BACKGROUND Although blood transfusion is an essential therapeutic procedure, it can present risks, including transmitting infectious diseases, such as malaria. In Acre, the thick blood smear microscopic examination (TBS) is used to screen infected malaria blood donors. However, TBS has low sensitivity for detecting Plasmodium in situations of low parasitaemia, such as those presented by asymptomatic clinically healthy individuals. OBJECTIVES To investigate the pertinence of using polymerase chain reaction (PCR) to detect malarial infection for screening blood donors in Cruzeiro do Sul, Acre, an endemic high-risk malaria area in the Legal Amazon. METHODS A cross-sectional study was conducted among individuals eligible and ineligible to be blood donors, according to clinical and epidemiological criteria. Besides the mandatory screening of HCV, HBV, and HIV tests, malaria PCR and TBS were also carried out on all blood donor candidates who attended the Cruzeiro do Sul Blood Centre from July to September 2022. FINDINGS Of the 230 participants, 209 (91%) were eligible for blood donation by clinical-epidemiological screening. Surprisingly, no blood donor candidate reported a history of malaria. All TBS microscopic tests were negative at the time of recruitment. However, samples from four blood donor candidates (two eligible by clinical and epidemiological malaria criteria and two ineligible by hypertension and recent tattoo) were positive by Plasmodium and P. vivax molecular tests. MAIN CONCLUSIONS Malaria molecular techniques for screening blood donors should be introduced in the Brazilian Blood Centres to maximise recipient safety. Furthermore, selecting zero-risk donors could pave the way to build a transmissible malaria-free environment in the blood bank context in the near future. procedure risks diseases Acre (TBS However parasitaemia (PCR highrisk high risk Amazon crosssectional cross sectional HCV HBV 2022 23 participants 20 91% 91 (91% clinicalepidemiological Surprisingly recruitment tattoo P safety Furthermore zerorisk zero malariafree free future 202 2 9 (91 (9 (

Innate immunity refers to the mechanisms responsible for the first line of defense against pathogens, cancer cells and toxins. The innate immune system is also responsible for the initial activation of the body’s specific immune response (adaptive immunity). Innate immunity was studied and further developed in parallel with adaptive immunity beginning in the first half of the 19th century and has been gaining increasing importance to our understanding of health and disease. In the present overview, we describe the main findings and ideas that contributed to the development of innate immunity as a continually expanding branch of modern immunology. We start with the toxicological studies by Von Haller and Magendie, in the late 18th and early 19th centuries, and continue with the discoveries in invertebrate immunity that supported the discovery and characterization of lipopolysaccharide (LPS) and pattern recognition receptors that led to the development of the pattern recognition and danger theory. pathogens toxins bodys body s immunity. . immunity) th disease overview immunology Magendie centuries LPS (LPS theory

BACKGROUND Cerebral malaria is a lethal complication of Plasmodium falciparum infections in need of better therapies. Previous work in murine experimental cerebral malaria (ECM) indicated that the combination of artemether plus intraperitoneal whole blood improved vascular integrity and increased survival compared to artemether alone. However, the effects of blood or plasma transfusion administered via the intravenous route have not previously been evaluated in ECM. OBJECTIVES To evaluate the effects of intravenous whole blood compared to intravenous plasma on hematological parameters, vascular integrity, and survival in artemether-treated ECM. METHODS Mice with late-stage ECM received artemether alone or in combination with whole blood or plasma administered via the jugular vein. The outcome measures were hematocrit and platelets; plasma angiopoietin 1, angiopoietin 2, and haptoglobin; blood-brain barrier permeability; and survival. FINDINGS Survival increased from 54% with artemether alone to 90% with the combination of artemether and intravenous whole blood. Intravenous plasma lowered survival to 18%. Intravenous transfusion provided fast and pronounced recoveries of hematocrit, platelets, angiopoietins levels and blood brain barrier integrity. MAIN CONCLUSIONS The outcome of artemether-treated ECM was improved by intravenous whole blood but worsened by intravenous plasma. Compared to prior studies of transfusion via the intraperitoneal route, intravenous administration was more efficacious. therapies (ECM However parameters artemethertreated treated latestage late stage vein platelets 1 2 haptoglobin bloodbrain permeability 54 90 18 18% efficacious 5 9

In the present study, we investigated the genetic diversity of Plasmodium vivax metacaspase 1 (PvMCA1) catalytic domain in two municipalities of the main malaria hotspot in Brazil, i.e., the Juruá Valley, and observed complete sequence identity among all P. vivax field isolates and the Sal-1 reference strain. Analysis of PvMCA1 catalytic domain in different P. vivax genomic sequences publicly available also revealed a high degree of conservation worldwide, with very few amino acid substitutions that were not related to putative histidine and cysteine catalytic residues, whose involvement with the active site of protease was herein predicted by molecular modeling. The genetic conservation presented by PvMCA1 may contribute to its eligibility as a druggable target candidate in vivax malaria.

