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Costa AFO, Kuznetsova V, Marani LO, Lopes IA, Binelli LS, Scheucher PS, Schiavinato JL, Madeira MIA, Pagnano KBB, Duarte BK, Glória ABF, Rego EM, Traina F, Welner R, Figueiredo-Pontes LL. IMBALANCED ACTIVATING AND INHIBITORY RECEPTORS ON CD56DIM NATURAL KILLER CELLS PREDICTS POOR OUTCOMES IN ACUTE MYELOID LEUKEMIA. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Marani LO, Garcia CAB, Lopes I, Costa AFO, Madeira MIA, Binelli LS, Schiavinato JL, Scheucher PS, Silva FB, Lima ASG, Fagundes ABFG, Maranhão E, Higashi M, Kerbauy F, Ayoub FL, Duarte BK, Pagnano KB, Traina F, Rego EM, Figueiredo-Pontes LL. ANORMALIDADES 3Q E DESREGULAÇÃO DE EVI1 EM LEUCEMIA MIELOIDE AGUDA: DO DIAGNÓSTICO AO DESFECHO CLÍNICO. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Bassan VL, Barretto GD, de Almeida FC, Palma PVB, Binelli LS, da Silva JPL, Fontanari C, Castro RC, de Figueiredo Pontes LL, Frantz FG, de Castro FA. Philadelphia-negative myeloproliferative neoplasms display alterations in monocyte subpopulations frequency and immunophenotype. Med Oncol 2022; 39:223. [PMID: 36175590 PMCID: PMC9522456 DOI: 10.1007/s12032-022-01825-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/14/2022] [Indexed: 11/06/2022]
Abstract
Philadelphia-negative myeloproliferative neoplasms (MPN) are clonal hematological diseases associated with driver mutations in JAK2, CALR, and MPL genes. Moreover, several evidence suggests that chronic inflammation and alterations in stromal and immune cells may contribute to MPN’s pathophysiology. We evaluated the frequency and the immunophenotype of peripheral blood monocyte subpopulations in patients with polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (MF). Peripheral blood monocytes from PV (n = 16), ET (n = 16), and MF (n = 15) patients and healthy donors (n = 10) were isolated and submitted to immunophenotyping to determine the frequency of monocyte subpopulations and surface markers expression density. Plasma samples were used to measure the levels of soluble CD163, a biomarker of monocyte activity. PV, ET, and MF patients presented increased frequency of intermediate and non-classical monocytes and reduced frequency of classical monocytes compared to controls. Positivity for JAK2 mutation was significantly associated with the percentage of intermediate monocytes. PV, ET, and MF patients presented high-activated monocytes, evidenced by higher HLA-DR expression and increased soluble CD163 levels. The three MPN categories presented increased frequency of CD56+ aberrant monocytes, and PV and ET patients presented reduced frequency of CD80/86+ monocytes. Therefore, alterations in monocyte subpopulations frequency and surface markers expression pattern may contribute to oncoinflammation and may be associated with the pathophysiology of MPN.
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Affiliation(s)
- Vitor Leonardo Bassan
- Department of Clinical Analyses, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Avenida do Café, s/nº - Vila Monte Alegre, Ribeirão Preto, São Paulo, 14040-903, Brazil.
