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Arq. gastroenterol ; 58(2): 131-138, Apr.-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1285331


ABSTRACT BACKGROUND: Individuals with cirrhosis have a chronic systemic inflammation associated with an immune dysfunction, affecting the progression of the liver disease. The neutrophil-lymphocyte ratio (NLR) was proposed as a marker of systemic inflammatory response and survival in patients with cirrhosis. OBJECTIVE: Evaluate the prognostic role of NLR in cirrhotic patients and its relation with inflammatory cytokines(IL-6, IL-10 and IL-17). METHODS: In this prospective study two groups were evaluated: 1) Stable cirrhotic in outpatient follow-up (n=193); 2) Hospitalized cirrhotic for acute decompensation for at least 48 hours (n=334) with admission and 48 hours tests evaluation. Circulating inflammatory cytokines were available for 130 hospitalized patients. RESULTS: In outpatients with stable cirrhosis, NLR correlated with MELD score and other variables associated with severity of disease. However, after a median of 32 months of follow up NLR was not associated with mortality (HR 1.058, 95%CI 0.900-1.243; P=0.495). In hospitalized patients, NLR at 48-hour after admission was independently associated with 90-day survival (HR 1.061, 95%CI 1.020-1.103; P=0.003) in multivariate Cox-regression analysis. The 90-day Kaplan-Meier survival probability was 87% for patients with a 48-hour NLR <3.6 and 62% for NLR ≥3.6 (P<0.001). Elevation of NLR in the first 48 hours was also independently associated with mortality (HR 2.038, 95%CI 1295-3207; P=0.002). The 90-day Kaplan-Meier survival probability was 83% when NLR did not increase and 62% when NLR increased (P<0.001). IL-6, IL-10 and IL-17 at admission were positively correlated with both admission and 48-hour NLR. Lower levels of baseline IL-10 were associated with NLR increase during first 48-hour. CONCLUSION: NLR evaluated at 48 hours of hospitalization and its early increase after admission were independently associated with short-term mortality in patients hospitalized for acute decompensation of cirrhosis.

RESUMO CONTEXTO: Na cirrose há um quadro crônico de inflamação sistêmica associada a disfunção imune, que impactam na progressão da doença hepática. A razão neutrófilo-linfócito (RNL) foi proposta como um marcador de resposta inflamatória sistêmica e sobrevida em pacientes com cirrose hepática. OBJETIVO: Avaliar o papel de RNL como marcador prognóstico em portadores de cirrose hepática e sua relação com citocinas inflamatórias (IL-6, IL-10 e IL-17). MÉTODOS: É um estudo prospectivo com duas coortes: 1) pacientes cirróticos estáveis em acompanhamento ambulatorial (n=193); 2) pacientes cirróticos hospitalizados por descompensação aguda por no mínimo 48 horas (n=334) com avaliação de exames de admissão de 48 horas. Citocinas inflamatórias séricas estavam disponíveis em 130 pacientes hospitalizados. RESULTADOS: Nos pacientes ambulatoriais com cirrose estável, RNL se correlacionou com MELD e outras variáveis associadas com gravidade da doença. Entretanto, após uma mediana de 32 meses de seguimento, RNL não apresentou associação com mortalidade (HR 1.058, 95%CI 0.900-1.243; P=0.495). Nos pacientes hospitalizados, RNL de 48 horas após a admissão apresentou associação independente com sobrevida em 90 dias (HR 1.061, 95%CI 1.020-1.103; P=0.003) na regressão multivariada de Cox. A probabilidade de sobrevivência pela curva de Kaplan-Meier em 90 dias foi de 87% em pacientes com RNL de 48 horas <3.6 e 62% nos pacientes com RNL ≥3.6 (P<0.001). A elevação de RNL nas primeiras 48 horas também foi um fator independente associado a mortalidade (HR 2.038, 95%CI 1295-3207; P=0.002). A avaliação de sobrevida em 90 dias pela curva de Kaplan-Meier foi de 83% nos pacientes em que RNL não apresentou elevação e 62% nos que apresentaram elevação de RNL (P<0.001). IL-6, IL-10 e IL-17 na admissão se correlacionaram positivamente com RNL de admissão e de 48 horas. Níveis mais baixos de IL-10 basal foram associados com elevação de RNL nas primeiras 48 horas. CONCLUSÃO: RNL avaliada em 48 horas de hospitalização e sua elevação precoce após a admissão foram fatores independentemente associados a mortalidade em curto prazo nos pacientes hospitalizados com descompensação aguda da cirrose.

Humans , Lymphocytes , Neutrophils/pathology , Prognosis , Prospective Studies , Retrospective Studies , Liver Cirrhosis/complications , Liver Cirrhosis/pathology
Arch. argent. pediatr ; 118(2): 139-142, abr. 2020. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1100250


Antecedentes: La púrpura de Henoch-Schönlein (PHS) es una vasculitis sistémica de vasos pequeños. El objetivo fue evaluar el índice de neutrófilos/linfocitos (INL) en sangre y el volumen plaquetario medio (VPM) en la PHS e investigar la relación con el compromiso renal y gastrointestinal.Métodos: Se incluyeron niños con PHS y controles sanos. Se evaluaron concentración de hemoglobina, recuento de leucocitos, recuento de trombocitos, INL, VPM, velocidad de sedimentación globular y proteína C-reactiva.Resultados: El INL fue significativamente mayor en los pacientes con PHS con hemorragia gastrointestinal (p < 0,001). El valor ideal de corte del INL para predecir la hemorragia gastrointestinal fue 2,05, con 93 % de sensibilidad y 62 % de especificidad. El VPM fue significativamente mayor en los pacientes con PHS con compromiso renal (p = 0,027).Conclusiones: El INL en sangre y el VPM podrían ser útiles para identificar el compromiso renal y gastrointestinal en la PHS

