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1. Immunoglobulin E and systemic lupus erythematosus

Author

Atta A.M., Sousa C.P., Carvalho E.M., and Sousa-Atta M.L.B.

Subjects
Systemic lupus erythematosus, Antinuclear IgE antibody, Allergy, IgG anti-IgE, IgE, Medicine (General), R5-920, Biology (General), QH301-705.5
Abstract

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by intense polyclonal production of autoantibodies and circulating immune complexes. Some reports have associated SLE with a Th2 immune response and allergy. In the present study 21 female patients with SLE were investigated for total IgE and IgE antibodies to dust house aeroallergens by an automated enzyme-linked fluorescent assay, and were also evaluated for antinuclear IgE autoantibodies by a modified indirect immunofluorescence test using HEp-2 cells as antigen substrate. Additionally, immunocapture ELISA was used to investigate serum anti-IgE IgG autoantibodies. Serum IgE above 150 IU/ml, ranging from 152 to 609 IU/ml (median = 394 IU IgE/ml), was observed in 7 of 21 SLE patients (33%), 5 of them presenting proteinuria, urinary cellular casts and augmented production of anti-dsDNA antibodies. While only 2 of 21 SLE patients (9.5%) were positive for IgE antibodies to aeroallergens, all 10 patients with respiratory allergy (100%) from the atopic control group (3 males and 7 females), had these immunoglobulins. SLE patients and healthy controls presented similar anti-IgE IgG autoantibody titers (X = 0.37 ± 0.20 and 0.34 ± 0.18, respectively), differing from atopic controls (0.94 ± 0.26). Antinuclear IgE autoantibodies were detected in 17 of 21 (81%) sera from SLE patients, predominating the fine speckled pattern of fluorescence, that was also observed in IgG-ANA. Concluding, SLE patients can present increased IgE levels and antinuclear IgE autoantibodies without specific clinical signs of allergy or production of antiallergen IgE antibodies, excluding a possible association between SLE and allergy.

Published
2004

2. Regulation of T cell response to leishmania antigens by determinants of histocompatibility leukocyte class I and II molecules

Author

Bacellar O., Russo C., and Carvalho E.M.

Subjects
HLA class I, tegumentary leishmaniasis, modulation of T cell response by HLA class I, interferon-g and HLA class I, soluble antigen and HLA class I, Medicine (General), R5-920, Biology (General), QH301-705.5
Abstract

It has been shown that HLA class I molecules play a significant role in the regulation of the proliferation of T cells activated by mitogens and antigens. We evaluated the ability of mAb to a framework determinant of HLA class I molecules to regulate T cell proliferation and interferon gamma (IFN-g) production against leishmania, PPD, C. albicans and tetanus toxoid antigens in patients with tegumentary leishmaniasis and healthy subjects. The anti-major histocompatibility complex (MHC) mAb (W6/32) suppressed lymphocyte proliferation by 90% in cultures stimulated with aCD3, but the suppression was variable in cultures stimulated with leishmania antigen. This suppression ranged from 30-67% and was observed only in 5 of 11 patients. IFN-g production against leishmania antigen was also suppressed by anti-HLA class I mAb. In 3 patients IFN-g levels were suppressed by more than 60%, while in the other 2 cultures IFN-g levels were 36 and 10% lower than controls. The suppression by HLA class I mAb to the proliferative response in leishmaniasis patients and in healthy controls varied with the antigens and the patients or donors tested. To determine whether the suppression is directed at antigen presenting cells (APCs) or at the responding T cells, experiments with antigen-primed non-adherent cells, separately incubated with W6/32, were performed. Suppression of proliferation was only observed when the W6/32 mAb was added in the presence of T cells. These data provide evidence that a mAb directed at HLA class I framework determinants can suppress proliferation and cytokine secretion in response to several antigens.

Published
1998

3. Absence of linkage between MHC and a gene involved in susceptibility to human schistosomiasis

Author

Chiarella J.M., Goldberg A.C., Abel L., Carvalho E.M., Kalil J., and Dessein A.

