Are there differences in oxidative stress and inflammatory processes between the autogenous and reactive subtypes of obsessive-compulsive disorder? A controlled cross-sectional study

Objective: To date, no study has investigated whether autogenous and reactive obsessive-compulsive disorder (OCD) types are different entities in terms of oxidative stress and inflammatory processes. The aim of this study is to compare them in terms of these features. Methods: The study was conducted in subjects with reactive OCD (n=19), autogenous OCD (n=14), and a control group (n=17). All participants were non-smokers. Sociodemographic data were collected and the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Obsessive Beliefs Questionnaire (OBQ), and Overvalued Ideas Scale (OVIS) were administered. High-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), interleukin-10 (IL-10), paraoxonase (PON1), total oxidant status (TOS), and total antioxidant status (TAS) were measured. Results: There were no significant differences in TAS, TOS, or oxidative stress index (OSI) between the OCD and control groups. PON1 and hs-CRP levels were higher in the OCD group, whereas IL-6 and IL-10 levels were lower. Comparison across the three groups revealed no differences in TAS, TOS, OSI, or PON1 levels; however, hs-CRP was significantly higher while IL-6 and IL-10 were significantly lower in the reactive group compared to controls. Conclusion: Our results show that, although inflammatory processes may play a role in OCD, the autogenous and reactive subtypes do not differ from each other in these respects. The classification of OCD into autogenous and reactive subtypes should be reevaluated.

Relação entre os níveis de ferritina e o prognóstico da COVID-19 / Relationship between ferritin levels and the prognosis of COVID-19

O elevado nível de ferritina sérica tem sido associado à COVID-19 grave devido à sua estimulação por citocinas relacionadas com o processo inflamatório. Embora este aumento seja esperado, esta revisão propõe analisar o quão elevado o nível de ferritina pode estar relacionado com esta severidade. Nesta linha de pensamento, a hiperferritinemia na COVID-19 poderia ser um importante fator de previsão e outra forma de compreender as complicações da COVID-19 - coagulopatia, síndrome do desconforto respiratório agudo (SDRA). Além disso, esta correlação tem sido vista como uma possível quinta síndrome entre as outras "síndromes hiperferritinêmicas", todas caracterizadas por ferritina sérica elevada; esta é uma comparação e análise pertinente em termos de tratamentos. [au]

The high level of serum ferritin has been associated with severe COVID-19 due to its stimulation by cytokines related to the inflammatory process. Although this increase is expected, this review proposes to analyze how high ferritin can be related to this severeness. According to this premise, the hyperferritinemia on COVID-19 could be an important factor of prediction and another way to understand the complications of COVID-19 -coagulopathy, acute respiratory distress syndrome (ARDS). Furthermore, this correlation has been seen as a possible fifth syndrome among the other "hyperferritinemic syndromes", which are all characterized by high serum ferritin; this is an pertinent comparison and analyzation in terms of treatments. [au]

Acute kidney injury caused by venomous animals: inflammatory mechanisms

Abstract Either bites or stings of venomous animals comprise relevant public health problems in tropical countries. Acute kidney injury (AKI) induced by animal toxins is related to worse prognostic and outcomes. Being one the most important pathways to induce AKI following envenoming due to animal toxins, inflammation is an essential biological response that eliminates pathogenic bacteria and repairs tissue after injury. However, direct nephrotoxicity (i.e. apoptotic and necrotic mechanisms of toxins), pigmenturia (i.e. rhabdomyolysis and hemolysis), anaphylactic reactions, and coagulopathies could contribute to the renal injury. All these mechanisms are closely integrated, but inflammation is a distinct process. Hence, it is important to improve our understanding on inflammation mechanisms of these syndromes to provide a promising outlook to reduce morbidity and mortality. This literature review highlights the main scientific evidence of acute kidney injury induced by bites or stings from venomous animals and their inflammatory mechanisms. It included observational, cross-sectional, case-control and cohort human studies available up to December 2019. Descriptors were used according to Medical Subject Headings (MeSH), namely: Acute kidney injury or Venom and Inflammation on Medline/Pubmed and Google Scholar; Kidney disease or Acute kidney injury on Lilacs and SciELO. The present review evidenced that, among the described forms of renal inflammation, it can occur either directly or indirectly on renal cells by means of intravascular, systemic and endothelial hemolysis, activation of inflammatory pathway, as well as direct action of venom cytotoxic components on kidney structures.

Comparative analysis of tissular response after abdominal wall repair using polypropylene mesh and bovine pericardium mesh / Análise comparativa da resposta tecidual após reparo da parede abdominal utilizando tela de polipropileno e de pericárdio bovino

ABSTRACT Background: The use of polypropylene meshes for surgical repair of the abdominal wall contributes to a reduction of the of recurrence rates of hernias or defects. However, its intra-abdominal use comes along with the formation of adhesions and several complications. The study and the search for alternative materials, including bovine pericardium, have been regarded as an option for the correction and treatment of resulting hernias with better adaptations and effectiveness. Aim: Evaluating the inflammatory process of the bovine pericardium in comparison with the inflammatory process of synthetic polypropylene mesh. Method: Bovine pericardium mesh and polypropylene mesh were placed, both on the same animal. The first group had the mesh removed for analysis on day 20, and the second group on day 40. The variables congestion, granulation, giant cells, necrosis, acute inflammation, chronic inflammation and collagen were analyzed. Results: All variables were found in greater numbers as a response to the polypropylene mesh, except for the collagen, which, on day 40, was greater in response to the bovine pericardium mesh. Conclusion: The data in this study suggest that there is less inflammatory reaction in response to bovine pericardium mesh when compared to polypropylene mesh.