Background: Henoch-Schönlein purpura (HSP) is a systemic small-vessel vasculitis that occurs mainly in children. The aim was to evaluate the blood neutrophil-to-lymphocyte ratio (NLR) and mean platelet volume (MPV) in patients with HSP and to investigate the relationship with gastrointestinal and renal involvement.Methods: Children with HSP and healthy individuals as controls were included. Hemoglobin level, white blood cell count, platelet count, NLR, MPV erythrocyte sedimentation rate and C-reactive protein were evaluated.Results: There were 71 HSP children and 74 controls. NLR was significantly higher in HSP patients with gastrointestinal bleeding than without gastrointestinal bleeding (p < 0,001). The optimal cutoff value of NLR for predicting gastrointestinal bleeding was 2.05, with 93 % sensitivity and 62 % specificity. MPV was significantly higher in HSP patients with renal involvement than without renal involvement (p = 0,027).Conclusions:Blood NLR and MPV may be useful markers to identify gastrointestinal and renal involvement in HSP patients.

Humans , Male , Female , Child, Preschool , Child , Adolescent , Purpura, Schoenlein-Henoch/blood , Lymphocytes/pathology , Mean Platelet Volume , Neutrophils/pathology , Purpura, Schoenlein-Henoch/diagnosis , Retrospective Studies , Lymphocyte Count , Gastrointestinal Hemorrhage , Kidney Diseases
Clinics ; 75: e1450, 2020. tab, graf
Article in English | LILACS | ID: biblio-1101088


Systemic lupus erythematosus (SLE) is a chronic systematic autoimmune disease. Current methods of diagnosing SLE or evaluating its activity are complex and expensive. Numerous studies have suggested that neutrophil-to-lymphocyte ratio (NLR) is closely correlated with the presence of SLE and its activity, suggesting that it may serve as a diagnostic and monitoring indicator for SLE. Therefore, we performed a meta-analysis to systematically assess the association between NLR and SLE. We performed a literature search until 12 April 2019 in the PubMed, Web of Science, and China National Knowledge Infrastructure databases. Cross-sectional studies comparing the NLR of SLE patients versus those of healthy controls, of active versus inactive SLE patients, and of SLE patients with versus without lupus nephritis were considered for inclusion. Mean intergroup NLR differences were estimated using standardized mean differences and their 95% confidence intervals. Study quality was assessed using the Agency for Healthcare Research and Quality instrument for cross-sectional studies. Fourteen studies with 1,781 SLE patients and 1,330 healthy controls were included in this meta-analysis. The pooled results showed that the NLR was significantly higher in SLE patients than in healthy controls, in active SLE patients than in inactive SLE patients, and in SLE patients with lupus nephritis than in those without lupus nephritis. NLR may be an indicator for monitoring disease activity and reflecting renal involvement in SLE patients. Nevertheless, more high-quality studies are warranted to further validate our findings.

Humans , Lymphocytes/pathology , Lupus Erythematosus, Systemic/blood , Neutrophils/pathology , China , Cross-Sectional Studies , Lupus Erythematosus, Systemic/diagnosis
Braz. oral res. (Online) ; 34: e015, 2020. tab, graf
Article in English | LILACS | ID: biblio-1089381


Abstract We sought to compare the characteristics and clinical significance of neutrophil extracellular traps in gingival samples from patients with periodontitis and those with gingivitis. The clinical indexes of gingival samples from patients with periodontitis and gingivitis were measured; the expression of TNF-alpha and IL-8 was measured by real-time fluorescent quantitative PCR; and the expression of TLR-8 and MMP-9 was measured by western blotting assays. Chemotaxis, phagocytosis and phagocytic activity of neutrophils were measured. Compared with the healthy group, the expression of TNF-α and IL-8 in the periodontitis group and the gingivitis group increased significantly (p < 0.05), and TNF-α in the gingivitis group was significantly lower than that in the healthy group (p < 0.05). The expression of IL-8 in the periodontitis group was significantly higher than that in the periodontitis group (p < 0.05). Furthermore, the expression of TLR-8 and MMP-9 in the periodontitis group was different from that in the gingivitis group and the healthy group, and the expression of TLR-8 and MMP-9 in the gingivitis group was significantly different from that in the healthy group (p < 0.05). In addition, the neutrophil mobility index in healthy people was 3.02 ± 0.53, that in the periodontitis group was 2.21 ± 0.13, and that in the gingivitis group was 2.31 ± 0.12. In conclusion, the chemotaxis of neutrophils in gingival samples of patients with periodontitis and gingivitis was decreased, the phagocytotic ability and activity of neutrophils were reduced, and the release of the extracellular trap-releasing inducible factors TNF-alpha and IL-8 also declined.

