Investigação de marcadores moleculares sanguíneos durante a infecção pelo vírus Chikungunya / Investigation of blood molecular markers during Chikungunya virus infection

A febre Chikungunya (CHIKF) é uma infecção viral causada pelo vírus Chikungunya (CHIKV). Os sintomas agudos incluem febre alta de início súbito, erupção cutânea, poliartrite e poliartralgia. Embora a infecção geralmente seja resolvida em menos de duas semanas, muitos pacientes experenciam recorrente dor e inflamação nas articulações, que podem persistir por anos. Esse estudo buscou marcadores moleculares no sangue de infectados pelo CHIKV que estejam associados a dor articular e cronicidade da CHIKF. O sequenciamento de receptores de células B (BCR) e T (TCR) demonstrou que a infecção por CHIKV diminui a diversidade desses receptores. Essa diversidade é ainda menor, durante a fase aguda da infecção, naqueles pacientes que irão desenvolver cronicidade. A menor diversidade de BCR em infectados está associada a um aumento na expressão de genes envolvidos na diferenciação e ativação de osteoclastos pela sinalização RANK/RANKL. Em adição, a cronicidade pode estar relacionada um aumento na expressão do gene ZBTB7A cuja expressão confere maior resistência a apoptose em precursores de osteoclastos naqueles pacientes que vão se tornar crônicos. Caso o envolvimento dos osteoclastos durante a patogênese de CHIKF seja confirmado, os pacientes poderão se beneficiar de abordagens terapêuticas já existentes como alternativas adicionais ao tratamento de CHIKF

Chikungunya fever (CHIKF) is a viral infection caused by the Chikungunya virus (CHIKV). Acute symptoms include sudden-onset high fever, rash, polyarthritis, and polyarthralgia. Although the infection usually resolves within two weeks, many patients experience recurrent joint pain and inflammation, which can persist for years. This study sought molecular markers in the blood of CHIKV-infected individuals that are associated with joint pain and chronicity of CHIKF. Sequencing of B (BCR) and T (TCR) cell receptors demonstrated that CHIKV infection decreases the diversity of these receptors. The diversity is even lower, during the acute phase of the infection, in those patients who will develop chronicity. The lower diversity of BCR in infected individuals is associated with an increase in the expression of genes involved in the differentiation and activation of osteoclasts by RANK/RANKL signaling. In addition, chronicity may be related to an increase in the expression of the ZBTB7A gene whose expression confers greater resistance to apoptosis in osteoclast precursors in those patients who will become chronic. If osteoclast role during CHIKF pathogenesis is confirmed, patients may benefit from existing therapeutic approaches as additional alternatives to CHIKF treatment

Development and in vivo evaluation of lipid-based nanocarriers containing Jatropha isabellei dry extract from the dichloromethane fraction intended for oral treatment of arthritic diseases

In this study, a dichloromethane fraction dry extract from the underground parts of Jatropha isabellei (DFJi) was used to prepare lipid nanocarriers (LNCJi) aimed at providing the oral delivery of terpenic compounds in the treatment of arthritis. The lipid nanocarriers were prepared by the spontaneous emulsification method. The lipid nanocarriers displayed sizes ranging from 180 to 200 nm and zeta potential values of around -18 mV. A high value of entrapment efficiency (> 90%) was obtained for jatrophone, which was used as the chemical marker of DFJi. LNCJi stored at 4°C were demonstrated to be stable through measurements of transmitted light after analytical centrifugation of the samples. In vitro drug release studies conducted in biorelevant dissolution media demonstrated that jatrophone release was faster from LNCJi than from free DFJi. When tested in an acute arthritis model, the LNCJi exhibited antinociceptive properties after oral administration of a 50 mg/kg dose, unlike the free DFJi, although no reduction in articular diameter was observed. These results suggest that an increase in the oral absorption of DFJi constituents may have occurred through the carrying of this fraction in LNCJi, thus improving the antinociceptive activity of this compound

