RESUMO
Because histopathological changes in the lungs of patients with systemic sclerosis (SSc) are consistent with alveolar and vessel cell damage, we presume that this interaction can be characterized by analyzing the expression of proteins regulating nitric oxide (NO) and plasminogen activator inhibitor-1 (PAI-1) synthesis. To validate the importance of alveolar-vascular interactions and to explore the quantitative relationship between these factors and other clinical data, we studied these markers in 23 cases of SSc nonspecific interstitial pneumonia (SSc-NSIP). We used immunohistochemistry and morphometry to evaluate the amount of cells in alveolar septa and vessels staining for NO synthase (NOS) and PAI-1, and the outcomes of our study were cellular and fibrotic NSIP, pulmonary function tests, and survival time until death. General linear model analysis demonstrated that staining for septal inducible NOS (iNOS) related significantly to staining of septal cells for interleukin (IL)-4 and to septal IL-13. In univariate analysis, higher levels of septal and vascular cells staining for iNOS were associated with a smaller percentage of septal and vascular cells expressing fibroblast growth factor and myofibroblast proliferation, respectively. Multivariate Cox model analysis demonstrated that, after controlling for SSc-NSIP histological patterns, just three variables were significantly associated with survival time: septal iNOS (P=0.04), septal IL-13 (P=0.03), and septal basic fibroblast growth factor (bFGF; P=0.02). Augmented NOS, IL-13, and bFGF in SSc-NSIP histological patterns suggest a possible functional role for iNOS in SSc. In addition, the extent of iNOS, PAI-1, and IL-4 staining in alveolar septa and vessels provides a possible independent diagnostic measure for the degree of pulmonary dysfunction and fibrosis with an impact on the survival of patients with SSc.
Assuntos
Doenças Pulmonares Intersticiais/patologia , Óxido Nítrico Sintase/metabolismo , Inibidor 1 de Ativador de Plasminogênio/metabolismo , Escleroderma Sistêmico/patologia , Adulto , Biomarcadores/sangue , Citocinas/sangue , Feminino , Humanos , Imuno-Histoquímica , Interleucina-13/metabolismo , Interleucina-4/metabolismo , Estimativa de Kaplan-Meier , Doenças Pulmonares Intersticiais/etiologia , Doenças Pulmonares Intersticiais/metabolismo , Doenças Pulmonares Intersticiais/mortalidade , Pessoa de Meia-Idade , Óxido Nítrico Sintase Tipo II/metabolismo , Isoformas de Proteínas/sangue , Escleroderma Sistêmico/complicações , Escleroderma Sistêmico/metabolismo , Escleroderma Sistêmico/mortalidadeRESUMO
Because histopathological changes in the lungs of patients with systemic sclerosis (SSc) are consistent with alveolar and vessel cell damage, we presume that this interaction can be characterized by analyzing the expression of proteins regulating nitric oxide (NO) and plasminogen activator inhibitor-1 (PAI-1) synthesis. To validate the importance of alveolar-vascular interactions and to explore the quantitative relationship between these factors and other clinical data, we studied these markers in 23 cases of SSc nonspecific interstitial pneumonia (SSc-NSIP). We used immunohistochemistry and morphometry to evaluate the amount of cells in alveolar septa and vessels staining for NO synthase (NOS) and PAI-1, and the outcomes of our study were cellular and fibrotic NSIP, pulmonary function tests, and survival time until death. General linear model analysis demonstrated that staining for septal inducible NOS (iNOS) related significantly to staining of septal cells for interleukin (IL)-4 and to septal IL-13. In univariate analysis, higher levels of septal and vascular cells staining for iNOS were associated with a smaller percentage of septal and vascular cells expressing fibroblast growth factor and myofibroblast proliferation, respectively. Multivariate Cox model analysis demonstrated that, after controlling for SSc-NSIP histological patterns, just three variables were significantly associated with survival time: septal iNOS (P=0.04), septal IL-13 (P=0.03), and septal basic fibroblast growth factor (bFGF; P=0.02). Augmented NOS, IL-13, and bFGF in SSc-NSIP histological patterns suggest a possible functional role for iNOS in SSc. In addition, the extent of iNOS, PAI-1, and IL-4 staining in alveolar septa and vessels provides a possible independent diagnostic measure for the degree of pulmonary dysfunction and fibrosis with an impact on the survival of patients with SSc.
Assuntos
Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Doenças Pulmonares Intersticiais/patologia , Óxido Nítrico Sintase/metabolismo , Inibidor 1 de Ativador de Plasminogênio/metabolismo , Escleroderma Sistêmico/patologia , Biomarcadores/sangue , Citocinas/sangue , Imuno-Histoquímica , /metabolismo , /metabolismo , Estimativa de Kaplan-Meier , Doenças Pulmonares Intersticiais/etiologia , Doenças Pulmonares Intersticiais/metabolismo , Doenças Pulmonares Intersticiais/mortalidade , Óxido Nítrico Sintase Tipo II/metabolismo , Isoformas de Proteínas/sangue , Escleroderma Sistêmico/complicações , Escleroderma Sistêmico/metabolismo , Escleroderma Sistêmico/mortalidadeRESUMO
Two dental cleansing products, Rc-Prep and Largal Ultra, were subjected to a comparative study, evaluating their efficacy in vitro on 15 recently-extracted dentary units, through optic microscopy applied on the dentine wall of the instrumented root canal. Both materials were applied on separate hemisections of the canal during 15 minutes intervals, with two applications on each canal. Rc-Prep was observed to have a slight, not significant advantage over Largal-Ultra in its cleansing effect over the dentine smear, although the compact, granular and amorphous layer of dentine smear over the root canal wall, blocking the entry to dentine channels, persisted after use of both products. In view of conditions observed in the dentine walls, the authors assume that adhesion and adaptation of obturating materials over these structures is exceedingly difficult. Although variability was not considered as is usual in clinical studies, in vitro evaluation as observed in this study allows a more accurate comparative analysis, since it was performed on one individual tooth, with analogous instrumentation and on dentary tissue with similar characteristics.