Humans , Male , Female , Young Adult , Periodontitis/pathology , Extracellular Traps , Gingivitis/pathology , Neutrophils/pathology , Reference Values , RNA/analysis , Case-Control Studies , Periodontal Index , Blotting, Western , Interleukin-8/analysis , Actins/analysis , Tumor Necrosis Factor-alpha/analysis , Matrix Metalloproteinase 9/analysis , Electrophoresis, Agar Gel , Toll-Like Receptor 8/analysis , Real-Time Polymerase Chain Reaction , Middle Aged
Einstein (Säo Paulo) ; 18: eAO4860, 2020. tab, graf
Article in English | LILACS | ID: biblio-1056071


ABSTRACT Objective: To evaluate the impact of neutrophil-lymphocyte ratio change after curative surgery for gastric cancer. Methods: A retrospective analysis of patients with gastric cancer who underwent curative surgery between 2009 and 2017 was performed. A cutoff value was established for the neutrophil-lymphocyte ratio in the pre- and postoperative periods, according to the median value, and four subgroups were formed (low-low/low-high/high-low/high-high). Clinical-pathological and survival data were analyzed and related to these subgroups. Results: A total of 325 patients were included in the study. The cutoff values of the neutrophil-lymphocyte ratio were 2.14 and 1.8 for the pre and postoperative periods, respectively. In patients with stages I and II, the high-high subgroup presented worse overall survival (p=0.016) and disease-free survival (p=0.001). Complications were higher in the low-high subgroup of patients. Conclusion: The neutrophil-lymphocyte ratio is a low cost, efficient and reproducible marker. The prognosis individualization can be performed according to the identification of subgroups at a higher risk of complications and worse prognosis.

RESUMO Objetivo: Avaliar o impacto da alteração da relação neutrófilo-linfócito após ressecção curativa por câncer gástrico. Métodos: Realizou-se análise retrospectiva de pacientes com câncer gástrico submetidos à gastrectomia curativa entre 2009 e 2017. Foi estabelecido valor de corte para a relação neutrófilo-linfócito nos períodos pré e pós-operatório de acordo com a mediana, e quatro subgrupos foram formados (baixo-baixo/baixo-alto/alto-baixo/alto-alto). Dados clínicos e patológicos e de sobrevida foram analisados e relacionados com estes subgrupos. Resultados: Foram incluídos no estudo 325 pacientes. Os valores de corte para a relação neutrófilo-linfócito foram 2,14 e 1,8 para os períodos pré e pós-operatório, respectivamente. Em pacientes com estádios I e II, o subgrupo alto-alto apresentou pior sobrevida global (p=0,016) e sobrevida livre de doença (p=0,001). As complicações ocorreram mais em pacientes do subgrupo baixo-alto. Conclusão: A relação neutrófilo-linfócito é um marcador de baixo custo, eficiente e reprodutível. A individualização do prognóstico pode ser realizada de acordo com a identificação de subgrupos com maior risco de complicações e pior prognóstico.

Humans , Male , Female , Aged , Stomach Neoplasms/pathology , Lymphocytes/pathology , Neutrophils/pathology , Postoperative Period , Prognosis , Stomach Neoplasms/surgery , Biomarkers , Retrospective Studies , Lymphocyte Count , Gastrectomy , Middle Aged
Braz. j. otorhinolaryngol. (Impr.) ; 85(5): 578-587, Sept.-Oct. 2019. tab, graf
Article in English | LILACS | ID: biblio-1039294


Abstract Introduction: Systemic inflammatory biomarkers are promising predictive and prognostic factors for solid cancers. The neutrophil-lymphocyte ratio and derived neutrophil-lymphocyte ratio are used to predict inflammation and used as biomarker in several malignancies. Objective: The purpose of this study was to demonstrate the diagnostic, predictive and prognostic role of neutrophil-lymphocyte ratio and derived neutrophil-lymphocyte ratio in patients with laryngeal neoplasms. Methods: A retrospective study was conducted on medical records involving 229 patients with benign, premalignant and malignant laryngeal neoplasms between 2002 and 2015. The diagnostic, predictive and prognostic role of neutrophil-lymphocyte ratio and derived neutrophil-lymphocyte ratio were evaluated using uni- and multivariate analysis. Results: The neutrophil-lymphocyte ratio and derived neutrophil-lymphocyte ratio were not statistically different between patients with benign, premalignant and malignant laryngeal neoplasms. Both neutrophil-lymphocyte ratio and derived neutrophil-lymphocyte ratio were predictive factors for stage, lymph node metastasis, and distant metastasis. Patients with high neutrophil-lymphocyte ratio value (≥4) had a poor prognosis when compared with patients with low neutrophil-lymphocyte ratio value (5 year, Overall Survival: 69.0% vs. 31.1%, p < 0.001; 5 year, disease free survival: 70.0% vs. 32.7%, p ˂ 0.001; 5 year, locoregional recurrence free survival: 69.7% vs. 32.0%, p < 0.001). Furthermore, neutrophil-lymphocyte ratio was an independent prognostic factor for 5 year: Overall survival (HR = 2.396; 95% CI 1.408-4.077; p = 0.001), Disease free survival (HR = 2.246; 95% CI 1.322-3.816; p = 0.006) and locoregional recurrence free survival (HR = 2.210; 95% CI 1.301-3.753; p = 0.003). Conclusion: Pretreatment neutrophil-lymphocyte ratio is a useful and reliable predictive and prognostic biomarker for patients with laryngeal carcinoma.

