Tambanãm conhecidas como gripe estomacal , as infeca§aµes por norovarus causam diarranãia aquosa, febre baixa e, o mais alarmante de tudo, va´mito por projanãtil, que éuma maneira extremamente eficaz de espalhar o varus
(Imagem: © CDC / Jessica A. Allen)
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Esta representação gra¡fica 3D departículas de norovarus ébaseada em imagens microsca³picas eletra´nicas departículas de varus reais.
Nos últimos meses, escolas de todo opaís fecharam devido a surtos de norovarus. Tambanãm conhecidas como gripe estomacal , as infecções por norovarus causam diarranãia aquosa, febre baixa e, o mais alarmante de tudo, va´mito por projanãtil, que éuma maneira extremamente eficaz de espalhar o varus .
O norovarus émuito infeccioso e se espalha rapidamente por uma população confinada, como em uma escola ou em um navio de cruzeiro. Embora a maioria dos pacientes se recupere em 24 a 48 horas, o norovarus éuma das principais causas de doenças na infa¢ncia e, nospaíses em desenvolvimento, resulta em cerca de 50.000 mortes de criana§as a cada ano .
Curiosamente, nem todos são igualmente vulnera¡veis ​​ao varus, e se vocêfica doente ou não pode depender do seu tipo sanguaneo .
Relacionado: Qual éo tipo sanguaneo mais raro?
a‰ difacil se livrar do norovarus
Sou microbiologista e fiquei interessado em norovarus porque, embora os sintomas do norovarus sejam angustiantes em qualquer circunsta¢ncia, meu encontro com o varus foi particularmente inconveniente. Durante uma viagem de rafting de sete dias pelo Grand Canyon, a doença passou pelas vigas e pela equipe, uma a uma. Obviamente, as instalações sanita¡rias do deserto não eram as melhores para lidar com esse surto. Felizmente, todos, inclusive eu, se recuperaram rapidamente. Acontece que surtos de norovarus em viagens de rafting no rio Colorado são comuns.
Por mais debilitante que possa ser a doença que causa, a partacula de norovarus évisualmente bonita. a‰ um tipo de varus conhecido como "não envelopado" ou "nu", o que significa que nunca adquire o revestimento de membrana tapico de outros varus, como o varus da gripe. AsuperfÍcie do norovarus éuma camada protanãica, chamada "capsadeo". O capsadeo protege o material genanãtico do norovarus.
A pelagem capsidiana éum fator que dificulta o controle do norovarus. Varus com revestimento de membrana são suscetíveis a a¡lcool e detergentes, mas não a norovarus. O norovarus pode sobreviver a temperaturas de congelamento a 145 graus Fahrenheit (aproximadamente a temperatura máxima da águaem uma ma¡quina de lavar loua§a), saba£o e soluções suaves de águasanita¡ria. O norovarus pode persistir nas ma£os humanas por horas e emsuperfÍcies e alimentos sãolidos por dias e também éresistente a desinfetantes para as ma£os a base de a¡lcool.
Para piorar as coisas, apenas uma pequena dose do varus - até10partículas virais - énecessa¡ria para causar a doena§a. Dado que uma pessoa infectada pode excretar muitos bilhaµes departículas virais, émuito difacil impedir a propagação do varus.
A suscetibilidade ao norovarus depende do tipo sanguaneo
Quando o norovarus éingerido, inicialmente infecta as células que revestem o intestino delgado. Os pesquisadores não sabem exatamente como essa infecção causa os sintomas da doena§a. Mas um aspecto fascinante do norovarus éque, após a exposição, o tipo sanguaneo determina, em grande parte, se uma pessoa fica doente .
Seu tipo sanguaneo - A, B, AB ou O - éditado por genes que determinam quais tipos de molanãculas, chamados oligossacaradeos, são encontrados nasuperfÍcie dos seus gla³bulos vermelhos. Os oligossacaradeos são produzidos a partir de diferentes tipos de açúcares, ligados de maneira complexa.
Os mesmos oligossacaradeos presentes nos gla³bulos vermelhos também aparecem nasuperfÍcie das células que revestem o intestino delgado. O norovarus e alguns outros varus usam esses oligossacaradeos para agarrar e infectar as células intestinais. a‰ a estrutura especafica desses oligossacaradeos que determina se uma determinada cepa de varus pode se conectar e invadir.
A presença de um oligossacaradeo, chamado antageno H1, énecessa¡ria para ligação por muitas cepas de norovarus.
As pessoas que não produzem o antageno H1 em suas células intestinais representam 20% da população de origem europanãia e são resistentes a muitas cepas de norovarus .
Mais açúcares podem ser ligados ao antageno H1 para fornecer os tipos sanguaneos A, B ou AB. As pessoas que não podem fazer as modificações A e B tem o tipo sanguaneo O.
Cepas diferentes de norovarus infectam pessoas diferentes
O norovarus evolui rapidamente. Atualmente, existem 29 linhagens diferentes que infectam seres humanos, e cada linhagem tem variantes diferentes. Cada um tem habilidades diferentes para se ligar a s moléculas de açúcar de formas variadas nasuperfÍcie celular intestinal. Estes açúcares são determinados pelo tipo de sangue.
Se um grupo de pessoas éexposto a uma cepa de norovarus, quem fica doente dependera¡ do tipo sanguaneo de cada pessoa. Poranãm, se o mesmo grupo de pessoas for exposto a uma cepa diferente de norovarus, pessoas diferentes podem ser resistentes ou suscetaveis. Em geral, aqueles que não produzem o antageno H1 e as pessoas com tipo sanguaneo B tendem a ser resistentes, enquanto as pessoas com tipos sanguaneos A, AB ou O tendem a ficar doentes , mas o padrãodepende da cepa especafica de norovarus.
Essa diferença de suscetibilidade tem uma conseqa¼aªncia interessante. Quando um surto ocorre, por exemplo, em um navio de cruzeiro, aproximadamente um tera§o das pessoas pode escapar da infecção. Como eles não sabem o motivo subjacente de sua resistência, acho que as pessoas poupadas se envolvem em um pensamento ma¡gico - por exemplo, "não adoeci porque bebi muito suco de uva". Obviamente, essas maticas técnicas evasivas não funcionara£o se o pra³ximo surto for uma tensão a qual o indivaduo ésuscetavel.
A imunidade ao norovarus tem vida curta
Uma infecção por norovarus provoca uma resposta imune robusta que elimina o varus em poucos dias. No entanto, a resposta parece ter vida curta. A maioria dos estudos descobriu que a imunidade contra a reinfecção com a mesma cepa de norovarus dura menos de seis meses . Além disso, a infecção por uma cepa de norovarus oferece pouca proteção contra a infecção de outra. Assim, vocêpode ter ataques repetidos com o norovarus.
A diversidade de cepas de norovarus e a impermanaªncia da resposta imune complica o desenvolvimento de uma vacina eficaz. Atualmente, os ensaios clínicos estãotestando os efeitos das vacinas fabricadas a partir das proteanas do capsadeo das duas cepas de norovarus mais prevalentes.
Em geral, essas vacinas experimentais produzem boas respostas imunes ; a longevidade da resposta imune estãoagora em estudo . A próxima fase dos ensaios clínicos testara¡ se as vacinas realmente previnem ou reduzem os sintomas da infecção pelo norovarus.
Este artigo foi publicado originalmente na The Conversation. A publicação contribuiu com o artigo para Expert Voices da Live Science : Op-Ed & InsightsÂ