Orientador: Fernanda Lourenção Brighenti / Resumo: Este trabalho está dividido em 2 publicações cujos objetivos foram: a) realizar uma revisão sistemática da literatura, seguida de uma metanálise sobre a eficácia da terapia fotodinâmica (TFD) nos micro-organismos responsáveis pela cárie dentária (Publicação 1); b) avaliar o potencial in vitro dos óleos essenciais de Coffea arabica, Matricaria recutita e Eugenia uniflora e dos extratos vegetais de Senna splendida, Senna reticulata e Senna Macranthera para serem utilizados como monoterapia na terapia fotodinâmica sobre suspensões de micro-organismos de interesse médico-odontológico. Publicação 1: A questão de pesquisa e as palavras-chave foram construídas de acordo com a estratégia do PICO. A pesquisa do artigo foi realizada nas bases de dados Embase, Lilacs, Scielo, Medline, Scopus, Cochrane Library, Web of Science, Science Direct e Pubmed. Ensaios clínicos randomizados e estudos in vitro foram selecionados na revisão. O estudo foi conduzido de acordo com as diretrizes do PRISMA para revisão sistemática. Publicação 2: Foram utilizadas as seguintes cepas de referência em suspensão: Cutibacterium acnes ATCC 6919, Streptococcus mutans ATCC 35688, Staphylococcus aureus ATCC 25923, Escherichia coli ATCC 25922 e Candida albicans ATCC 90028. Os materiais vegetais foram testados nas concentrações de 50 μg/mL (extratos) ou 2% (óleos essenciais). Foram estudados cinco grupos: controle negativo, material vegetal sem exposição a luz (FS-luz), material vegetal com exposição a luz (FS+luz),... (Resumo completo, clicar acesso eletrônico abaixo) / Mestre

Host survival during plague, caused by the Gram-negative bacterium Yersinia pestis, is favored by a robust early innate immune response initiated by IL-1β and IL-18. Precursors of these cytokines are expressed downstream of TLR signaling and are then enzymatically processed into mature bioactive forms, typically by caspase-1 which is activated through a process dependent on multi-molecular structures called inflammasomes. Y. pestis evades immune detection in part by using a Type three secretion system (T3SS) to inject effector proteins (Yops) into host cells and suppress IL-1β and IL-18 production. We investigated the cooperation between two effectors, YopM and YopJ, in regulating inflammasome activation, and found that Y. pestis lacking both YopM and YopJ triggers robust caspase-1 activation and IL-1Β/IL-18 production in vitro. Furthermore, this strain is attenuated in a manner dependent upon caspase-1, IL-1β and IL-18 in vivo, yet neither effector appears essential for full virulence. We then demonstrate that YopM fails to inhibit NLRP3/NLRC4 mediated caspase-1 activation and is not a general caspase-1 inhibitor. Instead, YopM specifically prevents the activation of a Pyrin-dependent inflammasome by the Rho-GTPase inhibiting effector YopE. Mutations rendering Pyrin hyperactive are implicated in the autoinflammatory disease Familial Mediterranean Fever (FMF) in humans, and we discuss the potential significance of this disease in relation to plague. Altogether, the Y. pestis T3SS activates and inhibits several inflammasome pathways, and the fact that so many T3SS components are involved in manipulating IL-1β/IL-18 underscores the importance of these mechanisms in plague.

Host cell attachment by pathogenic bacteria can play very different roles in the course of infection. The pathogenic spirochetes Borrelia hermsii and Borrelia burgdorferi sensu lato which cause relapsing fever and Lyme disease, respectively, are transmitted by the bite of infected ticks. After transmission, these spirochetes can cause systemic infection. Relapsing fever spirochetes remain largely in the bloodstream causing febrile episodes, while Lyme disease will often colonize a variety of tissues, such as the heart, joint and nervous system, resulting in a chronic multisystemic disorder. Borrelia species have the ability to bind to various cell types, a process which plays a crucial role in pathogenesis and may influence spirochetal clearance from the bloodstream. Colonization of multiple tissues and cell types is likely promoted by the ability to bind to components found in target tissues, and many B. burgdorferi adhesins have been shown to promote attachment to a wide variety of cells and extracellular matrix components. Different Lyme disease strains have been shown to preferentially colonize certain tissues, although the basis of this tissue tropism is not well understood. In this study we found that among different Lyme disease strains, allelic variation of the adhesin DbpA contributes to variation in its in vitro binding activities raising the possibility that this variation contributes to tissue tropism in vivo. In studying B. hermsii infection, we found evidence by both histological and fluorescence in situ hybridization (FISH) analysis of tissues that indicated that red blood cells were removed by tissue resident macrophages in infected mice. Spirochetes in the spleen and liver were often visualized associated with RBCs, lending support to the hypothesis that direct interaction of B. hermsii spirochetes with RBCs leads to clearance of bacteria from the bloodstream. Our findings indicate that host cell attachment play a key role in the establishment of Lyme disease infection, and in contrast contributes to the clearance of relapsing fever infection.