Resumo: O artigo examina a história de Louis Pasteur do ponto de vista de um filme clássico que foi projetado durante os Seminários Semanais do Instituto Oswaldo Cruz no final das atividades de 2017. Embora bastante antigo, o filme The Story of Louis Pasteur (Warner Bros., 1936) inspirou os espectadores e deu lugar a um debate animado que levou os autores a decidir publicar os comentários da Coordenadora dos Seminários, do debatedor convidado e do público. O filme incorpora personagens reais e fictícios para comunicar ao público o legado de um dos maiores precursores da história da saúde pública. O artigo destaca os episódios reais da biografia de Pasteur e também os ficcionais, sem desmerecer o trabalho dos criadores cinematográficos. O principal mérito do filme, um dos primeiros passos de uma política de divulgação científica, é de revelar a importância das vacinas e da higiene das mãos na prevenção das doenças infecciosas. Os autores argumentam que o cineasta retratou primorosamente a tenacidade do grande cientista na busca incansável por descobertas, além de sua ideia de que somente o trabalho persistente pode levar a resultados recompensadores, lembrando que o contexto criado por pesquisadores anteriores permitiu que Pasteur estabelecesse paradigmas novos. Finalmente, os autores citam trechos do filme que ilustram realidades que persistem até os dias de hoje: (i) a tendência da ciência de resistir, por inércia, aos paradigmas novos, exemplificada pela oposição da comunidade de ciência médica à proposição de práticas simples como a lavagem de mãos e a fervura de instrumentos e (ii) a confiança excessiva, e até arrogância, de alguns especialistas, em vez da serenidade e da humildade que nascem da pesquisa dedicada e do conhecimento acumulado.

Abstract: This article examines the story of Louis Pasteur from the point of view of a classic movie presented at the Weekly Seminars of the “Oswaldo Cruz Institute”, at the end of the 2017 activities. Although very old, the movie The Story of Louis Pasteur (Warner Bros., 1936) inspired spectators and gave rise to an energetic debate that led the authors to decide for publishing the comments of the Seminar Coordinator, the guest commentator and the audience. The movie communicates to the public the legacy of one of the greatest precursors of the public health history using also fictional characters. The article presents the reliable passages in Pasteur’s biography and the fictional ones, without disrespecting the production of the creators of cinematographic work. The major merit of the movie, one of the first steps towards the policy of scientific diffusion, is to disclose the importance of vaccines and hand hygiene to prevent infectious diseases. The authors argue that the film-maker impeccably captured the scientist’s tenacity in the relentless search for discoveries and Pasteur’s idea that only persistent work can lead to rewarding results, remembering that the context created by previous researchers enabled Pasteur to establish new paradigms. Finally, the authors cite movie passages illustrating realities that are still in force: (i) the inertial resistance of science to new paradigms, illustrated by the medical-scientific community opposing to simple practices proposition, such as washing hands and boiling instruments, and (ii) the excessive confidence, and even arrogance, of some specialists, instead of serenity and humility that arise from committed study and accumulated knowledge.

Resumen: Este artículo examina la historia de Louis Pasteur desde el punto de vista de una película clásica, presentada en los Seminarios Semanales del Instituto Oswaldo Cruz, al final de las actividades de 2017. A pesar de ser muy antigua, la película The Story of Louis Pasteur (Warner Bros., 1936) inspiró a los espectadores y provocó un animado debate que condujo a los autores a la decisión de publicar los comentarios de la Coordinadora de los Seminarios, así como los del comentarista invitado y de la audiencia. Utilizando también personajes de ficción, la película transmitía al público el legado de uno de los más grandes precursores de la historia de la salud pública. El artículo señala pasajes fidedignos en la biografía de Pasteur y ficticios, sin menoscabar el trabajo de los creadores cinematográficos. El mayor mérito de la película, uno de los primeros pasos hacia la política de divulgación científica, es revelar la importancia de las vacunas y de la higiene de las manos para prevenir enfermedades infecciosas. Los autores enfatizan que el director de la película capturó impecablemente la tenacidad del científico en su búsqueda sin descanso de descubrimientos, así como su idea de que solo un trabajo persistente podía conducir a resultados gratificantes, recordando que el contexto creado por investigadores previos permitieron a Pasteur establecer nuevos paradigmas. Finalmente, los autores citan pasajes de la película que ilustran realidades todavía muy vigentes: (i) la resistencia por inercia de la ciencia a nuevos paradigmas, ilustrados por la oposición de la comunidad médico-científica hacia la propuesta de prácticas simples, tales como lavarse las manos y hervir los instrumentos, así como (ii) la excesiva confianza, e incluso arrogancia, de algunos especialistas, en lugar de la serenidad y humildad que surgen del estudio realizado y el conocimiento acumulado.