| | - Gabriel Dessotti Barretto
- Department of Clinical Analyses, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Avenida do Café, s/nº - Vila Monte Alegre, Ribeirão Preto, São Paulo, 14040-903, Brazil
| | - Felipe Campos de Almeida
- Department of Clinical Analyses, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Avenida do Café, s/nº - Vila Monte Alegre, Ribeirão Preto, São Paulo, 14040-903, Brazil
| | - Patrícia Vianna Bonini Palma
- Regional Blood Center of Ribeirão Preto, Rua Tenente Catão Roxo, 2501 - Vila Monte Alegre, Ribeirão Preto, São Paulo, 14051-260, Brazil
| | - Larissa Sarri Binelli
- Regional Blood Center of Ribeirão Preto, Rua Tenente Catão Roxo, 2501 - Vila Monte Alegre, Ribeirão Preto, São Paulo, 14051-260, Brazil.,Department of Medical Images, Hematology and Clinical Oncology, University Hospital of the Ribeirão Preto Medical School, University of São Paulo, Rua Tenente Catão Roxo, 3900 - Vila Monte Alegre, Ribeirão Preto, São Paulo, 14015-010, Brazil
| | - João Paulo Lettieri da Silva
- Regional Blood Center of Ribeirão Preto, Rua Tenente Catão Roxo, 2501 - Vila Monte Alegre, Ribeirão Preto, São Paulo, 14051-260, Brazil.,Department of Medical Images, Hematology and Clinical Oncology, University Hospital of the Ribeirão Preto Medical School, University of São Paulo, Rua Tenente Catão Roxo, 3900 - Vila Monte Alegre, Ribeirão Preto, São Paulo, 14015-010, Brazil
| | - Caroline Fontanari
- Department of Clinical Analyses, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Avenida do Café, s/nº - Vila Monte Alegre, Ribeirão Preto, São Paulo, 14040-903, Brazil
| | - Ricardo Cardoso Castro
- Department of Clinical Analyses, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Avenida do Café, s/nº - Vila Monte Alegre, Ribeirão Preto, São Paulo, 14040-903, Brazil
| | - Lorena Lôbo de Figueiredo Pontes
- Regional Blood Center of Ribeirão Preto, Rua Tenente Catão Roxo, 2501 - Vila Monte Alegre, Ribeirão Preto, São Paulo, 14051-260, Brazil.,Department of Medical Images, Hematology and Clinical Oncology, University Hospital of the Ribeirão Preto Medical School, University of São Paulo, Rua Tenente Catão Roxo, 3900 - Vila Monte Alegre, Ribeirão Preto, São Paulo, 14015-010, Brazil
| | - Fabiani Gai Frantz
- Department of Clinical Analyses, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Avenida do Café, s/nº - Vila Monte Alegre, Ribeirão Preto, São Paulo, 14040-903, Brazil
| | - Fabíola Attié de Castro
- Department of Clinical Analyses, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Avenida do Café, s/nº - Vila Monte Alegre, Ribeirão Preto, São Paulo, 14040-903, Brazil
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Fernandes de Oliveira Costa A, Olops Marani L, Mantello Bianco T, Queiroz Arantes A, Aparecida Lopes I, Antonio Pereira-Martins D, Carvalho Palma L, Santos Scheucher P, Lilian dos Santos Schiavinato J, Sarri Binelli L, Araújo Silva C, Kobayashi SS, Agostinho Machado-Neto J, Magalhães Rego E, Samuel Welner R, Lobo de Figueiredo-Pontes L. Altered distribution and function of NK-cell subsets lead to impaired tumor surveillance in JAK2V617F myeloproliferative neoplasms. Front Immunol 2022; 13:768592. [PMID: 36211444 PMCID: PMC9539129 DOI: 10.3389/fimmu.2022.768592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 08/30/2022] [Indexed: 01/15/2023] Open
Abstract
In cancer, tumor cells and their neoplastic microenvironment can sculpt the immunogenic phenotype of a developing tumor. In this context, natural killer (NK) cells are subtypes of lymphocytes of the innate immune system recognized for their potential to eliminate neoplastic cells, not only through direct cytolytic activity but also by favoring the development of an adaptive antitumor immune response. Even though the protective effect against leukemia due to NK-cell alloreactivity mediated by the absence of the KIR-ligand has already been shown, and some data on the role of NK cells in myeloproliferative neoplasms (MPN) has been explored, their mechanisms of immune escape have not been fully investigated. It is still unclear whether NK cells can affect the biology of BCR-ABL1-negative MPN and which mechanisms are involved in the control of leukemic stem cell expansion. Aiming to investigate the potential contribution of NK cells to the pathogenesis of MPN, we characterized the frequency, receptor expression, maturation profile, and function of NK cells from a conditional Jak2V617F murine transgenic model, which faithfully resembles the main clinical and laboratory characteristics of human polycythemia vera, and MPN patients. Immunophenotypic analysis was performed to characterize NK frequency, their subtypes, and receptor expression in both mutated and wild-type samples. We observed a higher frequency of total NK cells in JAK2V617F mutated MPN and a maturation arrest that resulted in low-numbered mature CD11b+ NK cells and increased immature secretory CD27+ cells in both human and murine mutated samples. In agreement, inhibitory receptors were more expressed in MPN. NK cells from Jak2V617F mice presented a lower potential for proliferation and activation than wild-type NK cells. Colonies generated by murine hematopoietic stem cells (HSC) after mutated or wild-type NK co-culture exposure demonstrated that NK cells from Jak2V617F mice were deficient in regulating differentiation and clonogenic capacity. In conclusion, our findings suggest that NK cells have an immature profile with deficient cytotoxicity that may lead to impaired tumor surveillance in MPN. These data provide a new perspective on the behavior of NK cells in the context of myeloid malignancies and can contribute to the development of new therapeutic strategies, targeting onco-inflammatory pathways that can potentially control transformed HSCs.
