ABSTRACT
The diagnosis of pure neural leprosy (PNL) is based on clinical and laboratory data, including the histopathology of nerve biopsy specimens and detection of Mycobacterium leprae DNA by polymerase chain reaction (PCR). Given that histopathologic examination and PCR methods may not be sufficient to confirm the diagnosis, immunolabeling of lipoarabinomanan (LAM) and/or phenolic glycolipid 1 (PGL-1) M. leprae wall components was utilized in the present investigation in an attempt to detect any vestigial presence of M. leprae in acid-fast bacilli (AFB) nerve samples. Twenty-three PNL nerve samples (6 AFB and 17 AFBPCR) were cryosectioned and subjected to LAM and PGL-1 immunohistochemical staining by immunoperoxidase. Five nonleprosy nerve samples were used as controls. The 6 AFB samples showed LAM/PGL-1 immunoreactivity. Among the 17 AFB samples, 8 revealed LAM and/or PGL-1 immunoreactivity. In 17 AFBPCR patients, just 7 yielded LAM and/or PGL-1 nerve results. In the PNL cases, the detection of immunolabeled LAM and PGL-1 in the nerve samples would have contributed to an enhanced diagnostic efficiency in the absence of molecular diagnostic facilities.
Subject(s)
Antigens, Bacterial/metabolism , DNA, Bacterial/analysis , Glycolipids/metabolism , Leprosy, Tuberculoid/diagnosis , Lipopolysaccharides/metabolism , Mycobacterium leprae/genetics , Peripheral Nerves/metabolism , Adolescent , Adult , Aged , Biopsy , Female , Humans , Immunohistochemistry , Male , Middle Aged , Peripheral Nerves/immunology , Quality Improvement , Young AdultABSTRACT
Matrix metalloproteinases (MMPs) mediate demyelination and breakdown of the blood-nerve barrier in peripheral neuropathies. Matrix metalloproteinases and tissue inhibitor of metalloproteinase 1 gene expression and secretion were studied in cells of the human Schwann cell line ST88-14 stimulated with Mycobacterium leprae and tumor necrosis factor (TNF) and in nerve biopsies from patients with neural leprosy (n = 21) and nonleprous controls (n = 3). Mycobacterium leprae and TNF induced upregulation of MMP-2 and MMP-9 and increased secretion of these enzymes in cultured ST88-14 cells. The effects of TNF and M. leprae were synergistic, and anti-TNF antibody blockage partially inhibited this synergistic effect. Nerves with inflammatory infiltrates and fibrosis displayed higher TNF, MMP-2, and MMP-9 mRNA than controls. Leprous nerve biopsies with no inflammatory alterations also exhibited higher MMP-2 and MMP-9; tissue inhibitor of metalloproteinase 1 was significantly higher in biopsies with fibrosis and inflammation. Immunohistochemical double labeling of the nerves demonstrated that the MMPs were mainly expressed by macrophages and Schwann cells. The biopsies with endoneurial inflammatory infiltrates and epithelioid granulomas had the highest levels of MMP-2 and MMP-9 mRNA detected. Together, these results suggest that M. leprae and TNF may directly induce Schwann cells to upregulate and secrete MMPs regardless of the extent of inflammation in leprous neuropathy.
Subject(s)
Leprosy/etiology , Leprosy/pathology , Matrix Metalloproteinase 2/metabolism , Matrix Metalloproteinase 9/metabolism , Mycobacterium leprae/physiology , Peripheral Nervous System Diseases/enzymology , Schwann Cells/enzymology , Adult , Analysis of Variance , Cell Line, Tumor , Enzyme-Linked Immunosorbent Assay/methods , Female , Humans , Male , Middle Aged , Nerve Tissue Proteins/metabolism , Neurilemmoma/pathology , Peripheral Nervous System Diseases/microbiology , Tissue Inhibitor of Metalloproteinase-1/metabolism , Tumor Necrosis Factor-alpha/metabolism , Up-Regulation/physiologyABSTRACT
A assistência de enfermagem é uma importante ferramenta para aumentar a captação de órgãos para transplante.Um conhecimento prévio sobre o assunto é necessário para permitir uma perfeita integração do profissional de enfermagem durante este processo. O presente trabalho e' um estudodescritivo que explica os aspectos fundamentais para o diagnóstico de morte encefálica, sua importância para a captação de órgãos para transplante e os protocolos obrigatórios que devem ser realizados por enfermeiros e médicos para permitir a captação de órgãos para transplante desde a ocorrência da autorização familiar para a doação de orgãos do paciente. Esteconhecimento pode ser útil para melhorar a assistência de enfermagem durante todo o processo, possibilitando o aumento da captação de órgãos para transplantes.
The nursing assistance is an important tool to improve the organ caption for transplantation. A previous knowedge is necessary to allow a perfect integration of the nursing professional during this process. The present work is a descriptive study that explains the fundamental aspects related tothe brain death diagnosis, its importance to the organ caption and the mandatory protocols that must be performed by nurses and doctors to allow the organ caption for transplantation sincethe occurrence of a familiar permission for organ donation. This knowledge may be useful to improve the nursing assistance during the whole process enabling the increase of organ captionfor transplantation.
Subject(s)
Tissue and Organ Harvesting , Brain Death , Organ TransplantationABSTRACT
Las lectinas son proteínas que contienen áreas singulares para el reconocimiento de secuencias de azúcares en los glicoconjugados. La lecitina del tomate Lycopersicon esculentum (LEL) es capaz de reconocer específicamente los residuos de N-acetil-glucosamina (Gly-Nac) y poli-N-acetil-lactosamina. Utilizamos la técnica histoquímica para LEL conjugada a la biotina con el propósito de investigar en la glándula pineal de ratones adultos y durante el desarrollo, las estructuras morfológicas capaces de unirse a esta lecitina. Nuestros resultados experimentales mostraron un material de coloración por la LEL, solamente en la superficie de las células endoteliales de todos los vasos sanguíneos y en todas las regiones de la glándula. La excepción ocurrió en los ratones con un día pos-natal (PN1), donde solamente los vasos de la región más periférica de la glándula presentaban coloración marrón amarillenta por la LEL, pero ninguno presentaba esta coloración en la región más central de la glándula. La reacción apareció especialmente en el espacio interno de las pseudo-rosetas, demostrando así que este espacio está, seguramente, representado por un vaso.
