Rodrigo Scaliante de Moura

Sorologia da hanseníase utilizando PGL-I: revisão sistemática

Serology using a species-specific antigen for Mycobacterium leprae, PGL-I, could be a marker for the bacterial load of patients with leprosy. Various studies have identified the potential use of serology in the classification of patients for treatment purposes, case monitoring, identification of the risk of relapse and selection of household contacts with a higher risk of contracting the disease. A systematic review of the literature was conducted and 26 articles were included in this comparative analysis. The results of the use of PGL-I serology in different situations, its limitations and possible applications were evaluated. Studies show the efficacy of PGL-I serology in the classification of patients, treatment monitoring and as a predictive test for leprosy reactions. To improve early diagnosis and follow-up of the population at greatest risk of developing leprosy, the methodologies used in the past have yet to show a favorable cost-benefit ratio, although studies indicate that the use of the test might positively influence leprosy control programs. With simple and robust techniques, the use of PGL-I serology is viable.

Development and validation of a novel lateral flow immunoassay device for detection of aflatoxins in soy-based foods

Aflatoxins (AFs) are natural toxins produced as secondary fungal metabolites. Common in diverse commodities, the consumption of aflatoxin-contaminated foodstuffs has harmful effects on human health mainly due to their carcinogenic effects. There is considerable demand for the development of rapid, reliable and cost-effective screening tools, once regulatory authorities employ strict procedures for detection of aflatoxins. In this study, a sensitive and specific strip test assay was developed, based on a competitive format, for the detection of aflatoxins in soybean, a major Brazilian agricultural commodity. A monoclonal antibody (mAb) was produced, named as 3B6, with high specificity to aflatoxins B1, M1, G1, G2 and B2. For the development of a strip test, colloidal gold particles were coated with 3B6 mAb and used as the detector reagent. An AFB1–BSA conjugate was sprayed at the test line of a nitrocellulose membrane to serve as a competitor reagent, with an anti-species-specific antibody used at the control line. The strip test developed was capable of detecting as little as 0.5 μg kg−1 of aflatoxin. To validate the strip test, soybean grains infected and non-infected with the aflatoxin-producing fungus Aspergillus flavus were employed. The applicability of the developed test was demonstrated by screening 12 foodstuff samples (soy protein and soy milk) collected from different local markets. The results indicated that the strip tests developed were capable of accurately qualitatively identified aflatoxin-contaminated samples in less than 10 min. This method offers a promising device for application in routine monitoring during storage, transport, processing and handling of agricultural commodities.

A novel immunochromatographic strip test for rapid detection of Cry1Ac and Cry8Ka5 proteins in genetically modified crops

The cultivation of genetically modified (GM) crops has grown rapidly worldwide. This has led to regulatory authorities implementing strict procedures to monitor and verify the presence and abundance of GM varieties in agricultural crops. Immunochromatographic strip tests have been employed for the detection of transgenic proteins expressed in GM crops as rapid, reliable and cost-effective screening tools. In this study, we developed a novel and sensitive strip test assay, based on a sandwich format, for the identification of Cry1Ac and Cry8Ka5 transgenic proteins. We generated two monoclonal antibodies (mAb), namely 1B1 and 5H4, that bind with high specificity to Cry1Ac and Cry8Ka5 proteins. For the development of strip tests, colloidal gold particles were coated with 1B1 mAb and used as the detector reagent. The 5H4 mAb was sprayed at the test line of a nitrocellulose membrane to serve as a capture reagent and anti-species specific antibodies were used at the control line. The strip test developed was capable of detecting 0.06 μg of Cry1Ac and Cry8Ka5 proteins. For validation of the strip test, GM and non-GM cotton leaf samples were employed. The results indicated that the strip test was capable of distinguishing between GM and non-GM cotton samples, offering potential for use as a rapid and cost-effective screening tool for insect-resistant GM crops expressing Cry1Ac and Cry8Ka5 proteins to control lepidopterans and coleopteran pests, respectively.

