Menciona que Leishmania braziliensis es un protozoario causante de la leishmaniasis o uta, enfermedad endémica crónica de baja patogenicidad, alta morbilidad, metaxénica y zoonótica que compromete piel, mucosas y vísceras. Es transmitida por un díptero del género Lutzomyia, afecta alrededor de 12 millones de personas alrededor del mundo y a 12 departamentos en el Perú. Leishmania braziliensis tiene patrones moleculares de membrana asociadas a patógenos que son reconocidos por los receptores tipo toll (TLR) presentes en el hospedero, tanto en la superficie celular como a nivel intracelular. Los TLRs están conformados por una familia de 23 tipos que van a reconocer ligandos presentes en patógenos en común. Cuando se da la unión del ligando con un TLR desencadenará una secuencia de señales activando la expresión de moléculas coestimuladoras y citoquinas promoviendo una inflamación y activando la respuesta adaptativa. El presente trabajo tiene como objetivos caracterizar a la cepa C234 de Leishmania braziliensis mediante secuenciamiento y detectar y cuantificar los niveles de expresión de mRNA de los genes TLR-3, TLR-4 y TLR-9 y de las citoquinas IL-12 y TNF-α en macrófagos murinos enfrentados a la cepa C234 de Leishmania braziliensis, endémica del Perú. Se infectó macrófagos peritoneales de ratones Balb/c con promastigotes de Leishmania braziliensis y se cultivaron por 24 horas, se midió los niveles de óxido nítrico (ON), se extrajo mRNA de los macrófagos y se detectó y cuantificó los niveles de expresión en los genes de TLR-3, TLR- 4 y TLR-9, y de las citoquinas proinflamatorias IL-12 y TNF-α, a través de la técnica de retrotranscripción mediante la reacción en cadena de la polimerasa cuantitativa en tiempo real (RT-qPCR). Los resultados indicaron que el estudio filogenético de la cepa C234 mostró alta homología (96%) para Leishmania braziliensis. Además, los macrófagos infectados con Leishmania braziliensis presentaron mayor producción de ON sólo en las primeras horas de infección, descendiendo a las 24 y 48 horas; y se detectó expresión de mRNA para los genes TLR-3, TLR-4 y TLR-9 y de las citoquinas IL-12 y TNF-α. Se concluye que la cepa nativa C234 pertenece a la especie Leishmania braziliensis y que la disminución de la producción de ON está relacionada al mayor tiempo de infección y bajos niveles de expresión del gen TLR-4, así mismo, el incremento del nivel de expresión de mRNA de los genes TLR-3 y TLR-9 podrían estar implicados en la activación de la expresión génica de la citoquina IL-12 en macrófagos peritoneales murinos infectados con Leishmania braziliensis. / Tesis

Les leishmanioses sont un ensemble de maladies causées par un parasite du genre Leishmania. L'augmentation des résistances aux traitements actuellement disponibles conduit à la nécessité de développer de nouvelles molécules antileishmaniennes. La GDP-MP, une enzyme indispensable à la virulence du parasite a été choisie comme cible thérapeutique. Dans la première partie de ce travail, des modèles de GDP-MP de L. donovani et de H. sapiens ont été construits par modélisation moléculaire en utilisant la construction par homologie de séquence puis la relaxation par dynamique moléculaire. La conception d'inhibiteurs assistée par l'évaluation par amarrage moléculaire de ces molécules a conduit à l'identification de nombreuses molécules potentiellement inhibitrices de la GDP-MP. Parmi ces molécules identifiées, certaines sont des analogues de GDP-Mannose présentant différents motifs de remplacement pour le pont pyrophosphate ainsi que pour la guanosine. Une autre classe de composés sont les analogues de GDP portant un motif bisphosphoré. Une étude méthodologique portant sur l'obtention de conjugués 1,4-triazoles par CuAAC sur des analogues de guanosine a été conduite, et a mis en évidence, l'efficacité de l'utilisation de nanoparticules de cuivre (I) formées in situ par réduction du sulfate de cuivre en solution aqueuse par de l'hydrate d'hydrazine pour la synthèse de ces composés. Cette méthode, en association avec la chimie des H-phosphonates, a permis, l'accès à une librairie de dérivés de GDP-Mannose. De cette