Safe-by-design development of a topical patch for drug delivery

Few topical products have been developed specifically to treat acute and chronic arthritis and inflammation, using non-steroidal anti-inflammatory drugs (NSAIDs). The lack of dosing accuracy commonly found in locally applied semisolid products for cutaneous use is a critical issue that leads to treatment failure. The aim of the present work is to develop a differentiated and innovative topical patch based on a monolithic hydrogel for ibuprofen skin delivery, in order to provide a safer and accurate way of drug administration along with improved treatment compliance. Topical patches based on hydroxypropylmethylcellulose (HPMC) were optimized in composition, in terms of enhancer and adhesive, supported on a systematic assessment of in vitro release and permeation behavior and adhesion properties. Several mathematical models were used to scrutinize the release mechanisms from the patches. In vitro release kinetics was shown to be mainly driven by diffusion. However, other mechanisms seemed to be also present, supporting the feasibility of using patches for sustained drug delivery. PEG 200 provided the best permeation rate, with a permeation enhancement ratio of ca. 3 times higher, than the commercial reference. The addition of Eudragit L30D 55 to the formulation led to the best adhesion profile, thus achieving a successful development based on a safe-by-design concept.

Effect of avocado/soybean unsaponifiables on periodontal repair in rats with arthritis and induced periodontitis

Abstract Objective: This study aimed to evaluate the effect of avocado/soybean unsaponifiables (ASU) on periodontal repair in rats with induced periodontitis and arthritis. Methodology: Forty-five rats were submitted to periodontitis induction by insertion of ligatures into the upper second molars, maintained for 15 days. These animals were randomly allocated to 3 groups according to the presence of induced arthritis (ART) and the application of the ASU: Control (CTR) group-healthy animals, where saline solution was administered; ART-animals with induced arthritis, where saline solution was administered; ART/ASU-animals with induced arthritis, where ASU (0.6 mg/ kg) was administered. The drugs were administered daily by gavage and the animals were euthanized after 7, 15 and 30 days of the ligature removal. Bone resorption, inflammatory infiltrate composition and marker proteins expression of the differentiation and formation of osteoclasts (RANKL and TRAP) were assessed. Results: The ART/ASU group presented higher bone volume than the ART group at 7 and 30 days after the ligature removal. Furthermore, the ART group presented higher quantity of inflammatory cells and expression of TRAP and RANKL than the other groups. Conclusion: ASU administration improves the repair of periodontal tissues in an experimental periodontitis model in rats with induced arthritis.

Chronic polyarthritis as the first manifestation of childhood systemic polyarteritis nodosa / Poliartrite crônica como primeira manifestação de poliarterite nodosa sistêmica pediátrica

ABSTRACT Arthritis has been reported as an acute pattern, generally evanescent with oligoarthritis, mostly affecting knees and ankles in childhood systemic polyarteritis nodosa. However, chronic polyarthritis with morning stiffness mimicking juvenile idiopathic arthritis has not been reported. We describe the case of a 4-year old girl who had additive and chronic polyarthritis with edema, tenderness, pain on motion and morning stiffness for 2 months. After 45 days, she also presented painful subcutaneous nodules and erythematous-violaceous lesions in the extensor region of upper and lower limbs. She was admitted to university hospital due to high fever, malaise, myalgia, anorexia, loss of weight (1kg), painful skin lesions and severe functional disability. She was bedridden by chronic polyarthritis with limitation on motion. Systolic and diastolic blood pressures were greater than 95th percentile for height. Urine protein/creatinine ratio was 0.39g/day, and immunological tests were negative. Anti-streptolysin O was 1,687UI/mL. Skin biopsy revealed necrotizing vasculitis in medium- and small-sized vessels compatible with polyarteritis nodosa. Therefore, we had the diagnosis of systemic polyarteritis nodosa. Prednisone 2mg/kg/day was administered with complete resolution of skin lesions and arthritis, and improvement of proteinuria (0.26g/day) after 15 days. The diagnosis of childhood systemic polyarteritis nodosa should be considered for patients with chronic polyarthritis associated to cutaneous vasculitis triggered by streptococcal infection.

