Magister Scientiae - MSc / In many forensic cases, such as mass disasters reconstruction cases, the recovered DNA is highly degraded. In such incidences, typing of STR loci has become one of the most powerful tools for retrieving information from the degraded DNA. However, as DNA degradation proceeds, three phenomena occur consecutively: loci imbalance, allele dropout and no amplification. To solve the problem of degraded DNA, redesigned primer sets have been developed in which the primers were positioned as close as possible to the STR repeat region. These reduced primer sets were called Miniplexes. Unfortunately, a few of the CODIS STR loci cannot be made into smaller amplicons. For this reason non-CODIS miniSTRs have been developed. The present study was undertaken for the population genetic analysis of microsatellite variation in four South African populations; Afrikaner, Xhosa, Mixed Ancestry and Asian Indian using eight non-CODIS miniSTR loci. These miniSTRs loci were characterized within the populations by estimating the levels of diversity of the markers, estimating the population genetic parameters, and studying the inter-population relationships. All of the miniSTRs were amplified successfully and the genetic variability parameters across all loci in Afrikaner, Mixed Ancestry, Asian Indian and Xhosa were estimated to be in the range of 3 (D4S2364) to 12 (D9S2157) alleles, the total number of alleles over all loci ranged from 100 to 204, the allelic richness ranged from 3.612 to 10.307 and the heterozygosity ranged from 0.4360 to 0.8073. Genetic distance was least between Afrikaner and Asian Indian and highest between Xhosa and Mixed Ancestry. Deviations from Hardy-Weinberg equilibrium were not observed for most of the loci. The low mean FIS (-0.027) and FIT (-0.010) and FST (0.017) values across the populations indicated low level of inbreeding within (FIS) and among (FST) the populations. The Asian Indian population showed higher levels of the inbreeding coefficient, indicating less gene exchange between it and other populations. These 8 markers can be used for genetic investigations and assessing population structure. The study contributed to the knowledge and genetic characterization of four South African populations. In addition, these MiniSTRs prove to be useful in cases where more genetic information is needed. / South Africa

As leishmanioses são protozooses de alta prevalência em regiões tropicais como o Brasil, transmitidas por vetores flebotomíneos, cujos reservatórios são compostos por diferentes espécies animais. No vetor, os parasitos assumem uma forma flagelada indistinguível entre as espécies e outros tripanossomatídeos. A doença apresenta amplo espectro pela existência de varias espécies de leishmânias e por diferenças na susceptibilidade individual dos hospedeiros. Tanto para o prognóstico individual como também nas investigações epidemiológicas, levando-se em conta futuras medidas de controle desta doença, a identificação espécie especifica é de crucial importância. Um fator importante na rede causal é a determinação da preferência alimentar dos vetores, permitindo assim a intervenção adequada no controle da doença e de seus reservatórios. Atualmente, técnicas moleculares como a PCR, permitem diagnosticar a infecção, identificar a espécie infectante no vetor e seus hospedeiros,assim como o hábito alimentar dos flebotomíneos. Observou-se um aumento significativo de notificações de leishmaniose tegumentar e visceral no Estado do Mato Grosso do Sul, sendo que até o presente momento, pouco se conhece a respeito de sua etiologia. Neste sentido, em colaboração com pesquisadores do Mato Grosso do Sul e por meio da técnica de PCR, temos como objetivo: determinar a infecção natural dos flebotomíneos capturados em campo; identificar as espécies de leishmânias provenientes de amostras humanas e caninas e isoladas em hamster; padronizar reação que determine a fonte alimentar de flebotomíneos; em Campo Grande e Bela Vista. Para a identificação de leishmânia, foi utilizada como alvo seqüências de mini exon e nos casos positivos para subgênero Viannia utilizou-se a técnica de RFLP. Para identificação de fonte alimentar foi utilizado como alvo regiões conservadas do gene citocromo b. Na capital Campo Grande, a captura foi realizada no período de 2003 a 2005. Entre os anos de 2003 - 2004 a taxa mínima de infecção (TM) foi de 1,6%, sendo identificado L.