Brucellosis is a chronic, recurring disease caused by the bacterium Brucella abortus, along with other species of the genus Brucella, and is one of the most common bacterial zoonosis worldwide. The bacteria preferentially infect and reside within host macrophages, causing an undulant fever, joint pain, and other flu-like symptoms, in addition to more severe problems like hepatosplenomegaly and endocarditis. Brucella infection is most often acquired via inhalation through the respiratory route, or via consumption of unpasteurized dairy products. Although ingestion is a major route of infection, the transcriptional response of B. abortus during oral infection remains poorly characterized. In this project, RNA sequencing was used to discover genes with the greatest transcriptional changes in B. abortus subjected to deoxycholate, a host bile acid encountered by bacteria during oral infection. Gene deletion strains of B. abortus were then created and tested for susceptibility to pH and bile acid stress, along with their ability to invade and replicate within macrophages. If the genes of interest are important for the oral infection process, B. abortus strains lacking these genes will likely be more susceptible to pH and deoxycholate stress and may exhibit attenuation in the macrophage infection model. Determination of genes important for the oral infection process would further elucidate the molecular mechanisms by which B. abortus invades the host, and could help lead to future treatments and novel therapeutics. / Master of Science / Brucellosis, caused by the bacterium Brucella abortus, is a zoonotic disease, meaning that humans can acquire the illness from animals. Once infected, sufferers of brucellosis experience a chronic, recurring fever that repeatedly rises and falls. Additionally, the disease can cause enlargement of the spleen and liver, and can sometimes cause inflammation of the valves within the heart. Although B. abortus can infect a host through many routes of entry (inhalation, accidental injection, etc), patients are often infected through the consumption of contaminated, unpasteurized dairy products. The genes utilized by B. abortus during oral infection have not been well characterized, so it is not well known what mechanisms B. abortus uses to survive the pH and bile acid stresses it faces in the host stomach and intestines. This research examines which genes are increasingly or decreasingly utilized by B. abortus when it is subjected to deoxycholate—a bile acid stress used to simulate the host small intestine. Genes that exhibited the largest change in expression upon deoxycholate exposure were then chosen for further study: new strains of B. abortus lacking these genes of interest were created to determine if the gene deletion decreased the bacteria's ability to survive acid and deoxycholate stress, along with its ability to infect host macrophages, a type of white blood cell. If deletion of these genes weakens the ability of B. abortus to survive and infect, then these genes likely have a role during the oral infection process. By further elucidating which genes are used by B. abortus to survive host defenses and infect via the oral route, one could then create new medicines that are more effective at inhibiting the mechanisms needed by B. abortus for successful infection and persistence within the host.

Abstract Radiographic oral and maxillofacial findings were recorded in a cohort of 293 home living elderly, in Helsinki, Finland, derived from a random sample of 8035 subjects, , born in 1904, 1909, and 1912, who participated in the Helsinki Ageing Study. They were 76, 81, and 86 years old at the commencement of the radiographic study. The relationships of potentially infectious findings with increased all-cause mortality over four years were studied. During the four-year follow-up, 18.5% of the subjects died. Of the 124 edentulous subjects, 17% had condylar findings, 13% radiopaque intraosseous findings, 9% retained roots, 6% maxillary sinus findings, 4% impacted teeth and 3% radiolucent findings. Edentulous women had more arthrotic condylar findings than men. The mean number of teeth in the 169 dentate subjects was 13.9, 15.5 in men and 13.2 in women. Carious teeth were found in 75%, radiolucent findings in 41%, teeth with vertical infrabony pockets in 51%, furcation lesions in 28%, calculus in 40%, and condylar findings in 25%. Periodontal attachment loss was slight in 18%, moderate in 31%, and advanced in 46%. 21% of the teeth had been endodontically treated. Periapical lesions were found in 17% of these teeth, and in 4% of the other teeth. 75% of the rootfillings were inadequate, exhibiting periapical lesions twice as often as the adequate ones. Men had more carious teeth, periapical lesions and furcation lesions than women, indicating better oral hygiene and/or utilisation of dental services in women. Compared with the previous studies carried out in Finland, slightly more teeth and less tooth-associated pathology were found in the present subjects. In contemporary Scandinavian studies, only a slightly better oral health status in the elderly has been reported. During the four-year follow-up, mortality was higher in the subjects with moderate to advanced infrabony pockets, OR 2.2, 1.0-4.7. In the previous studies, similar associations have been found in larger study cohorts including younger subjects. Our results indicate that oral foci may be more dangerous for the elderly than it has been previously thought, as the subjects who died had poorer dental health than those who survived.