Resumo Introdução: Biomarcadores inflamatórios sistêmicos são fatores preditivos e prognósticos promissores para cânceres sólidos. A relação neutrófilo-linfócito e a relação neutrófilo-linfócito derivada são utilizadas para predizer a inflamação e como biomarcadores em várias malignidades. Objetivo: O objetivo deste estudo foi demonstrar o papel diagnóstico, preditivo e prognóstico da relação neutrófilo-linfócito e relação neutrófilo-linfócito derivada em pacientes com neoplasias laríngeas. Método: Foi realizado um estudo retrospectivo em prontuários médicos de 229 pacientes com neoplasias laríngeas benignas, pré-malignas e malignas entre 2002 e 2015. O papel diagnóstico, preditivo e prognóstico da relação neutrófilo-linfócito e relação neutrófilo-linfócito derivada foi avaliado por meio de análise uni- e multivariada. Resultados: A relação neutrófilo-linfócito e a relação neutrófilo-linfócito derivada não foram estatisticamente diferentes entre pacientes com neoplasias laríngeas benignas, pré-malignas e malignas. Ambas as relação neutrófilo-linfócito e relação neutrófilo-linfócito derivada foram fatores preditivos para o estágio, metástase linfonodal e metástase a distância. Pacientes com valor alto da relação neutrófilo-linfócito (≥ 4) apresentaram pior prognóstico quando comparados com pacientes com valor mais baixo da relação neutrófilo-linfócito (5 anos, Sobrevida Global: 69,0% vs. 31,1%, p < 0,001; 5 anos, sobrevida livre de doença: 70,0% vs. 32,7%, p < 0,001; 5 anos, sobrevida livre de recorrência loco-regional: 69,7% vs. 32,0%, p < 0,001). Além disso, a relação neutrófilo-linfócito foi um fator prognóstico independente para 5 anos: Sobrevida global (HR = 2,396; IC95% 1,408-4,077; p = 0,001), sobrevida livre de doença (HR = 2,246; IC95%: 1,322-3,816; p = 0,006) e sobrevida livre de recorrência loco-regional (HR = 2,210; IC95%: 1,301-3,753; p = 0,003). Conclusão: A relação neutrófilo-linfócito no pré-tratamento é um biomarcador preditivo e de prognóstico útil e confiável para pacientes com carcinoma de laringe.

Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Carcinoma, Squamous Cell/pathology , Laryngeal Neoplasms/pathology , Neutrophils/pathology , Prognosis , Preoperative Care , Carcinoma, Squamous Cell/blood , Biomarkers, Tumor/blood , Laryngeal Neoplasms/blood , Predictive Value of Tests , Retrospective Studies , Lymphocyte Count , Disease-Free Survival , Disease Progression , Neoplasm Recurrence, Local , Neoplasm Staging
Int. braz. j. urol ; 45(2): 315-324, Mar.-Apr. 2019. tab, graf
Article in English | LILACS | ID: biblio-1002193


ABSTRACT Objectives: To evaluate the neutrophil-to-lymphocyte ratio (NLR) as a prognostic factor for response of high risk non muscle invasive bladder cancer (HRNMIBC) treated with BCG therapy. Materials and Methods: Between March 2010 and February 2014 in a tertiary center 100 consecutive patients with newly diagnosed HRNMIBC were retrospectively analyzed. Patients were divided according to NLR value: 46 patients with NLR value less than 3 (NLR < 3 group), and 54 patients with NLR value more than 3 (NLR ≥ 3 group). At the end of follow-up 52 patients were high grade disease free (BCG-responder group) and 48 patients underwent radical cystectomy for high grade recurrence or progression to muscle invasive disease (BCG non-responder group). The average follow-up was 60 months. Intervention: analysis and correlation of preoperative NLR value with response to BCG in terms of recurrence and progression. Results: The optimal cut-off for NLR was ≥ 3 according to the receiver operating characteristics analysis (AUC 0.760, 95% CI, 0.669-0.850). Mean NLR value was 3.65 ± 1.16 in BCG non-responder group and 2.61 ± 0.77 in BCG responder group (p = 0.01). NLR correlated with recurrence (r = 0.55, p = 0.01) and progression risk scores (r = 0.49, p = 0.01). In multivariate analysis, NLR (p = 0.02) and EORTC recurrence risk groups (p = 0.01) were associated to the primary endpoint. The log-rank test showed statistically significant difference between NLR < 3 and NLR ≥ 3 curves (p < 0.05). Conclusions: NLR value preoperatively evaluated could be a useful tool to predict BCG response of HRNMIBC. These results could lead to the development of prospective studies to assess the real prognostic value of NLR in HRNMIBC.

Humans , Male , Female , Aged , Urinary Bladder Neoplasms/drug therapy , BCG Vaccine/therapeutic use , Lymphocytes/pathology , Carcinoma, Transitional Cell/drug therapy , Adjuvants, Immunologic/therapeutic use , Neutrophils/pathology , Prognosis , Urinary Bladder Neoplasms/surgery , Urinary Bladder Neoplasms/pathology , Carcinoma, Transitional Cell/surgery , Carcinoma, Transitional Cell/pathology , Biomarkers, Tumor/blood , Cystectomy , Retrospective Studies , Lymphocyte Count , Disease Progression , Neoplasm Grading , Middle Aged , Neoplasm Recurrence, Local/surgery , Neoplasm Staging
Actual. osteol ; 15(1): 34-43, ene. abr. 2019. ilus.
Article in Spanish | LILACS | ID: biblio-1049002


La brucelosis es una de las enfermedades zoonóticas más importantes a nivel mundial capaz de producir enfermedad crónica en los seres humanos. La localización osteoarticular es la presentación más común de la enfermedad activa en el hombre. Sin embargo, algunos de los mecanismos moleculares implicados en la enfermedad osteoarticular han comenzado a dilucidarse recientemente. Brucella abortus induce daño óseo a través de diversos mecanismos en los cuales están implicados TNF-α y RANKL. En estos procesos participan células inflamatorias que incluyen monocitos/macrófagos, neutrófilos, linfocitos T del tipo Th17 y linfocitos B. Además, B. abortus puede afectar directamente las células osteoarticulares. La bacteria inhibe la deposición de la matriz ósea por los osteoblastos y modifica el fenotipo de estas células para producir metaloproteinasas de matriz (MMPs) y la secreción de citoquinas que contribuyen a la degradación del hueso. Por otro lado, la infección por B. abortus induce un aumento en la osteoclastogénesis, lo que aumenta la resorción de la matriz ósea orgánica y mineral y contribuye al daño óseo. Dado que la patología inducida por Brucella afecta el tejido articular, se estudió el efecto de la infección sobre los sinoviocitos. Estos estudios revelaron que, además de inducir la activación de estas células para secretar quemoquinas, citoquinas proinflamatorias y MMPs, la infección inhibe la muerte por apoptosis de los sinoviocitos. Brucella es una bacteria intracelular que se replica en el retículo endoplásmico de los macrófagos. El análisis de los sinoviocitos infectados con B. abortus indicó que las bacterias también se multiplican en el retículo endoplasmático, lo que sugiere que la bacteria podría usar este tipo celular para la multiplicación intracelular durante la localización osteoarticular de la enfermedad. Los hallazgos presentados en esta revisión intentan responder a preguntas sobre los mediadores inflamatorios implicados en el daño osteoarticular causado por Brucella. (AU)