Resumo: O artigo examina a história de Louis Pasteur do ponto de vista de um filme clássico que foi projetado durante os Seminários Semanais do Instituto Oswaldo Cruz no final das atividades de 2017. Embora bastante antigo, o filme The Story of Louis Pasteur (Warner Bros., 1936) inspirou os espectadores e deu lugar a um debate animado que levou os autores a decidir publicar os comentários da Coordenadora dos Seminários, do debatedor convidado e do público. O filme incorpora personagens reais e fictícios para comunicar ao público o legado de um dos maiores precursores da história da saúde pública. O artigo destaca os episódios reais da biografia de Pasteur e também os ficcionais, sem desmerecer o trabalho dos criadores cinematográficos. O principal mérito do filme, um dos primeiros passos de uma política de divulgação científica, é de revelar a importância das vacinas e da higiene das mãos na prevenção das doenças infecciosas. Os autores argumentam que o cineasta retratou primorosamente a tenacidade do grande cientista na busca incansável por descobertas, além de sua ideia de que somente o trabalho persistente pode levar a resultados recompensadores, lembrando que o contexto criado por pesquisadores anteriores permitiu que Pasteur estabelecesse paradigmas novos. Finalmente, os autores citam trechos do filme que ilustram realidades que persistem até os dias de hoje: (i) a tendência da ciência de resistir, por inércia, aos paradigmas novos, exemplificada pela oposição da comunidade de ciência médica à proposição de práticas simples como a lavagem de mãos e a fervura de instrumentos e (ii) a confiança excessiva, e até arrogância, de alguns especialistas, em vez da serenidade e da humildade que nascem da pesquisa dedicada e do conhecimento acumulado.

Abstract: This article examines the story of Louis Pasteur from the point of view of a classic movie presented at the Weekly Seminars of the “Oswaldo Cruz Institute”, at the end of the 2017 activities. Although very old, the movie The Story of Louis Pasteur (Warner Bros., 1936) inspired spectators and gave rise to an energetic debate that led the authors to decide for publishing the comments of the Seminar Coordinator, the guest commentator and the audience. The movie communicates to the public the legacy of one of the greatest precursors of the public health history using also fictional characters. The article presents the reliable passages in Pasteur’s biography and the fictional ones, without disrespecting the production of the creators of cinematographic work. The major merit of the movie, one of the first steps towards the policy of scientific diffusion, is to disclose the importance of vaccines and hand hygiene to prevent infectious diseases. The authors argue that the film-maker impeccably captured the scientist’s tenacity in the relentless search for discoveries and Pasteur’s idea that only persistent work can lead to rewarding results, remembering that the context created by previous researchers enabled Pasteur to establish new paradigms. Finally, the authors cite movie passages illustrating realities that are still in force: (i) the inertial resistance of science to new paradigms, illustrated by the medical-scientific community opposing to simple practices proposition, such as washing hands and boiling instruments, and (ii) the excessive confidence, and even arrogance, of some specialists, instead of serenity and humility that arise from committed study and accumulated knowledge.