A transmissão oral ganhou destaque devido aos recentes surtos que ocorreram no Brasil com a ingestão de alimentos contaminados, além dessa via outra de grande importância é a transmissão transplacentária, sendo assim o presente trabalho associou as duas formas de transmissão da doença, juntamente com o tratamento com o benzonidazol único medicamento disponível no Brasil para o tratamento da doença. O medicamente é adotado somente para o tratamento da fase aguda, porém alguns pesquisadores mostraram alguns benefícios da terapia com benzonidazol na fase crônica da doença podendo o medicamento diminuir o avanço da doença e prolongar a soro conversão negativa em pacientes intermediários. Assim o objetivo deste trabalho foi de investigar a eficácia do tratamento tanto na fase aguda quanto na fase crônica da doença, bem como o efeito do tratamento em fêmeas de fase crônica. Utilizou-se camundongos Balb/c infectados com 2 x 105 formas tripomastigotas sanguíneos da cepa RC de T. cruzi administrado via oral. Os animais de fase aguda tratados receberam 50mg/Kg/dia de benzonidazol por 16 dias enquanto que aos animais de fase crônica o tratamento se iniciou ao 3º dia de gestação sendo administrado pelo mesmo período. O curso da parasitemia sanguínea foi verificada bem como ao fim do tratamento a parasitemia tecidual em baço, fígado e coração; placenta e feto, quando havia, empregando-se as técnicas de qPCR, com dois distintos métodos de cálculos matemáticos, imunofluorescência em microscopia confocal e análise histopatológica por coloração HE. A administração de benzonidazol proporcionou a diminuição das cargas parasitárias de baço, fígado e coração elucidando a eficácia do medicamento também em fase crônica. Porém em placenta e feto o medicamento gerou aumento de parasitas teciduais nos grupos que receberam tratamento em detrimento aos que não receberam. Deste modo, podemos sugerir que o tratamento com benzonidazol pode ser indicado para minimizar a carga de parasitas ou até mesmo para sua completa erradicação em indivíduos em fase crônica. Bem como, sugerimos que o medicamento deve ser ofertado por maior tempo aos indivíduos chagásicos tanto na fase aguda quanto na fase crônica visto que apresenta melhores resultados com o prolongamento da terapia. Entrementes dissuadimos o tratamento durante o período gestacional visto que, pode induzir a diminuição das barreiras imunológicas maternas e/ou facilitar a migração parasitária para os tecidos placentários e fetais. / Chagas\' disease affect millions of people around the world and the benznidazole is the only drug for the treatment in Brazil, but it is used basically for the acute phase of the disease. Some researchers showed many benefits of benznidazole therapy in chronic phase like reduction of the progression of the disease. Therefore, the objective of this work was investigate the efficacy of treatment in both acute and chronic phase of this disease, as well as the effect of treatment of female mouse in chronic phase. Balb/c mice were infected with 2 x 105 trypomastigotes forms of RC strain of Trypanosoma cruzi by oral route. Mice in acute phase were treated with 50mg/Kg/day Benznidazole for 16 days. Some chronically-infected mice were treated by 3rd to 18th day of gestation with the same dose. Blood parasitaemias were determined by microscopic examination of tail vein blood amount. Tissues parasitism were determined by qPCR with two different mathematical forms, immunofluorescence confocal microscopy and histopathology by HE staining. Administration of benznidazole promoted decrease of parasites in spleen, liver and heart indicating the efficacy of the drug in the chronic phase. However in placenta and fetus the drug caused tissues parasites increased in the groups that received treatment. Therefore, we suggest that the treatment with benznidazole would be indicated to minimize the number of parasites or eliminate them in individuals in chronic phase. As well, we suggest that the drug should be offered for longer chagasic individuals to both acute and chronic phase because it shows better results with prolonged therapy. However, our results indicate the treatment do not be offered during pregnancy because it can induce the decrease of maternal immunological barriers and facilitate the parasite migration to the placental and fetal tissues.