manière, des analogues de guanosine et de quinoléines diversement substituées ont été synthétisés. Les composés obtenus ont été évalués sur les GDP-MP recombinantes ainsi que sur cultures de parasites. Certains des composés bisphosphonates présentent à la fois une bonne inhibition de la GDP-MP et une bonne activité antiparasitaire. Les expériences futures de cristallographie des protéines permettront d'élucider le mode de fixation de ces composés et d'orienter les pharmacomodulations futures des inhibiteurs identifiés. / Leishmaniasis is a set of disease caused by a parasite of the genus Leishmania. The increased resistance to currently available treatments led to the need to develop new antileishmanial compounds. GDP-MP, an enzyme essential for the virulence of the parasite was chosen as a therapeutic target. In the first part of this work, GDP-MP models L. donovani and H. sapiens were constructed by molecular modeling using the method of sequence homology and molecular dynamics relaxation. The evaluation of inhibitors by molecular docking has led to the identification of many potential inhibitors of GDP-MP. Among these molecules identified, some are GDP-Mannose analogs having different substitution patterns for the pyrophosphate bridge and for guanosine. Another class of compounds is the analogues of GDP wearing bisphosphorus moiety. A methodological study for the synthesis of guanosine conjugated 1,4-triazoles analogs by CuAAC was conducted and showed the effectiveness of the use of copper nanoparticles (I), formed in situ by reduction of copper sulfate in aqueous solution of hydrazine hydrate, for the synthesis of these compounds. This method in combination with the H-phosphonate chemistry, has allowed access to a library of derivatives of GDP-Mannose. In this way, guanosine analogs, and variously substituted quinolines were synthesized. The obtained compounds were evaluated on the recombinant GDP-MP as well as parasite cultures. Some bisphosphonate compounds have both a good inhibition of the GDP-MP and good antiparasitic activity. Future experiments of protein crystallography will elucidate the mode of binding of these compounds and will determine future pharmacomodulations on the identified inhibitors.

Quantification of pathogen load, although challenging, is of paramount importance for accurate diagnosis and clinical management of a range of infectious diseases in a point-of-need testing (PONT) scenario such as in resource-limited settings. We formulated a quantification approach to test the standard-curve based absolute quantification ability of isothermal recombinase polymerase amplification (RPA) assay. As a test of principle, a 10-fold dilution series of Leishmania donovani (LD) genomic DNA prepared in nuclease-free-water (NFW), and from culture-spiked-blood (CSB) were tested, and a 15 min assay was performed. A modified algorithm was formulated to derive the detection outcome. The threshold-record times (Tr) in seconds thus obtained were plotted against the initial load of parasite genomes for log-linear regression analysis. The quantitative RPA (Q-RPA) assay was further evaluated against a LD quantitative (q)-PCR assay with DNA extracted from visceral and post-Kala-azar dermal leishmaniasis case specimens and stratified into different ranges of threshold cycle (Ct). The best-fitted regression models were found linear with mean r2/root mean square error (RMSE) values of residual points (in seconds) estimated as 0.996/8.063 and 0.992/7.46 for replicated series of NFW and CSB, respectively. In both series, the lower limit of detection reached less than 0.1 parasite genome equivalent DNA. Absolute agreement between Q-RPA and LD-qPCR was found for test positivity, and strong positive correlations were observed between the Tr and Ct values (r = 0.89; p < 0.0001) as well as between the absolute parasite loads (r = 0.87; p < 0.0001) quantified by respective assays. The findings in this very first Q-RPA assay for leishmaniasis are suggestive of its potential in monitoring LD load in clinical specimens, and the development of rapid Q-RPA assays for other infectious diseases.

