RESUMO
RESUMO A coriorretinopatia de Birdshot é uma uveíte posterior bilateral crônica rara que acomete, preferencialmente, mulheres de meia-idade. O quadro clínico é composto de pouco ou nenhum processo inflamatório de segmento anterior, associado a vitreíte e lesões coriorretinianas ovoides branco-amareladas de característica hiperfluorescente na angiofluoresceinografia e hipofluorescente na angiografia com indocianina verde. O tratamento se dá por meio de corticoides e outras drogas imunossupressoras. Todavia, em alguns casos, a doença é refratária a tal terapêutica, sendo necessário lançar mão de outras drogas, como os agentes biológicos. O presente artigo busca relatar um caso de coriorretinopatia de Birdshot em ajuste de terapia imunossupressora que evoluiu com má resposta às drogas iniciais e bom controle após uso de imunobiológico e discutir as opções terapêuticas disponíveis atualmente.
ABSTRACT Birdshot chorioretinopathy is a rare chronic bilateral posterior uveitis that preferentially affects middle-aged women. The clinical picture is composed of little or no anterior segment inflammatory process, associated with vitritis and yellowish-white ovoid chorioretinal lesions with hyperfluorescent characteristics on fluorescein angiography and hypofluorescent characteristics on green indocyanine green angiography. Treatment is with corticosteroids and other immunosuppressive drugs. However, in some cases, the disease is refractory to such therapy, making it necessary to resort to other drugs such as biological agents. The present article seeks to report a case of Birdshot chorioretinopathy in an adjustment of immunosuppressive therapy that evolved with poor response to the initial drugs and good control after the use of immunobiologicals and discuss the currently available therapeutic options.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Coriorretinopatia de Birdshot/diagnóstico , Coriorretinopatia de Birdshot/tratamento farmacológico , Imunossupressores/administração & dosagem , Dexametasona/administração & dosagem , Prednisona/administração & dosagem , Angiofluoresceinografia , Antígenos HLA-A/análise , Metotrexato/administração & dosagem , Tomografia de Coerência Óptica , Adalimumab/administração & dosagem , Glucocorticoides/administração & dosagemRESUMO
INTRODUCTION: The inflammatory microenvironment has emerged as one of the focuses of cancer research. Little is known about the immune environment in esophageal adenocarcinoma (EAC) and possible tumor-escape mechanisms to avoid immune cell attack. PATIENTS AND METHODS: We measured T cell inflammation (CD3, CD8) in the microenvironment using a standardized software-based evaluation algorithm considering different predefined tumor areas as well as expression of MHC class 1 and PD-L1 on 75 analyzable primarily resected and locally advanced (≥ pT2) EACs. We correlated these findings statistically with clinical data. RESULTS: Patients with high amounts of T cell infiltration in their tumor center showed a significant survival benefit of 41.4 months compared to 16.3 months in T cell poor tumors (p = 0.025), although CD3 fails to serve as an independent prognostic marker in multivariate analysis. For the invasion zone, a correlation between number of T-cells and overall survival was not detectable. Loss of MHC1 protein expression on tumor cells was seen in 32% and PD-L1 expression using the combined positive score (CPS) in 21.2%. Most likely due to small numbers of cases, both markers are not prognostically relevant, even though PD-L1 expression correlates with advanced tumor stages. DISCUSSION: Our analyses reveal an outstanding, though not statistically independent, prognostic relevance of T-cell-rich inflammation in our group of EACs, in particular driven by the tumor center. For the first time, we describe that the inner part of the invasion zone in EACs shows significantly fewer T-cells than other tumor segments and is prognostically irrelevant. We also demonstrate that the loss of antigen presenting ability via MHC1 downregulation by the carcinoma cells is a common escape mechanism in EACs. Future work will need to show whether tumors with MHC class 1 loss respond less well to immunotherapy.
