Consideraciones bioéticas en el manejo de la esclerosis lateral amiotrófica: Una aproximación al quehacer fonoaudiológico

Introducción: La esclerosis lateral amiotrófica (ELA) es la forma más común de enfermedad degenerativa de motoneurona en la edad adulta y es considerada una enfermedad terminal. Por lo mismo, el accionar del fonoaudiólogo debe considerar el respeto a los principios bioéticos básicos para garantizar una asistencia adecuada. Objetivo: Conocer aquellas consideraciones bioéticas relacionadas al manejo y estudio de personas con ELA para luego brindar una aproximación hacia el quehacer fonoaudiológico. Método: Se efectuó una búsqueda bibliográfica en las bases de datos PubMed, Scopus y SciELO. Se filtraron artículos publicados desde 2000 hasta junio de 2023 y fueron seleccionados aquellos que abordaban algún componente bioético en población con ELA. Resultados: Aspectos relacionados al uso del consentimiento informado y a la toma de decisiones compartidas destacaron como elementos esenciales para apoyar la autonomía de las personas. Conclusión: Una correcta comunicación y una toma de decisiones compartida son claves para respetar la autonomía de las personas. A su vez, la estandarización de procedimientos mediante la investigación clínica permitirá aportar al cumplimiento de los principios bioéticos de beneficencia y no maleficencia, indispensables para la práctica profesional.

Introduction: Amyotrophic lateral sclerosis (ALS) is the most common form of degenerative motor neuron disease in adulthood and is considered a terminal disease. For this reason, the actions of the speech therapist must consider respect for basic bioethical principles to guarantee adequate assistance. Objective: To know those bioethical considerations related to the management and study of people with ALS to then provide an approach to speech therapy. Methodology: A bibliographic search was carried out in the PubMed, Scopus, and SciELO databases. Articles published from 2000 to June 2023 were filtered and those that addressed a bioethical component in the population with ALS were selected. Results: Aspects related to the use of informed consent and shared decision-making stood out as essential elements to support people's autonomy. Conclusion: Proper communication and shared decision-making are key to respecting people's autonomy. In turn, the standardization of procedures through clinical research will contribute to compliance with the bioethical principles of beneficence and non-maleficence, essential for professional practice.

Prescription patterns of riluzole in a population of patients with motor neuron disease / Patrón de prescripción de riluzol en una población de pacientes con enfermedad de neurona motora

SUMMARY OBJECTIVE: To determine the prescription pattern of riluzol and the variables associated to its use in a population of patients with motor neuron disease affiliated to the Colombian General Social Security Health System (SGSSS) in 2017. METHOD: Descriptive cross-sectional study. Through a systemized data base of approximately 3,5 million members to the Colombian SGSSS; patients who had been given riluzol uninterruptedly between April 1 and June 30 of 2017, were selected. Sociodemographic, pharmacological variables and comorbidities were analyzed. Defined daily dose (DDD) was estimated for 1.000 inhabitants/day and its costs. RESULTS: There were found 81 patients with motor neuron disease receiving riluzol, with an average age of 60,8+12,6 years. 48.1% were male. The prevalence of motor neuron disease was 29/100.000 individuals. Patients received riluzol in 50 mg tablets and the doses was estimated in 0,016 DDD for 1.000 inhabitants/day 63% were receiving medicines that reflect comorbidity or could interact with riluzol. The total cost of riluzol dispensed in 2017 was USD 85.348 and per prescribed daily dose on average was USD 2,3. CONCLUSIONS: The use of riluzol in patients with motor neuron disease in Colombia was carried by the recommended doses by the WHO and with a direct cost lower than reported in other countries. Studies are recommended in order to determine the effectiveness of riluzol in real-life conditions.

RESUMEN OBJETIVOS: Determinar el patrón de prescripción de riluzol y las variables asociadas a su utilización en una población de pacientes con enfermedad de neurona motora afiliados al Sistema General de Seguridad Social en Salud de Colombia (SGSSS) en 2017. METODOLOGÍA: Estudio descriptivo de corte transversal. Mediante una base de datos sistematizada de aproximadamente 3,5 millones de afiliados al SGSSS de Colombia; se seleccionaron pacientes a quienes se les haya dispensado riluzol de manera ininterrumpida entre 1 abril y 30 junio de 2017. Se analizaron variables socio-demográficas, farmacológicas y las comorbilidades. Se estimaron la dosis diaria definida (DDD) por 1.000 habitantes/día y los costos. RESULTADOS: Se encontraron 81 pacientes con enfermedad de neurona motora recibiendo riluzol, con edad promedio de 60,8+12,6 años. El 48,1% eran hombres. La prevalencia de enfermedad de neurona motora fue 2,29/100.000 personas. Los pacientes recibieron riluzol en tabletas de 50 mg y se estimó la dosis en 0,016 DDD por 1.000 habitantes/día. El 63% recibían medicamentos que reflejan comorbilidad o pudieran tener interacción con riluzol. El costo total del riluzol dispensado en 2017 fue USD 85.348 y por dosis diaria prescrita en promedio fue USD 2,3. CONCLUSIONES: El uso de riluzol en pacientes con enfermedad de neurona motora en Colombia se realizó a las dosis recomendadas por la OMS y con un costo directo menor al reportado en otros países. Se recomienda realizar estudios que permitan determinar la efectividad del riluzol en condiciones de la vida real.

La enfermedad neurológica de Leonardo da Vinci / The neurological disease of Leonardo da Vinci

Introducción: el año 2019 se conmemoraron los 500 años de la muerte de Leonardo da Vinci en el Chateux du Cloux, Francia. Según registros históricos, Leonardo vivió los últimos años de su vida con una parálisis en su mano derecha, atribuida a un probable accidente cerebrovascular (ACV), lo cual afectó a su capacidad para emprender nuevos proyectos pictóricos. Este trabajo describe como fueron los últimos años de vida de Leonardo, revisa los antecedentes sobre salud y su probable enfermedad neurológica, sus eventuales etio-logías y sus consecuencias. Desarrollo: Leonardo llegó a Francia en 1516 por invitación del rey Francisco I para llevar el Renacimiento y completar su formación personal. En 1517 es visitado por el cardenal Luis de Aragón, y su secretario registra en su diario que Leonardo se encuentra afectado de una parálisis de la mano derecha. Algunos autores sugieren un ACV como causa probable, sobretodo porque según el historiador Vasari, Leonardo vivió sus últimos años en condición de discapacidad. Se llega a plantear que su condición de vege-tariano habría podido influir como factor de riesgo de ACV. Sin embargo, un dibujo no fechado de Figino muestra a Leonardo con una parálisis de tipo periférica de la mano derecha, abriendo el diagnóstico diferencial. Conclusiones: no hay información suficiente para valorar el tipo y la causa de enfermedad neurológica de Leonardo da Vinci, no obstante, está influyó significativamente en su interacción con su discípulo Francisco Melzi y su mecenas Francisco I, hecho que contribuyó a que su legado perdure hasta hoy.