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Affiliation(s)
- Amanda Fernandes de Oliveira Costa
- Division of Hematology, Department of Medical Imaging, Hematology, and Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Leticia Olops Marani
- Division of Hematology, Department of Medical Imaging, Hematology, and Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Thiago Mantello Bianco
- Division of Hematology, Department of Medical Imaging, Hematology, and Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Adriana Queiroz Arantes
- Division of Hematology, Department of Medical Imaging, Hematology, and Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Izabela Aparecida Lopes
- Division of Hematology, Department of Medical Imaging, Hematology, and Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Diego Antonio Pereira-Martins
- Center for Cell-based Therapy, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirao Preto, Brazil
| | - Leonardo Carvalho Palma
- Division of Hematology, Department of Medical Imaging, Hematology, and Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Priscila Santos Scheucher
- Division of Hematology, Department of Medical Imaging, Hematology, and Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Josiane Lilian dos Santos Schiavinato
- Division of Hematology, Department of Medical Imaging, Hematology, and Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Cleide Araújo Silva
- Center for Cell-based Therapy, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirao Preto, Brazil
| | - Susumu S. Kobayashi
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States,Division of Translational Genomics, Exploratory Oncology Research, and Clinical Trial Center, National Cancer Center, Kashiwa, Japan
| | | | - Eduardo Magalhães Rego
- Center for Cell-based Therapy, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirao Preto, Brazil,Division of Hematology, University of São Paulo Medical School, São Paulo, Brazil
| | - Robert Samuel Welner
- Division Hematology/Oncology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Lorena Lobo de Figueiredo-Pontes
- Division of Hematology, Department of Medical Imaging, Hematology, and Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil,Center for Cell-based Therapy, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirao Preto, Brazil,*Correspondence: Lorena Lobo de Figueiredo-Pontes,
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Braz AMM, Winckler FC, Binelli LS, Chimeno LG, Lopes LBM, Lima RS, Simões RP, Grotto RMT, Golim MDA, Silva GF. Inflammation response and liver stiffness: predictive model of regression of hepatic stiffness after sustained virological response in cirrhotics patients with chronic hepatitis C. Clin Exp Med 2021; 21:587-597. [PMID: 33835323 DOI: 10.1007/s10238-021-00708-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 03/26/2021] [Indexed: 02/07/2023]
Abstract
Cirrhotic patients with chronic hepatitis C should be monitored for the evaluation of liver function and screening of hepatocellular carcinoma even after sustained virological response (SVR). The stage of inflammatory resolution and regression of fibrosis is likely to happen, once treatment and viral clearance are achieved. However, liver examinations by elastography show that 30-40% of patients do not exhibit a reduction of liver stiffness. This work was a cohort study in cirrhotic patients whose purpose was to identify immunological factors involved in the regression of liver stiffness in chronic hepatitis C and characterize possible serum biomarkers with prognostic value. The sample universe consisted of 31 cirrhotic patients who underwent leukocyte immunophenotyping, quantification of cytokines/chemokines and metalloproteinase inhibitors in the pretreatment (M1) and in the evaluation of SVR (M2). After exclusion criteria application, 16 patients included were once more evaluated in M3 (like M1) and classified into regressors (R) or non-regressors (NR), decrease or not ≥ 25% stiffness, respectively. The results from ROC curve, machine learning (ML) and linear discriminant analysis showed that TCD4 + lymphocytes (absolute) are the most important biomarkers for the prediction of the regression (AUC = 0.90). NR patients presented levels less than R of liver stiffness since baseline, whereas NK cells were increased in NR. Therefore, it was concluded that there is a difference in the profile of circulating immune cells in R and NR, thus allowing the development of a predictive model of regression of liver stiffness after SVR. These findings should be validated in greater numbers of patients.
