ABSTRACT
Abstract Objective This study aimed to investigate the impact of post-thoracotomy analgesia with dexmedetomidine and morphine on immunocytes. Methods A total of 118 patients with post-thoracotomy Patient-Controlled Intravenous Analgesia (PCIA) in our hospital from March 2016 to July 2018 were randomly selected and divided into the Composite (COM) Group (57 patients administered with dexmedetomidine [1.0 µg.kg-1 body weight] and morphine [0.48 mg.kg-1 body weight]) and the Morphine (MOR) group (61 patients administered with morphine [0.48 mg.kg-1]). The values of lymphocyte subsets (CD3+, CD4+, and CD8+) and Natural Killer cells in the peripheral blood of these two groups were detected by FACSCalibur flow cytometry at different time points (before anesthesia induction [T0], immediately after tracheal extubation [T1], 12 hours after surgery [T2], 24 hours after surgery [T3], 48 hours after surgery [T4], 72 hours after surgery [T5], and 7 days after surgery [T6]). The doses of morphine at T3 to T5 and the adverse reactions between the two groups were also recorded and compared. Results The CD3+ level and the CD4+/CD8+ ratio at T2 to T5 and the CD4+ level and NK cells at T3 to T5 were significantly higher in the COM Group than in the MOR Group (p< 0.05). The postoperative morphine dose and the incidence of postoperative itching, nausea, and vomiting were significantly lower in the COM Group than in the MOR Group (p< 0.05). Conclusions Dexmedetomidine combined with morphine for post-thoracotomy PCIA can improve the function of immunocytes, reduce morphine consumption, and reduce the adverse reactions during analgesia induction.
Resumo Objetivo Estudar o impacto em linfócitos causado pelo uso da dexmedetomidina associada à morfina para analgesia pós-toracotomia. Método Um total de 118 pacientes utilizando Analgesia Intravenosa Controlada pelo Paciente (AICP) pós-toracotomia em nosso hospital, de março de 2016 a julho de 2018, foram selecionados aleatoriamente e divididos em dois grupos: o Grupo Combinado [COM, 57 pacientes que receberam dexmedetomidina (1,0 µg.kg-1 de peso corpóreo) associada à morfina (0,48 mg.kg-1 de peso corpóreo)] e o Grupo Morfina [MOR, 61 pacientes, que receberam somente morfina (0,48 mg.kg-)]. Os valores dos subconjuntos de linfócitos (CD3+, CD4+ e CD8+) e das células NK no sangue periférico desses dois grupos foram medidos por citometria de fluxo FACSCalibur em diferentes momentos do estudo [antes da indução anestésica (T0), imediatamente após extubação traqueal (T1), 12 horas após a cirurgia (T2), 24 horas após a cirurgia (T3), 48 horas após a cirurgia (T4), 72 horas após a cirurgia (T5) e 7 dias após a cirurgia (T6)]. As doses de morfina do momento T3 ao T5 e as reações adversas entre os dois grupos também foram registradas e comparadas. Resultados O nível de CD3+ e a razão CD4+/CD8+ de T2 a T5, e o nível de CD4+ e as células NK de T3 a T5 do Grupo COM foram significantemente maiores (p< 0,05) quando comparados ao Grupo MOR. A dose de morfina no pós-operatório e a incidência de prurido, náusea e vômito no pós-operatório foram significantemente menores no grupo MOR (p< 0,05). Conclusões Dexmedetomidina combinada com morfina para AICP no período pós-toracotomia pode melhorar a função dos linfócitos, reduzir o consumo de morfina e diminuir reações adversas durante a analgesia.