Introduction: the year2019 marked the 500th anniversary of the death of Leonardo da Vinci at the Chateau du Cloux, France. According to historical records, Leonardo lived the last years of his life with palsy on his right hand, attributed to a probable stroke, which affected his ability to undertake new pictorial projects. This study describes how were the last years of Leonardo's life, reviews his medical history and his probable neurological disease, with its possible etiologies and its consequences. Discussion: Leonardo arrived in France in 1516 invited by King Francis I to lead the Renaissance and complete his education. In 1517, cardinal Luis de Aragón visited Leonardo, and his secretary recorded in his diary that he was affected by a palsy on his right hand. Some authors suggest that stroke could have been a probable cause, especially because according to the historian Vasari, Leonardo lived his last years in a condition of disability. His vegetarian food habit could have been a risk factor for his suspected stroke. However, an undated drawing by Figino shows Leonardo with a peripheral nerve palsy on his right hand, opening up the differential diagnosis. Conclusions:there is not enough information to assess the type and cause of Leonardo da Vinci's neurological disease. However, this condition significantly affected his interaction with his discipleFrancisco Melzi and his patron Francisco I, a fact that contributed to his legacy enduring until today.

Sarcocystis neurona and related Sarcocystis spp. shed by opossums (Didelphis spp.) in South America / Sarcocystis neurona e Sarcocystis spp. relacionados, excretados por gambás (Didelphis spp.) na América do Sul

Abstract Protozoan parasites of the genus Sarcocystis are obligatory heteroxenous cyst-forming coccidia that infect a wide variety of animals and encompass approximately 200 described species. At least four Sarcocystis spp. (S. falcatula, S. neurona, S. lindsayi and S. speeri) use opossums (Didelphis spp.) as definitive hosts, and two of them, S. neurona and S. falcatula, are known to cause disease in horses and birds, respectively. Opossums are restricted to the Americas, but their distribution in the Americas is heterogeneous. Five Didelphis spp. are distributed in South America (D. aurita, D. albiventris, D. marsupialis, D. imperfecta and D. pernigra) whereas just one opossum species (D. virginiana) is found in North America. Studies conducted in the last decades show that Sarcocystis spp., derived from South American Didelphis spp., have biological and genetic differences in relation to Sarcocystis spp. shed by the North American opossum D. virginiana. The aim of this review was to address the peculiar scenario of Sarcocystis species shed by South American opossums, with a special focus on diagnosis, epidemiology, and animal infections, as well as the genetic characteristics of these parasites.

Resumo Parasitos protozoários do gênero Sarcocystis são coccídios heteroxenos formadores de cistos, que infectam variadas espécies animais e compreendem cerca de 200 espécies descritas. Pelo menos quatro Sarcocystis spp. (S. falcatula, S. neurona, S. lindsayi e S. speeri) utilizam gambás (Didelphis spp.) como hospedeiros definitivos; e duas delas, S. neurona and S. falcatula são conhecidas por causarem doença em equinos e aves, respectivamente. Gambás didelfídeos são restritos ao continente americano, contudo são distribuídos de forma heterogênea nas Américas. Cinco Didelphis spp. são distribuídos na América do Sul (D. aurita, D. albiventris, D. marsupialis, D. imperfecta e D. pernigra), enquanto somente uma espécie (D. virginiana) é encontrada na América do Norte. Trabalhos conduzidos, nas últimas décadas, mostram que Sarcocystis spp. derivados de Didelphis spp. sul-americanos possuem diferenças biológicas e genéticas, quando comparados a Sarcocystis spp. excretados pelo gambá norte-americano D. virginiana. O objetivo desta revisão é discutir a situação peculiar das espécies de Sarcocystis na América do Sul com um foco especial em diagnóstico, epidemiologia e infecções animais, assim como nas características genéticas desses parasitos.

Rehabilitación robótica en espasticidad de mano y muñeca / Robotic rehabilitation in hand and wrist spasticity

Introducción. El presente estudio es una serie de casos clínicos que describe los resultados en el tratamiento de la espasticidad de mano y muñeca mediante órtesis robóticas realizado por el grupo de investigación F-Ciber-Rehabilitación en Manizales (Colombia). Materiales y métodos. Se seleccionaron cinco (5) pacientes con espasticidad de mano y muñeca secundaria a lesión de neurona motora superior de diferente etiología, a quienes se les practicó terapia física y movilización pasiva con la órtesis robótica PRO-DWix®. Resultados. Los pacientes presentaron mejoría de la espasticidad según la escala Ashworth Modificada, disminución de la intensidad del dolor según la escala EVA y recuperación gradual del arco de movilidad articular según goniometría; además, luego de tres meses de rehabilitación robótica presentaron beneficios en su calidad de vida. Discusión. Se requieren ensayos clínicos aleatorizados para determinar las ventajas de la terapia física convencional complementada con terapia robótica, frente a la sola terapia convencional. Conclusiones. La movilización pasiva con órtesis robóticas en pacientes con espasticidad de mano y muñeca por lesiones de neurona motora superior, favorece la modulación de la espasticidad, la disminución del dolor, la recuperación del arco de movilidad articular y la calidad de vida. Nivel de evidencia. El propósito del estudio es generar evidencia clínica de nivel III respecto de las ventajas de la movilización pasiva con órtesis robóticas en la rehabilitación de pacientes con espasticidad de mano y muñeca

Introduction. The present study is a clinical case series describing the results in the treatment of hand and wrist spasticity by means of robotic orthoses carried out by the F-Ciber-Rehabilitation research group in Manizales (Colombia). Materials and methods. Five (5) patients with hand and wrist spasticity secondary to upper motor neuron lesion of different etiology were selected and underwent physical therapy and passive mobilization with the PRO-DWix® robotic orthosis. Results. The patients presented improvement of spasticity according to the Modified Ashworth scale, decrease of pain intensity according to the VAS scale and gradual recovery of joint mobility arc according to goniometry; furthermore, after three months of robotic rehabilitation they presented benefits in their quality of life. Discussion. Randomized clinical trials are required to determine the advantages of conventional physical therapy supplemented with robotic therapy, versus conventional therapy alone. Conclusions. Passive mobilization with robotic orthoses in patients with hand and wrist spasticity due to upper motor neuron lesions favors spasticity modulation, pain reduction, recovery of joint range of motion, and quality of life. Level of evidence. The purpose of the study is to generate level III clinical evidence regarding the advantages of passive mobilization with robotic orthoses in the rehabilitation of patients with hand and wrist spasticity.

