RESUMO
Laboratory animals are fundamental to study immunological aspects and the efficacy of new drugs to treat leishmaniasis. However, we do not have practical and good animal models to study leishmaniasis caused by Leishmania (Viannia) braziliensis - L(V)b. In this study, thirty-two experimental animals (Cavia porcellus) were injected in the hind foot with 3x105 promastigote forms of L(V)b. The animals were followed for eight weeks. None of the experimental animals developed lesions or presented the parasite in any of the tests performed (histopathological exam, smears, culture, inoculation in hamsters, and polymerase chain reaction)
Assuntos
Animais , Cobaias , Cobaias/parasitologia , Leishmania braziliensis/efeitos dos fármacos , Leishmania braziliensis/parasitologiaRESUMO
Laboratory animals are fundamental to study immunological aspects and the efficacy of new drugs to treat leishmaniasis. However, we do not have practical and good animal models to study leishmaniasis caused by Leishmania (Viannia) braziliensis - L(V)b. In this study, thirty-two experimental animals (Cavia porcellus) were injected in the hind foot with 3x10(5) promastigote forms of L(V)b. The animals were followed for eight weeks. None of the experimental animals developed lesions or presented the parasite in any of the tests performed (histopathological exam, smears, culture, inoculation in hamsters, and polymerase chain reaction).
RESUMO
Depression in cancer patients is common and may affect treatment outcome either directly (by lowering defenses) or indirectly (by lowering compliance). Neoadjuvant chemotherapy for advanced uterine cervix or breast cancer is a strenuous undertaking and may lead to depression and impair patients' willingness to comply with the rest of the treatment (eg, surgery or radiotherapy). We compare Beck Depression Inventory (BDI) scores both before and after neoadjuvant chemotherapy in order to verify if depression influences treatment outcome. We studied 22 advanced uterine cervix and 20 breast cancer patients submitted to three courses of neoadjuvant chemotherapy. We used cisplatin and ifosfamide for cervix, and fluorouracil, adriamycin, and cyclophosphamide for breast cancer. We did not identify significant differences in the number of depressed patients, before and after treatment. Cognitive affective, somatic-performance, and total BDI scores were not significantly different from before to after chemotherapy for both breast and uterine cervix cancer. After treatment, the number of depressive breast cancer patients increased while the number of uterine cervix cancer patients decreased. This trend to depression was found more often in less responsive breast cancer patients than in the more responsive cervix cancer patients. We were not able to link depression to treatment failure or success, but patients who responded to treatment were less depressed at the end of treatment.
Assuntos
Neoplasias da Mama/psicologia , Depressão , Neoplasias Uterinas/psicologia , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/patologia , Cisplatino/administração & dosagem , Ciclofosfamida/administração & dosagem , Doxorrubicina/administração & dosagem , Feminino , Fluoruracila/administração & dosagem , Humanos , Ifosfamida/administração & dosagem , Pessoa de Meia-Idade , Terapia Neoadjuvante , Resultado do Tratamento , Recusa do Paciente ao Tratamento , Neoplasias Uterinas/tratamento farmacológico , Neoplasias Uterinas/patologiaRESUMO
BACKGROUND: Our objective was to determine the possible presence of IgA antibodies directed against human central nervous system (CNS) structures in sera from coeliac disease (CD) patients. METHODS: Serum samples were collected from 4 patients with active CD on a gluten-containing diet, 11 biopsy-proven CD patients on a gluten-free diet (GFD), and 52 non-coeliac gastrointestinal controls. In all patients IgA antigliadin antibody (AGA) titres were determined with enzyme-linked immunoassay (ELISA), and IgA antiendomysium antibodies (EMA) with indirect immunofluorescence on human umbilical cord. Cryostat sections of human brain occipital cortex were incubated with the patients' sera and subsequently labelled with anti-human IgA fluorescein conjugate. RESULTS: All sera from patients with active CD on a gluten-containing diet yielded positive results in both the IgG-AGA and EMA test and in indirect immunofluorescence on brain tissue, disclosing a strong fluorescence over blood-vessels structures. All sera from CD patients on a GFD and from non-coeliac gastrointestinal controls gave a negative result on both the EMA test and the immunofluorescence reaction on human brain. CONCLUSIONS: Sera from patients with active CD contain IgA antibodies that react with human brain vessel structures, giving intense fluorescence. These antibodies are not present in sera from coeliac patients on a GFD or non-coeliac controls. This finding might be involved in the abnormal nervous system manifestations frequently described in association with coeliac disease.