Subjects
HLA, linkage study, human schistosomiasis, Medicine (General), R5-920, Biology (General), QH301-705.5
Abstract

Six hundred million people are at risk of infection by Schistosoma mansoni. MHC haplotypes have been reported to segregate with susceptibility to schistosomiasis in murine models. In humans, a major gene related to susceptibility/resistance to infection by S. mansoni (SM1) and displaying the mean fecal egg count as phenotype was detected by segregation analysis. This gene displayed a codominant mode of inheritance with an estimated frequency of 0.20-0.25 for the deleterious allele and accounted for more than 50% of the variance of infection levels. To determine if the SM1 gene segregates with the human MHC chromosomal region, we performed a linkage study by the lod score method. We typed for HLA-A, B, C, DR and DQ antigens in 11 informative families from an endemic area for schistosomiasis in Bahia, Brazil, by the microlymphocytotoxicity technique. HLA-DR typing by the polymerase chain reaction with sequence-specific primers (PCR-SSP) and HLA-DQ were confirmed by PCR-sequence-specific oligonucleotide probes (PCR-SSOP). The lod scores for the different q values obtained clearly indicate that there is no physical linkage between HLA and SM1 genes. Thus, susceptibility or resistance to schistosomiasis, as defined by mean fecal egg count, is not primarily dependent on the host's HLA profile. However, if the HLA molecule plays an important role in specific immune responses to S. mansoni, this may involve the development of the different clinical aspects of the disease such as granuloma formation and development of hepatosplenomegaly.

Published
1998

10. Tumor necrosis factor (cachectin) in human visceral leishmaniasis

Author

Barral-Netto, M., Badaro, R., Barral, A., Almeida, R.P., Santos, S.B., Badaro, F., Pedral-Sampaio, D., Carvalho, E.M., Falcoff, E., and Falcoff, R.

Subjects
Leishmaniasis -- Physiological aspects, Tumor necrosis factor -- Measurement, Leishmaniasis -- Development and progression, Health
Abstract

Visceral leishmaniasis (VL) or kala-azar, is a disease caused by the parasite Leishmania donovani, which is transmitted by the bite of sandflies. The clinical disease is characterized by fever, anemia, leukopenia (reduced white cell count), and hepatosplenomegaly (enlargement of the liver and spleen), and in full blown cases, by marked immunologic dysfunction. Cachectin, or tumor necrosis factor-alpha (TNF-alpha), is a cytokine, a nonantibody protein produced in response to specific antigenic stimuli. It acts as an intercellular mediator, and is believed to play a role in the mediation of normal cellular function, inflammation, and in the body's response to bacterial or parasitic infection. The levels of TNF-alpha in patients with VL were measured to assess the possibility of using these levels as indicators of the progress of the disease. The study group consisted of 58 patients with VL; 28 patients with acute disease, and 30 with cryptic disease. Cryptic disease patients had no symptoms of VL, but had a positive skin test, indicating an immune response to the infection. Fifteen healthy volunteers comprised the control group. Blood levels of TNF-alpha were elevated in the patients with acute VL prior to treatment and fell afterward. In cases refractory (resistant) to treatment, TNF-alpha levels remained high. Normal levels were observed in the asymptomatic and control groups. Levels of TNF-alpha appear to be a suitable marker for measuring the progress of VL and patient response to therapy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1991

13. High HTLV-1 proviral load, a marker for HTLV-1 associated myelopathy/tropical spastic paraparesis, is also detected in patients with infective dermatitis associated with HTLV-1

Author

Primo, J., Siqueira, I., Nascimento, M.C.F., Oliveira, M.F., Farre, L., Carvalho, E.M., and Bittencourt, A.L.

Subjects
lcsh:R5-920, HTLV-1 associated myelopathy/tropical spastic paraparesis, lcsh:Biology (General), immune system diseases, hemic and lymphatic diseases, virus diseases, HTLV-1 proviral loads, lcsh:Medicine (General), lcsh:QH301-705.5, Infective dermatitis associated with HTLV-1
Abstract

Salvador (BA, Brazil) is an endemic area for human T-cell lymphotrophic virus type 1 (HTLV-1). The overall prevalence of HTLV-1 infection in the general population has been estimated to be 1.76%. HTLV-1 carriers may develop a variety of diseases such as adult T-cell leukemia/lymphoma, HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and infective dermatitis associated with HTLV-1 (IDH). IDH is a chronic and severe form of childhood exudative and infective dermatitis involving mainly the scalp, neck and ears. It has recently been observed that 30% of patients with IDH develop juvenile HAM/TSP. The replication of HTLV-1 has been reported to be greater in adult HAM/TSP patients than in asymptomatic HTLV-1 carriers. In the current study, the proviral load of 28 children and adolescents with IDH not associated with HAM/TSP was determined and the results were compared to those obtained in 28 HTLV-1 adult carriers and 28 adult patients with HAM/TSP. The proviral load in IDH patients was similar to that of patients with HAM/TSP and much higher than that found in HTLV-1 carriers. The high levels of proviral load in IDH patients were not associated with age, duration of illness, duration of breast-feeding, or activity status of the skin disease. Since proviral load is associated with neurological disability, these data support the view that IDH patients are at high risk of developing HAM/TSP.