(V.) braziliensis, já para o período de 2004 - 2005 a TM foi de 0,38%, para L.(L.) amazonensis, cuja maioria das espécies pertencia à Lu. longipalpis. Cinco amostras humanas provenientes de Campo Grande e outros municípios e isolados em hamster foram identificadas como L.(V.) braziliensis. No município de Bela Vista, no período entre 2004-2006, a maioria das espécies capturadas pertencia à espécie Bi. flaviscutelata. Destes, foi possível identificar TM de 0,6% de L. (L.) amazonensis e taxa de 0,24% para outros tripanossomatídeos. De um total de 10 amostras de cães isoladas em hamsters, 2 foram identificadas como L.(L.) amazonensis. A PCR para identificação de fonte alimentar foi capaz de identificar sangue de humano, galinha, camundongo, cavalo, gambá, capivara, porco, cachorro doméstico e cachorro do mato. Para validação da técnica, foram utilizados flebotomíneos capturados em Campo Grande (MS). Verificou-se que 68% dos insetos capturados alimentaram-se em galinha. Acreditamos que os resultados advindos deste projeto possam contribuir no desenho de futuras medidas de controle desta doença no Estado do Mato Grosso do Sul. / Leishmaniases protozooses have a high incidence in tropical regions such as Brazil and they are transmitted by sand fly vectors, their reservoirs consisting of different animal species. Flagellate forms in the vector are indistinguishable among the leishmania species as well as among other trypanosomatides. The disease presents a large spectrum due to the several leishmania species and also to different individual susceptibilities of hosts. Both for the individual prognosis as well as for epidemiological investigations in the future control measures of the disease the specific species identification is of crucial importance. An important factor in the causal net of the disease is knowledge of the vectors food source preferences, thus allowing an adequate intervention to control the spreading of the disease as well as of the reservoirs. Nowadays molecular techniques such as PCR allow an infection diagnosis, identification of the parasite infection in the vectors and hosts as well as the sand flies feeding habits. A significant increase of tegument and visceral leishmaniasis notifications was detected in Mato Grosso do Sul State (MS) and so far little is known about their etiology. In collaboration with Mato Grosso do Sul researchers we aim at the following goals, applying PCR techniques: determine the natural infections of field captured sand flies; identify leishmania species originating from human and canine isolates in hamsters; standardize the reaction to determine feeding source from sand flies captured in Campo Grande and Bela Vista. For leishmania species identification mini-exon sequences were used as target and in cases positive for Viannia subgenus the RFLP was applied. For food source identification citochrome b gene conserved regions were used as targets. Captures in Campo Grande were performed between 2003 to 2005. Between the years 2003 -2004 the minimum infection rate (MR) of 1.6% was found for L.(V.) braziliensis, while for the period 2004-2005 MR for L.(L.) amazonensis was 0.38% and the majority of sandfly species were identified as Lu. longipalpis. Five human isolates from Campo Grande and other municipalities were identified as L.(V.) braziliensis. The majority of specimens captured in Bela Vista municipality between 2004-2006 were Bi. flaviscutelata. From these a MR of 0.6% were identified as L .(L.) amazonensis and 0.24% for other Kinetoplastidia species. From a total of 10 canine isolates 2 were identified as L.(L.) amazonensis. Standardization of PCR for food source identification was capable to distinguish the origin of several blood sources: human, chicken, mouse, horse, opossum, capybara, pig, domestic and bush dogs. Sandflies captured in Campo Grande (MS) were used to validate the technique. A percentage of 68% from these captures had fed on chicken. We believe that results shown in this project may contribute to the design of future control measures of this disease in the State of Mato Grosso do Sul.