RESUMO Na poliarterite nodosa sistêmica pediátrica, a artrite caracteriza-se pelo padrão agudo, geralmente evanescente, com oligoartrite, e afeta principalmente joelhos e tornozelos. No entanto, a poliartrite crônica com rigidez matinal e simulando artrite idiopática juvenil ainda não foi relatada. Descrevemos o caso de uma menina de 4 anos que apresentou poliartrite crônica aditiva com edema, dor à palpação e movimento, e rigidez matinal por 2 meses. Após 45 dias, também apresentou nódulos subcutâneos dolorosos e lesões eritêmato-violáceas na região extensora dos membros superiores e inferiores. Foi internada no hospital universitário por conta de febre alta, mal-estar, mialgia, anorexia, perda de peso (1kg), lesões de pele muito dolorosas e incapacidade funcional grave. Estava restrita ao leito devido à poliartrite crônica com limitação do movimento. Pressões sistólica e diastólica foram maiores que percentil 95 para altura. Relação proteína/creatinina urinária estava 0,39g/dia, e os testes imunológicos foram negativos. Antiestreptolisina O era 1.687UI/mL. A biópsia de pele revelou vasculite necrosante de vasos de pequeno e médio calibre, compatível com poliarterite nodosa. Portanto, foi realizado o diagnóstico de poliarterite nodosa sistêmica. Foi administrada prednisona 2mg/kg/dia com resolução completa das lesões de pele e da artrite, além de melhora da proteinúria (0,26g/dia) após 15 dias. O diagnóstico de poliarterite nodosa sistêmica pediátrica deve ser considerado em pacientes com poliartrite crônica associado a lesões cutâneas vasculíticas, sendo a infecção estreptocócica um importante fator desencadeante.

Septic arthritis: immunopathogenesis, experimental models and therapy

Septic arthritis is an inflammatory disease of the joints that is started by an infection whose most common agent is Staphylococcus aureus. In this review we discuss some of the most arthritogenic bacterial factors and the contribution of innate and specific immune mechanisms to joint destruction. Special emphasis is given to the induction of experimental arthritis by S. aureus in mice. The improvement of therapy by association of antibiotics with down-modulation of immunity is also included.

Septic arthritis: immunopathogenesis, experimental models and therapy

Septic arthritis is an inflammatory disease of the joints that is started by an infection whose most common agent is Staphylococcus aureus. In this review we discuss some of the most arthritogenic bacterial factors and the contribution of innate and specific immune mechanisms to joint destruction. Special emphasis is given to the induction of experimental arthritis by S. aureus in mice. The improvement of therapy by association of antibiotics with down-modulation of immunity is also included.

Polyarthritis due to systemic lupus erythematosus in a dog / Poliartrite por lúpus eritematoso sistêmico em um cão

A five year old male mongrel dog was presented for medical consultation with a history of arthralgia. Complete blood count revealed linfopenia and neutropenia, antinuclear antibody was positive at 1:1,256, and synovial fluid analysis showed inflammatory arthritis with lupus erythematosus cells. No significant proteinuria was detected on urinalysis, and microalbuminuria measurement was performed to determine glomerulonephritis in early stage. Based on clinical signs, synovial fluid analysis, antinuclear antibody test and complete blood count, the diagnosis was systemic lupus erythematosus. The measurement of microalbuminuria was useful to demonstrate the absence of glomerulonephritis, and the performance of complementary tests proved to be indispensable for diagnosis and prognosis. Glucocorticoid treatment led to complete remission.

