Effect of myofunctional therapy on snoring in obese patients: a randomized trial.

Objective: To analyze the effectiveness of myofunctional therapy (MT) in the treatment of habitual snoring in obese patients. Material and Methods: This randomized clinical trial consisted of an experimental group (n=14) that underwent MT and a control group (n=26) that performed nonspecific exercises for the treatment of snoring. The Epworth sleepiness scale (ESS), Pittsburgh sleep quality index (PSQI), and short-form health survey (SF-36) were applied before and after treatment. Snoring was assessed subjectively by asking the partner about improvement after treatment. The SnoreLab app was used for objective assessment. Results: There was no significant effect of MT on any of the SnoreLab variables analyzed when groups, time points or covariates (adherence, age, body mass index [BMI], neck circumference, and sex) were compared. Neck circumference (cm) and the Pittsburgh sleep quality index score were significantly higher after treatment. There was no change in the Epworth sleepiness scale score after treatment. A correlation was found between BMI and the Pittsburgh sleep quality index and between BMI and the functional capacity component of the SF-36. Patient adherence was similar between groups. Discussion: Apps for recording snoring are a useful tool to be explored. MT exerted no significant effect on habitual snoring in obese patients despite the reduction of the snore score in the experimental group. Therapy applied without exclusion criteria based on the severity of sleep breathing disorders and pharyngeal characteristics fails to achieve the results necessary to treat habitual snoring in obese patients.

Pregnancy and lactation after Roux-en-Y gastric bypass worsen nonalcoholic fatty liver disease in obese rats and lead to differential programming of hepatic de novo lipogenesis in offspring.

Maternal obesity increases the risk of nonalcoholic fatty liver disease (NAFLD) in offspring. The Roux-en-Y gastric bypass (RYBG) is effective for achieving weight loss and ameliorates NAFLD. To determine whether these benefits are maintained after pregnancy and/or lactation, and whether they modulate hepatic morphofunction in the next generation, we evaluated hepatic lipid metabolism in Western diet (WD)-obese female rats that underwent RYGB and in their F1 offspring at adulthood. Female Wistar rats consumed a WD from 21 to 130 days of age, before being submitted to RYGB (WD-RYGB-F0) or SHAM (WD-SHAM-F0) operations. After 5 weeks, these females were mated with control male breeders, and the male and female F1 offspring were identified as WD-RYGB-F1 and WD-SHAM-F1. WD-RYGB-F0 dams exhibited lower serum lipids levels, but severe hepatic steatosis and pathological features of advanced liver injury. The hepatic proteins involved in lipogenesis were reduced in WD-RYGB-F0, as were the genes related to ß-oxidation and bile acids (BAs). Although the female and male WD-RYGB-F1 groups did not exhibit hepatic steatosis, the livers of female WD-RYGB-F1 demonstrated higher amounts of lipogenic genes and proteins, while male WD-RYGB-F1 presented a similar downregulation of lipogenic factors to that seen in WD-RYGB-F0 dams. In contrast, maternal and offspring groups of both sexes displayed reductions in the expressions of genes involved in BAs physiology and gluconeogenesis. As such, RYGB aggravates NAFLD after pregnancy and lactation and induces a gender-dependent differential expression of the hepatic lipogenesis pathway in offspring, indicating that female WD-RYGB-F1 may be an increased risk of developing NAFLD.

Comparison of gluteus medius strength between individuals with obesity and normal-weight individuals: a cross-sectional study.

BACKGROUND: The hip abductor muscles, primarily the gluteus medius, play an important role in stabilizing the pelvis during gait. Gluteus medius weakness is associated with biomechanical changes and musculoskeletal disorders. Individuals with obesity can have great difficulty maintaining abductor muscular function due to being overweight and possibly experiencing a decrease in muscle mass. However, it is still unclear whether the musculature of person with obesity can compensate for these changes. Therefore, the aim of this study was to compare gluteus medius strength between individuals with obesity and normal-weight individuals using a digital hand-held dynamometer. METHODS: Twenty-five participants with obesity (BMI > 35 kg/m2) were matched for sex, age, and height with normal-weight individuals. Gluteus medius strength was measured by a single examiner using a belt-stabilized hand-held digital dynamometer placed on the knee of the individuals positioned in lateral decubitus. Three measurements were recorded with rest intervals, and only the highest value measured for each limb was used for analysis. The differences between pairs were calculated, and the normality of the data was assessed using the Shapiro-Wilk test (p < 0.05). The matrices of the variables were standardized and analysed using principal component analysis (PCA). RESULTS: For the strength variables (Newtons) on both sides, no significant differences were detected between the groups (p > 0.05). However, significant differences were detected in these variables between the groups (p < 0.05) when the measurements were normalized to body weight (Newtons/kilograms). PCA indicated that both the absolute and normalized values of strength are lower in participants with obesity than in normal-weight. CONCLUSIONS: These findings suggest that people with obesity could have the same or less strength (PCA) to move more mass, which may imply a relative weakness that induces functional limitations.