O HBoV é um novo parvovírus que foi isolado pela primeira vez em 2005 nas secreções respiratórias de pacientes humanos que tiveram pneumonia. Desde então, é associado a doenças do trato respiratório superior e doença gastrointestinal em pacientes adultos e pediátricos, desde a sua descoberta na Suécia e posteriormente em diversos países no Mundo. Quase todos os estudos foram realizados em amostras de secreção do trato respiratório, normalmente, de crianças com menos de 2 anos de idade e a maioria com infecção respiratória. As taxas de prevalência variam de 1,5% a 19% nos diferentes países. A Análise filogenética deste novo vírus demonstrou que tratava-se de um parvovirus, mais estreitamente relacionado ao parvovírus bovino e ao minuto vírus canino e por isso foi denominado de Bocavírus Humano. A variabilidade genética do HBoV é baixa e estudos filogenéticos indicam que duas linhagens circulam paralelamente ao redor do mundo. Entretanto, como ainda é um vírus relativamente novo, devem se feitos estudos mais detalhados de suas variantes. Em nosso estudo, com a finalidade de determinar a prevalência e conhecer a variabilidade genética do HBoV circulante, foram analisados de janeiro de 2008 a fevereiro de 2010, 935 amostras de aspirado de nasofaringe de crianças com menos de 2 anos de idade, com doença respiratória aguda, internadas no Hospital da Santa Casa de Misericórdia de São Paulo. Pela técnica de PCR, obtivemos 47 (4,7%) amostras positivas para HBoV e dessas 27 amostras apresentaram coinfecção com outros vírus respiratórios, 45 amostras foram seqüenciadas na região da VP1/VP2 de um fragmento de 658 nt. A análise filogenética, quando comparada com seqüência do genBank representativas de vários países, mostrou a circulação, em nossa amostragem, de grupos de HBoV semelhantes aos que circulam no Japão e Taiwan. A variabilidade genética entre as nossas amostras foram inferiores a 1%, tanto entre si como quando comparadas com as amostras do genBank. / HBoV is a new parvovirus which was first isolated in 2005 from respiratory secretions from human patients who had pneumonia. It has been associated with respiratory and gastrointestinal diseases in adult and pediatric patients since its discovery in Sweden and later in several countries worldwide. Almost all studies were performed on samples of secretions from the respiratory tract, usually in children under 2 years of age. Prevalence rates vary from 1.5% to 19% in different countries. The phylogenetic analysis of this new virus showed that it was a parvovirus, more closely related to bovine parvovirus and canine minute virus, and therefore called Human Bocavirus. The genetic variability of HBoV is low and phylogenetic studies indicate that there are two strains circulating alongside around the world. However, as it is still a relatively new virus, more detailed studies of its variants should be carried out. In our study, 935 samples of nasopharyngeal aspirate from children under 2 years old with acute respiratory disease, patients at Santa Casa de Misericordia Hospital, São Paulo, were analyzed from February 2008 to February 2010 in order to determine the prevalence and genetic variability of HBoV stock. Using the PCR method, we obtained 47 (4.7%) positive samples for HBoV from which 27 showed coinfection with other respiratory viruses; 45 samples from a fragment of 658 nt were sequenced in the VP1/VP2 region. The phylogenetic analysis, when compared with GenBank sequences representing several countries, showed the presence in our samples of groups of HBoV similar to those circulating in Japan and Taiwan. Genetic variation in our samples were below 1%, both among themselves and when compared with samples from GenBank.

Currently, there is a growing interest in the use of probiotic products, and there are many of them in the market. With the growing interest, greater emphasis is placed on the identification of declared probiotic microorganisms. Precise identification of microbial composition is often a difficult task and it requires more advanced methods especially in the field of molecular diagnostics. The diploma thesis was focused on the verification of the presence od declared probiotic microorganisms in probiotic food supplements GS Laktobacily Forte 21, Biopron 9 Premium and Linex® Forte. DNA was isolated from the complex matrices by phenol extraction, commercial kit and magnetic carriers F79/L3-PLL in the quality suitable for PCR. Subsequently, the isolated DNA was amplified by real-time polymerase chain reaction using genus- and species-specific primers. The specific PCR product was subjected to agarose gel electrophoresis, whereas species identification was not always in compliance with the data declared by producers. The next part of the thesis was focused on polymerase chain reaction with high-resolution melting analysis to distinguish bacterial strains belonging to the Lactobacillus group and to identify probiotic microorganisms present in the complex matrices of the probiotic food supplements. Eight primer sets were tested (V1F HRM a V1R-HRM, CHAU-V3F a CHAU-V3R, CHAU-V6F a CHAU-V6R, LAC2 a LAC4, LAC1 a LAC2, P1V1 a P2V1, poxcDNAFw a poxPromRVC, poxcDNAFw a poxPromRVT). Three primer pairs (V1F HRM a V1R-HRM, poxcDNAFw a poxPromRVC, poxcDNAFw a poxPromRVT) were evaluated as the most suitable for distinguishing Lactobacillus bacterial strains.

