Made available in DSpace on 2016-12-23T13:56:10Z (GMT). No. of bitstreams: 1 Dissertacao de Adrielle Hoffmann.pdf: 1434617 bytes, checksum: 427eb50baa714de01ab9deab183c0308 (MD5) Previous issue date: 2011-08-10 / As onicomicoses, infecções fúngicas de unhas, são causadas por fungos filamentosos dermatófitos e não-dermatófitos e leveduras e representam as micoses superficiais mais difíceis de serem diagnosticadas e tratadas. O tratamento é através do uso tópico e/ou oral com drogas antifúngicas e pode ainda envolver a remoção da unha. O uso de agentes tópicos concomitante à terapia sistêmica leva à melhores resultados clínicos e micológicos. A eficácia da associação medicamentosa pode estar associada à ação complementar entre as drogas, envolvendo diferentes níveis de penetração ungueal e, dependendo dos antifúngicos, de diferentes alvos de ação na célula fúngica. O objetivo do presente estudo consistiu em estabelecer a ocorrência de fungos filamentosos na etiologia das onicomicoses e a suscetibilidade in vitro destes às drogas terbinafina, ciclopirox olamina, cetoconazol e itraconazol, conforme o documento M38-A2 (2008) do CLSI. Foi tambem avaliada a combinação entre estas drogas antifúngicas através do cálculo do índice fracionário de concentração inibitória (IFCI). Nossos resultados demonstraram que prevalência das onicomicoses, no período de janeiro de 2009 a abril de 2011, em Vitória, ES, foi de 50% dentre as dermatomicoses. A maioria dos isolados (77%) foi obtido de pacientes do sexo feminino e o local de maior acometimento foram as unhas dos pés para ambos os sexos. As unhas das mãos foram mais acometidas por leveduras e as unhas dos pés, por fungos filamentosos. Em geral, os gêneros de fungos filamentosos mais predominantes na etiologia das onicomicoses foram Trichophyton spp (21,7%), Fusarium spp. (11,2%) e Scytalidium spp.(8,4%). Para fungos filamentosos, os testes de suscetibilidade in vitro mostraram que isolados de dermatófitos foram mais sensíveis que isolados do grupo não-dermatófitos. Entre os nãodermatófitos, Fusarium spp. foi menos inibido que Scytalidium spp., que por sua vez, foi menos inibido que o dermatófito Trichophyton spp. Dentre as combinações testadas não houve nenhum efeito antagônico e,, com exceção daquela entre itraconazol e cetoconazol, as demais apresentaram efeito sinérgico sobre algum isolado. A combinação entre drogas apresentou maiores índices de sinergismo para o gênero Scytalidium spp. O melhor resultado para este gênero foi também obtido pela combinação itraconazol e terbinafina / The onychomycosis, fungal nail infections, are caused by filamentous fungi dermatophytes and non-dermatophytes and yeasts and represent the most difficult superficial mycosis to be diagnosed and treated. Treatment involves use of topical and/or oral antifungal drugs, as well as removal of the nail. The use of topical agents concomitant to systemic therapy leads to better clinical and mycological results. The efficacy of combination therapy may be associated with a complementary action between the drugs, involving different levels of nail penetration and, depending on the antifungal, different targets of action in the fungal cell. The purpose of this study was to establish the occurrence of filamentous fungi in the etiology of onychomycosis and in vitro susceptibility to the drugs terbinafine, ciclopirox olamine, ketoconazole and itraconazole, according to document M38-A2 (2008) CLSI. It was also evaluated the combination among these antifungal drugs by calculating the fractional inhibitory concentration index (FICI). Our results showed that the prevalence of onychomycosis in the period from January 2009 to April 2011, in Vitoria, ES, Brazil, was 50% among the dermatomycosis cases. Most of the isolates (77%) were obtained from female patients and toenails were the local with greater involvement for both sexes. The fingernails were more affected by yeast and toenails, by filamentous fungi. In general, the genera of filamentous fungi more prevalent in the etiology of onychomycosis was Trichophyton spp (21.7%), Fusarium spp. (11.2%) and Scytalidium spp. (8.4%). For filamentous fungi, the in vitro susceptibility testing showed that dermatophytes were more susceptible than non-dermatophytes isolates. Among non-dermatophytes, Fusarium spp. was less inhibited than Scytalidium spp., which in turn, was less inhibited than the dermatophyte Trichophyton spp. Among the combinations tested, there was no antagonistic effect and,, with exception of ketoconazole and itraconazole, those ones showed synergistic effect for isolates. The best results were presented for combinations involving itraconazole and terbinafine. The drug combination with greater synergistic effect was observed for genus Scytalidium spp. being that the combination itraconazole and terbinafine presented also the best results for this genus