RESUMO Racional: O uso de telas de polipropileno para a correção cirúrgica da parede abdominal contribui para redução dos índices de recidiva das hérnias ou defeitos. No entanto, o seu uso intra-abdominal cursa com a formação de aderências e diversas complicações. O estudo e a busca por materiais alternativos, como pericárdio bovino, têm se mostrado uma opção na correção e tratamento de hérnias que resultem com melhores adaptações e efetividades. Objetivo: Avaliar o processo inflamatório do pericárdio bovino em comparação ao processo inflamatório da tela sintética de polipropileno. Método: Foi realizada a colocação de tela de pericárdio bovino e polipropileno, ambas no mesmo animal. O primeiro grupo as teve retiradas para análise no dia 20, e o segundo grupo no dia 40. Foram analisadas as variáveis congestão, granulação, células gigantes, necrose, inflamação aguda, inflamação crônica e colágeno. Resultados: Todas as variáveis foram encontradas em maior número como resposta a tela de polipropileno, exceto a variável colágeno, que no dia 40 apresentou-se em maior quantidade em resposta à tela de pericárdio bovino. Conclusão: Há menor reação inflamatória em resposta a tela de pericárdio bovino, quando comparada com a de polipropileno.

Influence of galantamine in the inflammatory process and tissular lesions caused by Trypanosoma cruzi QM2 strain

Abstract INTRODUCTION: Trypanosoma cruzi infection triggers an inflammatory process with exacerbated production of cytokines that stimulate inflammatory and anti-inflammatory signals, including the efferent anti-inflammatory signal known as the anti-inflammatory cholinergic pathway. Thus, the use of anticholinesterase drugs, such as galantamine, could minimize the inflammatory process caused by this disease. METHODS For the study at 30, 60, and 90 days, 120 Swiss mice were divided into three groups. Each group was subdivided into four subgroups: uninfected/untreated (CTRL), uninfected/treated (GAL), infected/untreated (INF), and infected/treated (GAL/INF). The infected groups were inoculated intraperitoneally with 0.1 ml of mouse blood containing 5 × 104 trypomastigote forms of the T. cruzi QM2 strain. The galantamine-treated groups received 5 mg/kg of galantamine orally, through pipetting. From each subgroup, the parameters of parasitemia, histopathological analysis, butyrylcholinesterase activity (BuChE), and functional study of the colon were evaluated. RESULTS: BuChE performance was observed when AChE was suppressed, with increased activity in the GAL/INF group similar to the INF group on the 30th day post infection, thus corroborating the absence of a significant difference in parasitic curves and histopathological analysis. CONCLUSIONS: The presence of an inflammatory process and nests of amastigotes, as well as evidence of reactivity to ACh and NOR, suggest that galantamine did not interfere with the colonic inflammatory response or even in colonic tissue parasitism at this stage of Chagas disease.

Nutrientes y alimentos en la esclerosis múltiple / Nutrients and foods in multiple sclerosis. Abstract

La alimentación influye en la mejora de la sintomatología de cualquier enfermedad, incluida la esclerosis múltiple (EM),la cual, se caracteriza por un proceso inflamatorio crónico, autoinmune del sistema nervioso central generando situaciones como inflamación, alteraciones; digestivas y mentales, discapacidad, y fatiga. El propósito de la presente revisión fue identificar la evidencia científica sobre los aspectos nutricionales que mejoran la progresión de EM. La metodología consistió en la búsqueda de literatura, en bases de datos electrónicas, referente a nutrición y esclerosis múltiple, principalmente entre los años 2015-2020. Entre los resultados de los aspectos nutricionales que mostraron eficacia en mejorar la progresión de EM, se encuentran el zinc, vitamina D, fibra, probióticos, aceite de pescado y de oliva, cacao, cúrcuma, y salmón. Existen evidencias del papel inmunomodulador del Zn y de la vitamina D en la inhibición de la producción de citocinas proinflamatorias. Niveles bajos de ambos componentes se asocian con mayor riesgo de padecer EM. Otros componentes de interés nutricional son la fibra y probióticos; producen ácidos grasos de cadena corta, con propiedades antiinflamatorias. La primera se conoce por su papel en la motilidad gastrointestinal y los segundos por su acción celular y molecular en procesos inflamatorios, y modulación del microbioma, por mencionar algunos. Los aspectos nutricionales antes mencionados pueden contribuir a modular la inflamación y mejorar la fatiga. Finalmente, este documento genera un panorama importante para continuar con la investigación referente a la influencia de la alimentación en pacientes con EM(AU)