In these days are probiotic lactic acid bacteria (LAB) very often used in food processing industry, such as milk products, cheese and fermented salami production. As well as the food conservation agent. Except of the industry usage of the LAB there are microbiological aspects. Identification of the bacterial species methods based on the isolation and amplification of DNA are very often used last few years. Diploma thesis deal with the bacterial cell of Lactobacillus species lysis and it´s optimalization. At first it was tested the optimal concentration of lysozyme (3mg/ml, 5mg/ml, 10mg/ml) and the exposure times (3, 5 a 10 hours). Another testing was aimed to the use and suitability of washing powder to the bacterial cell of Lactobacillus species lysis. I tested the Amway washing powder optimal concentration (1%, 2%, 3% a 4%). Four of another comercial washing powders were tested too. All these tests were performed at the pure Lactobacillus bacterial culture. To ensure the results I tested the washing powders at the real food matrix (Acidified milk, yogurt mango, yogurt white). All the methods were evaluated at the amplification method PCR with specific primers for the Lactobacillus genus. The DNA isolation was performed with the paramagnetic microsperes P(HEMA-co-GMA) and the amount of the DNA was quantified spectrophotometrically. The PCR products detection was performed with the agarose gel electrophoresis.

The rapid and accurate identification of the bacterium of the genus Lactobacillus, which are an important part of the normal gastrointestinal microflora and fermented dairy products are currently mainly used amplification methods. The aim of the study was to analyze the possibility of resolution of selected bacterial strains of the genus Lactobacillus, using the metod of polymerase chain reaction in the real time combined with high resolution melting curve analysis (qPCR HRM). It was tested five primers designed for qPCR-HRM analysis of lactic acid bacteria. The specificity of the primers was also verified simultaneously using bioinformatic analysis. On the basis of analysis of the DNA were selected as the most appropriate primers P1V1/P2V1, V3F/V3R and V6F/V6R. The suitability of the primers V3F/V3R and V6F/V6R was verified on a complex sample of food supplement from which the DNA was isolated using magnetic particles. The presence of bacteria of the genus Lactobacillus was performed using high resoluting melting analysis curves. The obtained results were in agreement with the information given by the manufacturer.

No description available.

A partir de 280 isolados fúngicos de cana-de-açúcar, 18 cepas foram avaliadas quanto á presença de genes da policetídeo sintase por meio da técnica do PCR. Estes fungos foram identificados taxonomicamente por uma abordagem polifásica, classificando-os dentro de quatro ordens e nove gêneros. A avaliação da atividade biológica demonstrou a presença de metabolitos com propriedades antibióticas quando enfrentados a micro-organismos patogênicos. Segundo a análise de correspondência múltipla, esta atividade poderia estar associada com a local de isolamento dos fungos. Foram detectadas 36 seqüências similares a genes PKS a partir de 17 destes fungos. A análise filogenética do domínio KS, conduzida pelo método de neighbor-joining, indicou que 16 seqüências se acomodaram dentro do grupo monofilético dos PKS envolvidos na produção de policetídeos não reduzidos e as outras 10 seqüências se acomodaram dentro do grupo monofilético dos PKS envolvidos na produção de policetídeos reduzidos. A análise do domínio CMT também apontou que as seqüências podiam se acomodaram em grupos de PKS dependendo do grau de redução do policetídeo, todas as seqüências CMT se relacionaram com PKS envolvidos na produção de policetídeos reduzidos. As análises dos modelos estruturais também demonstraram que as seqüências estavam altamente relacionadas com estruturas protéicas da família das enzimas de condensação, destacando a presença de uma hélice característica que carrega o resíduo de cisteína, responsável pela atividade de condensação. Extratos orgânicos obtidos de cultivos dos fungos foram avaliados