Maternal Roux-en-Y gastric bypass surgery reduces lipid deposition and increases UCP1 expression in the brown adipose tissue of male offspring.

Maternal obesity induced by cafeteria diet (CAF) predisposes offspring to obesity and metabolic diseases, events that could be avoided by maternal bariatric surgery (BS). Herein we evaluated whether maternal BS is able to modulate brown adipose tissue (BAT) morphology and function in adult male rats born from obese female rats submitted to Roux-en-Y gastric bypass (RYGB). For this, adult male rat offspring were obtained from female rats that consumed standard diet (CTL), or CAF diet, and were submitted to simulated operation or RYGB. Analysis of offspring showed that, at 120 days of life, the maternal CAF diet induced adiposity and decreased the expression of mitochondrial Complex I (CI) and Complex III (CIII) in the BAT, resulting in higher accumulation of lipids than in BAT from offspring of CTL dams. Moreover, maternal RYGB increased UCP1 expression and prevented excessive deposition of lipids in the BAT of adult male offspring rats. However, maternal RYGB failed to reverse the effects of maternal diet on CI and CIII expression. Thus, maternal CAF promotes higher lipid deposition in the BAT of offspring, contributing to elevated adiposity. Maternal RYGB prevented obesity in offspring, probably by increasing the expression of UCP1.

Maternal Roux-en-Y gastric bypass impairs insulin action and endocrine pancreatic function in male F1 offspring.

PURPOSE: Obesity is predominant in women of reproductive age. Roux-en-Y gastric bypass (RYGB) is the most common bariatric procedure that is performed in obese women for weight loss and metabolic improvement. However, some studies suggest that this procedure negatively affects offspring. Herein, using Western diet (WD)-obese female rats, we investigated the effects of maternal RYGB on postnatal body development, glucose tolerance, insulin secretion and action in their adult male F1 offspring. METHODS: Female Wistar rats consumed a Western diet (WD) for 18 weeks, before being submitted to RYGB (WD-RYGB) or SHAM (WD-SHAM) operations. After 5 weeks, WD-RYGB and WD-SHAM females were mated with control male breeders, and the F1 offspring were identified as: WD-RYGB-F1 and WD-SHAM-F1. RESULTS: The male F1 offspring of WD-RYGB dams exhibited decreased BW, but enhanced total nasoanal length gain. At 120 days of age, WD-RYGB-F1 rats displayed normal fasting glycemia and glucose tolerance but demonstrated reduced insulinemia and higher glucose disappearance after insulin stimulus. In addition, these rodents presented insulin resistance in the gastrocnemius muscle and retroperitoneal fat, as judged by lower Akt phosphorylation after insulin administration, but an increase in this protein in the liver. Finally, the islets from WD-RYGB-F1 rats secreted less insulin in response to glucose and displayed increased ß-cell area and mass. CONCLUSIONS: RYGB in WD dams negatively affected their F1 offspring, leading to catch-up growth, insulin resistance in skeletal muscle and white fat, and ß-cell dysfunction. Therefore, our data are the first to demonstrate that the RYGB in female rats may aggravate the metabolic imprinting induced by maternal WD consumption, in their male F1 descendants. However, since we only used male F1 rats, further studies are necessary to demonstrate if such effect may also occur in female F1 offspring from dams that underwent RYGB operation.

Duodeno-jejunal bypass restores ß-cell hypersecretion and islet hypertrophy in western diet obese rats.