Resumen: Este artículo examina la historia de Louis Pasteur desde el punto de vista de una película clásica, presentada en los Seminarios Semanales del Instituto Oswaldo Cruz, al final de las actividades de 2017. A pesar de ser muy antigua, la película The Story of Louis Pasteur (Warner Bros., 1936) inspiró a los espectadores y provocó un animado debate que condujo a los autores a la decisión de publicar los comentarios de la Coordinadora de los Seminarios, así como los del comentarista invitado y de la audiencia. Utilizando también personajes de ficción, la película transmitía al público el legado de uno de los más grandes precursores de la historia de la salud pública. El artículo señala pasajes fidedignos en la biografía de Pasteur y ficticios, sin menoscabar el trabajo de los creadores cinematográficos. El mayor mérito de la película, uno de los primeros pasos hacia la política de divulgación científica, es revelar la importancia de las vacunas y de la higiene de las manos para prevenir enfermedades infecciosas. Los autores enfatizan que el director de la película capturó impecablemente la tenacidad del científico en su búsqueda sin descanso de descubrimientos, así como su idea de que solo un trabajo persistente podía conducir a resultados gratificantes, recordando que el contexto creado por investigadores previos permitieron a Pasteur establecer nuevos paradigmas. Finalmente, los autores citan pasajes de la película que ilustran realidades todavía muy vigentes: (i) la resistencia por inercia de la ciencia a nuevos paradigmas, ilustrados por la oposición de la comunidad médico-científica hacia la propuesta de prácticas simples, tales como lavarse las manos y hervir los instrumentos, así como (ii) la excesiva confianza, e incluso arrogancia, de algunos especialistas, en lugar de la serenidad y humildad que surgen del estudio realizado y el conocimiento acumulado.

Abstract The present work analyses some particular aspects of Oswaldo Cruz's unique biography, valuing his work, which was built along a successful physician and scientist professional trajectory and also as a courageous and fortunate formulator of public health policies and of fight strategies against the epidemics that seasonally affected the city of Rio de Janeiro at the beginning of the 20th century. The authors also dwell on his legacy as Head scientist and manager of the Institute that bears his name and became the template for experimental research and medicine in Brazil and the bedrock of the Fundação Oswaldo Cruz, one of the most important Brazilian Institutions devoted to teaching, research, development and production in health. This heritage made possible to overcome the existing dissensions between doctors and scientists to build a sanitary movement committed to the major health problems in Brazil. Finally, the paper explores some features of the character and reports some of his moments during his passage, as a Full Academician, at the Brazilian Academia Nacional de Medicina.

BACKGROUND The prompt diagnosis of plasmodial species for effective treatment prevents worsening of individual health and avoids transmission maintenance or even malaria reintroduction in areas where Plasmodium does not exist. Polymerase chain reaction (PCR) allows for the detection of parasites below the threshold of microscopic examination. OBJECTIVE Our aim was to develop a real-time PCR test to reduce diagnostic errors and increase efficacy. METHODS The lower limit of quantification and the linearity/analytical sensitivity to measure sensitivity or limit of detection (LoD) were determined. Intra-assay variations (repeatability) and alterations between assays, operators, and instruments (reproducibility) were also assessed to set precision. FINDINGS The linearity in SYBR™ Green and TaqMan™ systems was 106 and 102 copies and analytical sensitivity 1.13 and 1.17 copies/μL, respectively. Real-time PCR was more sensitive than conventional PCR, showing a LoD of 0.01 parasite (p)/μL. Reproducibility and repeatability (precision) were 100% for up to 0.1 p/μL in SYBR™ Green and 1 p/μL in TaqMan™ and conventional PCR. CONCLUSION Real-time PCR may replace conventional PCR in reference laboratories for P. vivax detection due to its rapidity. The TaqMan™ system is the most indicated when quantification assays are required. Performing tests in triplicate when diagnosing Plasmodium-infected-asymptomatic individuals is recommended to minimise diagnostic errors.

BACKGROUND AND OBJECTIVE Brazil is responsible for a large number of Plasmodium vivax cases in America. Given the emergence of P. vivax parasites resistant to chloroquine and the effectiveness of antifolates in vivax malaria treatment together with a correlation between mutations in P. vivax dhfr and dhps genes and SP treatment failure, the point mutations in these genes were investigated. METHODS Blood samples from 54 patients experiencing vivax malaria symptomatic episodes in the Amazonian Region were investigated. Genomic DNA was extracted using a DNA extraction kit (QIAGENTM). Nested polymerase chain reaction (PCR) amplification was carried out followed by Sanger sequencing to detect single nucleotide polymorphisms (SNPs). FINDINGS All tested isolates showed non-synonymous mutations in pvdhfr gene: 117N (54/54, 100%) and 58R (25/54, 46%). Double mutant allele 58R/117N (FRTNI, 28%) was the most frequent followed by triple mutant alleles (58R/117N/173L, FRTNL, 11%; 58R/61M/117N, FRMNI, 5% 117N/173L, FSTNL, 4%) and quadruple mutant allele (58R/61M/117N/173L, FRMNL, 2%). A single mutation was observed at codon C383G in pvdhps gene (SGKAV, 48%). CONCLUSION No evidence of molecular signatures associated with P. vivax resistance to SP was observed in the Brazilian samples.

