Hipótese era de que havia restos de vírus na garganta dos pacientes mesmo após a cura, mas nova explicação envolve integração do Sars-CoV-2 no genoma humano

Fernando Reinach, O Estado de S.Paulo

O método mais sensível para saber se uma pessoa está infectada pelo Sars-CoV-2 consiste em coletar uma amostra da secreção presente na garganta e nas narinas. Em seguida, se usa o PCR para detectar a presença do RNA do vírus na amostra. Se o resultado for positivo, a pessoa está infectada: é o famoso teste de PCR. O problema é que, mesmo após a pessoa estar curada, esse teste continua dando resultados positivos em muitos casos.

Isso ocorre porque fragmentos do RNA do vírus continuam presentes na garganta da pessoa por meses. Mas de onde viriam esses fragmentos se o vírus foi eliminado pelo sistema imune e a pessoa está curada? Até agora a explicação era que mesmo depois da cura sobrariam restos do vírus na garganta. Agora foi descoberto que a explicação é outra.

Fernando Reinach
O biólogo Fernando Reinach  Foto: Clayton de Souza/Estadão

O genoma do Sars-CoV-2 consiste em uma molécula de RNA recoberta por uma cápsula de onde saem os espinhos que aparecem nas fotos. Após invadir uma célula humana, o RNA presente no vírus é liberado e multiplicado, gerando um número enorme de outras moléculas de RNA que são encapsuladas, se transformando em novas partículas virais. Essa nova geração de vírus é liberada e infecta outras células. É assim que o vírus se espalha pelo corpo.

Faz muitos anos que sabemos que moléculas de RNA presentes no interior de uma célula humana podem ser transformadas em moléculas de DNA e essas moléculas de DNA ocasionalmente podem ser inseridas no DNA da célula hospedeira. 

Sabendo disso, os cientistas resolveram investigar se isso acontecia com o RNA do Sars-CoV-2. Para tanto, usaram diversos métodos que consistem em isolar o DNA de células infectadas, sequenciar esse DNA e verificar se pedaços de DNA com sequências do Sars-CoV-2 estão presentes. Não só os cientistas encontraram diversos fragmentos do vírus em diversas regiões do genoma, mas descobriram que as regiões que delimitam os locais da inserção são típicas de um mecanismo que existe em todos nós e que pode transformar moléculas de RNA em DNA e inseri-las no genoma.

Também foi possível demonstrar que esses fragmentos inseridos não são capazes de produzir novas partículas virais (e por isso a pessoa continua curada), mas produzem fragmentos de RNA que podem ser detectados nos testes de PCR. 

Essas descobertas demonstram que, em muitas pessoas, o vírus, além de invadir as células e continuar a se espalhar pelo corpo até ser combatido pelo sistema imune, também consegue inserir no genoma das células infectadas pedaços do seu genoma – que permanecem no corpo mesmo após ele estar curado. Esses fragmentos continuam a produzir pedaços de RNA e proteína enquanto essas células que foram infectadas e seus descendentes ficarem em nosso corpo. São esses fragmentos de RNA que são detectados pelo teste de PCR em pessoas já curadas.

Ainda não se sabe se esse fenômeno tem alguma consequência além de gerar testes de PCR positivos, mas os cientistas sugerem que esses fragmentos produzidos podem talvez servir como um estímulo contínuo para o sistema imune ou podem estar envolvidos na presença dos sintomas que, em algumas pessoas, podem durar meses após o término da infecção (a chamada covid longa). Esse fenômeno não é único do Sars-CoV-2, ele já foi detectado em infecções por outros vírus. 

O fato é que, após nos curarmos de uma infecção, duas modificações ocorrem em nosso corpo: nosso sistema imune passa a produzir anticorpos e células capazes de combater o vírus e o genoma de parte de nossas células passa a ter fragmentos do genoma do Sars-CoV-2. Essa descoberta pode ter implicações importantes ou ser somente uma explicação de por que algumas pessoas apresentam testes de PCR positivos depois de curadas. É cedo para saber.

MAIS INFORMAÇÕES: REVERSE-TRANSCRIBED SARS-COV-2 RNA CAN INTEGRATE INTO THE GENOME OF CULTURED HUMAN CELLS AND CAN BE EXPRESSED IN PATIENT-DERIVED TISSUES. PROC. NAT. ACAD. SCI. USA https://doi.org/10.1073/pnas.2105968118

* É BIÓLOGO, PHD EM BIOLOGIA CELULAR E MOLECULAR PELA CORNELL UNIVERSITY E AUTOR DE A CHEGADA DO NOVO CORONAVÍRUS NO BRASIL; FOLHA DE LÓTUS, ESCORREGADOR DE MOSQUITO; E A LONGA MARCHA DOS GRILOS CANIBAIS

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