RESUMO
The authors present the results of a dermatological survey conducted among the Xavánte Indians from the Pimentel Barbosa Reservation, state of Mato Grosso, Brazil Scabies, pediculosis, and pioderma were the most frequent diseases, clearly related to poor hygiene. The finding of perleche indicates the presence of nutritional deficiency. Endemic pemphigus foliaceus (fogo selvagem) was the most serious dermatological affection found in this population.
RESUMO
Endemic pemphigus foliaceus (EPF), is an autoimmune disease associated with production of IgG antibodies against epidermal antigens. We have tested 38 patients and 50 control subjects living in endemic areas to investigate whether HLA genes are associated with host factors that determine whether or not exposed individuals will develop this disease. A variant of HLA-DR1, an antigen common in Blacks (DRB1*0102), was found to be the main susceptibility factor (relative risk = 7.3, P less than 0.0002). Two amino acids, in positions 85 and 86 of DRB1, distinguish DRB1*0102 from DRB1*0101. These residues appear to be involved in the formation of a functional epitope that causes T cell recognition and determines disease susceptibility. Moreover, subjects having DQw2 did not develop the disease, while the frequency of DQw2 in controls was 22% (RR = 0.04, P less than 0.006). Thus HLA genes appear to play a crucial role in the response to an environmental factor which in this setting frequently leads to the development of autoimmune disease. An HLA-DQ allele, DQw2, appears to be associated with factors that prevent the development of the disease in exposed individuals.
Assuntos
Doenças Autoimunes/imunologia , Antígenos HLA-DQ/análise , Antígenos HLA-DR/análise , Pênfigo/imunologia , Doenças Autoimunes/genética , Brasil , Epitopos/análise , Antígenos HLA-DQ/genética , Antígenos HLA-DQ/imunologia , Antígenos HLA-DR/genética , Antígenos HLA-DR/imunologia , Humanos , Pênfigo/genética , RiscoAssuntos
Gravidez , Recém-Nascido , Humanos , Masculino , Feminino , Pênfigo/imunologia , Anticorpos , Imunofluorescência , Imunoglobulina G , Complicações na GravidezRESUMO
The aim of the present research was to standardize the indirect immunofluorescence reaction for Endemic Pemphigus Foliaceus (Fogo Selvagem). We found that fresh human skin was the ideal substrate and could proceed from foreskin, head, neck, or anterior abdominal wall. PBS pre-washing of the skin preceding the incubation with the serum should be avoided since the antigenicity might be diminished. TAS-calcium pre-serves the Pemphigus antigenic properties of the skin and shall be preferred as the diluent for the sera. Albumin-coated slides are useful because they increase the adherence of the skin sections. The conjugate appropriate dilution is convenientely determined by the radial immunodiffusion test (Ouchterlony method). So far as the correlation between the antibody titer and the clinical activity is concerned, we concluded that a titer of 160 or more was of bad prognosis, since it was associated with the generalized form of the disease or with cases of the localized form refractory to the usual therapy. Nevertheless, this assumption needs confirmation by further studies involving an appropriate clinical approach.
Assuntos
Autoanticorpos/imunologia , Imunofluorescência , Pênfigo/imunologia , Humanos , Imunodifusão/métodos , Pele/imunologiaRESUMO
PIP: Although the belief persists that sexuality is an adult concern, not to be spoken of with children and adolescents lest such discussions awaken desires and prompt early sexual initiation, in reality adult inhibitions and repressions have created a problem of adolescent sexuality where none need exist. A pregnant adolescent is immediately rejected by friends, family, and teachers, although later on she is again accepted. She has 2 alternatives: carrying the pregnancy to term or abortion. A 1981 study of adolescents aged 10-23 years indicated that the majority had had some type of sexual interaction such as caressing or kissing, but only minority had experienced coitus. The majority of the young people believed that virginity was desirable for both sexes. Few of the boys who had had intercourse had done so with prostitutes. 62% said that females took the initiative equally with males in sexual matters. The majority had heard of contraceptives and knew where to obtain them, but only 11% had ever used a method. Half did not know how their parents would react if they knew about their children's contraceptive usage, and 1/4 feared they would be expelled from the house or subjected to some other violent reaction if their parents found out. Only 18% thought their parents would have a sympathetic attitude. Half thought abortion was a crime but the rest had a range of attitudes reflecting the diverse attitudes of the general population. Various organizations in the Dominican Republic provide much-needed sex education which prompts the creation of conditions of equality and mutual respect in the family. The Adolescent Center of the Dominican Association for Family Welfare provides training in sex education for selected groups of adolescents, who spread their knowledge among their peers. In the past 3 years, 110 such adolescents, called multipliers, have been trained. 42 talks, 6 round tables, 4 intensive and 8 general courses in sex education have been provided for 8900 adolescents. 8 meetings attended by 200 parents of adolescents, 5 workshops attended by 169 teachers were held, 50 clients received psychological counseling, and a sex education manual was prepared.^ieng