With reduced prevalence of visceral leishmaniasis (VL) in the Indian subcontinent (ISC), direct and field deployable diagnostic tests are needed to implement an effective diagnostic and surveillance algorithm for post-elimination VL control. In this regard, here we investigated the diagnostic efficacies of a loop-mediated isothermal amplification (LAMP) assay (Loopamp™ Leishmania Detection Kit, Eiken Chemical CO., Ltd, Japan), a real-time quantitative PCR assay (qPCR) and the Leishmania antigen ELISA (CLIN-TECH, UK) with different sampling techniques and evaluated their prospect to incorporate into post-elimination VL control strategies. Eighty clinically and rK39 rapid diagnostic test confirmed VL cases and 80 endemic healthy controls were enrolled in the study. Peripheral blood and dried blood spots (DBS) were collected from all the participants at the time of diagnosis. DNA was extracted from whole blood (WB) and DBS via silica columns (QIAGEN) and boil & spin (B&S) methods and tested with qPCR and Loopamp. Urine was collected from all participants at the time of diagnosis and was directly subjected to the Leishmania antigen ELISA. 41 patients were followed up and urine samples were collected at day 30 and day 180 after treatment and ELISA was performed. The sensitivities of the Loopamp-WB(B&S) and Loopamp-WB(QIA) were 96.2% (95% CI 89·43-99·22) and 95% (95% CI 87·69-98·62) respectively. The sensitivity of Loopamp- DBS(QIA) was 85% (95% CI 75·26- 92·00). The sensitivities of the qPCR-WB(QIA) and qPCR-DBS(QIA) were 93.8% (95% CI 86·01-97·94) and 72.5% (95% CI 61·38-81·90) respectively. The specificity of all molecular assays was 100%. The sensitivity and specificity of the Leishmania antigen ELISA were 97.5% (95% CI 91·47-99·70) and 91.95% (95% CI 84·12-96·70) respectively. The Leishmania antigen ELISA depicted clinical cure at day 180 in all the followed-up cases. Efficacy and sustainability identify the Loopamp-WB(B&S) and the Leishmania antigen ELISA as promising and minimally invasive VL diagnostic tools to support VL diagnostic and surveillance activities respectively in the post-elimination era.

No description available.

Little is known about the generation of Leishmania morphology and the function of morphology in trypanosomatids, despite every species having characteristic cell shapes and undergoing changes in morphology between life cycle stages. To address this I analysed morphogenesis of the cell body and flagellum through the cell cycle of the Leishmania insect (promastigote) life cycle stage using a novel method for determining cell cycle stage from cell size and DNA content. This showed cell body morphology is generated by growth and then remodelling of cell shape around mitosis and cytokinesis. Mathematical modelling of flagellum growth indicated flagellum length continues to increase over multiple cell cycles and does not reach a defined length. I also observed little link between the cell cycle and flagellum length regulation during differentiation to the mammalian macrophage-inhabiting (amastigote) life cycle stage. Analysis of motility showed the diverse flagellar lengths of promastigote Leishmania cells bestow different swimming abilities, and the capacity of Leishmania promastigotes for highly directional swimming differs sharply from trypomastigote Trypanosoma brucei. This difference did not arise from altered flagellar beating therefore appeared to be linked to morphology. Together these indicate the mechanisms of cell body morphogenesis, flagellum length regulation, life cycle stage differentiation and the swimming abilities of the cells the morphogenetic processes generate differ significantly between Leishmania and T. brucei. These insights motivated the programming of automated micrograph analysis tools based on a new DNA staining method to support similar future morphometric analyses. This is the first comprehensive comparison of morphogenesis and function of morphology in a promastigote and a trypomastigote and, by considering these new insights in the context of existing molecular biology and the morphological diversity across many trypanosomatid species, give insight into basic Leishmania biology, the shared molecular mechanisms underlying morphogenesis and the potential functions of the diverse morphologies which are seen in different trypanosomatid species and life cycle stages.