Assuntos
Autoanticorpos/sangue , Encéfalo/irrigação sanguínea , Encéfalo/imunologia , Doença Celíaca/imunologia , Imunoglobulina A/sangue , Adulto , Idoso , Estudos de Casos e Controles , Pré-Escolar , Ensaio de Imunoadsorção Enzimática , Feminino , Sangue Fetal/imunologia , Técnica Indireta de Fluorescência para Anticorpo , Gliadina/imunologia , Humanos , Lactente , Masculino , Pessoa de Meia-IdadeRESUMO
Fogo selvagem is an autoimmune blistering skin disease that principally occurs among rural Brazilians living in geographically clumped disease foci. Exposure to hematophagous black flies possibly is related to the cause of the disease. We compared the occurrence, proportions, and richness of simuliid species immatures and the biting activity of adult females within a recently discovered, high prevalence focus of fogo selvagem, the Limão Verde Terena Reservation, to that of neighboring regions with no reported cases of fogo selvagem. Nine black fly species were collected from 12 stream sites during 5 trips to the fogo selvagem focus. The species showed longitudinal (upstream-downstream) trends in occurrence, proportions, and richness, and the abundance of simuliid immatures was greater at downstream sites. The most prevalent species at the focus, Simulium nigrimanum (Macquart), dominated the stream sites with highly abundant simuliid assemblages, and was the most common black fly in human bait collections. This species was absent or in very low numbers in neighboring valleys and villages that did not have cases of fogo selvagem.
Assuntos
Dípteros , Indígenas Sul-Americanos , Mordeduras e Picadas de Insetos , Pênfigo/epidemiologia , Animais , Brasil/epidemiologia , Bovinos , Cães , Equidae , Feminino , Geografia , Cavalos , Humanos , PrevalênciaRESUMO
Endemic pemphigus foliaceus or fogo selvagem (FS) in an organ-specific autoimmune skin disease characterized by epidermal vesicles and mediated by autoantibodies. Family cases are frequent and not everyone living in endemic region develops FS suggesting that host factors play a role in determining whether exposed individuals will be affected. Because our previous works with Brazilian Mestizos and with Xavante Indians have shown that particular HLA alleles confer increased risk for the disease, we decided to extend these studies to another homogeneous population, the Terena Indians. 19 out of 20 Terena patients were either positive for DRB1*0404, 1402 or 1406 (p < 0.005, RR = 14). These findings were in agreement with the data obtained from the Xavante study. In Mestizos the association was with DRB1*01. All these alleles involved in predisposition to the disease in different populations shared the same amino acid sequence at position 67-74 on the third hypervariable region of the DRB1 gene: LLEQRRAA, suggesting that inheritance of this sequence is involved in the susceptibility to FS. When patients and controls data from different studies were pooled and analyzed disregarding the ethnic background and the HLA alleles involved, the results obtained clearly supported the hypothesis that matching for this epitope is highly significant and predictive of FS predisposition (p < 0.00001, RR = 6.4).