Diet influences the improvement of the symptoms of any disease, including multiple sclerosis (MS), which is characterized by a chronic, autoimmune inflammatory process of the central nervous system generating situations such as inflammation, mental and digestive alterations, disability and fatigue. The aim of this review was to identify the scientific evidence on the nutritional aspects that improve the progression of MS. The methodology consisted of searching literature, in electronic databases, referring to nutrition and multiple sclerosis, mainly between the years 2015-2020. The results of the nutritional aspects that showed effectiveness in improving the progression of MS, are zinc, vitamin D, fiber, probiotics, fish oil and olive oil, cocoa, turmeric and salmon. There is evidence of the immunomodulatory role of Zn and vitamin D in inhibiting the production of proinflammatory citokines. Low levels of both components are associated with an increased risk of MS. Other components of nutritional interest are fiber and probiotics; they produce short chain fatty acids, with anti-inflammatory properties. The first is known for its role in gastrointestinal motility and the second one for its cellular and molecular actions in inflammatory processes and the microbiome modulation, to name a few. The nutrition aspects mentioned above, can contribute to modulate inflammation and improve fatigue. Finally, this paper creates an important perspective to continue the investigation concerning the influence of diet in MS patients(AU)

Suplementação De Ômega-3 Em Praticante De Exercício Físico Intenso / Supplementation Of Ômega-3 In Practice Of Intense Physical Exercise

Objetivo: analisar pesquisas acerca da suplementação com ácidos graxos poliinsaturados ômega-3 (AGPI-n3) em praticantes de exercícios físicos intensos (EFI). Método: Para a realização do estudo, foram consultados artigos disponíveis nas seguintes bases de dados eletrônicas: Scielo, PubMed, Lilacs, Revistas Científicas. Os estudos dos artigos consultados foram realizados em indivíduos adultos. Resultados: Foram identificados os artigos que se enquadravam no quadro de exigências de acordo com o objetivo desta revisão. Foram selecionados 10 artigos (n=10), de modo a investigar os itens de maior relevância, que foram: referência, revista, teste físico, grupo avaliado (número e gênero), quantidade de tempo e de suplementação e principais resultados. Conclusão: Os resultados evidenciaram que a suplementação com AGPI-n3 pode prevenir doenças cardíacas, alterar o metabolismo lipídico, suprimir marcadores inflamatórios em exercícios de resistência, melhorar a função pulmonar durante exercícios, aumentar a quantidade de ácido eicosapentaenoico (EPA) e docosahexaenóico (DHA) no sangue.

Objective: to analyze the research on supplementation with omega-3 polyunsaturated fatty acids (PUFA-n3) in intense physical exercise practitioners (EFI). Methods: For the accomplishment of the study, articles were available in the following electronic databases: Scielo, PubMed, Lilacs, Scientific Journals. The articles were consulted in adults. Results: The articles that fit the requirements framework were identified according to the purpose of this review. Ten articles (n = 10) were selected, in order to investigate the most relevant items, which were: reference, journal, physical test, group evaluated (number and gender), amount of time and supplementation, and main results. Conclusion: The results showed that supplementation with PUFA-n3 can prevent heart disease, alter lipid metabolism, suppress inflammatory markers in endurance exercises, improve pulmonary function during exercise, increase the amount of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA ) in the blood

Fistulización a recto de un teratoma quístico maduro, una rara complicación / Rectal fistulization of a mature cystic teratoma, a rare complication

RESUMEN Los teratomas quísticos maduros son los tumores ováricos más frecuentes. La fistulización de estos a órganos vecinos (colon, intestino delgado y vejiga) es una complicación que cuando se presenta nos obliga a descartar un proceso infiltrativo. Tanto la malignización como la formación de fistulas son complicaciones excepcionales. Está descrito en la bibliografía la malignización como mecanismo de formación de dichas fistulas. Este hecho nos suele obligar a llevar a cabo intervenciones agresivas, como exenteraciones pélvicas anteriores y posteriores. Sin embargo, una revisión de los casos publicados (18) muestra que sólo el 22 % de las fistulas son resultado de una malignización de dicho teratoma. Presentamos una paciente con un teratoma quístico maduro que fistulizó a recto y su manejo en nuestro servicio. Precis: La fistulización a órganos vecinos de un teratoma es una complicación excepcional que requiere un diagnóstico preciso puesto que no siempre es secundaria a neoplasia.

ABSTRACT Mature cystic teratomas are the most common ovarian tumors. The fistulization of these teratomas to adjacent organs (colon, small intestine and bladder) is a complication that when it occurs forces us to rule out an infiltrative process. Together with malignancy, the fistula is a rare complication. Literature describes malignancy as a mechanism for the formation of these fistulas. This event usually forces us to carry out aggressive interventions, such as anterior and posterior pelvic exenterations. However, the case records of 18 patients report that only 22 % of fistulas are produced by malignant teratoma. The following case study presents a mature cystic teratoma that fistulated the rectum and its management in our service.

Protective effects of ethanolic extract from the red algae Amansia multifida on experimental inflammation, nociception and seizure experimental models / Efeito protetor do extrato etanólico da alga marinha vermelha Amansia multifida em modelos experimentais de inflamação, nocicepção e convulsão

This study aimed to investigate the EEAm effect in mice models of nociception, inflammation and in behavioral tests evaluating the central nervous system. EEAm had inhibitory effects in the following tests: acetic acid-induced writhing (78%); formalin (62% - inflammatory phase); open field (46%). EEAm increased the nociceptive latency (56%) in tail flick test and increased the death-latency by 36% in the pentylenetetrazole-induced seizure model. Moreover, EEAm inhibited paw edema (82%) and peritonitis (45%) induced by carrageenan. In conclusion, EEAm presents antinociceptive, anti-inflammatory and anticonvulsant effects involving peripheral and central-acting mechanisms in mice.