Enfermedad de motoneurona inferior asociada al signo ojos de serpiente: una nueva entidad clínico-radiológica / Lower motor neuron disease with snake eyes sign: a new clinical-radiological entity

Las enfermedades de la moto neurona inferior constituyen un grupo heterogéneo de entidades con pronósticos diferentes. El signo radiológico "ojos de serpiente" hace referencia a la hiperintensidad bilateral en el asta anterior de la médula espinal en los cortes axiales de las imágenes por resonancia magnética, generalmente asociada a afecciones como infartos espinales, amiotrofia espondilótica, enfermedad de Hirayama y esclerosis lateral amiotrófica. Se ha descripto recientemente un reducido número de casos de enfermedad de moto neurona inferior asociada a "ojos de serpiente" con características clínicas y pronóstico distintivos. Presentamos dos casos de enfermedad de moto neurona inferior asociada al signo "ojos de serpiente" en pacientes jóvenes. El curso clínico fue progresivo con períodos prolongados de estabilidad clínica y ausencia de compromiso de moto neurona superior durante la evolución. Los pacientes presentaron debilidad segmentaria y asimétrica de miembros superiores con predominio distal en el primer caso y proximal en el segundo. Los casos presentados se corresponden en gran parte con lo comunicado en la literatura, dando apoyo a la existencia de una nueva entidad con pronóstico relativamente benigno denominada enfermedad de moto neurona inferior esporádica con signo de ojos de serpiente en las imágenes por resonancia magnética y cuya identificación debiera obviar tratamientos innecesarios (AU)

Lower motor neuron diseases are a heterogeneous group of entities with different prognosis. The "snake eyes" sign refers to bilateral hyper intensity of the anterior horns on axial magnetic resonance imaging of the spinal cord. It has been associated with ischemia, cervical spondylosis, Hirayama disease, and amyotrophic lateral sclerosis. Recently, a small number of cases of lower motor neuron disease associated with the "snake eyes" sign have been described as having distinctive clinical manifestations and prognosis. Two young patients with "snake eyes" sign associated with lower motor neuron disease had a progressive initial course followed by a stabilization of symptoms without involvement of upper motor neuron. They presented with asymmetric segmental arm weakness with distal predominance in the first a case and proximal predominance in the second. These cases match with those reported in the literature giving support to lower motor neuron disease with "snake eyes" as a pathological entity with a relatively good prognosis. This diagnosis should avoid unnecessary treatments (AU)

Signo de la copa de vino: A propósito de un caso con esclerosis lateral primaria y demencia frontotemporal / Wine glass sign in a patient with primary lateral sclerosis and frontotemporal dementia: a case report

La esclerosis lateral primaria es muy poco frecuente, representa 2-4 % del grupo de enfermedades de motoneurona. Se caracteriza por espasticidad corticoespinal y síndrome pseudobulbar. La resonancia magnética nuclear muestra lesiones hiperintensas de secuencias potenciadas en T2; cuando el compromiso es bilateral, la imagen da la apariencia de copa de vino . Caso clínico: Paciente varón de 56 años de edad, con un cuadro clínico de dos años de evolución, caracterizado por desinhibición, apatía, y conducta social inapropiada. La evolución clínica mostró criterios diagnósticos de esclerosis lateral primaria y de demencia frontotemporal. La resonancia magnética de encéfalo, protocolo T2, corte coronal reveló el compromiso bilateral de los haces cortico-espinales desde el centro semioval hasta las pirámides bulbares semejando la imagen en copa de vino . Aunque infrecuente, el caso muestra la posible asociación de Esclerosis Lateral Primaria (ELP) con demencia frontotemporal; la imagen en copa de vino puede estar presente en enfermedad de motoneurona y, cuando particularmente asociada a ELP, puede ser de gran ayuda en el diagnostico diferencial con otras entidades crónicas de curso clínico similar.

Primary lateral sclerosis is a very uncommon progressive disease and represents 2-4% of motor neuron diseases group. It is characterized by cortico-spinal spasticity and pseudo bulbar syndrome. Magnetic resonance shows white matter hyperintensities in T2 weight sequence. When the impairment is symmetrical, the image takes the appearance of a wine glass . Clinical case: A 56-year-old male patient with a clinical picture of 2-years duration characterized by disinhibition, apathy, and inappropriate social behavior. The clinical evolution met the diagnostic criteria of primary lateral sclerosis and frontotemporal dementia. Magnetic resonance imaging in coronal T2 weighted sequences, showed symmetrical impairment of corticospinal pathway from the semiovale centrum to the medullary pyramids showing the wine glass appearance. Although infrequent, the case shows the possible association of Primary Lateral Sclerosis (PLS) with frontotemporal dementia; the wine glass image in magnetic resonance may be present in motor neuron disease, when particularly associated with PLS may be of great help in the differential diagnosis with other chronic entities of similar clinical course.

Fatores de risco associados à prevalência de anticorpos anti-Sarcocystis neurona, Neospora spp. e Toxoplasma gondii em equinos de Roraima, Amazônia / Risk factors associated to the prevalence of anti-Sarcocystis neurona, Neospora spp. and Toxoplasma gondii antibodies in horses from Roraima, Brazilian Amazon

Amostras de sangue de 303 equinos provenientes de 56 propriedades do município de Rorainópolis, Roraima, foram avaliadas por Reação de Imunofluorescência Indireta (RIF) para pesquisa de anticorpos contra Sarcocystis neurona, Toxoplasma gondii e Neospora spp. Algumas amostras de soros positivos para Sarcocystis spp. foram avaliadas pelo Western Blotting (WB) utilizando antígenos crus de S. neurona. A partir dos resultados sorológicos, possíveis fatores de risco foram avaliados frente a variáveis individuais e de propriedade. A prevalência de anticorpos anti-Sarcocystis spp. foi estimada em 43,2% (37,6-49,0%), anti-Neospora sp. em 26,7% (21,9-32,2%) e anti-T. gondii de 18,5% (14,3-23,4%). Quatorze amostras (14/15) testadas por WB resultaram positivas para antígenos de S. neurona. Das propriedades, 76,8% (43/56) apresentaram pelo menos um equino positivo para Sarcocystis spp.; 69,6% (39/56) para Neospora spp. e 55,4% (31/56) para T. gondii. Dos equinos, 13 (4,3%) apresentarem anticorpos para os três agentes, 50 (16,5%) para Sarcocystis spp. e Neospora spp., 10 (3,3%) para Neospora spp. e T. gondii, e oito (2,6%) para Sarcocystis spp. e T. gondii. As variáveis associadas (P≤0,05) à presença de anticorpos foram: para Neospora spp. não pastejar em áreas alugadas, ausência de assistência veterinária na propriedade, sexo masculino, não estabular animais e plantel equino acima de 5 animais; enquanto para T. gondii foram o contato com felinos, animais da raça lavradeiro, animal estabulado, criação de bovinos na propriedade e plantel equino acima de 5 animais. Não houveram variáveis associadas a presença de anticorpos contra S. neurona. Relata-se no presente estudo a primeira detecção de anticorpos anti-S. neurona, Neospora spp. e T. gondii em equinos do estado de Roraima, localizado na Amazônia Setentrional Brasileira, ressaltando para a elevada frequência de fazendas com equinos soropositivos.