The obligate intracellular bacterium Chlamydia trachomatis is the most common bacterial STD agent in the US. This bacterium has a unique biphasic developmental cycle in which the infectious elementary body (EB) infects a host mucosal epithelial cell and differentiates into the replicative form (the reticulate body or RB) within a modified vacuole called an inclusion. The RB later divides and develops back into an EB and is released, perpetuating the infectious cycle. When developing chlamydiae are exposed to unfavorable environmental conditions, they deviate from the normal developmental cycle into a non-infectious but viable state termed persistence. Previous data from our laboratory indicate that i) during C. trachomatis/HSV co-infection, the chlamydiae become persistent and ii) HSV gD interaction with host cell surface is sufficient to induce this response. During viral entry, HSV gD interacts with one of four host co-receptors, one of which is the host adhesion molecule nectin-1. Interestingly, Western blotting demonstrated that nectin-1 is significantly decreased in C. trachomatis-infected HeLa cells. Additional studies indicated that active C. trachomatis replication is required for nectin-1 down-regulation and nectin-1 is likely down-regulated post-translationally. CPAF, a chlamydia-secreted protease, is responsible for degrading several host proteins. Both in vivo experiments using CPAF-specific chemical inhibitors and cell-free cleavage assays using recombinant CPAF indicate that nectin-1 is degraded by CPAF in C. trachomatis-infected cells. Further studies suggest that nectin-1 is the most likely candidate involved in triggering HSV-induced chlamydial persistence. Co-infection experiments using nectin-1-specific HSV-1 mutants suggest that nectin-1 is, indeed, required for persistence induction. Additional studies in single co-receptor-expressing CHO cells demonstrate that, despite the fact that HSV-1 enters both HVEM- and nectin-1-expressing cells, viral co-infection reduces chlamydial infectivity only in the CHO-nectin-1 cell line. These data confirm that HSV/nectin-1 interaction is sufficient for chlamydial persistence induction. Although nectin-1 ligation is known to activate Cdc42, pull-down assays indicate that Cdc42 is not activated in co-infected HeLa cells. Taken together, these data suggest that: i) HSV gD-nectin-1 binding activates a novel host epithelial cell pathway that restricts chlamydial development and ii) the chlamydiae may degrade nectin-1 to evade this inhibitory host response.

Bacterial sexually transmitted infections (STIs), notably syphilis, gonorrhea, and chlamydia, have been increasing among men who have sex with men (MSM) in the United States. The rise has been attributed to various factors, including increased condomless sexual acts due to the high uptake of pre-exposure prophylaxis (PrEP) for HIV prevention. To address this concerning trend, post-exposure prophylaxis with doxycycline (Doxy-PEP) has emerged as a potential biomedical intervention. This study aimed to assess the effectiveness of Doxy-PEP in preventing bacterial STIs among MSM in Central Florida, a region with rising STI rates. A de-identified dataset from Pineapple Health Clinic in Orlando, Florida, was analyzed (n = 73) participants who received Doxy-PEP for bacterial STIs between July 01, 2022, and June 30, 2023. Results revealed elevated rates of any bacterial STI and syphilis incidence among both HIV-negative and HIV-positive individuals, contrary to expectations from previous literature. Notably, the HIV-positive cohort showed significantly higher incidence rates of syphilis. The study also found discrepancies in gonorrhea incidence and resistance profiles, raising questions about the effectiveness of Doxy-PEP against gonorrhea in this population. The older age of the HIV-positive cohort and differences in medication regimens further complicated the analysis. These findings suggest the effectiveness of Doxy-PEP may vary in real-world settings compared to controlled trials. Limitations include the small sample size, single healthcare clinic setting, differences in medication regimens, and the investigational status of Doxy-PEP. However, the study highlights the need for interventions considering diverse demographics and local antibiotic resistance patterns. Future research should explore these factors to develop effective strategies for reducing STI incidence among MSM in Central Florida.