INTRODUÇÃO: A leishmaniose tegumentar americana (LT) é uma doença infecciosa, não contagiosa, de transmissão vetorial com ciclo heteroxênico causada por parasitos do gênero Leishmania. É considerada uma enfermidade polimórfica que acomete pele e mucosas. Os medicamentos atualmente disponíveis para o tratamento da doença são insatisfatórios devido à sua eficácia limitada e seus efeitos colaterais, além do alto custo e a resistência que os protozoários acumulam contra essas drogas. O aumento da tolerabilidade é fundamental para o êxito global do tratamento. As formulações lipídicas comerciais da anfotericina B (AB), Ambisome®, Abelcet®e Amphocil®, apresentaram-se como um avanço no tratamento da (LT). Sistemas de nanoemulsões lipídicas reduzem a toxicidade de quimioterápicos e, ao mesmo tempo, aumentam sua ação farmacológica. Emulsões lipídicas com composição semelhante aos quilomícrons tem potencial aplicabilidade para vetorização de AB. OBJETIVO: Avaliar a citotoxicidade in vitro da anfotericina B desoxicolato (AB) e sua associação à nanoemulsão lipídica, o quilomícron artificial (QMA-AB), e in vivo, a tolerabilidade e eficácia terapêutica no tratamento da leishmaniose tegumentar em camundongos BALB/c. MÉTODOS: Para os testes in vitro, foi determinada a concentração inibitória (IC50) em formas promastigotas, a concentração citotóxica (CC50) em macrófagos sem infecção e a taxa de macrófagos infectados quando tratados com as formulações QMA, AB e QMA-AB. Já para os testes in vivo, camundongos BALB/c foram infectados com L. amazonensis e tratados com 2,5 mg/kg/dia de AB e 17,5 mg/kg/dia de QMA-AB e QMA. Durante o tratamento os animais foram monitorados semanalmente acerca do peso corporal e do diâmetro das patas. Ao término do tratamento os camundongos foram eutanasiados e amostras de sangue e tecido foram coletadas para análises bioquímicas, hematológicas, histopatológicas e quantificação da carga parasitária por método molecular qPCR. A análise estatística foi realizada com teste ANOVA seguido de Bonferroni ou Kruskal-Wallis com pós-teste de Dunn. As variáveis categóricas foram reportadas em tabelas de contingência (teste exato de Fisher). As análises foram consideradas estatisticamente significantes com p < 0,05. RESULTADOS: A formulação QMA-AB foi mais efetiva contra formas promastigotas apresentando IC50 em torno de 0,012 micro g/mL, enquanto que o IC50 de AB foi de 0,023 micro g/mL. AB foi mais tóxica para os macrófagos J744 com baixa concentração, 2,324 micro g/mL. QMA-AB foi menos tóxica para os macrófagos com CC50 de 8,106 micro g/mL, superior à AB, e apresentou alto índice de seletividade (IS=675,5). A formulação QMA-AB diminuiu a taxa de infecção em macrófagos, foi menos tóxica, mais eficaz no tratamento dos animais infectados e reduziu em torno de 60% o tamanho do diâmetro das lesões em relação à AB e 95% da carga parasitária. CONCLUSÕES: A associação QMA-AB apresentou-se como uma alternativa em potencial no tratamento da LT na busca de uma preparação de alta eficácia terapêutica, baixa toxicidade e baixo custo para o Sistema Único de Saúde / INTRODUCTION: American tegumentary leishmaniasis (ATL) is an infectious, non-contagious, vector-borne disease with heteroxenic cycle caused by parasites of the genus Leishmania. It is considered a polymorphic disease that affects skin and mucous membranes. Medications currently available for the treatment of the disease are unsatisfactory because of their limited effectiveness and side effects, and the high cost and resistance that protozoa accumulate against these drugs. Increased tolerability is critical to the overall success of treatment. The commercial lipid formulations of amphotericin B (AB), Ambisome®, Abelcet® and Amphocil®, presented as an advance in the treatment of (ATL). Lipid nanoemulsion systems reduce the toxicity of chemotherapeutics and, at the same time, increase their pharmacological action. Lipid emulsions with composition similar to chylomicrons have potential applicability for vectorization of AB. OBJECTIVE: This study evaluated the in vitro cytotoxicity of amphotericin B deoxycholate (AB) and its association with lipid nanoemulsion, artificial chylomicron (ACM), and in vivo, the tolerability and therapeutic efficacy in the treatment of cutaneous leishmaniasis in BALB/c. METHODS: For in vitro tests, the inhibitory concentration (IC50) in promastigote forms, the cytotoxic concentration (CC50) in non-infected macrophages and the rate of infected macrophages when treated with the ACM, AB and ACM-AB formulations were determined. For the in vivo tests, BALB/c mice were infected with L. amazonensis and treated with 2,5 mg/kg/day of AB and 17,5 mg/kg/day of ACM-AB and ACM. During the treatment the animals