Assuntos
Adenocarcinoma/imunologia , Neoplasias Esofágicas/imunologia , Linfócitos do Interstício Tumoral/citologia , Evasão Tumoral/imunologia , Microambiente Tumoral/imunologia , Adenocarcinoma/mortalidade , Adenocarcinoma/patologia , Idoso , Antígeno B7-H1/análise , Antígeno B7-H1/metabolismo , Regulação para Baixo , Neoplasias Esofágicas/mortalidade , Neoplasias Esofágicas/patologia , Feminino , Antígenos HLA-A/análise , Antígenos HLA-A/metabolismo , Antígenos HLA-B/análise , Antígenos HLA-B/metabolismo , Humanos , Imunidade Celular , Inflamação/imunologia , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica/imunologia , Prognóstico , Fatores de TempoRESUMO
OBJECTIVE: The main purpose of this study was to investigate the class I HLA antigens and class II HLA allele frequencies in 164 patients with leukemia: 35 patients with ALL (acute lymphoid leukemia), 50 with AML (acute myeloid leukemia) and 78 with CML (chronic myeloid leukemia). METHODS: The genotyping of class I HLA was performed by microlymphocytotoxicity and of class II by PCR-SSP (polymerase chain reaction - sequence specific of primers) (One Lambda, Canoga Park, CA, USA). RESULTS: In patients with LLA, frequencies of HLA-B45 and HLA-B56 were higher (P = 0.02; OR = 3.13; 95%IC = 0.94-10.44; P = 0.03; OR = 3.61; 95%IC = 0.47-27.64, respectively), than in controls. In patients with AML, the frequency of HLA-B7 (P = 0.01; OR = 2.41; 95%IC = 1.25-4.67) was higher than in controls. The presence of HLA-B45 (P= 0.01; OR = 3.29; 95%IC = 1.46-7.40), HLA-DRB1*04 (P = 0.002; OR = 2.17; 95%IC = 1.36-3.46) and HLA-DRB1*08 (P = 0.004; OR = 2.36; 95%IC = 1.34-4.16) was associated to increased risk of CML developing. CONCLUSION: Our results suggest that variants of HLA confer susceptibility to the same forms of leukemia, and could provide new tools for the investigation of genetics and etiology of this disease.
Assuntos
Frequência do Gene , Antígenos HLA-A/análise , Antígenos HLA-B/análise , Leucemia/genética , Adolescente , Adulto , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Predisposição Genética para Doença , Haplótipos , Humanos , Lactente , Cariotipagem , Leucemia/etnologia , Leucemia Mielogênica Crônica BCR-ABL Positiva/genética , Leucemia Mieloide Aguda/genética , Masculino , Pessoa de Meia-Idade , Fenótipo , Leucemia-Linfoma Linfoblástico de Células Precursoras/genéticaRESUMO
OBJETIVOS: O objetivo deste estudo foi investigar a freqüência de antígenos HLA Classe I e de alelos HLA Classe II em 164 pacientes com vários tipos de leucemias: 35 pacientes com LLA (leucemia linfóide aguda), 50 com LMA (leucemia mielóide aguda) e 78 com LMC (leucemia mielóide crônica). MÉTODOS: A tipagem HLA Classe I foi realizada por microlinfocitotoxicidade e a de Classe II por PCR-SSP (polymerase chain reaction - sequence specific of primers), ambas da One Lambda (Canoga Park, CA, US). RESULTADOS: Em pacientes com LLA, as freqüências das variantes HLA-B45 e HLA-B56 foram maiores (P = 0,02; OR = 3,13; 95 por centoIC = 0,94-10,44; P = 0,03; OR = 3,61; 95 por centoIC = 0,47-27,64, respectivamente), quando comparadas com controles. Nos pacientes com LMA, a freqüência de HLA-B7 (P = 0,01; OR = 2,41; 95 por centoIC = 1,25-4,67) foi maior que em controles. A presença de HLA-B45 (P= 0,01; OR = 3,29; 95 por centoIC = 1,46-7,40) e de HLA-DRB1*04 (P = 0,002; OR = 2,17; 95 por centoIC = 1,36-3,46) e HLA-DRB1*08 (P = 0,004; OR = 2,36; 95 por centoIC = 1,34-4,16) foi associada ao maior risco de desenvolver LMC. CONCLUSÃO: Nossos resultados sugerem que variantes HLA conferem susceptibilidade a algumas formas de leucemia e podem prover novas ferramentas para a investigação da genética e etiologia desta doença.