Samples of 303 horses from 56 ranches of Rorainópolis municipality, state of Roraima, were evaluated by means of the Indirect Immunofluorescence Test (IFAT) to detect antibodies against Sarcocystis spp., Toxoplasma gondii and Neospora spp. A subset of positive sample (n=15) against Sarcocystis spp. was evaluated by Western Blotting (WB) with crude antigen of S. neurona. From the serological result, possible risk factors were evaluated against individual or farming variables. The prevalence of anti-Sarcocystis spp. antibodies was estimated to be 43.2% (37.6-49.0%), anti-Neospora sp. was 26.7% (21.9-32.2%), and anti-T. gondii was 18.5% (14.3-23.4%). Fourteen samples (14/15) evaluated by WB were positive for S. neurona antigens. From the ranches, 76.8% (43/56) presented at least one positive horse for Sarcocystis spp., 69.6% (39/56) for Neospora spp., and 55.4% (31/56) for T. gondii. Thirteen (14.3%) horses had antibodies against all agents, 50 (16.5%) had antibodies against Sarcocystis spp. and Neospora spp., 10 (3.3%) for Neospora spp. and T. gondii, and eight (2.6%) for Sarcocystis spp. and T. gondii. Associated variables (P≤0.05) for antibodies against Neospora spp. were not found in horses fed on rented pastures, not in horses without veterinary assistance and stables, and not in herds up to 5 horses; while they were associated for T. gondii by contact with cats, in the Lavradeiro breed with use of stables, in horses raise with cattle, and in herds up to 5 horses. There were no variables associated with the presence of antibodies against S. neurona. Antibodies against S. neurona, Neospora spp. and T. gondii were reported in horses from the state of Roraima, Northern Brazilian Amazon, highlighting to the elevate prevalence on ranches.(AU)

Effect of temperature in bursting of thalamic reticular cells / Efecto de la temperatura en las descargas en ráfaga de la célula del núcleo reticular del tálamo

Abstract Objective: To show the relation between the four parameters associated to bursting discharges of the thalamic reticular cells (TRNn): the maximum firing frequency (fmax) and the temperature at which it occurs (Tfmax), the range of temperatures defined as the full width at half maximum (∆Th) and the maximum specific low threshold calcium conductance (GT). Materials and Methods: In order to simulate the TRNn bursting activity, a computational simulation model was implemented using the NEURON software, which incorporates morphological and electrophysiological data, and stimuli properties closely related to reality. Results: It was found that there are nonlinear relations between the parameters. The fmax frequency follows a quadratic growth with temperature and tends asymptotically towards a limit value with the maximum calcium conductance. In the same manner, ∆Th increases until reaching a limit value as function of fmax and GT. However, the increment per frequency unit is bigger than the increment per conductance unit. Conclusions: Four equations were obtained that model the relations between the parameters associated to bursting discharges of the TRNn in rats and other neurons with similar characteristics in different animal species.

Resumen Objetivo: Mostrar la relación entre los cuatro parámetros asociados a las descargas en ráfaga de las neuronas del núcleo reticular del tálamo (TRNn): la frecuencia máxima de descarga (fmax) y la temperatura a la cual se produce (Tfmax), el rango de temperaturas definido como ancho a media altura (∆Th) y la conductancia máxima de calcio de bajo umbral (GT). Materiales y métodos: Para simular las descargas en ráfaga de las TRNn se implementó un modelo de simulación computacional usando el software NEURON, que incorpora datos morfológicos, electrofisiologicos y las propiedades de los estímulos en estrecha relación con la realidad. Resultados: Se encontraron relaciones no lineales entre los parámetros. La frecuencia fmax crece de forma cuadrática con la temperatura y tiende asintóticamente a un valor límite con la conductancia. Así mismo, ∆Th también se incrementan hasta alcanzar un valor límite en función de fmax y GT. No obstante, es mayor el incremento por cada unidad de frecuencia que por cada unidad de conductancia. Conclusiones: Se obtuvieron cuatro ecuaciones que modelan las relaciones entre los pará- metros asociados a las descargas en ráfaga de las neuronas TRN en ratas y otras neuronas con características similares en diferentes especies animales.

Marcadores moleculares de la asfixia perinatal / Molecular markers of perinatal asphyxia

Introducción: la asfixia perinatal es un problema de salud que puede acarrear alteraciones del neurodesarrollo en los recién nacidos. Las determinaciones en suero de enolasa específica de neurona, lactato deshidrogenasa y aspartato amino transferasa han sido utilizadas como marcadores de asfixia perinatal. Objetivos: evaluar el valor de las determinaciones en suero de lactato deshidrogenasa, aspartato amino transferasa y enolasa específica de neurona como marcadores moleculares de la asfixia perinatal. Métodos: se realizó un estudio observacional descriptivo de corte transversal. Se trabajó con una muestra intencional de 41 recién nacidos asfícticos, clasificados con distintos grados de encefalopatía hipóxico-isquémica según los criterios de Sarnat. Se tomaron muestras de suero al momento del nacimiento y a las 72 horas siguientes. Las determinaciones en suero de enolasa específica de neurona se realizaron por ELISA. Se cuantificó lactato deshidrogenasa y aspartato amino transferasa por espectrofotometría. Resultados: todos los pacientes presentaron valores elevados en suero, de los tres analitos, a las 24 y 72 horas de nacidos. Los valores enzimáticos no variaron significativamente entre las 24 y 72 horas de nacidos sin tomar en cuenta el grado de encefalopatía hipóxico-isquémica. Existe correlación positiva entre los valores enzimáticos a las 24 y a las 72 horas de enolasa específica de neurona y lactato deshidrogenasa. No fue posible diferenciar el grado de encefalopatía hipóxico-isquémica a través de los niveles en suero de estas enzimas. Conclusiones: los valores de estas determinaciones enzimáticas contribuyen a describir desde el punto de vista bioquímico el cuadro del neonato con asfixia perinatal(AU)

Introduction: perinatal asphyxia is a health problem which may cause neurodevelopmental alterations in newborns. Serum determinations of neuron-specific enolase, lactate dehydrogenase, and aspartate aminotransferase have been used as markers of perinatal asphyxia. Objectives: evaluate the value of serum determinations of lactate dehydrogenase, aspartate aminotransferase and neuron-specific enolase as molecular markers of perinatal asphyxia. Methods: a cross-sectional observational descriptive study was conducted of 41 asphyxiated newborns classified as different grades of hypoxic-ischemic encephalopathy according to Sarnat's scale. Serum samples were taken at birth and 72 hours later. Serum determinations of neuron-specific enolase were obtained by ELISA. Lactate dehydrogenase and aspartate aminotransferase were quantified by espectrophotometry. Results: all the patients had high serum values of the three analytes 24 and 72 hours after birth. Enzyme values did not vary significantly from 24 to 72 hours after birth, not considering the grade of hypoxic-ischemic encephalopathy. A positive correlation was found between enzyme values for neuron-specific enolase and lactate dehydrogenase at 24 and 72 hours. It was not possible to differentiate the grade of hypoxic-ischemic encephalopathy via the serum levels of these enzymes. Conclusions: the values of these enzyme determinations contribute to describe the status of neonates with perinatal asphyxia from a biochemical point of view(AU)