PURPOSE: Duodeno-jejunal bypass (DJB) operation improves glucose homeostasis in morbid obesity, independently of weight loss or reductions in adiposity, through mechanisms not yet fully elucidated. Herein, we evaluated the effects of DJB upon glucose homeostasis, endocrine pancreatic morphology, and ß-cell responsiveness to potentiating agents of cholinergic and cAMP pathways, in western diet (WD) obese rats, at 2 months after operation. METHODS: From 8 to 18 weeks of age male Wistar rats fed on a WD. After this period, a sham (WD Sham group) or DJB (WD DJB) operations were performed. At 2 months after operation glucose homeostasis was verified. RESULTS: Body weight was similar between WD DJB and WD Sham rats, but WD DJB rats showed a decrease in Lee index, retroperitoneal and perigonadal fat pads. Also, WD DJB rats displayed reduced fasting glycemia and insulinemia, and increased insulin-induced Akt activation in the gastrocnemius. Islets from WD DJB rats secreted less amounts of insulin, in response to activators of the cholinergic (carbachol and phorbol 12-myristate 13-acetate) and cAMP (forskolin and 3-isobutyl-1-methyl-xantine) pathways. Islets of WD DJB rats had higher sintaxin-1 protein content than WD Sham, but without modification in muscarinic-3 receptor, protein kinase (PK)-Cα, and (PK)-Aα protein amounts. In addition, islets of WD DJB animals showed reduction in islets and ß-cell masses. CONCLUSION: DJB surgery improves fasting glycemia and insulin action in skeletal muscle. Better endocrine pancreatic morphofunction was associated, at least in part, with the regulation of the cholinergic and cAMP pathways, and improvements in syntaxin-1 islet protein content induced by DJB.

Itinerário terapêutico de pacientes com obesidade atendidos em serviço de alta complexidade de um hospital universitário / Therapeutic itinerary of patients with obesity treated in high-complexity services of a university hospital

RESUMO Este artigo relata pesquisa de natureza qualitativa que objetivou analisar o Itinerário Terapêutico (IT) de 21 pacientes cadastrados no Serviço de Assistência de Alta Complexidade ao Indivíduo com Obesidade do Hospital Universitário do Oeste do Paraná. Utilizou-se a entrevista em profundidade para a obtenção dos dados e, para sua organização e análise, adotou-se o referencial de Kleinman (1978), que defende a interferência dos subsistemas familiar, popular e profissional no IT percorrido pelas pessoas na busca de solução para problemas de saúde. No subsistema familiar, observou-se apoio da família e amigos na procura por tratamento clínico para a obesidade. Poucos pacientes aderiram a tratamentos alternativos, próprio do subsistema popular. A intervenção e orientação de profissionais da saúde, característica do subsistema profissional, mostrou-se decisiva na procura por tratamento especializado para a obesidade. O estudo do IT dos sujeitos da pesquisa revelou maior influência do núcleo familiar e profissional do que propriamente do núcleo popular. O referencial de Kleinman apresentou limites para a análise do IT de indivíduos obesos, não incluindo elementos importantes na abordagem do problema da obesidade.

ABSTRACT This paper reports a qualitative research that aimed to analyze the Therapeutic Itinerary (TI) of 21 patients enrolled in a High Complexity Assistance Service for Individuals with Obesity provided by the University Hospital of the West of Paraná. In-depth interview was (State) applied as a means of data collection and, for data organization and analysis, it was adopted Kleinman's (1978) referential, which advocates the interference of subsystems family, popular and professional in the TI path of those that seek to solve their health problems. In family subsystem, the support of family and friends in the search for obesity clinical treatment was observed. Few patients adhered to alternative treatments, characteristic of the popular subsystem itself. Intervention and orientation of health professionals, inherent of the professional subsystem, proved to be crucial in the search for obesity specialized treatment. The TI study of the research subjects revealed that the family and professional core influence is stronger than the popular one. Kleinman's referential is limited as for the TI analysis of obese individuals, because it does not comprise important elements towards the obesity problem approach.

Liver steatosis in hypothalamic obese rats improves after duodeno-jejunal bypass by reduction in de novo lipogenesis pathway.

AIMS: Hypothalamic obesity is a severe condition without any effective therapy. Bariatric operations appear as an alternative treatment, but the effects of this procedure are controversial. We, herein, investigated the effects of duodeno-jejunal bypass (DJB) surgery upon the lipid profile and expression of genes and proteins, involved in the regulation of hepatic lipid metabolism, in hypothalamic obese (HyO) rats. METHODS: During the first 5days of life, male newborn Wistar rats received subcutaneous injections of monosodium glutamate [4g/kg body weight, HyO group] or saline (control, CTL group). At 90days of life, HyO rats were randomly submitted to DJB (HyO DJB) or Sham-operations (HyO Sham group). Six months after DJB, adiposity, hepatic steatosis and lipid metabolism were verified. KEY FINDINGS: HyO Sham rats were obese, hyperinsulinemic, insulin resistant and dyslipidemic. These rats had higher liver contents of trygliceride (TG) and presented disorganization of the hepatocyte structures, in association with higher hepatic contents of acetyl-CoA carboxylase (ACC), fatty acid synthase (FASN), and stearoyl-CoA desaturase-1 mRNAs and protein. DJB surgery normalized insulinemia, insulin resistance, and dyslipidemia in HyO rats. TG content in the liver and the hepatic microscopic structures were also normalized in HyO DJB rats, while the expressions of ACC and FASN proteins were decreased in the liver of these rodents. SIGNIFICANCE: The DJB-induced amelioration in hepatic steatosis manifested as a late effect in HyO rats, and was partly associated with a downregulation in hepatic de novo lipogenesis processes, indicating that DJB protects against liver steatosis in hypothalamic obesity.