OBJECTIVE: The main purpose of this study was to investigate the class I HLA antigens and class II HLA allele frequencies in 164 patients with leukemia: 35 patients with ALL (acute lymphoid leukemia), 50 with AML (acute myeloid leukemia) and 78 with CML (chronic myeloid leukemia). METHODS: The genotyping of class I HLA was performed by microlymphocytotoxicity and of class II by PCR-SSP (polymerase chain reaction - sequence specific of primers) (One Lambda, Canoga Park, CA, USA). RESULTS: In patients with LLA, frequencies of HLA-B45 and HLA-B56 were higher (P = 0.02; OR = 3.13; 95 percentIC = 0.94-10.44; P = 0.03; OR = 3.61; 95 percentIC = 0.47-27.64, respectively), than in controls. In patients with AML, the frequency of HLA-B7 (P = 0.01; OR = 2.41; 95 percentIC = 1.25-4.67) was higher than in controls. The presence of HLA-B45 (P= 0.01; OR = 3.29; 95 percentIC = 1.46-7.40), HLA-DRB1*04 (P = 0.002; OR = 2.17; 95 percentIC = 1.36-3.46) and HLA-DRB1*08 (P = 0.004; OR = 2.36; 95 percentIC = 1.34-4.16) was associated to increased risk of CML developing. CONCLUSION: Our results suggest that variants of HLA confer susceptibility to the same forms of leukemia, and could provide new tools for the investigation of genetics and etiology of this disease.
Assuntos
Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Frequência do Gene , Antígenos HLA-A/análise , Antígenos HLA-B/análise , Leucemia/genética , Brasil/epidemiologia , Predisposição Genética para Doença , Haplótipos , Cariotipagem , Leucemia Mielogênica Crônica BCR-ABL Positiva/genética , Leucemia Mieloide Aguda/genética , Leucemia/etnologia , Fenótipo , Leucemia-Linfoma Linfoblástico de Células Precursoras/genéticaRESUMO
PURPOSE: To evaluate the human leucocyte antigen (HLA) class 1 (HLA-A and HLA-B) and HLA class 2 (HLA-DRB1 and HLA-DQB1) allele profiles in the susceptibility to cytomegalovirus retinitis (CMV-R) in patients with AIDS. METHODS: Cytomegalovirus retinitis was clinically diagnosed by indirect binocular ophthalmoscopy. Human leucocyte antigens class 1 were typed using a complement-dependent microlymphocytotoxicity assay, and HLA class 2 alleles were identified using amplified DNA hybridized to sequence-specific oligonucleotide primers. RESULTS: The frequencies of HLA class 1 antigens and HLA class 2 alleles observed in patients and controls were similar; however, HLA-A31 antigen was over-represented in patients with AIDS, independent of the presence of CMV-R. CONCLUSION: There was no association between HLA molecules/alleles and CMV-R in Brazilian patients with AIDS. However, the results support the role of the HLA system in the susceptibility to developing AIDS.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Síndrome da Imunodeficiência Adquirida/imunologia , Alelos , Retinite por Citomegalovirus/complicações , Frequência do Gene , Antígenos de Histocompatibilidade Classe II/genética , Antígenos de Histocompatibilidade Classe I/genética , Síndrome da Imunodeficiência Adquirida/genética , Adolescente , Adulto , Idoso , Brasil , Criança , Pré-Escolar , Feminino , Predisposição Genética para Doença , Antígenos HLA-A/análise , Humanos , Lactente , Masculino , Pessoa de Meia-IdadeRESUMO
Class I and class III major histocompatibility complex (MHC) antigen frequencies were analyzed in 130 haplotypes from 33 families belonging to a group of Amerindians culturally and linguistically isolated for more than 12 centuries in Mexico: the Tarascos. The most frequent antigens in this ethnic group of the HLA-A locus are: A2 (gf 0.353), A24 (gf = 0.223), A31 (gf = 0.184), and A28 (gf = 0.161); and the most frequent of the HLA-B locus are: B35 (gf = 0.230), B39 (gf = 0.192), B15 (gf = 0.146), and B5 (gf = 0.123). On the other hand, class III antigens demonstrated relatively high frequencies of the SC31 (frequency = 0.561), SC01 (frequency = 0.076), and SC42 (frequency = 0.069) complotypes. Also important was the relatively high frequency of the HLA-B27 antigen (gf 0.061) and the SC33 complotype (frequency = 0.046), which are either absent or found infrequently in other Amerindian groups. Analysis of MHC haplotypes revealed that four of them have relatively high frequencies, these were the following: [B39;SC31] (11.6%), [B35;SC31] (11.6%), [B15;SC31] (8.0%), and [B5;SC31] (5.8%). Other MHC haplotypes had frequencies lower than 5.0%. The decreased frequency of BF alleles other than BF*S and the presence of the SC33 and SC32 complotypes suggest long time preservation from genetic admixture. This information withstands the basis for population genetic analysis and disease association studies in Mexican mestizos.
