An initial investigation of serum cytokine levels in patients with gadolinium retention / Uma investigação inicial dos níveis séricos de citocinas em pacientes com retenção de gadolínio

Abstract Objective: To determine whether individuals with proposed gadolinium deposition disease (GDD) have elevated serum levels of pro-inflammatory and pro-fibrotic cytokines, and whether specific cytokines are correlated with certain symptoms. Materials and Methods: Twenty-four participants recruited between May 2016 and June 2017 met GDD diagnostic criteria. The 64 control subjects provided serum samples before prophylactic flu vaccination. Serum cytokine levels were obtained with Luminex serum cytokine assay using eBiosciences/Affymetrix human 62-plex kits. Wilcoxon rank-sum tests were performed to assess the difference between the median fluorescence intensity values for the participants and the control group. Generalized linear models were built to evaluate the association between each cytokine of interest and selected participant symptoms. Results: Serum levels of 14 cytokines, including nine pro-inflammatory cytokines, were statistically significantly elevated compared to controls (p ≤ 0.05). Hypotheses regarding pro-fibrotic cytokines and cytokine links to specific symptoms' intensity were not confirmed. Conclusion: The statistically significantly elevated cytokines may be markers of susceptibility to GDD or agents of symptom induction. These findings suggest that individuals developing symptoms characteristic of GDD after a contrast-assisted magnetic resonance imaging should be studied to investigate whether gadolinium retention and elevated cytokines may be related to their symptoms.

Resumo Objetivo: Determinar se indivíduos com doença de deposição de gadolínio (DDG) apresentam níveis séricos elevados de citocinas pró-inflamatórias e pró-fibróticas e se citocinas específicas estão correlacionadas com determinados sintomas. Materiais e Métodos: Vinte e quatro participantes recrutados entre maio/2016 e junho/2017 cumpriram os critérios de diagnóstico de DDG. Amostras de soro de 64 indivíduos controles foram obtidas antes de vacinação profilática contra a gripe. Os níveis de citocinas séricas foram mensurados com o ensaio Luminex usando kits 62-plex humanos. Foram realizados testes de Wilcoxon para avaliar a diferença dos valores médios de intensidade de fluorescência entre os participantes e o grupo controle. Foram construídos modelos lineares generalizados para avaliar a associação entre cada citocina de interesse e os sintomas dos participantes selecionados. Resultados: Níveis séricos de 14 citocinas, incluindo 9 citocinas pró-inflamatórias, foram estatisticamente significantes em comparação aos controles (p ≤ 0,05). Hipóteses sobre as citocinas pró-fibróticas e associação das citocinas com a intensidade de sintomas específicos não foram confirmadas. Conclusão: Citocinas estatisticamente elevadas podem ser marcadores de suscetibilidade para DDG ou agentes de indução de sintomas. Esses achados sugerem que indivíduos que desenvolvem sintomas da DDG após ressonância magnética com contraste devem ser estudados para investigar se a retenção de gadolínio e citocinas elevadas podem estar relacionadas aos seus sintomas.

Obesidad y sueño / Obesity and sleep

The progress of the obesity epidemic in children and adolescents and its close relationship with sleep and their comorbidities are a reason for growing concern. In this articule we review the epidemiology, prenantal, and postnatal risk factors of obesity, and associated comorbidities, such as: metabolic syndrome; chronic pro-inflammatory state and sleep-disordered breathing (SDB), with the involved pathophysiological mechanisms. We also analyze the links between obesity and SDB, the consequences of this association, in terms of enhancing the damage to physical and psychological health and the main therapeutic available measures

El avance de la epidemia de la obesidad en niños y adolescentes, su estrecha relación con el sueño y sus comorbilidades son motivo de una preocupación creciente. En este artículo revisaremos la epidemiología y factores de riesgo prenatales y postnatales de la obesidad. y las comorbilidades asociadas, tales como: síndrome metabólico, estado pro-inflamatorio crónico y trastornos respiratorios del sueño (TRS), con los mecanismos fisiopatológicos involucrados. También analizaremod las interconexiones entre la obesidad y los TRS, las consecuencias de esta asociación, en cuanto a potenciarel daño a la salud física y psicológica y las principales medidad terapéuticas disponibles

Adiposidad, estado pro-inflamatorio y resistencia a la insulina durante la menopausia

La obesidad se ha convertido en un verdadero problema de salud pública, debido a la alta prevalencia y a las complicaciones metabólicas asociadas. Existen evidencias epidemiológicas que muestran asociación entre la adiposidad y el estado pro-inflamatorio. Entre los grupos poblacionales más vulnerables en la edad adulta, se encuentran las mujeres posmenopáusicas. Durante la menopausia, se producen cambios metabólicos, que favorecen la ganancia de peso y la obesidad abdominal, facilitando el desarrollo de insulino resistencia y sus consecuencias clínicas como la diabetes mellitus tipo 2 y enfermedades cardiovasculares. Existen numerosos estudios clínicos y experimentales, que soportan la teoría de que el riego de sufrir estas patologías, está fuertemente asociado al aumento de la actividad pro-inflamatoria, desempeñando los estrógenos un papel fundamental en dicho proceso. Los cambios que se producen en las adipocinas como la leptina, la adiponectina, el factor de necrosis tumoral alfa, la interleucina 6, y en la proteína C reactiva, condicionan de manera significativa el estado pro-inflamatorio en la obesidad. La evaluación de estos indicadores, junto con los de adiposidad y de resistencia a la insulina, pudiera ayudar a identificar el riesgo de experimentar enfermedades metabólicas en la posmenopausia temprana y la comprensión de los mecanismos puede suministrar nuevas alternativas en la profilaxis y en el tratamiento de estos trastornos.

Obesity has become a real public health problem because of its high prevalence and associated metabolic complications. There is epidemiological evidence showing association between adiposity and pro-inflammatory state. Among the most vulnerable population groups in adulthood, are postmenopausal women. During menopause, the metabolic changes that favor weight gain and abdominal obesity, facilitating the development of insulin resistance and its clinical consequences such as type 2 diabetes mellitus and cardiovascular disease. Numerous experimental and clinical studies that support the theory that the risk of developing these diseases are strongly associated with increased pro-inflammatory activity, and estrogens play a key role in this process. The changes that occur in adipokines such as leptin, adiponectin, tumor necrosis factor alpha, interleukin 6, and C-reactive protein, influence significantly the pro-inflammatory state in obesity. The evaluation of these indicators, along with adiposity and insulin resistance, could help identify the risk for metabolic diseases in early postmenopausal and understanding of the mechanisms may provide new alternatives in the prophylaxis and treatment of these disorders.