parar detectar a presença de compostos tipo lovastatina. Por meio de cromatografia CCDS, detectaram-se bandas de 10 extratos com o mesmo deslocamento que a lovastatina padrão, mas apenas 6 destas foram confirmados por CLAE. O isolado A. flavus CBMAI 1023, foi selecionado para a realização de experimentos de produção a maior escala onde foi possível isolar e caracterizar um novo policetídeo. / From a group of 280 sugarcane-derived fungi 18 strains were assessed for the presence of polyketide synthase genes by PCR approaches. These fungi were identified taxonomically by a polyphasic approach classifying into four orders and nine genres. Biological activity tests showed the presence of antibiotic metabolites against pathogenic microorganisms and the relationship of this activity might be linked with the fungal isolate location by multiple correspondence analyses. 36 sequences similar to PKS genes fragments were detected from 17 of these fungi. A neighbor-joining phylogenetic analysis of the KS domain showed that 16 sequences fit on the monophyletic group of PKS evolved with production of non reduced polyketides, and the other 10 sequences fit on the monophyletic group of PKS evolved with the production of reduced polyketides. CMT domain analysis also pointed that the sequences fit with groups of PKS depending on polyketide reduction grade, all ten related to PKS evolved with the synthesis of reduced polyketides. Protein structural analysis also pointed out that these sequences are closely related with proteins from condensing enzyme family, highlighting the presence of a characteristic helix elbow that bears the cysteine residue responsible for the condensation activity. The fungi were also tested for their capacity of producing lovastatin compounds where chromatographic TLC detected bands from 10 extracts with the same dislocation compared to a lovastatin, but only 6 were confirmed by HPLC. The A. flavus CBMAI (1023) were selected for upscale production experiments, from where it was possible isolate and characterize a new polyketide compound.

O vírus linfotrópico das células T humanas tipo 1 (HTLV-1), é responsável por patologias como a mielopatia associada ao HTLV-1 ou paraparesia espástica tropical (HAM/TSP) e a leucemia/linfoma das células T do adulto (ATL) dentre outras. As vias de replicação até hoje demonstradas, não suportam a hipótese de um estado virêmico. Neste estudo, a detecção de partículas virais plasmáticas foi executada, por PCR em Tempo Real e Nested PCR em 190 amostras de pacientes infectados pelo HTLV-1(assintomáticos ou com HAM/TSP), em acompanhamento, no Instituto de Infectologia Emílio Ribas. 12 indivíduos (8%) testados por PCR em tempo real (n=150) e 6 indivíduos (18%) testados por Nested PCR (n=33, dado que sete amostras foram excluídas da análise) apresentaram RNA do HTLV-1 detectável no plasma. Em conclusão, foi possível identificar RNA plasmático do HTLV-1, tanto em pessoas assintomáticas quanto com HAM/TSP. Esta detecção abre novas possibilidades de discussão sobre a replicação do HTLV-1 e das vias de transmissão, sugerindo maiores investigações para elucidar o assunto. / The human T-cell lymphotropic virus type1 (HTLV-1) is responsible for some pathologies such as HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and Adult T-cell Leukemia/ Lymphoma (ATL) among others. Its ways of replication so far presented do not support the hypothesis of a viremic stage. In this study, the detection of the plasmatic viral load was performed by real time PCR and Nested PCR in 190 samples from HTLV-1 infected individuals (Either Asymptomatic or HAM/TSP cases) following up at Instituto de Infectologia Emílio Ribas. 12 individuals (8%) tested by Real time PCR (n= 150) and 6 individuals (18%) tested by Nested PCR (n= 33, given that 7 samples were excluded from the analysis) presented detectable HTLV-1 RNA in the plasma. In conclusion, it was possible to indentify HTLV-1 plasmatic RNA in asymptomatic carriers as well as in HAM/TSP cases. This detection opens new possibilities of discussion about HTLV-1 replication and transmission pathways, suggesting further investigation for clarifying this matter.