Neste estudo objetivou-se investigar o efeito do EEAm em modelos de nocicepção e inflamação, e em testes comportamentais que avaliam o sistema nervoso central em camundongos. EEAm exibiu efeitos inibitórios nos testes comportamentais de contorções abdominais induzidas por ácido acético (78%); formalina (62% - fase inflamatória) e campo aberto (46%). EEAm aumentou a latência de nocicepção no teste de retirada da cauda (56%) e a latência de morte 36% no modelo de convulsões induzidas por pentilenetetrazol. Além disso, EEAm inibiu o edema de pata (82%) e a peritonite (45%) induzidos por carragenana. Como conclusão, EEAm apresenta efeitos antinociceptivo, anti-inflamatório e anticonvulsivante em camundongos por mecanismos periféricos e centrais.

Lactobacillus spp. e bifidobacterium sp. atenuam a mucosite intestinal experimental induzidapor 5-fluorouracil em camundongos

A mucosite intestinal é um dos efeitos adversos mais incidentes do tratamento com 5-Fluorouracil. Nesse contexto, microrganismos probióticos são cada vez mais utilizados como alternativas para proteção da mucosa gastrintestinal deste efeito colateral e distúrbios associados. Este estudo teve como objetivo avaliar o efeito de Probiotil®composto pelosprobióticos Lactobacillus acidophilus e Bifidobacterium lactis, e Probiatop® composto porLactobacillus acidophilus, Lactobacillus paracasei, Lactobacillus rhamnosus eBifidobacterium lactis na mucosite intestinal experimental induzida por 5-FU. Para aexecução do protocolo utilizou-se camundongos machos Swiss (25-30g) que foram tratadoscom dose única intraperitoneal de 5-FU (450mg/Kg i.p.), com exceção dos controles (Salina eDMSO). Os grupos probióticos foram tratados com o Probiotil®ou Probiatop®1h, 24h e 48h(v.o.) após a indução por 5-FU, sendo eutanasiados após 72h da indução de mucosite.Segmentos do duodeno, jejuno e íleo foram obtidos para as seguintes avaliações: mensuração da relação vilo/cripta; escores histológicos; dosagem de glutationa (GSH), malondialdeído(MDA), citocinas pró-inflamatórias (TNF-α e IL-6) e atividade da enzima mieloperoxidase(MPO). Além disso, avaliou-se a análise ponderal, leucograma, esvaziamento gástrico etrânsito intestinal dos animais. Observou-se que Probiatop®diminuiu a perda de peso induzida por 5-FU, mas este efeito não foi demonstrado pelo Probiotil®...

Intestinal Mucositis is a higher adverse effects of treatment with 5-fluorouracil. In thiscontext, probiotics are widely used to protect gastrointestinal disorders. Here we report theeffect Probiotil®composed by probiotics Lactobacillus acidophilus and Bifidobacteriumlactis, and Probiatop®composed by Lactobacillus acidophilus, Lactobacillus paracasei,Lactobacillus rhamnosus and Bifidobacterium lactis in intestinal mucositis induced by 5-FU.Such methodology was used male Swiss mice (25-30g), treated with a single intraperitonealdose by 5-FU (450 mg / kg ip), and controls with(saline and DMSO). In the Probiotics groupswas administrated Probiotil®or Probiatop®1h, 24h and 48h (V.O.) after induction by 5-FU .72h after 5-FU administration, mice was euthanized. Segments from Duodenum, jejunum andileum were removed for evaluations: measurement of villous / crypt ratio; Histological scores;concentration of glutathione (GSH), malondialdehyde (MDA), proinflammatory cytokines(TNF-α and IL-6) activity and myeloperoxidase (MPO). In addition, we investigated theweight analysis, leukogram, gastric emptying and intestinal transit of animals. Our resultsshowed that Probiatop®decreased the weight loss induced by 5-FU, but Probiotil®did notchange weight loss...

Role of cyclooxygenase-2 in Trypanosoma cruzi survival in the early stages of parasite host-cell interaction

Chagas disease, caused by the intracellular protozoan Trypanosoma cruzi, is a serious health problem in Latin America. During this parasitic infection, the heart is one of the major organs affected. The pathogenesis of tissue remodelling, particularly regarding cardiomyocyte behaviour after parasite infection and the molecular mechanisms that occur immediately following parasite entry into host cells are not yet completely understood. When cells are infected with T. cruzi, they develop an inflammatory response, in which cyclooxygenase-2 (COX-2) catalyses rate-limiting steps in the arachidonic acid pathway. However, how the parasite interaction modulates COX-2 activity is poorly understood. In this study, the H9c2 cell line was used as our model and we investigated cellular and biochemical aspects during the initial 48 h of parasitic infection. Oscillatory activity of COX-2 was observed, which correlated with the control of the pro-inflammatory environment in infected cells. Interestingly, subcellular trafficking was also verified, correlated with the control of Cox-2 mRNA or the activated COX-2 protein in cells, which is directly connected with the assemble of stress granules structures. Our collective findings suggest that in the very early stage of the T. cruzi-host cell interaction, the parasite is able to modulate the cellular metabolism in order to survives.