Les infections fongiques invasives, sont des infections sévères grevées d’une lourde mortalité. Elles sont actuellement un problème majeur de santé publique et leur incidence augmente. Les candidémies représentent la quatrième cause d’infection hématogène nosocomiale aux Etats-Unis, les cryptococcoses sont responsables de 600 000 décès chaque année en Afrique et l’aspergillose invasive infecte 10% des patients transplantés de cellules souches. La mortalité de ces infections reste élevée avec des taux de mortalité de 50, 15 et 40% respectivement. L’augmentation de leur incidence est due à l’accroissement des populations immunodéprimées à risque de développer des infections fongiques en raison de l’augmentation des thérapeutiques immunosuppressives et de l’allongement de la durée de vie des patients immunodéprimés. Les infections fongiques invasives surviennent chez des patients immunodéprimés, majoritairement dans un contexte d’immunodépression acquise (neutropénie, chimiothérapie, greffe de cellules souches périphériques ou transplantation d’organe solide, diabète, infection par le virus de l’immunodéficience humaine), mais également secondairement à un déficit immunitaire héréditaire (granulomatose septique chronique, déficit immunitaire combiné, neutropénie congénitale, défaut de l’axe IFNγ-IL12). Cependant certains patients développent des infections fongiques invasives sans immunodépression ou facteurs de risques identifiés. Nous avons donc émis l’hypothèse que ces infections avaient possiblement une origine génétique non identifiée. Au cours de ma thèse, j’ai étudié une cohorte de patients présentant des infections fongiques invasives sans facteur favorisant identifié afin de rechercher une étiologie génétique à ces infections. Le premier groupe de patients que j’ai étudié présentait une dermatophytose invasive ou dermatophytose profonde sans immunodépression. Contrairement à la dermatophytose superficielle, en général bénigne et fréquente dans la population générale; la dermatophytose profonde est une infection rare, invasive et sévère, dans laquelle les dermatophytes (qui sont des champignons filamenteux) envahissent les tissus dermiques et hypodermiques, les ganglions et parfois les organes profonds. Les patients que j’ai étudié étaient tous originaires d’Afrique du Nord, pour la plupart issus de familles consanguines, dont certains avec des cas multiples. Ces observations suggéraient une origine génétique de la dermatophytose profonde avec une hérédité probablement récessive. Au cours de ma thèse, j’ai étudié les caractéristiques cliniques, immunologiques et génétiques de 18 patients atteints d’une dermatophytose profonde, issus de neuf familles Marocaines, Algériennes, Tunisiennes ou Egyptiennes. En parallèle, j’ai étudié des patients ayant présenté des infections fongiques avec localisations cérébrales. L’une de ces patients a présenté des abcès cérébraux suite à une infection disséminée à Exophiala dermatitidis et trois patients ont développé des infections du système nerveux central à Candida spp.. Les infections invasives à Exophiala dermatitidis sont des infections rares, avec de fréquentes atteintes du système nerveux central, survenant majoritairement chez des patients sans déficit immunitaire identifié suggérant l’existence d’une origine génétique probable méconnue chez ces patients. Les candidoses invasives surviennent habituellement chez des patients neutropéniques, ayant récemment subi une intervention chirurgicale ou étant porteurs d’un cathéter intraveineux. Parmi les candidoses invasives, les localisations au système nerveux central sont rares, et classiquement rapportées chez des nouveau-nés prématurés ou suite à une intervention neurochirurgicale. J’ai par ailleurs étudié une patiente ayant développé des infections invasives des tissus sous-cutanés et des adénopathies dues à un champignon filamenteux. (...) / Invasive fungal diseases are a major health problem as they are severe infections complicated with high mortality rates and with rising incidence. Invasive fungal diseases occur mainly in patients with acquired immunodeficiencies, but also with primary immunodeficiencies (chronic granulomatous disease, defect in IFN-ϒ/IL-12 axis, congenital neutropenia). However, few patients develop invasive fungal disease without known risk factor. We therefore hypothesized that these infections probably have an unidentified genetic etiology. I studied a cohort of patients who developed invasive fungal diseases without risk factors and searched for a genetic etiology to their infections. The first group of patients presented with deep dermatophytosis without known immunodeficiency. Deep dermatophytosis is a rare, invasive and severe infection where dermatophytes invade dermis, hypodermis, lymph nodes and sometimes deep organs. I could study clinical, immunological and genetic characteristics of 18 patients from nine families who presented deep dermatophytosis. I also studied patients who developed central nervous system (CNS) fungal infections; one patient with CNS Exophiala dermatitidis infection and three patients with CNS Candida spp. infection. Invasive E. dermatitidis infections are rare, with frequent CNS