Anestesia para cesárea en paciente con esclerosis lateral amiotrófica: reporte de caso / Anaesthetic management of a patient diagnosed with amyotrophic lateral sclerosis taken to caesarean section: Case report

ABSTRACT Introduction: In the obstetric population with amyotrophic lateral sclerosis, caesarean delivery may be indicated in order to avoid greater maternal respiratory distress induced by the physiologic changes at the end of gestation and the progressive muscle weakness caused by the disease. Optimal anaesthetic management is required in order to guarantee the ideal conditions for surgery and to preserve patient respiratory function. Objective: To describe the anaesthetic management of a patient diagnosed with amyotrophic lateral sclerosis scheduled for caesarean section. Methods and results: We describe the case of a 38-week pregnant woman diagnosed with amyotrophic lateral sclerosis who under went caesarean section under sequential combined spinal-epidural anaesthesia. In addition, a review of the literature was conducted. Conclusions: Combined spinal-epidural anaesthesia was a good option as anaesthetic technique for caesarean section in this patient with amyotrophic lateral sclerosis.

RESUMEN Introducción: En las gestantes con diagnóstico de esclerosis lateral amiotrófica puede estar indicado parto por cesárea para evitar una mayor dificultad respiratoria materna debido a los cambios al final de la gestación ya la debilidad muscular progresiva propia de la enfermedad, motivo por el cual es necesario un manejo anestésico que garantice las condiciones idóneas para la cirugía y preserve la función respiratoria. Objetivo: Describir el manejo anestésico de una paciente con diagnóstico de esclerosis lateral amiotrófica programada para cesárea. Métodos y resultados: Mostramos el caso de una gestante de 38 semanas con diagnóstico de esclerosis lateral amiotrófica a quien se le realizó una cesárea, y cuya técnica anestésica empleada fue combinada espinal-epidural secuencial. Además, se realizó una revisión de la literatura al respecto. Conclusiones: La anestesia regional combinada espinal-epidural secuencial fue una buena opción como técnica anestésica en esta paciente con esclerosis lateral amiotrófica para cesárea.

Persistencia de epónimos en terminologia histologica / Eponyms persistence in terminologia histologica

El uso de epónimos aún es una práctica frecuentemente utilizada entre médicos clínicos y académicos para referirse a las distintas estructuras en histología. A pesar de los esfuerzos por parte de la comunidad morfológica por desarraigarlos del lenguaje médico, hoy en día se encuentran, inclusive presentes en Terminologia Histologica, tal como en los casos de Schannocytus (H2.00.06.2.02003) referente a la Célula de Schwann; Complexus golgiensis (H1.00.01.3.0146) referente al Aparato de Golgi, Cellula panethensis (H3.04.03.0.00017) referente a la Célula de Paneth, y Neuron purkinjense (H3.11.03.4.01015) referente a la Neurona de Purkinje, que aluden a los investigadores Theodor Schwann, Camillo Golgi, Joseph Paneth y Jan Evangelista Purkinje, respectivamente. El objetivo del presente estudio fue realizar un análisis de los términos antes nombrados desde un punto de vista lingüístico y proponer nuevas denominaciones, siguiendo los parámetros establecidos en la Terminología, en la cual los nombres de las estructuras deben tener un valor informativo, estar escritos en latín como lengua base y eliminar el uso de los epónimos. Los términos analizados, se refieren a nombres de células u organelos frecuentemente utilizados en textos educativos, sin embargo, son poco descriptivos, muchos de ellos con raíces netamente griegas y otros neologismos, cuyas denominaciones, por consenso y en honor a investigadores connotados han perdurado en el tiempo. Proponemos modificaciones con respecto a su denominación, así como a sus derivados, utilizando términos procedentes del latín. En resumen, pretendemos que con estos antecedentes iniciales puedan entregarse argumentos que permitan seguir unificando criterios y que ellos puedan ser considerados por los expertos que conforman el Programa Federativo Internacional de Terminología Anatómica y, como bien se señala, permitir el establecimiento de diálogo con los miembros de la Federación Internacional de Asociaciones de Anatomistas e ir mejorando la comunicación científica entre los diferentes actores de las ciencias morfológicas.

Eponyms are still frequently used among clinicians and scholars to refer to the various structures in histology. Despite efforts by the morphological community to eradicate eponyms from medical language, nowadays they are practical, and even present in Terminologia Histologica (TH), such as in the case of Schannocytus (H2.00.06.2.02003) concerning the term Schwann cell; Complexus golgiensis (H1.00.01.3.0146) relating to the Golgi apparatus, Cellula panethensis (H3.04.03.0.00017) concerning the Paneth cell and Neuron purkinjense (H3.11.03.4.01015), the term Purkinje neuron which refers to researchers Theodor Schwann, Camillo Golgi, Joseph Paneth and Jan Evangelist Purkinje, respectively. The aim of this study was to conduct an analysis of these terms from a linguistic point of view and propose new Latin names, following guidelines established in the terminology wherein the names of structures must, have an informative value, be written in Latin as a base language, and eliminate the use of eponyms. The terms analyzed, refer to cells or organelles names frequently used, they have limited descriptive value, many with purely Greek roots and other neologisms, which names have endured over time in honor of renowned researchers. Using terms from Larin, we propose modifications with respect to classification and derivatives. In conclusion, we hope that with this introduction, the information to consolidate standards will be considered by the experts of the Federal International Committee on Anatomical Terminology and further, initiate a dialogue with International Federation of Associations of Anatomists members, while encouraging ongoing communication between the various players of morphological sciences.

Esclerosis lateral amiotrófica: actualización / La esclerose lateral amiotrófica: atualização / Amyotrophic lateral sclerosis: update

La esclerosis lateral amiotrófica es una enfermedad neurodegenerativa que tiene consecuencias devastadoras para el paciente y su familia. Aún no existe claridad sobre su etiología, cerca del 10 % de los pacientes tienen patrón hereditario. La prevalencia mundial varía entre 2 y 11 casos por 100.000 habitantes; el rango de edad de presentación es de 58 a 63 años para los casos esporádicos, y de 47 a 52 años para los familiares, con una ligera predilección por el sexo masculino. Las manifestaciones clínicas incluyen signos de daño de las neuronas motorassuperior e inferior tanto en las extremidades como en la musculatura bulbar, y en algunos pacientes hay deterioro cognitivo frontotemporal. El diagnóstico continúa siendo fundamentalmente clínico, apoyado por estudios neurofisiológicos; de estos, la electromiografía de aguja ha sido el más útil para el diagnóstico temprano. No existe tratamiento curativo y solo un medicamento, el riluzol, ha demostrado efectividad para retrasar el uso de ventilación mecánica y prolongar levemente la supervivencia. Por tanto, el tratamiento de estos pacientes se basa en medidas de soporte, especialmente en los aspectos de nutrición y ventilación, además de controlar los síntomas motores y no motores de la enfermedad...

