RESUMO
This study was designed to compare the clinical and cardiological features of endomyocardial disease in temperate and tropical regions. Eleven patients were studied in the U.K., 47 in India and 8 in Brazil. The patients in the U.K. were older, with a male predominance, and they had a systemic illness: the hypereosinophilic syndrome. Half of these patients presented in the early necrotic stage of the disease, and all had biventricular involvement. On the other hand, patients in the tropical countries were younger, with an equal sex incidence, and were from poor, malnourished communities with heavy parasite loads, especially filariasis in India. None presented in the early necrotic stage of the disease and a quarter had isolated right or left ventricular disease. In order to account for these differences between patients in temperate and tropical regions with endomyocardial disease, it was proposed that the nature of the underlying disease and the rate at which endomyocardial lesions develop, determine the clinical features of this disorder. In temperate climates eosinophil granule toxins may produce a rapidly progressive form of the disease in patients with the hypereosinophilic syndrome, whereas the disease may take longer to develop in patients in tropical climates, who have a less marked eosinophilia due to parasitic infections.
Assuntos
Cardiomiopatias/fisiopatologia , Adolescente , Adulto , Brasil , Criança , Eletrocardiografia , Fibrose Endomiocárdica/fisiopatologia , Eosinofilia/fisiopatologia , Feminino , Humanos , Índia , Masculino , Reino UnidoRESUMO
111Indium-oxine-labelled rat eosinophils were injected i.v. into rats infected with Nippostrongylus brasiliensis and controls. Radionuclide imaging was done to measure the rate and extent of radioactive uptake into different regions of the body in vivo. Radioactivity appeared first in the lungs then in the livers and spleens. The distribution of radioactivity and parasites was studied by gamma counting, histology and parasite counts. In infected rats, increased amounts of radioactivity localized in the skin, lungs and small intestines during the dermal, pulmonary and intestinal stages of the disease. It was concluded that localization of radioactivity was closely related to the tissue distribution of migratory larvae and adult worms. This technique may be of value in measuring alterations in eosinophil distribution and tissue localization in vivo, especially in helminthic infections and other disease where many eosinophils accumulate in tissues.
Assuntos
Eosinófilos/fisiologia , Infecções por Nematoides/sangue , Compostos Organometálicos , Animais , Índio , Intestino Grosso/patologia , Intestino Delgado/patologia , Fígado/patologia , Pulmão/patologia , Infecções por Nematoides/diagnóstico por imagem , Infecções por Nematoides/parasitologia , Nippostrongylus/fisiologia , Oxiquinolina/análogos & derivados , Radioisótopos , Cintilografia , Ratos , Ratos Endogâmicos , Pele/patologiaRESUMO
Sem considerar areas geograficas, a endomiocardiofibrose (EMF) e a princial causa da patologia da doenca endomiocardica eosinofilica e da endomiocardiofibrose tropical mostram que se trata de um mesmo processo, de aparente patogenese. O desenvolvimento de fibrose no endocardio parece associado com produtos de celulas eosinofilicas, havendo uma associacao positiva entre cardiopatia e o numero de eosinofilos degranulados, no sangue e nos tecidos.Trabalhos experientais em celulas isoladas de coracao de ratos mostram a toxicidade para essas celulas produzidas por elementos de secrecao dos eosinofilos.Esses produtos, alem de causarem alteracoes morfologicas nas membranas, inibem as principais enzimas oxidativas da cadeia respiratoria das mitocondrias. Esses resultados devem estimular novos estudos em doencas com hipereosinofilia em areas tropicais, a fim de consubstanciar a hipotese de que os eosinofilos sao tambem responsaveis pela endomiocardiofibrose tropical