Assuntos
Complemento C2/análise , Complemento C4/análise , Antígenos HLA-A/análise , Antígenos HLA-B/análise , Indígenas Centro-Americanos/genética , Complexo Principal de Histocompatibilidade/genética , Frequência do Gene , Genes MHC Classe I , Teste de Histocompatibilidade , Humanos , México/etnologiaRESUMO
We evaluated the effect of interferon-alpha2b as a chemosensitiser on HCT-15 cell line in treatment with doxorubicin. Chemosensitivity was determined by [3H]-thymidine incorporation and tetrazolium assays. The levels of expression of P-glycoprotein, Bcl-2 oncoprotein and HLA-ABC complex, and cell cycle/apoptosis analysis were determined by flow cytometry. Dox 50 ng/ml - IFN alpha 2b 500 IU/ml treatment inhibited cell proliferation (47.2 +/- 1.4%, p < 0.0001; MTT assay: 40.6 +/- 1.2%, p < 0.0001) and augmented the expression of P-170, Bcl-2 and HLA-ABC, while it didn't exert apoptosis, producing a slight G2/M arrest. A concentration of IFN-alpha2b, that by itself is not cytotoxic, can potentiate the efficacy of the anticancer drug. This effect is not due to a down-modulation of P-170. The absence of apoptosis and augmented levels of Bcl-2 expression suggests that this could be one of the mechanisms of drug resistance exerted by these cells.
Assuntos
Antineoplásicos/farmacologia , Apoptose/efeitos dos fármacos , Ciclo Celular/efeitos dos fármacos , Divisão Celular/efeitos dos fármacos , Doxorrubicina/toxicidade , Resistência a Múltiplos Medicamentos , Interferon-alfa/farmacologia , Proteínas de Membrana , Membro 1 da Subfamília B de Cassetes de Ligação de ATP/genética , Adenocarcinoma , Sobrevivência Celular/efeitos dos fármacos , Neoplasias do Colo , Resistência a Múltiplos Medicamentos/fisiologia , Sinergismo Farmacológico , Fase G2 , Antígenos HLA/análise , Antígenos HLA-A/análise , Antígenos HLA-C/análise , Proteína da Hemocromatose , Antígenos de Histocompatibilidade Classe I/análise , Humanos , Interferon alfa-2 , Mitose , Proteína Oncogênica v-cbl , Proteínas Recombinantes , Proteínas Oncogênicas de Retroviridae/genética , Células Tumorais CultivadasRESUMO
Considerando que o sistema HLA contem genes que controlam a resposta imune, bem como genes de susceptibilidade genética a diversas doenças, temos como objetivo a realização de um estudo de associação entre os antígenos HLA e a doença de CHAGAS, forma cardíaca. Foram analisadas as freqüências dos antigenos HLA-A, -B, -C, -DR E -DQ em 47 pacientes com cardiopatia chagásica crônica e 95 indivíduos controles. Essas amostras iniciais são constituídas por caucasóides e negroides. As analises estatísticas mostram um aumento estatisticamente significante da freqüência de HLA-DR2 nos pacientes, quando comparados com os controles. a significativo ns freqüências de dr-2, cujas freqüências nos pacientes e controles são de 48,3por cento e 12,3por cento, respectivamente (pc=0,0058). Os resultados sugerem uma associação positiva do antígeno DR-2 com cardiopatia chagásica crônica. Embora os resultados indiquem uma possível associação com DR-2 também em negroides, os nossos dados não são conclusivos para esse grupo racial, devido ao pequeno tamanho da amostra analisada
Assuntos
Humanos , Antígenos HLA-A/análise , Antígenos HLA-B/análise , Antígenos HLA-C/análise , Antígenos HLA-DQ/análise , Antígenos HLA-DR/análise , Antígenos HLA/análise , Cardiomiopatia Chagásica/fisiopatologia , Doença de Chagas/fisiopatologia , ImunogenéticaRESUMO
Foi realizado um estudo de associaçäo HLA e doença, onde 40 pacientes com diagnóstico clínico e laboratorial de Paracoccidioidomicose (PCM) e, 80 indivíduos brancos, clinicamente saudáveis, usados como controles, foram tipados para os antígenos HLA-A, -B, -Cw, -DR e - DQ. Os resultados obtidos mostraram uma associaçäo positiva dos antígenos HLA-A1 (P = 0.050), -A3 (P = 0.014), -B8 (P = 0.014), -Cw7 (P = 0.020), - DQw2 (P = 0.014) e DQw3 (P = 0.019) nos pacientes e uma associaçäo negativa dos antígenos HLA-Cw3 (P = 0.032), -DR1 (P = 0.019) e -DQw1 (P = 0.003) no mesmo grupo, comparados aos controles e, sem correçäo pelo número de antígenos testados (50). Os resultados sugerem uma fraca associaçäo destes antígenos HLA com a doença, uma vez que outros fatores podem também estar influenciando na susceptibilidade genética à PCM. Se corrigido o valor de P, segundo Svejgaard e Ryder (HLA and disease, J, Dausset and A. Svejgaard, eds., 1977), nenhuma associaçäo é demonstrada neste estudo