INTRODUÇÃO: A endomiocardiofibrose (EMF) é uma miocardiopatia de padrão restritivo de etiologia desconhecida, prevalente em regiões tropicais. Caracteriza-se por espessamento fibroso do endocárdio e miocárdio subjacente, comprometendo ponta e via de entrada de um ou de ambos os ventrículos. Sua etiopatogenia é pouco conhecida e muitos autores a associam à doença infecciosa cardíaca ou sistêmica, à eosinofilia prévia e/ou à carência nutricional. O prognóstico em geral é grave e a ressecção cirúrgica da lesão é indicada aos pacientes com insuficiência cardíaca refratária a tratamento clínico, em classe funcional III ou IV (NYHA). Os estudos anatomopatológicos até o momento foram realizados em material de autópsia ou de biópsia endomiocárdica. OBJETIVOS: Este estudo retrospectivo se propõe a (1) descrever os três aspectos morfológicos da lesão endocárdica (fibrose, infiltrado inflamatório e vasos) utilizando microscopia óptica comum e técnicas imunoistoquímicas, assim como correlacioná-los aos dados clínicos, laboratoriais e de imagem dos pacientes (2) comparar os aspectos morfológicos de espécimes de ressecção cirúrgica com os de autópsia a fim de verificar se os primeiros podem ser empregados para diagnóstico histológico da doença; e (3) discutir a patogenia da EMF e realizar pesquisa de agentes infecciosos cardiotrópicos em amostra endomiocárdica incluída em parafina por técnica de biologia molecular. MÉTODOS: Foram utilizadas amostras de ressecção cirúrgica endocárdica incluídas em parafina provenientes de 31 pacientes com diagnóstico clínico e cineangiocardiográfico de EMF, operados no InCor entre 1991 e 2005. As amostras foram coradas por técnicas convencionais (HE, tricômico de Masson, Verhoeff e reticulina) e submetidas a reações imunoistoquímicas para fibras colágenas tipo I, III e IV, para células inflamatórias (CD3, CD20, CD68) e para endotélio de linfáticos (D2-40). Amostras de nove corações de autópsia de pacientes com o mesmo diagnóstico serviram de controle positivo da doença. A pesquisa de agentes infecciosos foi feita por reação de cadeia de polimerase e reação de transcrição reversa de cadeia de polimerase (PCR e RT-PCR) em amostras endomiocárdicas incluídas em parafina, para T. gondii e para vírus cardiotrópicos (enterovirus, adenovirus, influenza A e B, citomegalovirus, parvovirus B19 e herpes simples). Para identificar alterações vasculares intramiocárdicas, procedeu-se à revisão de prontuários clínicos dos pacientes e de 16 cineangiocoronariografias. RESULTADOS: Foi observado intenso espessamento endocárdico ventricular à custa de fibrose hialina superficial escassamente celular, com fibras colágenas tipos I e III, predominando o tipo I sobre o III. O colágeno tipo IV foi identificado na membrana basal de vasos. Na porção profunda da lesão endocárdica observou-se escasso infiltrado inflamatório crônico com macrófagos, linfócitos T e B em menor número. O infiltrado estava distribuído ao redor de vasos proliferados com intensas alterações estruturais na parede e com participação de linfáticos. No miocárdio superficial identificou-se miocardite \"borderline\" (critério de \"Dallas\"). Foram obtidos ácidos nucléicos em quantidade suficiente para a reação de PCR/RT-PCR em 12/36 (33%) amostras. Genomas de agentes infecciosos foram identificados em 6/12 (50%) pacientes. Dois casos foram positivos para enterovirus (EV), dois para citomegalovirus (CMV), um para ambos (CMV e EV) e um para T. gondii. Não foram observadas diferenças histopatológicas entre as amostras cirúrgicas e as de autópsia. Foram detectadas alterações vasculares à cineangiocoronariografia em 9/16 (56%) pacientes. Não houve correlação anatomoclínica definida entre os múltiplos dados comparados. CONCLUSÕES: Os resultados indicam que na EMF ocorre processo inflamatório crônico mantido por rede vascular anômala rica em linfáticos localizada na profundidade da lesão endocárdica. A rede vascular provavelmente contribui para a manutenção da placa fibrótica e deve ser considerada como fator importante na patogenia da doença. O diagnóstico anatomopatológico pode ser feito com segurança em material de ressecção cirúrgica. A análise molecular do endomiocárdio