Rafael Brandão Varella

Background: Merkel cell polyomavirus (MCPyV) has been established as an etiological agent in Merkel cell carcinoma (MCC), yet its role in other cutaneous neoplasms remains under investigation. The impact of the host’s immunogenetic characteristics on the persistence of Merkel cell polyomavirus (MCPyV) in non-melanoma skin cancer (NMSC) is not yet well understood. Objective: Our aim was to investigate the presence of MCPyV in various skin lesions, particularly NMSC, and its association with cytokine gene polymorphisms related to immune regulation. Methods: We analyzed 274 skin biopsies (lesional, perilesional, and healthy skin) from 84 patients undergoing dermatological evaluation. MCPyV DNA and polymorphisms in IL-6, IL-10, IFN-γ, and TNF-α genes were detected using PCR-based assays. Results: MCPyV was significantly more prevalent in NMSC and non-cancerous lesions than in surgical margins or healthy skin (p = 0.050 and 0.048, respectively). Concordance between lesion and margin samples was low (κ = 0.305), suggesting microenvironment-specific viral persistence. Notably, high-expression IL-10 genotypes (-1082 GG) and low-expression IL-6 genotypes (-174 AA) were significantly associated with MCPyV detection (p = 0.048 and p = 0.015, respectively). Conclusions: MCPyV preferentially localizes to NMSC lesions, particularly in individuals with immunogenetic profiles favoring viral persistence. Since the role of MCPyV in the pathogenesis of NMSC remains uncertain, our results highlight the need for further studies to clarify whether the lesion’s microenvironment supports viral persistence or indicates a more intricate interaction between the virus and the host, which could be significant for the development of skin cancer.

This essay examines the structural crisis hindering effective science dissemination, particularly in contexts lacking a robust scientific ambiance and foundational education. Using Brazil—a major global economy with paradoxically low literacy and PISA scores—as a case study, the article argues that attempts to inculcate science often fail due to deep-seated formative deficiencies. It traces the historical shift from holistic, humanistic education towards a pragmatic, utilitarian model, leading to a conflation of science (theory) with technology (techne) and a decline in speculative inquiry and major breakthroughs. Factors such as knowledge fragmentation, the "reverse Flynn effect," and a contemporary scientific modus operandi driven by quantitativism and immediate results further exacerbate this issue. The paper warns against science detached from ethical and humanistic values, citing historical misuses. It concludes that meaningful science dissemination, capable of fostering critical discernment, requires a revitalized educational approach centered on integrated, humanistic knowledge. Only by cultivating such a foundational scientific culture can society genuinely engage with and benefit from scientific advancements, avoiding a descent into "digital neo-barbarianism."

Background: Merkel cell polyomavirus (MCPyV) has been established as an etiological agent in Merkel cell carcinoma (MCC), yet its role in other cutaneous neoplasms re-mains under investigation. In the context of non-melanoma skin cancer (NMSC), the influence of host immunogenetics on MCPyV persistence is poorly understood. Objec-tive: To investigate the presence of MCPyV in various skin lesions, particularly NMSC, and its association with cytokine gene polymorphisms related to immune regulation. Methods: We analyzed 274 skin biopsies (lesional, perilesional, and healthy skin) from 84 patients undergoing dermatological evaluation. MCPyV DNA and polymorphisms in IL-6, IL-10, IFN-γ, and TNF-α genes were detected using PCR-based assays. Results: MCPyV was significantly more prevalent in NMSC and non-malignant lesions than in surgical margins or healthy skin (p = 0.050 and 0.048, respectively). Concordance be-tween lesion and margin samples was low (κ = 0.305), suggesting microenviron-ment-specific viral persistence. Notably, high-expression IL-10 genotypes (-1082GG) and low-expression IL-6 genotypes (-174AA) were significantly associated with MCPyV detection (p = 0.048 and p = 0.015, respectively). Conclusion: MCPyV prefer-entially localizes to NMSC lesions, particularly in individuals with immunogenetic profiles favoring viral persistence. Given the unclear role of MCPyV in NMSC patho-genesis, our findings call for comprehensive studies to determine whether the lesional environment facilitates viral persistence or reflects a more complex viral–host interac-tion with potential implications in cutaneous oncogenesis.

INTRODUÇÃO À VIROLOGIA GERAL E HUMANA

In June 2024, when questioned under oath by the U.S. House of Representatives’ Select Subcommittee on the Coronavirus Pandemic, Dr. Anthony Fauci, the driving force behind numerous pandemic-related policies that became models worldwide, categorically stated that the decisions made were not "supported by scientific evidence" (U.S. House of Representatives, 2024). Among these were the six-foot social distancing rule and the controversial use of masks for children, causing an uproar in the global press. Beyond the "scientific" merits of such policies, the words of the former director of the National Institutes of Health (NIH) - an organization equivalent to Brazil’s Ministry of Health - invite profound reflections on how societies and even the scientific community, currently averse to the free exchange of ideas, understand the modus operandi of scientific labor. This activity, which belongs to human speculative intellect in the pursuit of knowledge, has been adorned with an infallibility that clashes with its foundational principles.

Em junho de 2024, ao ser questionado sob juramento pelo Subcomitê Selecionado sobre a Pandemia do Coronavírus da Câmara dos Representantes dos EUA, o dr. Anthony Fauci, principal força motriz das várias políticas relacionadas à pandemia de Covid-19 que se tornaram modelo para o restante do planeta, foi categórico ao afirmar que as decisões tomadas não “tinham respaldo científico” (Câmara de Representantes dos EUA, 2024), dentre as quais o distanciamento de cerca de 1,8 metro (6 pés na medida americana) e o polêmico uso de máscara em crianças, gerando grande alvoroço na imprensa mundial. Para além da discussão de mérito “científico” de tais políticas, as palavras do ex-diretor do National Institutes of Health (NIH), órgão equivalente ao Ministério da Saúde brasileiro, traz consigo profundas reflexões sobre como as sociedades e a própria comunidade científica, atualmente pouco afeita à livre discussão de ideias, compreende o modus agendi do labor científico, atividade própria do intelecto especulativo humano de busca pelo saber, mas que todavia vem se adornando de uma infalibilidade que se choca com seus próprios fundamentos.

Background: Human papillomavirus (HPV) infection profoundly affects women living with HIV (WLWH). This infection leads to cervical cancer (CC) and increased mortality. Methods: This study monitored HPV infection in WLWH in Rio de Janeiro, Brazil, before (T1) and after (T2) 4 years of vaccination. HPV genotyping and the presence of intraepithelial lesions were investigated at both time points. Results: Among the 156 WLWH who received the quadrivalent HPV vaccine (4vHPV) at T1, 30 (19.2%) were initially found to have HPV DNA. After vaccination, only three (7%) of those who were HPV-negative at T1 tested positive for HPV. Most women who tested positive for HPV DNA at T1 had normal Pap smear results. However, this cohort also demonstrated a significant increase in cases of atypical squamous cells of uncertain significance and cervical intraepithelial neoplasia in PCR-negative HPV DNA samples at T2 ( p < .01). Conversely, women who initially tested negative for HPV DNA continued to exhibit normal Pap smear results in 2018 ( p < .01). Conclusions: This study highlights the persistence of HPV in WLWH despite vaccination and underscores the importance of continued molecular and cytologic screening. The findings enhance our understanding of vaccine effectiveness in this population and emphasize the need for tailored preventive strategies.