Papel de las mitocondrias y el estrés oxidativo en el proceso inflamatorio renal / Mitochondria and oxidative stress participation in renal inflammatory process

La muerte celular programada y la fibrosis renal son procesos inherentes a la enfermedad renal crónica y, en tal sentido, ha sido recientemente descripta una clara desregulación de la maquinaria respiratoria mitocondrial en pacientes con enfermedad renal crónica asociada con un aumento del estrés oxidativo. Las células tubulares lesionadas vinculadas a los macrófagos intersticiales y miofibroblastos producen citoquinas y factores de crecimiento que promueven un estado inflamatorio, inducen la apoptosis de las células tubulares y facilitan la acumulación de matriz extracelular. La angiotensina II desempeña un papel central en la fibrogénesis renal y conduce a una rápida progresión de la enfermedad renal crónica. Los niveles crecientes de la angiotensina II inducen citoquinas pro-inflamatorias, la activación de NF-kB, moléculas de adhesión, quimiocinas, factores de crecimiento y estrés oxidativo. Toda la evidencia actual sugiere que la angiotensina II aumenta el estrés oxidativo mitocondrial, regula la inducción de apoptosis y condiciona al estado inflamatorio. Por lo tanto, existiría un papel determinante de las mitocondrias y el estrés oxidativo en el proceso inflamatorio renal. Finalmente, esta revisión resume nuestro actual conocimiento acerca de los posibles mecanismos que contribuirían con la apoptosis modulada por la inflamación y/o el estrés oxidativo durante la enfermedad renal crónica. Además, se propone un nuevo concepto de herramientas anti-inflamatorias que regulan el estrés oxidativo mitocondrial lo cual afectaría directamente al proceso inflamatorio y la apoptosis. Esta idea podría tener consecuencias atractivas sobre el tratamiento de patologías inflamatorias renales y de otras afines.

The apoptosis and renal fibrosis are processes inherent to the chronic kidney disease, and consequently a clear deregulation of the mitochondrial respiratory mechanism has been described in patients with chronic renal disease associated to an increase of the oxidative stress. The injured tubular cells linked to the interstitial macrophages and myofibroblasts produce cytokines and growth factors that encourage an inflammatory condition, inducing the apoptosis of the tubular cells and enabling the accumulation of the extracellular matrix. The angiotensin II has a central role in the renal fibrogenesis leading to a rapid progression of the chronic kidney disease. The growing levels of the angiotensin II induce pro-inflammatory cytokines, the activation of NF-kB, adhesion molecules,chemokines, growth factors, and oxidative stress. The current evidence suggests that the angiotensin II increases the mitochondrial oxidative stress, regulates the induction of the apoptosis and conditions the inflammatory process. Therefore the mitochondria and the oxidative stress would play a determinant role in the renal inflammatory process. Finally, this review summarizes our present knowledge regarding the possible mechanisms that would contribute to the apoptosis conditioned by inflammation and/or oxidative stress during the chronic renal disease. Additionally, a new concept of the anti-inflammatory tools is proposed to regulate the mitochondrial oxidative stress that would directly affect the inflammatory process and apoptosis. This concept could have positive consequences on the treatment of renal inflammatory pathologies and related diseases.

Perfil sérico de melatonina, citocinas e cortisol em gestantes com pré-eclâmpsia / Serum profile of melatonin, cytokines and cortisol in pregnant women with preeclampsia

A pré-eclâmpsia (PE) é a maior causa de mortalidade e morbidade materna e perinatal. Sua etiologia permanece desconhecida, o que torna impossível a realização de prevenção primária dessa doença. O entendimento do perfil de substâncias que estão alteradas na PE é de relevância para poder atuar preventivamente. Considerando que vários hormônios envolvidos na resposta imunológica participam da fisiopatologia da PE e que, como demonstrado recentemente, a melatonina tem papel relevante na fisiopatologia da inflamação aguda, nossa hipótese seria que este hormônio poderia também atuar fisiopatologia da PE. OBJETIVOS: avaliar o perfil de citocinas e hormônios no soro de pacientes com PE para estabelecer se o eixo imune-pineal estaria ativado nesta doença. MÉTODOS: Realizamos estudo prospectivo caso-controle, no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, no período de Outubro de 2010 a Outubro de 2013. O grupo experimental foi formado por pacientes com PE pura no momento do diagnóstico (sem medicação anti-hipertensiva inicial por 24h). Gestantes saudáveis e normotensas, pareadas por idade materna, idade gestacional e paridade, foram selecionadas como controles. Citocinas (TNF, IL-8, IL-6, IL-1beta, IL-4, IFN-y , VEGF , IL-10, IL-12p40, IL-17 e IL-2), cortisol, níveis séricos de melatonina pela manhã (08h-11h) e à noite (23h- 01h), assim como os níveis de 6-sulfatoximelatonina (6-SMT) nos diferentes períodos do dia (bl1:12h-18h, bl2:18h-24h,bl3:24h-06h,bl4:06-12h) foram avaliados por MULTIPLEX e ELISA. A diferença entre os grupos foi avaliada por Two-way ANOVA seguido de pós teste de Bonferroni. Foi considerada significativamente diferente quando a probabilidade da hipótese nula foi rejeitada (p < 0,05). A correlação entre parâmetros foi avaliada por regressão linear simples e teste de Pearson. RESULTADOS: De um total de 31 pacientes inicialmente avaliadas, 14 gestantes com PE e 12 controles foram incluídas. As características das...