Repair of large incisional hernias. To drain or not to drain. Randomized clinical trial

ABSTRACT PURPOSE: To evaluate the occurrence of seroma and surgical wound infection after surgery. METHODS: A total of 42 individuals with large incisional hernias were subjected toonlay mesh repair. Following the mesh placement, the participants were randomly allocated to two groups. In group 1, closed-suction drains were placed in the subcutaneous tissue, while progressive tension sutures were performed in group 2. The participants were subjected to clinical and ultrasound assessment to detect seroma and surgical wound infection at three time-points after surgery. RESULTS: The occurrence of seroma at the early, intermediate or late assessments was respectively 19.0%, 47.6%, 52.4% in group 1 and 28.6%, 57.1%, 42.9% in group 2 and was not significantly different between groups (p 0.469; 0.631; 0.619). Surgical wound infection occurred 19% in group 1 and 23.8% in group 2, without a significant difference between the groups (p>0.999). CONCLUSION: The frequency of seroma and infection did not exhibit significant differences between individuals subjected to onlay mesh repair of large incisional hernias with drains or progressive tension sutures without drainage.

Endoanal pilonidal sinus: case report and literature review / Cisto pilonidal endoanal: relato de caso e revisão de literatura

ABSTRACT: Pilonidal sinus is a term first used by Hodges in 1880 to describe granulomatous lesions containing hairs in its interior. The presence of endoanal pilonidal sinus is rare and only nine cases have been reported in medical literature. This article describes a male, 42 years, initially submitted to fistulotomy with seton placement that four years later evolved with complaints of anal purulent discharge associated with painful anal groin. During the first evaluation a small endoanal tumor was found. It was located in posterolateral anus position and contained hair in its interior, without purulent discharge at that moment. Underwent surgery that confirmed the presence of endoanal pilonidal sinus. The sinus was opened and left to heal by secondary intention. The patient had good outcome with no signs of recurrence. (AU)

RESUMO: O termo cisto pilonidal foi descrito pela primeira vez por Hodges em 1880 para descrever lesões granulomatosas contendo pêlos em seu interior. A presença de cisto pilonidal endoanal é rara e existem apenas nove casos relatados na literatura médica. Descreve-se um caso masculino, 42 anos, em acompanhamento há 5 anos no serviço. Submetido inicialmente à fistulostomia em dois tempos com sedenho, evoluindo 4 anos depois com queixas de secreção purulenta intermitente por via anal associada a presença de tumoração dolorosa. No exame físico constatou-se presença de orifício contendo pêlos em seu interior, sem secreção purulenta no momento do exame. Foi encaminhado para tratamento cirúrgico que confirmou diagnóstico de cisto pilonidal endoanal. No procedimento foi realizada abertura do cisto que foi deixado para cicatrizar por segunda intenção. O paciente apresentou boa evolução, sem sinais de recidiva local. (AU)

Repair of large incisional hernias. To drain or not to drain. Randomized clinical trial.

PURPOSE: To evaluate the occurrence of seroma and surgical wound infection after surgery. METHODS: A total of 42 individuals with large incisional hernias were subjected toonlay mesh repair. Following the mesh placement, the participants were randomly allocated to two groups. In group 1, closed-suction drains were placed in the subcutaneous tissue, while progressive tension sutures were performed in group 2. The participants were subjected to clinical and ultrasound assessment to detect seroma and surgical wound infection at three time-points after surgery. RESULTS: The occurrence of seroma at the early, intermediate or late assessments was respectively 19.0%, 47.6%, 52.4% in group 1 and 28.6%, 57.1%, 42.9% in group 2 and was not significantly different between groups (p 0.469; 0.631; 0.619). Surgical wound infection occurred 19% in group 1 and 23.8% in group 2, without a significant difference between the groups (p>0.999). CONCLUSION: The frequency of seroma and infection did not exhibit significant differences between individuals subjected to onlay mesh repair of large incisional hernias with drains or progressive tension sutures without drainage.