Foi atendido um cão com cinco anos de idade sem raça definida, macho, por apresentar artralgia. O hemograma revelou linfopenia e neutropenia, o anticorpo antinuclear foi positivo em 1:1.256 e a análise de líquido sinovial demostrou artropatia inflamatória com células de lúpus eritematoso. Não foi detectada proteinúria significativa na urinálise, e exame de detecção de microalbuminúria foi realizada para determinar glomerulonefrite em fase inicial. Baseado em sinais clínicos, análise do líquido sinovial, teste de anticorpos antinucleares e hemograma, o diagnóstico foi lúpus eritematoso sistêmico. A mensuração da microalbuminúria mostrou-se útil para demonstrar ausência de glomerulonefrite, e a realização de exames complementares mostrou-se indispensável para o diagnóstico e o prognóstico. O tratamento com glicocorticoides levou à remissão completa dos sinais clínicos.

Reproductive failures associated with antibodies against caprine arthritis-encephalitis virus, Toxoplasma gondii and Neospora caninum in goats in the state of Sao Paulo, Brazil / Falhas reprodutivas associadas com a presença de do vírus da artrite-encefalite caprina, Toxoplasma gondii e Neospora caninum em caprinos no estado de São Paulo, Brasil

This study aimed at assessing the occurrence of antibodies against the caprine arthritis-encephalitis virus (CAEV), Toxoplasma gondii and Neospora caninum, as well as the associations between the presence of antibodies and the occurrence of reproductive failures in goats. Serum samples were collected from 923 goats of both sexes, over 3 months of age, from 17 dairy farms located in different municipalities of São Paulo State, Brazil. Infections by T. gondii, N. caninum and CAEV were evaluated by indirect methods of diagnosis based on indirect fluorescence antibody test (IFAT), Neospora agglutination test (NAT), and agar gel immunodiffusion (AGID), respectively. A survey was conducted on the farms to obtain information about reproduction dates (abortions, stillbirths and births of weak and premature kids) and zoosanitary management. Antibodies against CAEV, T. gondii and N. caninum was found in 37.81%, 23.62% and 17.23% respectively. There was no significant association between the presence of anti-CAEV antibodies and CAEV/T. gondii or CAEV/N. caninum co-infection, suggesting that CAEV does not predispose goats to infection by these agents. However, when CAEV/T. gondii (p<0.01) or CAEV/N. caninum (p<0.001) co-infection was present, the occurrence of reproductive failures was significantly higher what could indicate that CAEV-induced immunosuppression may predispose goats to develop the clinical symptoms of toxoplasmosis and neosporosis increasing the risks of the reproductive failures.

O objetivo do presente estudo foi avaliar a ocorrência de anticorpos para o vírus da atrite-encefalite caprina (CAEV), Toxoplasma gondii e Neospora caninum e de possíveis associações entre a presença de anticorpos e a ocorrência de problemas reprodutivos em caprinos. Para tanto, foram colhidas amostras sangüíneas de 923 caprinos de ambos os sexos, acima de três meses de idade e oriundos de 17 propriedades leiteiras, de diferentes municípios do estado de São Paulo, Brasil. Os diagnósticos para T. gondii, N. caninum e CAEV foram baseados, respectivamente, na reação de imunofluorescência indireta (RIFI), teste de aglutinação para Neospora (NAT) e a imunodifusão em gel de ágar (IDGA). Um inquérito epidemiológico foi aplicado nas propriedades para obtenção de informações sobre dados reprodutivos (abortamentos, natimortalidade e nascimentos de filhotes fracos e prematuros) e de manejo zoossanitário. As ocorrências de anticorpos foram de 37,81% para CAEV, de 23,62% para T. gondii e de 17,23% para N. caninum. Não houve associação significativa entre a presença de anticorpos anti-CAEV e co-infecção com T. gondii ou N. caninum, sugerindo que o CAEV não predispõe os caprinos à infecção por estes agentes. Entretanto, quando havia, nas fazendas, animais com co-infecção pelo CAEV e T. gondii (p<0,01) ou CAEV e N. caninum (p<0,001) as ocorrências de falhas reprodutivas foram significativamente maiores, sugerindo que a imunossupressão causada pelo CAEV pode predispor os caprinos ao desenvolvimento de sintomas clínicos da toxoplasmose e neosporose, potencializando os riscos da ocorrência de problemas reprodutivos causados por estas enfermidades.

