REGINA MAIA DE SOUZA
Projetos de Pesquisa
Unidades Organizacionais
LIM/46 - Laboratório de Parasitologia Médica, Hospital das Clínicas, Faculdade de Medicina
18 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 18
- Comparative study on liposomal amphotericin B and other therapies in the treatment of mucosal leishmaniasis: A 15-year retrospective cohort study(2019) SANTOS, Carolina Rocio; TUON, Felipe Francisco; CIESLINSKI, Juliette; SOUZA, Regina Maia de; IMAMURA, Rui; AMATO, Valdir SabbagaBackground Liposomal amphotericin B (L-AMB) has been used for mucosal leishmaniasis (ML), but comparative studies on L-AMB and other drugs used for the treatment of ML have not been conducted. The present study aimed to evaluate the outcome of patients with ML who were treated with L-AMB. Methods This is a 15-year retrospective study of Brazilian patients with a confirmed diagnosis of ML. The therapeutic options for the treatment of ML consisted of L-AMB, amphotericin B lipid complex (ABLC), deoxycholate amphotericin B (d-AMB), itraconazole, antimonial pentavalent, or pentamidine. Healing, cure rate and adverse effects (AEs) associated with the drugs used to treat this condition were analyzed. Results In 71 patients, a total of 105 treatments were evaluated. The outcome of the treatment with each drug was compared, and results showed that L-AMB was superior to other therapeutic regimens (P = 0.001; odds ratio [OR] = 4.84; 95% confidence interval [CI] = 1.78-13.17). d-AMB had worse AEs than other treatment regimens (P = 0.001, OR = 0.09; 95% CI = 0.09-0.43). Approximately 66% of the patients presented with AEs during ML treatment. Although L-AMB was less nephrotoxic than d-AMB, it was associated with acute kidney injury compared with other drugs (P <0.05). Conclusion L-AMB was more effective than other therapies for the treatment of ML. However, a high incidence of toxicity was associated with its use. Therapeutic choices should be reassessed, and the development of new drugs is necessary for the treatment of ML.
- Liposomal drug delivery systems for the treatment of leishmaniasis(2022) TUON, Felipe Francisco; DANTAS, Leticia Ramos; SOUZA, Regina Maia de; RIBEIRO, Victoria Stadler Tasca; AMATO, Valdir SabbagaHuman leishmaniasis is a vector-borne, neglected infectious disease that is widely distributed in America, Africa, Europe, and Asia. Current therapy is based on old and toxic drugs, including antimonials, aminoglycosides, and amphotericin. As a neglected disease, investment in the development of new therapeutic molecules is scarce. Considering these aspects, the optimization of treatment through novel delivery systems for current therapeutic agents is an attractive alternative. The encapsulation into liposomes of drugs used in treating leishmaniasis increases the concentration of these molecules in macrophages, which may not only increase the chance of cure but also expand their therapeutic spectrum to include resistant Leishmania, as well as reducing toxicity since the drug is less exposed to healthy cells. The classical example is the liposomal formulation of amphotericin B, a well-established therapeutic option that uses liposomes to decrease the progression of renal failure in patients. However, loading other leishmanicidal drugs into liposomes, such as pentavalent antimonials, presents an opportunity for innovative and cheaper therapeutic options for the treatment of human leishmaniasis. This review aims to discuss liposomes as a drug delivery system for leishmanicidal drugs.
- DISCREPANCIES AND CONSEQUENCES OF INDIRECT HEMAGGLUTINATION, INDIRECT IMMUNOFLUORESCENCE AND ELISA TESTS FOR THE DIAGNOSIS OF CHAGAS DISEASE(2012) SOUZA, Regina Maia de; AMATO NETO, VicenteUsing the indirect hemagglutination (IH), indirect immunofluorescence (IIF) and enzyme linked immunosorbent assay (ELISA) tests for the diagnosis of Chagas disease, 4000 serum samples were examined. This study was conducted with different purposes: clinical interest, research support and parasitological monitoring of those patients with Chagas disease who were treated with heart transplantations. The tests occurred without patient selection and in accordance with the medical requests. The results showed discrepancies and brought about several questions, considering the different results that all three methods showed when considered together. What was found brought about concerns and we suggest the adoption of different measures, aiming to avoid these mismatches in the context of this disease.