Clostrioides difficile is a common cause of nosocomial (hospital-acquired) infections. Patients receiving antibiotic treatment experience dysbiosis of gut microbiota, and C. difficile, normally held in check by the various other organisms, takes this opportunity to propagate. Symptoms of infection generally include diarrhea, colitis, dehydration, and fever. Understanding that C. difficile generally only causes illness when it is the dominant bacterium (i.e. when growth is relatively unchecked by other microbes), it is appropriate to investigate potential competitive organisms that may be introduced after antibiotic courses or during active C. difficile infection to effectively displace it. Fecal samples from the University of Central Florida Lift fecal collection station were aseptically plated onto modified cycloserine cefoxitin fructose agar (CCFA). Visually remarkable colonies (certain colonies that looked unique in comparison to others) were restreaked on new plates of the same media to verify growth, then transferred to brain heart infusion-supplemented (BHIS) plates for propagation. Colonies were inoculated in glycerol stocks for storage, then grown in BHIS liquid media to prepare for identification. Genomic extraction was performed on each sample, and spectrophotometric quantification and gel electrophoresis were executed to confirm successful extraction. Genomic samples will be sent to an external laboratory for identification via polymerase chain reaction and Sanger sequencing. We hypothesize that at least one bacterial strain from the fecal collection station will potentially inhibit C. difficile infection. Should such an organism be identified, it follows that the efficacy of its application in conventional hospital settings may be examined. Current regulation of fecal microbiota transplants, an effective therapeutic practice, is cumbersome, and changing the classification of fecal transplants may improve timeliness and effectiveness of treatment.

Cryptococcus neoformans is an encapsulated yeast responsible for severe meningoencephalitis. The importance of epidemiological studies on cryptococcosis has increased since the beginning of the AIDS epidemic. C. neoformans exists in two varieties containing four serotypes, C. neoformans var. neoformans (serotypes A and D) and C. neoformans var. gattii (serotypes B and C). Locally C. neoformans var. neoformans has been associated with pigeon feces during those months having an average temperature of 64.2°F j(17.8°C) and above. Clinical and environmental isolates of C. neoformans obtained from regional hospitals and environmental samplings, respectively, have been grouped into their variety status utilizing canavanine-glycine-bromthymol blue agar. Polyclonal antisera against C. neoformans serotypes A, B, C and D were isolated from challenged rabbits. Serotyping C. neofromans isolates using the polyclonal antisera resulted in 57% (20 of 35) of the serotypes confirmed with a direct immunofluorescent assay utilizing a single monoclonal antibody (E1). Data from the immunofluorescence assay suggest all C. neoformans obtained from regional hospitals (26 of 26) and those isolated from the environment (9 of 9) belong to the A serotype group. These data have provided information leading to the origin of infection for cryptococcosis in our region, which may be beneficial to immunocompromised individuals.

Scrub typhus is a potentially fatal infection that threatens one billion persons in the Asia-Pacific region and is caused by the obligate intracellular bacterium, Orientia tsutsugamushi. How this organism facilitates its intracellular survival and pathogenesis is poorly understood. Intracellular bacterial pathogens utilize the Type 1 (T1SS) or Type 4 secretion system (T4SS) to translocate ankyrin repeat-containing proteins (Anks) into the host cell to modulate host cell processes. The O. tsutsugamushi genome encodes one of the largest known bacterial Ank libraries as well as Type 1 and Type 4 secretion systems (T1SS and T4SS), which are expressed during infection. In silico analyses of the Anks’ C-termini revealed that they possess characteristics of T1SS secretion signals. Escherichia coli expressing a functional T1SS was able to secrete chimeric hemolysin proteins bearing the C-termini of 19 of 20 O. tsutsugamushi Anks. In addition to infecting endothelial cells, O. tsutsugamushi infects professional phagocytes. To better understand why these innate immune cells are unable to eliminate O. tsutsugamushi, we addressed the activity of host NF-κB proinflammatory transcription factor. Screening of O. tsutsugamushi infected cells at an MOI of 1 revealed inhibition of NF-κB nuclear accumulation as early as 8 hours in HeLa and bone-marrow derived macrophage cells. When stimulating infected cells with TNF-α, IκBα degradation still occurs, however NF-κB dependent gene transcription remains downregulated. Immunofluorescence microscopic analysis of TNF-α treated cells ectopically expressing all O. tsutsugamushi Anks revealed that two nuclear trafficking Anks, Ank1 and Ank6, result in a significant decrease in NF-κB nuclear accumulation. Additionally, these Anks also significantly inhibited NF-κB dependent gene transcription. Co-immunoprecipitation experiments revealed that both Anks interact with importin-β1, exportin-1, and the p65 NF-κB subunit. Treating cells with importazole significantly reduces the nuclear accumulation of Ank1 and Ank6. Finally, treating infected cells or cells ectopically expressing Ank1 or Ank6 with leptomycin B resulted in restoration of NF-κB nuclear accumulation. With these data, we propose that O. tsutsugamushi secretes Ank1 and Ank6 to initially interact with importin-β1, which permits their nuclear entry where they then interact with NF-κB and subsequently exportin-1 to prevent NF-κB nuclear accumulation.