location, mainly reported in patients without known immunodeficiencies, suggesting a potential unknown genetic etiology in these patients. CNS candidiasis are also rare infections usually occuring in preterm neonates or following neurosurgery. Based on literature data previously reporting a large consanguineous Iranian family with CARD9 deficiency that developed chronic mucocutaneous and central nervous system candidiasis; according to candidate gene approach, I sequenced CARD9 in all patients. CARD9 is an adaptor protein expressed by myeloid cells that signals downstream Dectin-1 and Dectin2 that are the main Pattern Recognotion Receptor implicated in antifungal immunity. I identified in all studied patients homozygous CARD9 mutations. Among 18 patients with deep dermatophytosis, 16 had homozygous nonsense Q289X and two homozygous missense R101C mutation in CARD9. I identified R18W, R35Q and R70W homozygous missense mutations in the patients who developed E. dermatitidis and two patients who developed CNS candidiasis, respectively. Transmission was autosomal recessive for all patients, except for the one with E. dermatitidis infection who had an uniparental disomy. In contrast with controls, CARD9 expression is abolished in Q289X, reduced in R70W and normal in R18W patients’ myeloid cells. CARD9 deficient patients whole blood and dendritic cells display a selective response defect to Candida albicans and Saccharomyces cerevisiae ; with IL-6 and TNF-α production impairment after Candida albicans and Saccharomyces cerevisiae stimulation. This defect can explain elective fungal susceptibility of CARD9 deficient patients to invasive fungal infections. This work evidenced that CARD9 deficiency was the main genetic etiology of deep dermatophytosis. It also could evidence that CARD9 deficiency is associated with Exophiala dermatitidis and Candida spp. CNS infections. This susceptibility is associated with proinflammatory cytokines defect by dendritic cells and whole blood to fungal agents. Various fungal clinical phenotypes in CARD9 deficient patients assess CARD9 central role in skin and central nervous system antifungal immunity.

Arthroderma benhamiae has been almost unknown among clinical mycologists but it is a cause of around 40 % of dermatophytic infections according to current studies in the Czech Republic. The species is primarily transmitted to humans from guinea pigs and other rodents. The epidemiological situation is similar in other countries in Central and Western Europe. The reason of significant increase in the incidence of infections has not been identified yet, and no sufficiently informative molecular markers have been developed for typification of the species that could help to resolve the cause of this problem. For the purposes of this study, isolates (n=268) from cases of human and animal dermatophytoses from the Czech Republic, Germany, Belgium, Switzerland, Italy, Japan and USA were selected. Ten variable microsatellite markers were developed and sequence analysis of two genetic loci (ITS rDNA and gpdh gene) were performed to reveal intraspecific variation. Phenotype was also studied at the level of micro- and macromorphology of the strains and growth parameters at several temperatures and on several cultivation media. Mating type idiomorph of each isolate was determined and mating experiments were performed by crossing pairs of genetically related as well as genetically distant strains. Sequence...

INTRODUÇÃO: Infecções fúngicas superficiais podem ser causadas por dermatófitos, leveduras ou fungos filamentosos não dermatófitos. O tipo de lesão desenvolvida eventualmente se correlaciona ao agente etiológico, à capacidade de resposta imunológica do hospedeiro, ao sítio anatômico da lesão e tecido afetado. A proposta desse trabalho é isolar e identificar agentes de onicomicose em pessoas idosas (acima de 60 anos de idade), que frequentemente apresentam alteração da resposta imune. CASUISTICA E MÉTODOS: A técnica de identificação de fungos foi a análise do resultado conjunto do exame micológico direto, isolamento e microcultura do raspado ungueal. Escamas subungueais e escamas interdigitais foram coletadas de 35 pessoas idosas, com suspeita clínica de onicomicose, institucionalizados em duas casas assistenciais no município de São Bernardo do Campo, SP, Brasil. RESULTADOS: Os materiais coletados foram analisados e, no raspado ungueal, observou-se 18 (51,40%) resultados positivos no exame direto e 15 (44,40%) no isolamento. Os dermatófitos foram evidenciados em 8 (44,40%) dos isolados, identificando-se 5 (27,80%) como Trichophyton rubrum e 1 (5,60%) de cada um como Trichophyton tonsurans, Trichophyton mentagrophytes e Microsporum gypseum. O segundo grupo mais isolado foram 7 (38,90%) leveduras, identificadas como: 3 (16,70%) Candida guilliermondii, 2 (11,10%) Candida parapsilosis e 1 (5,60%) Candida glabrata, 1 (5,60%) Trichosporon asahii. O último grupo foi representado por 3 (16,70%) isolados de fungos filamentosos não dermatófitos, identificados como: Fusarium sp, Aspergillus sp e Neoscytalidium sp, 1 (5,60%) de cada um. Trinta (85,70%) dos raspados interdigitais foram negativos e em 5 (14,30%), a identificação dos agentes coincidiu com o fungo causador da onicomicose (2 Trichophyton rubrum, 1 Trichophyton mentagrophytes, 1 Candida guilliermondii e 1 Fusarium sp). No grupo controle (9 pessoas idosas clinicamente sem lesão ungueal) realizou-se coleta interdigital, isolando-se Candida guilliermondii em apenas 1 (11,0%). CONCLUSÕES: Pelo método de identificação empregado, observou-se que os fungos causadores de onicomicoses encontrados neste trabalho estão de acordo com relatos da literatura recente; a apresentação clínica da unha com onicomicose por fungos filamentosos não dermatófitos foi indistinguível daquela por dermatófitos ou candidoses e, do ponto de vista etiológico, não se observou diferença entre a onicomicose de pessoas idosas institucionalizadas com os dados da ocorrência de onicomicose na população geral divulgados pela literatura / INTRODUCTION: Superficial fungal infections can be caused by dermatophytes, yeasts or filamentous non-dermatophyte fungi. The type of injury eventually correlates to the the etiologic agent, the ability of the host immune response, the anatomical site of the lesion and the kind of the affected tissue. The purpose of this study is to isolate and identify agents of onychomycosis in the elderly (people over 60 years old), who often have alterations in the immune response. MATERIAL AND METHODS: The technique for the identification of fungi was the analysis of the combined result of mycological examination, isolation and microcultures of nail scrapings. Subungual and interdigital scales were collected from 35 elderly with a clinical suspicion of onychomycosis, institutionalized in two care houses in the city of Sao Bernardo do Campo, SP, Brazil. RESULTS: The collected materials were analyzed and the nail scrapings displayed 18 (51.40%) positive results on direct examination and 15 (44.40%) in isolation. Dermatophytes were found in 8 (44.40%) isolates, 5 (27.80%) beeing identified as Trichophyton rubrum and 1 (5.60%) of each others as Trichophyton tonsurans, Trichophyton mentagrophytes and Microsporum gypseum. The second more isolated group were composed by 7 (38.90%) yeasts, identified as: 3 (16.70%) Candida guilliermondii, 2 (11.10%) Candida parapsilosis, 1 (5.60%) Candida glabrata, and 1 ( 5.60%) Trichosporon asahii. The last group was represented by 3 (16.70%) isolated of non-dermatophyte filamentous fungi, identified as Fusarium sp, Aspergillus sp and Neoscytalidium sp 1 (5.60%) of each. Thirty (85.70%) of the interdigital scrapings were negative and 5 (14.30%) positive, being the agents coincident with the onychomycosis causing fungi (2 Trichophyton rubrum, 1 Trichophyton mentagrophytes, 1 Candida guilliermondii and 1 Fusarium sp) . In the control group (9 elderly with clinically uninjured nail) interdigital collecting was held, isolating Candida guilliermondii in only one (11.0%). CONCLUSIONS: Using this identification method, it was observed that the fungi that cause onychomycosis found in this study are consistent with the reports in the recent medical literature, the clinical presentation of toenail onychomycosis caused by non-dermatophyte molds was indistinguishable from that due to candidosis or dermatophyte and, in terms of etiology, no difference was observed between the onychomycosis of the institutionalized elderly from the occurrence of onychomycosis in the general population disclosed in the literature

Introdução: os dermatófitos afetam 40% da população mundial, e no sul do Brasil encontrase o maior número de portadores de HIV/habitante do país, sendo necessário, portanto, um controle epidemiológico desses fungos. Objetivo: determinar a prevalência dos dermatófitos na região metropolitana de Porto Alegre, Brasil, e comparar as espécies a partir dos dados dos pacientes. Métodos: foi realizado um estudo transversal com dados de pacientes atendidos em hospital de referência, no período de 1996-2011, sendo que as análises estatísticas utilizadas para cada objetivo específico do trabalho foram: regressão linear simples (determinar o comportamento da prevalência ao longo dos anos); Qui-quadrado (comparar a prevalência dos fungos entre o gênero masculino e feminino); Mann-Whitney U (comparar a idade dos pacientes entre os gêneros); Kruskal-Wallis (comparar a idade dos pacientes entre as espécies de dermatófitos); Qui-quadrado corrigido por Bonferroni (comparar a proporção étnica dos casos acometidos por cada espécie com a proporção amostral) e teste exato de Fisher/análise de resíduos (determinar as diferenças entre os locais anatômicos afetados pelos fungos). Em todas as análises, foi considerado =0,05. Resultados: foram obtidos 14.214 casos positivos no exame micológico cultural, sendo que 9.048 foram positivos para dermatófitos, o que torna este o maior estudo epidemiológico sobre dermatofitoses do país. Trichophyton rubrum ocorreu em 59,6% dos casos, seguido de