RESUMO
B cell-activating factor (BAFF) is an essential cytokine in primary Sjögren's syndrome (pSS) physiopathology. It has been reported that pSS patients develop germinal center-like (GC-like) structures in their minor salivary glands (MSGs). BAFF, BAFF-R, TACI, and BCMA expression was analyzed in MSGs from 29 subjects (nonspecific chronic sialadenitis and focal lymphocytic sialadenitis with the presence [pSS-GC(+)] or absence [pSS-GC(-)] of GC-like structures). Twenty-four percent of patients showed ectopic GC-like structures and a high focus score [p < 0.001 vs pSS-GC(-)]. BAFF serum levels (sBAFF) were high in pSS patients (p = 0.025 vs healthy subjects). However, the pSS-GC(-) group showed higher sBAFF levels than pSS-GC(+) patients. BAFF and BAFF-R glandular expression levels were higher in pSS-GC(+) patients, without significant differences compared to pSS-GC(-) patients. Soluble levels of BAFF correlated with anti-La/SSB antibodies and disease duration. Our results showed that BAFF could contribute to focal lymphocytic infiltration. The role of BAFF-binding receptors in MSGs is proposed as a mechanism for the possible establishment of ectopic GC-like structures and disease progression in some patients. In conclusion, this study supports previous evidence that considers the active BAFF system role in the pathogenesis of pSS and the need for strong biomarkers in this disease.
Assuntos
Fator Ativador de Células B/metabolismo , Receptor do Fator Ativador de Células B/metabolismo , Glândulas Salivares Menores/patologia , Síndrome de Sjogren/metabolismo , Adulto , Idoso , Fator Ativador de Células B/sangue , Antígeno de Maturação de Linfócitos B/metabolismo , Estudos de Casos e Controles , Feminino , Centro Germinativo/patologia , Humanos , Imunofenotipagem , Masculino , Pessoa de Meia-Idade , Glândulas Salivares Menores/fisiologia , Índice de Gravidade de Doença , Síndrome de Sjogren/etiologia , Síndrome de Sjogren/imunologia , Síndrome de Sjogren/patologia , Proteína Transmembrana Ativadora e Interagente do CAML/metabolismoRESUMO
OBJECTIVE: To show the results of the study on the Mayo femoral stem during its first ten years of use in Mexico. MATERIAL: Forty-two bone sparing Mayo femoral stems were studied; they were placed in 39 patients from July 2000 to March 2009, ages 24-71 years (mean 51.6 years), with a mean follow-up of 61 months. METHODS: The clinical results of 42 arthroplasties performed by 3 surgeons were assessed using the Merle D'Aubigné scale; a radiologic assessment was made and the findings and complications were described. RESULTS: No stem-related complications were found in this study. There was one case of revision due to recurrent dislocation, secondary to poor placement of the acetabulum. No cases of clinical or radiologic loosening were reported. CONCLUSIONS: Conservative hip arthroplasty with the Mayo stem has proven to be an excellent medium- and long-term option for femoral hip replacement, with expectations that it may exceed the durability of other types of implants without harming the femoral diaphysis. This may facilitate eventual stem revision and give us the opportunity of using a standard primary implant.