RESUMEN
Regulatory T (TREG) cells play an important role in maintaining immune tolerance and avoiding autoimmunity. We analyzed the expression of membrane molecules in TREG and effector T cells in systemic lupus erythematosus (SLE). TREG and effector T cells were analyzed for the expression of CTLA-4, PD1, CD28, CD95, GITR, HLA-DR, OX40, CD40L, and CD45RO in 26 patients with active disease, 31 with inactive disease, and 26 healthy controls. TREG cells were defined as CD25+/highCD127Ø/lowFoxP3+, and effector T cells were defined as CD25+CD127+FoxP3Ø. The ratio of TREG to effector T cells expressing GITR, PD1, HLA-DR, OX40, CD40L, and CD45RO was determined in the three groups. The frequency of TREG cells was similar in patients with SLE and controls. However, SLE patients had a decreased frequency of CTLA-4+TREG and CD28+TREG cells and an increased frequency of CD40L+TREG cells. There was a decrease in the TREG/effector-T ratio for GITR+, HLA-DR+, OX40+, and CD45RO+ cells, and an increased ratio of TREG/effector-T CD40L+ cells in patients with SLE. In addition, CD40L+TREG cell frequency correlated with the SLE disease activity index (P=0.0163). In conclusion, our findings showed several abnormalities in the expression of functionally critical surface molecules in TREG and effector T cells in SLE that may be relevant to the pathogenesis of this disease.
Asunto(s)
Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Antígenos de Superficie/metabolismo , Leucocitos Mononucleares/metabolismo , Lupus Eritematoso Sistémico/inmunología , Linfocitos T Reguladores/inmunología , Análisis de Varianza , /análisis , /análisis , /análisis , /análisis , /análisis , Citometría de Flujo , Factores de Transcripción Forkhead/análisis , Proteína Relacionada con TNFR Inducida por Glucocorticoide/análisis , Antígenos HLA-DR/análisis , /análisis , /análisis , Lupus Eritematoso Sistémico/metabolismo , Lupus Eritematoso Sistémico/fisiopatología , Receptor de Muerte Celular Programada 1/análisis , /análisis , Estadísticas no ParamétricasRESUMEN
Dois casos de pacientes desenvolveram importantes alteracoes eletrocardiograficas, ecocardiograficas, radiologicas e insuficiencia cardiaca congestiva na vigencia de tratamento antidepressivo com imiprimina e responderam satisfatoriamente ao tratamento medico apos a suspensao desta droga
Asunto(s)
Humanos , Femenino , Adulto , Anciano , Imipramina , CardiomiopatíasRESUMEN
Dois pacientes com tetralogia de Fallot (TF) e agenesia da arteria pulmonar esquerda(AAPE) foram tratados cirurgicamente, com bons resultados. Como no ato cirurgico o anel pulmonar era inadequado, a via de saida do ventriculo direito (VSVD) foi ampliada com um "patch" de dacron. Uma revisao da literatura demonstrou que os resultados cirurgicos desta rara anomalia nao eram bons ate que, em duas experiencias recentes, a competencia valvular pulmonar foi mantida com o uso de protese biologica na VSVD. Apesar da incompetencia valvular pulmonar, bem tolerada na correcao classica da TF, os nossos pacientes evoluiram bem. Persiste a controversia sobre qual o melhor tratamento da VSVD na TF com AAPE