Subject(s)
Humans , Male , Female , Adult , Pain, Postoperative/drug therapy , Thoracotomy , Killer Cells, Natural/drug effects , Analgesia, Patient-Controlled , Lymphocyte Subsets/drug effects , Analgesics, Non-Narcotic/pharmacology , Dexmedetomidine/pharmacology , Analgesics, Opioid/pharmacology , Morphine/pharmacology , Analgesics, Non-Narcotic/therapeutic use , Dexmedetomidine/therapeutic use , Analgesics, Opioid/therapeutic use , Middle Aged , Morphine/therapeutic useABSTRACT
OBJECTIVE: In a zinc supplementation trial (with a significant impact on diarrheal morbidity), to evaluate effect of zinc supplementation on cellular immune status before and after 120 days of supplementation. DESIGN: A double blind, randomized controlled trial with immune assessment at baseline and after 120 days on supplement. SETTING: Community based study in an urban slum population. SUBJECTS: Randomly selected children (zinc 38, control 48), had a Multitest CMI skin test at both times. In 66 children (zinc 22, control 34), proportions of CD3, CD4, CD8, CD16, CD20 cells and the CD/CD8 ratio were also estimated using a whole blood lysis method and flowcytometry. INTERVENTION: Zinc gluconate to provide elemental zinc 10 mg daily and 20 mg during diarrhea. MAIN OUTCOME RESULTS: Regarding CMI, the percentage of anergic or hypoergic children (using induration score) decreased from 67% to 47% in the zinc group, while in the control group it remained unchanged (73% vs 71%) (p = 0.05). The percentage of children deteriorating between first and second tests was significantly lower in the zinc group (13% vs 33%, p = 0.03). Regarding lymphocyte subsets, the zinc group had a significantly higher rise in the geometric means of CD3 (25%, p = 0.02), CD4 (64% p = 0.001), and CD4/CD8 ratio (73% p = 0.004) with no difference in CD8 and CD20. The rise in CD4 was significantly higher in the zinc as compared to the control group; the ratio of geometric means was 1.45 (95% CI, 1.03-2.01). CONCLUSION: Zinc supplementation improves cellular immune status, which may have been one of the mechanisms for observed impact of zinc supplementation on diarrheal morbidity.
Subject(s)
Child, Preschool , Diarrhea/prevention & control , Double-Blind Method , Gluconates/therapeutic use , Humans , Immunity, Cellular/drug effects , Infant , Lymphocyte Subsets/drug effects , Multivariate Analysis , Zinc/therapeutic useABSTRACT
We studied the effects of D-penicillamine (DP) on the clinical response, immunoinflammatory parameters and the lymphocyte subsets in 46 patients with rheumatoid arthritis (RA). Patients were evaluated before the start of the drug and then at 3 and 9 months during the follow up. 38 of 46 (82.6%) patients could continue DP treatment for over 9 months, while in 8 the drug was withdrawn due to adverse effects. Improvement in the various disease activity indices of more than 50% (responders) was seen in 25 of 38 (65.8%) patients. Responders showed a significant decrease in the serum IgA and IgM at 9 months, and in IgM only at 3 months. The serum levels of C3 and C4 did not show any significant change. Serum levels of C-reactive protein and rheumatoid factor (RF) showed a significant decrease at 3 and 9 months. A significant decrease in CD3+ and CD4+ lymphocytes along with a fall in CD4+/CD8+ lymphocyte ratio was also seen in responders at 3 and 9 months, compared to the baseline. Our results suggest that DP may have immunomodulatory action in RA.