Amyotrophic lateral sclerosis is a neurodegenerative disease with devastating consequences for the patient and his/her family. Its etiology is still not clear. In about 10 % of the patients there is a hereditary pattern of the disease. Worldwide, prevalence ranges from 2 to 11 cases per 100,000 people. Age of presentation varies from 58 to 63 years for sporadic cases, and from 47 to 52 years for the familial ones. Concerning gender, there is a slight preference for males. Clinical manifestations include signs of upper and lower motor neurons, damage in limbs and bulbar muscles, and, in some patients, frontotemporal cognitive dysfunction. Diagnosis is essentially clinical supported by neurophysiologicalstudies, such as needle electromyography, which is the most important test for early diagnosis. There is no cure, but riluzol has proven to delay the use of mechanical ventilation and to slightly prolong survival. Consequently, management is based on support measures, such as those related to nutrition and ventilatory function, in addition to control of the motor and non-motor symptoms of the disease...

La esclerose lateral amiotrófica é uma doença neurodegenerativa que tem consequências devastadoras para o doente e sua família. Ainda não existe claridade sobre sua etiologia, cerca de 10 % dos doentes tem padrão hereditário. A prevalência mundial variaentre 2 e 11 casos por 100.000 habitantes; a faixa de idade de apresentação é de 58 a 63 anos para os casos esporádicos, e de 47 a 52 anos para os familiares, com uma ligeira predileção pelo sexo masculino. As manifestações clínicas incluem signos de dano dos neurônios motores superior e inferior tanto nas extremidades como na musculatura bulbar, e em alguns doentes há deterioro cognitivo fronto-temporal. Odiagnóstico continua sendo fundamentalmente clínico, apoiado por estudos neurofisiológicos; destes, a eletromiografia de agulha há sido o mais útil para o diagnóstico precoce. Não existe tratamento curativo e só um medicamento, o Riluzol, há demostradoefeito para retrasar o uso de ventilação mecânica e prolongar levemente a supervivência. Por tanto, o tratamento destes doentes se baseia em medidas de suporte, especialmente nos aspectos de nutrição e ventilação, ademais de controlar os síntomas motores e não motores da doença...

Hippocampal neuronal apoptosis in rat offspring due to gestational diabetes / Apoptosis neuronal del hipocampo en crías de ratas debido a la diabetes gestacional

Gestational diabetes mellitus (GDM) defined as impaired glucose tolerance affects approximately 6 % of all pregnant women who have never before had diabetes, but who do have high blood glucose levels during pregnancy. This study was done to evaluate the apoptosis in the neuronal cells in the CA1, CA2 and CA3 subfields of hippocampus and dentate gyrus in offspring of gestational diabetes at the 7, 21 and 28 d in postnatal rats. Thirty Wistar rat dams were randomly allocated in control and diabetic group. Dams in diabetic group were received 40 mg/kg/BW of streptozotocin at the first day of gestation and control groups received an equivalent volume normal saline injection intraperitoneally (IP). Six offspring of GDM and control dams, at the 7, 21, 28 postnatal day were randomly were sacrificed quickly with anesthesia. The coronal sections of brain serially collected. The apoptosis neurons were evaluated with TUNEL Assay. In the CA1, the number of apoptotic cells in 7, 21 and 28 d of postnatal life were significantly increased in GDM compared to controls (P<0.001). In the CA2, CA3 the number of apoptotic cells in 7, 21 and 28 d age-old offspring were significantly increased in GDM compared to controls (P<0.001). In the dentate gyrus, the number of apoptotic cells in 7, 21 and 28 d of postnatal life were significantly increased in GDM compared to controls (P<0.01). This study showed that the uncontrolled gestational diabetes significantly increases neuronal apoptosis in hippocampal and dentate gyrus in rat offspring.

La diabetes mellitus gestacional (DMG) se define como la intolerancia a la glucosa que afecta aproximadamente al 6 % de todas las mujeres embarazadas que nunca han tenido diabetes, pero que sí tienen niveles de glucosa en la sangre elevados durante el embarazo. El objetivo de este estudio fue evaluar la apoptosis de células neuronales en CA1, CA2 y CA3, subcampos del hipocampo y el giro dentado, en las crías de ratas con diabetes gestacional en los días 7, 21 y 28 luego del nacimiento. Se utilizaron 30 ratas Wistar asignadas aleatoriamente en grupos control y diabético (GDM). Se administró al grupo diabético 40 mg/kg de peso corporal de estreptozotocina en el primer día de gestación y el grupo control recibió un volumen equivalente de solución salina normal por inyección vía intraperitoneal. Seis crías de los grupos GDM y control fueron seleccionadas aleatoriamente y sacrificadas bajo anestesia los días 7, 21, 28. Se tomaron secciones seriales coronales del cerebro. La apoptosis neuronal se evaluó mediante ensayo TUNEL. En el CA1, el número de células apoptóticas a los 7, 21 y 28 d se incrementó significativamente en el grupo GDM en comparación con los controles (P <0.001). En el CA2 y CA3 el número de células apoptóticas en los días 7, 21 y 28 también se incrementó significativamente en GDM en comparación con los controles (P <0,001). En el giro dentado, el número de células apoptóticas en los días 7, 21 y 28 se incrementó significativamente en GDM en comparación con los controles (P <0,01). Este estudio mostró que la diabetes gestacional no controlada aumenta significativamente la apoptosis neuronal en el hipocampo y el giro dentado en las crías de las ratas.

Prevalence of antibodies against Neospora spp. and Sarcocystis neurona in donkeys from northeastern Brazil / Prevalência de anticorpos contra Neospora spp e Sarcocystis neurona em jumentos do nordeste do Brazil

Abstract Sarcocystis neurona and Neospora hughesi are coccidian protozoa that can cause neurological illness in horses in America. In this study we report seroprevalence of Neospora spp. andS. neurona in sera of 333 donkeys from the northeastern region of Brazil. Antibodies to Neospora spp. were detected in 2% (7 donkeys) of 333 sera tested by the indirect fluorescent antibody test (IFAT) with a cut-off dilution of 1:40. Antibodies to S. neurona were found in 3% (10 donkeys) of the samples tested by IFAT (cut-off ≥50) and 21% (69 donkeys) by the direct agglutination test (SAT ≥50). The SAT and IFAT results for S. neurona showed a poor concordance (value of Kappa=0.051). This is the first report ofNeospora spp. antibodies in Brazilian donkeys and the first detection of antibodies against S. neurona in this animal species.