Published
2009

14. Analysis of access to hypertensive and diabetic drugs in the Family Health Strategy, State of Pernambuco, Brazil

Author

De Carvalho Barreto, M.N.S., Pessoa Cesse, E.A., Fonseca Lima, R., Da Silva Marinho, M.G., Da Silva Specht, Y., Freese de Carvalho, E.M., and Fontbonne, Annick

Abstract

OBJECTIVE: To evaluate the access to drugs for hypertension and diabetes and the direct cost of buying them among users of the Family Health Strategy (FHS) in the state of Pernambuco, Brazil. METHODS: Population-based, cross-sectional study of a systematic random sample of 785 patients with hypertension and 823 patients with diabetes mellitus who were registered in 208 randomly selected FHS teams in 35 municipalities of the state of Pernambuco. The selected municipalities were classified into three levels with probability proportional to municipality size (LS, large-sized; MS, medium-sized; SS, small-sized). To verify differences between the cities, we used the χ2 test. RESULTS: Pharmacological treatment was used by 91.2% patients with hypertension whereas 85.6% patients with diabetes mellitus used oral antidiabetic drugs (OADs), and 15.4% used insulin. The FHS team itself provided antihypertensive medications to 69.0% patients with hypertension, OADs to 75.0% patients with diabetes mellitus, and insulin treatment to 65.4%. The 36.9% patients with hypertension and 29.8% with diabetes mellitus that had to buy all or part of their medications reported median monthly cost of R$ 18.30, R$ 14.00, and R$ 27.61 for antihypertensive drugs, OADs, and insulin, respectively.

Published
2015

16. Clinical and immunological features of patients with atopy and concomitant HTLV-1 infection

Author

Gaspar-Sobrinho, F.P., Souza-Machado, A., Santos, S.B., Orge, G., Lessa, H.A., Cruz, A.A., and Carvalho, E.M.

Subjects
body regions, lcsh:R5-920, lcsh:Biology (General), Atopy, HTLV-1, Cytokines, lcsh:Medicine (General), lcsh:QH301-705.5, Asthma, Rhinitis
Abstract

Human T-cell lymphotropic virus type 1 (HTLV-1) induces an exacerbated type 1 immune response characterized by high spontaneous IFN-γ and TNF-α production. Allergic rhinitis and asthma are associated with the type 2 immune response, with elevated secretion of IL-4 and IL-5. The aim of this study was to characterize the immune response in atopic HTLV-1 carriers. The cytokine profile of atopic HTLV-1 carriers (N = 10; all females) was compared with that of non-atopic HTLV-1 carriers (N = 14; 9 females and 5 males). Mean patient age of atopic and non-atopic groups was 45 ± 8 and 38 ± 11 years, respectively. All atopic HTLV-1 carriers had rhinitis with or without asthma and a skin prick test positive for Dermatophagoides pteronyssinus antigen 1 (Derp-1). There was no difference in cytokine levels between the two groups in unstimulated peripheral blood mononuclear cell cultures. In cultures stimulated with Derp-1, IFN-γ levels tended to be higher (P = 0.06) and IL-5 levels were higher (P = 0.02) in atopic HTLV-1 patients than in non-atopic subjects. In contrast, IL-10 was lower (P = 0.004) in atopic than in non-atopic HTLV-1-infected subjects. This study shows that HTLV-1 infection with an exaggerated type 1 immune response does not prevent atopy. In this case, the exacerbated type 1 and type 2 immune responses were due to a lack of IL-10 production, a cytokine that plays an important role in down-modulating type 1 and type 2 immune responses and in preventing the development of chronic inflammatory diseases.