Preeclampsia (PE) is a major cause of maternal and perinatal mortality and morbidity. Since its etiology remains unknown, it is impossible to have a primary prevention of the disease. The understanding of the substance profiles that are altered in PE is important to prevent the disease. Considering that many hormones involved in immune response are involved in the physiopathology of PE and that melatonin has a relevant role in the acute inflammatory process, our hypothesis is that this hormone would also be involved in the physiopathology of PE. OBJECTIVES: To analyze the serum profile of cytokines and hormones in pregnant women with PE in order to evaluate if the immune-pineal axis is activated in this disease. METHODS: A prospective case-control study was conducted at the Clinical Hospital USP between October 2010 and October 2013. Only patients with pure PE at the moment of diagnosis (without anti-hypertensive medication for the initial 24h after diagnosis) were included. Normotensive healthy pregnant women that were matched by maternal age, gestational age and parity were included as controls. Cytokines (IL-6, IL-1b, IL-8, TNF and IFNy), cortisol and serum melatonin levels in the morning (08h-11h) and at night (23h-01h), as well as 6-sulfatoximelatonin (6-SMT) levels in different periods of the day (bl1:12h- 18h, bl2:18h-24h, bl3:24h-06h, bl4:06-12h) were measured by MULTIPLEX and ELISA. Differences between groups were analyzed using two-way ANOVA followed by Bonferronis's test. Statistical difference was considered when the null hypothesis was rejected (p < 0.05). Correlations between parameters were analyzed using linear regression and Pearson test. RESULTS: From a total of 31 patients initially evaluated, 14 patients with PE and 12 controls were included. Demographics such as maternal age, parity, gestational age at the dosages, body-mass index were similar in both groups (p > 0.05). TNF and IL-8 levels were higher in the...

Arnica montana: una revisión bioquímica y homeopática / Arnica montana: A biochemical and homeopathic review

El Arnica montana es uno de los medicamentos que se emplean con mayor frecuencia en la práctica homeopática. Comúnmente, es la primera elección en la atención de traumatismos, contusiones y golpes, especialmente de partes blandas. También se emplea en torceduras, fracturas, esfuerzos exagerados, enfermedades reumáticas, traumas emocionales y para mejorar la recuperación de los pacientes que se someten a intervenciones quirúrgicas. Debido al interés que genera, el Arnica montana ha sido objeto de numerosos estudios en diferentes áreas para comprobar su alcance y determinar sus mecanismos de acción. A continuación se presenta una revisión de algunos artículos publicados sobre este medicamento; unos versan sobre sus principios activos y otros analizan diversos experimentos que se han efectuado.

Arnica montana is one of the most often used drugs in homeopathic practice. Commonly, it is the first choice in the trauma care, bruises and bumps, especially soft tissue. Also used in sprains, fractures, exaggerated efforts, rheumatic diseases and emotional trauma to improve recovery of patients who undergo surgery. Due to the interest generated, Arnica montana has been the subject of numerous studies in different areas to check their range and determine their mechanisms of action. Below is a review of some articles published on this medication, some deal with other active principles and discusses various experiments that have been conducted.

Effects of vitamin C supplementation on acute phase Chagas disease in experimentally infected mice with Trypanosoma cruzi QM1 strain / Efeitos da suplementação de vitamina C sobre a fase aguda da doença de Chagas em camundongos experimentalmente infectados pela cepa QM1 de Trypanosoma cruzi

The tissue changes that occur in Chagas disease are related to the degree of oxidative stress and antioxidant capacity of affected tissue. Studies with vitamin C supplementation did not develop oxidative damage caused by Chagas disease in the host, but other studies cite the use of peroxiredoxins ascorbate - dependent on T. cruzi to offer protection against immune reaction. Based on these propositions, thirty "Swiss" mice were infected with T. cruzi QM1 strain and treated with two different vitamin C doses in order to study the parasitemia evolution, histopathological changes and lipid peroxidation biomarkers during the acute phase of Chagas disease. The results showed that the parasite clearance was greater in animals fed with vitamin C overdose. There were no significant differences regarding the biomarkers of lipid peroxidation and inflammatory process or the increase of myocardium in animals treated with the recommended dosage. The largest amount of parasite growth towards the end of the acute phase suggests the benefit of high doses of vitamin C for trypomastigotes. The supplementation doesn't influence the production of free radicals or the number of amastigote nests in the acute phase of Chagas disease.

As alterações teciduais que ocorrem na doença de Chagas estão relacionadas ao grau de estresse oxidativo e à capacidade antioxidante do tecido afetado. Estudos realizados com suplementação de vitamina C revelaram redução no dano oxidativo causado no hospedeiro pela doença de Chagas, porém outros estudos citam o uso de peroxiredoxinas dependentes de ascorbato pelo T. cruzi para se proteger da ação imune. Com base nessas proposições, trinta camundongos "Swiss" foram infectados com a cepa QM1 de T. cruzi e tratados com duas diferentes doses de vitamina C para estudar a evolução da parasitemia, alterações histopatológicas e dosagem de biomarcadores de peroxidação lipídica durante a fase aguda da doença de Chagas. Os resultados mostraram que a parasitemia foi maior nos animais que receberam uma superdosagem de vitamina C. Não houve diferenças significativas quanto aos biomarcadores de peroxidação lipídica e houve maior processo inflamatório no miocárdio dos animais tratados com dosagem recomendada. O maior crescimento parasitário ao fim da fase aguda sugere benefício de altas doses de vitamina C aos tripomastigotas. A suplementação não exerceu influência sobre a produção de radicais livres e o número de ninhos de amastigotas na fase aguda da doença de Chagas.