Resumo Sarcocystis neurona e Neospora hughesi são protozoários coccídios que infectam equídeos e são responsáveis por doenças neurológicas nessas espécies. Neste estudo, a soroprevalência de infecção porS. neurona e Neospora spp. foi determinada em amostras de 333 soros de jumentos da Região Nordeste do Brasil. Anticorpos contra Neospora spp. foram detectados em 2% (7 jumentos) dos 333 animais examinados pela reação de imunofluorescência indireta (RIFI), com ponto de corte de 40. Anticorpos contra S. neurona foram detectados em 3% (10 jumentos) das amostras pela RIFI (ponto de corte de 50) e em 21% (69 jumentos) pela técnica de aglutinação direta (SAT - ponto de corte de 50). SAT e RIFI, para diagnóstico de S. neurona, apresentaram uma baixa concordância (Kappa = 0,051). Essa é a primeira observação de anticorpos anti-N. caninum em jumentos brasileiros e a primeira detecção de anticorpos contra S. neurona nessa espécie.

A review of Sarcocystis spp. shed by opossums (Didelphis spp.) in Brazil / Revisão sobre Sarcocystis spp. excretados por gambás (Didelphis spp.) no Brasil

South American opossums are the definitive hosts of Sarcocystis neurona, Sarcocystis falcatula, Sarcocystis speeri and Sarcocystis lindsayi. The sporocysts of these species of Sarcocystis are morphologically similar and methods like infectivity and pathogenicity for intermediate hosts (immunodeficient mice and psittacine birds) and molecular tools are used for identification. Opossums are synanthropic wild animals, and widely distributed in Brazilian territory. Previous studies have shown high environmental contamination with S. neurona sporocysts in several Brazilian regions. This paper reviews information on Sarcocystis spp. shed by various opossum species and its occurrence in Brazil.(AU)

Os gambás Sul-americanos são os hospedeiros definitivos de Sarcocystis falcatula, Sarcocystis neurona, Sarcocystis speeri e Sarcocystis lindsayi. Estas espécies de Sarcocystis são morfologicamente similares, mas podem ser distinguidas por sua patogenicidade e infectividade em hospedeiros intermediários (aves e camundongos imunodeficientes) e técnicas moleculares. Os gambás são animais silvestres e sinantrópicos e amplamente distribuídos no território nacional. Estudos anteriores demonstraram uma alta contaminação ambiental com esporocistos de S. neurona em diversas regiões brasileiras. Este artigo revisa informações sobre Sarcocystis spp. excretados por gambás e sua ocorrência no Brasil.(AU)

Exposure of free-living jaguars to Toxoplasma gondii, Neospora caninum and Sarcocystis neurona in the Brazilian Pantanal / Exposição de onças-pintadas a Toxoplasma gondii, Neospora caninum e Sarcocystis neurona no Pantanal brasileiro

Toxoplasma gondii, Neospora caninum and Sarcocystis neurona are related apicomplexan parasites that cause reproductive and neurological disorders in a wide range of domestic and wild animals. In the present study, the immunofluorescence antibody test (IFAT) was used to investigate the presence of antibodies against T. gondii, N. caninum and S. neurona in the sera of 11 free-living jaguars (Panthera onca) in two protected areas in the Pantanal region of Mato Grosso state, Brazil. Ten jaguars (90.9%) showed seropositivity for T. gondii, eight (72.7%) for S. neurona, and seven (63.6%) for N. caninum antigens. Our findings reveal exposure of jaguars to these related coccidian parasites and circulation of these pathogens in this wild ecosystem. To the best of our knowledge, this is the first serological detection of N. caninum and S. neurona in free-living jaguars.

Toxoplasma gondii, Neospora caninum e Sarcocystis neurona são coccídios relacionados responsáveis por causar desordens reprodutivas e neurológicas em uma ampla variedade de animais domésticos e selvagens. No presente estudo, a Reação de Imunofluorescência Indireta (RIFI) foi utilizada para investigar a presença de anticorpos contra T. gondii, N. caninum e S.neurona em soros de 11 onças-pintadas de vida livre (Panthera onca), provenientes de duas áreas protegidas na região do Pantanal do Estado de Mato Grosso, Brasil. Dez (90,9%), sete (63,6%) e oito (72,7%) onças amostradas foram soropositivas para T. gondii, N. caninum e S. neurona, respectivamente. Os resultados indicam a exposição a esses coccídios relacionados entre as onças-pintadas e a circulação ambiental desses patógenos nesse ecossistema selvagem. Este é o primeiro relato da detecção sorológica de N. caninum e S. neurona em onças-pintadas de vida livre.

Frequency of antibodies against Sarcocystis neurona and Neospora caninum in domestic cats in the state of Bahia, Brazil / Frequência de anticorpos contra Sarcocystis neurona e Neospora caninum em gatos domésticos do Estado da Bahia, Brasil

Sarcocystis neurona is the major agent of equine protozoal myeloencephalitis. It infects several mammalian species in the Americas, where the definitive hosts, marsupials of the genus Didelphis (D. virginiana and D. albiventris) are found. Domestic cats are one of the confirmed intermediate hosts of the parasite; however, antibodies against S. neurona had never before been demonstrated in Brazilian cats. The aim of this study was to determine whether cats in Bahia, Brazil, are exposed to the parasite. A total of 272 feline serum samples (134 from feral and 138 from house cats) were subjected to an indirect fluorescent antibody test using cultured merozoites of S. neurona as antigen. Positivity was detected in 4.0% (11/272) of the tested samples, with titers ranging from 25 to 800. The feline sera were also tested for antibodies against the protozoan Neospora caninum, with an observed antibody frequency of 2.9%. To the author's knowledge, this is the first study to report antibodies against S. neurona in Brazilian cats. We conclude that cats are exposed to the parasite in the region of this study. Further investigations are needed to confirm the role of cats in the transmission cycle of S. neurona in Brazil.

Sarcocystis neurona é o principal agente da mieloencefalite protozoária equina. Esse parasito infecta várias espécies de mamíferos nas Américas, onde são encontrados os hospedeiros definitivos, os marsupiais do gênero Didelphis (D. virginiana and D. albiventris). O gato doméstico é um dos hospedeiros intermediários do parasito. Contudo, anticorpos contra S. neurona ainda não tinham sido demonstrados em gatos brasileiros. O objetivo deste trabalho foi determinar se gatos da Bahia, Brasil, são expostos ao parasito. Amostras séricas de 272 felinos (134 de gatos errantes e 138 de gatos domiciliados) foram testadas pelo teste de imunofluorescência indireta, utilizando-se como antígeno, merozoítos produzidos em cultura celular. Entre as amostras testadas, 4,0% (11/272) foram positivas com títulos entre 25 e 800. Os soros dos felinos foram também testados para anticorpos contra o protozoário Neospora caninum, cuja frequência de anticorpos foi de 2,9%. Esse é o primeiro relato de anticorpos contra S. neurona em gatos brasileiros. Conclui-se que os gatos da região estudada são expostos a S. neurona. Estudos futuros são necessários, a fim de se confirmar o papel dos gatos no ciclo de transmissão de S. neurona no Brasil.