- Identification of Leishmania species by next generation sequencing of hsp70 gene(2022) SOUZA, Regina Maia de; MARTINS, Roberta Cristina Ruedas; FRANCO, Lucas Augusto Moyses; TUON, Felipe Francisco; OLIVEIRA JUNIOR, Isael Gomes de; SILVA, Camila Alves Maia da; IMAMURA, Rui; AMATO, Valdir SabbagaLeishmaniasis is a major public health problem worldwide. Although next generation sequencing technology has been widely used in the diagnosis of infectious diseases, it has been scarcely applied in identification of Leishmania species. The aim of this study was to compare the efficiency of MinIONTM nanopore sequencing and polymerase chain reaction restriction fragment length polymorphism in identifying Leishmania species. Our results showed that the MinIONTM sequencer was able to discriminate reference strains and clinical samples with high sensitivity in a cost and time effective manner without the prior need for culture.
- EVALUATION OF THE "SYMBIOSYS" IMMUNOASSAY FOR THE SEROLOGICAL DIAGNOSIS OF CHAGAS DISEASE(2012) SOUZA, Regina Maia de; AMATO NETO, Vicente; BEZERRA, Rita Cristina; GAKYIA, Erika; BRAZ, Lucia Maria Almeida
- USEFULNESS OF kDNA PCR IN THE DIAGNOSIS OF VISCERAL LEISHMANIASIS REACTIVATION IN CO-INFECTED PATIENTS(2013) NICODEMO, Antonio Carlos; AMATO, Valdir Sabbaga; TUON, Felipe Francisco; SOUZA, Regina Maia de; OKAY, Thelma Suely; ALMEIDA, Lucia MariaIt is important to develop new methods for diagnosing relapses in the co-infection of visceral leishmaniasis (VL) and HIV to enable earlier detection using less invasive methods. We report a case of a co-infected patient who had relapses after VL treatment, where the qualitative kDNA PCR showed a good performance. The kDNA PCR seems to be a useful tool for diagnosing VL and may be a good marker for predicting VL relapses after treatment of co-infected patients with clinical symptoms of the disease.
- Evaluation of eleven immunochromatographic assays for SARS-CoV-2 detection: investigating the dengue cross-reaction(2022) OLIVEIRA, Beatriz Araujo; OLIVEIRA, Lea Campos de; OLIVEIRA, Franciane Mendes de; PEREIRA, Geovana Maria; SOUZA, Regina Maia de; MANULI, Erika Regina; MARCHINI, Fabricio Klerynton; ESPINOZA, Evelyn Patricia Sanchez; PARK, Marcelo; TANIGUCHI, Leandro; MENDES, Pedro Vitale; FRANCO, Lucas Augusto Moyses; NASTRI, Ana Catharina; OLIVEIRA, Maura Salaroli de; VIEIRA JUNIOR, Jose Mauro; KALLAS, Esper Georges; LEVIN, Anna Sara; SABINO, Ester Cerdeira; COSTA, Silvia FigueiredoCOVID-19 disease is spread worldwide and diagnostic techniques have been studied in order to contain the pandemic. Immunochromatographic (IC) assays are feasible and a low-cost alternative especially in low and middle-income countries, which lack structure to perform certain diagnostic techniques. Here we evaluate the sensitivity and specificity of eleven different IC tests in 145 serum samples from confirmed cases of COVID-19 using RT-PCR and 100 negative serum samples from blood donors collected in February 2019. We also evaluated the cross-reactivity with dengue using 20 serum samples from patients with confirmed diagnosis for dengue collected in early 2019 through four different tests. We found high sensitivity (92%), specificity (100%) and an almost perfect agreement (Kappa 0.92) of IC assay, especially when we evaluated IgG and IgM combined after 10 days from the onset of symptoms with RT-PCR. However, we detected cross-reactivity between dengue and COVID-19 mainly with IgM antibodies (5 to 20% of cross-reaction) and demonstrated the need for better studies about diagnostic techniques for these diseases.