Analysis of myosin-V immunoreactive myenteric neurons from arthritic rats / Análise dos neurônios mioentéricos miosina-V imunoreativos de ratos artríticos

CONTEXT: The inflammatory response itself and the consequent oxidative stress are able to promote neurodegeneration. So, it is possible that enteric nervous system is affected by inflammatory diseases threatening quality of life of patients. However, gastrointestinal symptoms of arthritis are usually attributed to anti-inflammatory drugs rather than neural damage. OBJECTIVE: To confirm if the general population of myenteric neurons from the ileum and jejunum of rats is affected by arthritis. METHODS: Twenty Holtzmann rats, 58-day-old male, were used and divided in four groups: control group (C30), arthritic group (Art30), older control group (C60) and older arthritic group (Art60). At 58 days old, the animals in groups Art30 and Art60 received an injection of the complete Freund's adjuvant in order to induce arthritis. The whole-mount preparations of ileum and jejunum were processed for myosin-V immunohistochemistry. Quantitative and morphometric analyses were performed. RESULTS: Groups Art30 and Art60 presented, respectively, a reduction of 2 percent and 6 percent in intestinal area when compared to their control groups. No significant differences were observed in general neuronal density among the four groups (P>0.05). Group C60 presented a reduction of 14.4 percent and 10.9 percent in mean neuronal cell body area when compared to group C30 (P<0.05), for the ileum and jejunum, respectively. The other groups had a similar mean neuronal cell body area (P>0.05). CONCLUSION: Arthritis does not promote quantitative or morphological damages in general myenteric population. However, studies in progress have revealed some significant alterations in myenteric neurons subpopulations (nitrergic and VIP-ergic neurons).

CONTEXTO: A resposta inflamatória e o estresse oxidativo acentuados em decorrência da artrite reumatóide são capazes de promover neurodegeneração. Nessas condições, é possível que o sistema nervoso entérico seja afetado, diminuindo a qualidade de vida dos pacientes. No entanto, os sintomas da artrite no trato gastrointestinal são geralmente associados ao uso de medicamentos anti-inflamatórios do que a um possível dano neural. OBJETIVO: Verificar se a população geral de neurônios mioentéricos do íleo e do jejuno de ratos artríticos é afetada pela artrite. MÉTODOS: Foram utilizados 20 ratos Holtzmann, inicialmente com 58 dias de idade, divididos em 4 grupos: controle com 88 dias (C30); artrítico com 88 dias (Art30); controle com 118 dias (C60) e artrítico com 118 dias (Art60). Os animais dos grupos Art30 e Art60 receberam aos 58 dias de idade o adjuvante completo de Freund para indução da artrite. Os preparados totais de íleo e jejuno foram submetidos a imunoistoquímica para a proteína miosina-V. Realizou-se análises quantitativas e morfométricas dos neurônios. RESULTADOS: Os animais Art30 e Art60 apresentaram, respectivamente, redução de 2 por cento e 6 por cento na área intestinal em relação aos seus controles. Não foram observadas diferenças na densidade neuronal geral entre os quatro grupos (P>0,05). O grupo C60 apresentou redução de 14,4 por cento e 10,9 por cento na área média do corpo celular neuronal em relação ao grupo C30 (P<0,05). Os demais grupos apresentaram área média de corpo celular semelhante (P>0,05). CONCLUSÃO: A artrite não provocou alterações quantitativas ou morfológicas na população mioentérica geral, entretanto, estudos em andamento revelam alterações significativas em subpopulações de neurônios mioentéricos (nitrérgicos e VIP-érgicos).

A rare case of disseminated cysticercosis: Case report and literature review.