Os surtos de doença de Chagas aguda estão relacionados ao consumo de comidas e bebidas contaminadas por fezes de triatomíneos contendo tripomastigotas de T. cruzi, tornando assim a infecção oral uma importante via de transmissão. Ambas as infecções vetoriais e orais desencadeiam importantes manifestações cardíacas nos hospedeiros e que estão relacionadas a uma desregulada resposta imune. O objetivo deste estudo foi avaliar a parasitemia sanguínea durante a fase aguda da infecção, a produção de macrófagos peritoneais, alterações nas sub-populações de linfócitos CD4+/CD8+, citocinas Th1 e Th2, concentração de nitrito e a histopatologia cardíaca. Um grupo de ratos Wistar foi intraperitonealmente infectados com 1X105 com cepa Y de tripomastigotas sanguíneos de T. cruzi e outro grupo de ratos Wistar foi infectado oralmente com 8X105 de tripomastigotas metacíclicos da mesma cepa. A infecção intraperitoneal desencadeou um aumento estatístico no aumento do número de parasitas, macrófagos peritoneais, proliferação de células T CD4+ e CD8+, aumento na concentração de NO, IL-12 e elevado foco inflamatório cardíaco quando comparado à infecção oral. Entretanto nossos resultados demonstraram que a infecção oral pode levar a uma doença sistêmica e que as diferentes vias de inoculação promovem respostas imunes distintas. / Acute Chagas disease outbreaks are related to the consumption of food or drink contaminated by triatomine feces containing trypomastigotes of T. cruzi, thus making oral infection an important route of transmission. Both vectorial and oral infections trigger important cardiac manifestations in the host that are related to a dysregulated immune response. The aims of this work were to evaluate the number of blood trypomastigotes during the acute phase of infection, peritoneal macrophages, possible alterations of lymphocyte CD4+/CD8+ sub-populations, Th1 and Th2 cytokines, nitrite concentrations and cardiac histopathology. One group of male Wistar rats was intraperitoneally infected with 1X105 blood trypomastigotes of the T. cruzi Y strain, and another group of Wistar rats was orally infected with 8X105 metacyclic trypomastigotes of the same strain. The intraperitoneal infection triggered statistically enhanced parasite numbers, peritoneal macrophage numbers, proliferation of CD4+ and CD8+ T cells, increased concentrations of NO and IL-12 and elevated cardiac inflammatory foci when compared to the oral infection. Therefore, our results demonstrate that oral infection can lead to systemic disease and that the different inoculation routes promoted distinct immune responses.

Os surtos de doença de Chagas aguda estão relacionados ao consumo de comidas e bebidas contaminadas por fezes de triatomíneos contendo tripomastigotas de T. cruzi, tornando assim a infecção oral uma importante via de transmissão. Ambas as infecções vetoriais e orais desencadeiam importantes manifestações cardíacas nos hospedeiros e que estão relacionadas a uma desregulada resposta imune. O objetivo deste estudo foi avaliar a parasitemia sanguínea durante a fase aguda da infecção, a produção de macrófagos peritoneais, alterações nas sub-populações de linfócitos CD4+/CD8+, citocinas Th1 e Th2, concentração de nitrito e a histopatologia cardíaca. Um grupo de ratos Wistar foi intraperitonealmente infectados com 1X105 com cepa Y de tripomastigotas sanguíneos de T. cruzi e outro grupo de ratos Wistar foi infectado oralmente com 8X105 de tripomastigotas metacíclicos da mesma cepa. A infecção intraperitoneal desencadeou um aumento estatístico no aumento do número de parasitas, macrófagos peritoneais, proliferação de células T CD4+ e CD8+, aumento na concentração de NO, IL-12 e elevado foco inflamatório cardíaco quando comparado à infecção oral. Entretanto nossos resultados demonstraram que a infecção oral pode levar a uma doença sistêmica e que as diferentes vias de inoculação promovem respostas imunes distintas. / Acute Chagas disease outbreaks are related to the consumption of food or drink contaminated by triatomine feces containing trypomastigotes of T. cruzi, thus making oral infection an important route of transmission. Both vectorial and oral infections trigger important cardiac manifestations in the host that are related to a dysregulated immune response. The aims of this work were to evaluate the number of blood trypomastigotes during the acute phase of infection, peritoneal macrophages, possible alterations of lymphocyte CD4+/CD8+ sub-populations, Th1 and Th2 cytokines, nitrite concentrations and cardiac histopathology. One group of male Wistar rats was intraperitoneally infected with 1X105 blood trypomastigotes of the T. cruzi Y strain, and another group of Wistar rats was orally infected with 8X105 metacyclic trypomastigotes of the same strain. The intraperitoneal infection triggered statistically enhanced parasite numbers, peritoneal macrophage numbers, proliferation of CD4+ and CD8+ T cells, increased concentrations of NO and IL-12 and elevated cardiac inflammatory foci when compared to the oral infection. Therefore, our results demonstrate that oral infection can lead to systemic disease and that the different inoculation routes promoted distinct immune responses.