Assuntos
Doenças Endêmicas , Epitopos/genética , Antígenos HLA-DR/genética , Indígenas Sul-Americanos/genética , Pênfigo/genética , Alelos , Brasil/epidemiologia , Suscetibilidade a Doenças/imunologia , Frequência do Gene , Antígenos HLA-DR/imunologia , Cadeias HLA-DRB1 , Humanos , Pênfigo/epidemiologia , Pênfigo/imunologia , População Branca/genéticaRESUMO
Fogo Selvagem (FS) is an autoimmune disease characterized by subcorneal vesicles and antidesmoglein-1 autoantibodies. Previous epidemiologic data have linked the onset of FS to exposure to an environmental antigen(s). This investigation describes a unique human settlement with an extraordinarily high prevalence of FS. This community is made up of Amerindians belonging to the Terena tribe, which has settled on the Limao Verde reservation in the state of Mato Grosso do Sul in Brazil. Twenty-six well-characterized FS cases have been identified within a total population of 998, yielding a prevalence of 2.6%. Seventeen of the patients (65 %) were males, and over 50% were older than 30 y of age. The incidence of the disease shows temporal periodicity, i.e., years with several cases of FS alternating with years with no cases. Over one-half of the cases occurred in genetically related family members. Another Terena reservation, the Ipegue/Taunay, located 90 km west of the Limao Verde reservation, was also evaluated as a control group. This reservation, with a population of 2203, had no recorded cases of FS. Thus, the Limao Verde reservation represents a new focus of FS in which the disease exhibits temporal, geographic, and familial clustering. These results suggest that the environmental antigen or antigens precipitating FS are endemic to the Limao Verde reservation. This reservation appears to be an ideal population for carrying out sero-epidemiologic, genetic, and environmental studies aimed at disclosing the etiology of FS.
Assuntos
Doenças Autoimunes/epidemiologia , Indígenas Sul-Americanos , Pênfigo/epidemiologia , Adolescente , Adulto , Idoso , Autoanticorpos/análise , Doenças Autoimunes/genética , Doenças Autoimunes/imunologia , Brasil , Criança , Análise por Conglomerados , Epiderme/imunologia , Feminino , Humanos , Indígenas Sul-Americanos/genética , Masculino , Pessoa de Meia-Idade , Linhagem , Pênfigo/genética , Pênfigo/imunologia , Prevalência , Fatores de TempoRESUMO
BACKGROUND: Fogo selvagem (FS) is an autoimmune disease that is endemic in certain regions of Brazil and appears to be precipitated by an environmental factor. OBJECTIVE: Our purpose was to confirm the occurrence and prevalence of FS in a population of Xavante Indians living in an endemic region of central Brazil. METHODS: Clinical, anthropologic, and immunologic studies were carried out in patients and in normal inhabitants of the Pimentel Barbosa Indian Reservation, Mato Grosso, Brazil. RESULTS: FS was identified and confirmed in 10 patients from a patient pool of 295 with various skin diseases. The Xavante settlement has a total population of 746. Anti-desmoglein 1 autoantibodies were detected in all patients with FS and were absent from more than 300 serum samples collected from randomly selected unaffected persons. CONCLUSION: FS is strongly linked to outdoor activities and is largely restricted to immunogenetically predisposed persons. FS appears to have been endemic in certain regions of South America for several centuries.
Assuntos
Indígenas Sul-Americanos , Pênfigo/etnologia , Adolescente , Adulto , Autoanticorpos/imunologia , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Linhagem , Pênfigo/genética , Pênfigo/imunologia , Pênfigo/patologia , Pele/imunologiaRESUMO
OBJECTIVE: To compare the survival, neurodevelopmental, and health outcomes of children with severe respiratory illness treated with and without extracorporeal membrane oxygenation (ECMO). DESIGN: Prospective collection of clinical and demographic data of all neonates reaching illness severity criteria, with follow-up at 8 and 20 months of age. Patients were assigned to treatment by the attending physician. PATIENTS: Consecutive sample of 74 neonates during a 24-month period with an alveolar-to-arterial gradient exceeding 620 for 8 or more hours. RESULTS: Eighteen (69%) of 26 neonates treated with conventional therapy survived to 20 months, in comparison with 43 (90%) of 48 neonates treated with ECMO. The conventionally treated group had significantly more chronic lung disease, longer duration of oxygen therapy, more chronic reactive airway disease, and more rehospitalizations than those treated with ECMO. Hospital charges were similar in the two groups. Macrocephaly was noted in 24% of those treated with ECMO and in none of the conventional group. Of those completing evaluation, 4 (24%) of 17 conventionally treated survivors and 20 (26%) of 38 ECMO-treated survivors had neurodevelopmental impairment. CONCLUSION: Survivors of severe neonatal respiratory illness have significant pulmonary and neurodevelopmental impairment, regardless of the treatment used. Neonates treated with ECMO had neurodevelopmental outcomes similar to those of patients treated conventionally, but better pulmonary outcomes.