were monitored weekly about body weight and leg diameter. At the end of the treatment the mice were euthanized and blood and tissue samples were collected for biochemical, hematological, histopathological and quantitative analysis of the parasite load. Statistical analysis was performed using ANOVA followed by Bonferroni or Kruskal-Wallis with Dunn post-test. Categorical variables were reported in contingency tables (Fisher\'s exact test). The analyzes were considered statistically significant at p < 0.05. RESULTS: The ACM-AB formulation was more effective against promastigote forms exhibiting IC50 around 0,012 Micro g/mL, while the IC50 of AB was 0,023 Micro g/mL. AB was more toxic to J744 macrophages with low concentration, 2,324 Micro g/mL. ACM-AB was less toxic to macrophages with CC50 of 8,106 Micro g/mL, higher than AB, and presented a high selectivity index (IS = 675.5). The ACM-AB formulation decreased the rate of macrophages infected, was less toxic, more effective in the treatment of infected animals and reduced the size of the lesion diameter by about 60% in relation to AB and 95% of the parasite load. CONCLUSIONS: The ACM-AB association was presented as a potential alternative in the treatment of ATL in the search for a high therapeutic efficacy, low toxicity and low cost preparation for the Unified Health System

A leishmaniose tegumentar americana (LTA) é uma doença infecciosa, crônica, não contagiosa, causada por diferentes espécies de protozoários do gênero Leishmania. A interação entre a espécie de Leishmania e os mecanismos da resposta imune do hospedeiro resulta em um amplo espectro de manifestações clínicas, histopatológicas e imunopatológicas na infecção humana. No Brasil, esta endemia representa um sério problema de saúde pública, sendo o estado do Maranhão responsável por 13% da casuística nacional. O objetivo deste estudo foi caracterizar o perfil imunopatológico de lesões cutâneas de 22 pacientes com LTA, causada por Leishmania (Viannia) sp, oriundos do estado do Maranhão. A reação de imunoistoquímica em biópsias de pele foi realizada empregando os anticorpos monoclonais anti-humano CD68, CD1a, fator XIIIa, CD4, CD8, IL-10 e IFN-g e os anticorpos policlonais anti-Lisozima, Foxp3 e TGF-b. A análise histológica das lesões demonstrou a presença de intenso infiltrado inflamatório na derme composto de macrófagos, linfócitos e plasmócitos com formação de granuloma na maioria dos casos. Formas sugestivas de Leishmania foram observadas em 90,9% dos casos examinados. A análise imunoistoquímica mostrou densidade superior de macrófagos ativados (4824,0 células/mm²) quando comparados aos não ativados 3458,9 células/mm²). Foi detectada densidade de células de Langerhans (CD1a+) de 310,4 células/mm² na epiderme e células dendríticas dérmicas (fator XIIIa+) de 633,6 células/mm² na derme. Foi verificada ainda, predominância de linfócitos T CD8+ (2374,1células/mm²) em relação a T CD4+ (1267,6 células/mm²). A densidade de células Treg Foxp3+ foi de 301,3 células/mm². A análise de correlação mostrou correlação positiva entre células TGF-b+ e T CD8+ e fator XIIIa+; e uma correlação negativa entre a densidade de células IFN-g+ e TGF-b+. As lesões de pacientes infectados com L. (Viannia) sp, apresentaram maior densidade de células Treg Foxp3+, e IL-10+ e IFN-g+ quando comparadas a de pacientes infectados por Leishmania (Viannia) braziliensis. A densidade de células TGF-b+ mostrou-se semelhante nos dois grupos de pacientes. A avaliação dos marcadores de acordo com o tempo de evolução da doença, não mostrou diferenças entre as densidades de células imunomarcadas. Esses dados indicam que embora exista um perfil imunopatológico associado ao controle da infecção, a presença de uma resposta regulatória no sítio da lesão pode estar relacionada à persistência parasitária. / American tegumentary leishmaniasis (ATL) is a chronic, non contagious, infectious disease caused by different protozoan parasite species of the genus Leishmania. The interaction between Leishmania species and host response results in a wide spectrum of clinical, histopathological and immunopathological presentations in humans infection. In Brazil, this endemic disease is a serious public health problem and Maranhão State is responsible for 13% of Brazilian cases. The aim of this study was to characterize the immunopathology of lesions from 22 biopsies of patients with ATL, caused by Leishmania (Viannia) sp, from Maranhão State. Immunohistochemistry was carried out by incubating skin biopsies with monoclonal mouse anti- human CD68, CD1a, XIIIa factor, CD4, CD8, IL-10 and IFN-g and polyclonal rabbit\'s anti- human lysozyme, Foxp3 and TGF-b. Analysis of skin biopsies demonstrated a dense inflammatory