T. interdigitale (34%), Microsporum canis (2,6%), Epidermophyton floccosum (1,5%), M. gypseum (1,3%), T. tonsurans (0,9%) e T. violaceum (1 caso). Para T. interdigitale, E. floccosum, T. rubrum e M. canis, os coeficientes angulares das regressões lineares foram +1,119, +0,211, -0,826 e -0,324% ao ano, respectivamente. No gênero masculino verificou-se maior prevalência de infecção (79,3% versus 54,9%), porém as mulheres acometidas apresentaram idade superior aos homens. T. interdigitale e M. canis foram mais frequentes em pacientes caucasianos, enquanto T. rubrum acometeu menos pacientes pardos do que o esperado. Tinea unguium foi a dermatofitose mais prevalente (48,5%), sendo as unhas dos pés mais acometidas do que as unhas das mãos (94,4% versus 4,1%), seguida de tinea pedis (33,1%), corporis (6,8%), cruris (5,9%), manuum (2,4%), capitis e facie (1,5% cada) e barbae (0,07%). T. rubrum foi o fungo predominante em todas as regiões do corpo, exceto no couro cabeludo, em que M. canis foi responsável por 75% dos casos. As maiores associações positivas para cada espécie foram: T. rubrum (região inguinal); T. interdigitale e E. floccosum (pele dos pés); M. canis e T. tonsurans (couro cabeludo); M. gypseum (face). Conclusão: este estudo corrobora os demais estudos da região quanto à distribuição dos dermatófitos, sendo T. rubrum a espécie mais comum. T. tonsurans apresenta baixíssima prevalência, diferentemente de outros estados brasileiros, onde esse fungo está entre os primeiros do ranking. Porém, este estudo mostrou diferença entre homens e mulheres quanto à idade e à prevalência na infecção por dermatófitos. Além disso, observamos uma diminuição na prevalência de T. rubrum e M. canis, acompanhada de um aumento de T. interdigilate e E. floccosum. Nesse sentido, é preciso haver mais estudos epidemiológicos na região para o devido acompanhamento e controle da evolução das dermatofitoses. / Background: dermatophytes affect 40% of the world population. In Brazil, largest number of patients with HIV/inhabitant occurs in the south, requiring epidemiological control of these fungi. Objective: to determine the prevalence of dermatophytes in the metropolitan area of Porto Alegre, Brazil, and to compare species based on patient data. Methods: we conducted a cross-sectional study with data of patients from a highly respected hospital 1996-2011. The statistical analyses performed for each specific objective were: Simple linear regression (to determine the prevalence of behavior over the years), Chi-square (to compare prevalence of fungi between the genders), Mann-Whitney U (to compare patients' age between the genders), Kruskal-Wallis (to compare the ages of pacients among species of dermatophytes); Chi-square corrected by Bonferroni (to compare ethnic proportion of cases affected by each species with the sample proportion), Fisher's Exact Test / Analysis waste (to determine differences between anatomical sites affected by fungi). In all analyses, = 0.05 was considered. Results: were obtained 14,214 cases mycological culture-positive, being 9,048 cases positive for dermatophytes, making this work the largest epidemiological study of dermatophytosis in the country. Trichophyton rubrum occurred in 59.6% of cases, followed by T. interdigitale (34%), Microsporum canis (2.6%), Epidermophyton floccosum (1.5%), M. gypseum (1.3%), T. tonsurans (0.9%) and T. violaceum (1 case). The slopes of the linear regressions, for T. interdigitale, E. floccosum, T. rubrum and M. canis, were +1.119, +0.211, -0.826 and -0.324% per year, respectively. Males presented higher prevalence of infection (79.3% versus 54.9%), but women were older than men. T. interdigitale and M. canis were most prevalent in Caucasians and T. rubrum was less prevalent in brown people than expected. Tinea unguium was more prevalent of the dermatophytosis (48.5%) being toenails more affected than fingernails (94.4% vs. 4.1%), followed by tinea pedis (33.1%), corporis (6.8%), cruris (5.9%) manuum (2.4%), facie and capitis (1.5% each one) and barbae (0.07%). T. rubrum was the predominant fungus in all regions of the body except in the scalp where M. canis was the responsible for 75% of the cases. The species with the highest positive associations were: T. rubrum (groin); T. interdigitale and E. floccosum (skin of the feet); M. canis and T. tonsurans (scalp); M. gypseum (face). Conclusion: this study corroborates other similar studies in the region related to the distribution of dermatophytes, being T. rubrum the most common species followed by T. interdigitale, and being T. tonsurans the one that presents a very low prevalence, unlike other States. However, this study showed gender differences in relation to age and prevalence of the infection by dermatophytes. Moreover, we observed a decrease in the prevalence of T. rubrum and M. canis and an increase of T. interdigilate and E. floccosum. In this sense, the continuation of epidemiological studies in the region is necessary for monitoring and controlling the evolution of dermatophytosis.