Brucellosis is one of the most important zoonotic diseases that can produce chronic disease in humans worldwide. Osteoarticular involvement is the most common presentation of human active disease. The molecular mechanisms implicated in bone damage have started to be elucidated. B. abortus induces bone damage through diverse mechanisms in which TNF-α and RANKL are implicated. These processes are driven by inflammatory cells, including monocytes/macrophages, neutrophils, Th17 lymphocytes and B cells. Also, Brucella abortus (B. abortus) can directly affect osteoarticular cells. The bacterium inhibits bone matrix deposition by osteoblast and modifies the phenotype of these cells to produce matrix methalloproteinases (MMPs) and cytokine secretion that contribute to bone matrix degradation. B. abortus also affects osteoclast increasing mineral and organic bone matrix resorption and contributing to bone damage. Since the pathology induced by Brucella species involves joint tissue, experiments conducted in sinoviocytes revealed that besides inducing the activation of these cells to secrete chemokines, proinflammatory cytokines and MMPS, the infection also inhibits sinoviocyte apoptosis. Brucella is an intracellular bacterium that replicate in the endoplasmic reticulum of macrophages. The analysis of B. abortus infected sinoviocytes indicated that bacteria also replicate in their reticulum suggesting that the bacterium could use this cell type for intracellular replication during the osteoarticular localization of the disease. The findings presented in this review try to answer key questions about the inflammatory mediators involved in osteoarticular damage caused by Brucella. (AU)

Humans , Animals , Osteoarthritis/pathology , Brucella abortus/pathogenicity , Brucellosis/pathology , Osteoarthritis/immunology , Osteoblasts/pathology , Osteocytes/microbiology , Osteogenesis/immunology , Brucella abortus/immunology , Brucellosis/etiology , Brucellosis/immunology , B-Lymphocytes/pathology , Cytokines/adverse effects , Tumor Necrosis Factor-alpha/adverse effects , Matrix Metalloproteinases/chemical synthesis , RANK Ligand/adverse effects , Th17 Cells/pathology , Synoviocytes/immunology , Macrophages/pathology , Neutrophils/pathology
Rev. bras. parasitol. vet ; 27(4): 430-438, Oct.-Dec. 2018. graf
Article in English | LILACS | ID: biblio-977936


Abstract Visceral leishmaniasis (VL) is a disease caused by the protozoa Leishmania infantum and can cause an inflammatory reaction in the gastrointestinal tract, however the role of granulocytic cells (neutrophils, eosinophils, and mast cells) in the intestine of dogs infected is not fully understood. We performed a quantitative analysis these cells in the intestinal wall of dogs with canine visceral leishmaniasis (CVL). Twenty dogs were assigned to one of three groups: group 1 (G1, n=8), dogs with CVL and L. infantum amastigotes in the intestine; group 2 (G2, n=9), dogs with CVL but without intestinal amastigotes; and group 3 (G3, n=3), uninfected dogs (control group). Granulocytic cells were counted in the crypt-villus unit (mucosa), submucosa, and muscle layer of the intestinal mucosa. Cell counts were higher in the intestinal wall of dogs from G2 followed by G1 and G3 (p≤0.05). In G1, there was a low inverse correlation between parasite burden of the small intestine and granulocyte counts (r= -0.1, p≤0.01). However, in G2 dogs, mast cell and eosinophil numbers showed positive correlation (r=0.85, p≤0.01). The granulocytic cell hyperplasia observed in the intestine of L. infantum-infected dogs suggests that these cells may be involved in the cell-mediated immune response for parasite elimination.

Resumo A leishmaniose visceral (LV) é uma doença causada pelo protozoário Leishmania infantum e pode causar uma reação inflamatória no trato gastrointestinal, entretanto o papel das células granulocíticas (neutrófilos, eosinófilos e mastócitos) no intestino de cães infectados não é totalmente compreendido. Neste estudo realizamos uma análise quantitativa dessas células na parede intestinal de cães com LV. Vinte cães foram distribuídos em três grupos: grupo 1 (G1, n=8), cães com LV e amastigotas de L. infantum no intestino; grupo 2 (G2, n=9), cães com LV, mas sem amastigotas intestinais; e grupo 3 (G3, n=3), não infectados (grupo controle). Células granulocíticas foram contadas na unidade cripta-vilo (mucosa), submucosa e camada muscular da mucosa intestinal. Observamos hiperplasia dessas células na parede intestinal de cães do G2, seguidas das G1 em relação ao G3 (p≤0,05). No G1, houve uma correlação inversa baixa entre a carga parasitária do intestino delgado e a contagem de granulócitos (r= -0,1; p≤0,01). No entanto, nos cães do G2, os números de mastócitos e eosinófilos apresentaram correlação positiva (r=0,85; p≤0,01). A hiperplasia de células granulocíticas observada no intestino de cães infectados por L. infantum sugere que essas células podem estar envolvidas na resposta imune mediada por células para a eliminação do parasita.