infiltrate in the dermis, characterized by the presence of mononuclear cells, mainly lymphocytes, macrophages, plasma cells and granulomas in most samples. Suggestive forms of amastigotes were detected in 90.9% samples observed. Immunohistochemistry showed high levels of activated macrophages (4824.0 cell/mm²) when compared to inactive macrophages (3458.9 cells/mm²). In the epidermis, the densities of Langerhans Cells (CD1a+) were 310.4 cells/mm², while in the dermis the densities of dermal dendritic cells (factor XIIIa+) were 633,6 cells/mm². High density of CD8 T+ lymphocytes (2374.1 cell/mm²) has been found compared to CD4+ T lymphocytes (1267.6 cell/mm²). The cellular density of Treg (Foxp3+) was 301 cells/mm². Among cell markers there were positive correlations between TGF-b-producing cells and CD8+ T lymphocytes and between TGF-b-producing cells and dendritic dermal cells, as well as a negative correlation between TGF-b-producing cells and IFN-g-producing cells. Patients infected with L. (Viannia) sp. presented increased densities of Treg cells and IL-10 and IFN-g- producing cells compared to Leishmania (Viannia) braziliensis infected patients. The density TGF-b+ producing cells was similar in both groups of patients. Evaluation of Immunological markers according time of infection showed no differences in the densities of immunostain cell. Results suggest that the profile of immunopathological response is associated to the control of infection, although the presence of a regulatory response at the site of infection can be responsible to the persistence of parasite in skin.

Introdução. O Litoral Norte Paulista, até a década de 1980, era hipoendêmico para transmissão de leishmaniose tegumentar americana (LTA). A partir da década de 1990, esta parasitose adquiriu caráter epidêmico em todos os municípios: Caraguatatuba, Ilhabela, São Sebastião e Ubatuba. Objetivo. Realizar análise descritiva da ocorrência dos casos de LTA autóctone no Litoral Norte Paulista, entre 1993 e 2005 e registrar as espécies de flebotomíneos na área de transmissão. Métodos. Foram analisados dados secundários obtidos das fichas de casos de LTA autóctones, notificados ao serviço de vigilância epidemiológica da Secretaria Estadual de Saúde, segundo distribuição espacial, temporal, atributos pessoais e dados das fichas de captura entomológica da Superintendência de Controle de Endemias. Resultados. A LTA apresentou distribuição espacial heterogênea, com casos isolados e agrupados. Houve sincronismo na manifestação do agravo, com ciclicidade, em intervalo de seis a oito anos. Todas as faixas etárias e sexo foram acometidos, sem evidência de risco com ocupação específica. A fauna flebotomínea foi composta por dezesseis espécies, com predomínio de Ny. intermedia (>80,4%), no peri e intra domicílio. Conclusões. A LTA apresenta estreita relação com a floresta e a transmissão ocorre no peri e no intradomicílio, tanto no ambiente periurbano como no interior da mata. Neste caso, a transmissão estaria mais relacionada com os focos enzoóticos. / Introduction. The northern coast of the State of São Paulo was, up to the decade of the 1980´s, hypoendemic for the transmission of American cutaneous leishmaniasis (ACL). However, as from the decade of the 1990´s this disease acquired epidemic characteristic in all the municipalities: Caraguatatuba, Ilhabela, São Sebastião and Ubatuba. Objective. To undertake a descriptive study of the occurrences of the autochthonous cases of ACL in the four municipalities of the northern coast of the state of São Paulo, between 1993 and 2005, and to record the phlebotomine species in the area of transmission. Methods. Secondary data of spatial and temporal distribution and personal characteristics were analyzed from the records of autochthonous ACL cases notified to the epidemiological surveillance service of the State Health Secretariat. Information on phlebotomines were obtained from data of entomological captures undertaken by the Superintendência de Controle de Endemias. Results. The ACL presented heterogeneous spatial distribution with both isolated and clustered cases. There was synchronicity in the occurrence of the disease in all the municipalities, with cyclicality at intervals of from six to eight years. All age groups and both sexes were affected, without any particular profession. The phebotomine fauna consisted of sixteen species, with Ny. intermedia predominating (>80.4%) both in the peri and intra domicíle. Conclusions. ACL presented a close relation with the forest and its transmission occurs in the peri and intra-domicile, in the periurban environment and within the forest. In this latter case the transmission is more closely related to the enzootic foci.