de pele é o tipo mais frequente, correspondendo a cerca de 25% de todos os tumores malignos registrados no Brasil. Há que se destacar que uma formulação de uso tópico foi desenvolvida pelo grupo para uso contra câncer de pele e o estudo da estabilidade acelerada desta formulação foi avaliado nesse trabalho. Os frutos da espécie S. lycocarpum foram coletados, secos, triturados, submetidos à extração ácido-base e o precipitado foi suspenso em etanol e filtrado. Os heterosídeos alcaloídicos, SS e SM, foram isolados por cromatografia em coluna a vácuo e purificados em CLAE semipreparativa. A formulação contendo extrato alcaloídico armazenada em temperatura ambiente (27 ± 2 oC) apresentou a melhor estabilidade física. Ensaios para avaliação da atividade antifúngica in vitro do extrato alcaloídico, SS, SM e aglicona (SD) foram realizados com cepas de fungos dermatófitos e Candida spp., sendo que a SM apresentou o menor valor de concentração inibitória. No ensaio de citotoxidade em células humanas de carcinoma espinocelular (A431) e células de fibroblastos de camundongos (L929) foi possível observar a toxidade do extrato alcaloídico e das substâncias, SS, SM e SD frente às células cancerígenas. No ensaio in vivo, os animais foram induzidos ao câncer de pele não-melanoma do tipo espinocelular com células A431 e verificou-se que apenas o grupo de animais tratados com a formulação Curaderm BEC 5 apresentou redução tumoral. Em contrapartida, o grupo tratado com formulação contendo extrato alcaloídico se comportou da mesma maneira que os grupos controle da formulação e controle negativo. Com auxílio da histologia confirmou-se que o câncer de pele induzido nos animais foi do tipo espinocelular. No ensaio imunoistoquímico foi utilizado o anticorpo caspase-3 para marcar as células em apoptose nos tumores, sendo que o maior número de células apoptóticas foi verificada no grupo tratado com a formulação Curaderm BEC 5. / Solanum lycocarpum A. Saint-Hilaire (Solanaceae), commonly known as wolf apple or wolf´s fruit, is a plant native of Brazil very common in the Brazilian savanna. High concentrations of steroidal alkaloids are found in S. lycocarpum fruits, and solasonine (SS) and solamargine (SM) are the most important ones. These two alkaloids present potential antifungal and anticancer activities. Dermatophytic fungi are the most common agents responsible for superficial mycoses in humans and animals, by infecting exclusively the stratum corneum of skin, hair and nails. Skin cancer is the most frequent type corresponding to roughly 25% of all the malignant tumors registered in Brazil. A topical formulation for skin cancer treatment was developed by our research group and its stability tests are reported in this work. The S. lycocarpum fruits were collected, dried, milled and submitted to acid-base extraction furnishing a precipitate, which was solubilized in ethanol and then filtered. The heterosidic alkaloids SS and SM were isolated by using vacuum column chromatography and purified by semi-preparative HPLC. The formulation containing the alkaloidic extract stored at room temperature (27 ± 2 oC) was more stable than the ones in other conditions. Antifungal in vitro test of the alkaloidic extract, SS, SM and the aglycone (SD) were performed with Candida spp and dermatophytic fungi strains. The alkaloid SM displayed the lower inhibitory concentration. The toxicity of the alkaloidic extract, SS, SM and SD was verified in a cytotoxicicity test performed with both cultured human cells of spinocellular carcinoma (A431) and mice fibroblast cells (L929). An in vivo cytotoxicicity test was performed by inducing non-melanoma skin cancer in mice with spinocellular cells A431, in which only the animals treated with a commercial formulation Curaderm BEC 5, showed tumor reduction. There was no statistical difference between the group treated with the formulation containing the alkaloidic extract and control groups. Histological analysis confirmed that the skin cancer induced in the animals were spinocellular type. In an immunohistoquimic test, caspase-3 antibody was employed to stain the cells in apoptosis in the tumors, showing that apoptotic cells were more numerous in the group treated with the formulation Curaderm BEC 5.