A transmissão oral ganhou destaque devido aos recentes surtos que ocorreram no Brasil com a ingestão de alimentos contaminados, além dessa via outra de grande importância é a transmissão transplacentária, sendo assim o presente trabalho associou as duas formas de transmissão da doença, juntamente com o tratamento com o benzonidazol único medicamento disponível no Brasil para o tratamento da doença. O medicamente é adotado somente para o tratamento da fase aguda, porém alguns pesquisadores mostraram alguns benefícios da terapia com benzonidazol na fase crônica da doença podendo o medicamento diminuir o avanço da doença e prolongar a soro conversão negativa em pacientes intermediários. Assim o objetivo deste trabalho foi de investigar a eficácia do tratamento tanto na fase aguda quanto na fase crônica da doença, bem como o efeito do tratamento em fêmeas de fase crônica. Utilizou-se camundongos Balb/c infectados com 2 x 105 formas tripomastigotas sanguíneos da cepa RC de T. cruzi administrado via oral. Os animais de fase aguda tratados receberam 50mg/Kg/dia de benzonidazol por 16 dias enquanto que aos animais de fase crônica o tratamento se iniciou ao 3º dia de gestação sendo administrado pelo mesmo período. O curso da parasitemia sanguínea foi verificada bem como ao fim do tratamento a parasitemia tecidual em baço, fígado e coração; placenta e feto, quando havia, empregando-se as técnicas de qPCR, com dois distintos métodos de cálculos matemáticos, imunofluorescência em microscopia confocal e análise histopatológica por coloração HE. A administração de benzonidazol proporcionou a diminuição das cargas parasitárias de baço, fígado e coração elucidando a eficácia do medicamento também em fase crônica. Porém em placenta e feto o medicamento gerou aumento de parasitas teciduais nos grupos que receberam tratamento em detrimento aos que não receberam. Deste modo, podemos sugerir que o tratamento com benzonidazol pode ser indicado para minimizar a carga de parasitas ou até mesmo para sua completa erradicação em indivíduos em fase crônica. Bem como, sugerimos que o medicamento deve ser ofertado por maior tempo aos indivíduos chagásicos tanto na fase aguda quanto na fase crônica visto que apresenta melhores resultados com o prolongamento da terapia. Entrementes dissuadimos o tratamento durante o período gestacional visto que, pode induzir a diminuição das barreiras imunológicas maternas e/ou facilitar a migração parasitária para os tecidos placentários e fetais. / Chagas\' disease affect millions of people around the world and the benznidazole is the only drug for the treatment in Brazil, but it is used basically for the acute phase of the disease. Some researchers showed many benefits of benznidazole therapy in chronic phase like reduction of the progression of the disease. Therefore, the objective of this work was investigate the efficacy of treatment in both acute and chronic phase of this disease, as well as the effect of treatment of female mouse in chronic phase. Balb/c mice were infected with 2 x 105 trypomastigotes forms of RC strain of Trypanosoma cruzi by oral route. Mice in acute phase were treated with 50mg/Kg/day Benznidazole for 16 days. Some chronically-infected mice were treated by 3rd to 18th day of gestation with the same dose. Blood parasitaemias were determined by microscopic examination of tail vein blood amount. Tissues parasitism were determined by qPCR with two different mathematical forms, immunofluorescence confocal microscopy and histopathology by HE staining. Administration of benznidazole promoted decrease of parasites in spleen, liver and heart indicating the efficacy of the drug in the chronic phase. However in placenta and fetus the drug caused tissues parasites increased in the groups that received treatment. Therefore, we suggest that the treatment with benznidazole would be indicated to minimize the number of parasites or eliminate them in individuals in chronic phase. As well, we suggest that the drug should be offered for longer chagasic individuals to both acute and chronic phase because it shows better results with prolonged therapy. However, our results indicate the treatment do not be offered during pregnancy because it can induce the decrease of maternal immunological barriers and facilitate the parasite migration to the placental and fetal tissues.