BACKGROUND The central repetitive region (CRR) of the Plasmodium vivax circumsporozoite surface protein (CSP) is composed of a repetitive sequence that is characterised by three variants: VK210, VK247 and P. vivax-like. The most important challenge in the treatment of P. vivax infection is the possibility of differential response based on the parasite genotype. OBJECTIVES To characterise the CSP variants in P. vivax isolates from individuals residing in a malaria-endemic region in Brazil and to profile these variants based on sensitivity to chloroquine and mefloquine. METHODS The CSP variants were determined by sequencing and the sensitivity of the P. vivax isolates to chloroquine and mefloquine was determined by Deli-test. FINDINGS Although five different allele sizes were amplified, the sequencing results showed that all of the isolates belonged to the VK210 variant. However, we observed substantial genetic diversity in the CRR, resulting in the identification of 10 different VK210 subtypes. The frequency of isolates that were resistant to chloroquine and mefloquine was 11.8 and 23.8%, respectively. However, we did not observe any difference in the frequency of the resistant isolates belonging to the VK210 subtypes. MAIN CONCLUSION The VK210 variant is the most frequently observed in the studied region and there is significant genetic variability in the CRR of the P. vivax CSP. Moreover, the antimalarial drug sensitivity profiles of the isolates does not seem to be related to the VK210 subtypes.

Brazil, a country of continental proportions, presents three profiles of malaria transmission. The first and most important numerically, occurs inside the Amazon. The Amazon accounts for approximately 60% of the nation’s territory and approximately 13% of the Brazilian population. This region hosts 99.5% of the nation’s malaria cases, which are predominantly caused by Plasmodium vivax (i.e., 82% of cases in 2013). The second involves imported malaria, which corresponds to malaria cases acquired outside the region where the individuals live or the diagnosis was made. These cases are imported from endemic regions of Brazil (i.e., the Amazon) or from other countries in South and Central America, Africa and Asia. Imported malaria comprised 89% of the cases found outside the area of active transmission in Brazil in 2013. These cases highlight an important question with respect to both therapeutic and epidemiological issues because patients, especially those with falciparum malaria, arriving in a region where the health professionals may not have experience with the clinical manifestations of malaria and its diagnosis could suffer dramatic consequences associated with a potential delay in treatment. Additionally, because the Anopheles vectors exist in most of the country, even a single case of malaria, if not diagnosed and treated immediately, may result in introduced cases, causing outbreaks and even introducing or reintroducing the disease to a non-endemic, receptive region. Cases introduced outside the Amazon usually occur in areas in which malaria was formerly endemic and are transmitted by competent vectors belonging to the subgenus Nyssorhynchus (i.e., Anopheles darlingi, Anopheles aquasalis and species of the Albitarsis complex). The third type of transmission accounts for only 0.05% of all cases and is caused by autochthonous malaria in the Atlantic Forest, located primarily along the southeastern Atlantic Coast. They are caused by parasites that seem to be (or to be very close to) P. vivax and, in a less extent, by Plasmodium malariae and it is transmitted by the bromeliad mosquito Anopheles (Kerteszia) cruzii. This paper deals mainly with the two profiles of malaria found outside the Amazon: the imported and ensuing introduced cases and the autochthonous cases. We also provide an update regarding the situation in Brazil and the Brazilian endemic Amazon.

Cerebral malaria (CM) is a life-threatening complication of Plasmodium falciparum malaria that continues to be a major global health problem. Brain vascular dysfunction is a main factor underlying the pathogenesis of CM and can be a target for the development of adjuvant therapies for the disease. Vascular occlusion by parasitised red blood cells and vasoconstriction/vascular dysfunction results in impaired cerebral blood flow, ischaemia, hypoxia, acidosis and death. In this review, we discuss the mechanisms of vascular dysfunction in CM and the roles of low nitric oxide bioavailability, high levels of endothelin-1 and dysfunction of the angiopoietin-Tie2 axis. We also discuss the usefulness and relevance of the murine experimental model of CM by Plasmodium berghei ANKA to identify mechanisms of disease and to screen potential therapeutic interventions.