Dermatófitos são fungos filamentosos que infectam substratos queratinizados como pele, unha e cabelo em busca de nutrientes para se desenvolverem e permanecerem no hospedeiro. Pertencem aos gêneros Epidermophyton, Microsporum ou Trichophyton, os quais, dependendo de seu habitat natural, são classificados em espécies geofílicas, zoofílicas ou antropofílicas. O uso indiscriminado de antifúngicos levou à seleção de cepas resistentes, e o comportamento invasivo desses patógenos em pacientes imunodeprimidos aumentou nos últimos anos, dificultando o tratamento das dermatofitoses. Há, portanto, a necessidade de estudos para um melhor entendimento da biologia dos dermatófitos devido as suas importâncias médica e/ou veterinária e o escasso conhecimento da interação destes patógenos com os hospedeiros. No presente trabalho, analisamos oito espécies de dermatófitos: Arthroderma benhamiae, Microsporum canis, Microsporum gypseum, Trichophyton interdigitale, Trichophyton equinum, Trichophyton rubrum, Trichophyton tonsurans e Trichophyton verrucosum. Análises de genômica comparativa e de expressão de genes potencialmente envolvidos na degradação de queratina foram realizadas. Além disso, efetuamos o sequenciamento genômico em larga escala de uma das linhagens. A estrutura dos genes sub3, sub5 e sub7, que codificam serina endopeptidases com atividade queratinolítica, mep3 e mep4, que codificam proteínas pertencentes ao grupo das metaloendopeptidases, dppV, lap1 e lap2, que codificam exopeptidases, foi analisada por meio de ferramentas computacionais. Essas análises revelaram que os genes que codificam proteases possuem alto grau de conservação em suas estruturas, que é menor quando comparadas apenas suas regiões não codificadoras. As análises permitiram também a identificação em regiões promotoras de consensos específicos a gêneros de dermatófitos. Observamos que o acúmulo de transcritos destes genes, avaliados durante o cultivo em queratina, mimetizando o processo infeccioso, não está correlacionado à similaridade das sequências gênicas entre as espécies. Não encontramos correlação entre o nicho preferencial dos dermatófitos e suas sequências gênicas ou níveis transcricionais. Observamos que, na grande maioria das vezes, genes que codificam endo e exopeptidases, possuem acúmulo de transcritos em períodos iniciais de degradação de queratina. Nossos resultados sugerem que diferenças pontuais na sequencia gênica, diferenças em regiões promotoras ou, até mesmo, expressão variável destes genes que codificam um conjunto proteico com funções sinérgicas e provavelmente compensatórias, contribuam para os diferentes graus de reações inflamatórias no hospedeiro, bem como para a especificidade patógeno-hospedeiro. / Dermatophytes are filamentous fungi that infect keratinized substrates such as skin, nail and hair, searching for nutrients for their development and permanence in the host. They belong to the genera Epidermophyton, Microsporum or Trichophyton, and, depending on their natural habitat, are classified into geophilics, zoophilics or anthropophilics species. The indiscriminate use of antifungals has led to the selection of resistant strains, and the invasive behaviour of these pathogens in immunocompromised patients increased in the last years, hampering the treatment of the dermatophytoses. Therefore, there is a need of studies for a better understanding of the biology of the dermatophytes due to their medical and/or veterinary importance and the scarce knowledge about the interaction of these pathogens with their hosts. In this work, we analyzed eight species of dermatophytes: Arthroderma benhamiae, Microsporum canis, Microsporum gypseum, Trichophyton interdigitale, Trichophyton equinum, Trichophyton rubrum, Trichophyton tonsurans, and Trichophyton verrucosum. Comparative genomics and gene expression analyses of genes potentially involved in keratin degradation were performed. Moreover, we performed a large-scale genome sequencing of one of the strains. The structure of the genes sub3, sub5, and sub7, which encode serine endopeptidases with keratinolytic activity, mep3, and mep4, which encode proteins belonging to the group of the metalloendopeptidases, dppV, lap1, and lap2, encoding exopeptidases, were analyzed by computational tools. These analyses revealed that the genes encoding proteases possesses high degree of conservation in their structures, which are lower when their non-coding regions are compared. The analyses also allowed the identification of consensus in promoter regions, specific of dermatophytes genera. We observed that the transcripts accumulation of these genes, evaluated during the cultivation in keratin, mimicking the infection process, is not correlated to the gene sequence similarities among the species. We have not found any correlation between the preferential niche of dermatophytes and their gene sequences or transcription levels. Most of the times, we observed that genes encoding endo and exopeptidases accumulated transcripts at the beginning of keratin degradation. Our results suggest that specific differences in the genic sequencing, differences in promoter regions, or even variable expression of these genes encoding a set of proteins with synergic and probably compensatory functions, contribute to different levels of inflammatory reactions in the host, as well as to the host-pathogen specificity.