Assuntos
Oxigenação por Membrana Extracorpórea , Insuficiência Respiratória/terapia , Doença Crônica , Deficiências do Desenvolvimento/etiologia , Humanos , Recém-Nascido , Pneumopatias/etiologia , Doenças do Sistema Nervoso/etiologia , Estudos Prospectivos , Respiração Artificial , Insuficiência Respiratória/complicações , Insuficiência Respiratória/mortalidade , Taxa de Sobrevida , Resultado do TratamentoAssuntos
Doenças Autoimunes/imunologia , Genes MHC da Classe II , Marcadores Genéticos , Antígenos HLA-DQ/genética , Antígenos HLA-DR/genética , Antígenos de Histocompatibilidade Classe II/genética , Indígenas Sul-Americanos/genética , Pênfigo/imunologia , Alelos , Sequência de Aminoácidos , Doenças Autoimunes/genética , Brasil , Suscetibilidade a Doenças/imunologia , Frequência do Gene , Predisposição Genética para Doença , Cadeias beta de HLA-DQ , Cadeias HLA-DRB1 , Humanos , Imunoglobulina G/imunologia , Dados de Sequência Molecular , Pênfigo/etnologia , Pênfigo/genética , Alinhamento de Sequência , Homologia de Sequência de AminoácidosRESUMO
We have studied the HLA class II alleles in 277 South American Indians, which included Argentinian tribes from the Gran Chaco: Toba (n = 135), Toba-Pilaga (n = 19), Mataco-Wichi (n = 49), and Xavantes, a tribe from Central Brazil (n = 74). In the Brazilian tribe, only four DR groups were found: DRB1*1602 (gf = 0.303), DRB1*04 including DRB1*0404 (gf = 0.070) and DRB1*0407 (gf = 0.077), DRB1*0802 (gf = 0.265), and DRB1*1402 (gf = 0.303). The HLA class II allele frequencies were similar among the different Argentinian tribes, and 90% of DRB1 alleles belonged to three families: DRB1*04 (including DRB1*0403, DRB1*0404, DRB1*0407, DRB1*0411, and DRB1*0417), DRB1*0802, and DRB1*14 (including DRB1*1402 and DRB1*1406). At the DPB1 locus, we found only seven alleles, the most frequent being DPB1*0402. Comparison of HLA class II alleles with those of North American Indians that we have previously studied shows that the frequency of some HLA class II alleles in Brazilian Xavantes resembles that of North American Indians more than that of the Argentinian Indian tribes. The allele DRB1*0417 was found exclusively in this population.