Animals , Male , Female , Dogs , Leishmania infantum , Dog Diseases/pathology , Intestinal Mucosa/pathology , Leishmaniasis, Visceral/pathology , Case-Control Studies , Dog Diseases/parasitology , Eosinophils/pathology , Intestinal Mucosa/parasitology , Leishmaniasis, Visceral/parasitology , Mast Cells/pathology , Neutrophils/pathology
Clinics ; 73: e360, 2018. tab, graf
Article in English | LILACS | ID: biblio-952782


High levels of inflammatory markers and the neutrophil-lymphocyte ratio appear to be associated with worse overall survival in solid tumors. However, few studies have analyzed the role of the neutrophil-lymphocyte ratio in gastric cancer patients scheduled to undergo curative resection. In the present study, a systematic review and meta-analysis was performed to analyze the relationship between the neutrophil-lymphocyte ratio and overall survival in patients with gastric cancer submitted to curative resection and to identify the clinicopathological features (age, gender, tumor depth, nodal involvement and tumor differentiation) that are correlated with high neutrophil-lymphocyte ratios. A literature search of PubMed, Scopus, Cochrane and EMBASE through November 2017 was conducted. Articles that included gastric cancer patients submitted to curative resection and preoperatory neutrophil-lymphocyte ratio values were included. A total of 7 studies comprising 3264 patients from 5 different countries were included. The meta-analysis revealed an association of high neutrophil-lymphocyte ratios with older age, male gender, lower 5-year overall survival, increased depth of tumor invasion, positive nodal involvement but not with histological differentiation. Evaluation of the neutrophil-lymphocyte ratio is a cost-effective method that is widely available in preoperatory settings. Furthermore, it can effectively predict prognosis, as high values of this biomarker are related to more aggressive tumor characteristics. This ratio can also be used to stratify risk in patients within the same disease stage and may be used to assist in individualized follow-up and treatment.

Humans , Male , Stomach Neoplasms/pathology , Lymphocytes/pathology , Neutrophils/pathology , Prognosis , Stomach Neoplasms/surgery , Biomarkers , Survival Analysis , Sex Factors , Age Factors , Lymphocyte Count , Leukocyte Count
An. bras. dermatol ; 91(5,supl.1): 154-156, Sept.-Oct. 2016. tab, graf
Article in English | LILACS | ID: biblio-837946


Abstract Histiocytoid Sweet's Syndrome is a rare inflammatory disease described in 2005 as a variant of the classical Sweet's Syndrome (SS). Histopathologically, the dermal inflammatory infiltrate is composed mainly of mononuclear cells that have a histiocytic appearance and represent immature myeloid cells. We describe a case of Histiocytoid Sweet's Syndrome in an 18-year-old man. Although this patient had clinical manifestations compatible with SS, the cutaneous lesions consisted of erythematous annular plaques, which are not typical for this entity and have not been described in histiocytic form so far. The histiocytic subtype was confirmed by histopathological analysis that showed positivity for myeloperoxidase in multiple cells with histiocytic appearance.

Humans , Male , Adolescent , Skin Diseases, Genetic/pathology , Sweet Syndrome/pathology , Erythema/pathology , Histiocytes/pathology , Skin/pathology , Biopsy , Neutrophils/pathology
An. bras. dermatol ; 91(4): 500-502, July-Aug. 2016. graf
Article in English | LILACS | ID: lil-792454


Abstract: A 54 year-old woman with a 3-year history of rheumatoid arthritis (RA) consulted us because of weight loss, fever and skin eruption. On physical examination, erythematous plaques with a pseudo-vesicular appearance were seen on the back of both shoulders. Histological examination was consistent with rheumatoid neutrophilic dermatosis (RND). After 3 days of prednisone treatment, the skin eruption resolved. RND is a rare cutaneous manifestation of seropositive RA, characterized by asymptomatic, symmetrical erythematous plaques with a pseudo-vesicular appearance. Histology characteristically reveals a dense, neutrophilic infiltrate with leucocitoclasis but without other signs of vasculitis. Lesions may resolve spontaneously or with RA treatment. This case illustrates an uncommon skin manifestation of active rheumatoid arthritis.

Humans , Female , Middle Aged , Arthritis, Rheumatoid/pathology , Skin Diseases, Vesiculobullous/pathology , Skin/pathology , Biopsy , Erythema/pathology , Neutrophils/pathology
An. bras. dermatol ; 91(3): 345-349, tab, graf
Article in English | LILACS | ID: lil-787306


Abstract Leprosy is a chronic disease characterized by manifestations in the peripheral nerves and skin. The course of the disease may be interrupted by acute phenomena called reactions. This article reports a peculiar case of type 2 leprosy reaction with Sweet's syndrome-like features as the first clinical manifestation of leprosy, resulting in a delay in the diagnosis due to unusual clinical presentation. The patient had clinical and histopathological features reminiscent of Sweet's syndrome associated with clusters of vacuolated histiocytes containing acid-fast bacilli isolated or forming globi. Herein, it is discussed how to recognize type 2 leprosy reaction with Sweet's syndrome features, the differential diagnosis with type 1 leprosy reaction and the treatment options. When this kind of reaction is the first clinical presentation of leprosy, the correct diagnosis might be not suspected clinically, and established only with histopathologic evaluation.