Subject(s)
Adolescent , Adult , Arthritis, Rheumatoid/drug therapy , Female , Follow-Up Studies , Humans , Lymphocyte Subsets/drug effects , Male , Middle Aged , Penicillamine/therapeutic useABSTRACT
Los efectos de la vacuna BCG sobre el sistema inmune han dado resultados contradictorios y no se dispone en la actualidad de datos que demuestren fehacientemente su mecanismo de acción. Por estos antecedentes decidimos estudiar las modificaciones de las subpoblaciones linfocitarias T y la respuesta blastogénica en 60 lactantes de 3 meses de edad randomizados en 3 grupos 20 niños vacunados con PPD >8mm (BCG+PPD+), 20 niños vacunados anérgicos al PPD(BCG+PPD-) y 20 no vacunados con PPD negativo (BCG-PPD-). Los siguientes fueron los resultados obtenidos (xñDS) en el recuento de CD3, CD4, CD8 en los diferentes grupos: BCG+PPD+:56ñ10; 42ñ8.6; 33ñ7.3 porciento respectivamente. BCG+PPD-: 49ñ9.6 porciento; 45ñ10.6; 33ñ7.7 porciento. BCG-PPD-: 47ñ7.1 porciento; 40ñ7.4; 30ñ5.3 porciento (p:n.s.). Por su parte los índices de estimulación linfocitaria guardaron estrecha correlación con la respuesta in vivo al PPD. Nuestros resultados permiten concluir que el BCG no modifica los niveles de subpoblaciones linfocitarias T
Subject(s)
Humans , Male , Female , Infant , BCG Vaccine/immunology , Immune System/drug effects , Lymphocyte Subsets/drug effects , Case-Control StudiesABSTRACT
Desde hace años, los clínicos se han encontrado con pacientes asmáticos que no responden a corticoides. Estos comprenden pacientes con obstrucción irreversible de su vía aérea, pacientes con enfermedad severa que requieren altas dosis y un subgrupo menos frecuente, que se caracteriza por obstrucción bronquial reversible con ß2 agonistas, pero que no responden a corticoides, a dosis adecuadas. Diversos autores estudiaron la farmacocinética de los corticoides en estos pacientes, así como la presencia de anticuerpos antilipocortina, y los receptores esteróideos, no pudiendo aclarar el mecanismo de esta resistencia. La explicación a este fenómeno parece centrarse en la respuesta de los linfocitos, monocitos y eosinófilos de los pacientes a estas drogas, con disminución de efecto sobre varias funciones de las mismas, que nos acerca a la comprensión de la inflamación bronquial en asma
Subject(s)
Humans , Asthma/complications , Drug Resistance/immunology , Status Asthmaticus/drug therapy , Glucocorticoids/therapeutic use , In Vitro Techniques , Anti-Inflammatory Agents/adverse effects , Anti-Inflammatory Agents/therapeutic use , Asthma/drug therapy , Asthma/immunology , Drug Resistance/immunology , Drug Resistance/physiology , Forced Expiratory Flow Rates/drug effects , Leukocytes, Mononuclear/drug effects , Leukocytes, Mononuclear/physiology , Lymphocyte Subsets/drug effectsABSTRACT
The effect of primaquine on the cellular immune responses (lymphocyte subpopulations and their proliferative responses with PHA, Con-A and LPS, and phagocytosis by monocytes) of normal rhesus monkeys was studied under both in-vivo and in-vitro conditions. When the lymphocytes and monocytes from normal animals were treated in-vitro with primaquine, at concentration normally attainable during therapy, a significant inhibition in blastogenic response of lymphocytes and phagocytic capacity of monocytes was noticed after 4 hours of treatment. In contrast, the in-vivo effect of primaquine treatment on these cells was innocuous. From this study it is clear that the primaquine does not act as an immunosuppresant and can be given safely to any type of malaria patient.
Subject(s)
Animals , Immunity, Cellular/drug effects , Lymphocyte Activation/drug effects , Lymphocyte Subsets/drug effects , Macaca mulatta , Monocytes/drug effects , Phagocytosis/drug effects , Primaquine/adverse effectsABSTRACT
Subpopulations of peripheral lymphocytes were studied in 40 women taking oral hormonal contraceptives [OC's], in 50 women using intrauterine contraceptive devices [IUD's] and in 20 age matched control group of women who had never taken oral hormonal contraceptive pills not used intrauterine devices. The group taking oral hormonal contraceptive demonstrated significant depression of their T lymphocyte count when compared to the control group. While, the group using IUS's showed significant rise of their T lymphocytes count. On the other hand no significant quantitative difference in subpopulation of the peripheral lymphocytes "B cells" with IgG, IgA and IgM markers was observed between the three studied groups. These findings suggest that the use of oral hormonal contraceptives induces a state of immunological abnormality, affecting mainly the cellular limb of the immune system. While in IUD's users the increase in the T lymphocytes suggest that the ID's mode of action might partly be immunologically mediated