Duodenal-jejunal bypass surgery enhances glucose tolerance and beta-cell function in Western diet obese rats.

BACKGROUND: The aim of this study was to investigate the effect of the duodenal-jejunal bypass (DJB) on glucose homeostasis and islet insulin secretion in Western diet (WD) obese rats. METHODS: Male Wistar rats received a standard rodent chow diet (CTL group) or WD ad libitum. After 32 weeks of diet, WD rats were submitted to duodenal-jejunal bypass (WD DJB) or sham (WD S-DJB) operation. Intraperitoneal (ip) glucose tolerance test was performed 1 week after surgery. Body weight, fat pad depots, glycemia, insulinemia, HOMA-IR, and glucose-induced insulin secretion were evaluated 1 month after surgery. RESULTS: Body weight and fat pads of the WD group were higher than those of the CTL group. Sham and DJB surgeries did not alter these parameters. WD and WD S-DJB rats were glucose intolerant, insulin resistant, and hyperinsulinemic. WD DJB rats showed similar glucose tolerance, insulin sensitivity, and plasma insulin levels to those of CTL rats. WD rats presented higher fat and glycogen contents in the liver. DJB surgery normalized fat and glycogen stores in the liver of the WD DJB group. Insulin release at 11.1-mM glucose, in isolated islets from WD and WD S-DJB rats, was higher than from islets of CTL rats. In contrast, DJB surgery improves the beta-cell secretory capacity with increased glucose-induced secretion at 5.6-, 11.1-, and 22.2-mM glucose in WD DJB islets, compared with CTL islets. CONCLUSIONS: DJB surgery improves glucose homeostasis and enhances beta-cell glucose responsiveness in rats submitted to the WD diet without any modification in adiposity.

[Extract from Passiflora edulis on the healing of open wounds in rats: morphometric and histological study]. / Extrato de Passiflora edulis na cicatrização de feridas cutâneas abertas em ratos: estudo morfológico e histológico.

INTRODUCTION: In Brazilian countryside, cataplasm made from Passiflora edulis leaves has been used by the population as a healing agent for infections and skin inflammations in an empiric basis. PURPOSE: the aim of this work was to evaluate the healing process of open wounds in rats, in which Passiflora edulis hydro-alcoholic extract was applied. METHODS: Sixty male, adult Wistar rats were divided into two groups: Passiflora group and Control group. Rats of the first group were treated with Passiflora edulis extract, and those of the second group received distilled water. The daily application of the extract or distilled water was carried out on a 2 cm diameter standardized circular wound on the dorsal region of each animal. Wound assessment was performed macroscopically and microscopically on the 7th, 14th, and 21st postoperative days. Microscopic analysis included hematoxylin-eosine and Masson Trichromium stains, evaluating inflammatory response, fibroplasia and collagen deposition. The wound retraction was evaluated by digital planimetry. RESULTS: No significant difference in the rate of wound healing was detected comparing both groups. However, a significant increase in the number of fibroblastic cells was seen on the 7th PO day, and significantly greater collagen deposition was observed on the 14th day PO day in rats from the Passiflora group (p=0,012). CONCLUSIONS: The application of the Passiflora edulis extract does not accelerate the healing process of open wounds in rats, but is associated with increased number of fibroblastic cells on 7th P.O. day and greater collagen deposition on the 14th PO day.

Extrato de Passiflora edulis na cicatrização de feridas cutâneas abertas em ratos: estudo morfológico e histológico / Extract from Passiflora edulis on the healing of open wounds in rats: morphometric and histological study