Humans , Female , Adult , Sweet Syndrome/diagnosis , Leprosy, Multibacillary/diagnosis , Thalidomide/therapeutic use , Prednisone/therapeutic use , Sweet Syndrome/etiology , Sweet Syndrome/pathology , Sweet Syndrome/drug therapy , Erythema/diagnosis , Leprosy, Multibacillary/complications , Leprosy, Multibacillary/pathology , Leprosy, Multibacillary/drug therapy , Histiocytes/pathology , Leprostatic Agents/therapeutic use , Neutrophils/pathology
Pesqui. vet. bras ; 36(1): 13-18, Jan. 2016. tab, graf
Article in English | LILACS | ID: lil-777376


With the hypothesis that blocking chemokine signaling can ameliorate acute laminitis, the aim was to evaluate the therapeutic effect of intravenous DF1681B, a selective antagonist for CXCR1 and CXCR2 (chemokine receptors), in an oligofructose equine laminitis model. To twelve mixed breed clinically healthy hoses with no previous history of hoof-related lameness was administered oligofructose (10g/kg given by nasogastric tube) and divided into two groups: treated (intravenous DF1681B at 30mg/kg 6, 12, 18, and 24h after oligofructose) and non-treated groups. Laminar biopsies were performed before and 12, 36, and 72h after administering oligofructose. Samples were stained with periodic acid-Schiff (PAS) and scored from 0 to 6 according to epidermal cell and basal membrane changes. The IL-1β, IL-6, and CXCL1 RNA expressions were determined by RT-PCR. Parametric and non-parametric tests were used to compare times within each group (P<0.05). The PAS grades and IL-1β and IL-6 RNA expression increased in the non-treated group, but remained constant in the treated horses. In conclusion, DF1681B therapy reduced laminar inflammation and epidermal deterioration in treated horses. CXCR1/2 blockage should be considered therapeutically for equine acute laminitis.

A expressão de quimiocinas e a infiltração de leucócitos no tecido laminar são característicos de laminite aguda de equinos. O presente estudo avaliou o efeito terapêutico da administração intravenosa de DF1681B , um antagonista seletivo para CXCR1 e CXCR2 (receptores de quimiocinas), em um modelo de laminite equina por oligofrutose. Utilizaram-se doze cavalos sem raça definida, compreendendo quatro machos e oito fêmeas não gestantes, com idade (média ±SD) 7±3,5 anos, pesando 305±35kg e com uma pontuação média de condição corporal de 5±1/9. Os indivíduos elegíveis eram clinicamente saudáveis, sem história prévia de claudicação relacionados ao casco. Após administração de oligofrutose (10g/kg por sonda nasogástrica), os animais foram divididos em dois grupos: tratado (30mg/kg de DF1681B intravenosa, 6, 12, 18 e 24h após a oligofrutose) e não tratado, que recebeu placebo. Biópsias laminares foram realizadas antes e 12, 36 e 72h após a administração de oligofrutose. As amostras foram coradas com ácido periódico de Schiff (PAS) e classificadas de 0-6 de acordo com alterações nas células epidérmicas e na membrana basal. Também determinaram-se as expressões gênicas de IL-1β, CXCL1 e IL-6 por RT-PCR. Testes paramétricos e não paramétricos foram utilizados para comparar os momentos em cada grupo (P<0,05). Estatisticamente, os graus PAS e as expressões de IL-1β e IL-6 se elevaram após a indução no grupo não tratado, mas se mantiveram constantes nos cavalos tratados. Em conclusão, a terapia por DF1681B reduziu a inflamação laminar e a deterioração epidérmica em equinos submetidos ao modelo de intoxicação por oligofructose. O bloqueio de receptores CXCR1/2 deve ser considerado como uma opção terapêutica para prevenção da laminite aguda de equinos.

Animals , Horses/physiology , Neutrophils/pathology , Prebiotics , Chemokines/antagonists & inhibitors , Receptors, CXCR/antagonists & inhibitors , Biopsy/veterinary , Hoof and Claw/pathology , Histological Techniques/veterinary
Clinics ; 70(7): 524-530, 2015. tab, graf
Article in English | LILACS | ID: lil-752390


Recently, a series of studies explored the correlation between the neutrophil to lymphocyte ratio and the prognosis of lung cancer. However, the current opinion regarding the prognostic role of the neutrophil to lymphocyte ratio in lung cancer is inconsistent. We performed a meta-analysis of published articles to investigate the prognostic value of the neutrophil to lymphocyte ratio in lung cancer. The hazard ratio (HR) and its 95% confidence interval (CI) were calculated. An elevated neutrophil to lymphocyte ratio predicted worse overall survival, with a pooled HR of 1.243 (95%CI: 1.106-1.397; Pheterogeneity=0.001) from multivariate studies and 1.867 (95%CI: 1.487-2.344; Pheterogeneity=0.047) from univariate studies. Subgroup analysis showed that a high neutrophil to lymphocyte ratio yielded worse overall survival in non-small cell lung cancer (NSCLC) (HR=1.192, 95%CI: 1.061-1.399; Pheterogeneity=0.003) as well as small cell lung cancer (SCLC) (HR=1.550, 95% CI: 1.156-2.077; Pheterogeneity=0.625) in multivariate studies. The synthesized evidence from this meta-analysis of published articles demonstrated that an elevated neutrophil to lymphocyte ratio was a predictor of poor overall survival in patients with lung cancer. .