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Affiliation(s)
- Aline Márcia Marques Braz
- Graduate Program in Pathophysiology in Clinical Medicine, Department of Clinical Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, São Paulo, Brazil
- Flow Cytometry Laboratory, Applied Biotechnology Laboratory - LBA, Clinical Hospital of Botucatu Medical School, Av. Prof. Mário Rubens Guimarães Montenegro, s/n, Botucatu, São Paulo, Brazil
| | - Fernanda Cristina Winckler
- Graduate Program in Pathophysiology in Clinical Medicine, Department of Clinical Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, São Paulo, Brazil
| | - Larissa Sarri Binelli
- Flow Cytometry Laboratory, Applied Biotechnology Laboratory - LBA, Clinical Hospital of Botucatu Medical School, Av. Prof. Mário Rubens Guimarães Montenegro, s/n, Botucatu, São Paulo, Brazil
| | - Luis Guilherme Chimeno
- Flow Cytometry Laboratory, Applied Biotechnology Laboratory - LBA, Clinical Hospital of Botucatu Medical School, Av. Prof. Mário Rubens Guimarães Montenegro, s/n, Botucatu, São Paulo, Brazil
- Graduate Program in Research and Development (Medical Biotechnology, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, São Paulo, Brazil
| | - Lia Beatriz Mantovani Lopes
- Flow Cytometry Laboratory, Applied Biotechnology Laboratory - LBA, Clinical Hospital of Botucatu Medical School, Av. Prof. Mário Rubens Guimarães Montenegro, s/n, Botucatu, São Paulo, Brazil
- Graduate Program in Research and Development (Medical Biotechnology, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, São Paulo, Brazil
| | - Rodrigo Santos Lima
- Graduate Program in Pathology, Department of Pathology, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, São Paulo, Brazil
| | - Rafael Plana Simões
- Graduate Program in Research and Development (Medical Biotechnology, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, São Paulo, Brazil
- Department of Biotechnology and Bioprocess Engineering, São Paulo State University (UNESP), Faculty of Agronomic Sciences, Botucatu, São Paulo, Brazil
| | - Rejane Maria Tommasini Grotto
- Graduate Program in Research and Development (Medical Biotechnology, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, São Paulo, Brazil
- Graduate Program in Pathology, Department of Pathology, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, São Paulo, Brazil
- Department of Biotechnology and Bioprocess Engineering, São Paulo State University (UNESP), Faculty of Agronomic Sciences, Botucatu, São Paulo, Brazil
- Molecular Biology Laboratory, Applied Biotechnology Laboratory - LBA, Clinical Hospital of Botucatu Medical School, Botucatu, São Paulo, Brazil
| | - Marjorie de Assis Golim
- Flow Cytometry Laboratory, Applied Biotechnology Laboratory - LBA, Clinical Hospital of Botucatu Medical School, Av. Prof. Mário Rubens Guimarães Montenegro, s/n, Botucatu, São Paulo, Brazil.
- Graduate Program in Research and Development (Medical Biotechnology, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, São Paulo, Brazil.