Dolor neuropático (Parte I): actualización de su definición, mecanismos y diagnóstico / Neuropathic pain (Part I): an update on its definition, mechanisms and diagnosis

El diagnóstico adecuado del dolor neuropático ha sido y continúa siendo motivo de intenso debate. De hecho, en la actualidad no existen pruebas contundentes para el diagnóstico de este tipo de dolor; dicho diagnóstico suele ser eminentemente clínico. Más aún, en Argentina aún se carece de guías en el idioma castellano con algoritmos que encaminen hacia soluciones de diagnóstico y tratamiento de dolor neuropático. En la presente revisión, y basàndonos en los esfuerzos recientes de la comunidad internacional para la creación de criterios diagnósticos que permitan la correcta identificación de esta patología debilitante, nos hemos propuesto los siguientes objetivos: 1) ofrecer una visión actualizada del dolor neuropático, su definición, características clínicas y epidemiología, así como la delineación de sus potenciales mecanismos; 2) sugerir estrategias y criterios que contribuyan a un adecuado diagnóstico de los pacientes con dolor neuropático; 3) facilitar la selección de pacientes para el diseño eficaz de ensayos clínicos, y 4) dar el primer paso para la apertura de nuevos canales de comunicación entre médicos clínicos e investigadores clínicos y básicos dedicados al estudio del dolor.

The correct diagnosis of neurophatic pain remains a reason for intense debate. In fact, definitive proof for the diagnosis of this type of pain is still scarce; its identification is mostly of clinical nature. Moreover, guides in Spanish with algorithms orienting the diagnosis and treatment of neuropathic pain are unavailable in Argentina. In the present review, and based on recent efforts of the international community for the creation of a diagnostic criteria that allow the correct identification of neuropathic pain, we have focused in the followings objectives: 1) to offer an updated view of neuropathic pain, its definition, clinical manifestations and epidemiology, as well as the outlining of its potential mechanisms; 2) to suggest strategies and criteria thay may contribute to an adequate diagnosis of patients with neuropathic pain; 3) to facilitate the selection of patients for the design of clinical essays, and 4) to take the first step for the interaction and communication between physicians, and clinical and basic scientist involved in the study of pain.

Efecto del 3-nitropropionato sobre el metabolismo del lactato y del acetato en neuronas y astrocitos crecidos in vitro en concentraciones perinatales / Efeito do 3-nitropropionato sobre o metabolismo do lactato e do acetato em neuronios e astrocitos crescidos in vitro em concentrações perinatales / 3-Nitropropionate effect on the lactate and acetate metabolism of neurons and astrocytes grown in vitro with perinatal concentrations

Las reacciones anapleróticas son un mecanismo metabólico esencial para la continuidad postnatal del desarrollo cerebral, contribuyendo en procesos que requieren sustratos sintetizados a partir de intermediarios del ciclo de Krebs; sin embargo, se desconoce su papel en el neonato durante la prelactancia. Objetivo. Estimar la capacidad anaplerótica de neuronas y astrocitos crecidos in vitro. Materiales y métodos. Se midió el efecto del 3-nitropropionato (3-NPA)(2 mM), un inhibidor de Succinato Deshidrogenasa (SDH) sobre el metabolismo oxidativo y lipogénico de 14C derivados de acetato y lactato en concentraciones perinatales. Resultados. A pesar de la presencia del 3-NPA, se mantuvieron las velocidades de oxidación del lactato en neuronas y astrocitos en un 40 y 73% respectivamente y la lipogénesis en un 53 y 52% respectivamente. Con el acetato, la oxidación en neuronas y astrocitos se mantuvo en un 15 y 63% respectivamente, en tanto que la lipogénesis se mantuvo en astrocitos y aumentó en neuronas en un 174% (p<0,05). Todo esto comparado con sus respectivos controles sin inhibidor...

3-Nitropropionate effect on the lactate and acetate metabolism of neurons and astrocytes grown in vitro with perinatal concentrations.Anaplerotic reactions are an essential metabolic mechanism for the postnatal continuity of the brain development, contributing in processes that require substrates synthesized from Krebs cycle intermediates; however, their role during the presuckling period in theneonate is unknown. Objective. To estimate the anaplerotic capacity of neurons and astrocytes grown in vitro under perinatal conditions.Materials and methods. The effect of 3-nitropropionate (3-NPA)(2 mM) an inhibitor of the succinate dehydrogenase (SDH) on the oxidative and lipogenic metabolism of 14C-derived from acetate and lactate in perinatal concentrations. The results were compared with itsrespective controls without inhibitor. Results. In spite of the presence of 3-NPA, respiratory activity with lactate was 40% in neurons and73% in astrocytes, the lipogenesis was 53% in neurons and 52% in astrocytes. With acetate, the oxidation in neurons was 15% and 63% in astrocytes, lipogenesis was maintained in astrocytes but in neurons it increased up to 174% (p<0.05). Conclusions. These results demonstrate that in spite the oxalacetate depletion generated by 3-NPA, neurons as well as astrocytes are able to maintain the energeticmetabolism and the lipid synthesis using lactate or acetate thanks to the anaplerotic activity in the presuckling period. Additionally, astrocytes showed a capacity of buffering the effects of 3-NPA on the oxidation process greater than the neuron capacity. Neurons and astrocytes revealed a better capacity of directing acetate for lipid synthesis, activating the cytosolic acetyl-CoA synthetase pathway...

Efeito do 3-nitropropionato sobre o metabolismo do lactato e do acetato em neuronios e astrocitos crescidos in vitro em concentrações perinatales. As reações anapleróticas são um mecanismo metabólico essencial para a continuidade pos-natal do desenvolvimento cerebral,contribuindo nos processos que precisam substratos sintetizados a partir de intermediários do ciclo de Krebs. Embora, seu papel é desconhecido no neonato durante a prelactancia. Objetivo. Estimar a capacidade anaplerótica de neuronios e astrocitos crescidos in vitro.Materiais e métodos. Quantificou-se o efeito do 3-nitropropionato (3-NPA)(2 mM), um inibidor do Succinato Deshidrogenasa (SDH), sobre o metabolismo oxidativo e lipogénico de 14C derivados de acetato e lactato em concentrações perinatais. Resultados. A pesar da presença do 3-NPA, mantiveram-se as velocidades de oxidação do lactato em neuronas e astrocitos num 40 e 73% respectivamente e a lipogenesis em 53 e 52% respectivamente. Com o acetato, a oxidação em neuronas e astrocitos mantive-se num 15 a 63% respectivamente, no em tanto, a lipogénesis mantive-se em astrocitos e aumento em neuronas num 174% (p<0,05). Tudo o anterior comparado com seus respectivos controles sem inibidor. Conclusões. Estes resultados demonstram que a pesar da depleção do oxalacetato gerada pelo 3-NPA,as neuronas como os astrocitos são capazes de manter na prelactancia o metabolismo energético e a síntese de lípidos empregando lactato ou acetato devido à atividade anaplerótica. Adicionalmente, os astrocitos demonstraram ter maior capacidade de amortecer os efeitos do 3-NPA sobre a oxidação que as neuronas. As neuronas e os astrocitos apresentaram uma maior capacidade de dirigir o acetato para a síntese de lipídeos, ativando a via Acetil-CoA sintetasa citosólica...