A newly discovered cysteine protease, Prp, has been shown to perform an essential, site-specific cleavage of ribosomal protein L27 in Staphylococcus aureus. In Firmicutes and related bacteria, ribosomal protein L27 is encoded with a conserved N-terminal extension that must be removed to expose residues critical for ribosome function. Uncleavable and pre-cleaved variants were unable to complement an L27 deletion in S. aureus, indicating that this N-terminal processing event is essential and likely plays an important regulatory role. The gene encoding the responsible protease (prp) has been shown to be essential, and is found in all organisms encoding the N-terminal extension of L27. Cleavage of L27 by Prp represents a new target for potential antibiotic therapy. In order to characterize this protease, Prp has been overexpressed and purified. Using an assay we have developed, based on cleavage of a fluorogenic peptide derived from the conserved L27 cleavage sequence, we have undertaken an analysis of the enzyme kinetics and substrate specificity for Prp cleavage and tested predictions made based on a structural model using active-site mutants.

Introdução: Em estudo prospectivo, os efeitos da gastroplastia redutora com reconstrução em Y de Roux sobre a flora bacteriana e produção de citoquinas nas câmaras gástricas proximal e excluída foram estudados. Métodos: pacientes bariátricos (n=37) foram submetidos à avaliação endoscópica em ambos reservatórios gástricos,7,3+-1,4 anos após a gastroplastia. Idade foi de 42,4+-9,9 anos (70,2% sexo feminino), IMC pré-operatório de 53,5+-10,6, e IMC atual de 32,6+-7,8kg/m2. TNFalfa e TGF-beta foram medidos pelo método ELISA em biópsias da mucosa gástrica., assim como cultura quantitativa da secreção gástrica, com pH gástrico e teste respiratório lactulose/hidrogênio.Resultados: Nenhum dos pacientes apresentou queixas sugestivas de supercrescimento bacteriano gastrointestinal. Todavia, contagens elevadas de bactérias e fungos foram identificadas nas duas câmaras, principalmente no estômago proximal. Gram-positivos representaram a maioria dos isolados. O pH foi neutro na câmara proximal, enquanto que também na câmara distal nem sempre conservou-se em níveis esperados. Conclusões: 1)Produção elevadas de TNF-alfa e TGF-beta, com a colonização de aeróbios, anaeróbios e fungos em ambas câmaras gástricas foram identificadas; 2)O pH gástrico como a contagem bacteriana foram maiores no estômago proximal funcionante; 3)Teste respiratório foi positivo para supercrescimento bacteriano em 40,5% dos pacientes,entretanto não foram identificadas manifestações clínicas de supercrescimento bacteriano gastrointestinal. / Background: In a prospective study, the effect of Roux-en-Y gastric bypass (RYGBP) on bacterial flora and cytokines production in the used (proximal pouch) and unused (large bypassed) gastric chamber was analysed. Methods: Bariatric subjects (n=37) were submitted to endoscopic examination of both gastric reservoirs, 7.3 ± 1.4 years after RYGBP. Age was 42.4 ± 9.9 years (70.2% females), preoperative BMI was 53.5 ± 10.6, and current BMI was 32.6 ± 7.8 kg/m2.TNF-alpha and TGF-beta were meausured by enzyme-linked immunosorbent assay (ELISA) from gastric mucosal biopsies. Quantitative culture of gastric secretion along with gastric pH and actulose/hydrogen breath test were also investigated.Results: None of the subjects displayed complaints suggestive of GI bacterial overgrowth. Elevated counts of bacteria and fungi were identified in both chambers, mostly in the proximal stomach. Gram-positives represented the majority of the isolates. Gastric pH was neutral in the proximal pouch, whereas the distal chamber mostly but not always onserved the expected acidity. Conclusions: 1)Increased TNF-alpha and TGFbeta production, as aerobes, anaerobes and fungi colonization of both gastric chambers was detected; 2) Gastric pH as well as bacterial count was higher in the functioning proximal stomach; 3) Breath test was positive for bacterial overgrowth in 40.5% of the subjects, however clinical manifestation of GI bacterial overgrowth were not demonstrated