Assuntos
Alelos , Antígenos HLA-DP/genética , Antígenos HLA-DQ/genética , Antígenos HLA-DR/genética , Indígenas Sul-Americanos/genética , Adulto , Argentina , Brasil , DNA/análise , Frequência do Gene , Humanos , Hibridização de Ácido Nucleico , Sondas de Oligonucleotídeos , Reação em Cadeia da Polimerase , Polimorfismo GenéticoAssuntos
Dor nas Costas/etiologia , Neoplasias Induzidas por Radiação/diagnóstico , Segunda Neoplasia Primária/diagnóstico , Neurilemoma/diagnóstico , Paraplegia/etiologia , Compressão da Medula Espinal/etiologia , Neoplasias da Medula Espinal/diagnóstico , Adolescente , Ganglioneuroma/radioterapia , Humanos , Imageamento por Ressonância Magnética , Masculino , Neoplasias Induzidas por Radiação/complicações , Neoplasias Induzidas por Radiação/etiologia , Segunda Neoplasia Primária/complicações , Segunda Neoplasia Primária/etiologia , Neurilemoma/complicações , Neurilemoma/etiologia , Neoplasias da Medula Espinal/complicações , Neoplasias da Medula Espinal/etiologia , Neoplasias da Medula Espinal/radioterapiaRESUMO
Endemic pemphigus foliaceus (PF), also known as Fogo Selvagem (FS), is an organ-specific autoimmune disease mediated by autoantibodies. These autoantibodies are disease specific, predominantly restricted to the IgG4 subclass, and pathogenic, as demonstrated by passive transfer studies. In contrast to pemphigus vulgaris, neonatal skin disease does not appear to occur in babies born to mothers with non-endemic PF or FS. In the present study we have examined 19 mother/neonate pairs where the mother had documented FS. Mothers and neonates were examined soon after delivery and tested by immunofluorescent (IF) techniques for FS autoantibodies either in circulation (mothers' sera or babies' cord blood) or bound to the neonatal epidermis. All neonates included in this study were born with normal skin. Twelve biopsies from 17 neonates showed negative direct IF using both FITC-antihuman IgG or monoclonal anti-IgG subclass antibodies. In five biopsies the epidermal ICS of the babies showed weak staining. In 10 of the 19 cord sera tested, FS IgG autoantibodies were undetectable; in nine, these autoantibodies were present in low titers (less than 1:40). The sera of the mothers showed higher titers of FS autoantibodies, and IgG4 was the predominant IgG subclass autoantibodies. It appears that human placenta may modulate the expression of disease in the newborn by operating as a "biologic immunoadsorbent" of pathogenic autoantibodies.
Assuntos
Pênfigo/complicações , Pênfigo/etiologia , Complicações na Gravidez/etiologia , Adulto , Autoanticorpos/sangue , Brasil/epidemiologia , Colômbia/epidemiologia , Feminino , Humanos , Recém-Nascido , Troca Materno-Fetal , Pênfigo/imunologia , Gravidez , Pele/imunologia , Pele/patologiaRESUMO
Endemic pemphigus foliaceus or Fogo selvagem (FS) is an epidermal organ-specific autoimmune disease mediated by autoantibodies. Individuals at risk are peasants who live and work on farms located in the interior of certain endemic states of Brazil. This case-control study compares a group of 52 FS patients with 52 patients suffering from other dermatoses admitted and followed at the hospital for pemphigus (Hospital do Penfigo) in the city of Goiania, state of Goias. Patients and controls matched 1:1 by age, sex, and occupation were examined by two dermatologists at the time of admission and asked to respond to a prepared questionnaire. This questionnaire concerned current and past (1 and 5 years) exposure to environmental risk factors. The following risk factors were assessed: black fly bites, presence of rodents at home, exposure to cereal dust, exposure to fumes or dust released by tree and shrub removal, and exposure to insecticides. Relative risks were estimated from tabulated data by the odds ratio and tested for significance by the chi-square test. The 95% confidence interval for the odds ratio was also calculated for each of the risk factors. The only risk factor showing an odds ratio significantly different from one was exposure to simuliidae bites (odds ratio 4.7, p less than 0.001). This study reinforces the hypothesis that chronic exposure to black fly antigens may precipitate IgG4 antibody formation in predisposed individuals. These antibodies in turn may cross-react with epidermal antigens and cause acantholysis and the clinical expression of the disease known as FS.
