), (II) IFAT((-))/LST(+) (17) and (III) IFAT((+))/LST(+) (13). Prevalence of profiles I, II and III were 25.6, 5.4 and 4.1%, and an overall prevalence 35.1%. Incidence of profiles I, II and III were 5.4, 0.3 and 0.0%, and an overall incidence 5.7% dogs per month. Incidence at the age ranges <1 year, >= 1 year, <7 years and >= 7 years evidenced a highest rate in the age range <1 year (6.6% dogs per month). Parasitological diagnosis was positive in 19% dogs at the prevalence (85.7% profile I), and in 11% at the incidence (100% profile I). The clinical picture of 179 infected dogs showed 145 (81%) of profile I (82% subclinical); 21 (11.7%) of profile II (100% subclinical); and 13 (7.3%) of profile III (84.6% subclinical). Conversion from subclinical to sick dogs was higher (p < 0.05) in profile I (40.2%) than in profiles II (5.8%) and III (9%). Immunological conversion showed that only 3.2% of profile I dogs (prevalence) converted to LST(+) (two at the end of the first 6 months and 1 after 24 months), while 82.3% of profile II dogs converted to IFAT((+)) (11 in the first 6 months, whereas three after 12 months). A 100% death rate was observed in dogs from profile I alone.Conclusion: These results reinforce the need of adopting preventive strategies against CVL as early as in the first semester of the dog's life.