Toxoplasma gondii é um protozoário intracelular obrigatório que causa a toxoplasmose. Em modelo experimental, camundongos C57BL/6 infectados por via oral com 100 cistos de T. gondii, cepa ME-49, desenvolvem sérias lesões intestinais similares as observadas em doenças inflamatórias intestinais. Ao invadir as células epiteliais intestinais, o parasito induz uma resposta inflamatória de padrão T helper (Th) 1 elevada, ativada pela produção de quimiocinas e citocinas envolvidas na migração e ativação celular. Para que ocorra essa migração celular para o sítio de infecção é necessário a presença de receptores de quimiocinas. O receptor de quimiocinas CCR5 é muito importante para o recrutamento celular em algumas infecções e está envolvido com a migração de vários subtipos celulares como células dendríticas, células T e, em particular, células T reguladoras. CCR5 pode estar relacionado também a mecanismos independentes da migração celular, no qual a sinalização intracelular e ativação de NF-B podem levar a intensificação da resposta imunológica. Ainda não está claro o papel do receptor CCR5 no modelo de infecção oral por T. gondii. Dessa forma, animais C57BL/6 e deficientes em CCR5 foram infectados por via oral com 5 cistos de T. gondii, cepa ME-49, e alguns parâmetros imunológicos e bioquímicos foram avaliados no 8º dia de infecção. Os resultados mostraram que animais CCR5-/- apresentaram alta suscetibilidade à infecção oral por T. gondii, exibindo um intenso infiltrado inflamatório no íleo e regiões de ulceração epitelial, quando comparados com animais C57BL/6. Independentemente de serem deficientes ou não de CCR5, os camundongos apresentaram focos inflamatórios dispersos pelo parênquima do fígado, entretanto camundongos CCR5-/- apresentaram uma extensiva vacuolização dos hepatócitos, com excessivo acúmulo de lipídeos no órgão e elevada concentração sérica de triglicérides e de transaminases. A carga parasitária foi significativamente mais elevada no intestino delgado e no fígado dos animais CCR5-/- em comparação com animais C57BL/6. Foi observada também uma menor migração de células NK no intestino delgado, bem como um aumento na frequência de células T CD4+ neste órgão e uma menor concentração de IFN- e IL-12p40 no macerado do fígado dos animais CCR5-/- em comparação com C57BL/6. Análise de expressão gênica no fígado revelou redução na formação de transcritos para PPAR nos animais deficientes em CCR5, e quando os camundongos foram tratados com Gemfibrozil, um agonista de PPAR, houve reversão na vacuolização hepática e na concentração de triglicérides no soro dos animais CCR5-/-. Estes dados sugerem que a migração celular dependente de CCR5 é essencial para a modulação da resposta inflamatória induzida por T. gondii no intestino delgado. Além do mais, a ausência de CCR5 compromete a integridade hepática durante a infecção oral por T. gondii e os mecanismos moleculares envolvidos podem estar relacionados à expressão de PPAR. / T. gondii is an obligate intracellular protozoan parasite which is the causative agent of toxoplasmosis. In experimental model, C57BL/6 mice orally infected with a high parasitic load develop serious intestinal lesions, whose injuries are similar to those observed in Inflammatory Bowel Disease. This inflammation is caused due to parasite invasion of intestinal epithelial cells that elicit a robust Th1 type immune response. Moreover, chemokines produced by intestinal epithelial cells are involved in the migration and activation of inflammatory cells. In particular, the chemokine receptor CCR5 is important for cell recruitment in some infections and is involved with the migration of various cells subsets such as dendritic cells, T cells and, in particular regulatory T cells. CCR5 may also be related to mechanisms independent of cell migration, in which the intracellular signaling and activation of NF-B may lead to intensification of the immune response. The role of CCR5 has not been clear in the experimental oral T. gondii infection. Thus, wild type C57BL/6 mice and CCR5-/- littermates were infected with T. gondii by gavage and immune and biochemical parameters, were analyzed at day 8 after infection. The CCR5-/- mice showed to be highly susceptible to the parasite, with intense inflammatory infiltration in the ilea and regions of epithelial ulcerations in comparison with WT mice. Both strain of mice presented inflammatory foci scattered by parenchyma of the liver, however the CCR5-/- mice presented an extensive hepatocyte vacuolization with an excessive accumulation of lipids in the organ and elevated serum triglycerides and transaminases concentration. The parasite load was significantly higher on small intestine and liver samples of CCR5-/- in comparison with WT mice. There was also a minor migration of NK cells in the small intestine, as well as greater frequency of CD4+ T cells in this organ and a lower IFN- and IL-12p40 levels in liver homogenate samples in the CCR5-/- mice compared with WT mice. Gene expression analysis revealed a reduction in the formation of transcripts for PPAR in mice deficient in CCR5, and when the animals were treated with Gemfibrozil, a PPAR agonist, there was an improvement in the level of vacuolization and reduced triglycerides. These data suggest that a CCR5-dependent cell migration is essential for the modulation of T. gondii-induced inflammatory response in the small intestine. In addition, hepatic integrity during T. gondii oral infection is compromised in the absence of CCR5, and the molecular mechanisms involved can be related to PPAR expression.