Assuntos
Pênfigo/epidemiologia , Adolescente , Adulto , Idoso , Brasil/epidemiologia , Estudos de Casos e Controles , Criança , Exposição Ambiental , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de RiscoRESUMO
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
Herpes simplex virus type 1-infected cells bind C3b and iC3b, but not C3d, at the cell surface. Herpes simplex virus type 2 (HSV-2)-infected cells bind none of these C3 fragments. A transfection assay was used to demonstrate that binding of iC3b was to gC1. Although iC3b did not bind to HSV-2-infected cells, it did bind to mammalian cells transfected with the gC2 gene. Using linker insertion mutants, three domains on gC2 that are important for binding iC3b were mapped; these regions were similar to previously defined regions involved in binding C3b. These results suggest that some of the functions served by gC may be similar to those of CR3, the mammalian receptor for iC3b.
Assuntos
Complemento C3b/metabolismo , Eritrócitos/metabolismo , Receptores de Complemento/metabolismo , Simplexvirus/metabolismo , Proteínas do Envelope Viral/metabolismo , Sequência de Aminoácidos , Animais , Linhagem Celular , Células Cultivadas , Técnicas Imunoenzimáticas , Células L , Camundongos , Receptores de Complemento/química , Receptores de Complemento/genética , Receptores de Complemento 3b , Formação de Roseta , Proteínas do Envelope Viral/química , Proteínas do Envelope Viral/genéticaRESUMO
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 , RiscoRESUMO
We report the simultaneous occurrence of biopsy-proven temporal arteritis in husband and wife. Serologic and viral studies were negative, including viral culture of the wife's temporal artery. The concurrent incidence of giant cell arteritis in a married couple would suggest a common exogenous exposure.
Assuntos
Arterite de Células Gigantes/etiologia , Idoso , Biópsia , Feminino , Arterite de Células Gigantes/patologia , Arterite de Células Gigantes/fisiopatologia , Humanos , Masculino , Núcleo Familiar , Artérias Temporais/patologia , Vírus/isolamento & purificaçãoRESUMO
Estudou-se a funcao renal de ratos tratados com Glucantime (Antimoniato de Meglumine, Rhodia) e Pentostam (estibogloconato de Sodio, Wellcome) na dose de 30 mg de "Sb POT v" por 100g de peso por dia, durante 30 dias. Observou-se um disturbio na concentracao urinaria, que foi reversivel 7 dias apos cessada a administracao das drogas. O estudo histopatologico do rim, por meio da microscopia optica, nao evidenciou alteracoes significativas. Por outro lado, ratos tratados com altas doses dos antimoniais (220mg de "Sb POT v" por 100g de peso por dia) mostraram alteracoes funcionais e histopatologicas renais compativeis com necrose tubular aguda
Assuntos
Ratos , Animais , Rim/efeitos dos fármacos , Meglumina/toxicidade , Compostos Organometálicos/toxicidade , Capacidade de Concentração Renal/efeitos dos fármacos , Concentração Osmolar , Ratos Wistar , Sódio/metabolismo , Água/metabolismoRESUMO
Aspects of the renal function were assessed in rats treated with the pentavalent antimonials Glucantime (Meglumine Antimoniate, Rhodia) or Pentostam (Sodium Stibogluconate, Wellcome). In dose of 30 mg of Sbv (Glucantime or Pentostam) by 100 mg of weight by day for 30 days, renal functional changes were observed consisting of disturbances in urine concentrating capacity. Such disturbances were expressed by significantly low values of urine osmolality as compared to the basal values previous to the drugs. The decrease in urine osmolality was associated to a significant increase in urinary flow and in negative free-water clearance. There was no alteration in osmolar clearance and in fractional excretion of sodium. These observations suggest an interference of the drugs in the action of the antidiuretic hormone. The disturbance in urine concentration was reversible after a seven days period without the drugs administration. No significant histopathological alterations were observed in the kidneys of the rats treated with the drugs. On the other hand, the rats treated with a high dose of Pentostam (200 mg/100 grams of weight/day) showed the functional and the histopathological alterations of the acute tubular necrosis.