possibilitou a detecção de alta incidência de genomas de agentes infecciosos cardiotrópicos. Seu significado, contudo, permanece controverso. / BACKGROUND: Endomyocardial fibrosis (EMF) is a restrictive cardiomyopathy of unknown etiology prevalent in tropical regions. The disease involves the inflow tract and apex of either one or both ventricles and is characterized by a fibrous thickening of the endocardium and the underlying myocardium. Although its etiology remains unknown, most authors believe it could be related to systemic or heart infection/parasitism, previous blood eosinophilia or malnutrition. Surgical resection of the thickened endocardium is recommended to patients with advanced heart failure of functional class III or IV, New York Heart Association (NYHA). The gross and histological features of the heart have been comprehensively studied in autopsies and endomyocardial biopsies. Studies in surgical samples, however, are still lacking. AIMS: This study was conducted to evaluated: (1) the histomorphological changes of EMF as seen in surgical specimens by means of routine histological and immunohistochemical methods in an attempt to correlate them with clinical symptoms and coronary angiographic features; (2) to compare histological data between surgical and autopsy samples, and (3) to discuss probable pathogenetic mechanisms of the disease, as well as to investigate cardiotropic infective agents by means of molecular analysis of endomyocardial surgical samples. METHODS: We collected all available clinical records and endomyocardial surgical samples from 31 patients with EMF who had been submitted to surgery between 1991 and 2005 at InCor. The diagnosis was based on clinical, hemodynamic and angiocardiographic findings. The surgical samples were fixed in 10% formalin, submitted to standard processing, and stained with H&E, Masson\'s trichrome, reticulin and elastic stains. Immunohistochemical methods were employed to detect collagen fibers type I, III, and IV, inflammatory cells (CD3, CD20, CD68) and lymphatic vessels\' endothelium (D2-40). Nine samples from autopsied hearts of EMF patients were used as a positive control group. Polymerase chain reaction (PCR) and reverse transcription-PCR were used retrospectively to search for genomes of T. gondii and cardiotropic viruses (enterovirus, adenovirus, influenza A e B, cytomegalovirus, parvovirus B19 and herpes simplex) in the surgical material. All clinical and surgical reports were reviewed, including follow-ups and 16 coronary cineangiocardiographies. RESULTS: Ventricular endocardium was thickened by superficial acellular hyaline collagen fibers type I and III. Type-IV collagen fibers were seen only around vessels. Focal chronic inflammatory infiltrate with T-lymphocytes, macrophages and a few B-lymphocytes was seen around blood vessels with a peculiar pattern of vascular changes and numerous lymphatics within the endocardium. The superficial myocardium showed borderline myocarditis (Dallas criteria). RNA and DNA were successfully extracted from 12/36 samples. Infective agents were detected in 6/12 (50%) patients; two of them were positive for cytomegalovirus (CMV), two for enterovirus (EV), one for both (CMV and EV) and one for T. gondii. No histopathological differences between surgical samples and autopsy fragments were observed. Vascular blush or neovascularity was detected in 9 of the 16 coronary cineangiocardiographies reviewed. Clinicopathologic characteristics are associated neither with infective genomes in the endocardium nor with vascular blush. CONCLUSIONS: Results indicate that there is an non especific chronic inflammatory process maintained by an anomalous vascular net rich in lymphatics situated deep within the endocardium. This angiolymphatic web probably contributes to the maintenance of the fibrotic plaque and might be considered an important pathological finding concerning in the pathogenesis of EMF. Histopathological changes as seen in surgical material are diagnostic of EMF. Molecular analysis of the endomyocardium revealed high incidence of cardiotropic infective agents, but their role in the pathogenesis of the disease is still controversial.