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Antígenos HLA/análise , Paracoccidioidomicose/imunologia , Antígeno HLA-A1/análise , /análise , /análise , Antígeno HLA-DR1/análise , Antígenos HLA-A/análise , Antígenos HLA-B/análise , Antígenos HLA-C/análise , Antígenos HLA-DQ/análise , Antígenos HLA-DR/análise , Estudos de Casos e Controles , População Branca , Trabalhadores RuraisRESUMO
HLA antigens vary in different ethnical groups and in Chile there are no reports on the frequency of these antigens in a normal representative population. The few existing studies are of indigenous populations and control groups, without including HLA-DR antigens. Therefore, the aim of this study was to study the frequency of HLA A, B and C antigens in 349 individuals and HLA-DR in 257, using the microlymphocytotoxicity method, and compared the results with those on normal caucasian populations (Europe and USA). Significant differences were found for 7 antigens of group A, 10 of group B, 4 of group C and 6 of group DR. The observed difference allow us to conclude that the population from Santiago has a distinct HLA antigen distribution. This fact must be bore in mind future studies in genetics, paternity or autoimmune diseases.
Assuntos
Antígenos HLA/análise , Adulto , Chile , Feminino , Antígenos HLA-A/análise , Antígenos HLA-A/genética , Antígenos HLA-B/análise , Antígenos HLA-B/genética , Antígenos HLA-C/análise , Antígenos HLA-C/genética , Antígenos HLA-DR/análise , Antígenos HLA-DR/genética , Humanos , Masculino , População Urbana , População BrancaRESUMO
Data from a previous study concerning the distribution of human leukocyte antigen (HLA) haplotypes in siblings with essential hypertension suggested that at least one of the genes responsible for the genetic susceptibility to this disease is located in or near the HLA complex. The objective of the present study was to investigate if a given HLA-A, B, or DR gene could represent a marker for susceptibility to essential hypertension at the population level. Thus, the frequencies of HLA antigens were determined in Caucasian patients with essential hypertension (HLA-A and B antigens were determined in 89 cases, 85 of which were also typed for HLA-DR antigens). The results showed an increased frequency (p = 0.00064) of HLA-DR4, which was present in 34% of the patients and in 16% of local ethnically matched control subjects. We conclude that HLA-DR4 may represent a marker for susceptibility to essential hypertension in the Brazilian Caucasian population.
Assuntos
Antígenos HLA-A/análise , Antígenos HLA-B/análise , Antígeno HLA-DR4/análise , Hipertensão/imunologia , Brasil , Feminino , Humanos , Masculino , População BrancaAssuntos
Antígeno de Mitsuda , Antígenos HLA-A/análise , Antígenos HLA-B/análise , Antígenos HLA-DQ/análise , Antígenos HLA-DR/análise , Antígenos HLA/análise , Antígenos HLA/imunologia , Hanseníase/imunologia , Hanseníase/patologia , Hanseníase/tratamento farmacológico , Imunofenotipagem , Mycobacterium/imunologia , Reações Cruzadas , Vacinas de Produtos Inativados/imunologiaRESUMO
Eighty patients with paracoccidioidomycosis were typed for 43 HLA specificities from loci A, B, C and DR. A highly significant increased frequency of HLA-B40 (relative risk 29.2) and HLA-Cw1 (relative risk 8.8) were found in patients compared to control subjects. The frequencies HLA-A2, B7 and B21 were also increased in patients and haplotypes-B40-Cw1 and -A2-B40 were positively correlated with the disease. DR antigen frequencies were not significantly altered in the patients and evidence of a protective effect was not found for any of the 43 antigens tested. These findings further support the involvement of the HLA system in the genetic susceptibility to paracoccidioidomycosis and the importance of ethnic variability in this association.