Description of Leprosy Classification at Baseline Among Patients Enrolled at the Uniform Multidrug Therapy Clinical Trial for Leprosy Patients in Brazil

The uniform multidrug therapy clinical trial, Brazil (U-MDT/CT-BR), database was used to describe and report the performance of available tools to classify 830 leprosy patients as paucibacillary (PB) and multibacillary (MB) at baseline. In a modified Ridley and Jopling (R&J) classification, considering clinical features, histopathological results of skin biopsies and the slit-skin smear bacterial load results were used as the gold standard method for classification. Anti-phenolic glycolipid-I (PGL-I) serology by ML Flow test, the slit skin smear bacterial load, and the number of skin lesions were evaluated. Considering the R&J classification system as gold standard, ML Flow tests correctly allocated 70% patients in the PB group and 87% in the MB group. The classification based on counting the number of skin lesions correctly allocated 46% PB patients and 99% MB leprosy cases. Slit skin smears properly classified 91% and 97% of PB and MB patients, respectively. Based on U-MDT/CT-BR results, classification of leprosy patients for treatment purposes is unnecessary because it does not impact clinical and laboratories outcomes. In this context, the identification of new biomarkers to detect patients at a higher risk to develop leprosy reactions or relapse remains an important research challenge.

Serology with ML Flow test in health professionals from three different states of Brazil

BACKGROUND In highly endemic countries, transmission and sub-clinical infection of leprosy are likely and the disease manifests itself in individuals without any known close contact with a leprosy patient. Health workers are social contacts belonging to the same network (the Health System) and some of them share the same social environment (nursing assistants) as patients with known patients and / or carriers. OBJECTIVE To identify ML Flow seropositivity among health professionals. METHODS We conducted a cross-sectional study using a serological survey with the ML Flow test in 450 health professionals (doctors, nurses and nursing assistants), in order to detect seropositivity in areas of high and low endemicity in municipalities from three Brazilian states (RJ, MS and RS). RESULTS The results showed general 16% seropositivity, higher in low endemic areas, regardless of whether there was direct care for leprosy patients. Paradoxically, a statistical association was observed between the area studied and seropositivity, as the place with the lowest endemicity (CA) had the highest seropositivity rate (p = 0.033). CONCLUSION The authors suggest these results are associated with a presence of an unspecified link to bovine serum albumin (BSA), carrier of PGL-1 in the ML Flow test, and recommend expanded seroepidemiological research utilizing tests with human and bovine albumin.

Adherence to antiretroviral therapy and correlation with adverse effects and coinfections in people living with HIV/AIDS in the municipality of Goiás State

INTRODUCTION Acquired immunodeficiency syndrome is an advanced stage of a human immunodeficiency virus infection. The antiretroviral therapy aims to improve the life quality of HIV patients and a good adherence is essential for a better prognosis. This study aimed to evaluate the adherence of human immunodeficiency virus/acquired immunodeficiency syndrome patients to antiretroviral therapy recommended by the Brazilian health system in Anápolis/Goiás, and correlate the level of adherence with sociodemographic data and clinical-laboratory variables. METHODS Adherence to antiretroviral therapy was assessed using the Questionnaire for Evaluation of Adherence to Antiretroviral Therapy. The sociodemographic data were collected using a standardized questionnaire and the clinical-laboratory records were reviewed. RESULTS Among 220 patients included, 59% (129/220) were men and the average age was 41 years. Infection was acquired primarily through sexual contact (92%, 202/220), and 69% (152/220) of the patients were heterosexual. Approximately 86% (188/220) of the patients had good or strict adherence to antiretroviral therapy. In our study, the use of illicit drugs was associated with low adherence to antiretroviral therapy (p=0.0004), and no significant association was observed between adherence levels and other sociodemographic data (p>0.05). The logistic regression indicated that adverse effects (p=0.0018) and sexual orientation (p=0.0152) were associated with the level of adherence to antiretroviral therapy. Patients with good or strict adherence had higher CD4+T lymphocyte count (p<0.0001) and undetectable viral load (p<0.0001). Patients with low adherence (14%, 32/220) had higher frequency of adverse events (p=0.0009). The frequency of coinfections was 25% (55/220), with syphilis and tuberculosis being the most common coinfections. CONCLUSIONS Adherence was related to use of illicit drugs, adverse effects, and sexual orientation.