Exercício físico, processo inflamatório e adaptação: uma visão geral / Physical exercise, inflammatory process and adaptive condition: an overview

O exercício físico induz inflamação, evento que ocorre para promover o reparo e remodelamento tecidual após o trauma. A ativação do processo inflamatório é local e sistêmico, valendo-se para isso de diversas células e componentes secretados. O objetivo é restabelecer a homeostasia orgânica após uma única sessão ou após diversas sessões de exercícios. A resposta de fase aguda consiste de ações integradas entre leucócitos, citocinas, proteínas de fase aguda, hormônios e outras moléculas sinalizadoras que controlam a resposta tanto a uma sessão de exercícios como também direcionam as adaptações decorrentes do treinamento. Nessa revisão, apresentaremos um panorama geral sobre inflamação e exercício físico, e os dados na literatura sobre marcadores de inflamação em resposta a diferentes protocolos experimentais. Os resultados obtidos apontam respostas distintas sobre o processo inflamatório em relação aos efeitos agudos ou crônicos dos exercícios. De forma geral, uma única sessão de exercício físico intenso induz um estado pró-inflamatório, representado por leucocitose transitória, em decorrência de neutrofilia, monocitose e linfocitose, seguida de supressão parcial da imunidade celular. Também têm sido observados aumentos nas concentrações séricas da enzima creatina quinase, proteína C-reativa e moléculas de adesão celular, além do aumento na secreção de cortisol e citocinas. Já o treinamento físico sistematizado pode levar a um estado anti-inflamatório local e sistêmico. Esse ambiente anti-inflamatório viabilizaria a adaptação e, ao mesmo tempo, protegeria o organismo contra o desenvolvimento de patologias inflamatórias crônicas e dos efeitos nocivos do overtraining, quando parece prevalecer um estado pró-inflamatório e pró-oxidante crônico e sistêmico.

Physical exercise induces inflammation, a physiological response that is part of immune system activity and promotes tissue remodeling after exercise overload. The activation of the inflammatory process is local and systemic and is mediated by different cells and secreted compounds. The objective is to reestablish organ homeostasis after a single bout of exercise or after several exercise sessions. The acute-phase response involves the combined actions of activated leukocytes, cytokines, acute-phase proteins, hormones, and other signaling molecules that control the response to an exercise session and guide the adaptations resulting from training. This review provides an overview of the inflammatory process related to exercise and literature data regarding markers of inflammation in response to different experimental protocols. The results obtained indicate distinct inflammatory responses to acute and chronic exercise. In general, acute exercise induces a proinflammatory response characterized by transient leukocytosis (neutrophilia, monocytosis, and lymphocytosis), followed by a partial cellular immunosuppressive state. An increase in serum concentrations of creatine kinase, C-reactive protein and cell adhesion molecules is also observed, in addition to an increased secretion of cortisol and cytokines. In contrast, chronic exercise results in a local and systemic anti-inflammatory response that promotes tissue adaptation and protects the organism against the development of chronic inflammatory diseases and against the effects of non-functional overtraining, a condition in which a systemic and chronic proinflammatory and pro-oxidant state seems to prevail.

Efeito da suplementação com L-Arginina sobre a produção de mediadores inflamatórios e fatores regenerativos pelo tecido muscular esquelético decorrente de uma sessão de exercício resistido de alta intensidade / Effect of L-Arginine supplementation upon the production of inflammatory mediators and regenerative factors of skeletal muscle tissue arising from a course of oriented pratice of resistance training

Os mecanismos envolvidos na adaptação do tecido muscular à prática de exercícios aeróbios, já está bem elucidada em diversos estudos. Essa adaptação ocorre por meio de um processo de reparo desencadeado por dano muscular (processo inflamatório). O objetivo do presente estudo foi avaliar o efeito da suplementação com L-arginina sobre os mecanismos envolvidos na liberação de mediadores inflamatórios e fatores regenerativos do tecido muscular esquelético após uma simples sessão de exercício resistido (ER) de alta intensidade, e avaliar o possível papel protetor da L-arginina sobre os efeitos desencadeados pelo ER no tecido muscular esquelético. Ratos machos Wistar foram divididos em 5 grupos: (grupo controle (C), pós-exercício(0), 8, 24 e 48 horas pós-exercício), suplementados com L-arginina (1 g/kg) uma hora antes do início do exercício, ou aminoguanidina (50 mg/kg) 30 minutos antes do início do treino, ambos por gavagem. Os animais foram submetidos a prática do TR durante 4 dias por meio de uma escada com 80° de inclinação, e com aparato de sobrepeso, correspondentes à 80% do peso corporal de cada animal, acoplado aos animais somente no quarto dia de treinamento. O sangue periférico e o tecido muscular esquelético (extensor digitorum longus) foram coletados para a análise de Mieloperoxidase (MPO), fator de necrose tumoral (TNF-α), citocina-induzida quimiotática para neutrófilos (CINC-2), fator transformador de crescimento (TGF-β), Colágeno tipo 1, Fator de crescimento endotelial vascular (VEGF), creatina quinase (CK), alanina aminotransferase (ALT), aspartato aminotransferase (AST) e a Proteína C Reativa (CRP) por RT-PCR e ELISA. A suplementação com L-arginina promoveu grande redução na migração de neutrófilos no tecido muscular esquelético, na produção de TNF-α, CINC-2 e CRP, e potencializou a produção e expressão dos fatores regenerativos musculares (TGF-β, Colágeno tipo 1 e VEGF). O pré-tratamento com aminoguanidina reverteu o processo. A suplementação com...