Assuntos
Antígenos HLA/análise , Paracoccidioidomicose/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Antígenos HLA-A/análise , Antígenos HLA-B/análise , Antígeno HLA-B40 , Antígenos HLA-C/análise , Antígenos HLA-DR/análise , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de RiscoRESUMO
To the best of our knowledge this is the seventh case report of monozygotic twins both affected by myasthenia gravis (MG). The monozygotism was proven by sex identity, blood group and HLA determinations ('O' Rh+, A2, A19.2, B40, CW3). One paternal aunt was also affected and the three cases have high titles of anti-acetylcholine receptor antibodies and anti-striated muscle antibodies, which indicate an acquired form of MG. After several myasthenic crises the twins are now doing well with corticosteroid therapy. The paternal aunt has a more benign form of MG, with ocular and limb involvement (grade IIa of Osserman) and was submitted to thymectomy. The authors discuss the use of corticosteroid for the infantile form of MG instead of thymectomy, based on the immaturity of the immune system in the young age. The use of other immunosuppressive drugs is not advisable because of potential hazardous development of neoplasms.
Assuntos
Autoanticorpos/análise , Doenças em Gêmeos/genética , Antígenos HLA-A/análise , Miastenia Gravis/genética , Receptores Colinérgicos/imunologia , Adulto , Feminino , Homozigoto , Humanos , Lactente , Miastenia Gravis/tratamento farmacológico , Linhagem , Prednisona/uso terapêuticoRESUMO
In order to investigate the possible association between Brazilian pemphigus foliaceus and HLA, we studied 48 patients and 74 matched controls, all Brazilian Caucasoids, for HLA-A,B,C; DR1 to DRw8 and DQw1 to DQw3. The frequencies of DR1, DR4 and B16 were significantly increased, while DR7 was significantly decreased among the patients. Furthermore DQw2, likewise the DR specificities associated with it - DR3 and DR7 - never occurred among the patients in the absence of the susceptibility markers DR1, DQw1 or DR4, DQw3. Acting on these findings, we suggest that at least two MHC-class II genes are involved in the pathogenesis of Brazilian pemphigus foliaceus: at least one gene, associated to DR1,DQw1 and to DR4,DQw3, confers susceptibility and at least one gene, associated to DR7,DQw2 and DR3,DQw2, confers resistance. The susceptibility gene(s) seem(s) to be epistatic to or dominant over (if allelic) the resistance gene(s). Both are dominant over other alleles at their locus (or loci).
Assuntos
Antígenos de Histocompatibilidade Classe II/genética , Pênfigo/imunologia , Adolescente , Adulto , Idoso , Brasil , Criança , Feminino , Genes MHC da Classe II , Predisposição Genética para Doença , Antígenos HLA-A/análise , Antígenos HLA-B/análise , Antígenos HLA-C/análise , Antígenos HLA-DR/análise , Antígenos HLA-DR/genética , Humanos , Imunidade Inata , Masculino , Pessoa de Meia-Idade , Pênfigo/genética , FenótipoRESUMO
The distribution of 12 HLA-A, 14 HLA-B, seven HLA-C, seven HLA-DR and three HLA-DQ antigens was determined in 32 non-consanguineous white Brazilians suffering from chromoblastomycosis and 77 healthy controls, matched for ethnic background, sex and age and living in the same geographical area. A significant difference between the two groups was seen only in respect to one HLA-A antigen: A29 was present in 28% of patients as opposed to 4% of the controls (P corrected = 0.03). This finding indicates that susceptibility to chromoblastomycosis may be influenced by a gene located on chromosome 6, in the region of the major histocompatibility complex. The relative risk for an HLA-A29 carrier to develop chromoblastomycosis was estimated as 10.