Toxoplasma gondii é um protozoário intracelular obrigatório que causa a toxoplasmose. Em modelo experimental, camundongos C57BL/6 infectados por via oral com 100 cistos de T. gondii, cepa ME-49, desenvolvem sérias lesões intestinais similares as observadas em doenças inflamatórias intestinais. Ao invadir as células epiteliais intestinais, o parasito induz uma resposta inflamatória de padrão T helper (Th) 1 elevada, ativada pela produção de quimiocinas e citocinas envolvidas na migração e ativação celular. Para que ocorra essa migração celular para o sítio de infecção é necessário a presença de receptores de quimiocinas. O receptor de quimiocinas CCR5 é muito importante para o recrutamento celular em algumas infecções e está envolvido com a migração de vários subtipos celulares como células dendríticas, células T e, em particular, células T reguladoras. CCR5 pode estar relacionado também a mecanismos independentes da migração celular, no qual a sinalização intracelular e ativação de NF-B podem levar a intensificação da resposta imunológica. Ainda não está claro o papel do receptor CCR5 no modelo de infecção oral por T. gondii. Dessa forma, animais C57BL/6 e deficientes em CCR5 foram infectados por via oral com 5 cistos de T. gondii, cepa ME-49, e alguns parâmetros imunológicos e bioquímicos foram avaliados no 8º dia de infecção. Os resultados mostraram que animais CCR5-/- apresentaram alta suscetibilidade à infecção oral por T. gondii, exibindo um intenso infiltrado inflamatório no íleo e regiões de ulceração epitelial, quando comparados com animais C57BL/6. Independentemente de serem deficientes ou não de CCR5, os camundongos apresentaram focos inflamatórios dispersos pelo parênquima do fígado, entretanto camundongos CCR5-/- apresentaram uma extensiva vacuolização dos hepatócitos, com excessivo acúmulo de lipídeos no órgão e elevada concentração sérica de triglicérides e de transaminases. A carga parasitária foi significativamente mais elevada no intestino delgado e no fígado dos animais CCR5-/- em comparação com animais C57BL/6. Foi observada também uma menor migração de células NK no intestino delgado, bem como um aumento na frequência de células T CD4+ neste órgão e uma menor concentração de IFN- e IL-12p40 no macerado do fígado dos animais CCR5-/- em comparação com C57BL/6. Análise de expressão gênica no fígado revelou redução na formação de transcritos para PPAR nos animais deficientes em CCR5, e quando os camundongos foram tratados com Gemfibrozil, um agonista de PPAR, houve reversão na vacuolização hepática e na concentração de triglicérides no soro dos animais CCR5-/-. Estes dados sugerem que a migração celular dependente de CCR5 é essencial para a modulação da resposta inflamatória induzida por T. gondii no intestino delgado. Além do mais, a ausência de CCR5 compromete a integridade hepática durante a infecção oral por T. gondii e os mecanismos moleculares envolvidos podem estar relacionados à expressão de PPAR. / T. gondii is an obligate intracellular protozoan parasite which is the causative agent of toxoplasmosis. In experimental model, C57BL/6 mice orally infected with a high parasitic load develop serious intestinal lesions, whose injuries are similar to those observed in Inflammatory Bowel Disease. This inflammation is caused due to parasite invasion of intestinal epithelial cells that elicit a robust Th1 type immune response. Moreover, chemokines produced by intestinal epithelial cells are involved in the migration and activation of inflammatory cells. In particular, the chemokine receptor CCR5 is important for cell recruitment in some infections and is involved with the migration of various cells subsets such as dendritic cells, T cells and, in particular regulatory T cells. CCR5 may also be related to mechanisms independent of cell migration, in which the intracellular signaling and activation of NF-B may lead to intensification of the immune response. The role of CCR5 has not been clear in the experimental oral T. gondii infection. Thus, wild type C57BL/6 mice and CCR5-/- littermates were infected with T. gondii by gavage and immune and biochemical parameters, were analyzed at day 8 after infection. The CCR5-/- mice showed to be highly susceptible to the parasite, with intense inflammatory infiltration in the ilea and regions of epithelial ulcerations in comparison with WT mice. Both strain of mice presented inflammatory foci scattered by parenchyma of the liver, however the CCR5-/- mice presented an extensive hepatocyte vacuolization with an excessive accumulation of lipids in the organ and elevated serum triglycerides and transaminases concentration. The parasite load was significantly higher on small intestine and liver samples of CCR5-/- in comparison with WT mice. There was also a minor migration of NK cells in the small intestine, as well as greater frequency of CD4+ T cells in this organ and a lower IFN- and IL-12p40 levels in liver homogenate samples in the CCR5-/- mice compared with WT mice. Gene expression analysis revealed a reduction in the formation of transcripts for PPAR in mice deficient in CCR5, and when the animals were treated with Gemfibrozil, a PPAR agonist, there was an improvement in the level of vacuolization and reduced triglycerides. These data suggest that a CCR5-dependent cell migration is essential for the modulation of T. gondii-induced inflammatory response in the small intestine. In addition, hepatic integrity during T. gondii oral infection is compromised in the absence of CCR5, and the molecular mechanisms involved can be related to PPAR expression.