Humans , Carcinoma, Non-Small-Cell Lung/pathology , Lung Neoplasms/pathology , Lymphocytes/pathology , Neutrophils/pathology , Small Cell Lung Carcinoma/pathology , Carcinoma, Non-Small-Cell Lung/mortality , Lymphocyte Count , Lung Neoplasms/mortality , Prognosis , Small Cell Lung Carcinoma/mortality
An. bras. dermatol ; 90(3): 391-393, May-Jun/2015. graf
Article in English | LILACS | ID: lil-749657


Abstract Besides being an uncommon clinicopathological entity, interstitial granulomatous dermatitis, also described as interstitial granulomatous dermatitis with arthritis (IGDA), has shown a wide spectrum of clinical manifestations, such as linear and erythematous lesions, papules, plaques and nodules. Histological features include dense dermal histiocytic infiltrate, usually in a palisade configuration, and scattered neutrophils and eosinophils. We describe a middle aged woman with rheumatoid arthritis of difficult management and cutaneous lesions compatible with IGDA.

Female , Humans , Middle Aged , Arthritis, Rheumatoid/complications , Dermatitis/pathology , Granuloma/pathology , Biopsy , Dermatitis/etiology , Eosinophils/pathology , Granuloma/etiology , Neutrophils/pathology , Skin/pathology
Korean Journal of Urology ; : 324-329, 2015.
Article in English | WPRIM | ID: wpr-34594


PURPOSE: To evaluate the predictive role of the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), mean platelet volume (MPV), and platelet count (PLT) in the diagnosis of testicular torsion (TT) and testicular viability following TT. MATERIALS AND METHODS: We analyzed two study groups in this retrospective study: 75 patients with a diagnosis of TT (group 1) and 56 age-matched healthy subjects (group 2). We performed a complete blood count as a part of the diagnostic procedure, and NLR, PLR, MPV, and PLT values were recorded. We compared the patient and control groups in terms of these parameters. Then, TT patients were divided into two subgroups according to the time elapsed since the onset of symptoms. Subsequently, we evaluated the relationship between the duration of symptoms and these parameters. RESULTS: There were significant differences between groups 1 and 2 in NLR, PLR, and PLT (p<0.001 for all). There was no predictive role of MPV in the diagnosis of TT (p=0.328). We determined significantly high sensitivity and specificity levels for NLR in the prediction of TT diagnosis (84% and 92%, respectively). Furthermore, NLR was significantly related to the duration of symptoms in TT patients (p=0.01). CONCLUSIONS: NLR may be a useful parameter in the diagnosis of TT. Furthermore, NLR may be used as a predictive factor for testicular viability following TT.

Adolescent , Humans , Lymphocyte Count/methods , Male , Neutrophils/pathology , Platelet Count/methods , Predictive Value of Tests , Prognosis , Retrospective Studies , Sensitivity and Specificity , Spermatic Cord Torsion/blood , Symptom Assessment/methods , Testis/pathology , Tissue Survival , Turkey
Salvador; s.n; 2015. 61 p. ilus.
Thesis in Portuguese | LILACS | ID: biblio-1000970


Os neutrófilos são essenciais para a resposta imune inata contra uma variedade de patógenos. Eles são capazes de modular a resposta imune através da produção de citocinas e quimiocinas, degranulação e a sua interação direta com outras células no local da infecção, tais como as células dendríticas. A interação entre as células do sistema imune inato é essencial para direcionar a resposta imune adaptativa, a qual é responsável pela eliminação de microrganismos e manutenção de memória imunológica. Objetivo: Este estudo avaliou a interação de neutrófilos humanos com Leishmania braziliensis, através da análise da expressão de moléculas de superfície, liberação de enzimas presentes nos grânulos e produção de espécies reativas de oxigênio (ROS). Também foi avaliada a interação entre neutrófilos humanos infectados e células dendríticas, a fim de se observar o efeito desta interação na indução da ativação das células dendríticas. Metodologia: Os neutrófilos foram purificados a partir do sangue periférico de doadores saudáveis e as células dendríticas foram geradas in vitro. Os neutrófilos foram infectados ou não com L. braziliensis e co-cultivados com as células dendríticas. Em seguida, os sobrenadantes e as células foram coletadas para avaliar a liberação de enzimas, tais como mieloperoxidase (MPO) e metaloproteinase 9 (MMP-9). O fenótipo e a função dos neutrófilos foram analisados através da expressão de Mac-1 (CD18 e CD11b), CD16, CD62-L e produção de ROS...

Neutrophils are essential in the innate immune response against a variety of pathogens. They are able to modulate immune response by cytokine and chemokine production, release of granules and their direct interaction with other cells at the infection site. Dendritic cells are recruited in response to cytokines and chemokines produced by neutrophils. The interaction between cells of the innate immune system is essential for targeting the adaptive immune response, which is responsible for eliminating microorganisms and the maintenance of immunological memory. Objective: Evaluate the interaction of human neutrophils with Leishmania braziliensis, through the analysis of surface molecule expression, release of granules enzymes and production of reactive oxygen species (ROS). We also evaluated the interaction between human infected neutrophils and dendritic cells, in order to observe the effect of this interaction on dendritic cells. Methodology: Neutrophils were purified from peripheral blood of healthy donors and dendritic cells were generated in vitro. Neutrophils were infected or not with L. braziliensis and cocultured with DC. Afterwards, supernatants and cells were harvested to evaluate the release of granules enzymes, such as myeloperoxidase (MPO) and metalloproteinase 9 (MMP-9). Neutrophils phenotype and function were analyzed by the expression of Mac-1 (CD18 and CD11b), CD16 and ROS production...

Humans , Dendritic Cells/cytology , Dendritic Cells/immunology , Dendritic Cells/pathology , Leishmania braziliensis/growth & development , Leishmania braziliensis/immunology , Leishmania braziliensis/parasitology , Leishmania braziliensis/pathogenicity , Neutrophils/immunology , Neutrophils/parasitology , Neutrophils/pathology