Cysticercosis is a common tropical disease. One of the uncommon manifestations of cysticercosis and a rare complication is its disseminated form. We report an immunocompetent patient with disseminated cysticercosis who had involvement of the brain, subcutaneous tissues, lungs and skeletal muscles and presented with arthritis. He was otherwise asymptomatic in spite of the extensive involvement of multiple organs. A planned approach to therapy is necessary to prevent complications.

possible effect of ginger against Freund's complete adjuvant-induced arthritis in male rats

Ginger, a herbal product with broad anti inflammatory actions, is used as an alternative medicine in a number of inflammatory conditions. Confirmation of this contribution was sought in this study in Sprague-Dawley rats [140 +/- 30 g] treated with a single injection [0.1 ml of 0.5mg/ml of a commercial preparation of Freund's complete Adjuvant [FCA] to induce mono-arthritis in intra-planters in right hind paw. Before induction of arthritis by one week, each rat [in the prophylactic group] received a daily oral dose of ginger tea with a dose of 500mg/Kg, and after induction of arthritis by two days, each rat [in the treatment group] received a daily oral dose of ginger tea with a dose of 500mg/Kg. This confirmation was done by evaluating RBCs count, WBCs count, platelets count, hemoglobin content, hematocrit%, albumin level, alkaline phosphatase concentration, reduced glutathione concentration [GSH], plasma malondialdehyde concentration [MDA], superoxide dismutase concentration [SOD], body weight change, paw thickness, serum level of immunoglobulin G and Histopathological study of the soft tissue and the hard bony tissue. Within 2 days of FCA injection, the control group produced maximum edematous swelling of the paw that was sustained nearly up to the end of the investigation period. But, ginger, both in prophylactic and treated groups, significantly lower magnitudes of unsustained swelling of the paw during the investigation period. Also in ginger prophylactic and treated groups significant increase in body weight compared to arthritic group. Here, ginger prophylactic and treated groups showed remarkable improvement in the haematolgical parameters compared to arthritic group. There was significant increase in albumin level, significant decrease in alkaline phosphatase concentration, significant increase in reduced glutathione concentration, superoxide dismutase concentration and significant decrease in plasma malondialdehyde concentration in ginger prophylactic and treated groups compared to arthritic group. Histological results showed moderate improvement, against arthritic effect of FCA, either as treatment or as prophylactic. From these results, it is concluded that ginger can protect and reduce the inflammatory and oxidative responses produced in a FCA mono-arthritic model of rats

Endocarditis infecciosa por Streptococcus dysgalactiae subsp equisimilis / Infective endocarditis by Streptococcus dysgalactiae subsp equisimilis

La infección por Streptococcus dysgalactiae subsp equisimilis es causa frecuente de faringitis, artritis e infecciones de piel y tejidos blandos; excepcionalmente se ha descrito como causa de endocarditis infecciosa. Se presenta el caso de un paciente masculino de 42 años quien ingresa al Hospital Vargas de Caracas con fiebre, astenia, dolor en hombro derecho con limitación funcional y dolor en hipocondrio derecho; a las 48 horas se evidencia soplo mesosistólico en foco mitral, hemorragias en astillas y lesiones de Janeway, por lo que se plantea Endocarditis Infecciosa, y se inicia tratamiento con Vancomicina + Gentamicina. Los hemocultivos muestran crecimiento de Streptococcus equisimilis en ambos frascos; el ecocardiograma transtorácico evidencia una vegetación en valva posterior de válvula mitral. Luego de 48 horas de inicio de tratamiento remite la fiebre. El ecocardiograma control a los 14 días mostró la desaparición de la vegetación en la válvula mitral. El paciente recibió tratamiento por 6 semanas