Doentes que apresentam comprometimento cognitivo, como a doença de Alzheimer (DA), podem apresentar maior prevalência de infecções bucais. Entre elas, a periodontite crônica é uma infecção frequente associada ao aumento do nível sérico de marcadores inflamatórios, e recentemente tem sido apontada como um fator que pode relacionar-se à progressão da DA através de seus mecanismos sistêmicos. O objetivo deste trabalho foi verificar a prevalência de infecções bucais e os níveis séricos de IL-1beta, TNF- alfa e IL-6 em doentes com DA, comprometimento cognitivo leve (CCL) e idosos não-demenciados. Foram avaliados 65 idosos (25 com DA, 19 com CCL e 21 saudáveis). A avaliação incluiu o Mini Exame do Estado Mental, Questionário de Atividades Funcionais (Pfeffer), Avaliação Periodontal, índice CPOD, Questionário de Avaliação Clínica Orofacial (EDOF-HC) e avaliação de concentração sérica de IL-1beta, TNF-alfa e IL-6. Os doentes com DA e CCL apresentaram maior quantidade de dentes ausentes e por um período maior de tempo do que os idosos saudáveis (P= 0.038) e a doença periodontal (DP) foi a causa principal das perdas dentárias (P= 0.035). Os doentes apresentaram maior prevalência de candidose do que os controles (P= 0.05). As análises de correlação demonstraram que quanto maior a concentração de IL-6, pior a funcionalidade pelo índice de Pfeffer (P < 0,001; Pearson) e pior o índice cognitivo (P=0,018; Pearson). Por outro lado, quanto maior a concentração de TNF-alfa, piores os índices IS, PCS média e máxima e PCI média e máxima (P < 0,001; Pearson), maior o tempo de uso de próteses (P=0,010; Pearson) e pior o índice de placa O´Leary (P=0,008; Pearson). IL-6 e TNF-alfa se correlacionaram positivamente (P < 0,001; Pearson). Conclui-se que há um aumento sérico de citocinas associado ao comprometimento cognitivo e à doença periodontal. Estudos futuros poderão esclarecer os mecanismos que determinam aumento de IL-6 nas demências e aumento de TNF-alfa nas infecções periodontais e elucidar possíveis associações entre eles / Patients that present cognitive impairment, as Alzheimer´s Disease (AD), may have high prevalence of oral infections. Among them, chronic periodontitis is often associated to the increase of seric inflammatory biomarkers, and it recently has been referred as a factor than can change the progression of AD by its systemic mechanisms. The objective of this study was to investigate the prevalence of oral infections and seric levels of IL-1alfa, TNF-alfa and IL-6 in patients with AD, mild cognitive impairment (MCI) and non demented elderly. Sixty-five elderly were evaluated (21 with AD, 8 with MCI and 15 healthy). The evaluation included the Mini Mental State Exam, Questionnaire of Functional Activities (Pfeffer), periodontal evaluation, DMFT, Clinical Orofacial Questionnaire (EDOF-HC) and seric concentrations of IL-1beta, TNF-alfa and IL-6. The patients with AD and MCI had more absent teeth and for a longer period of time than the healthy elderly (P= 0.038) and periodontal disease (PD) was the main cause of teeth losses (P= 0.035). The patients had higher prevalence of candidiasis than the controls (P= 0.05). The serum level of IL-6 was higher in the patients that showed bad performance in the MMSE (P=0.018; Pearson) and daily life activities - Pfeffer (P < 0.001; Pearson). The TNF-alfa serum level was more elevated when patients had PPD, CAL, BI (P < 0.001; Pearson) and O\'Leary plaque index (P=0.008; Pearson). IL-6 e TNF-alfa were positively correlated (P < 0.001; Pearson). In conclusion, there is a seric increase of cytokines associated with the cognitive impairment and periodontal disease. Future studies are necessary to clarify the mechanisms that underlie the increase of IL-6 in dementias and the increase of TNF-alfa in periodontal infections and possible associations between them

Les Papillomavirus Humains (HPV) sont responsables de près de 100% des cancers du col utérin. Récemment, ces HPV sont apparus comme étant aussi la cause de certaines tumeurs des voies aérodigestives supérieures, et particulièrement des carcinomes épidermoïdes de l’oropharynx. En France, la proportion des tumeurs oropharyngées HPV-induites est mal connue, notamment parce que le dépistage viral n’est pas recommandé. De plus, il est difficile d’évaluer la proportion de tumeurs HPV positives dans les tumorothèques car les échantillons tumoraux sont fixés dans du formol puis inclus en paraffine (FFIP), ce qui complexifie les techniques de détection. Nous avons, au cours de nos travaux, testé une méthode de détection des HPV à haut risque oncogène indiquée pour le traitement des frottis en phase liquide. Nous l’avons mise à l’épreuve sur des prélèvements FFIP et comparée à la technique de référence qu’est la PCR (Polymerase Chain Reaction) suivie d’une électrophorèse sur gel. Nos résultats indiquent que cette technique est applicable aux prélèvements tissulaires et apparaît même comme étant plus sensible. En France, deux tiers des patients atteints de tumeurs des VADS sont pris en charge à des stades tardifs. Ceci s’explique en partie par l’absence de dépistage organisé de ces cancers. Nous avons donc mené une étude prospective sur des patients atteints d’une tumeur des VADS afin de tester le frottis oral comme technique de dépistage des cancers mais également des infections par les HPV. Nos résultats indiquent que le frottis a une spécificité proche de celle de la biopsie (94,4%) pour le dépistage des cancers des VADS, mais une moindre sensibilité (66,7%). Cette étude nous a permis de mettre en évidence une tumeur HPV-induite dans 12,2% des cas. Parmi eux, nous avons détecté grâce à un frottis buccal (en zone saine) une infection par un HPV à haut risque oncogène dans 53,3% des cas. L’OMS a classé les HPV comme agents carcinogènes depuis 1995, et a établi que les patientes ayant développé un cancer du col utérin avaient un risque 6 fois plus élevé de développer une autre tumeur HPV-induite. Dans ce contexte, nous avons prévu une étude prospective multi-centrique visant à dépister une infection orale par un HPV oncogène chez des patientes porteuses d’une lésion pré-néoplasique ou néoplasique du col utérin. Le taux de co-infection des deux sites anatomiques est inconnu chez les femmes infectées au niveau génital. Dans la mesure où l’infection orale pourrait être à l’origine d’une seconde localisation tumorale, il semble important d’en connaître la proportion afin de proposer par la suite un suivi particulier aux populations « à risque ». Au-delà des traitements des cancers avérés se pose la question de la vaccination préventive, qui existe contre les HPV 16 et 18 dans la prévention des cancers du col utérin. Le type 16 étant retrouvé dans 90% des tumeurs épidermoïdes de l’oropharynx HPV-induites, l’extension des recommandations vaccinales apparaît comme une nouvelle question de santé publique / The Human Papillomavirus (HPV) are involved in almost 100% of cervical cancers. Recently, HPVs have been recognized as the cause of tumors of the upper aerodigestive tract, especially of squamous cell carcinoma of the oropharynx. In France, the proportion of oropharyngeal HPV-related tumors is unknown, partly because viral testing is not in guidelines. Moreover, assess the proportion of HPV-positive tumors in tumor banks is difficult because the tumor samples were fixed in formalin and embedded in paraffin (FFPE), which complicates detection techniques. We tested a high risk HPV detection method, indicated for liquid based pap smear, on FFPE samples. We compared this technique to the gold-standard : PCR (Polymerase Chain Reaction) followed by electrophoresis. Our results indicate that this technique is applicable to FFPE samples and even appears to be more sensitive. The majority of French patients (2/3) with head and neck consult with an advanced stage of disease. This is explained in part by the lack of organized screening of these cancers, contrary to breast, prostate, cervical, or colorectal cancers. But an early treatment is essential to increase the survival rate. We therefore conducted a prospective study on patients with head and neck tumors to test the oral brushing as screening cancer and HPV detection. We found tumor and/or dystrophic cells in 97.8% of patients with biopsy, and in 88.9% of patients by brushing. Compared with biopsy, our results suggested that smear has similar specificity for HPV detection in tumors (94.4%), but lower sensitivity (66.7%). This study has shown an HPV-related tumor in 12.2% of cases. Among them, we detected by brushing (in healthy area) an oral infection by high-risk HPV in 53.3% of cases. WHO has classified HPV as carcinogenic agents since 1995, and determined that patients who developed cervical cancer are six-times more likely to develop another HPV-related tumor. In this context, we have planned a multicenter prospective study to detect oral HPV infection in patients with a pre-neoplastic or neoplastic lesion of the cervix. Co-infection rate of the two anatomical sites is unknown in women infected with genital level. Insofar oral infection could be the cause of a second tumor location, it seems important to know how much women are co-infected to propose thereafter a special monitoring. The preventive vaccination, which exists against HPV 16 and 18 in the prevention of cervical cancer, is a future perspective. Because HPV 16 is found in 90% of HPV-related squamous cell carcinoma of the oropharynx, extending vaccine recommendations emerge as a new public health issue