INTRODUÇÃO: Nas regiões interioranas do Brasil o cataplasma feito com folhas de Passiflora edulis tem sido usado pela população como cicatrizante, para tratar infecções e inflamações cutâneas, sem a comprovação científica dos seus potenciais benefícios. OBJETIVO: Avaliar a cicatrização de feridas abertas em ratos com a aplicação tópica de extrato hidroalcoólico de Passiflora edulis. MÉTODOS: Foram utilizados 60 ratos da linhagem Wistar, machos, adultos, divididos em dois grupos: o grupo Passiflora e o grupo Controle. Os animais do primeiro grupo foram tratados com o extrato de Passiflora edulis, e os do segundo grupo, com água destilada. A aplicação diária do extrato e da água destilada foi realizada sobre ferida circular padronizada de 2cm de diâmetro na região dorsal de cada animal. A avaliação da ferida foi feita do ponto de vista macro e microscópico nos períodos pré-determinados (7º, 14º e 21º dias). Fez-se a análise macroscópica da evolução do aspecto da lesão e medida da retração cicatricial da ferida, por planimetria digital. O estudo histológico em lâminas coradas pela Hematoxilina-Eosina e Tricômico de Masson considerou os parâmetros de elementos celulares inflamatórios incluindo colagenização e reepitelização. RESULTADOS: Não houve diferença estatisticamente significante entre as áreas cirúrgicas das feridas tratadas com Passiflora edulis e o grupo Controle; entretanto, histologicamente houve colagenização significantemente maior no 14º dia de pós-operatório nos animais do grupo Passiflora (p = 0,012). CONCLUSÕES: O uso tópico do extrato de Passiflora edulis não apresenta macroscopicamente efeito significativo na cicatrização de feridas na pele de ratos; entretanto microscopicamente apresenta aumento da proliferação fibroblástica no 7º dia e colagenização maior no 14º dia de pós-operatório.

INTRODUCTION: In Brazilian countryside, cataplasm made from Passiflora edulis leaves has been used by the population as a healing agent for infections and skin inflammations in an empiric basis. PURPOSE: the aim of this work was to evaluate the healing process of open wounds in rats, in which Passiflora edulis hydro-alcoholic extract was applied. METHODS: Sixty male, adult Wistar rats were divided into two groups: Passiflora group and Control group. Rats of the first group were treated with Passiflora edulis extract, and those of the second group received distilled water. The daily application of the extract or distilled water was carried out on a 2 cm diameter standardized circular wound on the dorsal region of each animal. Wound assessment was performed macroscopically and microscopically on the 7th, 14th, and 21st postoperative days. Microscopic analysis included hematoxylin-eosine and Masson Trichromium stains, evaluating inflammatory response, fibroplasia and collagen deposition. The wound retraction was evaluated by digital planimetry. RESULTS: No significant difference in the rate of wound healing was detected comparing both groups. However, a significant increase in the number of fibroblastic cells was seen on the 7th PO day, and significantly greater collagen deposition was observed on the 14th day PO day in rats from the Passiflora group (p=0,012). CONCLUSIONS: The application of the Passiflora edulis extract does not accelerate the healing process of open wounds in rats, but is associated with increased number of fibroblastic cells on 7th P.O. day and greater collagen deposition on the 14th PO day.

Proposta de imunoterapia contra a toxina de Helicobacter pylori: estudo em ratos de Wistar / Immunotherpay proposes against Helycobacter pylori toxin: experimental study in Wistar rats

Este estudo teve por objetivo isolar toxina de Helicobacter pylori, transformá-lo em imunógeno e avaliar sua capacidade imunogênica. Inicialmente procedeu-se ao isolamento de cepas de Helicobacter pylori provenientes de 25 biópsias gástricas, coletadas por via endoscópica, em pacientes internados no Hospital Evangélico de Curitiba, durante os meses de maio a junho de 1993. Após o isolamento e caracterizaçäo, as cepas foram submetidas a cultivo para produçäo de tozina, cuja atividade tóxica foi demonstrada através de teste de citotoxicidade em cultura de célula HeLa e pela inoculaçäo intra-gástrica em ratos de Wistar, com posterior avaliaçäo histopatológica do tecido estomacal. A toxina foi inativada, transformada em toxóide, e padronizada quanto ao conteúdo total de proteínas. A seguir, foram imunizados por via intra-muscular, 20 ratos Wistar com duas doses de 20g do toxóide em intervalo de 7 dias. Após 14 dias da primeira dose, os animais foram desafiados com 5ml da toxina ativa por via intra-gástrica e sacrficado após 5 dias, sendo entäo coletadas amostras do tecido estomacal para estudo histopatológico. Simultâneamente o mesmo procedimento foi realizado em outro grupo de 20 ratos näo imunizados previamente, servindo como controle do desafio com toxina ativa. Os achados histopatológicos demonstraram a presença de lesöes inflamatórias gástricas em 100 por cento dos ratos imunizados e nöo se observou alteraçöes histológicas nos ratos imunizados. Concluiu-se que foi possível isolar uma toxina de Helicobacter pylori, transformá-la em toxóide e este conferiu proteçäo imunológica contra a toxina