Thirty-seven samples were taken from the water, step access and air/water interface surfaces of 10 commercial whirlpools in Delaware and Madison Counties, Indiana between September and March of 1986-1988. Dermatophytes were isolated from 19 of the samples, representing 51%. At least three species of the yeast genus Candid. were isolated from 13 (35%) of these samples. Fifty-eight percent of all dermatophytes isolated were found in male-only whirlpools, as were nearly 62% of all Candida species. Isolated dermatophytes included Trichophyton rubrum, T. menta,grophytes, T. tonsurans, T. verrucosum, Epidermophyton floccosum, Microsporum nanum, and one Trichophvton species. Whirlpools were grouped based on similarity of fungi isolated from each facility. Male whirlpools sorted into one group, except for one that clustered with female facilities. Coliform bacteria were found in 43% of all samples, and blue-green fluorescent pseudomonads were found in 54% of all samples. Most dermatophytes were isolated from the step access surface of the facilities tested, and more Candida species were isolated from the water than from either surface tested. / Department of Biology

Orientador: Eduardo Bagagli / Resumo: Os dermatófitos são um grupo de fungos constituídos pelos gêneros Trichophyton, Epidermophyton e Microsporum que têm a habilidade de degradar a queratina. É por essa razão que podem colonizar a pele do homem e dos animais, embora também possam crescer no ambiente, geralmente em solos com restos de queratina. As características morfológicas permitem a identificação e classificação taxonômica das espécies, mas realizar um diagnóstico baseado nestas características pode levar a erros. As técnicas moleculares ajudam a realizar diagnósticos mais rápidos baseados em uma identificação molecular e também têm possibilitado importantes avanços quanto aos estudos filogenéticos, sendo as sequências ITS1-5.8S-ITS2 as mais utilizadas. No entanto, estes marcadores não são suficientes para identificar e elucidar todas as relações filogenéticas e taxonômicas dos dermatófitos devido à ampla variedade de espécies existentes, -sendo necessário novos marcadores genéticos, como o intein PRP8. Os inteins são elementos genéticos parasitas, de natureza proteica, presentes em alguns fungos e estão associados a importantes genes altamente conservados. Ointein PRP8 está localizado nogenePRP8 que codifica para a proteína PRP8 associada ao complexo do spliciosoma. O presente estudo visa caracterizar o intein PRP8 em fungos dermatófitos, de forma a empregar estes elementos genéticos como marcadores moleculares para uma correta identificação destas espécies e elucidações das relações filogenéticas do grupo.... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Dermatophytes are a fungal group composed by the genera Trichophyton, Epidermophyton and Microsporum with the ability to degrade keratin. That is why they can colonize the skin of man and animals, although they can also grow in the environment, usually in soils with remains of keratin. The morphological characteristics allow the identification and taxonomic classification of the species, but a diagnosis based on these characteristics is difficult. Molecular techniques made diagnoses based on molecular identification faster and made possible important advances in phylogenetic studies, with ITS1-5.8s-ITS2 sequences being the most used. However, these markers are not enough to elucidate all the phylogenetic relationships and taxonomic of dermatophytes due to the wide variety of existing species, and new genetic markers may be needed for correct identification and phylogenetic studies, such as the PRP8 intein. Inteins are parasitic genetic elements of a protein nature present in some fungi and are associated with important highly conserved genes. The PRP8 intein is located within the PRP8 gene coding for the PRP8 protein associated with the spliciosome complex. The present study aims to characterize the PRP8 intein in dermatophyte fungi, in order to use these genetic elements as molecular markers for a correct identification of these species and elucidations of the phylogenetic relationships of the group. To accomplish this goal, 45 strains were molecularly characterized using th... (Complete abstract click electronic access below) / Mestre

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