RESUMO

O uso de plantas medicinais pela população brasileira é prática tradicional, sendo muitas vezes o único recurso utilizado na atenção básica de saúde. O uso terapêutico dessas plantas envolve várias etapas da cadeia produtiva, sendo a procedência, coleta, secagem, armazenamento, comércio, modo de preparo pelo usuário e uso. O objetivo desse trabalho documental, de caráter exploratório, foi levantar a produção científica existente sobre os problemas associados a cada uma dessas etapas e discutir as questões relacionadas à carência de estudos para comprovar a eficácia farmacológica e a ausência de riscos toxicológicos, bem como a prática de autodiagnóstico. As vinte plantas mais comercializadas em grande mercado do município do Rio de Janeiro em agosto de 2007 serviram de base para o levantamento documental do presente estudo. Dessas, seis apresentaram propriedades tóxicas comprovadas dependendo do preparo e uso, a arnica (Solidago chilensis Meyen), aroeira (Shinus terebinthifolius Raddi.), arruda (Ruta graveolens L.), babosa (Aloe vera L.), confrei (Symphytum officinale L.) e poejo (Mentha pulegium Lam. & DC.). A Agência Nacional de Vigilância Sanitária aponta contra indicações para boldo-do-Chile (Peumus boldus Molina), chapéu-de-couro (Echinodorus macrophyllus Micheli), erva-cidreira (Lippia alba N.E.Br.), erva-de-bicho (Polygonum spp.), espinheira-santa (Maytenus spp.), picão (Bidens pilosa L.), poejo (Mentha pulegium Lam.) e tanchagem (Plantago major L.). O abajerú, arnica, boldo-do-Chile, confrei, erva-de-bicho e espinheira-santa tiveram relato de problemas de identificação na coleta e comercialização frente a outras morfologicamente semelhantes. Plantas cultivadas e silvestres apresentam variabilidade de princípios ativos influenciados por fatores ambientais e genéticos, como chapéu-de-couro (Echinodorus macrophyllus Micheli), erva-cidreira (Lippia alba N.E.Br.) e erva-de-bicho (Polygonum spp.). A contaminação e o comprometimento da preservação dos princípios ativos pela secagem e armazenamento inadequados foram relatados para o guaco (Mikania glomerata Sprengel), camomila (Chamomilla recutita L.), erva-cidreira, chapéu-de-couro e boldo-do-Chile (Peumus boldus Molina). Pode-se constatar que todas as etapas da cadeia produtiva das plantas medicinais apresentam desafios para que se possa garantir identificação da espécie, disponibilidade, qualidade, segurança e eficácia de uso.

The use of medicinal plants by the Brazilian population is a traditional practice and is often the main resource used in primary healthcare. The therapeutic use of these plants involves several steps in the supply chain: origin, harvest, drying, storage, form of preparation by the user and use. The aim of this documental study of exploratory nature was to survey the scientific literature about the problems associated with each of those steps and discuss the issues related to the lack of studies to prove the pharmacological efficacy and the absence of toxicological risks, as well as the autodiagnosis practice. The 20 plants most commercialized in a large market of Rio de Janeiro City in August 2007 were the basis for the documental survey of the present study. Of these, six had proven toxic properties depending on their preparation and use: arnica (Solidago chilensis Meyen), aroeira (Shinus terebinthifolius Raddi.), rue (Ruta graveolens L.), "babosa" (Aloe vera L.), comfrey (Symphytum officinale L.) and pennyroyal (Mentha pulegium Lam. & DC.). The National Agency for Sanitary Surveillance shows contraindications for: "boldo-do-Chile" (Peumus boldus Molina), "chapéu-de-couro" (Echinodorus macrophyllus Micheli), lemon balm (Lippia alba N.E.Br.), "erva-de-bicho" (Polygonum spp.), "espinheira-santa" (Maytenus spp.), "picão" (Bidens pilosa L.), pennyroyal (Mentha pulegium Lam.) and plantain (Plantago major L.). "Abajerú", arnica, "boldo-do-Chile", comfrey, "erva-de-bicho" and "espinheira-santa" were reported to show identification problems in the harvest and in the commercialization compared to morphologically similar plants. Cultivated and wild plants showed variability in active principles influenced by environmental and genetic factors: "chapéu-de-couro" (Echinodorus macrophyllus Micheli), lemon balm (Lippia alba N.E.Br.) and "erva-de-bicho" (Polygonum spp.). Contamination and compromising of the preservation of active principles due to inadequate drying and storage was reported for guaco (Mikania glomerata Sprengel), camomile (Chamomilla recutita L.), lemon balm, "chapéu-de-couro" and "boldo-do-Chile" (Peumus boldus Molina). All stages of the supply chain of medicinal plants constitute challenges to ensure the proper species identification, availability, quality, safety, and efficacy of their use.

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Leptospirosis is a public health problem. Infection with pathogenic Leptospira occurs by exposure to many environments and is traditionally associated with occupational risk activities. Pulsed-field gel electrophoresis was used to investigate the epidemiological relatedness among Leptospira isolates. However, analysis by PFGE yielded inconclusive data as a result of extensive DNA degradation. This degradation can be significantly reduced by the inclusion of thiourea in the electrophoresis buffer, improving the analysis of DNA banding patterns.

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Vibrio cholerae is an important human pathogen and the cause of cholera. Since genetic variation and antibiotic resistance of strains have implications for effective treatment of the disease, we examined the genetic diversity and antibiotic resistance profile in 92 clinical strains (serogroup O1) and 56 environmental strains (O1 antigen, 42 strains; non-O1 antigen, 14 strains) isolated in Brazil between 1991 and 1999. Clinical and environmental O1 strains showed greater drug resistance compared to environmental non-O1 strains. Nearly all clinical O1 strains were resistant to one or more antibiotics while half of the environmental O1 and non-O1 strains were resistant to one or more antibiotics. No plasmids or class 1 integrons were detected in the strains by PCR analysis. Multilocus enzyme electrophoresis analysis (MLEE) suggests most of the O1 strains belong to a single (South American) clone that is related but different to seventh-pandemic strains isolated from other parts of the world. Our results show that there is a close genetic relationship between clinical and environmental O1 strains and that many serogroups and the environment can be a reservoir for antibiotic resistance.

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Susceptibility profiles of 99 Bacteroides fragilis strains for 9 antimicrobial agents were defined by using an agar dilution method. The isolates were uniformly susceptible to imipenen and metronidazole. All isolates were resistant to ampicillin. The resistance rates to amoxicillin/clavulanate, cefoxitin, cefotaxime, chloramphenicol, clindamycin and tetracycline were 3.0, 12.1, 15.1, 1.0, 18.2 and 75.7%, respectively. Sixteen strains showed reduced susceptibility to metronidazole (MIC 2-4 mg/L) but none had nim genes using PCR. All strains were also investigated for the presence of cepA, cfiA, cfxA, ermF and tetQ genes by PCR methodology and 92.9, 4.9, 24.2, 2 and 64.6% of the strains were respectively found positive. These results reflect the importance of surveys of susceptibility profiles and the relevance of detecting major genetic determinants to monitor the dissemination of these genes.

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