- Performance of a qualitative rapid chromatographic immunoassay to diagnose COVID-19 in patients in a middle-income country(2020) COSTA, Silvia Figueiredo; BUSS, Lewis; ESPINOZA, Evelyn Patricia Sanchez; JR, Jose Mauro Vieira; SILVA, Lea Campos de Oliveira da; SOUZA, Regina Maia de; NETO, Lauro Perdigao; PORTO, Ana Paula Matos; LAZARI, Carolina; SANTOS, Vera Aparecida dos; DUARTE, Alberto da Silva; NASTRI, Ana Catharina; LEITE, Gabriel Fialkovitz da Costa; MANULI, Erika; OLIVEIRA, Maura Salaroli de; ZAMPELLI, Daniella Bosco; PASTORE JUNIOR, Laerte; SEGURADO, Aluisio Cotrim; LEVIN, Anna S.; SABINO, EsterObjectives: We evaluated a rapid chromatographic immunoassay (IgG/IgM antibodies) and an ELISA assay to diagnose COVID-19 in patient sat two Brazilian hospitals. Methods: A total of 122 subjects with COVID-19 were included: 106 SARS-COV-2 RT-PCR-positive patients and 16 RT-PCR-negative patients with symptoms and chest computed tomography (CT) consistent with COVID-19. Ninety-six historical blood donation samples were used as controls. Demographic and clinical characteristics were retrieved from electronic records. Sensitivity and specificity were calculated, as were their 95% binomial confidence intervals using the Clopper-Pearson method. All analyses were performed in R version 3.6.3. Results: The sensitivity of the chromatographic immunoassay in all RT-PCR-positive patients, irrespective of the timing of symptom onset, was 85.8% (95% binomial CI 77.7% to 91.9%). This increased with time after symptom onset, and at >14 days was 94.9% (85.9% to 98.9%). The specificity was 100% (96.4% to 100%). 15/16 (94%) RT- PCR-negative cases tested positive. The most frequent comorbidities were hypertension and diabetes mellitus and the most frequent symptoms were fever, cough, and dyspnea. All RT-PCR-negative patients had pneumonia. The most frequent thoracic CT findings were ground glass changes (n = 11, 68%), which were bilateral in 9 (56%) patients, and diffuse reticulonodular infiltrates (n = 5, 31%). Conclusions: The COVID-19 rapid chromatographic immunoassay evaluated in this study had a high sensitivity and specificity using plasma, particularly after 14 days from symptom onset. ELISA and qualitative rapid chromatographic immunoassays can be used for the diagnosis of RT-PCR-negative patients.
bookPart Protozooses intestinais(2013) GAKIYA, Erika; BRAZ, Lúcia Maria Almeida; SOUZA, Regina Maia de; BEZERRA, Rita Cristina; AMATO NETO, Ruth Semira Rodríguez Alarcón- Lipid nanoparticles for amphotericin delivery in the treatment of American tegumentary leishmaniasis(2020) SOUZA, Regina Maia de; MARANHAO, Raul Cavalcante; TAVARES, Elaine Rufo; FILIPPIN-MONTEIRO, Fabiola Branco; NICODEMO, Antonio Carlos; MORIKAWA, Aleksandra Tiemi; KANASHIRO, Edite Hatsumi Yamashiro; AMATO, Valdir SabbagaLeishmaniasis occurs in the five continents and represents a serious public health challenge, but is still a neglected disease, and the current pharmacological weaponry is far from satisfactory. Triglyceride-rich nanoparticles mimicking chylomicrons (TGNP) behave metabolically like native chylomicrons when injected into the bloodstream. Previously we have shown that TGNP as vehicle to amphothericin B (AB) for treatment of fungi infection showed reduced renal toxicity and lower animal death rates compared to conventional AB. The aim of the current study was to test the tolerability and effectiveness of the TGNP-AB preparation in a murine model of Leishmania amazonensis infection. The in vitro assays determined the cytotoxicity of TGNP-AB, AB, and TGNP in macrophages and promastigote forms and the leishmanicidal activity in infected macrophages. The in vivo toxicity tests were performed in healthy mice with increasing doses of TGPN-AB and AB. Then, animals were treated with 2.5 mg/kg/day of AB, 17.5 mg/kg/day of TGNP-AB, or TGNP three times a week for 4 weeks. TGNP-AB formulation was less cytotoxic for macrophages than AB. TGNP-AB was more effective than AB against the promastigotes forms of the parasite and more effective in reducing the number of infected macrophages and the number of amastigotes forms per cell. TGNP-AB-treated animals showed lower hepatotoxicity. In addition, TGNP-AB group showed a marked reduction in lesion size on the paws and parasitic load. The TGNP-AB preparation attained excellent leishmanicidal activity with remarkable lower drug toxicity at very high doses that, due to the toxicity-buffering properties of the nanocarrier, become fully tolerable.