| | - Giovanni Faria Silva
- Graduate Program in Pathophysiology in Clinical Medicine, Department of Clinical Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, São Paulo, Brazil
- Graduate Program in Research and Development (Medical Biotechnology, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, São Paulo, Brazil
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Binelli LS, Costa AFO, Marani LO, Lopes IA, Traina F, Palma LC, Garibaldi PMM, Figueiredo-Pontes LL. NATURAL KILLER CELLS PHENOTYPE CORRELATES WITH TYROSINE KINASE INHIBITORS TREATMENT RESPONSE IN CHRONIC MYELOID LEUKEMIA PATIENTS. Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Azevedo MDCS, Marques H, Binelli LS, Malange MSV, Devides AC, Silva EA, Fachin LRV, Ghidella CC, Soares CT, Garlet GP, Rosa PS, Belone ADFF, Trombone APF. Simultaneous analysis of multiple T helper subsets in leprosy reveals distinct patterns of Th1, Th2, Th17 and Tregs markers expression in clinical forms and reactional events. Med Microbiol Immunol 2017; 206:429-439. [PMID: 28875310 DOI: 10.1007/s00430-017-0519-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 08/29/2017] [Indexed: 12/01/2022]
Abstract
Leprosy is a chronic infectious disease caused by Mycobacterium leprae. Previous studies have demonstrated that the difference among clinical forms of leprosy can be associated with the immune response of patients, mainly by T helper (Th) and regulatory T cells (Tregs). Then, aiming at clarifying the immune response, the expression of cytokines related to Th1, Th2, Th17 and Tregs profiles were evaluated by qPCR in 87 skin biopsies from leprosy patients. Additionally, cytokines and anti-PGL-1 antibodies were determined in serum by ELISA. The results showed that the expression of various targets (mRNA) related to Th1, Th2, Th17 and Tregs were significantly modulated in leprosy when compared with healthy individuals, suggesting the presence of a mixed profile. In addition, the targets related to Th1 predominated in the tuberculoid pole and side and Th2 and Tregs predominated in the lepromatous pole and side; however, Th17 targets showed a mixed profile. Concerning reactional events, Tregs markers were decreased and IL-15 was increased in reversal reaction and IL-17F, CCL20 and IL-8 in erythema nodosum leprosum, when compared with the respective non-reactional leprosy patients. Additionally, ELISA analysis demonstrated that IL-22, IL-6, IL-10 and anti-PGL-1 antibody levels were significantly higher in the serum of patients when compared with healthy individuals, and IL-10 and anti-PGL-1 antibodies were also increased in the lepromatous pole and side. Together, these results indicate that Th1, Th2 and Th17 are involved in the determination of clinical forms of leprosy and suggest that decreased Tregs activity may be involved in the pathogenesis of reactional events.
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Affiliation(s)
| | - Heloisa Marques
- Centro de Ciências da Saúde, Universidade do Sagrado Coração, Rua Irmã Arminda, 10-50, Jardim Brasil, Bauru, São Paulo, 17.011-160, Brazil
| | - Larissa Sarri Binelli
- Centro de Ciências da Saúde, Universidade do Sagrado Coração, Rua Irmã Arminda, 10-50, Jardim Brasil, Bauru, São Paulo, 17.011-160, Brazil
| | - Mariana Silva Vieira Malange
- Centro de Ciências da Saúde, Universidade do Sagrado Coração, Rua Irmã Arminda, 10-50, Jardim Brasil, Bauru, São Paulo, 17.011-160, Brazil
| | - Amanda Carreira Devides
- Centro de Ciências da Saúde, Universidade do Sagrado Coração, Rua Irmã Arminda, 10-50, Jardim Brasil, Bauru, São Paulo, 17.011-160, Brazil
| | - Eliane Aparecida Silva
- Instituto Lauro de Souza Lima, Rodovia Comandante João Ribeiro de Barros, Km 225/226, Bauru, São Paulo, 17034-971, Brazil
| | - Luciana Raquel Vincenzi Fachin
- Instituto Lauro de Souza Lima, Rodovia Comandante João Ribeiro de Barros, Km 225/226, Bauru, São Paulo, 17034-971, Brazil
| | - Cassio Cesar Ghidella
- Centro de Referência de Hanseníase e Tuberculose, Rua Pedro Guimarães s/n, Bairro Santa Cruz, Rondonópolis, Mato Grosso, 78710-760, Brazil
| | - Cleverson Teixeira Soares
- Instituto Lauro de Souza Lima, Rodovia Comandante João Ribeiro de Barros, Km 225/226, Bauru, São Paulo, 17034-971, Brazil
| | - Gustavo Pompermaier Garlet
- Departamento de Ciências Biológicas, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru, São Paulo, 17012-901, Brazil
| | - Patrícia Sammarco Rosa
- Instituto Lauro de Souza Lima, Rodovia Comandante João Ribeiro de Barros, Km 225/226, Bauru, São Paulo, 17034-971, Brazil
| | | | - Ana Paula Favaro Trombone
- Centro de Ciências da Saúde, Universidade do Sagrado Coração, Rua Irmã Arminda, 10-50, Jardim Brasil, Bauru, São Paulo, 17.011-160, Brazil.
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