RESUMO
Infection by Helicobacter pylori is associated with the development of several gastroduodenal diseases, including gastritis, peptic ulcer disease (gastric ulcers and duodenal ulcers), and gastric adenocarcinoma. Although a number of putative virulence factors have been reported for H. pylori, there are conflicting results regarding their association with specific H. pylori-related diseases. In this work, we investigated the presence of virB11 and cagT, located in the left half of the cag pathogenicity island (cagPAI), and the jhp917-jhp918 sequences, components of the dupA gene located in the plasticity zone of H. pylori, in Brazilian isolates of H. pylori. We also examined the association between these genes and H. pylori-related gastritis, peptic ulcer disease, and gastric and duodenal ulcers in an attempt to identify a gene marker for clinical outcomes related to infection by H. pylori. The cagT gene was associated with peptic ulcer disease and gastric ulcers, whereas the virB11 gene was detected in nearly all of the samples. The dupA gene was not associated with duodenal ulcers or any gastroduodenal disease here analyzed. These results suggest that cagT could be a useful prognostic marker for the development of peptic ulcer disease in the state of São Paulo, Brazil. They also indicate that cagT is associated with greater virulence and peptic ulceration, and that this gene is an essential component of the type IV secretion system of H. pylori.
Assuntos
Genes Bacterianos , Ilhas Genômicas , Infecções por Helicobacter/microbiologia , Infecções por Helicobacter/patologia , Helicobacter pylori/genética , Helicobacter pylori/patogenicidade , Adulto , Proteínas de Bactérias/genética , Brasil , Feminino , Gastrite/microbiologia , Gastrite/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Úlcera Péptica/microbiologia , Úlcera Péptica/patologia , Fatores de Virulência/genéticaRESUMO
Several lines of evidence in experimental animals indicate that the kinin system may participate in the pathogenesis of envenomation by the Tityus serrulatus (Ts) scorpion sting, but there are no studies in humans with regard to this system. In this study, we evaluated the plasma levels of high-molecular (HKg) and low-molecular (LKg) weight kininogens (detected by ELISA), the activities of plasma or tissue kallikreins and kininase II (enzymatic action upon selective substrates), and the Ts plasma venom levels (ELISA). A total of 27 patients (12 males) aged 12-72 were evaluated immediately at hospital admittance. According to the severity of envenomation, patients were classified as mild (n = 15), moderate (n = 8), and severe cases (n = 4). Controls were paired for age and sex. Plasma venom levels were associated with the severity of envenomation. Severe cases presented lower levels of LKg in relation to mild and controls. Inverse correlations were seen between LKg levels and the venom concentration. The results of this study suggested that the kinin system may participate in the pathogenesis of human Ts envenomation and knowledge about this system may be useful to develop new strategies to reduce the damage caused by scorpion envenomation.
Assuntos
Glicemia , Calicreínas/metabolismo , Cininas/efeitos dos fármacos , Venenos de Escorpião/efeitos adversos , Picada de Aranha/sangue , Adolescente , Adulto , Idoso , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Cininogênios/sangue , Cininas/sangue , Masculino , Pessoa de Meia-Idade , Venenos de Escorpião/sangue , Índice de Gravidade de Doença , Picada de Aranha/classificaçãoRESUMO
Scorpion envenomation is a common medical problem in many countries and an important cause of morbidity and mortality, especially among children. The plasma levels of pro-inflammatory (IL-1beta, IL-6, IL-8 and TNF-alpha) and anti-inflammatory (IL-10) cytokines were measured in individuals stung by Tityus serrulatus (Ts) scorpions. According to clinical manifestations patients were classified, as defined by the Brazilian Ministry of Health, as having mild (n=15, mean age=42.2 years), moderate (n=8, mean age=26 years) or severe (n=4, mean age=14 years) envenomation. Blood samples were taken immediately (T1) and 6h (T2) after admission to the hospital. Eighteen age-matched healthy volunteers were used as control. TNF-alpha, IL-1beta, IL-6 and IL-8 levels were significantly increased in moderate and severe cases and the levels of these cytokines were positively correlated with the severity of envenomation, as evaluated by clinical profile and plasma venom concentration. IL-10 levels were increased in severe and moderate cases and reduced in mild cases. The results reported in the present study suggest that the physiopathological manifestation of Ts envenomation may be mediated, at least in part, by cytokines, and that the early treatment after scorpion sting with drugs that inhibit cytokine production, such as glucocorticoids, may have a potential beneficial effect, ameliorating the severity of the clinical manifestations observed, particularly in severe and moderate cases.
Assuntos
Citocinas/sangue , Picadas de Escorpião/imunologia , Escorpiões , Adolescente , Adulto , Idoso , Animais , Brasil , Estudos de Casos e Controles , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Interleucina-1/sangue , Interleucina-10/sangue , Interleucina-6/sangue , Interleucina-8/sangue , Masculino , Pessoa de Meia-Idade , Picadas de Escorpião/sangue , Picadas de Escorpião/patologia , Índice de Gravidade de Doença , Fator de Necrose Tumoral alfa/metabolismoRESUMO
Os autores estudaram retrospectivamente 103 gestantes com diabetes potencial e que foram submetidas ao teste oral de tolerancia a glicose (GTT) apos a 28a. semana de gestacao. Os resultados mostraram que 32% das pacientes tinham GTT alterado (diabetes gestacional, grupo I) e 68% com GTT normal (grupo II). As pacientes do grupo I apresentaram maior incidencia de toximia gravidica e candidiase vaginal. Tambem tiveram 42,4% de partos operatorios contra apenas 28,6% do grupo II. No que se refere ao peso dos recem-nascidos nao houve diferenca significativa entre eles. Entretanto os RN do grupo I apresentaram maior morbidade do que os do grupo II. Finalmente, e proposta uma conduta para o rastreamento da diabetes gestacional