Streptococcus dysgalactiae subsp equisimilis is frequent in patients with pharyngitis, arthritis and skin infections; it rarely causes infective endocarditis. We describe a 42 year-old male patient complaining of fever, malaise, right shoulder pain and right upper quadrant pain who was admitted to the Hospital Vargas, Caracas, Venezuela. After 48 hours his physical examination revealed mesosystolic murmur at the apex, splinter hemorrhages and Janeway lesions, suggestive of Infective Endocarditis Blood cultures identified Streptococcus equisimilis; transthoracic echocardiogram revealed a vegetation over the posterior leaflet of mitral valve; the patient was treated with Vancomycin + Gentamycin. After 48 hours of treatment the fever subsided. A transthoracic echocardiogram after 14 days showed no vegetations. The patient was treated during 6 weeks

Gonartrosis por ocronosis alkaptonurica: reporte de un caso y revisión de la literatura / Gonarthrosys by ochronosis alkaptonuria: a case report and literature review

La ocronosis alkaptonurica es una rara enfermedad autosómica recesiva del metabolismo de la tirosina y fenilalanina caracterizada por una triada de orinas oscura (alkaptonuria), coloración negruzca de tejidos conectivos (ocronosis) y degeneración articular en adultos jóvenes (artritis ocronotica), por deficiencia del la 1,2 dioxigenasa homogentísica, produciendo la acumulación del Ácido Homogentísico (HGA). De tratamiento poco efectivo tanto con Vitamina C como con Nitisinone, aunque este último inhibe síntesis HGA. Se hace el reporte de una paciente femenina de 53 años, con gonartrosis bilateral severa a predominio izquierdo, sin antecedentes patológicos conocidos, que durante la artroplastia se evidenciaron lesiones negruzcas en todo el cartílago articular, por lo que se tomaron muestras para anatomía patológica que reportaron lesiones sugestivas de artrítis ocronótica. Posteriomente se evidencia orinas oscuras a la exposición al aire libre, artropatía degenerativa no limitante en esqueleto axil y parentesco de consanguinidad tanto de sus abuelos como de sus padres. Se hace este reporte por ser el primer caso registrado en la literatura nacional, además de su excepcional frecuencia.

Search for crystals in synovial fluid

Synovial fluid analysis is a very important diagnostic procedure in rheumatology. Cell count allows the differentiation between inflammatory arthritis, in which cell count exceeds 2000 cells/mm3, and non inflammatory arthropathy, in which cell count is less than 1000 cells/mm. Demonstration of crystals in synovial fluid is a rapid and inexpensive way to diagnose microcrystalline arthritis. Synovial fluid must be examined under normal and polarized light. Monosodium urate crystals are negatively birefringent, whereas calcium pyrophosphate dihydrate crystals are positively birefringent. Other crystals [cholesterol, oxalate, corticosteroids] can also be identified in synovial fluid. Various artefacts must be avoided including anticoagulant crystals and synovial fluid must be anticoagulated with sodium heparin or citrate

Inducción de tolerancia oral en animales de experimentación a colágeno Tipo II purificado / Induction of oral tolerance in animales of experimentation to purified Type II collagen

Las enfermedades autoimunitarias constituyen hoy en día un problema de salud de relevancia, especialmenteporque son enfermedades crónicas severas que afectan considerablemente la calidad de vida de los pacientes yademás porque en la mayoría de los casos el tratamiento es solamente paliativo e insatisfactorio pues no modifica la evolución de la enfermedad. Un ejemplo bien conocido de este tipo de enfermedad es el de la ArtritisReumatoidea. En este sentido interesantes estudios handemostrado que la inducción de la tolerancia inmunológica por vía oral es efectiva en enfermedades autoinmunes humanas, constituyendo una alternativaventajosa, simple y barata de tratamiento. Dos mecanismos parecen estar involucrados: interacción, anivel de mucosas, del antígeno con células linfocitarias reguladoras (LTreg) que ejercerían un efecto supresorde la respuesta inmunitaria específica contra el antígeno ingerido11, o interacción de células dendríticas concélulas epiteliales que tiene deficiencia en moléculas coestimulatorias (CD80 y CD86), lo que conduciría a inducción de tolerancia.