Chagas disease, a neglected disease caused by the protozoan Trypanosoma cruzi, is endemic in 21 Latin American countries, affecting 6–8 million people. Increasing numbers of Chagas disease cases have also been reported in non-endemic countries due to migration, contamination via blood transfusions or organ transplantation, characterizing Chagas as an emerging disease in such regions. While most individuals in the chronic phase of Chagas disease remain in an asymptomatic clinical form named indeterminate, approximately 30% of the patients develop a cardiomyopathy that is amongst the deadliest cardiopathies known. The clinical distinctions between the indeterminate and the cardiac clinical forms are associated with different immune responses mediated by innate and adaptive cells. In this review, we present a collection of studies focusing on the human disease, discussing several aspects that demonstrate the association between chemokines, cytokines, and cytotoxic molecules with the distinct clinical outcomes of human infection with Trypanosoma cruzi. In addition, we discuss the role of gene polymorphisms in the transcriptional control of these immunoregulatory molecules. Finally, we discuss the potential application of cytokine expression and gene polymorphisms as markers of susceptibility to developing the severe form of Chagas disease, and as targets for disease control.

Effects of glyphosate exposure on gut.

Objetivou-se investigar a influência de diferentes tipos e formatos de rótulos nutricionais no cuidado com a saúde. Essa revisão integrativa recuperou artigos indexados nos bancos de dados eletrônicos da Biblioteca Virtual em Saúde (BVS), Periódicos da Capes, Google Acadêmico e na base de dados National Library of Medicines (NLM) - Pubmed/Medline e SciELO. Obteve-se o número de 36 artigos para compor esta revisão integrativa. Os estudos indicam que os rótulos de advertências/avisos se mostraram mais eficientes em mudar o comportamento alimentar, devido à facilidade de compreensão pelos consumidores. De maneira interessante, variáveis como ser do sexo feminino, possuir no mínimo o nível superior, ser mais velho e praticante de atividade física foram associadas ao maior interesse na utilização dos rótulos. A partir dos resultados explicitados nessa revisão integrativa, constata-se que a rotulagem dos alimentos é uma ferramenta de promoção da saúde e potencialmente útil no manejo de como pessoas com doenças crônicas não transmissíveis podem fazer escolhas alimentares mais saudáveis e de acordo com suas limitações. O uso de uma linguagem acessível às diferentes classes sociais é uma medida que necessita ser amplamente adotada, a fim de beneficiar todos os consumidores.

Although leucocytes are targets of renin-angiotensin system (RAS) effector molecules and RAS-modulating drugs exert immunomodulatory effects, their impact onTrypanosoma cruziinfection remains poorly understood. By using the framework of a systematic review, we integrated the preclinical and clinical evidence to investigate the relevance of angiotensin-inhibiting drugs onT. cruziinfections. From a comprehensive and structured search in biomedical databases, only original studies were analysed. In preclinical and clinical studies, captopril, enalapril and losartan were RAS-modulating drugs used. The mainin vitrofindings indicated that these drugs increased parasite uptake per host cells, IL-12 expression by infected dendritic cells and IFN-γby T lymphocytes, in addition to attenuating IL-10 and IL-17 production by CD8 + T cells. In animal models, reduced parasitaemia, tissue parasitism, leucocytes infiltration and mortality were often observed inT. cruzi-infected animals receiving RAS-modulating drugs. In patients with Chagas’ disease, these drugs exerted a controversial impact on cytokine and hormone levels, and a limited effect on cardiovascular function. Considering a detailed evaluation of reporting and methodological quality, the current preclinical and clinical evidence is at high risk of bias, and we hope that our critical analysis will be useful in mitigating the risk of bias in further studies.