Assuntos
Cromoblastomicose/genética , Antígenos HLA/análise , Antígenos HLA-A/análise , Adulto , Idoso , Cromoblastomicose/imunologia , Suscetibilidade a Doenças , Feminino , Antígenos HLA-A/genética , Antígenos HLA-B/análise , Antígenos HLA-C/análise , Antígenos HLA-DQ/análise , Antígenos HLA-DR/análise , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The first case was a 2 year-old girl with Blackfan-Diamond anemia who developed the immune reaction two weeks after receiving two transfusions of sedimented erythrocytes. HLA typing of lymphocytes showed the presence of three HLA-A, two of which were present in the donors. The second was a newborn who initially received an exchange transfusion and three weeks later another transfusion of whole blood. Both cases exhibited a severe bone marrow involvement and a skin biopsy with the pattern of keratinocyte apoptosis and lymphocyte satellitosis. These histological findings although highly suggestive must be evaluated in the appropriate clinical setting.
Assuntos
Doença Enxerto-Hospedeiro/patologia , Pele/patologia , Reação Transfusional , Biópsia , Medula Óssea/patologia , Pré-Escolar , Feminino , Doença Enxerto-Hospedeiro/etiologia , Antígenos HLA-A/análise , Humanos , Lactente , MasculinoRESUMO
Se presentaron dos casos de enfermedad injerto contra huésped asociada a transfusiones (Eichat) en los que la biopsia de piel jugó un papel central en la orientación diagnóstica. El primero correspondió a una niña de 2 años con anemia de Blackfan-Diamond que desarrolló el proceso inmune dos semanas después de recibir dos transfusiones de glóbulos rojos sedimentados. El estudio del HLA linfocitario mostró la presencia de 3 HLA-A, dos de los cuales estaban en los dadores. El segundo caso transfusiones de sangre completa.Ambos casos se acompañaron de un grave compromiso medular y en la biopsia de piel se reconoció el patrón de apoptosis de queratinocitos con satelitosis linfocitaria. Estos hallazgos histológicos, aunque altamente sugestivos, deen ser evaluados en el contexto clínico del paciente
Assuntos
Humanos , Lactente , Pré-Escolar , Masculino , Feminino , Doença Enxerto-Hospedeiro/etiologia , Transfusão de Sangue/efeitos adversos , Medula Óssea/patologia , Doença Enxerto-Hospedeiro/patologia , Antígenos HLA-A/análise , Pele/patologiaRESUMO
Se presentaron dos casos de enfermedad injerto contra huésped asociada a transfusiones (Eichat) en los que la biopsia de piel jugó un papel central en la orientación diagnóstica. El primero correspondió a una niña de 2 años con anemia de Blackfan-Diamond que desarrolló el proceso inmune dos semanas después de recibir dos transfusiones de glóbulos rojos sedimentados. El estudio del HLA linfocitario mostró la presencia de 3 HLA-A, dos de los cuales estaban en los dadores. El segundo caso transfusiones de sangre completa.Ambos casos se acompañaron de un grave compromiso medular y en la biopsia de piel se reconoció el patrón de apoptosis de queratinocitos con satelitosis linfocitaria. Estos hallazgos histológicos, aunque altamente sugestivos, deen ser evaluados en el contexto clínico del paciente (AU)
Assuntos
Humanos , Lactente , Pré-Escolar , Masculino , Feminino , Doença Enxerto-Hospedeiro/etiologia , Transfusão de Sangue/efeitos adversos , Doença Enxerto-Hospedeiro/patologia , Medula Óssea/patologia , Antígenos HLA-A/análise , Pele/patologiaRESUMO
Neuroblastoma cell lines can have very low MHC Ag expression. The cell lines are insensitive to allo-killing by primed CTL, but are sensitive to non-MHC-restricted cytotoxicity. IFN-gamma increased class I expression, but the cells remained insensitive to CTL. Susceptibility to nonrestricted effectors was preserved. Class I+ glioma cell lines behaved similarly. The CTL resistance was localized to the recognition phase. Neuroblastoma lines did not form conjugates with primed T cells, but were lysed if they were coupled to the effectors via lectins. The levels of class I expression, and resistance to CTL, were constant over a range of IFN doses. HLA-A,B,C structure and distribution were studied more intensively on one cell line, CHP-100. HLA-A2 and -A3 were present on greater than or equal to 99% of the cells, in a unimodal distribution. After IFN treatment, the levels were similar to B cell controls. In two-dimensional gel electrophoresis, the molecules co-migrated with those of B cell controls. The defect may thus be in accessory proteins that are necessary for T cell recognition or binding, rather than in the structure or distribution of the HLA-A,B,C proteins.