Leishmaniose visceral (LV) é uma doença causada por Leishmania (Leishmania) infantum no Brasil. Na infecção ao lado da reposta imune específica, fatores inespecíficos do hospedeiro podem desempenhar um papel importante. Em trabalhos desenvolvidos pelo nosso grupo observou-se na infecção in vitro de macrófagos murinos por L. (L.). major o papel de IGF-I como efetor da resposta a IL-4, demonstrando que o IGF-I é um fator importante envolvido na interação parasito-hospedeiro no modelo de Leishmania (L.) major. Observou-se que os fatores envolvidos na interação mudam dependendo da espécie de Leishmania envolvida na infecção, desta forma, procuramos o papel do IL-4 e sua relação com o IGF-I na infecção de macrófagos humanos THP-1 por L. (L.) infantum. Macrófagos THP-1 foram infectados com L. (L.) infantum, sob o estimulo de IL-4 e IGF-I recombinante. Nossa análise do parasitismo não revelou um aumento após 24 e nem 48 horas e sim após 72 horas sob estimulo de IL-4 e o parasitismo sob estimulo de IGF-I não aumento após 24 e nem 72 horas e sim uma diminuição após 48 horas. Enquanto a produção de NO e a atividade da arginase se mantiveram constantes em todos os períodos avaliados a expressão de arginase 1 aumenta na infecção, mas os estímulos de IL-4 e IGF-I não tem efeito sobre a expressão. A expressão de IGF-I aumenta na infecção e os estímulos de IL-4 e IGF-I não tem efeito sobre a expressão. Já a expressão do receptor apresentou uma diminuição durante a infecção nos tempos avaliados. Considerando os nossos achados, onde a infecção de macrófago humano por L. (L.) infantum não estimulou a produção de NO e nem a atividade da arginase e os estímulos de IL-4 e IGF-I nas células infectadas não provocou um aumento significativo da atividade da arginase, os dados sugerem que a arginase tanto da célula quanto do parasita não sejam fundamentais para o desenvolvimento do parasita e onde a produção de NO na célula não seja danosa para o parasita. / Visceral leishmaniasis (LV) is a disease caused by Leishmania (Leishmania) infantum in Brazil. During infection the specific immune response, nonspecific host factors may play an important role. In studies developed by our group we observed the role of IGF-I as an effector of the IL-4 response in the in vitro infection of murine macrophages by L. (L.). major, demonstrating that IGF-I is an important factor involved in the parasite-host interaction in the Leishmania (L.) major model. It was observed that the factors involved in the interaction depend on the species of Leishmania involved in the infection. In this way, we look for the role of IL-4 and its relationship with IGF-I in L. (L.) infantum infected human THP-1 macrophages. THP-1 macrophages were infected with L. (L.) infantum under stimulation of recombinant IL-4 and recombinant IGF-I. Parasitism analysis did not show an increase after 24 and 48 hours, but after 72 hours under IL-4 stimulation and parasitism under IGF-I stimulation did not increase after 24 nor 72 hours but a decrease after 48 hours. While NO production and arginase activity remained constant at all evaluated periods, arginase 1 mRNA expression increased in infection, but the IL-4 and IGF-I stimuli had no effect on expression. Expression of IGF-I mRNA increases in infection and the IL-4 and IGF-I stimuli have no effect on expression. Already the expression of the receptor presented a decrease of mRNA during the infection in the evaluated times. The expression of the receptor showed a decrease in expression during infection at the times evaluated. Considering our findings, where human macrophage infection by L. (L.) infantum did not stimulate NO production and neither arginase activity nor the IL-4 and IGF-I stimuli in infected cells did not induce a significant increase of the arginase activity, the data suggest that neither cell nor parasite arginase are critical to parasite development and where NO production in the cell is not harmful to the parasite.