The mechanisms involved of muscular adaptation to aerobic exercise have previously been described in several studies. This adaptation occurred through a repair process following tissue damage (inflammatory process). The aim of this study was to analyze the effect of the L-arginine supplementation upon the mechanisms involved on release of inflammatory mediators and regenerative factors of skeletal muscle tissue post a single bout of high intensity of resistance exercise (RE), and evaluate the possible protective role of L-arginine supplementation in the effects of RE in skeletal muscle tissue. Male Wistar rats were divided into 5 groups: (control group (C), post-exercise (0), 8, 24 and 48 hours post-exercise), with L-arginine (1 g/kg) one hour before training began or aminoguanidine (50 mg/kg), 30 minutes before starting training, both by gavage. The animals were subjected to RE practice for four days, through a staircase with 80° tilt, with the overload apparatus corresponding to 80% relative to the body weight on the fourth day. Peripheral blood plasma samples, skeletal muscle (extensor digitorum longus) were collected for analysis of myeloperoxidase (MPO), tumor necrosis factor (TNF-α), cytokine-induced neutrophil chemoattranct-2 (CINC-2), transforming growth factor β (TGF-β), Collagen type 1, vascular endothelial growth factor (VEGF), creatine kinase (CK), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and C-Reactive protein (CRP) by RT-PCR and ELISA. L-arginine promoted a great reduction in neutrophil migration, TNF-α, CINC-2 and CRP, and up-regulated the regenerative factors of skeletal muscle (TGF-β, collagen type 1 and VEGF). Aminoguanidine pre-treatment reversed the process. L-arginine (nitric oxide precursor) supplementation played a protective role in the skeletal muscle tissue and increased the expression of regenerative factors after a high intensity RE session. We suggest that this protection is related to the nitric oxide (NO)...

Multiple Cholesterol Granuloma Involving the Paranasal Sinus: A Case Report

Cholesterol granuloma is a chronic inflammatory process associated with foreign body reaction to hemorrhage-related cholesterol crystal. It occurs most commonly in the middle ear cavity and the mastoid air cell complex. Sinonasal cholesterol granuloma is very rare, and there have been only 37 reported cases in the English literature so far. In this study, we examined a 61-year-old man suffering from bilateral orbital pain, headache and diplopia for 2 years. He had underwent a bilateral Caldwell-Luc operation 15 years ago. The brain MRI findings revealed 3 different cystic mass involving the bilateral sphenoid sinuses, and left ethmoid and maxillary sinuses. The patient was referred from the department of neurology, and the PNS CT findings were similar to the brain MRI. In the nasal endoscopic finding, there was a hard bilateral submucosal mass in the middle meatus. We planned an endoscopic sinus surgery for the mass, diagnosed as mucocele. The mass was accompanied by a greenish fluid and yellowish crystal in the left side of the lesion and dark reddish matter on the opposite site. Bone defects were observed in the left lamina papyracea and the intersinus septum of sphenoid sinus. The pathology was confirmed as a typical cholesterol granuloma. There is no recurrence during the last 18 months. We report this case of multiple cholesterol granuloma of the paranasal sinuses for the first time with literatures review.

The changed expression of CGRP immuno-positive nerve in the periodontal ligament of rat molar during tooth movement / 대한치과교정학회지

Bone resorptiion was predominate in compression site, bone formation in tension site of periodontal ligament during tooth movement. The biologic response at compressiion site was different from tension site. Thus the CGRP immuno-positive nerve fiber will respond differently to mechanical force according to the area(compression or tension site). The purpose of this study was to investigate this response of CGRP immuno-positive nerve fiber in the periodontal ligament according to the duration of applied force and the area (compression or tension site) during experimental tooth movement. The experimental animals were 7 week old male rat (approximately 200 gm), The orthodontic force was applied mesially to the right maxillary molar using the Ni-Ti coil spring during 12 hours, 1, 3, 7, and 12 days. Immunohistochemical staining using antibody against CGRP was performed after sacrifice. The results were as follows. The CGRP immuno-positive nerve bundle showed reduced immunoreactivity and nerve fibers reduced in density after application of orthodontic force for 12 hours and 1 day. The CGRP immuno-positive nerve fibers showed many thin branches at the apical periodontal ligament after application of force for 3 days as compared with normal. The tension site in the apical periodontal ligament showed more branches than the compression site. In 7 day group, the CGRP irnrnuno-positive nerve fibers increased in terms of the number and had many thin branches in the apical periodontal ligament. The tension site had more branches than the compression site, In 12 day group, the CGRP immuno-positive nerve fibers showed similar distribution to normal control at compression site of apical periodontal ligament, but the fibers at the tension site increased in number. The CGRP immuno-positive nerve fibers showed more increased at tension site than compression site after application of orthodontic force. Therefore it seems to have some relation to the bone remodeling besides the local inflammatory process.