Published
2010

26. Evaluation of NKT Cells in Leishmaniasis

Author

Campos, R.A., primary, Cunha, J.M., additional, Jesus, O.F., additional, Bacellar, O., additional, Figueiredo, F.C.C., additional, Lima, R.G.D., additional, Matos, R.S., additional, and Carvalho, E.M., additional

Published
2007
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39. Schistosoma mansoniantigens modulate allergic response in vitro in cells of asthmatic individuals

Author

Cardoso, L.S., Oliveira, S.C., Souza, R.P., Góes, A.M., Oliveira, R.R., Alcântara, L.M., Almeida, M.C., Carvalho, E.M., and Araujo, M.I.

Abstract

Schistosoma mansoniinfection is associated with a low prevalence of asthma and a less severe form of the disease. The mechanisms underlying this association may include the production of regulatory cells and cytokines. The aim of this study was to evaluate the immune response induced by the S. mansoniantigens, Sm22.6, PIII, and Sm29 and their ability to suppress allergen‐specific IL‐5 production by peripheral blood mononuclear cells (PBMC) from asthmatic individuals. PBMCs were stimulated in vitro with S. mansoniantigens in the presence or absence of antigen‐1 of the mite Dermatophagoides pteronyssinus(Der p1). Cytokines were measured in PBMC supernatants by enzyme‐linked immunosorbent assay (ELISA), and the phenotype of cells producing IL‐10 was assessed using flow cytometry. High production of S. mansoniantigen‐specific IL‐10 was observed not only in cells of S. mansoni‐infected individuals, but also in cells of noninfected asthmatic individuals. In the former group, the main cellular sources of IL‐10 were CD4+CD25+, and CD14+cells. The levels of IFN‐γ, IL‐5, and IL‐13 in the noninfected asthmatic group were ∼100 pg/ml in response to the antigens. Moreover, when S. mansoniantigens were added to cultures stimulated with Der p1, levels of IL‐10 were increased (Der p1 = 234 ± 118; Der p1 + Sm22.6 = 1189 ± 595; Derp1 + PIII = 799 ± 331; Derp1 + Sm29 = 652 ± 288 pg/ml) with reduced levels of IL‐5 (Der p1 = 286 ± 219; Der p1 + Sm22.6 = 93 ± 153; Derp1 + PIII = 132 ± 188; Derp1 + Sm29 = 96 ± 86 pg/ml). The S. mansoniantigens evaluated in the present study induced the production of the regulatory cytokine IL‐10 and down‐modulated the Th2 immune response that participates in the pathology of asthma. Drug Dev Res 72:538–548, 2011. © 2011 Wiley‐Liss, Inc.

Published
2011
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40. Schistosoma mansoni infection is associated with a reduced course of asthma

Author

Medeiros, M., Figueiredo, J.P., Almeida, M.C., Matos, M.A., Araujo, M.I., Cruz, A.A., Atta, A.M., Rego, M.A.V., de Jesus, A.R., Taketomi, E.A., and Carvalho, E.M.

Abstract

Background:: Helminthic infections decrease skin reactivity to indoor allergens, but data on whether they influence asthma severity are lacking. Objective:: This study evaluated the course of asthma in patients with and without Schistosoma mansoni infection. Methods:: Asthmatic subjects were enrolled from 3 low-socioeconomic areas: a rural area endemic for schistosomiasis (group 1) in addition to a rural area (group 2) and a slum area (group 3), both of which were not endemic for schistosomiasis. A questionnaire on the basis of the International Study of Asthma and Allergies in Childhood study was applied in these 3 areas, and from each area, 21 age- and sex-matched asthmatic subjects were selected for a prospective 1-year study. Pulmonary function tests, skin prick tests with indoor allergens, stool examinations, and serum evaluations were performed in these subjects. Every 3 months, the subjects were evaluated for asthma exacerbation through physical examination, and a questionnaire regarding asthma symptoms and use of antiasthma medicine was administered. Results:: The prevalence of S mansoni infection was greater in group 1 compared with in groups 2 and 3 (P<.0001), whereas the frequency of other helminth and protozoa infections was similar among the 3 groups. The frequency of positive skin test responses to indoor allergens was less (19.0%) in group 1 subjects relative to those in group 2 (76.2%) and group 3 (57.1%; P<.001). The frequencies of symptoms, use of antiasthma drugs, and pulmonary abnormal findings at physical examination were less in group 1 subjects than in group 2 and 3 subjects (P=.0001). Conclusion:: Our results suggest that S mansoni infection is associated with a milder course of asthma.

Published
2003
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